<p>Domain II Topic A – Nutrition Screening and Assessment d. Dietary (1) Analysis of dietary information a. Energy/nutrient requirements and recommendations i. Nutrients 1. Carbohydrates: 4 kcal/g 2. Protein: 4 kcal/g 3. Fat: 9 kcal/g 4. Alcohol: 7 kcal/g ii. General Dietary Recommendation 1. 55-60% Carbohydrate 2. 12-15% Protein 3. 30% Fat b. Calculation methods (manual vs. computerized) i. Manual Nutrient Calculation 1. Example Calculation Peter consumed 2000 calories yesterday- 55% CHO, 30% Fat and 15% Protein. How many calories of each nutrient did Peter consume? 2000 kcal x .55 = 1100 kcal 2000 kcal x .15 = 300 kcal 2000 kcal x .30 = 600 kcal + 2000 kcal How many grams of each nutrient are present in Peter’s diet? 1100 kcal / 4 kcal/g = 275 gm CHO 300 kcal/ 4 kcal/g = 75 gm Pro 600 kcal/ 9 kcal/g = 67 gm Fat ii. Computerized Nutrient Calculation 1. Each food and the specific portion consumed are entered into a computer program, which calculates the amount of each nutrient consumed throughout the day. 2. Examples of these programs include Nutritionist Pro and Nutri Quest. iii. Calculating Nutrient Needs 1. Harris Benedict Equation Males: 66+(13.7 x wt in kg)+(5 x ht in cm) –(6.8 age) Females: 655+(9.6 x wt in kg)+(1.8 x ht in cm)-(4.7 x age)</p><p>Sedentary 1.2 Ambulatory 1.3 Light Activity 1.35-1.6 Moderate activity 1.4-1.75 Heavy activity 1.5-2.2</p><p> c. Data interpretation and limitations i. Not all nutrients may be listed for interpretation ii. A particular food may not be there so you have substitute another iii. The nutrient database may not be kept up tot date iv. Programs may be expensive d. Outcomes monitoring i. Monitoring: the assessment of dietary or nutritional status at intermittent times with the aim of detecting changes in dietary or nutritional status of a population e. Documentation i. Documenting nutrient needs for a client give a reference for recommending nutrition interventions. e. Economic/social (2) Socioeconomic a. Lower income- must be sensitive to income in recommending food changes. (3) Cultural food patterns a. Chinese and Mexican- no milk, little cheese b. Mexican- most foods are fried, liberal fats c. Indochinese- calcium intake from dairy is low; get calcium form tofu, fish pastes d. Middle Easterners- bulgur, rice often consumed (4) Psychological/ behavioral a. Emotional eating- food is directly associated with emotional status b. Ingrained eating habits (5) Religious a. Kosher (Jewish religion)- no pork, shellfish; no meat and dairy at the same meal. b. Mormons- no caffeine, no alcohol c. Muslim- no pork, gelatin made form pork, alcohol (6) Lifestyles a. Time spent cooking effects the quality of food in a client’s diet b. Whether the client lives alone or not (7) Food fads/cultism a. Adkins- low carbohydrates high protein b. Low- Fat craze (8) Level of education a. Studies have shown that the more education one has, the better they eat. (9) Nutrition knowledge, interest, motivation</p>