NCM 105 - NUTRITION AND DIET THERAPY PT.2
Food Guides/Food Labels
- qualitative tool in planning nutritious diets for the
masses
- teaches the principles of eating a variety of foods
everyday in proper amounts of servings.
Cambodia - in the shape of Angkor Wat (temple
complex that’s one of the largest religious monuments
in the world); schoolchildren were surveyed by the
Ministry of Health about the foods they most commonly
eat
Benin - a round traditional house with a thatch roof;
drink a lot of water; nasa entrance yung water as a
symbol of hospitality and plenty of water should be
consumed in a day
Antigua and Barbuda - uses pineapple kasi native
fruit to sa kanila; more on fruits less on beans
Qatar - seafood shell
Korea - gives importance to physical activity; bike
Japan - same sa korea; shape of food guide is
spinning top which is the traditional toy; may
natakbong tao around a glass
Canada - no rice but there’s bread; least canned
goods
Philippines - eat more vegetables and fruits
China - uses the traditional five levels like temple;
physical activity and water
India - more cereals less meats
Malaysia - more on fruits
Dash Diet - dietary approach to stop hypertension;
expensive diet
Diabetic Diet - diabetic people does not have a
special diet
The Asian-Pacific Type 2 Diabetes Policy Group
has outlined the following simple reminders:
 eat most vegetables, legumes, lentils, noodles,
rice, bread, grains, barley, wholegrain cereals,
fresh fruit (low-sugar)
 eat moderately protein-rich food
 eat less sugars, salt, and alcohol
Nutritional Guidelines for Filipinos (NGF), 2000
- set of dietary guidelines based on the:
 eating pattern
 lifestyle
 health status of Filipinos
- provides the general public with easy and simple
recommendations on proper diet and practices
thet bring about good health for every individual
1. eat a variety of foods everyday - no single
food provides all nutrients
2. breast-feed infants exclusively from birth
to 6 months, and then, give appropriate
foods while continuing breast-feeding –
give suitable complementary food in addition
to breast feeding at about 6 months or when
the infant is ready. Start with small amounts
when introducing new foods
3. maintain children’s normal growth through
proper diet and monitor their growth
regularly – weigh children regularly. Maintain
normal growth with proper diet
4. consume fish, lean meat, poultry or dried
beans – these are intended to correct
deficiencies in the current dietary pattern of
Filipinos. These include good quality protein,
iron, and zinc.
5. eat more vegetables, fruits and root crops
– these are intended to correct deficiencies in
the current dietary pattern of Filipinos. These
include good quality protein, iron, and zinc.
6. eat foods cooked in edible/cooking oil daily
– these are intended to correct deficiencies in
the current dietary pattern of Filipinos. These
include good quality protein, iron, and zinc.
7. consume milk, milk products and other
calcium-rich foods, such as small fish and
ark green leafy vegetables every day –
these are intended to correct deficiencies in
the current dietary pattern of Filipinos. These
include good quality protein, iron, and zinc.
8. use iodized salt, but avoid excessive intake
of salty foods – use iodized salt to prevent
iodine deficiency, which is a major cause of
mental and physical underdevelopment among
Filipinos. Caution about the use of excessive
salty foods among persons at high risk for
hypertension
9. eat clean and safe food – prevent food-borne
diseases. Know the sources of contamination
10. for a healthy and good nutrition, exercise
regularly, do not smoke, and avoid drinking
alcoholic beverages – observe a healthy
lifestyle with regular exercise, abstinence from
smoking and alcohol consumption. If alcohol is
consumed occasionally, drink in moderation
Terms Used on Food Labels
free - nutritionally trivial and unlikely to have a
physiologic consequence
good source of - the product provides between 10
and 19 percent of the daily value for a given nutrient
healthy - food low in fat, saturated fat, cholesterol, and
sodium
high - 20% more of the daily value
less - 25% less of a given nutrient or kcalories
light or lite - 1/3 fewer kcalories than normal, 50% or
less of fat or sodium
low - amount that would allow frequent consumption
without exceeding the daily value
more - 10% more of the daily value
organic (on food labels) - 95% of the product's
ingredients have been grown and processed according
to USDA regulations
ENERGY
kcalorie free - fewer than 5kcalories per serving
low kcalorie - 40kcalories or less
reduced kcalories - 25% fewer kcalories
FAT AND CHOLESTEROL
percent fat free – if the product meets the definition of
low fat or fat free; amount of fat in 100g
fat free – less than 0.5g of fat per serving; zero-fat, nofat, nonfat
low fat – 3g or less fat
less fat – 25% less fat
saturated fat free – less than 0.5g of saturated fat
low saturated fat – 1g or less saturates fat and less
than 0.5g of trans fat
less saturated fat – 25% less saturated fat and trans
fat combined
trans fat free – less than 0.5g of trans fat and
saturated fat
cholesterol free – less than 2mg cholesterol per
serving
low cholesterol – 20mg or less cholesterol
less cholesterol – at least 25% less cholesterol
extra lean - less than 5g of fat, 2g of saturated fat and
trans fat, and 95mg of cholesterol
lean – less than 10g of fat, 4,5g of saturated and trans
fat, 95mg of cholesterol
CARBOHYDRTAES: FIBER AND SUGAR
high fiber – 5g or more of fiber
sugar-free – less than 0.5g of sugar
SODIUM
sodium free and salt free – less than 5mg of sodium
low sodium – 140 mg or less
very low sodium – 35mg or less
LABEL CLAIMS
Nutrient claims – the level of nutrient in food; ex, is fat
free or less sodium
Health claims – relationship of food or food
component to a disease or health-related condition; ex.
Soluble fiber from oatmeal
Structure-function claims – effect that a substance
has on the body structure or function of the body and
so not make reference to a disease; ex. Supports
immunity and digestive health
*products containing sugar replacers may claim to
“not promote tooth decay” if they meet FDA
criteria for dental plaque activity
*products containing aspartame must carry a
warning for people with phenylketonuria
*products that claim to be “reduced calories” must
provide at least 25% fewer kcalories per serving
*products containing less than 0.5g or sugar per
serving can claim to be “sugarless” or “sugarfree”
Diabetes Mellitus
medical nutrition therapy - treatment for diabetes;
continuous process of modifying nutrient intake
1. Goals of medical nutrition therapy
2. maintain near-normal blood glucose levels
3. normalize the serum lipoprotein levels and
blood levels
4. allow and maintain reasonable body weight
5. promote overall health because of
heterogeneous eme of diabetes
Nutritional goals, principles and recommendations
calories - for weight loss, either low-carb or low-fat
calorie-restricted diets
protein - nephropathy decrease of kidney function;
no more than 0.8 g/kg body weight
fat - saturated fat less than 7% of daily calories
cholesterol - less than 200mg/day
carbohydrates - glycemic control
sweeteners - use of non-nutritive sweeteners which
are safe to consume
fiber - 25-35g per day
sodium - 2000mg/day
alcohol - 2 serving for boys 1 serving for girls
vitamins and minerals - chromium and vitamin E and
C may benefit daw pero di proven na may effect sa
diabetes
Diet principle
1. individualization - ability of patient,
willingness to cooperate, health profession
should be sensitive,
2. energy - weight reduction of about 10-20 lbs
in obese patients; equal input and output for
normal weight patient; underweight patient
meets the normal weight
3. carbohydrate - 50-60% of normal carbs
4. protein and fat - not the same as carbs na
may limitation kasi walang effect sa blood
sugar; does not need to be consistent
everyday
5. exercise - needed to improve the bodys
response to insulin, to lower blood glucose
levels, key factor in the success in achieving
lower body weight and normal weight
6. meal patterns – sunod-sunod na gagawin to
minimize hypo- or hyperglycemia
7. measuring foods - when the food is cooked
na yung pagmeasure ng pagkain
8. special foods - not necessary kasi expensive,
low in calorie
CLASSIFICARIOM OF DIABETES MELLITUS
Type 1 - no insulin is produced; beta cell destruction
Type 2 - may insulin but hindi enough; progressive
insulin secretory defect
gestational diabetes - occurs in pregnancy with
multiple pregnancies; gave birth to more than 8lbs
baby, increased BMI prior to pregnancy
Other specific type of diabetes:
 genetic defects in beta cell function, insulin
action
 disease of the exocrine pancreas
 drug- or chemical-induced
Clinical Symptoms of DB
pyloria -frequent urination
polydipsia - increased thirst
polyphagia -increased appetite
dehydration - not balanced by water intake
weight loss - eating more than usual to relieve hunger
blurred vision -when blood sugar is too high
slow healing sores of frequent infection - type 2
diabetes
areas of darkened skin - type 2 diabetes have velvety
skin in the folds like armpits and necks
(acanthosisnigricans), may be sign of insulin
resistance
Biochemical Symptoms of DB
glycosuria -presence of sugar in urine
hyperglycemia - elevated blood glucose due to lack of
insulin
ketosis or acidosis - accumulation of ketone bodies
due to rapid oxidation of fatty acids
ketonuria - presence of ketone bodies
glycemic index - measure how quickly a food can
make your blood sugar rise
low in GI - pasta, legumes, rye bread
intermediate glycemic index -ice cream, rolled oats,
sweet corn, white sugar, chico, and mango
high GI - white bread, baked potatoes, papaya, corn
flakes, pineapples
Management of DM
NUTRITION
1. nutrition care process
2. individualized to keep nutritional needs
3. goals of nutrition therapy of DM:
 CARBS
 PROTEINS – don’t use protein to treat
hyperglycemia
 FATS - minimize trans fat, 2 servings
of fish every week
 Other recommendations:
 recommended dietary
modifications
 maintain/achieved calories
 strategies in teaching meal
planning
o carbs counting
o exchange list
o portion control
4. distribution of the TER for GDM are as follows
 breakfast - 10%
 AM Snack -10%
 lunch - 30%
 PM Snack - 10%
 dinner - 30%
 bedtime snack - 10%
food sources
carbs available - digestible- sugars, dextrin, starch, and
glycogen; digests in gastrointestinal tract
unavailable indigestible - oligosaccharides, dietary
fibers, resistant starch - cellulose, hemicellulose
animal food - milk contains lactose, animal food that
contributes to carbs intake
Medications
sulfonylureas – taken before meals, increases insulin
production in the pancreas
meglitinides - same as sulfonylureas but with rapid
onset and shorter duration
incretins - inhibit the enzyme dipeptidyl IV in the gut
that breaks down the hormones incretins which help
the pancreas to produce more insulin and your glucose
to stop producing glucose
DPP 4 Inhibitor - used in type 2 DM
Glycemic effects of foods
- effect on the person’s blood sugar and insulin levels.
low glycemic effects - desirable one, slow absorption
of carbs,
high glycemic - not desirable, may slow absorption
pero may surge ng blood glucose and may over
reaction, promotes patients to over eat
gastric emptying and absorption - happen in small
intestine
gastric emptying - delayed ang absorption
food factors
whole rice - slow to digest and results in low blood
glucose
processing such as cooking - decrease of glucose
response
diabetes - caused by sugar that will cause carbs,
caloric control is needed not limitation in carbohydrates
to prevent diabetes
recommend high fiber foods (fiber - can prevent
glucose surge which prevent diabetes; found in foods
low in glycemic index); can reduce the risk of type 2
diabetes.
Nutritional Assessment LESSON 1
Definition and Types of Assessment
Nutritional status is the state of health of an
individual as it relates to how the diet could meet the
daily nutrient requirement (Guthrie & Beerman, 2013).
Optimum nutritional status is at the center of a
continuum state of nutrition, with undernutrition at the
extreme end of deficiency and overnutrition
manifesting in overconsumption of food or nutrients.
Definition of nutritional assessment and nutritional
screening
Nutritional assessment is “an evaluation of the
nutritional status of individuals and populations through
measurements of food and nutrient intake and
evaluation of nutrition-related health indicators” (Lee,
R, 2004). The American Dietetic Association (ADA)
also defines nutritional assessment as “a systematic
approach to collect, record, and interpret relevant data
from patients, clients, family members, caregivers, and
other individuals and groups. Nutrition assessment is
an ongoing, dynamic process that involves initial data
collection as well as continual assessment and
analysis of the patient’s/client’s status (Hammonds, et
al., 2014).
Nutritional screening “is the process of
identifying characteristics which are associated with
nutrition problems”. The purpose of nutrition screening
is to pinpoint individuals who are at risk to become
malnourished.
Purpose of Nutritional Assessment
1. Define nutritional problems that need attention.
As an integral part of situational analysis, it is
the first step in the nutrition program planning
and management cycle.
2. Provide baseline data for planning and
evaluation programs.
3. Help identify priorities and responsibilities of
the public health system at all administrative
levels (Ex: from national to barangay level)
4. In the clinical setting, nutritional assessment is
used to identify nutrition problems, and to
determine, monitor and evaluate the progress
in the management of a particular disease
condition.
Types of Nutritional Assessment Systems
1. Nutritional Survey – an epidemiological
investigation of the nutritional status of the
population by various methods; may include
an evaluation of factors affecting nutritional
status. One-time assessment for 6 months of
baseline monitoring.
2. Nutrition Surveillance – continuous monitoring
of the nutritional status of selected population
groups.
3. Nutrition Screening – involves comparing an
individual’s measurements with predetermined
risk levels of “cut-off” points. Usually less
comprehensive than survey or surveillance.
Useful in identifying individuals in need of
immediate intervention. Operation Timbang
collects only age and weight data, targets only
preschoolers, and is used to screen children
for inclusion in food assistance programs.
Methods of Nutritional Assessment
The four methods often used to assess nutritional
status are:




Anthropometry
Biochemical
Clinical
Dietary

Less sensitive and generally an indicator of
past nutritional status (chronic malnutrition);
determines stunting or dwarfism
 Instruments for measuring stature are
measuring stick, steel, tape, stadiometer or
microtoise. Height is recorded to the nearest
0.1cm.
3.
Weight – Body weight is one of the most
important measures for nutritional assessment. It is the
sum of the protein, fat, water, and bone mineral mass;
therefore, changes in these components could affect
body weight such as in acute or chronic illness.
 Instruments used to measure weight are
weighing scales such as beam balance scales,
spring, or digital type of scales. For infants,
pan-type pediatric electronic or balance-beam
scales accurate to within 10g should be used.
4.
Body circumferences
 Head circumference - is an important
measure to screen abnormalities of head and
brain growth, particularly during the first year
of life. It is also measured using a non-stretch
tape which is positioned just above the
eyebrows, above the ears and around the
circumference of the head to get the largest
circumference.
 Head and chest circumferences – are the
same at six months of age. After this, the skull
grows slowly and the chest grows more
rapidly. Head/chest circumference ratio is of
value in detecting protein-energy malnutrition
(PEM) in early childhood.
 Mid-upper arm circumference (MUAC) has
been mainly used for children 1-6years old.
Between 1-4 years, “reference values” change
little, the age need not be accurately known.
The Shakir’s tape is a coded tape that
measures MUAC and identifies the risk of
malnutrition among children.
Anthropometry
Anthropometry for Adults
Anthropometry means “measurement of the
human body”. It is identified as the measurements of
variations of the physical dimensions and gross
composition of the human body at different age levels
and degrees of nutrition (Jeliffe, 1989).
1. Desirable or “Ideal” Body Weight – is the
weight associated with food health. A table for
ideal body weight was developed by the life
insurance industry based on the formula of
Hamwi (1964). This does not adjust for
differences in age, race or frame size
Hamwi’s Formula:
Men: 106lbs for 5ft + 6lbs per inch over 5ft or 6lbs per in under 5ft
Women: 100lbs for 5ft + 5lbs per inch over 5ft
or -5lbs per inch under 5ft
2.
Body Mass Index (BMI) – also called as
Quetelet’s index, is correlated with overall mortality
and nutritional risk. It is the most widely used
nutritional index for underweight and overweight, but
does not estimate body composition and the
distribution of fat in the body.
Formula: BMI = Weight (kg)/Height (m²)
Classification of anthropometric measurements:


Growth Measurements
Measures of body composition
I.
Growth Measurements
1. Length (also known as recumbent length) –
measured with the subject lying down, usually
for infants and children up to two (2) years
who cannot stand without assistance.
 Instruments for taking length measurements
are an infantometer, measuring mat, and
length board made of wood, fiberglass, or
other materials. Length should be recorded to
the nearest 0.1cm.
2.
Stature (or standing height) – assess the
linear dimension of the body composed of the legs,
pelvis, spine, and skull.
International Classification of Body Mass Index
(BMI) in Adults
Principal
Cut-off
points
Category
Health Risk
<18.5
Underweight
For BMI <16,
suggests possible
eating disorder
18.5-24.9
Normal
Healthy, low health
risk
25.0-29.9
Overweight
Associated with
increased risk of
disease
≥30.0
Obese
Frame size – is necessary for the accurate
interpretation of weight. Frame size is usually
measured using elbow breadth and wrist
circumference. Elbow breadth is measured
using a caliper with the elbow flexed at 90
degrees. Wrist circumference is measured at
the smallest part of the wrist distal to the
styloid process of the ulna and radius.
Determining frame size from the ratio of
height to wrist circumference
R value
Associated with
further increase risk
of disease.
*adapted from WHO, 1995, 2000, 2004
Category
<18.5
Underweight
18.5-22.9
Normal
23.0-27.5
Overweight
≥27.5
Obese
Women
Men
Small
>10.9
>10.4
Medium
10.9 – 9.9
10.4 – 9.6
Large
<9.9
<9.6
Source: Lee. R. & Nieman. (2003). Nutritional
Assessment
Classification of BMI for the Asia-Pacific
Population
Principal cut-off points
Frame Size


Proxy measures for height
If height cannot be measured such as for nonambulatory persons, or those with contractures, severe
arthritis, paralysis, amputations, or other conditions
that limit the capacity to take height measurements,
knee height or arm span is used as a proxy measure
to determine height.



Arm span – is measured using a steel tape
with the arms spread in a horizontal position
and the length across both ends of the
fingertips is recorded.
Formula to estimate stature for Filipinos using
arm span (Tanchoco, et al):
Men= 118.24 + (0.28 x arm span) – (0.07 x
age) cm.
Women = 63.18 + (0.63 x arm span) – (0.17 x
age) cm.
Knee Height – measured using a sliding
board-blade caliper by placing the heel of the
left foot on the fixed blade and the movable
blade proximal to the knee cap (patella).
Formula for estimating stature among Filipinos
using the knee height data (Tanchoco, et al):
Men = 96.50 + (1.38 x knee height) – (0.08 x
age) cm
Women = 89.68 + (1.53 x knee height) – (0.17
x age) cm.

I.
Mid-Upper Arm Circumference (MUAC) – is
used to screen for undernutrition among
adults. It is also part of equations used in the
calculation of Arm Muscle Area (AMA) which is
an index of lean or muscle in the body.
Waist circumference (WC) – is a proxy
indicator of body fat distribution, specifically
central adiposity. WC is measured using
fiberglass tape to measure the smallest
circumference of the waist or midway between
the lowest rib and the iliac crest (WHO, 2011).
Waist/hip ratio (WHR) – is also an indicator of
body fat distribution. WHR is measured at the
largest circumference of the hips or at the level
of the greater trochanter. It can classify obesity
as gynoid or android (with ‘pear shape’ or
‘apple shape’ bodies, respectively). The
android type of obesity reflects more
abdominal fat and is correlated with an
increased risk of cardiovascular and related
disorders. Ratios above 0.85 for women and
1.0 for men indicate central body fat
distribution, hence “at risk” for dyslipidemias
and cardiovascular disease.
Waist-Height Ratio (WHtR) – also considered
as obesity index, like WHR. The value is
computed from waist circumference (cm)
divided by the height (cm), with a cut-off of
greater 0.5 to indicate an increased risk of
CVD and co-morbidities.
Methods to Assess Body Composition
Body composition provides an estimate of the
body’s reserves for fat, protein, water, and several
minerals. Body composition can be assessed by
direct method for body composition analysis.
1. Direct Method – there is only one direct
method for body composition analysis.
2. Indirect Method





Skinfold measurements –
estimate the thickness of
subcutaneous fat in different body
landmarks such as the triceps,
biceps, waist, hips, abdomen,
iliac, suprailiac, thighs, etc. The
common skinfold sites: Triceps
skinfold, biceps skinfold,
subscapular skinfold, and
suprailiac skinfold.
Densitometry – is a method of
assessing body composition by
measuring the density of the
whole body.
Plethysmography – a
modification of underwater
weighing which uses the principle
of air displacement rather than
water displacement to get body
density. The BODPOD is an
example of a machine that uses
the principle of air displacement
plethysmography; the PEAPOD is
the model used for infants and
children.
Magnetic Resonance Imaging
(MRI) – allows both imaging of the
body and in vivo chemical analysis
without hazard to the subject; can
be used to measure the amount
and distribution of intra-abdominal
fat.
Ultrasound – an inexpensive
method that can be used in
imaging, such as for determining
the size of the thyroid
Biochemical Assessment
Many of the routine blood and urine laboratory
tests found in patients’ charts are useful in providing
an objective assessment of nutritional status. Care
should be taken in interpreting test results for a
number of reasons;
1. There is no single available test for evaluating
short-term responses to medical nutritional
therapy. Laboratory tests should be used in
conjunction with anthropometric data, clinical
data, and dietary intake assessments.
2. Some tests are not applicable to a person,
e.g., serum albumin cannot be used to
evaluate protein status in patients with liver
failure, because this set assumes normal liver
function.
3. Lab tests are to be conducted several times
over a certain period to give more accurate
information compared to a single test.
Clinical examinations are conducted by the
physician on anatomic changes that can be seen or
felt in the superficial, epithelial tissues like skin, eyes,
hair, buccal mucosa, or organ systems (e.g., thyroid,
spleen, and liver). The use of the stethoscope, blood
pressure and pulse rate measurements, height, and
weight are standard procedures in physical
examination charting.
Clinical assessment also includes the medical
history of the client, like past surgeries and previous
diagnoses by other physicians, number of childbirths
(for adult mothers), and disorders of other family
members.
Dietary Assessment
There are several methods for collecting
information regarding actual and habitual dietary
intake. The most commonly used data collected are
food recalls and food frequency questionnaires and
food records.
The 24-hour food recall. In this method, the
individual is asked by the interviewer to report all foods
and beverages consumed during the past 24 hours.
Detailed supplements, along with portion sizes in
common household measures are included. Food
models, measuring cups, life-size pictures, or abstract
shapes are used to assist the patient in estimating the
correct portion sizes of foods consumed. This method
is useful in screening or during follow-up to evaluate
the adaptation of dietary recommendations.
Food Frequency Questionnaire (FFQ) is an
easy form to follow, although it could be timeconsuming, depending on the number of pages listing
foods and beverages to study the food habits and
choices of a person.
Food Records. These can provide a more
realistic picture of a patient’s usual intake. All food
items, beverages, snacks, and supplements are
recorded by the patient, usually over a period of 3 to 7
days using household measures. Cooking methods,
recipes, ingredients, and descriptions need to be
recorded as detailed as possible. A 7-day food record
is considered to be optimal for gathering this kind of
information because it includes weekends. Shorter
periods like a 3-day record (two weekdays and one
weekend) may be acceptable.
Comparison of Different Methods of Dietary Intake
Assessment
Strength
Does not
require
literacy.
Clinical Assessment
Clinical assessment is the physical
examination of an individual for signs and symptoms
suggestive of nutritional health and/or clinical
pathology. Signs usually come late in the pathogenesis
of a disease, unlike biochemical tests that can detect
early malnutrition states.
24-Hour
Recall
Can be
administer
ed
relatively
quickly.
Data may
be directly
Limitation
s
Dependent
on the
respondent
’s memory
Relies on
selfreported
information
.
Application
s
Appropriate
for most
people, as it
does not
require
literacy.
Useful for
the
assessment
of intake of
a variety of
entered
into a
dietary
analysis
program.
May be
conducted
in person
or over the
telephone
Requires
skilled
staff.
May be
difficult in
English as
a second
language.
Single
recall does
not
represent
the usual
intake.
nutrients
and
assessment
of meal
patterning
and food
group intake
Useful
counseling
tool
are
prepared.
Does not
rely on
memory
Food
Record
Multiple
days of
records
provide a
valid
measure
of intake
for most
nutrients.
Estimating
food
quantities/
food
ingredients
may be
difficult
esp. if
patients
are in
restaurants
.
Easy and
affordable
Food
Frequen
cy
May
assess
current as
well as
past diet
In a
clinical
setting,
may be
useful as a
screening
tool to
identify
inadequat
e intake of
any food
group so
that
dietary
and
nutrient
deficiencie
s may be
identified.
Does not
provide
valid
estimates
of the
absolute
intake of
individuals
Cannot
assess
meal
patterning
Difficult for
teens with
limited
cognitive
developme
nt
May be
timeconsuming
Patient
error in
filling out
the
questionnai
re
No way to
find out
how foods
Food
portions
may be
measured
at the time
of
consumpti
on
Computer
can
objectively
analyze
data
obtained
Does not
provide valid
estimates of
absolute
intake for
individuals;
thus, of
limited
usefulness
in clinical
settings.
May be
useful as a
screening
tool to
identify
inadequate
intake of
any food
group to
point out
dietary/nutri
ent
deficiencies.
Able to
assess the
usual
intake in a
single
interview
Diet
History
Appropriat
e for most
people
Evaluates
long-term
dietary
habits
Recording
foods
eaten may
influence
what is
eaten
Requires
literacy
Relies on
selfreported
information
Requires
skilled staff
Timeconsuming;
patient
error in
entering
accurate
food
qualities
Appropriate
for literate
and
motivated
individuals
Useful for
the
assessment
of intake of
a variety of
nutrients
and
assessment
of meal
patterning
and foodgroup intake
Useful
counseling
tool
Week-long
record may
not
accurately
represent
the
patient’s
normal
eating
habits
since food
intake will
be
analyzed
Relies on
memory
Timeconsuming
(1 to 1½
hours)
Requires
skilled
interviewer
Works only
if a patient
can
describe a
“typical”
daily intake
that is
difficult for
those who
Appropriate
for most
people, as it
does not
require
literacy
Useful
assessing
intake of
nutrients,
meal
patterning
and food
group intake
Useful
counseling
tool.
vary food
intake
greatly.
Patients
may not
include
foods that
they know
are
unhealthy.