Pediatric Nutrition in Practice

16 Emmett

Dietary History Method

The diet history method aims to find out what is
being eaten or drunk by the subject over the
course of a usual day [2]. For some eating occa-
sions and meals, this is a relatively simple task,
because some basic foods are eaten at similar
times almost every day. For the more complex
meals, the usual day needs to be expanded: for the
purposes of this type of assessment, covering a
usual week will provide enough information in
the first instance. The questioning should be sys-
tematic with standard prompts and follow-up
questions, as listed in table 1 ; however, some re-
sponses may be unexpected and should be probed
with further questions at the time. Always return
to the basic plan of the interview after a diversion
in order to cover the whole day. A record should
be kept during the interview of what is being said;
this could be a voice or video recording if the
child/parent is happy to allow it.
It is important to keep in mind the length of
the interview because if the interview is very
long, the child/parent may become bored or
stressed and give less accurate answers. It may be
possible to split the interview into sections car-
ried out at different times. A simple diet history
would typically take 45 min to complete, but if
the usual foods consumed are complex, it may
take much longer.
It is imperative not to show surprise or to
com ment on w hat i s b ei ng con su me d du r i ng t he
assessment, because it is important not to inf lu-
ence the answers given by the child/parent. The
aim is to obtain as accurate a picture as possible
of the child’s normal diet. This should give a
reasonable understanding of the type of foods
usually eaten and should allow a basic assess-
ment of whether there is likely to be a dietary
problem. This information will also help to tai-
lor any dietary advice needed to the individual
situation.

Diet Records

As a helpful adjunct to the main method, the par-

ent/child could be asked to keep a record of all the

foods and drinks consumed by the child over a

period of time [3]. Typically, this would be for at

least 24 h but may be between 3 and 7 days. In

some circumstances, it could be helpful to request

that diet records are kept for a few days prior to

the initial interview; they could then be used to

speed up the gaining of the detailed diet history.

Another area where they could be extremely help-

ful is in monitoring the child’s diet over time, ei-

ther to understand further the dietary problem

that has presented or to assess the degree to which

advice is being followed. In the latter case, asking

the child/parent to record the child’s food and

drink intake once or twice a week over the period

between consultations may be more helpful than

asking for more continuous recording. When the

diet records are received, they should be used as a

basis for follow-up questions to clarify any parts

that are not explicit. They can then be used to re-

inforce and adapt the dietary advice that has been

prescribed. If the parent/child is unable to keep a

record, then asking them at the follow-up consul-

tation about foods/drinks consumed by the child

over the previous 24 h could be helpful in inform-

ing the next stage of the consultation.

Interpretation and Advice

Table 2 lists some of the key aspects to consider in

interpreting a dietary assessment of a particular

child. As suggested, the interpretation is driven

by the problems with which the child has present-

ed, and examples are given for the most common

diseases related to diet. The type of health profes-

sional most likely to be of help in each situation is

also suggested.

The main usefulness of the dietary informa-

tion collected is to get an understanding of the

balance of the foods consumed, of any obvious

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 14–18

DOI: 10.1159/000367877