eNutrition 201
a TwoOldGuys™ e-Course
Nutrition for Nursing Students, independent study
Quiz 1


For the Final Exam for this course, you will be expected to assess the diet of a real, living Human [who will be known as “patient”], and to provide advice for specific changes to the diet to improve the long-term nutritional status of the patient. Obviously, before you can assess the patient's diet, you must first determine what their current diet is.
    Your first “quiz” is designed to provide these data, and nothing more. You are not expected to start the actual final paper today. The assessment and recommendations in the final paper (when you write it later) will require you to apply virtually everything you are expected to learn from this course [and if you have already learned it without this course, why are you taking this course rather than trying to ‘test out’ of it?] to an actual case study, which is why the paper is called “final exam” rather than “term paper” although it should look like a term paper, complete with citations in APA format. By collecting the diet data at the beginning of the semester, and using the software to convert “food” to “nutrients” this early, you will have a picture of your patient's diet so you can apply what you learn as you learn it to a real, live Human creature!
    Select a patient from whom you will be able to collect detailed food intake information. You should know that HIPAA regulations apply to these data, your assessment, and your recommendations. Therefore, patient confidentiality requires that you do not disclose the patient's identity in any documents you create for this course. In order for me to grade the documents you are to create, I will need to know the patient's age, sex, height, weight, and any health history which is directly relevant to your recommendations. If you are unclear as to what HIPAA allows you to disclose see the link to U.S. Department of Health & Human Services website, and click on 'Understanding HIPAA Privacy.' [Even if you are taking this course from somewhere other than the United States, the U.S. regulations apply because your reports will be submitted into the U.S., to a “covered entity,” which can be considered to be engaged in research.]
    You are to collect total food intake [food item, quantity usually as volume (cups, ounces)] for seven (7) consecutive days. The rationale for requiring 7 days is that the patient may object that one to three days data do not reflect how they ‘normally’ eat. Seven days will be how they normally eat unless there was an unusual event, such as a lengthy family emergency. Besides, having collected such detailed information for such a long time, you will see why weight management programs which require reporting comparable details over months [years even] tend to have high “drop-out” rates. The data are to be grouped by day, then by meal [Breakfast, Lunch, Dinner, Snacks]:
  ·Breakfast is considered to be a meal consumed after arising and before beginning the day's activities. It includes second breakfast, but not elevenses, if your patient is a Hobbit (from J.R.R.R. Tolkien).
  ·Lunch is considered to be the midday meal, even if it's only a snack.
  ·Dinner is considered to be the evening meal (dinner, supper, or both).
  ·Snacks is considered to include all snacks [mid-morning, elevenses, mid-afternoon, high tea, cocktail hour, evening, late-night, bedtime, midnight refrigerator raid, …].

    These data are to be entered into the Diet Analysis Plus software, which I required along with your textbook. If you did not buy the required text bundled with Diet Analysis Plus 9.0 Windows/Macintosh CD-ROM, 9th Edition, the software CD-ROM can be purchased separately from Wadsworth Cengage Learning. The Diet Analysis+ software will convert “food” to nutrients, and compare the daily averages to the recommended daily average intake values [as a percent]. This will save you a huge amount of research and frustration trying to find these conversions yourself.
{HOW TO} Open DietAnalysis+ by clicking on the DA+ button; You will then have an option to take a tutorial on how to use the program. (I recommend taking the tutorial, but it's entirely up to you; it is not required.)
    1) Then click on the Profile button and then the *Create Profile button and follow instructions to create a file for your patient [the name you enter for the profile WILL print on the reports, so do not enter the patient's actual name!]. Once you have the profile started,
    2) click on the Track Diet button, to enter your data. Due to a limitation of the software, you should enter only one day at a time;
    3) then click on the View Reports button to SAVE THE DATA & exit Track Diet. By viewing a report, you can confirm that the data was saved correctly.
    4) Now, click on the Track Diet button again to enter one more day. Be sure to exit by clicking on the View Report button, or the data will not be saved.
    5) Repeat until all 7 days are entered.
You could use MyPyramid on the link to USDA's My Pyramid website, then click on “MyPyramid Tracker”, but it allows only one day's data, so you will have to average the seven days manually.
  Diet Analysis+ does allow you to “create a food” or even a recipe. To create a food you will have to type in the name of the food, and all of the information off the nutrition facts label. I recommend (but do not require) that you create at least one food, just to get practice reading Nutrition Facts labels.
  For now [quiz 1] you are to print out the Diet Analysis+ results, which can be done by:
{HOW TO, continued}
    6) select Print Reports from the buttons at the top, then Custom Average Reports.
    7) Follow the steps across the top: step 1 choose a start date, step 2 choose an end date (to include all 7 days of data); step 3 choose the reports to average [Profile DRI Goals and Intake vs Goals must be checked (and all other reports must be unchecked); step 4 choose meals, check all four;
    8) then click on the Print Custom Average button on the lower right - the selected reports will display.
    9) Finally from the file drop-down menu (far upper left) click on print. In the print dialog box, you have the option to select the printer; select print to file [it may say Microsoft Document Writer], and you will be instructed to select where to save the document & what to name it; I would save into a folder for Nutrition homework..This file can be attached to an email to submit your Quiz 1 answer, and can be copied to a flash drive to take it to another computer. THE ACTUAL DATA FILE CANNOT BE COPIED TO A FLASH DRIVE!

If you ‘mis-place’ your file copy or your copy of the printed results, you will need to remember the date range of your data in order to reprint the reports later [while you are working on your final paper, which probably won't be until toward the end of the semester].
    5) For Quiz 1, I need to see only the Profile DRI Goals & Intake vs Goals reports.
  For your own interest, you may display or print [use the Custom Average Reports to do this; the other available reports use a three day average] any of the reports that sound interesting to you.
  Later, you will assess adequacy of the patient's diet as your final exam for this course. The details of this assessment are at the link to the final exam on the course outline. In brief, the assessment will examine caloric balance and nutritional value. You will be expected to identify potential problems both with insufficient nutrient intake and with excessive nutrient intake. From the identified problems, you will select the two or three which you consider to be the most serious, and explain why you chose the ones you chose. Then you will make specific recommendations for the patient to correct these two or three problems, and explain why you chose to correct them as you did [remembering that I have a strong bias toward getting nutrients fromfood, not supplements, unless your patient is pregnant].

Obviously, it will take 7 days to collect 7 days worth of data. Therefore, Quiz 1 will not be due until you have had time to collect and enter seven days worth of data. The “question” for Quiz 1 is “Collect 7 days worth of diet data for an actual patient.



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revised: 15 May 2010