oping skills
- Duration and frequency of use of substances, including tobacco, alcohol, illegal drugs, and caffeine
Assessing Your Patientís Dietary Intake
There are several methods for obtaining a dietary history. Each has its advantages and disadvantages.
- An informal, qualitative method in which you ask the patient to recall all of the foods and beverages that were consumed in the last 24 hours, including the quantities and methods of preparation.
- An advantage of this method is that dietary information is easily obtained. It is also good during a first encounter with a new patient in which there is no other nutritional data. Patients should be able to recall all that they have consumed in the last 24 hours.
- A disadvantage of this method is that it is very limited and may not represent an adequate food intake for the patient. Data achieved using this method may not represent the long-term dietary habits of the patient. Estimating food quantities and food ingredients may be difficult especially if the patient ate in restaurants.
Usual Intake/Diet History
- This method asks the patient to recall a typical daily intake pattern, including amount, frequencies and methods of preparation. This intake history should include all meals, beverages and snacks.
- Advantages of this method are that it evaluates long-term dietary habits and is quick and easy to do. Based on the information acquired, you may identify patients who would benefit from meeting with a registered dietitian.
- A disadvantage of this method is that a limited amount of information on the actual quantities of food and beverages is obtained. Also, this method only works if a patient can actually describe a "typical" daily intake, which is difficult for those who vary their food intake greatly. In these patients it is would be advisable to use the 24-hour recall method. Another disadvantage is that patients may not include foods that they know are unhealthy.
- An excellent method to better understand a patientís nutritional status is to use a usual intake and lifestyle recall. This consists of asking the patient to run through a typical day in chronological order, describing all food consumption as well as activities. This method is very helpful because it may reveal other factors that can affect the patientís nutritional and overall health. [For example: (1) the patient sits in traffic for a 3-hour round trip each day; (2) the patient comes home from work late and eat dinner just before bedtime; or (3) the most exercise the patient gets is walking to and from the parking lot at work.]
Food Frequency Questionnaire
- This method makes use of a standardized written checklist where patients check off the particular foods or type of foods they consume. It is used to determine trends in patientsí consumption of certain foods. The checklist puts together foods with similar nutrient content, and frequencies are listed to identify daily, weekly, or monthly consumption.
- An advantage of this method is that it makes it possible to identify inadequate intake of any food group, so that dietary and nutrient deficiencies may be identified. The questionnaire can be geared to a patientís pre-existing medical conditions.
- Disadvantages include patient error in filling out the questionnaire and no way to find out how foods are prepared. Patients may over- or under-estimate food quantities.
Dietary Food Log
- This method asks the patient to record all food, beverage and snack consumption for a one- week period. Specific foods and quantities should be recorded. The data from the food log may later be entered into a computer program, which will analyze the nutrient components of the foods eaten according to specific name brands or food types. Patients are asked to enter data into the food log immediately after food is consumed so they do not forget.
- The most important advantage of this method is that a computer can objectively analyze data obtained. Data on calorie, fat, protein and carbohydrate consumption can be obtained. Also, since patients are asked to enter data immedi