Dietary Assessment MyPlate Comparison Chart

3-Day Diet Record and Food Frequency Questionnaire (DHQ) (submit with Parts 2 & 3- so keep a copy!)

Name of interviewer: Molly Carroll _________________

Client information:

Initials: _ET________ Sex: _female_________ Age:_22______

Habitual physical activity:

Type(s): _Running, walking__________________________________________

Exertion level:_moderate-intense___ Minutes per day:_2 hours__________

Food Group My Plate Recommended

Quantity1

*Note: used physically active listing

on MyPlate site under Daily Food

Plan

DRI calorie goal: _2,600_________

3-Day Diet Record

(Average quantity/day)2

*Note: averaged by NutriCalc:

1,756 kcals

Food Frequency

Questionnaire (DHQ)

(Approximate

quantity/day):

1,120 kcals

grams % of total

calories

grams % of total

calories

grams % of total

calories

Protein (total) 52.62 10-35% 95.7 21% 46.2 16.5%

Carbohydrate

(total) 357.46 45-65% 235.3 52% 120 42.9%

Fat (total) 80.88 20-35% 50.0 25% 37.9 30.5%

Fruits (cups) 2 cups 3.6 cups 1.0 cups

Vegetables (cups) 3.5 cups 1.9 cups 1.5 cups

Grains (oz-eq) 9 oz. 6.6 oz. 2.7 oz.

Protein foods (oz,

tsp, cups) 6.5 oz. 5.4 oz. 6.6 oz.

Dairy (cups) 3 cups 0.6 cups 0.8 cups

Added Oils/Fats

(tsp)3 8 tsp. 9 tsp.

8.4 tsp. (see below for

calculation)

Discretionary

calories (kcals)3 360 kcals 179 kcals 491.3 kcals

Calculation for added oils/ fats in 3 day record:

Day 1: 2 tablespoons of added fats ( 1 tbsp. vinaigrette & 1 tbsp. olive oil)

Day 2: 4 tablespoons of added fats (1 tbsp. cream cheese & ~ 3 tbsp. oil in Pad Thai)

Day 3: 3 tablespoons of added fats (1 tbsp. vinaigrette & 2 tbsp. Tahini – sesame seeds)

(2+4+3)/3= an average of 3 tablespoons of added fats/day

3 tsp.= 1 tbsp. then 3 tbsp.= 9 tsp.

Discretionary kcals in 3 day record:

Day 2: 1 beer- 179 kcals

Added oils/fats in food frequency questionnaire:

Total fats (g): 37.9 g x 1 tsp./4.5 g = 8.4 tsp. fat

Discretionary kcals in food frequency questionnaire:

Discretionary oil (g) + discretionary solid fat (g) + added sugars (tsp) + alcohol (g) = 12.8 g + 16.7 g +

5.2 tsp. + 19.8 g

Oil kcals: 12.8 g x 9 kcals/1 g = 115.2 kcals discretionary oil

Solid fat kcals: 16.7 g x 9 kcals/1 g = 150.3 kcals discretionary solid fat

According to http://msue.anr.msu.edu/news/how_to_convert_grams_of_sugars_into_teaspoons, there are

4.2 g in 1 tsp. of sugar

So 5.2 tsp. sugar x 4.2 g/1 tsp. = 21.8 g x 4 kcal/1 g = 87.2 kcals added sugar

Alcohol kcals: 19.8 g x 7 kcals/1 g = 138.6 kcals

So total discretionary kcals= 115.2 kcals + 150.3 kcals + 87.2 kcals + 138.6 kcals = 491.3 kcals

1 The MyPlate food group recommended listings are appropriate for individuals who get less than 30 minutes per day of moderate physical

activity, beyond normal daily activities. You will need to make recommendation adjustments for clients who are more physically active. 2 For 3-day diet record, total the quantity eaten over three days for each food group on a separate sheet, then divide by three to determine

average daily intake. Report averages in the table above. 3 When completing the Comparison Chart, be mindful that you will need to use your professional judgment when deciding what to include in the

Oils/Fats (tsp) and Discretionary/empty calories (kcals) sections.

Examples in the Oils/Fats (tsp) category may include: salad dressing, butter, oils, etc.; there are 4.5 grams in a tsp.

Examples in the Discretionary/empty calories (kcals) section may include: energy drinks, soda, alcohol, high- octane desserts, etc.

Observations and Responses

Process of Completing the DHQ: Reflect on the process of completing the DHQ electronically

1. Roles as interviewer AND interviewee:

It was quite tedious to interview as reading my partner questions took much longer

than it would have for her to simply answer the questions herself. My partner was

unsure about how often she would eat or drink something during the year for many of

the food items, as she said she varies her diet throughout the year. Not only was the

process time-consuming with this uncertainty, but the report may also have been

inaccurate because of this. Being the interviewee went similarly. It was tedious for

both my partner to ask me questions and for me to answer the questions and took a

while. I too was unsure about how often I ate certain foods, how much I ate of certain

foods, and specific details about my food – such as how often my juice was calcium-

fortified and how often lettuce was dark green in my salads. Consequently, I am not

sure my frequency report was entirely accurate either. By the end, I would say we

were both frustrated from the time it took to accomplish the questionnaires and I was

additionally frustrated because of the inaccuracy I perceived.

2. Your evaluation of the FFQ (what did you like about the program? areas for improvement?)

I liked how many foods the program included; for myself, I could not think of a

specific food that I frequently eat which the questionnaire did not include. However,

it was difficult to remember how I ate of certain foods and how often I ate them,

especially for the foods that I do not eat that often. I tend not to pay too much

attention to the specific amount of foods that I eat as well, so this question was also

hard to answer. As stated before, my partner also had a difficult time remembering

how often she would eat or drink something, and had issues remembering specific

details about foods – such as whether or not she ate white meat chicken. Although we

may not have been able to answer the questions accurately due to our uncertainty, I am

not sure how you could improve the program to fix the issue. I think an inability to

remember every food item eaten and the amount eaten is simply a part of food

frequency questionnaires. Even with the potential inaccuracy, the questionnaire can

generally identify which food groups are under or over-consumed – such as cups of

vegetables per day – even if the exact amounts are slightly off.

3. Were any of the foods or beverages you or your partner typically consume missing from the

data base? etc.

As I stated before, I do not think that any of the foods I frequently consume were

missed in the questionnaire; however, my partner felt that the questionnaire did not

include many cultural foods. She stated that she eats Japanese foods frequently and

many of these items were not in the database. In addition, there was no chocolate soy

milk option, which my partner frequently consumes, but only a chocolate milk option.

Compare and Contrast dietary intake assessment methods: Compare MyPlate recommended food group

quantities to both assessment methods on the Diet Assessment Comparison Table.

4. How do each of the analyses compare to the MyPlate recommendations? Which are higher or

lower?

Protein/carbs/fat:

Protein/carbs/fat are all within range of MyPlate recommendations for both

assessments, except the percent carbs for the food frequency questionnaire, but the

percentage is only slightly lower than recommended, lower than the MyPlate range by

only 2.1%. Grams of protein were higher (by about 43 g) than the MyPlate gram

recommendation for the 3 day record and slightly lower (by about 6 g) than the

MyPlate gram recommendation for the frequency questionnaire. Grams of

carbohydrates were significantly lower than the gram recommendation for both the 3

day record and the frequency questionnaire, but the frequency questionnaire was lower

than the recommendation by about 237 grams while the 3 day diet record was lower

than the recommendation by about 122 grams. Grams of fat were lower than the

MyPlate recommendation by about 30 grams for the 3 day record and lower than the

MyPlate recommendation by about 42 grams for the frequency questionnaire. For

both assessments, the macronutrients consumed occupied the MyPlate goal range of

kcal percentage (excepting the slight difference for the food frequency carb %).

However, because my partner did not meet the DRI kcal goal on the MyPlate column

of the table, the macronutrient gram amounts in both assessments differed widely from

the goal gram amounts.

Fruit:

Cups of fruit were higher than the MyPlate recommendation for the 3 day record, but

lower than the recommendation for the food frequency report. The fruit amounts

varied quite a bit between assessments, 1.6 cups higher than recommended for the 3

day record and 1 cup lower than recommended for the food frequency questionnaire.

Vegetables:

Cups of vegetables were lower than the MyPlate recommendation by 1.6 cups for the

3 day record and lower than the recommendation by 2 cups for the frequency

questionaire.

Grains:

Ounces of grains were lower than the MyPlate recommendation for both the 3 day

record and the food frequency report, although grain ounces were 2.4 ounces lower

than recommended for the 3 day diet record and 6.3 ounces lower than recommended

for the food frequency report.

Protein foods:

Ounces of protein were lower than the recommended MyPlate amount by about 1

ounce for the 3 day record, but the food frequency questionnaire nearly met the

recommended amount, higher than the MyPlate recommendation by only 0.1 ounces –

which I would say met the recommendation.

Dairy:

Dairy was lower than recommended for both the 3 day record and the frequency

questionnaire. Both assessments had similar amounts with 0.6 cups for the 3 day

record and 0.8 cups for the frequency questionnaire, a little over 2 cups below the

MyPlate amount.

Added oils/fats:

The 3 day record was higher than the MyPlate recommended amount by 1 teaspoon,

while the food frequency questionnaire was higher than the recommended amount by

only 0.4 teaspoons.

Discretionary calories:

While discretionary kcals for the 3 day record were lower than the MyPlate

recommendation by about 181 kcals, discretionary kcals for the frequency

questionnaire were higher than the recommended MyPlate amount by 131 kcals.

5. Elaborate on your response to the aforementioned question. Provide an explanation/tell me

why?

The nutrient values for the 3 day record and the frequency questionnaire varied so

widely in meeting the MyPlate recommendations because the assessments were over

different periods of time. The food that a person eats for three days out of the year

will most likely vary from the food that a person typically eats over an entire year,

which means the average nutrients for three days out of the year will vary from the

average nutrients for an entire year. The comparison of a short range of time to a wide

range of time will generally not be the same. In addition, a three day diet record can

often cause an individual to consume and record foods that may be better than what

they usually consume, as they may feel pressure to produce a healthy record.

6. Which assessment method best reflected the usual intake of your partner (3-day diet record vs.

FFQ)? Justify why you think this is the case.

The frequency questionnaire likely reflected the usual intake of my partner better than

the three day record, as the frequency questionnaire gives an average for food

consumed over a larger time period. Statistically, data taken from a larger pool of

information gives more accurate averages. As my partner stated that she tends to vary

her diet throughout the year, her three day record probably includes only a small

portion of the types of foods she frequently consumes. For example, the average daily

cups of fruit my partner consumed during the three day record were 2.6 cups higher

than the average daily cups she estimated to consume during the year. I think it is

more reasonable to assume that she consumed more fruit daily during her 3 day record

than she consumes on average days of the year.

Nutrition Advice: Based on your analyses and what you know about his/her lifestyle and food habits,

what nutrition advice do you recommend for your partner? (use specific 2010 DGA report recommendations

– see http://health.gov/dietaryguidelines/2010.asp#reports (Links to an external site.) (Links to an external

site.) - include page numbers from report)

Increase vegetable and fruit intake – Based on both of my partner’s 3 day record and frequency report

and what I know about her lifestyle/food habits, I would recommend increasing her vegetable and

fruit intake. Although her fruit intake was above the recommended amount on her 3 days record, I

have determined that the frequency questionnaire is a more accurate representation of her fruit intake,

where cups of fruit consumed were lower than the MyPlate recommendation. The 2010 Dietary

Guidelines recommend increasing consumption of vegetables and fruits, as these two food groups are

commonly under-consumed by Americans. Increasing vegetables and fruits would increase valuable

nutrients which my partner has under-consumed according to the frequency report, such as dietary

fiber (my partner consumed an average of 12.6 a day compared to the recommended 25 g), folate (my

partner consumed an average of 283 mcg/day vs. recommended 400 mcg), and potassium (report lists

no specific recommendation). My partner may want to include beans as part of her diet – the Dietary

Guidelines stated that these can be considered part of the vegetable group – as these also contain

valuable nutrients such as dietary fiber, potassium, and folate. My partner can incorporate this into

her diet by aiming to consume at least 2 cups of fruits/day and 3.5 cups of vegetables/day, according

to her recommended amount. These fruits and vegetables should be of a variety of colors for a better

variety of nutrients and she should especially focus on including dark green and orange vegetables

recommended by the Dietary Guidelines, as these colors contain a lot of nutrients (pg. 48 Dietary

Guidelines).

Increase grains- Based on my partner’s food frequency report, my partner may want to increase

grains, although according to what I know of her diet, I feel that she eats enough grains. However,

my partner may want to consider increasing the proportion of grains she eats that are whole. The

Dietary Guidelines state that at least half of all grains consumed should be whole, as whole grains

contain key nutrients such as the B vitamins and dietary fiber. I would recommend to my partner to

choose a whole grain option whenever possible. Although this is not possible at some restaurants or

when eating at a guest’s home, there are generally many whole grain options provided in stores that

can be purchased instead of the refined grain form (pg. 49-50 Dietary Guidelines).

Increase dairy- Although my partner does include some dairy in her diet, she does not include

enough, based on evidence from the frequency report and what I know of her diet. The frequency

questionnaire results may have been skewed slightly by the lack of a chocolate soy milk option,

which my partner more frequently consumes. However, increasing the amount of dairy she

consumes per day by about two cups would increase valuable nutrients in her diet such as calcium,

vitamin D, and vitamin A – if products are fortified. I would recommended that my partner look for

products that are fortified, especially soy milk products fortified with vitamin A and D, as my partner

likes to consume soy milk, and the Dietary Guidelines list fortified soy milk as a milk product. Two

additional cups of dairy per day could be present in the form of glasses of milk/soy milk, or cups of

yogurt or cottage cheese as a snack, which my partner also enjoys consuming (pg 51 Dietary

Guidelines).

Discretionary kcals- These values are too high according to the frequency report for my partner, and

based on my knowledge of her diet, I would recommend that she decrease added oils/fats and alcohol

in her diet slightly. Her discretionary kcals are not excessively over the limit amount of the MyPlate

recommendation, so I would not focus too much on this recommendation, but suggest that she limit

added oils when she can, such as using a tsp. less of oils in cooking or in salad dressing, and to limit

alcohol to no more than one drink a day, according to the Dietary Guidelines (pg. 40 and 44 of

Dietary Guidelines).

Experience and Reflection: After completing this assignment, how do you empathize with nutrition

program clients who must complete these assessments to participate in food assistance programs or research

projects? Use the advantages and limitations of each assessment to support your observations.

I empathize with both the clients and the interviewers very much. From both the point of the

interviewer and the interviewee, the process of either assessment is tedious, long, and frustrating.

The same or similar questions are asked over and over again – with the multiple passes used in

reviewing the 3 day record and the amounts of every food and how often each food is consumed for

the frequency questionnaire.

Limitations and advantages:

I would think that if an interview was performed for too long in one period of time, the

client may begin to give inaccurate answers to questions due to exhaustion. This

could provide inaccurate answers for the multiple pass method of a 3 day diet record

and for answers to the food frequency questionnaire.

Limitations of the 3 day diet record include the inconvenience of recording a diet

record for three days. It takes time to remember to bring your record sheet with you

wherever you eat and to remember to record what you eat even when you have the

record with you. It also takes time to record the amount of a food consumed to the

closest accuracy possible. The food frequency questionnaire has an advantage over

the 3 day record as it does not involve the inconvenience of recording food eaten on

the client’s own time.

However, the 3 day record has an advantage over the food frequency questionnaire in

that the 3 day record does not rely much on memory. As my partner and I both

demonstrated, it was quite difficult to remember average amounts of foods eaten and

how often they were eaten – especially for foods that were not frequently eaten – with

the food frequency questionnaire.

Another limitation of both methods of assessment is that the amounts of food may be

inaccurately represented. For the 3 day record, the client may inaccurately record the

amount eaten without actually measuring the food or simply fail to record the amount

eaten. The interviewer will then have to ask the client how much was eaten, but the

client may inaccurately remember the amount eaten or misperceive the amount that

they ate. For the frequency questionnaire, it is difficult to remember amounts of food

eaten and the frequency they were eaten, as stated before, which may give inaccurate

results.

Finally, as stated before, because the frequency questionnaire records food eaten over

a larger period of time, its averages are likely more accurate than the 3 day record

averages, giving the frequency questionnaire an advantage over the 3 day record.