Clinical
Nutrition
Assessment
Dr Niikee Schoendorfer
UQ Medical School
n.schoendorfer@uq.edu.au
Session objectives
1.
Understand the role that nutrition and lifestyle
play in the development of chronic disease
2.
Provide an assessment of patients diet and
lifestyle
3.
Gain practical skills in the provision of basic
nutritional and lifestyle advice
4.
Identify useful adjunct patient information
resources
What Causes Chronic Disease?
 Many
chronic diseases are preventable
 Adopt
healthy behaviours –

controlling body weight

eating nutritious foods

avoiding tobacco use

increasing physical activity
What Causes Chronic Disease?
Chronic
conditions
Heart disease
Stroke
Diabetes II
Kidney disease
Arthritis
Osteoporosis
Lung cancer
Colorectal cancer
COPD
Asthma
Depression
Oral health
Tobacco
smoking
Physical
inactivity
(a)
(b)
Contributing Factors
Risky alcohol
Poor
Obesity
consumption
diet
Hypertension
High
blood
fats
(b)
Source: Australian Institute of Health and Welfare (AIHW) 2002. Chronic
diseases and associated risk factors in Australia, 2001. Canberra: AIHW.
(a) rheumatoid arthritis
(b) osteoarthritis
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Source(s): Australian Health
Survey: Updated Results, 2011-12
Health Statistics in Australia
Public Health Campaigns
Taking Measurements
Cardiovascular Disease/ Diabetes Risk
Total Waist Measurement
Waist : Hip Ratio
Additional Weight Loss Measures
Circumferences –
- thigh
- bicep
- bust
Australian Dietary Guidelines
Recommendations:

Fruits and vegetables – variety of colours both
cooked and raw, also include legumes, nuts and
seeds

Cereals – preferably wholegrain

Meat, seafood and alternatives

Milk, Yoghurts and Cheese – reduced fat varieties

Drinking plenty of water
Australian Dietary Guidelines
 and

take care to:
Limit saturated fat and moderate total fat intake
 Choose
 Limit
foods low in salt
your alcohol intake if you choose to drink
 Consume
only moderate amounts of sugars and
foods containing added sugars.
 Australian
guide to health eating
https://www.eatforhealth.gov.au/guidelines
How does your diet
measure up?
Taken from
the
Australian
Dietary
Guidelines
Summary
http://www
.eatforhealt
h.gov.au/sit
es/default/f
iles/files/the
_guidelines/
n55a_austr
alian_dietar
y_guideline
s_summary_
131014.pdf
Recommended Food Servings
Recommended Food Servings
Recommended Food Servings
Recommended Food Servings
Recommended Food Servings
Portion
Distortion
38
Creeping portion distortion
Are you aware of
how much food
portion sizes have
increased in 20
years?
Slides marked by
are adapted from “Portion Distortion” by the
National Heart, Lung and Blood Institute Obesity Education Initiative at
http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/portion/index.htm
BURGER
20 Years Ago
333 calories
Today
How many calories
are in today’s burger?
BURGER
20 Years Ago
Today
333 calories
590 calories
Calorie Difference: 257 calories
Maintaining a Healthy Weight is a
Balancing Act
How long will you have to lift weights in
order to burn the extra 257 calories?*
*Based on a 60kg person
Calories In = Calories Out
1 hour and 30 minutes
FRENCH FRIES
20 Years Ago
210 Calories
Today
How many calories are in
today’s portion of fries?
FRENCH FRIES
20 Years Ago
210 Calories
Today
610 Calories
Calorie Difference: 400 Calories
How long will you have to walk leisurely
in order to burn those extra 400 calories?*
*Based on 72kg person
Calories In = Calories Out
1 hour and 10 minutes
SOFT DRINK
20 Years Ago
85 Calories
250mL
Today
How many calories are
in today’s portion?
SOFT DRINK
20 Years Ago
85 Calories
250mL
Today
250 Calories
600mL
Calorie Difference: 165 Calories
How long will you have to work in the
garden to burn those extra calories?*
*Based on 72kg person
Calories In = Calories Out
35 minutes
SANDWICH
20 Years Ago
320 calories
Today
How many calories are
in today’s sandwich?
SANDWICH
20 Years Ago
Today
320 calories
820 calories
Calorie Difference: 500 calories
How long will you have to ride a bike in
order to burn those extra calories?*
*Based on A 72kg person
Calories In = Calories Out
1 hour and 25 minutes
COFFEE
20 Years Ago
Coffee (with
whole milk and
sugar)
45 calories
Today
Mocha Coffee
(with steamed whole
milk and mocha
syrup)
How many calories
are in today's coffee?
COFFEE
20 Years Ago
45 calories
Today
350 calories
Calorie Difference: 305 calories
How long will you have to walk in order
to burn those extra 305 calories?*
*Based on 60kg person
Calories In = Calories Out
1 hour and 20 minutes
Larger portions add up
100 extra
calories per
day
4.5kg
weight gain
per year
Maintaining a healthy weight is a balancing act
59
MUFFIN
20 Years Ago
210 calories
Today
How many calories
are in today’s muffin?
MUFFIN
20 Years Ago
210 calories
Today
500 calories
Calorie Difference: 290 calories
How long will you have to vacuum in
order to burn those extra 290 calories?*
*Based on a 60kg person
Calories In = Calories Out
1 hour and 30 minutes
CHOCOLATE CHIP COOKIE
20 Years Ago
55 calories
Today
How many calories
are in today’s large
cookie?
CHOCOLATE CHIP COOKIE
20 Years Ago
55 calories
Today
275 calories
Calorie Difference: 220 calories
How long will you have to wash the car to
burn those extra 220 calories?*
*Based on 60kg person
Calories In = Calories Out
1 hour and 15 minutes
SPAGHETTI AND MEATBALLS
20 Years Ago
500 calories
1 cup spaghetti with
sauce and 3 small
meatballs
Today
How many calories
do you think are in
today's portion of
spaghetti and
meatballs?
SPAGHETTI AND MEATBALLS
20 Years Ago
500 calories
1 cup spaghetti with
sauce and 3 small
meatballs
Today
1,025 calories
2 cups of pasta with
sauce and 3 large
meatballs
Calorie Difference: 525 calories
70
Which portion would you choose?
71
You can save 300 calories by
choosing the 1 cup portion.
72
Why not fill up on
vegetables??!!?
73
Useful web resources
Activity calorie comparison
 http://www.8700.com.au/balanceand-burn/kj-activity-comparison/
Public Health Resources
 http://www.eatforhealth.gov.au/
Nutrient Reference Values
 http://www.nrv.gov.au/
Drug and Supplement Information
 http://www.nlm.nih.gov/medlineplus/d
ruginformation.html