Dietary History Taking. Objectives

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Alyson Holland
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1 Dietary History Taking Objectives Learn to elicit a systematic nutritional history from a patient. Recognise that inquiry of a patient s diet forms part of routine history taking. Be aware of how the wrong nutrition can adversely affect the health of individuals. Be comfortable with counseling a patient with obesity, or significant weight loss. Dietary History Taking Nutrition plays a pivotal role in general health as well as many medical conditions causing significant morbidity. Doctors are expected to assist patients in meeting currently accepted dietary guidelines as well guiding healthy eating habits and identifying major nutritional deficiencies. A. The Indications for taking a dietary History: Nutrition questions/history should be routinely incorporated into general history taking but particularly in Patients who have lost weight (greater than 10% or more) Malnourished patients, including alcoholism The elderly Obese patients Patients on drugs e.g., Steroids, Immunosuppressives Malabsorption States People leading a sedentary lifestyle/ no regular form of physical exercise. Worthwhile to assess the nutritional status of patients following major surgery, infection or trauma. B. The Effects of Poor Nutrition translates into Poor immune response to infection Easy fatiguebility Alterations in reproductive function Poor Wound healing Disturbances in psychological function.

2 C. Methods for Assessing a Dietary History Questionnaire (Interview Form) frequency of consumption of particular types of foods.. 24 hr. Recall a recall of all food consumed over the previous 24 hrs. Usual Diet Intake a collection of data of food consumed in a typical day. Food Log All food, beverages and snacks consumed over the previous week. History Taking Relevant questions to ask in taking a Dietary History: Current health status Changes in appetite/reduction in the intake of food. Clothes that don t fit the person anymore (weight loss) Physical and psychological disturbances that could contribute to weight loss Social History: o Intake of alcohol, including quantity o Physical Activity, daily exercise pattern o Occupation (sedentary) o Education status (knowledge of food preparation) o Economic Status (finance and availability of sweets/snacks) Family History of o cancer, diabetes, cardiac disease, hypertension and Obesity. o Health status of parents, siblings, children, etc Past Medical History o Any significant acute/chronic illness o Food allergies o Any previous history of special diets Drug History o O.T.C. drugs, prescription drugs, vitamin and mineral supplements

3 Nutritional History Taking in a Child Ask about the type of milk given, frequency of feeds, quantity, other sources of nutrition. When were solids introduced? Does the child consume foods prepared for the rest of the family Are any foods avoided and why? Indications for Referral to a Dietitian Patients with acute/chronic disorders who require complex dietary Changes..

4 SAMPLE NUTRITIONAL HISTORY Nutrition History 1. How many meals and snacks do you eat each day? Meals Snacks 2. How many times a week do you eat the following meals away from home? Breakfast Lunch Dinner What types of eating places do you frequently visit? (Check all that apply) Fast-food Restaurant Diner/cafeteria Other 3. On average, how many pieces of fruit or glasses of juice do you eat or drink each day? Fresh fruit Juice (8 oz cup) 4. On average, how many servings of vegetables do you eat each day? 5. On average, how many times a week do you eat a high-fiber breakfast cereal? 6. How many times a week do you eat red meat (beef, lamb, veal) or pork? 7. How many times a week do you eat chicken or turkey? 8. How many times a week do you eat fish or shellfish? 9. How many hours of television do you watch every day? Do you usually snack while watching television? Yes No 10. How many times a week do you eat desserts and sweets? 11. What types of beverages do you usually drink? How many servings of each do you drink a day? Water Juice Soda Diet soda Sports drinks Iced tea Iced tea with sugar Milk: Whole milk 2% milk 1% milk Skim milk Alcohol: Beer Wine Hard liquor FIGURE 1. Sample form for use in taking a nutrition history. Acknowledgements: American Family Physician. March 15, Taking a Nutrition History: A practical Approach for FamilyPhysicians Lisa Hark, P.H.D., R.D., Darwin Deen, J.R., M.D., M.S.

5 REFERENCES: 1. Taking a Nutrition History: A practical approach for Family Physicians American Family Physician. March15, Dietary Assessment UCLA Nutrition Education Website 3. Nutrition Clinic History Form University Health Sciences. 4. Clinical Medicine, Kumar and Clark, 5 th Edition.

DIABETES & HEALTHY EATING

DIABETES & HEALTHY EATING Food gives you the energy you need for healthy living. Your body changes most of the food you eat into a sugar called glucose. (glucose) Insulin helps your cells get the sugar