1. Nutritional Assessment and
Dietary Planning
Chapter 2

2. What Do We Mean by
“Nutritional Status”?
• Nutritional status
• Undernutrition
• Too little of a nutrient
• Nutritional toxicity
• Malnutrition
• Primary
• Secondary
• Nutritional adequacy

3. Nutrient Intake Largely Determines
Nutritional Status & Contributes to
Health

4. How Is Nutritional Status
Assessed?
• Critical during times of growth and
development
• ABCD methods of nutritional assessment
• Anthropometry
• Physical dimensions and composition
– height, weight, circumferences
– Body composition

5. How Is Nutritional Status
Assessed?
• ABCD methods of nutritional assessment
• Biochemical measurements
• Blood and urine
– Biological markers
• Clinical assessments
• Medical history
• Visible signs of illness
• Symptoms of disease or malnutrition

6. How Is Nutritional Status
Assessed?
• ABCD methods of nutritional assessment
• Dietary assessment
• Retrospective dietary assessment
– 24-hour recall
– Food frequency questionnaire
• Prospective dietary assessment
– Diet record
• Tools
• Food composition tables & dietary analysis
software

7. How Much of a Nutrient is
Adequate?
• Dietary Reference Intakes (DRIs)
• United States and Canada
• Influential factors
• Sex, life stage, genetics, medications, lifestyle
choices, and environmental influences
• Nutrient requirement
• DRIs are estimates in a healthy population

8. Dietary Reference Intakes (DRI)
Standards

9. How Much of a Nutrient is
Adequate?
• Estimated Average Requirements (EARs)
• Meet requirements of half the healthy
individuals in each life stage and sex
• There are not EAR values for all nutrients
• Inappropriate to use EAR for individuals

10. How Much of a Nutrient is
Adequate?
• Recommended Dietary Allowances (RDAs)
• Nutrient-intake goals for individuals
• 97% of healthy individuals in specified life stage
and sex
• Purposes
• Prevent nutrient deficiencies and promote
optimal health
• Built in safety margin
• Can only be established for nutrients with EARs

11. EARs Compared with RDAs

12. How Much of a Nutrient is
Adequate?
• Adequate Intake (AI)
• Nutrient intake goals for individuals
• Lack of research to support RDA because not
EAR
• No RDAs for infants 0 to 6 months of age; only
AIs

13. How Much of a Nutrient is
Adequate?
• Tolerable Upper Intake Levels (UL)
• Highest level of usual daily nutrient intake likely
to be safe
• Not all nutrients have an UL
• Insufficient research

14. Using EARs, RDAs, and ULs to
Assess Dietary Adequacy

15. How Much of a Nutrient is
Adequate?
• Evaluating energy intake
• Estimated Energy Requirements (EERs)
• Mathematical equations
• Age, sex, weight, height, and physical activity
level
• Acceptable Macronutrient Distribution Ranges
(AMDRs)
• Distribution of energy sources
• Current recommendations

16. Effects of Age and Activity Level
on EERs

17. How Can You Easily Assess and
Plan Your Diet?
• USDA Food Patterns
• Categorization of
foods into groups
• Currently 5 groups
• Dietary Guidelines
for Americans
• Revised every 5
years
• MyPlate

18. How Can You Easily Assess and
Plan Your Diet?
• 2010 Dietary Guidelines for Americans
• Two important facts
• Diet and physical activity
• Acquisition of adequate food
• Overarching goals
• Maintain energy balance over time
• Focus on consuming nutrient-dense foods
• Underlying premise
• Consume food, not supplements

19. How Can You Easily Assess and
Plan Your Diet?
• 2010 Dietary Guidelines for Americans
• Balance calories to manage weight
• Obesity epidemic
• Suggested strategies
• Reduce certain foods and food components
• Sodium, saturated fats, cholesterol, trans fatty
acids, solid fats, added sugars, and refined grains
• Suggested strategies

20. How Can You Easily Assess and
Plan Your Diet?
• 2010 Dietary Guidelines for Americans
• Increase certain foods and nutrients
• Nutrients of concern
– Potassium, dietary fiber, calcium, vitamin D
– Iron, folate, and vitamin B12 for certain groups
• Build healthy eating patterns
• Establish the current food patterns
• Focus on nutrient density
• Remember that beverages count

21. Amounts of Each Food Group
Recommended by the USDA Food
Guide and MyPlate

22. Examples of the Calories in Related
Nutrient-Dense and Non-Nutrient Dense
Food Choices

23. How Can You Easily Assess and
Plan Your Diet?
• 2010 Dietary Guidelines for Americans
• “Call to Action”
• Ensure all Americans have access
• Facilitate individual behavior change
• Set the stage for lifelong healthy eating, physical
activity, and weight management

24. How Can You Easily Assess and
Plan Your Diet?
• MyPlate
• Visual guide
• 12 different sets of dietary patterns
• Themes
• Build a healthy plate
• Cut back on certain foods
• Eat the right amount of calories
• Be physically active your way
• Food tracker

25. How Can You Easily Assess and
Plan Your Diet?
• Healthy People 2020
• Overall health objectives for the nation
• Helps policy makers
• Four overarching goals
• 39 topic areas

26. Many Private and Federal Groups
Work Together to Keep Us Healthy

27. How Can You Use Food Labels
to Plan a Healthy Diet?
• Food labels
• Food and Drug Administration (FDA)
• Required components
• Recent addition
• Other elements that may be presented on a food
label

28. How Can You Use Food Labels
to Plan a Healthy Diet?
• Nutrition Facts Panel
• Required elements
• Daily values
• Recommended intake goals
– Vitamins and minerals
• Upper limits
– Total fat, saturated fat, cholesterol, sodium, and
total carbohydrates
• “Good source” of particular nutrients

29. How Can You Use Food Labels
to Plan a Healthy Diet?
• Various claims
• Nutrient-content claims
• FDA regulation
• Structure/function claims
• Not approved by the FDA
• Health claims
• Types
• FDA approval

30. FDA-Approved Nutrient Content
Claims