Holistic Nutrition
 


An integrated approach to nutrition encourages healthy eating. Eating organic or fresh food, taking nutritional supplements to replenish vitamins and minerals and learning about the way we consume affect our body. Fiber is an important part of holistic diet. it regulates blood glucose levels, protect against heart disease and maintain healthy weight.

ACIDD Maryland through our collaborative care model provides nutritional assessment for our individuals in need by our dietitian.

A nutrition assessment is an in-depth evaluation of both objective and subjective data related to an individual’s food and nutrient intake, lifestyle, and medical history. Once the data on an individual is collected and organized, the practitioner can assess and evaluate the nutritional status of that person. The assessment leads to a plan of care, or intervention, designed to help the individual either maintain the assessed status or attain a healthier status.

The data for a nutritional assessment falls into four categories: anthropometric , biochemical , clinical, and dietary.

Anthropometrics.
Anthropometrics are the objective measurements of body muscle and fat . They are used to compare individuals, to compare growth in the young, and to assess weight loss or gain in the mature individual. Weight and height are the most frequently used anthropometric measurements, and skinfold measurements of several areas of the body are also taken.

Biochemical data.
Laboratory tests based on blood and urine can be important indicators of nutritional status, but they are influenced by non-nutritional factors as well. Lab results can be altered by medications, hydration status, and disease states or other metabolic processes, such as stress . As with the other areas of nutrition assessment, biochemical data need to be viewed as a part of the whole.

Clinical data.
Clinical data provides information about the individual’s medical history, including acute and chronic illness and diagnostic procedures, therapies, or treatments that may increase nutrient needs or induce malabsorption . Current medications need to be documented, and both prescription drugs and over-the-counter drugs, such as laxatives or analgesics, must be included in the analysis. Vitamins , minerals , and herbal preparations also need to be reviewed. Physical signs of malnutrition can be documented during the nutrition interview and are an important part of the assessment process.

Dietary data.
There are many ways to document dietary intake. The accuracy of the data is frequently challenged, however, since both questioning and observing can impact the actual intake. During a nutrition interview, the practitioner may ask what the individual ate during the previous twenty-four hours, beginning with the last item eaten prior to the interview. Practitioners can train individuals on completing a food diary. Documentation should include portion sizes and how the food was prepared. Brand names or the restaurant where the food was eaten can assist in assessing the details of the intake. Estimating portion sizes is difficult, and requesting that every food be measured or weighed is time-consuming and can be impractical. Food models and photographs of foods are therefore used to assist in recalling the portion size of the food.

During the nutrition interview, data collection will include questions about the individual’s lifestyle—including the number of meals eaten daily, where they are eaten, and who prepared the meals. Information about allergies , food intolerances, and food avoidances, as well as caffeine and alcohol use, should be collected. Exercise frequency and occupation help to identify the need for increased calories. Asking about the economics of the individual or family, and about the use and type of kitchen equipment, can assist in the development of a plan of care. Dental and oral health also impact the nutritional assessment, as well as information about gastrointestinal health, such as problems with constipation , gas or diarrhea, vomiting, or frequent heartburn.

Evaluation

After data are collected, the practitioner uses past experience as well as reference standards to assimilate the information into an assessment that provides an understanding of the individual’s nutritional status. The practitioner uses the anthropometric data to assess ideal and desirable weight, as well as skinfold measurements to determine body fat. Using the clinical, biochemical, and dietary data, influences on the nutritional status can be determined. A nutritional intervention, which usually includes dietary guidance and exercise recommendations, is then formulated and discussed with the individual.

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