Nutrition History Taking: A Practical Approach

Abstract

About 60% of adults in the United States have one or more diet-related chronic diagnoses, including cancer, cardiovascular and cerebrovascular diseases, diabetes mellitus, and obesity. It is imperative to address nutrition health in the clinical setting to decrease diet-related morbidity and mortality. Family physicians can use validated nutrition questionnaires, nutrition-tracking tools, and smartphone applications to obtain a nutrition history, implement brief intervention plans, and identify patients who warrant referral for interdisciplinary nutrition care. The validated Rapid Eating Assessment for Participants-Shortened Version, v.2 (REAP-S v.2) can be quickly used to initiate nutrition history taking. Patient responses to the REAP-S v.2 can guide physicians to an individualized nutrition history focused in the four areas of nutrition: insight and motivation, dietary intake pattern, metabolic demands and comorbid conditions, and consideration of other supplement or substance use. Family physicians should refer to the U.S. Department of Agriculture 2020-2025 Dietary Guidelines for Americans when assessing patient nutrient intake quality and pattern; however, it is also essential to assess nutrition health within the context of an individual patient. It is important to maintain a basic understanding of popular diet patterns, although diet pattern adherence is a better predictor of successful weight loss than diet type. Using various counseling and goal-setting techniques, physicians can partner with patients to identify and develop a realistic goal for nutrition intervention.