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How to Complete On Your Own A:

Evaluate your Eating Patterns and Behaviors
Use the template provided as a tool to help you evaluate your own eating habits.

Track your Diet & Exercise Habits
Use the template provided to track your diet and exercise habits over a four-day period.

Create a Client Questionnaire
Create your own version of a questionnaire with questions you think are critical when taking a client’s history.

Analyze your Own Nutritional Health
Complete the questionnaire you created as if you were the client. Then use the completed questionnaire along with your 4-day Diet & Exercise Journal to conduct a self-evaluation of your nutritional needs and risks, as you did for Jay Carter.

In addition to the reflection questions, there are four deliverables that are unique to this task. Each needs to be completed on a schedule, so be aware of all the different streams of work that you need to complete in order to gain the deepest understanding of the topics at hand. The steps below will remind you when to submit your work.

 

Evaluate Your Eating Patterns and Behaviors

1. Answer the questions in the Eating Patterns and Behaviors Template to get a sense for what your eating habits are and the motivations behind your habits. Follow your instincts (i.e., go with your “gut reaction”) when answering the questions. There is no need to research or over-analyze the questions.
   
   This step is meant to be an informal way of capturing what you think of your eating habits before using nutritional tools and techniques to make a more formal assessment. Your intuitions may or may not be right! Later, you can compare your responses to the more formal assessment you will do of your nutritional needs and risks.
   
   
2. When you are ready, submit the Eating Patterns and Behaviors Template to your mentor for review. Your answers will be kept confidential. Rrefer to the Submit your work section for details on how to name your work before submitting.

Track Your Diet & Exercise Habits

1. Record your daily diet and exercise routine. Use the Diet & Exercise Journal as a template to help you capture relevant details of your eating and exercise routine over the next four days. For reference, you may look at the sample journal available in the Tracking Diet & Exercise section of the Task Resources, which shows a completed journal for one day and includes examples of how to appropriately document portion size, etc.
   
   Before you can assess your own nutritional needs and risks, you need to first get a clear picture of how you really eat. Sometimes our perceptions of how we eat don’t match reality. For that reason, it can be helpful to write down what you really do eat over several days, so you can see your own trends in black and white. As you track your habits closely over the next four days, you may make mental notes of the patterns you see developing. When do you typically eat? How often? What factors influence your eating and exercise patterns?
   
   
2. When you have completed four days of the Diet & Exercise Journal, submit it to your mentor for review. Refer to the Submit your work section for details on how to name your work for submission.

 

Create Your Client Questionnaire

During the days when you are tracking your diet and exercise, you should also start working on a questionnaire that you think will help you to gather the information you need about your own future clients. First, you will test it out yourself and later in this rotation, you will have the opportunity to use it when interviewing a client (one of your peers) and assessing his/her needs and risks.

1. Prepare your questions using the Preparing the Client Questionnaire Template. Think about questions you would want to ask a client to help you assess his/her nutritional needs and risks. When you write them out, also include your rationale for asking these questions. Follow the directions in the template to help you prepare your questionnaire.
   
   
2. Do additional research, as needed, to help you formulate appropriate questions. You may want to think about what makes an effective questionnaire, keeping in mind that the goal of the questions is to provide a full picture in terms of the client’s nutritional history.
   
   To help you do your research, you may wish to refer to the following tools and resources:
   
   
   • Sample questionnaires available in the Creating a Client Questionnaire section of the Task Resources.
     
     
   • Your Client Assessment Template, attached in the overview for this task. This document will remind you of what you need to evaluate about your clients (and yourself, in this case).
     
     
   • Any notes you took from Task 1.1: Critiquing the Practitioner’s Interview about what a good practitioner should ask in a client history interview.
     
     
   • Your list of additional questions you think Michael Wilson should have asked Jay from Task 1.2: Assessing the Client’s Needs and Risks.
     
     
   • Step 1 of the Diagnoses and Treatment Process document in the General Nutrition Resources section of Resources.

3. When you are satisfied with your questions, create and save two copies of your questionnaire in MS Word. These copies will serve as templates for your work.
   
   
   • One template you will use in the next step of On Your Own A. Call this [YourLastName]_OYOA_MyClientQuestionnaire[Date=YYMMDD].doc
     
     
   • You will use the other template for your client interview during On Your Own C. Call this [YourLastName]_OYOC_MyClientQuestionnaire[Date=YYMMDD].doc

 

Analyze Your Nutritional Health

1. Fill out the questionnaire yourself using the first of the two templates you created in Step 3 above. If you have ideas on ways to improve the questionnaire as you complete it, you may edit it as you go. (Remember to carry over any changes to the other template you are saving for your client interview, too.)
   
   
2. Conduct a self-assessment of your nutritional health. Using the provided Client Assessment Template (like the one you used to assess Jay Carter in Task 1.2: Assessing Client Needs and Risks), analyze your nutritional needs and risks. You may refer to your completed Diet & Exercise Journal (you should have four days of journal entries by now), your Eating Patterns and Behaviors Template and your completed Client Questionnaire, which should provide the necessary data to complete the assessment.
   
   As you work on your self-assessment, you should think about whether your previous answers to the Client Questionnaire and Diet & Exercise Journal are enough to complete the template. If not (meaning, if you are completing the template based on information that you happen to know about yourself but that you would not know about a client), then you should modify the questions in your Client Questionnaire accordingly.
   
   Use the steps below to guide you through the assessment process, as you did earlier with Jay.

CLIENT ASSESSMENT TEMPLATE QUESTIONS

1. Assess your height and weight measurements and BMI to determine whether they fall within the normal range for your age. To do this, you may need to do some research to help you evaluate your height, weight and BMI measurements. You may refer to the Resources (link above) to see the FAQ on Assessing Ideal Body Weight and Weight Fluctuations.
   
   
   • Does your current height and weight fall within the normal range for your age?
     
     
   • Does your BMI fall within the normal range?
     
     
2. Assess any recent fluctuations in your weight and determine whether they fall within a healthy range. Consider the information you provided in your questionnaire about your high and low weight range. If you have concerns about any of these areas, what are your concerns, what might be the cause of the problem, and what would be reasonable treatments for the problem?
   
   You may want to reference the materials available in the Resources (link above), including the FAQ on Assessing Ideal Body Weight and Weight Fluctuations.
   
   
   • Do your high and low measurements in the last 12 months fall within the normal range?
     
     
   • Have you experienced any abnormal fluctuation in your weight in the last 12 months? Explain any issues or concerns with the range of the weight fluctuation.
     
     
   • What was the duration of the weight loss/gain period? How/why might the speed at which the weight was gained or lost be a cause for concern?
     
     
   • Describe any patterns of repeated weight fluctuation that may be unhealthy. What are specific causes of concern?
     
     
3. Assess the context in which you eat (where, when, etc.) and how it may affect your eating habits.
   
   
   • In what ways do you eat differently depending on when or where you eat (e.g. home vs. school; weekdays vs. weekends)? What challenges do you face in each of those contexts related to, for example:
     • who chooses the food
     • who prepares the food
     • the amount of food
     • meal times
     • snacking times
       
       
   • Considering these different contexts, what may cause you difficulty in making appropriate dietary choices? What solutions might help you overcome the problems?
     
     
4. Identify any additional outside influences that may affect your nutritional needs and risks.
   
   
   • What peer or familial influences, if any, may be positively or negatively affecting your eating habits and overall nutritional well-being?
     
     
   • Why do you eat differently at different times or in different settings?
     
     
   • How might these influences present new needs or risks for you?
     
     
5. Consider your level and type of physical activity. Assess whether or not it falls within the range of what is normal and healthy. You may refer to the FAQ on Guidelines for Healthy Exercise in the Exercise section of the Task Resources (link above) to help you calculate your specific exercise needs.
   
   
   • Does your amount of exercise fall within the range of the general recommendations for healthy activity?
     
     
   • Consider the type of physical activity. Is it extreme or intense in nature? Is it high-impact or low-impact? What effect does that have on you? What effect might it have over time?
     
     
   • What is your attitude toward physical exercise? Is it healthy? Obsessive? How might your attitude lead to problems down the road?
     
     
6. Assess your medical condition and history, as it relates to your nutritional well-being.
   
   
   • Do you have any illnesses or medical conditions? If so, how are they related to your nutritional well-being? What specific nutritional needs do they create, if any?
     
     
   • Are you taking any medications or supplements that may combine with foods in a negative way? If so, how?
     
     
   • Do you have any allergies? How might they impact your nutritional needs or diet plan?
     
     
7. Determine your caloric needs, considering your level of physical activity and your personal goals (e.g. weight gain or weight loss). You may refer to the FAQ on Determining Caloric Needs in the Caloric Guidelines for Teens section of the Task Resources (link above) to help you calculate your specific needs.
   
   
   • What are your caloric needs for maintaining your current weight?
     
     
   • What are your caloric needs given your weight change goals?
     
     
8. Analyze your current eating habits and patterns. If you determine that your diet is not well balanced, note deficiencies that may indicate potential health risks. (As you note problems or issues in any area, remember to dive into the science to provide evidence for your judgment. Are you on target for your needs from a biochemical standpoint? Why or why not?)
   
   
   • What is your current caloric intake, based on your submitted diet history (Diet & Exercise Journal)? To determine this, you may refer to the calorie calculator in the Caloric Guidelines for Teens section of the Task Resources.
     
     
   • Does your diet reflect an appropriate balance in terms of the percentage of calories that come from protein, carbohydrates and fats? (Look at overall balance as opposed to adequate amounts of each type, which is addressed in the next bullet.) Refer to the site about Dietary Calories from Protein, Carbohydrates, and Fats in the Diet and Nutrition section of the Task Resources for guidelines regarding the percentage of calories needed from each of these nutrients.
     
     
   • Determine whether your are getting enough protein (as opposed to carbohydrates and fats). To do this, calculate the protein you consume according to your diet history by looking up each individual food you listed in your diet history and determining how much protein it contains. Then determine whether the total is enough given your weight.
     
     
     • A teen needs approximately 1 gram of protein for every kilogram of body weight. If they get more, that is usually not a problem.
       
       
     • Refer to Protein Content of Common Foods in the Diet and Nutrition section of the Task Resources for help calculating your protein intake.

   (The reason you’re calculating whether you are getting enough protein, but not doing that for carbs and fats is that typically when a person gets enough protein, by default they do get enough carbs and fats.)

   • Does your diet history demonstrate a balanced diet? Compare your diet to the food guide pyramid and note any discrepancies.
     
     
   • Does your diet history include sufficient meals and snacks?
     
     
   • Does your diet history indicate that you may be eating too much or too little of any given food or type of food or drink? If you think so, what counts as too much and why?
     
     
   • If you identified any special nutritional considerations (such as medical conditions or food allergies), are they being addressed? If not, explain any discrepancies.
     
     
9. Analyze your goals and concerns related to your nutritional well-being.
   
   
   • Consider yours goals, including weight change goals and nutritional goals. Are they safe for someone your height and age?
     
     
   • Is the proposed timeline for reaching the desired goal reasonable and safe?
     
     
   • Note any lifestyle considerations (e.g., athlete, busy schedule…) and their potential impact with regard to your diet and exercise (e.g., need for more/fewer calories, easy snacks…).
     
   • Are you exhibiting any unsafe behaviors associated with your goals?

Review Your Questionnaire

Now that you have completed your self-assessment, take some time to revisit your questionnaire and revise it, if needed, before you submit it to your mentor for review.

1. Add or revise questions as appropriate.
   
   
   • Address any remaining gaps in your questionnaire that you uncovered when completing the self-assessment.

2. Re-read the questionnaire and critique its usability.
   
   
   • Does the questionnaire seem easy to follow and understand?
     
     
   • Did the questions flow in a logical order?
     
     
   • How would you change or improve it?

Submit Your Work

1. Review your work to make sure it is complete before submitting it for review.
   
   
2. Review the checklist located in the Submit your work section of this task and submit the following documents to your mentor:
   
   
   • Diet and Exercise Journal (resubmit with any edits based on mentor feedback)
     
     
   • Client Questionnaire
     
     
   • Client Assessment Template

3. Once you have submitted your materials, answer the questions in the Reflect on what you learned section of this task. You may answer the questions in a separate a Word document. Review the checklist located in the Submit your work section of this task and submit your response to your mentor when you are ready.
   
   

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Evaluating Your Eating Patterns and Behaviors

• Follow your gut instincts when evaluating your eating patterns and behaviors. The purpose of this informal evaluation is to see if what you think about your own nutrition aligns (or doesn’t align) with your more formal self-assessment.

Tracking Diet & Exercise

When tracking your diet and exercise in your journal, remember to:

• Record each meal and snack as you go. (It’s easier than trying to remember everything you ate at the end of the day.)
  
  
• Accurately describe the portion size as well as the type of food (for example, 3 oz. of 2% cottage cheese, 8 oz. of skim milk)
  
  
• Record the type of exercise and the duration (for example, walking for 30 minutes)

Preparing your Questionnaire

• Look at the sample questionnaires in order to identify questions you want to include in your own questionnaire. Borrowing some questions from the samples is fine but try to come up with additional questions of your own that will help you build a thorough client history.

Analyzing Your Own Nutritional Health

Height and Weight

• Remember that BMI is an indicator of body mass that leaves room for additional interpretation in the case of athletes. That is, an athlete who is very muscular and fit may appear to be overweight based on the BMI standards of what is normal body mass. Consider whether you fall into this category and make allowances when deciding whether or not your BMI falls within the normal range.

Weight Fluctuation

• Be aware of any dramatic shifts in your weight and look for patterns that could indicate unhealthy behaviors such as severe dieting.

Eating Context and Outside Influences

• Don’t overlook the way family or friends may influence your eating behaviors. Rather, consider the context in which you eat (when, where, and how much) as well as the outside influences (peers, family, etc.) who may be shaping those habits.
  
  
• Sometimes social relationships can motivate you in positive or negative ways that can affect your well-being. For example, people often make choices to follow their peers (teens are especially susceptible to this). Consider any peer or familial relationships and the potential impact they may have in shaping your behaviors and increasing your health risks.

Physical Activity

• Be aware of extrme behaviors when it comes to exercise. For example, if you do not exercise at all you would face different challenges than if you over-exercised. But in both cases the level of activity could have a significant effect on your overall well-being.

Caloric Needs

• When determining caloric needs, you should not forget to factor in you exercise habits. If you exercise a lot you would need more calories to maintain your current weight than you would if you led a very sedentary lifestyle.

Current Eating Habits

• Keep in mind, if a client is skipping meals or skipping snacks, it may or may not be a problem. To evaluate the situation, review Step 8 of the Client Assessment Template Questions in the Step-by-Step Guide.
  
  
• If the client’s diet does not reflect the suggested balance and variety offered by the Food Guide Pyramid, there may or may not be a problem. To evaluate the situation, review Step 8 of the Client Assessment Template Questions in the Step-by-Step Guide.
  
  
• A nutritional advisor should ask a client to track his/her diet history for several days, as opposed to just one day. It is recommended to get at least three days of history, including at least one weekday and one weekend day. This gives the practitioner more information to use when evaluating current eating habits and helps in identifying trends.
  

Client’s and Parent’s Goals and Concerns

• A practitioner should consider whether the client’s own personality traits or behaviors (e.g. overachiever, recluse, etc.) may be contributing to the risks he faces.
  
  
• Keep in mind that not all goals are healthy. Teens are sometimes influenced by peers to set unhealthy goals.
  
  
• A nutritional advisor should evaluate the client’s goals and parent’s goals independently of each other, but also take time to think about how the two may be interconnected. For example, the parent may have very high standards that could be driving the child’s behavior. The practitioner should consider the potential effect on the client’s well-being.
  
• When looking at the data have available to assess the client’s needs and risks, a practitioner may discover that information provided by the parent conflicts with information from the child. This does not mean that one is definitely right and the other is definitely wrong. A practitioner should consider both sides and entertain the possibility that they may both be right, but simply have different (but equally valid) perspectives.

Overall:

• In assessing the client’s needs and risks, a practitioner should consider whether s/he has enough information to develop a good nutritional plan. If not, s/he should identify the details that are lacking.

 

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When referring to a Wikipedia resource, note that while Wikipedia is a valuable resource, unlike some other websites anyone can contribute to or modify the site (whether they're knowledgeable about the topic or not). As a result, the site is subject to constant change by questionable sources. Be sure to cross-check information on Wikipedia with other reputable sites to ensure accuracy.

TASK RESOURCES

Tracking Diet & Exercise

Sample Diet and Exercise Journal - This is a one-day sample of a completed Diet & Exercise Journal based on Jay Carter's diet history.

Creating a Client Questionnaire

The following three client questionnaires were developed by different practitioners. They are all equally valid samples to refer to as you create your own client questionnaire.

• Sample 1 Client Questionnaire
  
  
• Sample 2 Client Questionnaire
  
  

Height and Weight

How to Assess Ideal Body Weight and Weight Fluctuations - This FAQ outlines helpful steps for assessing a client’s height and weight. It also includes tools and information on interpreting BMI and growth charts.

What is BMI and Why is it Useful? - This site gives you a detailed understanding of Body Mass Index for children and teens.

Exercise

The Benefits of Exercise - This site offers insights into the benefits of exercise for adolescents, including how to start an exercise program, what kind of exercise is best, and how much exercise is enough.

Guidelines for Healthy Exercise - This FAQ addresses questions related to the recommended amount of daily exercise for teens and how much exercise is too much.

Diet and Nutrition

The Truth about Snacking - This FAQ addresses the misconceptions around snacking that exist in today's world.

Common Causes of Unhealthy Eating Habits - Unhealthy eating habits develop over time. This FAQ explains some of the common causes of unhealthy eating habits and talks about how a dietitian can work with a client who has unhealthy eating habits.

Why Fiber is an Important Part of a Healthy Diet - This site explains why fiber is good for you and what foods contain fiber.

Dietary Calories from Proteins, Carbohydrates, and Fats - The U.S. Department of Agriculture’s Dietary Guidelines offer specific recommendations regarding the percentage of calories needed from key nutrients. See Chapter 5 for guidelines related to protein; Chapter 6 for fats; and Chapter 7 for carbohydrates.

Protein Content of Common Foods - This FAQ provides information on the amount of protein found in various common foods.

Assessing a Client's Diet History - This FAQ explains what a practitioner looks for when evaluating a client's diet history.

Herbs and Foods Interacting with Drugs - This page features information about interactions between food, medications and dietary supplements.

Caloric Guidelines for Teens

Determining Caloric Needs - Trying to calculate how many calories a person needs is not an exact science. Most of the formulas available today are estimates of caloric needs. This FAQ explains how to determine a teen's caloric needs.

General Calorie Requirements for Children and Teens
Guidelines vary somewhat as to appropriate caloric needs for children and teens. Click on the following links for caloric ranges that can serve as a general guideline. Each site has similar, equally valuable information. It’s best to use these guidelines in conjunction with the FAQ above to determine a client’s specific caloric needs.

• From Weight Loss Resources
  
  
• From Keep Kids Healthy

Scroll half-way down the page to view charts.

Calorie Calculator - A calorie calculator is a helpful tool for determining caloric consumption. Using the tool on the home page, you can plug in the foods and beverages contained in a client's diet history into the calculator and total them to arrive at an estimated number of calories per day.

Client and Parent Goals

Balancing Client and Parent Perspectives -This FAQ helps you understand the challenges of conducting an effective client interview when both a parent and child are present.

Athletes

Healthy Eating for Sports - This page provides a guide on how athletes can eat healthier to reach their peak performance level.

Serving Sizes

Controlling Portion Sizes - How do you know a reasonable portion of food when you see it? This page from the American Cancer Society provides tips on how to assess portion sizes.

What is a Serving Size? The serving size of a food product can be a confusing term. This page from Wikipedia explains the meaning of the term in different contexts.

 

GENERAL NUTRITION RESOURCES

Nutrition Tools & Practices

The Diagnosis & Treatment Process Specific to Nutrition - This document describes a process that health care professionals, and dietitians and nutritionists in particular, typically use to assess what is wrong with their patients, and how they develop treatment plans to help them.

MyPlate - This site provides information on the MyPlate Program, which was designed by the U.S. Dept. of Agriculture to promote healthy nutrition in children over two years of age. It serves as a general guide to daily food choices.

Background Information

The American Dietetic Association - This is the site for the nation's largest organization of food and nutrition professionals.

The American Society for Nutrition - This is the site for The American Society for Nutrition, a premier research society dedicated to improving the quality of life through the science of nutrition.

U.S. Department of Agriculture: Food and Nutrition - Under the U.S. Department of Agriculture's web site, this page gives you general useful information on food and nutrition.

U.S. Department of Agriculture: Dietary Guidelines for Americans - Under the U.S. Department of Agriculture's web site, this page provides guidelines regarding how good dietary habits can promote health and reduce risk for major chronic diseases.

Nutritional Needs of Adolescents - This article provides a detailed account of facts and statistics regarding the nutritional needs of adolescents.

The Science of Biology, Eighth Edition, William K. Purves - This link requires a username and password. Your username is vista1, and your password is arginine. Using the menu at the top of the screen, select Chapter 50 (on nutrition) for the most relevant material.