What Is the Nutrition Care Process?

To provide the best quality of care, dietitians use The Nutrition Care Process. A structured approach that can be personalized to meet the needs of all patients or clients.

The framework of the Nutrition Care Process supports decision-making and critical thinking while ensuring that care is provided efficiently and effectively.² When providing the utmost care and love to clients or patients, there are always steps or a process to guide and ensure quality.

Steps in The Nutrition Care Process

The Nutrition Care Process walks dietitians through 4 steps to support the initial assessment of patients with eating disorders and to plan follow-up care. The 4 steps include:²

1. Nutrition Assessment and Reassessment
2. Nutrition Diagnosis
3. Nutrition Intervention
4. Nutrition Monitoring/Evaluation

Step 1: Nutrition Assessment

The Nutrition Assessment has two parts. Part 1 is the initial assessment, a time to collect imperative data, background, and history, and then analyze and interpret it. Part 2 is the reassessment and is where the Nutrition Care Process cycle starts over.²

The key data to be obtained/collected during the Nutrition Assessment include:¹

• Food and nutrition history
• Client/patient history
• Anthropometric data/measurement
• Medical procedures, laboratory data, and test results
• Nutrition-focused physical examination

Food/nutrition history:

• Meal and snack patterns
• Adequacy of intake/change in appetite
• Nausea, vomiting
• History of bingeing, purging
• Physical activity patterns
• Food availability
• Food allergies/preferences

Client history:

• Medical/surgical
• Medications/supplement usage/diet pills
• Vital signs/history of current illness
• Socioeconomic status
• Bowel habits, history of laxative use

Anthropometric data/measurements:

• Height
• Weight (current, usual, ideal)
• Body weight index (BMI)
• Unintentional or intentional weight change

Medical procedures, laboratory data, and test results:

• Gastric emptying studies
• Bone scans
• Electrolytes
• Glucose/Hemoglobin A1C
• Lipid Panel

Nutrition-focused physical examination:

• Overall musculature, adipose stores
• Oral (tongue, gums, lips, mucous membranes, etc.)
• General physical appearance

Once the initial data, history, and background are collected, it is time to review and assess factors that affect nutrition and health status.²

After the data is assessed, the next step is to identify the nutrition problem or diagnosis.

Step 2: Nutrition Diagnosis

The Nutrition Diagnosis or Diagnoses identifies nutrition problems that the nutrition professional or dietitian is responsible for treating.²

From the data collected and analyzed in the Nutrition Assessment, practitioners can identify the nutrition diagnoses.

Once diagnoses are understood recommendations can be presented to a patient. From there, a patient or client can work with the practitioner to set goals to move towards for the betterment of their health.

When creating a nutrition diagnosis statement, specific nutrition diagnostic terms and the etiologies, signs, and symptoms will be identified.²

There are three parts to a nutrition diagnosis statement:²

1. The problem or nutrition diagnosis describes alterations in the client’s status
2. Etiology is a factor that contributes to a problem, including pathophysiological, situational, developmental, cultural, and/or environmental
3. Signs and symptoms supporting the existence of the nutrition diagnosis

Nutrition Diagnosis should be clear and concise and always specific to the patient or client being treated.

Example Nutrition Diagnosis: Disordered eating pattern related to harmful beliefs regarding food and nutrition as evidenced by the report of restrictive type behaviors and laxative abuse to rid the body of nourishment.

Related Reading

• Nutrition Counseling Guide
• Foods That Makes You Feel Good
• How Your Metabolism Functions
• The Physical Cues of Hunger/Satiety
• Dietitian Crafted Meal Plans for Treating EDs
• How to Regain Your Healthy Weight During Recovery
• Misconceptions of What Healthy Eating Is
• Mindful Eating and Appetite Awareness

Step 3: Nutrition Intervention

The Nutrition Intervention is a set of planned actions with the intention of aiding in the healing process. Interventions may support changes in nutrition-related behavior, risk factors, environmental conditions, or health status.²

All nutrition interventions should be SMART:²

• Specific
• Measurable
• Attainable
• Relevant
• Time-based

Again, it cannot be stressed enough how important it is to include the client. Working with the client to overcome barriers and roadblocks is imperative.

Step 4: Nutrition Monitoring and Evaluation

Nutrition monitoring and evaluation is the time to implement the reassessment process. Essentially, this takes us back to the start.

In reassessing the client or patient, all self-monitoring data and records will be reviewed to assess progress and if current goals or outcomes are being met.² This leads back into the cycle we call the Nutrition Care Plan.

Back to Step 1: Reassessment

After the initial nutrition assessment is completed, the next step is to schedule and complete the reassessment.

During the reassessment, all data will be reviewed, past goals looked at, and the patient or client will be worked with to explore what they feel is going well and what may have been more difficult.²

Note that patients or clients is drive their own recoveries. The dietitian is just there to guide them. 

During the reassessment, the practitioner will reexamine whether goals are being met and whether there is a need for adjustments or revisions to goals or Nutrition Diagnoses.

This cycle will continue if the nutrition professional identifies a need for ongoing nutrition care. This may also be a time to determine when a patient or client is ready to progress to a different level of care or to be discharged.