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Recommendations Summary

AWM: Assess Energy Intake and Nutrient Content of the Diet 2014

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.

• Recommendation(s)

  AWM: Assess Energy Intake and Nutrient Content of the Diet

  The registered dietitian nutritionist (RDN) should assess the energy intake and nutrient content of the diet. Any nutrient inadequacy and the nutrients affected are dependent on the composition of the diet followed, as well as on the nutritional needs of the individual.

  Rating: Strong
  Imperative

  • Risks/Harms of Implementing This Recommendation

    None.

  • Conditions of Application

    Energy intake and nutrient content may be assessed through the use of one of the following tools, for example:

    • Three-day, four-day or seven-day food records (including weekdays and weekend days)
    • Food frequency questionnaires
    • 24-hour dietary recalls
    • Typical daily dietary intake.

  • Potential Costs Associated with Application

    Costs of medical nutrition therapy (MNT) sessions vary, however MNT sessions are essential for improved outcomes.

  • Recommendation Narrative

    • Several studies report changes in nutrient adequacy with caloric restriction, however the extent of nutrient inadequacy and the nutrients affected are dependent on the composition of the diet followed, as well as on the nutritional needs of the individual (Ma et al, 2007; Truby et al, 2008)
    • Limited research reports reductions in nutrient adequacy with weight loss through an energy restriction of at least 500kcal per day or daily consumption below 1, 200kcal per day (Ashley et al, 2007; Noakes et al, 2004; Gardner et al, 2010)
    • Additional long-term studies in this area are needed.

  • Recommendation Strength Rationale

    The Conclusion Statement in support of this recommendation received Grade II.

  • Minority Opinions

    Consensus reached.

• Supporting Evidence

  The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).

  What is the relationship between nutrient adequacy and caloric restriction (assuming a food-based diet without vitamin or mineral supplementation)?

  • References

    Ashley JM, Herzog H, Clodfelter S, Bovee V, Schrage J, Pritsos C. Nutrient adequacy during weight loss interventions: A randomized study in women comparing the dietary intake in a meal replacement group with a traditional food group. Nutrition Journal 2007; 6: 12.
    
    Gardner CD, Kim S, Bersamin A, Dopler-Nelson M, Otten J, Oelrich B, Cherin R. Micronutrient quality of weight-loss diets that focus on macronutrients: results from the A TO Z study. Am J Clin Nutr. 2010; 92 (2): 304-312.
    
    Ma Y, Pagoto SL, Griffith JA, Merriam PA, Ockene IS, Hafner AR, Olendzki BC. A dietary quality comparison of popular weight-loss plans. J Am Diet Assoc. 2007; 107 (10): 1,786-1,791.
    
    Noakes M, Foster PR, Keogh JB, Clifton PM.  Meal replacements are as effective as structured weight-loss diets for treating obesity in adults with features of metabolic syndrome.  J Nutr 2004; 134(8): 1894-1899.
    
    Truby H, Hiscutt R, Herriot AM, Stanley M, Delooy A, Fox KR, Baic S, Robson PJ, Macdonald I, Taylor MA, Ware R, Logan C, Livingstone M. Commercial weight loss diets meet nutrient requirements in free living adults over 8 weeks: a randomised controlled weight loss trial. Nutr J. 2008; 7: 25.