Lesson 4 Upload

• Food Recall

  Method of collecting information on food intake wherein trained researchers/interviewers ask the respondent or sample subject to recall all food eaten and the amount consumed for the past 24 hours, starting from wake-up time in the morning until sleeping time at night, including in-between meals and midnight snacks
• Nutritional Assessment


  Interpretation of anthropometric, biochemical (laboratory), clinical and dietary data to determine whether a person or groups of people are well nourished or malnourished (over-nourished or under-nourished)
• Nutrition Intervention


  The process the nurse then selects the nutrition intervention that will be directed to the root cause (or etiology) of the nutrition problem and aimed at alleviating the signs and symptoms of the diagnosis
• Nutrition Monitoring/Evaluation

  The final step of the process is monitoring and evaluation, which the RDN uses to determine if the client has achieved, or is making progress toward, the planned goals
• Nutritional Status or Nutriture


  The degree to which the individual's psychological need for nutrients is being met by food she or he eats. It is the state of balance in the individual between the nutrient intake and the nutrient expenditure or needs
• Nutritional Survey


  An epidemiological investigation of the nutritional status of the population
• Nutrition and Dietetics Law of 2016 was enacted to regulate and standardize the practice of nutrition and dietetics in the Philippines, with a provision on Medical Nutrition Therapy (MNT) through the application of Nutrition Care Process (NCP) for purposes of disease prevention, treatment, and management
• Nurse's role


  • The nurse usually the first person who sees and observes the patient's eating problem, has direct communication with the patient on how well the patient's eats his food, on what kinds and amounts of food are refused, is responsible for the patient's attitude towards his food readily determined and must have knowledge in diet therapy (food allowed / restriction), should immediately forward the diet prescription to the dietary department and makes sure that the patient is ready to consume the food served on the tray
• Nurse's actions


  Listens and shows his/her general interest and understanding of the patient, helps the patient express his/her feelings, learned from the patient some of his/her favorite foods and dislikes, explains concerns on foods that cannot be eaten due to ethnic, cultural background and religious beliefs and becomes aware of what concerns the patient may have about the diet he will have at home, reports and documents and chart all the problems related to food intake
• Nutrition Care Process

  A systematic approach to providing high quality nutrition care, consisting of four distinct, interrelated steps: nutritional assessment; nutritional diagnosis; nutritional implementation; and nutritional monitoring and evaluation
• Nutritional Screening

  Rapidly identifies patients at high nutritional risk
• Nutritional Assessment


  Defines a patient's nutritional status, defines clinically relevant malnutrition and monitors changes in nutritional status
• Essential components of an adequate diet

  • Milk Group - provides most of the calcium requirements
  • Meat Group - provides generous amounts of protein in high quality
  • Bread and Cereal Group - furnishes carbohydrates, minerals and vitamins at a relatively at low costs
  • Vegetable-Fruit Group - important supplier of fiber, vitamins and minerals particularly Vitamin A and C
• Dietary History and Intake Data

  1. 24 Hour Recall - patient or individual completes a questionnaire or maybe an interview asking to recall everything that he or she ate within the last 24 hours

  2. Food Frequency Questionnaire - patient answers the questionnaire for frequency of food use as accurately as possible

  3. Dietary History - contains additional information about the patient's income, physical activity, ethnic and cultural background, influences on eating habits and religion, home life and meal patterns, factors that affect appetite, allergies, intolerances, food avoidance, dental and oral problems in eating, gastrointestinal problems, chronic diseases, dietary modifications and medication
• Ethnic and Religion

  • Christianity - practices holy week observances may restrict meat (Good Friday)
  • Seventh Day Adventist - do not eat pork and shellfish, do not drink alcohol, and encourages vegetarian diet
  • Judaism - do not eat pork, shellfish, blood products, mixing of milk or dairy products with meat in one meal, Kosher diet, no cooking during Sabbath day (Saturday)
  • Mormon - no alcohol, tobacco and caffeine
  • Islam - no pork (Haalal diet), no alcohol, caffeine, practices Ramadam (fasting from sunrise to sunset of the month)
  • Hinduism - all meats are prohibited
• Food Avoidance

  • Phenylalanine (EAA) - low protein diet to avoid imbalance of brain amino acids in Phenylketonuria
  • Purine - that needs to be avoided to reduce uric acid producing foods in gouty arthritis and hyperurecemia
  • Tyramine - is a high protein foods that underwent protein breakdown by aging, fermentation and smoking
  • Avoid Gluten intake - which is a protein found in wheat, rye, barley, and other starchy foods, except rice and corn in Celiac Disease
• Medications

  • Monoamineoxidase Inhibitors (MAOI) - an antidepressants, that must be to avoid tyramine containing foods like alcoholic beverages, dairy products, avocado, banana, meats, chocolates and condiments causes hypertensive crisis
  • Warfarin Sodium (Coumadin) - is an anticoagulant, avoid or instruct the patient to decrease intake of green leafy vegetables
  • Methimazole (Tapazole) - is an anti-thyroid, uses for Hyperthyroidism, inhibits synthesis of thyroid hormone by interfering with iodine. Teach the client to avoid seafood and iodine products
  • Estrogen Replacement Therapy (HRT) - that manages menopausal symptoms in women. Estrogens increase risk of cardiovascular disease and cancer so instruct the patient to AVOID or reduce alcohol, caffeine and smoking
• Food Diary or Record


  This method involves time, understanding and motivation on the part of the patient as she or he writes down everything he or she eats or drinks for a certain period of time
• Observation of Food Intake


  The most and accurate method of dietary intake assessment, because it requires knowing the amount and kind of food presented to the patient and record the amount actually eaten
• Nutrient Intake Analysis


  The process of determining the nutritional content of foods and food products, can be performed through a variety of certified methods
• General rules for menu planning

  • Use the whole day as a unit rather than the individual meal
  • Use some food from each of the food groups daily (energy giving foods, body building foods and body regulating foods)
  • Use some raw fruits or vegetables at least once a day
  • Plan to have for each meal at least one food with staying power or high in satiety value
  • Combine or alternate bland form with those of a more pronounced flavor
  • Combine and alternate soft and crisp foods
  • Have a variety of color, food and food arrangement
  • When more foods are served at one meal, decease the size of portions and use fewer rich foods
  • Meal or menu patterns are helpful in planning menu but consider the family's habits and needs. The traditional recommended patterns for breakfast like fruit, egg or substitute, bread or rice, hot beverage and for lunch and dinner: meat, fish and poultry, rice, vegetable and fruit or dessert
  • It is best to have a weekly menu plan
• Methods of assessing nutritional status

  • Direct - Deals with individuals and measures the objective criteria
  • Indirect - Uses community health indices reflecting nutritional influences
• Direct assessment

  1. Clinical Examination - Advantages as more coverage in a short time, inexpensive, no sophisticated equipments, Disadvantages as non-specificity of signs, overlapping of deficiency states and bias of the observer, System of collecting data starts from the head to toe (cephalocaudal), Establishing database, Methods of Collecting Data - Interview and Obeservation (IPPA), Sources of Data - Primary (Patient) and Secondary (Family Members, Significant Others, Health team members and Chart)

  2. Biochemical Examination - Estimation of enzyme activity or blood composition; tests samples are blood and urine and results generally compared to standards with advantages as objectivity and can detect easily states of nutritional deficiency and disadvantages as costly and time consuming
• Indirect assessment


  • Food Consumption Studies
  • Studies On Health Condition And Vital Statistics
  • Studies On Food Supply Situation
  • Studies On Socio-Economic Conditions
  • Studies On Cultural And Anthropological Influences
• Anthropometric Measurement


  The measurement of the variations of the physical dimensions and gross composition of the human body at different age levels and degrees of nutrition
• Anthropometric measurements

  • Weight
  • Height
  • Body mass index (BMI)
  • Body circumference (arm, waist, hip and calf)
  • Waist to hip ratio (WHR)
  • Elbow amplitude
  • Knee-heel length
• Weight for age


  Uses weighing scale, assesses body mass by computing the body mass index with formula of weight in kg over height in meter squared in kg/meter squared
• Height for age


  Uses statiometer, an anthropometric steel rods fixed accurately and vertically to the wall
• Anthropometric measurement


  Measurement of the variations of the physical dimensions and gross composition of the human body at different age levels and degrees of nutrition
• Anthropometric measurements

  • Weight
  • Height
  • Body mass index (BMI)
  • Body circumference (arm, waist, hip and calf)
  • Waist to hip ratio (WHR)
  • Elbow amplitude
  • Knee-heel length
• Weight for age

  1. Uses weighing scale

  2. Assess body mass by computing the body mass index with formula of weight in kg over height in meter squared in kg/meter squared
• Ideal BMI

  18.5 to 24.9 range
• Height for age


  Uses statiometer, is an anthropometric steel rods fixed accurately and vertically to the wall
• Weight for height/length

  1. Most accurate indicator of present state of nutrition

  2. Expression of leanness or wasting

  3. Formula of desirable body weight is equal to height in centimeter minus 10%
• Skin fold thickness


  Measured with reliable caliper
• Ideal and healthy waistline

  For women – <31 inches<|>For men – <35 inches
• Waist Circumference


  Accurate measure of the amount of visceral fat (CENTRAL OBESITY)
• Body composition

  Proportion of fat and non-fat mass in the body<|>Healthy body composition includes a lower percentage of body fat and a higher percentage of non-fat mass, which includes muscle, bones, and organs
• Three body types

  • Ectomorphs – long and lean, with little body fat, and little muscle
  • Endomorphs – big, high body fat, often pear-shaped, with a high tendency to store body fat
  • Mesomorphs – muscular and well-built, with a high metabolism and responsive muscle cells
• Benefits of having a good body composition

  • Decreased risk of type 2 diabetes, hypertension, and heart disease
  • Increased functional ability, allowing us to move and exercise more freely, which allows us to burn more calories
  • Better calorie-burning metabolism throughout the day
  • A lean and toned body