Center for Human Nutrition
Medical Nutrition Syllabus
Guide to Healthy Diet and Lifestyle
Medicine and Surgery Nutrition Assessment Checklist
Pediatric Nutrition Assessment Checklist
Adolescent Nutrition Assessment Checklist
Syllabus Menu: | Dietary Assessment | Weight Assessment | Dietary Recommendations | Nutritional Deficiencies | Nutrition During Lifecyle |
Nutrition in Pathological Conditions |
Vegetarianism | [Popular Diets | References |
A patientís nutritional status can be evaluated by using and integrating information obtained from a past medical history, family history and a social history. It is worthwhile to assess the nutritional status of every patient. Many complaints such as fatigue, headaches, and digestive disturbances can be improved by simple changes in diet. Nutrition also plays a pivotal role in prevention. Nutritional assessment becomes especially important when the patient has certain nutritional "red flags", such as:
Receiving simple intravenous solutions without oral intake for >10 days
- No regular exercise regime and/or sedentary lifestyle
- Recent loss of 10% or more of usual body weight
- Taking drugs such as steroids, immunosuppressants
- Infection, protracted fever, trauma
- Malabsorption syndromes, draining abscesses, renal dialysis
Past Medical History
- Immunizations, hospitalizations, operations, major injuries, chronic illnesses, and significant acute illnesses
- Current or recent prescription medications, vitamins and minerals, laxatives, topical medications, OTC medications, and nutritional supplements
- Potential drug-nutrient interactions, such as those caused by potassium-wasting diuretics
- Food allergies or lactose intolerance
- Family history of cancer, diabetes, heart disease, hypertension, obesity, and osteoporosis
- Parents, siblings, children, spouse: include ages, current health status, and cause of death if deceased
- Occupation, daily exercise pattern, marital and family status
- Economic status, educational level, residence, emotional response to illness and coping 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 i