Energy Expenditure


In addition to questionning the patient and/or family about calorie intake, the Expert Committee (2007) also recommends qualitative data gathering about physical activity or "energy expenditure" of the child. This data should be gathered at the minimum during each well-child visit for anticipatory guidance.

The current recommendations are that children engage in:



The following provides the specific recommendations and some suggested qualitative questions for the practicing NP:

Expert Committee Qualitative Assessment Recommendations

Suggested Qualitative Interview Questions for NPs

Assessment of levels of physical activity and sedentary behaviors:



1.    How often is your child able to be physically active?

2.    What types of physical activity does your child like?

3.    Do you feel like you there are things that keep your child from being physically active? (Assessing here for environmental and/or social barriers to being active)

4.    How many hours would you say your child engages in sedentary behavior such as watching TV or DVDs, playing video games, and using the computer?

After questioning, consider if the patient/family needs to consider changes in their physical activity practices to embrace a healthier lifestyle:

Self-Efficacy and readiness to change

1.    Does the patient/family feel like they are able to make changes in their current dietary practices?

2.    Do they feel confident that they can make changes and eat a healthy diet?

3.    Is the patient/family ready to make changes for a healthier diet?


As on the previous page - it would be one strategy to add these questions to a written questionnaire as the patient/family is waiting for their visit, review them during the visit and engage any or all of the necessary self-efficacy questions if necessary.