Page 52 - Nutrition Counseling and Education Skills: A Guide for Professionals

24-hour period.10–12 It has the advantage of being based on short-term memory.
To enhance memory, one may prompt the individual to recall the day of the week, time of day, where the

meal was eaten (home, work, restaurant), other events that happened during the day (watching television,
exercising, e-mail, shopping), and others who were present (family, friends). Clients may be asked to bring
food records to future appointments which will show day-to-day variations. Written instructions and
recording forms may be provided. The National Cancer Institute (NCI) has an automatic self-administered
24-hour recall used in research as well as a Canadian Diet History Questionnaire.13

The second method, the usual daily food intake, asks clients to explain the types and amounts of foods and
beverages usually consumed during one day’s time. Responses show what the person typically eats and drinks
during meals and snacks. In both approaches, the portion sizes, the methods of food preparation (frying versus
baking), the between-meal snacks, the time and place food is consumed, the condiments, the use of vitamin
and mineral supplements or alternative nutrition therapies, and any alcoholic beverages consumed require
consideration.

A third method is a food frequency questionnaire. This food and beverage checklist identifies the daily,
weekly, or monthly frequency of a client’s consumption of basic foods and beverages, such as milk and dairy
products, meats–fish–poultry, eggs, fruits and fruit juices, vegetables and salads, breads and cereals, desserts
and sweets, butter–margarine–fats–oils, between-meal snacks, and beverages, including coffee, tea, soft drinks,
and alcoholic beverages.7 Another alternative is to ask the person to complete a 1- to 3-day food record as
each item is consumed. Brand names, preparation methods, location where food is consumed, and portion
sizes are noted.

No method is considered to have total accuracy in assessing the nutritional status of the client, and each has
limitations and inherent inaccuracies, such as the following7:

• The previous 24-hour period may not have been typical or adequate to characterize a person’s food intake.
• Weekends may differ from weekdays.
• There are seasonal variations.
• The person may be unable to judge portion sizes.
• The person may have memory lapses, lack motivation, or have literacy issues.
• There is underreporting, especially among the overweight.
• Certain foods may be considered socially undesirable or unhealthy by clients, so they prefer not to reveal eating them.

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