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Dietary inadequacy or excess is frequently the cause of under- or overnutrition and often precedes biochemical, anthropometric, or clinical signs; thus, evaluation of an individual's diet plays an important role in nutritional diagnosis and treatment. Quality and quantity of food intake and the macro and micronutritients provided can be measured using a variety of techniques. In addition, past dieting history, development of feeding skills, abnormal eating habits, difficulty in feeding, and activity level should be assessed.

A number of methods are available for the collection of information about food consumption."1 Some are more appropriate for the assessment of population data on food intake. In the clinical setting, where individual information is important, more detailed and precise methods are generally used. The most common dietary assessment

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Uiols ¡11 clinical practice* arc the 24-hour recall. 3- to 7-day food records, or "usual patterns" described by the patient or caregiver. A complete dietary history combines a number of methods with the gathering of medical and clinical information relative to dietary assessment.

Each method has certain weaknesses and limitations, and difficulty in quantifying and qualifying actual intake is well documented." u Patients of normal weight give the most accurate record whereas underweight patients overestimate and overweight patients underestimate actual food consumed. Similarly, assessments of dietary intake over long periods tend to overestimate actual intake, and those covering a short period tend to underestimate intake. Because of considerable differences in nutrient intake data obtained bv different techniques, variability of intake from day to day. and difficulty in obtaining information on children by different care providers, it is helpful in some cases to use a combination of methods (24-hour recall with 3-day food records) to provide a more complete and accurate dietary evaluation. Kmphasis should be placed on careful questioning and detailed recording of intake.

Additional limitations to the accurate assessment of intake include a wide variety of food composition tables and computerized databases for analysis and difficulty in establishing actual nutrient needs.2 "

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