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Diet lab
NUTR 302L
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Types of data used to assess nutritional status
1. Anthropometrics - body composition
2. Biochemical analysis - lab measurements
3. Clinical manifestations - physical signs
4. Dietary intake - food/nutrients consumed
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Dietary intake
1. 24 hour recall
2. Food record
3. Food frequency
4. Weighed Food Intake
5. Diet history
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Dietary intake 24 hour recall
1. 24 hour recall
1) Interview of everything eaten in last 24 hours
2) Most useful for populations
3) Multiple recalls useful for individuals
Strength
Less than 20 min Inexpensive Easy to administer Low respondent
burden More objective than dietary history
Limitation
Relies on memory Truthfulness Atypical day Portion size
Data entry-labor intensive
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Dietary intake Food Record
2. Food record
1) Foods written down as consumed
2) Usually 3 days (2 weekdays, 1 weekend day) to 7 days
3) Most useful for individuals
Strength
Multiple days Not depend on memory Detailed intake data
Limitation
Cooperation/non compliance Response burden Truthfulness May
change diet Portion size
Data entry-labor intensive
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Dietary intake Food Frequency
3. Food frequency
1) Questionnaire designed
Strength
Easy Machine readable More representative of usual intake Large
population
Limitation
Quality of questionnaire Ethnic foods Portion size Not good for
absolute
nutrient intake
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Dietary intake Weighed Food Intake
4. Weighed Food Intake
1) Foods weighed when portioned and after consumed
2) Strength: Gold standard for assessing intake (metabolic
study setting)
3) Limitation: Difficult to conduct in normal life setting
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Dietary intake Diet History
5. Diet history
1) Usually combination of other method of assessing intake
with psychosocial/physical information obtained as well
2) Physical activity, appetite, economics, ethnicity, allergies,
wt
change, dental/oral health
3) Additional information helpful in determining behaviors
but
more time consuming
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Dietary intake
Each method has strength and limitation
Combination Food record and Food questionnaire
24 hr recall and Food questionnaire
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Diet lab
1. Subject/Interviewer
2. Greeting / introduce yourself / identify the subject
3. 24 h recall
4. Thank you
5. Analyze the 24hr recall using a software (Food Processor)
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Diet lab
6. NCP note Nutrition assessment : Gender, age, Ht, Wt, IBW,
%IBW, BMI, activity level
and final table
Write which one is higher/lower or just right compared
to DRI so that you can figure out potential problems
Energy
(Kcal)
CHO
(g)
Fiber
(g)
Fat (g) Sat.
Fat (g)
Pro (g) Vit. A
(g)
Vit. D
(g)
Vit. C
(mg)
Iron
(mg)
Ca
(mg)
Sodium
(mg)
Recall
DRI
%DRI
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Diet lab
6. NCP note
Nutrition diagnosis:
PES statement:
ex: Excessive calorie intake (problem)
R/Tregular consumption of large portions of
high-fat meals (etiology)
AEB 24 hr diet recall data (3000 Kcal) vs DRI
(2200 Kcal) (sign/symptom)
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Diet lab
6. NCP note
Nutrition intervention: -- Food and/or nutrient
delivery/nutrition education/
coordination of nutrition care
-- Meal/snack plan
-- Exercise
-- Goals: ex-Reduce BMI to normal range
Nutrition monitoring and evaluation -- Follow-up phone call
within a week
-- Wt log
-- ask 3 d food record
-- revisit the lab 2 wks later
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Dietary Guideline
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http://www.healthytimesblog.com/2011/06/choosemyplate-gov-ousts-usda-food-pyramid/
Basic 7 (1943)
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--1992-- Food Guide Pyramid
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MyPyramid (2005-2010)
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ChooseMyPlate (2011)
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USDA Dietary Guidelines 2010
1. Balancing calories to Manage weight
2. Enjoy your foods but eat less
3. Avoid oversized portions
4. Physical activities: moderate intensity for 30 min/d, most of
days of the week
5. Make half your plate fruits and vegetables (fruit 2c,
vegetables 2 1/2c for 2000Kcal)
6. Grain (6 oz) including whole grain (3 oz)
7. Fiber 20-35 g
8. Fat-free or low-fat milk
9. Fat: 20-35% of Kcal
10. Saturated fat: < 7-10% of Kcal, reduce solid fat
11. Cholesterol: < 200-300 mg/d
12. Trans FA: as low as possible
13. Use oils to replace solid fats where possible
14. Sodium: < 2300 mg/d (1 tsp of salt, 6g salt)
15. Variety of protein and sea foods (2 servings of 4 oz/wk)
16. Choose foods that provide more potassium, dietary fiber,
calcium, and vitamin D
17. If you choose to drink, man (2 drinks), woman (1 drink)
one drink: 12 fl oz beer, 5 fl oz wine, 1.5 fl oz of distilled
spirits
18. Avoid sugary drink and added sugar
19. Vit D DRI: 15 g/d
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2008 Physical activity guideline for American
At least 150 min/week, moderate intensity or 75 min/week,
vigorous-intensity aerobic physical activity or Combination Aerobic
activity: at least 10 min/episode throughout the week
For health benefit
Double the amount of time
Muscle-strengthening activity (moderate or high) :all muscle
groups 2-3 d/wk
For additional health benefit
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Helpful websites
www. choosemyplate.gov
www.nutrition.gov
www.cnpp.usda.gov/DGAs2010-DGACReport.htm
http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm
//fnic.nal.usda.gov
//health.gov/DietaryGuidelines/2010.asp
www.health.gov/paguidelines/
