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Diet-related disease > Methods for assessing nutritional status > Flashcards

Methods for assessing nutritional status Flashcards

Topic 2 on moodle

1
Q

Why would public health be interested in dietary assessment?

A

to evaluate the adequacy and safety of the food people eat

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2
Q

Why would dietary assessment be important from a clinical prospective?

A

To assist in diagnosis and treatment of diet related diseases

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3
Q

Why is dietary assessment important of research?

A

to study associations between food intake and disease

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4
Q

Why is it difficult to assess habitual diet?

A

Because diet varies so much depending on life stage, season, work or health and there is not a method that can measure diet without error

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5
Q

What does a reliable method mean?

A

when you repeat the experiment the repeated results will all be close to each other.

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6
Q

What does an accurate measure mean?

A

how close the measured result is to the actual result

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7
Q

What does a valid measure mean?

A

how good the method is at actually measuring what it is meant to measure

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8
Q

What is the problem with looking at domestic food production in dietary assessment?

A

no country is completely self-sufficient so looking at domestic food report alone will not be fully representative of national diet.

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9
Q

Who produces the food balance sheet?

A

the Food and Agricultural Organisation of the United Nations Statistics Division (FAOSTAT)

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10
Q

What is the food balance sheet?

A

It can provide a complete and comprehensive picture of the pattern of a countries food supply. Food produced plus food imported, minus food exported then adjust for any changes in stocks will give you a total that can be divided by the number of people in the population to give a per capita supply figure that is representative of nation diet.

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11
Q

How can you look at household food purchases?

A

by utilising the National Food survey (NFS) organised by the Ministry for Agriculture, Fisheries and Food (MAFF)

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12
Q

How does the national food survey work?

A

by getting one person in the house to collect info on foods purchased over a 7-day period.

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13
Q

What was the National Food Survey renamed to?

A

Living Cost and Food Survey (LCF)

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14
Q

What does the Living Cost and Food Survey (LCF) involve?

A

a comprehensive household questionnaire, individual questionnaire for each adult over 16, a personal expenditure diary kept by everyone over 2 weeks and a simplified diary kept by children aged 7-15.

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15
Q

What are the prospective methods for looking at individual food consumption?

A

Food diaries and chemical analysis of duplicate diets

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16
Q

What are the retrospective methods for looking at individual food consumption?

A

diet history, FFQ and 24-hour recall.

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17
Q

What 4 things do you need to carry out a food diary?

A

Record books, scales, personnel to collect the data and a computer analysis package

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18
Q

What should you tell or not tell participants completing a food diary?

A

Stress that is is usual diet that is being looked at and do not say what nutrient is being looked at

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19
Q

What is the most accurate method of dietary assessment in free-living individuals?

A

Food diary

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20
Q

How can food diary validity be improved?

A

by randomising study days across a variation of conditions to help eliminate bias. For example, a mix of week days and weekends, different seasons and different stages of the menstrual cycle.

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21
Q

How can reliability of food diary be improved?

A

By increasing the number of days it is carried out for

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22
Q

What are the limitations of using a food diary?

A

It is unsuitable for those who find it difficult to write and it requires a high degree of cooperation

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23
Q

Why might volunteers to record a food diary not be representative of the whole population?

A

Those who volunteer may be more health or diet conscious

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24
Q

What is good about using a food diary?

A

It doesn’t rely on memory or errors in estimating portion size

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25
Q

What are some of the errors associated with using a food diary?

A

coding errors (misreading someone’s dietary input), variation of intake over time and people altering their diet due to the diary

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26
Q

How can you find out food diary under-reporters?

A

use doubly- labelled water to measure EE and compare that to the EI from the food diary and when you have taken into consideration any changes in weight you can find any under-reporters.

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27
Q

How does chemical analysis of duplicate diet work?

A

subjects weigh and record food consumption at time of eating and put aside a duplicate portion that gets sent into a lab to be specially analysed for energy and nutrient content

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28
Q

What is good about chemical analysis of duplicate diet?

A

avoids errors associated with food tables (exact food not being found there or substitutes with different nutrient profiles needing to be used)

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29
Q

What are the negatives about chemical analysis of duplicate diet?

A

it is expensive, time-consuming and there is no guarantee that you will be able to get an exact replicate.

30
Q

What is a diet history?

A

When a subject is interviewed to obtain info on their food intake over a long period of time. It can look at current, recent or distant past, seasonal or whole year diet.

31
Q

What are the positives with diet history?

A

It may help to identify food patterns associated with deficiency so is used mainly in a clinical setting

32
Q

What are the negatives associated with diet history?

A

There may be a strong observer effect because if they know they are being assessed on diet they may not want to reveal all of their diet or exaggerate certain parts of the diet if there is a health professional present

33
Q

How does a 24 hour diet recall work?

A

This is an in-depth interview with a trained interviewer. The subject is interviewed to obtain information on food and drink consumed in the previous 24 hours

34
Q

What should the interviewer carrying out the 24 hour recall do?

A

They should avoid asking specific questions about meals and snacks as not everyone eats three set meals a day

35
Q

Why is a 24 hour diet recall a good method of dietary assessment?

A

it requires a relatively low level of subject commitment, relatively inexpensive and will not alter someone’s eating behaviour as they have already eaten

36
Q

What are the problems with 24 hour diet recall?

A

there may be problems with memory errors, quantification of portion size, may not be representative of normal diet or diet may be modified by participant to make it sound better.

37
Q

What are the 4 steps to the multiple pass system for 24 diet recall?

A

The first stage is to get a complete list of food and drinks consumed over 24 hours. Second, get a more detailed description including any brand names or cooking method. Third, estimate quantities of each food and final pass review all info given and add in any supplements used.

38
Q

What are FFQs?

A

FFQ’s collect qualitative, descriptive data for a long period habitual diet but it can be semi-quantitative if measures are added. It consists of a food list with foods that are significant sources of the nutrients of interest

39
Q

How is the response section of a FFQ organised?

A

To have continuous frequency categories with no gaps or overlaps. You can have 5-10 categories from ‘never’ to ‘more than 6 a day’

40
Q

What is good about FFQs

A

helpful in epidemiological studies where subjects can be ranked into broad groups based on intake and can reach a large number of people.

41
Q

What are the limitations of FFQ?

A

relies on memory, estimation of portion size and food composition tables andit can be easy to overestimate intake when you have a large number of food items in the survey so try and keep the food list no bigger than it needs to be.

42
Q

What are some problems with food composition tables?

A

There is a wide range of foods available but the foods should be relevant to the population you are looking at and updated regularly andthere can be missing information where nutrient amounts are not known, not all foods will be included and it does not account for different biological variants of the same food.

43
Q

Example of food comp table?

A

Prof. McCance and Dr Widdowson 7th edition food composition tables

44
Q

Example of ref for FFQ validity?

A

Statistical approaches for assessing the relative validity of a food-frequency questionnaire: use of correlation coefficients and the kappa statistic by L.F. Masson et. al. Oct 2002

45
Q

SDG for calories?

A

Reduction in cal intake by 120kcal/day/person

46
Q

SDG for fruit and veg?

A

Average intake of fruit and veg to reach at least 5 portions a day (>400g/day)

47
Q

SDG for oily fish?

A

Consumption to increase to at least 1 portion (140g) per person per week

48
Q

SDG for red meat?

A

Intake of red and processed meat to be pegged at 70g a day

49
Q

SDG for fat?

A

Average intake of total fat reduce to less than 35% of energy, average SFA intake to reduce to less than 11% of energy and average TFA intake to reduce to less than 1% of energy

50
Q

SDG for free sugars?

A

Average intake to not exceed 5% of energy in adults and children over 2 years

51
Q

SDG for salt?

A

Reduce into to no more than 6g/day

52
Q

SDG for fibre?

A

Increase average intake of fibre to 30g/day

53
Q

SDG for total carbs?

A

Average intake to equal 50% of total energy

54
Q

What did the LCFS find in relation to SDG?

A

no change in fruit, vegetable, fibre and oily fish consumption from 2001-2015 with the least deprived groups in society being the highest consumer of those dietary components. The amount of red meat, SFA and TFA has decreased over the 15 years

55
Q

What surveys look at monitoring eating and health every year?

A

NDNS and Scottish health survey

56
Q

Why is it important to carry out dietary surveys?

A

To know average intakes and to assess if population are meeting dietary goals and adequacy of diet

57
Q

What further research was suggested when the LCFS looked at SDT in 2004

A

Research into intake of NMES and sodium

58
Q

What are the main differences and similarities between SDT and SDG?

A

SDG included calorie goals to tackle obesity, got rid of bread recommendations as that directly relates to how much salt people are consuming and SDGs included advice on red meat consumption following significant research into its effects on colorectal cancer

59
Q

How much of all food and all food and drink is wasted according to a government survey?

A

17% and 15%

60
Q

Which foods are most likely to be wasted?

A

Bread at 32% and veg at 24%

61
Q

What did analysis of SDG for energy show, and in relation to SIMD?

A

Increase in energy density of food from 2001-2015 but no difference in deprivation groups

62
Q

What did analysis of SDG for fruit and veg show, and in relation to SIMD?

A

Intake stayed the same with the least deprived having a higher intake

63
Q

What did analysis of SDG for oily show, and in relation to SIMD?

A

Intake stayed the same, still far too low but least deprived have the highest intake

64
Q

What did analysis of SDG for red meat show, and in relation to SIMD?

A

Intake decreased and we are meeting goal

65
Q

What did analysis of SDG for sat fat and sugar show, and in relation to SIMD?

A

Both decreased but are still too high and no difference across groups

66
Q

What did analysis of SDG for fibre show, and in relation to SIMD?

A

Intake stayed the same with the least deprived group eating more.

67
Q

What did NDNS find in relation to sugar intake?

A

Sugar intake was looked at in different groups and no age group was meeting target of <5% of total energy in 2016 with most mean intakes being 10-14%.

68
Q

What did the 2016 Scottish Health survey find in relation to national BMI?

A

Average rose to 27.7. 65% of adults overweight and 29% of those are obese.

69
Q

What did the 2016 Scottish Health survey find in relation fruit and veg intake?

A

Lowest average intake was in those who were aged 16-24 with a mean daily intake of 2.5 portions a day. The proportion of people eating 5 portions a day was lowest in >75’s with just 14% and 22% of 16-24s that ate 0 portions a day. Overall mean no. of portions eating a day ranged from 2.5-3.4.

70
Q

What did the 2016 Scottish Health survey find in relation to alcohol consumption?

A

Male drinkers are 2x more likely to drink over 14 units a week and percentage people not drinking increased from 11-16%

Diet-related disease (2 decks)

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