When I first meet with people to discuss improved health and wellbeing, they just want to know, “what can I eat?” A nutritional assessment is required to make the most appropriate recommendations for eating and lifestyle choices.
How can we know what to eat, if we don’t know our requirements? As an accredited practising dietitian and founder of Eating for You, this is the first rule, “know yourself”.
Image Credit: Ja Ma, Unsplash Photos
What’s included in a nutritional assessment?
#1 Health and medical history
The health and medical history is an essential part of the nutritional assessment. It helps to identify current priorities for eating and lifestyle changes. You are probably familiar with this, as most health practitioners require this level of information.
The history includes:
- Personal data e.g. age
- Social history e.g. living arrangement, employment, interests
- Current health conditions
- Supplement (vitamin, mineral, protein, herbal) and medication use
- Tobacco, alcohol and other drug usage
#2 Detailed food and nutrition related history
The eating history is aimed a identifying preferences and assessing the nutritional adequacy of your usual food intake.
The collection of usual food intake may require the completion of a food diary or, participating in what is termed, a 24 hour recall interview, which assesses what you have eaten over the past day.
Food knowledge, beliefs and attitudes to eating are also discussed. These are considered alongside your cultural background.
Information about bowel movements and urination help to inform digestive function and hydration, respectively.
#3 Lifestyle history
Any lifestyle choices that impact on eating and health are also discussed:
- Physical activity
- Sleep
- Meditation and other relaxation techniques
- Relationships e.g. are you in control of, or involved in, meal preparation?
#4 Biochemical data, medical tests and procedures
Biochemical data refers to blood and urine tests. There is a range of tests conducted to assess different nutrition related health conditions. In Australia, it is the role of medical practitioners to order blood and other tests.
Blood tests help us to:
- Understand whether there is a deficit or excess of nutrients
- Identify risk factors for chronic disease
- Monitor the effect of diet over time
Test examples
Diabetes
- Fasting blood glucose test
- Longterm blood glucose levels test e.g. HbA1C
Irritable bowel syndrome
- Inflammatory marker: C reactive protein
- Gut profile: from a lactose hydrogen breath test, which helps identify gut bacteria imbalances
- Protein profile (assists in identifying autoimmune responses) e.g. antibody testing to eliminate or diagnose coeliac disease
- Full blood count (Red blood cells, White blood cells and Platelets): screens for a variety of disorders including infection and anaemia
- A report from a colonoscopy test may be provided too
Fatigue and weakness
- Full blood count (as described above)
- Thyroid function test: fatigue can be a result of an under active thyroid
- Urea and electrolytes: to assess kidney function
- Liver function test
The blood and other diagnostic tests, together with the health, eating and lifestyle histories, form a picture of your current health.
Whilst important in identifying risk factors for disease e.g. cholesterol, and diagnosing a disease e.g. high blood glucose in diabetes, blood tests alone do not direct your health and lifestyle plan. All parts of the nutritional assessment are considered.
Health practitioners also need to monitor many tests over time to gauge your progress e.g. cholesterol levels can be altered through an eating and lifestyle intervention within 6 weeks.
#5 Additional Eating for You nutritional assessments
- Mini mindfulness quiz
- Constitutional patterns, based on Eastern nutrition
In summary, a nutritional assessment helps to describe how, what and why you eat, as well as the impact of this on your health and wellbeing. A picture of your health is gained from your personal experience, as well as a range of tests.