last authored: Nov 2014, Becca Green-LaPierre
The dietary history collects retrospective information on patterns of food use during a longer, less precisely defined time period. It records a patient’s usual dietary intake (vs. actual food intake).
A full dietary history is composed of three components:
However, depending on time and opportunity for followup, the three day record is often skipped.
During the 24 hour recall, guide the patient to recall, in detail, all food and drink consumed the previous day, as well as any pertinent nutritional/herbal supplements.
Potential probes to use include:
These questions provide you with a general account of what the patient consumed the previous day.
Next, inquire about portion sizes.
Having visual aids such as food models, a measuring cup, and measuring spoons, can be very helpful.
Helpful cues include:
Show them a typical dinner plate and ask them what portion of their plate if filled with vegetables/meat/potato etc.
It is not necessary to inquire about the brand name of all foods, but it is important to note if your patient eats mostly processed, store bought foods to give you insight to the amount of sodum they consume and their personal food skills (e.g. cooking ability).
After gaining a sense of what the patient ate yesterday, record what day of the week it was. Ask them if that was a typical day for them in turns of eating? Do weekends differ from weekdays? The cross check is a mini questionnaire on the frequency of consumption of specific food items used to verify and clarify the information gathered from the 24h recall.
Potential probes include:
Being careful not to jump to conclusions, as you ask questions you might also gain a sense of their socio-economic status (Is everything no-name brand? Is there limited fresh fruits and vegetables? Does it seem like “healthy foods” are being rationed such as only 1 glass of milk at breakfast?). You could also ask questions around how often they go grocery shopping and where. How often they dine out and where. This information can be helpful to provide income-appropriate nutrition recommendations.
Have your patient record what they actually ate for three non-consecutive days. The patient should be as detailed as possible, including the timing of their meals, portion sizes and specifying whether meals are home made or store bought. It is best to write down what they ate soon after actually eating the meal so as to not rely on memory, as memory is less reliable.