Question #1 August 2014
Q1: How can
this method of assessing intake be valuable information and evidence for the
practice of dietetics? How could we encourage consumption of fruits and
vegetables containing carotenoids by implementing this type of assessment?
posted by Haleyhhughes @ 1:36 PM
11 comments
11 Comments:
Once we know how much F/V kids are actually eating, we may dive deeper into figuring out why they do/don't eat certain F/V. This could help aide in the creation of different interventions to promote more F/V consumption. I learned that if you get kids involved in the kitchen and prep process they're more likely to try the foods. We could educate kids about the importance of eating different colors to get different nutrients. We can also show them the evidence that a higher consumption has positive physical impacts on their body.
I think this could be helpful in the dietetics world. Many of these tests aren't done because we already have a method of measuring..we ask. But this isn't very accurate, and parents will lie about their children's consumption as well. I don't think it needs to be done to every pediatric patient but maybe if they know we have a very accurate way of knowing they will do a better job. I think Tina is right its important to make fitness a fad! We need to teach kids the importance and not approach it as medicinal.
Fruit and Vegetable intake is a great marker of overall nutritional adequacy as a diet high in F/V is often high in all of the essential nutrients, so this type of assessment is definitely beneficial because it is so much more accurate than a hand-written FFQ or Dietary Recall--so we can have a much better grasp of where our client is with overall dietary adequacy. When we are working with children, it's quite tough to rely on their memories being transcribed onto paper for us to analyze for nutritional adequacy. When I was working with Health Promotion and Wellness, I analyzed quite a few 72 hour dietary recalls, and I would always see scribbles, white-out marks and all that...as people would probably forget to write something or need to make changes or whatever, so if adults are having trouble recalling everything they eat and remembering to record it, children probably aren't the most accurate either. Plus I would always have clients say things like "Oh, I guess I had three chicken breasts that night, but I only wrote chicken breast, so you wouldn't have known how many I had" So with a FFQ or a recall, portion sizes are hard to really identify accurately. Many people (especially children) don't know what 1 cup of spinach looks like, much less actually measure out 1 cup of spinach leaves...so with these types of assessments we can pinpoint levels of certain nutrients (in this case carotenoids) and use that to give us a better picture of overall f/v consumption, nutritional adequacy etc. in a more accurate, and also honest, way--which I am all for.
I don't know how feasible these tests are to conduct with every client/patient but I think it's a step in the right direction. It'll be really interesting to see where technology and science takes our profession in the coming years...very exciting, but I sense a lot of changes on the horizon. Very interesting article!
Arthur makes a good point that if adults can't even remember what they ate and do a recall, it would be even harder for children recalls to be accurate. I think doing these types of assessments such as testing serum carotenoid is a better method, I'm just not sure how feasible it is for the majority of the population.
I agree that this method of assessment could be extremely valuable in our field. If we have concrete evidence to show the amounts of fruits and vegetables that people are eating, we will have a better chance of determining risk factors for disease, and goals to strive for to reach optimal health. Basing our recommendations on serving sizes is a good start, but it is always helpful to be able to be more specific and tailor our goals to each individual client.
Arthur brings up a good point that FFQs are confusing, inaccurate, and time consuming. If we could implement this type of assessment, it would improve in all of these areas and make us more effective in our jobs.
I think measuring the amount of carotenoids in the body could help us determine whether the carotenoids themselves are truly important in protecting against specific diseases. In the past, we have assumed that if people eat certain foods, they have certain levels of carotenoids in their body and those carotenoids have specific effects. This test will allow us to compare the actual (as opposed to assumed) amount of carotenoids in the body and the liklihood that a disease state is present.
I think that this test just gives us an accurate way of measuring consumption because as a few people have already mentioned, people are not usually very accurate in their recalls, whether it is intentional or not! As Arthur said, I’m not sure it would be feasible to do this test on every single patient but I could definitely see this having a use in the future with research as a more accurate way of measuring intake versus using a dietary recall method. Jeanne brings up a great point of determining whether carotenoids have a role in disease prevention with this test! Perhaps in the future this test will be used similarly to a hemoglobin test to measure iron deficiency and anemia in a setting such as WIC? Guess we’ll have to wait and see what the future holds!
Jeanne brings up a good point regarding the benefits of specific tests like this...if researchers have the ability to objectively measure actual serum levels of different phytonutrients and things of that sort, there is actual hard evidence for correlating those levels to the presence or absence of a particular health condition or disease state. As she said, in the past we have just kind of assumed that eating carotenoids=high serum levels=better health=everybody is happy.
Measuring the actual levels can be of great help to either confirm or otherwise debunk that notion; or any correlation between blood levels of any substance and diseases for that matter.
Anything that can provide us with a more accurate record of a child's F/V intake is going to be useful. Children are not good self-reporters of intake for obvious reasons, and this method offers us more reliable empirical data to work with. Eventually, after the test has been used for a number of studies, we might find that F/V intake is actually even lower than we'd thought. Then, if we know there is a significant deficit in carotenoid intake among certain populations, we have a stronger argument for pushing the fruits and vegetables that are highest in carotenoids to those people.
Brady mentioned that children are not good self-reports, but that is probably true of most adults, as well. Sometimes, even with the best intentions and the necessary knowledge, we forget to write things down or misjudge a portion size. We don't really know how accurate any food record is.
This method of measuring fruit and vegetable intake can be very valuable for our field, because as some have previously mentioned, we don’t really have a true way of measuring someone’s diet. We have to rely on people being honest, and that they have accurately recalled every food that they ate. This new method holds people accountable for their dietary intakes, and it could provide unbiased results.
We could use this type of assessment to encourage the consumption of fruits and vegetables containing carotenoids by telling patients and clients to strive for a high carotenoid level. At appointments, the patient’s carotenoid level could be measured, and then we as RDs will know if they are actually eating carotenoid-containing fruits and vegetables.
This assessment could also improve research in the dietetics field. Since diets high in carotenoid- containing produce are associated with a lower risk for developing chronic diseases, studies could be done to determine the threshold for what carotenoid level needs to be reached for disease prevention to occur. Then RDs could have patients strive for that carotenoid level.
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