Nutrition counseling Health Article

Definition

Nutrition counseling is an ongoing process in which a health professional, usually a registered dietitian, works with an individual to assess his or her usual dietary intake and identify areas where change is needed. The nutrition counselor provides information, educational materials, support, and follow-up to help the individual make and maintain the needed dietary changes.

Purpose

The goal of nutrition counseling is to help a person make and maintain dietary changes. For a person with a mental disorder, dietary change may be needed to promote healthier eating, to adopt a therapeutic diet, or to avoid nutrient-drug interactions. Nutrition counseling is an integral part of treatment for persons with eating disorders or chemical dependencies. Persons taking certain drugs, such as monoamine oxidase inhibitors, used to treat depression and anxiety disorders, need to follow a tyramine-controlled diet to avoid dietary interference with their medication. Many drugs used to treat mental disorders can cause weight gain or loss, so persons taking these medications may also benefit from nutrition counseling.

The nutrition counselor and individual work together to assess current eating patterns and identify areas where change is needed. Registered dietitians have met certain education and experience standards and are well qualified to provide nutrition counseling, but nurses, physicians, and health educators also provide nutrition counseling.

Assessing dietary habits

Nutrition counseling usually begins with an interview in which the counselor asks questions about a person's typical food intake. Nutrition counselors use different methods to assess typical food intake.

The 24-hour recall method is a listing of all the foods and beverages a person consumed within the previous 24-hour period. The nutrition counselor may ask a person to recall the first thing he or she ate or drank the previous morning. The counselor then records the estimated amounts of all the foods and beverages the person consumed the rest of the day. The 24-hour food recall can be used to provide an estimate of energy and nutrient intake. However, people tend to over- or underestimate intake of certain foods, and food intake on one day may not accurately represent typical food intake.

A food frequency questionnaire can sometimes provide a more accurate picture of a person's typical eating patterns. The nutrition counselor may ask the client how often he or she consumes certain food groups. For example, the counselor may ask a person how many servings of dairy products, fruits, vegetables, grains and cereals, meats, or fats he or she consumes in a typical day, week, or month.

Daily food records are also useful in assessing food intake. An individual keeps a written record of the amounts of all foods and beverages consumed over a given period of time. The nutrition counselor can then use the food records to analyze actual energy and nutrient intake. Three-day food records kept over two weekdays and one weekend day are often used.

Assessing body weight

Nutrition counselors may assess an individual's body weight by comparing his or her weight to various weight-for-height tables. A rough rule of thumb for determining a woman's ideal body weight is to allow 100 lb (45 kg) for the first 5 ft (1.5 m) of height plus 5 lb (2.3 kg) for every additional inch. A man is allowed 106 lb (48 kg) for the first 5 ft (1.5 m) of height plus 6 lb (2.7 kg) for every additional inch. However, this guide does not take into account a person's frame size.

Body mass index, or BMI, is another indicator used to assess body weight. BMI is calculated as weight in kilograms divided by height in meters squared. A BMI of 20 to 25 is considered normal weight, a BMI of less than 20 is considered underweight, and a BMI of greater than 25 is considered overweight.