Assessment of Nutritional

Status
HND 406 3(2-1)
(Nutritional Assessment Methods: Dietary Assessment)
 Dietary Assessment
 A diet history is perhaps the best means of obtaining dietary
intake information and refers to a review of an individual’s
usual patterns of food intake and the food selection variables
that dictate the food intake.

 Dietary intake data may be assessed either by collecting

retrospective intake data (e.g., a 24- hour recall or food
frequency questionnaire)
OR
 By summarizing prospective intake data (e.g., a food record
kept for a number of days by an individual or the caretaker).
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 Each method has specific purposes, strengths, and weaknesses.

 The choice of data collection depends on the purpose and

setting, but the goal is to determine the food and nutrient
intake that is typical for that individual.

Methods are
1. Food Record/Food Diary
2. Food Frequency Questionnaire
3. 24-hour Dietary Recall
Food Record

 A daily food record, or food diary, involves documenting dietary

intake as it occurs and is often used in outpatient clinic settings.

 The food diary is usually completed by the individual client. A

food diary or record is usually most accurate if the food and
amounts eaten are recorded at the time of consumption,
minimizing error from incomplete memory or attention.

 The individual’s nutrient intake is then calculated and averaged at

the end of the desired period, usually 3 to 7 days, and compared
with dietary reference intakes (DRIs) or personalized dietary
recommendations for disease management or prevention.
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Food Frequency Questionnaire
 The food frequency questionnaire is a retrospective review of intake
based on frequency (i.e., food consumed per day, per week, or per
month).

 For ease of evaluation, the food frequency chart organizes foods into
groups that have common nutrients. Because the focus of the food
frequency questionnaire is the frequency of consumption of food
groups without portion sizes, the information obtained is general, not
specific, and cannot be applied to certain nutrients.

 During illness, food consumption patterns can change, depending on

the stage of illness. Therefore it is helpful to complete food frequency
questionnaires for the period immediately before hospitalization or
before illness to obtain a complete and accurate history.
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 Other types of questionnaires can collect semiquantitative

information by including portion sizes as well. This
information helps pinpoint foods and food groups, and
therefore nutrients, that may be excessive or deficient in
the diet.

 When used with the usual intake or 24-hour recall

approach, the food frequency questionnaire enables the
assessor to double-check the accuracy of the information
obtained.
24-hour Recall

 The 24-hour recall method of data collection requires individuals to

remember the specific foods and amounts of foods they consumed
in the past 24 hours.

 The nutrition professional asks the person to recall his or her intake
using a specific set of questions to gain as much detailed
information as possible.

 For example, when told that the person had cereal for breakfast, the
nutritionist may ask, “What kind of cereal?” The next question
may be, “How much did you have?” at the same time that the
person is being shown a bowl or measuring cup to jog the memory
on portion size.
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 Problems commonly associated with this method of data collection

include

(1) an inability to recall accurately the kinds and amounts of food eaten,

(2) difficulty in determining whether the day being recalled represents an

individual’s typical intake or was exceptional, and

(3) the tendency for persons to exaggerate low intakes and underreport
high intakes of foods.

Concurrent use of food frequency questionnaires with 24-hour recalls or

food diaries (i.e., doing a cross-check) improves the accuracy of dietary
intake data