CNU 503 Quiz 2

What are the intended uses of the DGA?

MyPlate guidance, SNAP/WIC, Healthy People 2030, nutrition monitoring, research funding, food fortification, food labeling, and federal nutrition programs. (Slide: “Where Dietary Guidelines Should be Implemented.”)

What is the overall approach of the 2025–2030 DGA?

Greater emphasis on nutrients and specific intake targets. (Slide: “Greater emphasis on nutrients and specific intake targets.”)

What is the updated protein recommendation?

1.2–1.6 g/kg/day with protein at each meal. (Slide: “1.2–1.6 g/kg/day… Protein at each meal.”)

What is the updated guidance on dairy?

Full‑fat dairy recommended.
(Slide: “Full‑fat dairy.”)

What is the updated guidance on added sugars?

No added sugars or non‑nutritive sweeteners; <10 g added sugar per meal. (Slide: “No added sugar… per meal <10g added sugar.”)

What is the updated guidance on whole grains?

Still included but much less prominent. (Slide: “Retained but much less prominent.”)

What is the HEI?

Healthy Eating Index — a measure of how well dietary intake aligns with the DGA. (HEI is used to evaluate diet quality based on DGA standards.)

What does DGA stand for?

Dietary Guidelines for Americans. (Slide title: “The Dietary Guidelines for Americans.”)

What is a patient‑empowering message based on the DGA?

“Focus on adding nutrient‑dense foods like fruits, vegetables, whole grains, and dairy to improve overall health.”

Another empowering message?

“Small changes—like choosing full‑fat dairy or adding protein at each meal—can help meet DGA targets.”

Another empowering message? 2

“Limiting added sugars and saturated fats supports long‑term health and aligns with national nutrition guidelines.”

What is an FFQ?

A tool used in observational cohort studies to estimate typical eating patterns over a specified period. Slide: “Designed to be a gauge of typical eating patterns over a specified period of time.”

Strengths of FFQ?

Captures occasional foods, low participant burden, easy to code, good for large groups. Slide: “Able to capture occasional foods… lower participant burden… automatically coded.”

Weaknesses of FFQ?

Relies on recall, not fully quantitative, may not fit all demographics, social desirability bias, long (30–60 min). Slide: “Impossible to be truly quantitative… more subject to social desirability bias.”

Examples of FFQs?

Harvard FFQ, NCI FFQ, Block FFQ, NHANES FFQ. Slide: “Harvard FFQ… NCI FFQ… Block FFQ… NHANES FFQ.”

What is a food record?

A written or electronic log of foods eaten, including time, description, brand, preparation, and portion. Slide: “Usually prompts for meal/time, food description, brand, preparation and portion.”

Strengths of food records?

Most quantitative, best for nutrients, less recall bias, inclusive, captures timing and patterns. Slide: “Best for determining individual nutrients… less likelihood of forgetting foods.”

Weaknesses of food records?

High burden, affects eating behavior, expensive to analyze, variable completion quality. Slide: “High participant burden… affects eating behavior… a pain to analyze.”

What is a 24‑hr recall?

An interview (computer or practitioner) collecting all foods eaten in the past 24 hours using a multi‑pass method. Slide: “Requires multi-pass method… practitioner interviews client.”

Strengths of 24‑hr recall?

Low burden, open‑ended, good for nutrients and food groups, can capture context, automated options (ASA‑24). Slide: “Lowest participant burden… open-ended… can be automated with ASA‑24.”

Weaknesses of 24‑hr recall?

Not suitable for usual intake unless repeated; dependent on recall. Slide: “Not suitable for usual intake without several measures.”

What rapid diet assessments are used clinically?

REAPS, Rate Your Plate, NCI short dietary assessment instruments, SNAP‑Ed tools. Slide: “Rapid Eating Assessment for Participants… Rate Your Plate… SNAP‑Ed.”

What is REAPS?

A shortened rapid eating assessment tool based on FFQ principles. Slide: “Many rapid clinical assessments are sort-of based on this model… REAPS.”

What is Rate Your Plate?

A quick dietary quality assessment tool used in clinical settings. Slide: “Rate Your Plate.”

What emerging technologies assess diet?

Image analysis, chemical mouth sensors, biochemical markers, diet indices (HEI, inflammatory index). Slide: “Image analysis… chemical sensors… Healthy Eating Index.”

What technologies detect eating timing and behavior?

Glucose monitoring, accelerometers, gyroscopes, motion sensors (ear, neck, headband), smart toilets, location‑based analysis. Slide: “Glucose monitoring… motion detecting sensors… ‘smart toilets’.”

FFQ (definition)?

A questionnaire measuring frequency of food intake over time.

24‑hr recall (definition)?

A structured interview capturing all foods eaten in the past 24 hours.

REAPS (definition)?

Rapid Eating Assessment for Participants — a quick dietary screening tool.

Food diary/record (definition)?

A detailed log of foods eaten, often used for nutrient analysis.

HEI (definition)?

Healthy Eating Index — measures how well a diet aligns with the DGA. Slide: “Diet Indices… Healthy Eating Index.”

What food groups are Americans lacking?

Fruits and vegetables. Slide: “Eat fruits and vegetables daily.”

What nutrients are Americans lacking?

Fiber, vitamins, minerals commonly found in fruits, vegetables, and whole grains. Implied from DGA emphasis on whole foods.

What foods/nutrients does a healthy eating pattern limit?

Added/refined sugar, refined grains, saturated fats, sodium, alcohol. Slide: “Added/refined sugar… refined grains… saturated fats… sodium… alcohol.”

What is the recommended limit for added sugar?

<10 g added sugar per meal; 2025–2030 DGA recommend no acceptable amount of added sugar. Slide: “<10g added sugar at each meal… 2025–2030 DGA give no acceptable amount.”

What is the recommended limit for saturated fat?

<10% of daily calories. Slide: “<10% of Calories each day.”

What is the recommended limit for sodium?

“<2300mg/day.”

According to the DGA, what defines “healthy”?

Portion control, protein at every meal, fruits/vegetables daily, healthy fats, whole grains, limiting processed foods, added sugars, sugar substitutes, refined carbs, and alcohol. Slide: “Portion control… protein at every meal… limit highly processed foods…”

What are “healthy fats”?

Fats emphasized by the DGA, often from whole foods rather than processed sources. Slide: “Healthy fats.”

What are examples of healthy eating patterns?

Mediterranean, Vegetarian, DASH, Healthy American. Slide: “Healthy Mediterranean… Healthy Vegetarian… DASH… Healthy American.”

What does US News & World Report rank?

Popular diets for healthfulness. Slide: “US News and World Report ranking of popular diets.”

Why is weight loss through physical activity difficult?

It takes ~3 hours of moderate activity to burn ~1000 kcal. Slide: “~1000 kcal… ~3 hours moderate activity.”

Why still encourage physical activity?

It is vital for good health even if weight loss is slow. Slide: “Physical activity is equally vital for good health.”

What simple dietary changes can help patients eat more healthfully?

Focus on portions, replace high‑calorie beverages, promote fruits/vegetables, substitute sugary foods, avoid fried foods, choose lean meats or seafood. Slide: “Promote simple changes… replace high-calorie beverages… avoid fried foods…”

What is an empowering message for patients?

“Shift snacks toward fruits and vegetables to improve nutrient intake.” Slide: “Promote vegetables, fruits (e.g., shift snacking here).”

Another empowering message?

“Swap high‑fat meats for seafood or leaner options to reduce saturated fat.” Slide: “Swap high-fat meats for seafood or leaner options.”

HEI (definition)?

Healthy Eating Index — measures how well a diet aligns with the DGA. (Referenced in earlier DGA slides.)

DGA (definition)?

Dietary Guidelines for Americans — science‑based nutrition recommendations. (Referenced throughout slides.)

What does OARS stand for in Motivational Interviewing?

Open‑ended questions, Affirmations, Reflections, Summaries.

What are open‑ended questions in MI?

Questions that invite elaboration and help clients explore their thoughts (e.g., “Tell me more about…”).

What are affirmations in MI?

: Statements that recognize strengths, efforts, or positive intentions (e.g., “You’re really trying hard to make this change.”).

What are reflections in MI?

Statements that mirror or paraphrase what the client says to show understanding and encourage deeper thinking.

What are summaries in MI?

Organized reflections that pull together key points and reinforce change talk.

How do you incorporate OARS into a conversation?

Use open questions to explore, affirm strengths, reflect feelings/meaning, and summarize to guide toward change.

What is ambivalence i

Feeling two ways about change — wanting to change and not wanting to change at the same time.

Why is ambivalence important in behavior change?

It is normal and expected; MI helps clients resolve ambivalence by exploring their own motivations.

What are the components of the Spirit of MI?

A: Partnership, Acceptance, Compassion, Evocation.

What is partnership in MI?

Working collaboratively with the client rather than directing them.

What is acceptance in MI?

Respecting the client’s autonomy, worth, and capacity for change.

What is compassion in MI?

Prioritizing the client’s well‑being and acting in their best interest.

What is evocation in MI?

Drawing out the client’s own reasons and motivations for change.

What are the four processes of MI?

Engaging, Focusing, Evoking, Planning.

What is engaging?

Building a trusting, respectful connection with the client.

What is focusing?

Collaboratively identifying the direction or target for change.

What is evoking?

Eliciting the client’s own change talk and motivation.

What is planning?

Developing a concrete, actionable plan once motivation is clear.

Intended applications of the Dietary Guidelines for Americans (DGA)

Federal programs and clinical initiatives including MyPlate guidance, SNAP and WIC standards, Healthy People 2030 targets, national nutrition monitoring, research funding, food labeling, and federal meal programs.

Strategic focus of the 2025–2030 Dietary Guidelines for Americans

Placing a significantly greater emphasis on specific nutrient targets and individual intake goals rather than general dietary patterns alone.

Updated daily protein intake target in the 2025–2030 DGA

$1.2\text{--}1.6\,g/kg/day$, with an emphasis on distributing protein intake across every meal.

Updated guideline recommendation for dairy consumption

Recommending full-fat dairy options rather than low-fat or fat-free choices.

Updated guidance on added sugars and artificial sweeteners

Advises zero added sugars or non-nutritive sweeteners, with a mealtime threshold of under $10\,g$ of added sugar and no recognized acceptable daily limit.

Updated emphasis on whole grains in recent dietary guidance

Retained within the recommended food groups, but featured with noticeably less prominence than in past editions.

Healthy Eating Index (HEI)

A standardized scoring metric used to evaluate dietary quality and determine how closely an individual's or population's food intake aligns with federal dietary standards.

Dietary Guidelines for Americans (DGA)

National science-based policy guidelines updated every five years to promote health, meet nutrient needs, and reduce chronic disease risk.

Patient counseling message: Focus on nutrient-dense foods

"Focus on adding nutrient-dense whole foods like fresh fruits, vegetables, whole grains, and dairy to enhance overall health and diet quality."

Patient counseling message: Small achievable dietary changes

"Small, consistent changes—such as selecting full-fat dairy or adding protein to each meal—can effectively help meet dietary targets."

Patient counseling message: Sugar and saturated fat moderation

"Limiting added sugars and saturated fats supports long-term cardiovascular and metabolic health while aligning with national recommendations."

Food Frequency Questionnaire (FFQ)

A retrospective dietary assessment tool used in observational studies to estimate typical consumption frequency of specific foods over a set timeframe.

Primary strengths of Food Frequency Questionnaires (FFQs)

Captures seasonally or occasionally consumed foods, requires low participant effort, can be automatically coded, and is cost-effective for large-scale population studies.

Primary limitations of Food Frequency Questionnaires (FFQs)

Relies heavily on memory, lacks precise quantitative accuracy, may not reflect diverse cultural diets, takes $30\text{--}60\,min$ to complete, and is subject to social desirability bias.

Widely used epidemiological Food Frequency Questionnaires

Harvard FFQ, National Cancer Institute (NCI) FFQ, Block FFQ, and NHANES FFQ.

Food Record (Food Diary)

A prospective log in which participants record all consumed foods and drinks in real time, including timing, brand names, preparation methods, and portion sizes.

Primary strengths of Food Records

Provides precise quantitative nutrient data, minimizes memory recall bias, captures temporal eating patterns, and applies broadly across populations.

Primary limitations of Food Records

High respondent burden that frequently alters normal eating behavior, expensive and labor-intensive to analyze, and subject to variable record-keeping quality.

24-Hour Dietary Recall

A retrospective dietary assessment where an interviewer or computer tool guides a participant through recalling all items consumed during the previous 24 hours using a structured multi-pass method.

Primary strengths of 24-Hour Dietary Recalls

Low participant burden, flexible open-ended format, captures eating context, provides detailed quantitative nutrient estimates for populations, and can be automated using ASA-24.

Primary limitations of 24-Hour Dietary Recalls

Does not represent an individual's usual long-term diet unless repeated across multiple administration days, and remains subject to recall errors.

Rapid clinical dietary assessment tools

Brief screening instruments designed for quick clinical use, including REAPS, Rate Your Plate, NCI short dietary screeners, and SNAP-Ed tools.

Rapid Eating Assessment for Participants (REAPS)

A condensed dietary screening instrument derived from FFQ principles designed to quickly assess key dietary habits in clinical practice.

Rate Your Plate

A rapid dietary quality assessment tool used in clinical settings to help patients quickly evaluate meal balance and food choices.

Emerging technological methods for dietary evaluation

Advanced assessment tools such as automated photographic image analysis, chemical mouth sensors, objective biochemical biomarkers, and automated diet index scoring.

Technologies used to detect eating behavior and timing

Continuous glucose monitors, accelerometers, gyroscopes, wearable motion sensors (ear, neck, or headband devices), smart toilets, and location-based tracking.

Food groups systematically underconsumed by the American population

Fruits and vegetables.

Nutrients systematically underconsumed by the American population

Dietary fiber, essential vitamins, and minerals commonly abundant in whole fruits, vegetables, and intact grains.

Dietary components restricted in a healthy eating pattern

Added and refined sugars, refined grains, saturated fats, sodium, and alcohol.

DGA recommended limit for added sugar

Under $10\,g$ per meal, with current 2025–2030 guidelines establishing no acceptable daily limit for intake.

DGA recommended limit for saturated fat

Less than $10\%$ of total daily caloric intake.

DGA recommended limit for sodium

Less than $2300\,mg/day$.

Core components defining a "healthy" diet according to federal guidelines

Practicing portion control, consuming protein at every meal, eating daily fruits and vegetables, incorporating healthy fats, and limiting processed items, added sugars, artificial sweeteners, refined grains, and alcohol.

Characteristics of "healthy fats" in dietary guidance

Fats emphasizing unsaturated sources derived from whole food options like nuts, seeds, seafood, and plant oils rather than ultra-processed sources.