Calorie Consumption:


One thing is for sure -- you don't need to be a dietician to counsel patients and their families on appropriate eating patterns!


 The Expert Committee recommends that primary care providers perform a qualitative assessment of all of their pediatric pateints' dietary patterns at each well child visit for anticipatory guidance.

Qualitative assessment is a general term for verbal questioning of the patient and/or their family members. Included in this assessment should be the following:


Expert Committee Qualitative Assessment Recommendations

Suggested Qualitative Interview Questions for NPs

Identification of specific dietary practices

1.    How often does your child/family eat a meal at a restaurant or fast food establishment?

2.    Does your child drink sweetened beverages such as soda/pop, 100% fruit juices, or other sugared drinks? How much and how often?

3.    When your child eats a meal, what portion size does he/she eat?

4.    Does your child/family eat breakfast – how often and what type of breakfast do you typically eat?

5.    What types of snacks does your family/children typically eat (look for responses that indicate excessive consumption of snacks high in energy density, i.e. Junk food)

6.    How many fruits and vegetables does your family/child eat per day?

After questioning, consider if the patient/family needs to consider changes in their dietary 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?


One strategy to same time during an office visit is to provide the patient/parent or family member accompanying the patient with a handout that addresses the dietary questions to fill out in the waiting room or patient room as they wait for their visit. Then you can review their responses and initiate the self-efficacy for change questions if you believe they are necessary.