Foundations of Nutrition by MfT85YYG

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									                                   Foundations of Nutrition
                               Dietary Guidelines for Americans
                                 Self-Assessment Work Sheet


This Dietary Guidelines Self-Assessment is designed to provide insight into your eating patterns
and help to identify those to maintain and those that may need some improvement. Let’s get
started!

Focus Area 1. Adequate Nutrients within Calorie Needs

        Estimate your Calorie Needs.

        Step 1:         Circle one activity level below that best describes your usual amount of
                        activity:

         a. Sedentary                 Light physical activity associated with typical day-to-day life.

         b. Moderately Active         Light physical activity associated with typical day-to-day life, and walking
                                      1.5 to 3 miles per day at 3 to 4 miles an hour (walking or other activity for
                                      about 30 to 60 minutes per day).

         c. Active                    Light physical activity associated with typical day-to-day life, and walking
                                      more than 3 miles per day at 3 to 4 miles an hour (walking or other activity
                                      for more than 60 minutes a day.)



        Step 2:         Use the following chart to estimate your energy needs based on age,
                        gender, and the level of activity circled above:

                                                                       Activity Level
    Gender                   Age                Sedentary                Moderately                      Active
                                                                           Active
Child                2-3                    1,000*                    1,000-1,400*             1,000-1,400*

Female               4-8                    1,200                     1,400-1,600              1,400-1,800
                     9-13                   1,600                     1,600-2,000              1,800-2,200
                     14-18                  1,800                     2,000                    2,400
                     19-30                  2,000                     2,000 – 2,200            2,400
                     31-50                  1,800                     2,000                    2,200
                     51+                    1,600                     1,800                    2,000-2,200

Male                 4-8                   1,400              1,400-1,600       1,600-2,000
                     9-13                  1,800              1,800-2,200       2,000-2,200
                     14-18                 2,200              2,400-2,800       2,800-3,200
                     19-30                 2,400              2,600-2,800       3,000
                     31-50                 2,200              2,400-2,600       2,800-3,000
                     51+                   2,000              2,200-2,400       2,400-2,800
        All energy levels are in kilocalories, and are based on estimated energy requirements
        from the Institutes of Medicine Dietary Reference Intake Report, 2002.


        Step 3:         My estimated Calorie Needs: _____________________________.


                     Foundations of Nutrition – Dietary Guidelines for Americans 2005                                 1
                                                   Handout 2
                                Foundations of Nutrition
                            Dietary Guidelines for Americans
                              Self-Assessment Work Sheet


Focus Area 2. Weight Management

      Determine your Body Mass Index.

      Use this formula to calculate your BMI.
         BMI = (Weight in pounds ÷ Height in inches ÷ Height in inches) x 703

          Example -
          A person weighing 210 pounds and 6 feet tall would have a BMI = 210 pounds
          divided by 72 inches divided by 72 inches multiplied by 703 = 28.5

             My BMI is                                                                   Work Area:

             My BMI is (circle one)            Normal weight = 18.5-24.9
                                               Overweight = 25-29.9
                                               Obesity = BMI of 30 or greater



Focus Area 3. Physical Activity

      Check your level of physical activity.

             Approximately how many minutes per day are you moderately physically active?
             (Refer to the description of activity levels in Focus Area 1.)
                     __________________________________________________________

             How many days each week are you moderately physically active?

      (30-60 minutes of moderate to vigorous physical activity is recommended most
      days for adults)


Focus Area 4. Food Groups to Encourage

      Fruits and Vegetables
              Within a week, which types of vegetables do you eat (check all that apply).

                    Dark Green                                          Beans (Legumes)
                    Orange                                              Starchy Vegetables
                    Other Types of Vegetables

      Whole Grains
            Most days ____________ of the bread and cereal products I eat are whole grain.
                       (Check one)

                    few                                        at least half
                    less than half                             more than half

                  Foundations of Nutrition – Dietary Guidelines for Americans 2005               2
                                                Handout 2
                                  Foundations of Nutrition
                              Dietary Guidelines for Americans
                                Self-Assessment Work Sheet


Focus Area 5. Fats

    Choosing sensibly includes keeping track of the amount of fat that we eat in one day. How
    many grams of fat are recommended?

    For example: Calculations for grams of fat for total calories consumed per day-
    Total calories x 0.30/9 calories/gram = grams of fat
    For example - 2000 calories x 0.30/9 calories/gram = 66 grams of fat.


    Step 1: My estimated energy level is: ___________________

    Step 2: Calculate percent of calories from fat:

    Estimated energy level ______________ x .30 (30%) = _______________ Total
    recommended calories from fat

    Step 3: Calculate number of grams of fat recommended:

    Recommended calories from fat:___________ / 9 calories/gram = ___________ grams of
    fat.

Focus Areas 6 and 7. Carbohydrates, Sodium, Potassium

      Circle the description that best fits your current choices:

     I snack on fresh fruit and cut-up                Rarely        Sometimes          Most of   Always
     vegetables                                                                       the Time
     I check ingredient lists for sodium              Rarely        Sometimes          Most of   Always
                                                                                      the Time
     I drink water and low-sugar beverage             Rarely        Sometimes          Most of   Always
     choices most of the time.                                                        the Time


Focus Area 9. Food Safety

   1. Fight BAC! Clean.

      Check all the circumstances after which you wash your hands-
           Before cooking                       After using the restroom
           After brushing hair                  Before eating

   2. Separate, Cook, Chill - Write one example of how you apply each of these concepts in
      your home or during classroom cooking:

      Separate -

      Cook and Chill -

                   Foundations of Nutrition – Dietary Guidelines for Americans 2005                       3
                                                 Handout 2
                                 Foundations of Nutrition
                             Dietary Guidelines for Americans
                               Self-Assessment Work Sheet


How Am I Doing?
    Look back over parts 1 – 7 and summarize your results by answering “yes” or ‘no”
    to the following questions:

      Yes     No             I get 30-60 minutes of exercise most days of the week
      Yes     No             I eat vegetables from each of the six sub-groups
      Yes     No             Half or more of the breads and cereals I choose are whole grains
      Yes     No             I check on food labels for added sugars always or most of the time
      Yes     No             I eat fresh fruits and vegetables always or most of the time
      Yes     No             I choose water or low-sugar beverages most of the time or always
      Yes     No             I play it safe with food

If you answered “yes” to all of the above statements, congratulations, you are on the
road to lifelong health! If, like many of us, there are some areas for improvement, please
proceed to the next section.


I Want to Improve
       Choose one area from the statements above, and complete this contract with yourself.
       Good Luck! You can do it!


                                           My Improvement Plan


       During the week of                                                  .


       I promise to ______________________ for ________________ days of the week.


       I can _____________ and _______________to support my progress in reaching
       this goal. (Include asking friends, family, coworkers, or posting reminders, or other
       strategies that will support your success in reaching this goal.)


              As a reward I will give myself (facial, favorite magazine,
              something special) -




              Signed

              Date




                   Foundations of Nutrition – Dietary Guidelines for Americans 2005             4
                                                 Handout 2

								
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