Dietary assessment in adults
- Barbara Olendzki, RD, MPH, LDN
Barbara Olendzki, RD, MPH, LDN
- Assistant Professor of Medicine
- UMass Medical School
Before discussing dietary change with patients, it is helpful to assess a patient's current eating habits. The goal of dietary assessment is to identify appropriate and actionable areas of change in the patient's diet and lifestyle.
Patients with complex dietary concerns should receive a comprehensive assessment by a dietitian. A complete assessment will examine multiple components, including the physical ability to digest eat, chew and swallow food, evaluation for food intolerances, ability to digest and absorb foods, evaluation for possible eating disorders and appetite fluctuations, unintentional weight loss or gain, taste changes, and skills and ability to comply with dietary lifestyle changes. These patients will require an in-depth, comprehensive consult by a dietitian or behaviorist to assist with the accomplishment of dietary and lifestyle changes .
Although complex patients may be referred to a dietitian for such an assessment, other patients can be adequately assessed in a primary care setting. This can be expected to take 5 to 15 minutes. This topic will discuss methods to assess a patient's diet and related behaviors in the primary care setting.
Specific dietary and nutritional counseling recommendations will depend on the patient's comorbidities and are discussed in the appropriate topics. As examples:
●Type 2 diabetes mellitus (see "Nutritional considerations in type 2 diabetes mellitus")
- Whited MC, Schneider KL, Appelhans BM, et al. Severity of depressive symptoms and accuracy of dietary reporting among obese women with major depressive disorder seeking weight loss treatment. PLoS One 2014; 9:e90361.
- Wansink B, van Ittersum K. Portion size me: downsizing our consumption norms. J Am Diet Assoc 2007; 107:1103.
- Olendzki BC, Ma Y, Hébert JR, et al. Underreporting of energy intake and associated factors in a Latino population at risk of developing type 2 diabetes. J Am Diet Assoc 2008; 108:1003.
- Olendzki BC, Ma Y, Schneider KL, et al. A simple dietary message to improve dietary quality: Results from a pilot investigation. Nutrition 2009; 25:736.
- Ma Y, Olendzki BC, Wang J, et al. Single-component versus multicomponent dietary goals for the metabolic syndrome: a randomized trial. Ann Intern Med 2015; 162:248.
- Feig DI. Sugar-sweetened beverages and hypertension. Future Cardiol 2010; 6:773.
- Stookey JD, Constant F, Gardner CD, Popkin BM. Replacing sweetened caloric beverages with drinking water is associated with lower energy intake. Obesity (Silver Spring) 2007; 15:3013.
- Katcher HI, Hill AM, Lanford JL, et al. Lifestyle approaches and dietary strategies to lower LDL-cholesterol and triglycerides and raise HDL-cholesterol. Endocrinol Metab Clin North Am 2009; 38:45.
- Illner AK, Nöthlings U, Wagner K, et al. The assessment of individual usual food intake in large-scale prospective studies. Ann Nutr Metab 2010; 56:99.
- Schusdziarra V, Hausmann M, Wiedemann C, et al. Successful weight loss and maintenance in everyday clinical practice with an individually tailored change of eating habits on the basis of food energy density. Eur J Nutr 2011; 50:351.
- Forster H, Walsh MC, Gibney MJ, et al. Personalised nutrition: the role of new dietary assessment methods. Proc Nutr Soc 2016; 75:96.
- Illner AK, Freisling H, Boeing H, et al. Review and evaluation of innovative technologies for measuring diet in nutritional epidemiology. Int J Epidemiol 2012; 41:1187.
- Olendzki BC, Procter-Gray E, Wedick NM, et al. Disparities in access to healthy and unhealthy foods in central Massachusetts: implications for public health policy. J Am Coll Nutr 2015; 34:150.
- DIETARY ASSESSMENT
- Estimating portion sizes
- Assessment options
- - Quick approach
- - 24-hour dietary recall
- - Food diary
- - Food frequency questionnaire
- Assessment tools
- - Forms
- - Websites
- - Applications for smart phones and computers
- BEHAVIORAL ASSESSMENT
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS