Individual Nutritional Assessment

Question 1

Diet history pros/cons

Answer 1

Adv:
Detailed
Overcome many of the limitations of other methods such as FFQ
Above to capture variability

Disadvantage:
Labour intensive (up to 2hrs)
Require trained dietitian/ nutritionist
Can overestimate intake compared to weighed food record

Question 2

Food frequency questionnaire

Answer 2

Aims to assess the frequency with which food groups are consumed during a specific time period
Originally designed to look at food consumption patterns
Consists of lists of foods with frequency of use response options. Many different FFQ available.
Useful for groups not individuals.
Useful in research

Question 3

FFQ pros/ cons

Answer 3

Advantage:
Obtains information on usual intake over a month or more, can self complete, easy to standardise

Disadvantage:
Information is semi quantitative. Relied on participant me more and honesty

Question 4

24 hour recall

Answer 4

Nutritionist/ dietitian asks for client to recall exact food intake during the past 24 hours or previous day
Multiple pass method increases accuracy

Question 5

24 hour recall pros/ cons

Answer 5

Adv:
Quick
Cheap
Readily standardised

Disadvantage:
Single recall does not provide information on “usual” intake- can be overcome by doing repeated 24-hour recalls over several days.
Relied on participant memory and honesty

Question 6

Weighed food record

Answer 6

Weigh all food and beverages consumed during a specific time period- usually 3-7 days most common.
Description of food, cooking method, brand name recorded, if eating out record a description of food

Question 7

Weighed food record pros/cons

Answer 7

Advantage:
Most precise method of estimating food/ nutrient intakes of individuals

Disadvantage: very time consuming, expensive if using supervision, high level of cooperation required, individual may change habits in response, may affect foods eaten at time due to difficulty of measuring

Question 8

Estimated food record/ diary

Answer 8

Record at time of consumption all food and drinks consumed in household measures for a specific period of time
Description of food, cooking method, brand name also

Question 9

Estimated food record/ diary pros/ cons

Answer 9

Adv: More people willing to take part as simpler, less disruption of normal eating, more accurate representation of usual intake.

Disadvantage:
Loss of precision in quantifying intake- can be partly addressed by providing measuring cups/ spoons, food models, ‘measuring’ pages or educating on quantities prior to record keeping

Question 10

Selecting a method

Answer 10

What do you want to know- 
Actual intake of individual
Average usual intake of group or individual
Proportion of population at risk
Usual pattern of food use 

Individuals- weighed food record, estimated food record, diet history

Group- FFQ, 24hr recall
Limitations- all methods rely on self report- many underestimate energy intake
24 hour recalls worse than food records

Question 11

Getting the info

Answer 11

What eaten/ when eaten
Macro/ micro nutrient intakes
Energy intake
Specific things- eg saturated fat intake for CVD risk
Target the diet history or 24 hour recall to retrieve the information you required
Interviewer should use open ended questions
Focus on info you needed
Pick up on cues

Question 12

Analysis of info

Answer 12

Core food group analysis
Ready reckoner
Food works
Nuttab

Question 13

Nutrient reference values

Answer 13

Recommended dietary intake (RDI) - derived from EARs
estimated average requirements (EAR)
Adequate intakes (AI)- used when EAR (and therefore RDI) cannot be determined because of limited or inconsistent data. Based on the main intake of the population known to not have a deficiency.
Suggested dietary targets (SDTs)
Upper limits (UL): The amount set to avoid toxicity or other symptoms
Estimated energy requirements (EER): the average amount of energy (kJ) predicted to maintain weight and good health for a health adult of a particular age, gender, weight, height and level of physical activity
Acceptable macronutrient distribution range (AMDR): the estimated range require for each macronutrient (expressed a s % contribution to energy) that would allow for an adequate intake of all other nutrients, whilst maximising general health.

Question 14

EAR (estimated average requirement)

Answer 14

A daily nutrient level estimated to meet the requirements of half the healthy individuals in a particular life stage and gender group

Question 15

RDI (recommended dietary intake)

Answer 15

The average daily dietary intake level that is sufficient to meet the nutrient requirements of nearly all healthy individuals in a particular life stage and gender group

Question 16

Adequate intake (AI)

Answer 16

The average daily nutrient intake level based on observed or experimentally determined approximation or estimates of nutrition intake by a group (or groups) of apparently healthy people that are assumed to be adequate

Question 17

EER (estimated energy requirements)

Answer 17

The average dietary energy intake that is predicted to maintain energy balance in a healthy adults of defined age, gender, weighted height and level of physical activity, consistent with good health.
In children and pregnant and lactating women, the EER is taken to include the needs associated with the deposition of tissues or the secretion of milk at rates consistent with good health

Question 18

UL (upper level of intake)

Answer 18

Highest average daily nutrient intake level likely to post no adverse health effects to almost all individuals in the general population
As intake increases above the UL, the potential risk of adverse effects increases

Question 19

Suggested dietary targets (SDTs)

Answer 19

The

Amount of a nutrient required to prevent or reduce the risk of chronic disease

Question 20

New in NRVs

Answer 20

Fibre
Carbohydrates for infants
Fats- essential fatty acids
Water
Vitamins- vitamin K, choline, pantothenic acid, biotin
Minerals- chromium, copper, fluoride; iodine, manganese, molybdenum, phosphorus

Question 21

Aus dietary guideline:

Guideline 1:

Answer 21

To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious food and drinks to meet your energy needs.

Children and adolescents should eat sufficient amounts of nutritious foods to grow and develop normally. They should be physically active every day and their growth should be checked regularly.
Older people should eat nutritious foods and keep physically active to help maintain muscle strength and a healthy weight

Question 22

Aus dietary guidelines:

Guideline 2

Answer 22

Enjoy a wide variety of nutritious foods from these five food groups every day:
Plenty of vegetables of different types and colours, and legumes and beans
Fruit
Grain foods, mostly whole grain and or high cereal fibre varieties such as breads,
Cereals, rice, pasta, noodles, polenta, could cous, lays, quinoa and barley
Lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/ beans
Milk, yoghurt, cheese and or their alternatives, mostly reduced fat
And drink plenty of water

Question 23

Guideline 3:

Answer 23

Limit intake of foods containing saturated fat, added salt, added sugars and alcohol

• limit intake of foods high in saturated fat- replace high fat foods which contain predominately saturated fats with foods that contain polyunsaturated and monounsaturated fats.
• limit intake of foods and drinks containing added salt
• limit intake of foods and sugars containing added sugars
• limit intake of alcohol.

Question 24

Guideline 4 and 5

Answer 24

4: encourage, support and promote breastfeeding
5: care for your food, prepare and store it safely

Question 25

New NRVs and DG suggestions:

Answer 25

6-9 serves of cereals 
6 serves of veg 
2-3 serves of fruit 
2-3 serves of dairy
2.5-3 serves of meat 

15-25% from protein
45-65% from carbohydrate
20-35% from fats with no more then 10% from saturated fats

Question 26

Diet history

Answer 26

Attempts to estimate the usual food intake and meal pattern of individuals over a relatively long period of time (often a month)
Originally interview, now also computer and paper versions.
Traditionally 3 parts:
1. Interview about usual eating habits, eg what is the first thing you eat in the morning
2. Cross check of frequency usually from a checklist
3. 3- day estimated food record - (now often omitted)