Module 8 Lecture 1 Principles of Nutrition Assessment in Athletes Flashcards
The nutrition care process model
pre: screening & referral system
2. nutrition assessment & re-assessment
2. Nutrition diagnosis
3. Nutrition intervention
4. Nutrition monitoring & evaluation
post: outcomes management system
screening and referral system of the NCP
- identify risk factors
- use appropriate tools and methods
- involve interdisiplinary collaboration
nutrition assessment & re-assessment of the NCP
- obtain/ collect important and relevant data
- analyze/ interpret collected data
Nutrition diagnosis
PES
* P - identify problem
* E - Determine etiology/ cause
* S - state signs and symptoms
Purpose of nutrition assessment
to collect and interpret relevant client information to identify:
* If the athlete is at risk for malnutrition and, if so, why
* The potential to positively influence sport performance through dietary changes (sometimes just need to be told they are doing the right thing
Why is the nutrition assessment important?
gives you the evidence you need to know how to care for the athlete you’re working with
What determines the athletes NCP
Assessment data, not the athlete’s preferences or wishes, determine the nutrition care plan.
* What they want and the data might not match up such as want to cut calories but assessment says they are under a normal weight range already
the condition that occurs when the body’s requirements for one or more essential nutrients is not met.
malnutrition
common causes of malnutrition
- Inadequate or unbalanced diet
- Problems with digestion or absorption
- Certain medical conditions
relationship between starvation and malnutrition
starvation is a form of malnutrition
Relationship between appearance and malnutrition
You can appear healthy and be malnourished - cannot tell by looking at them
* starvation
* obesity: overnutrition but lack of certain nutrients
* athletes can be malnourished
Why is it dangerous to assume that athletes are all healthy?
If we assume people are healthy, there is a risk that preventable or treatable illness will be missed or discounted.
* lack of health assessmnet skills
* lack of understanding of health history
* lack of awareness of risk
* Ex. Capati vs. crunch & Sergi Grinkov, figure skater
What is an important aspect of nutrition assessment?
Critical Thinking
* Determine appropriate data to collect and selecting valid and reliable tools
* Distinguish relevant from irrelevant data
* Select appropriate norms and standards for comparing the data
* Organizing and categorizing the data in a meaningful way that relates to the nutrition concerns of the client
* Identifying the absolute base nutrition issue (versus issues that are symptoms more than the base issue)
By the end of the nutrition assessment process you must be able to say, with confidence:
- What the athlete’s specific nutrition-related concerns
- Why you know these are the concerns (evidence)
- What you need to do to correct or optimize the athlete’s nutritional health
Elements of the nutrition assessment
- Personal Health, Sport and Social History
- Dietary Assessment
- Body Weight and Composition Assessment
- Assessment of Energy Expenditure
- Fitness assessment
goal of Personal Health, Sport and Social History
Determine a client’s level of health risk
key elements of Personal Health and Sport History
- Demographic Information (Name, age, height, weight, gender)
- Family and personal history of disease or health concerns (including allergies)
- History of illness and injuries
- Surgical history
- Menstrual history (for females)
- Medication and supplement use
- Detailed information on their level of sport participation (Type, frequency, duration, intensity; Goals of sport participation)
key elemental of social history
- Socioeconomic status, social and medical support, cultural and religious beliefs, housing situation, and social isolation/connection
- Others involved in their Circle of Care ( formal consent to communicate with others in the Circle)
- Age, occupation, role in family, and education level
- Who is responsible for shopping for food, cooking, etc.
Lab Values of Interest for Athletes
- Blood lipid levels (Tchol, LDL, HDL, VLDL, LDL/HDL ratio, TG)
- HbA1c% (higher in diabetes)
- Blood Glucose (higher in diabetes)
- Urine Protein
- Urine Glucose
- BUN
- Serum Creatinine
- Albumin
Body Weight and Composition Assessment
- Current (Usual) Weight
- Ideal/optimal weight for sport (room for variation)
- Weight history
- body comp. measures (if accessible)
why is it important to get weight history>
Has weight changed? If so, in which direction and over what period of time
* The larger the magnitude of weight change over the shorter duration of time = increased risk for malnutrition
% Usual Body Weight =
Categories of Percent Usual Body Weight
Problem with % usual body weight measurement
Does not tell you how long it took to change
What does the importance of % weight change depend on?
The importance of this change will depend on the time over which it occurred
* And the population
% recent weight change =
How does weight change occur in adolescence?
weight/height should be increasing
* if stable this is a concern
What standards are widely used to assess significant weight changes in adults?
How does weight differ with sport?
some sports more advantageous to be heavy or light
* depends on sport
* depends on gender
NFPE
Nutrition Focused Physical Exam (findings)
includes a review of key physical areas related to nutrition.
Nutrition Focused Physical Exam
* clinical exam
What is included in NFPE
At minimum all athlete’s should have a visual examination and look at the athlete’s physical condition:
* Hair
* Skin (Colour, texture, integrity)
* Nails
* Muscle and Fat Mass
* Dentition/mouth teeth
* Eyes.
Dietary Assessment Methods
- 24 h recall
- food frequency questionarre
- food records
respondant burden
how much work the client has to do for dietary assessment
Components of Dietary Assessment
Includes foods and quantities eaten, eating habits, accessibility of food, and cultural and socioeconomic factors that effect selection of food. Details matter!!!
* Portion sizes
* Brand names
* Eating times
What is the 3 pass method for dietary assessment?
- pass 1 - when and what (general)
- Pass 2 - portion sizes
- Pass 3 - things often forgotten (items in or on things)
A nutrition diagnosis statement that identifies what nutrition problem the sport dietitian is working to improve.
PES statement
1. Problem (P)
2. Etiology (E)
3. Signs or symptoms (S)
What might be the best way to work with PES
Nutrition diagnoses can often be identified by working the PES Statement process backwards before writing it forwards:
* Signs and Symptoms
* Etiology
* Problem
Why is clinical documentation important when developed a NCP?
legal protection
* Sport dietitians chart the care provided to athletes exactly as they would the care provided to any other individual
What should be included in documentation?
- Formal, written account of the nutrition assessment and the data that was considered.
- PES statement(s).
- Intervention/Plan
- Monitoring
How should documentation be stored?
Must be stored per current regulatory requirements.
* documentation is confidential
* locked
* kept for 7 years
Why is keeping an open mind important?
Without keeping an open mind, the sport dietitian risks anchoring on early information and not asking enough questions to get to this athlete’s absolute base issue.
