Is your diet a healthy one? Are your nutritional and activity needs being met?

Working with seniors and teens, there is a need for a checklist to determine their general level of nutrition and physical wellness. Within a structured conversation and observation, those most in need of further assistance can be identified.

I’m a fan of quick check guidelines and rubrics. I have always been impressed with the elegance and simplicity of the APGAR score for newborns. Five easy to assess criteria, 3 ratings 0-2, add them up and act according to a list of “what to do’s” based on total score. Something like that for assessing nutrition and activity is ideal. Not too many things to remember to check. Questions that are revealing without being viewed as intrusive. Easily observed characteristics to check / confirm / substantiate answers to questions.

Anyone dealing potential nutritionally-fragile populations like teens and seniors needs a quick and easy assessment to find those in need of further assessment and/or intervention. This is more complex than the APGAR – newborns are in their birthday suits so you can get a good look. In adolescence and adults, clothing can hide a lot of clues. Verbal communication may be limited – teen yes/no answers to any question posed by an adult, seniors worried about giving the “wrong” answer. Getting information for assessment can be challenging.

Based on a brief conversation and general observation, this quick check can determine if basic nutrition and activity for good health are being met.

1. eating what – 5 serving of each of 3 main food groups – fruits and vegetables, grains and starches, and protein (5 oz total)
   2 – appropriate food choices, likely to be getting adequate nutrition and a variety of nutrients daily
   0 – too little for good health, may signal eating disorder
   0 – too much contributing to weight management problems
    
2. eating when – 3 meals (each about 25-30% of total daily calories) + snacks (no more than 5-10%), within 2 hours of getting up, at least 2 hours before going to bed
   2 – calories spread over time, never really hungry
   1 – hungries and low energy periods that lead to overeating, metabolic “starvation” mode
   0 – skipping meals, binge eating, junk food replacing meals
    
3. exercise / activity – at least 30 minutes per day, not out of breath going up one flight of stairs
   1 – obsessive exercising can signal eating disorder
   0 – inadequate activity for muscle tone, healthy bodily functions
    
4. weight – near BMI – not significantly above or below (??%)
   1 – somewhat underweight or overweight – BMI %
   0 – significantly underweight or overweight – BMI %
    
5. wellness – good color – face, eyes, tongue, breath, hands, nails
   1 – indicator that one or more of the other indicators are not being met
    
6. hydration – palms, finger tips, liquids
   0 – a significant portion of the population suffers from dehydration, especially seniors leading to urination problems, and constipation
    
7. medication – diabetes, cholesterol, blood pressure, depression, stress, weight-loss
   1 – not necessarily a problem but in combination with other factors, may contribute to drug/food interactions

What’s going on here…

Low “scores” can indicate a variety of problems that need to be verified and/or addressed.

• poor nutrition that can lead to later health problems – inadequate bone formation or bone loss, osteoporosis, anemia
• deficiencies of important nutrients essential to good health – calcium, iron, vitamin B12 and vitamin D
• possible eating disorders – the decision to become a strict vegetarian or adopt an overly restrictive diet can be an early sign that a teen is developing an eating disorder such as anorexia
• adequate protein from alternative sources – vegetarian foods that contain protein include beans, nuts, nut butters, lentils, tofu and other soy products

Learn more…

Vegetarianism in Teens
http://www.pamf.org/teen/health/nutrition/veggieteens.html

APGAR Scoring for Newborns – A score is given for each sign in the first few minutes after the birth.
http://www.childbirth.org/articles/apgar.html

Eating Attribute Test (EAT-26) – screening for eating disorders – questions seem leading, most middle school kids would have considered all the indicators and would register as potential eating disorder candidates