ASSIGNMENT 2: DIET RECORD ANALYSIS
ASSIGNMENT 2: DIET RECORD ANALYSIS Due: December 4th at 11:59 pm (EST) via CourseLink Dropbox • Section 1: Interpreting a growth chart. • Section 2: Analyzing a food record and comparing the nutrient intakes to the DRIs. • Section 3: Analyzing the feeding schedule of this family. • Section 4: Reflecting on the difference between feeding and eating. • Section 5: Fostering a non-judgmental and inclusive health care space. MAKE SURETO READ THE ASSIGNMENT, CASE STUDY & RUBRIC CAREFULLY! SECTION 1: INTERPRETING A GROWTH CHART • Review of terms… • Gestational age = • Chronological age • At birth = • After birth = ⮚Corrected age = ⮚ Your infant was born at 31wk, they were 9 wk preterm. If your baby is now 4months old (16 wk), what is their corrected age? SECTION 1: INTERPRETING A GROWTH CHART • Plot anthropometric measurements on a growth chart & complete Table 2 • Using the WHO growth charts for Canada, Birth to 24 months: Girls (Set 1 with 3rd to 97th percentile) (httzzzzzzzzzzzzzzzzzzzps://www.dietitians.ca/Dietitians-Views/Prenatal and-Infant/WHO-Growth-Charts/WHO-Growth-Charts-Set-1.aspx • Include your completed growth charts in your assignment appendix CASE STUDY Baby boy Matt was born at 39wk2d = considered term birth, would Age Weight (kg) Length (cm) HC (cm) ▪ Birth weight: 3178g = 3.2kg = ▪ Birth length: 52cm = ▪ Head circumference (HC): 33cm = You see this family in your office when Matt is 7months old because caregivers have concerns about his growth. They provide the following measurements 2weeks 3.45 53 35 5 weeks 4.01 63 36.5 3.5 mo 4.25 62 40.5 6mo 6.63 66 44 Today (7 mo) 7.12 69 44 BB Matt BB Matt SECTION 2: ANALYZING DIETARY RECORD • Using Cronometer (https://cronometer.com/) analyse this food record. • Under the tab Diary, you will enter every single food item listed by the caregivers using the function Add Food and the appropriate portion size. • To add recipes, under the tab Food, you can create a recipe with the ingredients listed by the caregivers. You can then add this recipe to the food diary. • Some details are missing from the food record where caregivers have omitted important details. You will have to make assumptions. • Include a screenshot of each day of the food record as entered in Cronometer (in the Appendices) SECTION 2: ANALYZING DIETARY RECORD SECTION 2: ANALYZING DIETARY RECORD • Use this information on macro & micronutrients to complete Table 3 • Use DRI Tables to interpret • Comment • Macronutrients- compare to AMDR SECTION 2: ANALYZING DIETARY RECORD • Question 2: Name 3 examples of food items that you would want clarifications on from the caregivers. Because details were missing, what assumptions have you made for these 3 examples? Be very specific. 3 bullet points, max ½ page double spaced. • Question 3: What is missing from this food record? Max 2 sentences double spaced. • Question 4: Take a closer look at the nutrient values for the PC Purée pouch, and Annie’s mac’n’cheese. What do you observe? Why is this? (hint: are all the nutrients available? What is the database used?) 1 paragraph, max ½ page double spaced. • Question 5: Suggest 2 nutrition topics you would discuss with the caregivers. Be specific and explain your rationale in making these recommendations. 2 paragraphs. Max 1 page double spaced. SECTION 3: ANALYZING FEEDING SCHEDULE • Question 6: • a) List 2 open-ended, non-judgemental questions you would ask Huang’s caregivers to better understand their reality and struggles feeding Huang. Comment on the feeding schedule you observe from the 3-day food record. • b) Identify one strength and one area of improvement that you would discuss with the caregivers. • Max 1.5 pages double spaced. SECTION 4: REFLECTING ON FEEDING & EATING • Question 7: Reflect on the difference between feeding and eating, and who plays which role in the feeding dynamic between Huang and her caregivers. How would you explain this concept to the caregivers? 1 paragraph, max ½ page double spaced. • Question 8: Discuss 3 potential reasons that caregivers might be concerned about their toddler eating habits. To justify your answer, select 2 peer-reviewed articles (primary or secondary research article) and reference those articles in your text and at the end of your report in your reference list following APA style. Max 1 page double spaced. o These two articles can relate to any aspect of this case study but MUST relate to the case (e.g. toddler growth, nutrient intake, feeding dynamic, parental concerns with children’s food relationship, cultural safety, etc). SECTION 5: FOSTERING A NON-JUDGMENTAL & INCLUSIVE HEALTH CARE SPACE • Question 9: We want to hear your thoughts. How can we make health care settings more inclusive for groups who are systematically excluded such as racialized groups, Indigenous peoples, Black people, people of color, LGBTQ2S+, and more? Max 1-page double spaced. REFERENCING • In-text citations not required to answer q2-q7, BUT specific links to the case study need to be made • Reference primary or secondary research in question 8 • Question 9 is based on your own opinion, but a strong reflection would reference research or policy statements to support reflection QUESTIONS? Pre-Class Readings: https://olderadultnutritionscreening.files.wordpress.com/2022/06/screen 14-tool_2022.pdf https://olderadultnutritionscreening.com/resources-for-older-adults/ https://csepguidelines.ca/guidelines/adults-65/ NEXT LECTURE: OLDER ADULTS Nutr2050 Appendix to Course Outline Assignment 2: Diet Record Analysis Due: December 4th at 11:59pm (EST) via CourseLink Dropbox Assessing a child’s growth and dietary intake provides valuable information about their overall health and eating habits. Assessing usual dietary intake is challenging since what caregivers feed their child can vary from day to day based on food accessibility, seasonal availability, cultural preferences, family values and food skills. Additionally, what a child might eat from the food provided by their caregiver can also change from meal to meal, based on the environment, the time of the day, and the presence of others at the mealtime. In this assignment, you will complete a growth chart with the measurements the caregivers have provided you for their child. You will also analyze a 3-day food record (also called diet record) that has been completed by the caregiver of a child. You will analyze the average intake across these three days and compare them to the Dietary Reference Intakes (DRIs). You will reflect on the process, interpret the data caregivers have given you, and provide some guidance for the caregivers on the feeding habits. The goal of the assignment is to learn about the process of analyzing a diet record and completing a growth chart, and the challenges that are inherent to these methods. You will also propose ways to foster a non-judgmental and inclusive health care space. The sections of this assignment include: Section 1: Interpreting a growth chart. Section 2: Analyzing a food record and comparing the nutrient intakes to the DRIs. Section 3: Analyzing the feeding schedule of this family. Section 4: Reflecting on the difference between feeding and eating. Section 5: Fostering a non-judgmental and inclusive health care space. Case Study: Baby Huang You are a registered dietitian in a family health team. A family comes to visit you on August 28th, 2023, for nutrition support. Their baby, Huang, is a young girl born on March 28th, 2022 at 39wk 5day gestation. The caregivers have brought some anthropometric measurements they had noted down, and they also completed a 3-day diet record. The caregivers voice that they are worried about Huang’s food intake and growth. They are not sure if they should be Page 8 of 20 Nutr*2050 Appendix Fall 2023 NUTR*2050: Nutrition Through the Lifecycle concerned that she sometimes refuses to eat at meals, and if they should offer formula in these cases. They are hoping you will guide them. Anthropometric data as provided by the caregivers Weight Length Head circumference Birth 2813g 48cm 32cm May 9th, 2022 9.26lbs 57cm 35.2cm July 28th 2022 5.8kg 63cm 39cm Oct 9th 2022 14.5lbs 74cm Dec 28th, 2022 16.3lbs 70cm 42.4cm January 30th 2023 7.8kg 73cm March 28th 2023 17 lbs 10 oz 44.0cm August 28th 2023 19.4lbs 80.5cm 45cm Food record as provided by the caregivers Time Day 1 – Aug 24 Daycare (9am – 3:30pm) Day 2 -Aug 25 Daycare (9am – 3:30pm) Day 3 -Aug 26 Home 6 am 4oz formula 6 oz formula - 7 am Half a slice white toast 1 spoon peanut butter 2 cup cheerios 1 cup 3.25% milk - 9 am ½ cup Oikos Greek yogurt, vanilla 1 clementine 1 purée pouch (https://www.presidentsch oic e.ca/product/pc-organics banana-sweet-potato-and blueberry-strained-baby food/20666167004_EA) 3 bites blueberry muffin 3 blueberry pancakes that we made at home 1 tbsp maple syrup 4 slices of a peach 10:45a m 1 cup 3.25% milk 1 cookie Refused rest of lunch 1tbsp hummus 6 slices cucumber 2 pork meatballs Half bagel 8 oz formula 1 pkg. Toddler Mum Mums, strawberry (https://mummums. co m/collections/toddl er mum-mums 1/products/toddler mum-mum-organ ic strawberry-rice biscuits) 11:30a m 1:30pm Nap time Nap time Nap time 2 pm 7 soda crackers 30g cheddar cheese ½ banana Refused snack 1/2cup baby cereal 4 pm serving smoothie Recipe (gives 10 servings) - - Page 9 of 20 Nutr*2050 Appendix Fall 2023 NUTR*2050: Nutrition Through the Lifecycle 2 cups plain non-fat Greek yogurt 2 tbsp maple syrup 3 cups frozen mangos 2 cups 3.25% milk 5 pm 2 bites spaghetti with beef and tomato sauce 1 cup milk Didn’t eat much - 6:30 pm 2 oz formula Half a serving smoothie 2 oz Annie’s Mac n Cheese 10 blueberries 2tbsp Oikos Greek yogurt, vanilla 7 pm Bedtime No milk during the night 10 Goldfish crackers, baked cheese flavour 1 plum 8 pm - Bedtime 3 oz formula Bedtime 8oz formula Format of the report • Maximum length 9 pages (title page and appendices do not count in the page limit); Include page numbers. o Specific guidance for each section and the maximum length for each question’s answers is specified throughout the outline. o Please use your judgment when respecting the length limit. These limits are suggested to ensure you elaborate on your key points in a succinct and organized manner. o Please indicate the section and question you are answering using subheadings. This will make grading easier. • Use 12-point font, Arial, double space, 2.54cm margins all around • Submitted in a Word format on your personal DropBox via CourseLink. Turnitin will be used. It is expected that it will flag the food record analysis, but all your answers to the questions should be in your own words. Content of the report Section 1: Interpreting a growth chart • Complete Table 1 below. • Complete Table 2 with Huang’s age, weight (kg), length (cm), and head circumference (cm) for each of the dates provided by the caregivers. • Using the WHO growth charts for Canada, Birth to 24 months: Girls (Set 1 with 3rd to 97th percentile) (https://www.dietitians.ca/Dietitians-Views/Prenatal-and Infant/WHO-Growth-Charts/WHO-Growth-Charts-Set-1.aspx), plot the data on the appropriate growth chart and identify the percentile for each time point. Note the percentiles in Table 2. Include the completed growth charts (in the appendices). Page 10 of 20 Nutr*2050 Appendix Fall 2023 NUTR*2050: Nutrition Through the Lifecycle • Question 1: What is your overall interpretation of the growth for each marker in Table 2, following what we have done in lectures (e.g., discuss the pattern of growth over time, and any details we should be aware of when interpreting the results). What would you tell the caregivers? 1 paragraph, max ½ page double space Table 1: Demographic data of the child Date of visit Name Sex Date of birth Gestational age Chronological age Corrected age Table 2: Anthropometric data of the child Date Age Weig ht (kg) Percentile Leng th (cm) Percentile Head circumferen ce (cm) Percentile Weight to Length ratio (percentile) Overall Interpretation Section 2: Analyzing a food record and comparing the nutrient intakes to the DRIs Using Cronometer (https://cronometer.com/) analyse this food record. • Under the tab Diary, you will enter every single food item listed by the caregivers using the function Add Food and the appropriate portion size. • To add recipes, under the tab Food, you can create a recipe with the ingredients listed by the caregivers. You can then add this recipe to the food diary. • Some details are missing from the food record where caregivers have omitted important details. You will have to make assumptions. • Include a screenshot of each day of the food record as entered in Cronometer (in the Appendices) Page 11 of 20 Nutr*2050 Appendix Fall 2023 NUTR*2050: Nutrition Through the Lifecycle Complete Table 3. Use 1 decimal point for the intakes. • List the RDA/AI and UL values for this child for the selected nutrients, Refer to the DRIs tables from Health Canada (https://www.canada.ca/en/health canada/services/food-nutrition/healthy-eating/dietary-reference intakes/tables.html) • Briefly compare these nutrients to the DRIs for this child. Question 2: Name 3 examples of food items that you would want clarifications on from the caregivers. Because details were missing, what assumptions have you made for these 3 examples? Be very