Nutritional Assessment and Education Guidelines
More than 40 different nutrients are needed for good health. Essential nutrients are the amino acids from protein, vitamins, minerals, fatty acids, and calories obtained from carbohydrates, protein, and fat. Since no single food supplies all these nutrients in the amounts needed, it is recommended that women eat a variety of nourishing food daily. To plan meals and snacks, foods are divided into five groups: (1) vegetables; (2) fruits; (3) breads, cereals, rice, and pasta; (4) milk, yogurt, cheese, and other dairy products; and (5) poultry, fish, lean meat, dry beans and peas, eggs, and nuts.

The 1990 edition of the Dietary Guidelines for Americans recommends the following:

• Eat a variety of foods
• Maintain healthy weight
• Choose a diet low in fat, saturated fat, and cholesterol
• Choose a diet with plenty of vegetables, fruits, and grain products
• Use sugar only in moderation
• Use salt and sodium in moderation

1. Provide nutrition assessment services for all patients to identify and assess for:

• Nutritional high-risk status
• Probable food deficiencies
• Probable food excesses
• Interest in breastfeeding
• Eligibility and certification for food supplement programs such as Women, Infants, and Children (WIC) and Food Stamps. If the woman has children, include school breakfast and lunch programs, summer feeding programs, and child care food programs.
• Smoking status
• Lactose intolerance
• Underlying eating disorder. It is not uncommon for substance-abusing women to have an underlying eating disorder -- a possibility that needs to be considered as a woman stops using drugs and<%-9>/or alcohol. Appropriate referrals for additional counselling may be needed.

2. Develop a nutrition care plan that describes the nature of the diet and counselling needs of the patient.

3. Provide nutrition counselling to:

• Teach about the appropriate diet, taking into account the patient's cultural food patterns, access to food, and lifestyle.
• Teach management of the food budget and meal planning as needed.
• Explain the WIC Program and other federally funded food assistance and nutrition programs.
• Provide nutrition education.
• Make referrals for smoking cessation counselling, as indicated.

4. Address special areas of concern. All patients should receive instruction and assistance regarding the following:

• Poor diet pattern
• Encourage the patient to eat nutritious foods as snacks, since these provide an important source of nutrients for a woman who does not eat three meals a day.
• Educate the patient on nutritious snacks, which may include, but are not limited to milk, cheese, yogurt, crackers, popcorn, fruit, carrot sticks, and leftover meat.