Dietary Self-Assessment



Suja Sadasuvin, MD

Lauren Oliver, MS, RD, LDN

Gita Rao, MD, MPH

Hannah Milch, MS-IV

Ashley Decker, MS-IV

Carine Lenders, MD, PhD

Kathy Gorman, MS, RD, LDN

Wayne W. LaMorte, MD, PhD, MPH

Nan Harvey, MD

Lorraine Stanfield, MD

Vanessa Supple, BA


Learning Objectives

After successfully completing this module, you will be able to:

  1. Explain the major recommendations from the US dietary guidelines for adults.
  2. Provide examples of nutrient- and energy-dense foods.
  3. Define the difference between portion and serving size.
  4. Calculate body mass index (BMI).
  5. Perform a 24-hour diet recall self-assessment.


We gratefully acknowledge support for this project from:





Dietary Guidelines for Americans

DGA2010.png Every five years the Department of Health and Human Services (HHS) and the Department of Agriculture (USDA) issue a report containing nutritional and dietary information and guidelines for the general public over two years of age based on a review of scientific evidence. The aim is to provide advice to promote health and to reduce risk for major chronic diseases through diet and physical activity. A detailed description of the process and the most recent report can be found at

From the web site:

"The Dietary Guidelines for Americans, 2010, released on January 31, 2011, emphasize three major goals for Americans:

The Dietary Guidelines for Americans, 2010 include 23 key recommendations for the general population and 6 additional key recommendations for specific population groups, such as pregnant women. The recommendations are intended to help people choose an overall healthy diet."


Major Recommendations

Manage Weight

Foods and Food Components to Reduce

Foods and Nutrients to Increase

Individuals should meet the following recommendations as part of a healthy eating pattern while staying within their calorie needs.

Recommendations for Specific Population Groups

Women capable of becoming pregnant

Women who are pregnant or breastfeeding

Individuals ages 50 years and older

Building Healthy Eating Patterns

General Recommendations for Adults

My Plate

MyPlate.png A new food guide plate was launched in 2011 to provide individualized dietary recommendations based on the 2010 Dietary Guidelines for Americans. This replaces the previous Food Guide Pyramid.



These are general recommendation for an adult consuming 2000 calories per day.


Grain_Clipart.png Grains: at least 3 oz. of whole-grain products (one slice of whole wheat bread = 1 oz.)


Vegetables: at least 2½ cups of vegetables. Each week select from all 5 vegetable subgroups: dark green, orange, legumes, starchy vegetables, and others.


 Fruit: at least 2 cups fruitFruit_Clipart.png


 Milk: up to 3 cups low-fat or fat-free milk products


 Protein: 5-6 oz of lean meats, beans, legumes, etc.

An important distinction to make here is the difference between portion size and serving size. People often consume a single portion that actually contains multiple servings. People's concepts of appropriate portion size have expanded over time (along with their waist line).



For More Information:

Basic Concepts

The fundamental goal, of course, is to promote health through a balanced, nutritious diet that balances calorie intake and calorie expenditure. A few basic definitions and reference points are important.

Nutrient-dense vs. Energy-dense Food

Nutrient-dense foods are characterized by a high amount of nutrients such as vitamins, calcium, fiber (e.g. mg/g, g/L): 

  • Fruits, vegetables, whole grains
  • Fat-free or low-fat milk and milk products
  • Lean meats, poultry, fish, beans, eggs, and nuts

Foods with added sugar or fat are usually not nutrient-dense.

Energy-dense food items are characterized by a high amount of calories (e.g. kcal/g, kcal/L):

  • Chocolate
  • French fries
  • Regular sodas and alcoholic drinks

Most nutrient-dense foods are not energy-dense, but nuts are an exception.

Calorie Needs of Adults

The calorie needs or energy requirements for adults vary with age, gender, height, weight, level of physical activity, and medical/surgical conditions. Generally, the calorie requirements are higher in adults who are males, younger, and athletes.

The table below provides some general guidelines.


CDC Recommendations for Physical Activity

To improve overall health, maintain weight and reduce the risk for chronic disease, most American adults (ages 18-64) should get:

Recommendations vary for other populations including children, older adults, and pregnant women, and there are also separate recommendations for those looking to lose weight.

CDC Physical Activity Guidelines



When discussing activity level with patients, it is useful to educate them about:

These and other useful techniques can be found at: Measuring Physical Activity Intensity


Dietary Self-Assessment

A dietary self-assessment should include four basic elements:

  1. Pre-assessment Reflection
  2. BMI Calculation
  3. MyPlate 24-hour Recall
  4. Interpret Results and Set Goals


1. Pre-assessment Reflection

Before beginning your self-assessment, ask yourself how you perceive your health based on your weight/BMI and current dietary habits. Not surprisingly, physicians who have a higher awareness of their own diet are more likely to counsel patients about nutrition and the importance of achieving a healthy weight, and physicians who have intentionally altered their own diets are more likely to assist patients in making dietary changes.

2. BMI Calculation

BMI is an abbreviation for body mass index. This is a calculated measurement based on one's height and weight that is used as screening tool for body fat and to identify potential health risks. BMI is not an exact measure of body composition, and it can be misleading, for example, when used in professional athletes. However, it is a useful screening tool in the general population.

BMI = kg/m2

(or BMI = lbs/in2  x 703)

One can also use the widget below to calculate BMI in adults.

Once you have calculated BMI, the table below will provide a general classification scheme.


3. Healthy Plate Food Tracker

For this part of the assessment you will need to know:

To start the recall: 

  1. Go to SuperTracker Foodtracker
  2. Register as a new user or login with your user ID and password.
  3. Enter your age, gender, weight, height, and activity level.
  4. Click "Proceed to Food Intake."

To complete the recall:

  1. Foodtracker will break the day into snacks and 3 meals. Search the database for the foods (or ingredients) and beverages you consumed in the last 24 hours.
  2. Select each food, estimate the quantity of each item you select, and add it to the appropriate meal or snack. You will then see the item added to your 24-hour food recall.
  3. When you are finished, you will see the calorie breakdown for each meal, as well as the day, and the nutrient breakdown for the entire day.

The nutrient intake will be calculated and compared to your personal MyPlate recommendations and to the 2011 Dietary Guidelines. Suggestions for improving your diet will be included.

Tips for Completing the 24-Hour Recall

  • Start with the first thing you ate when you woke up yesterday morning and work through the day.
  • Remember to include ALL  beverages and snacks.
  • Remember the difference between a serving and a portion. The quantity selected should reflect what you actually consumed.

If you do not find the exact food item you ate:

  • Select a generic version: e.g. in place of Smucker's strawberry jam, choose "JAM, PRESERVES, ALL FLAVORS."
  • If no generic version exists, choose an alternate item similar to that you ate: e.g., in place of cashew butter, choose "ALMOND BUTTER."
  • For mixed dishes, break the food down into its separate components (ingredients): e.g. for a basic vinaigrette dressing, choose "OLIVE OIL" and "VINEGAR" , plus any salt/pepper or other flavorings in the dressing. Provide ingredients found in casseroles, homemade soups, sandwiches, & toppings


Estimating Portion Size

Here are some helpful conversion factors.

1 cup = 16 Tablespoons

1 Tablespoon = 3 teaspoons = 1/16 cup = 0.0625 cups

1 teaspoon = 0.33 Tablespoon = 0.02 cups

And here are some easy ways to estimate portion sizes:



All portions above are based on one standard serving. If the cereal in your bowl looks like 2 fists, count it as 2 cups in the tracker.

4. Interpreting Your Results

Using the tracker is a great starting point to analyze your dietary intake, but remember:

Therefore, use your results as a general guideline. For a more accurate analysis, try measuring and recording your intake at meals and using the tracker for multiple days.

Next Steps

The next step is to honestly consider the results of the 24-hour recall and the recommendations and to review the basic information presented in the beginning of this module. What have you learned from the analysis and the recommendations?

Set short- and long-term achievable goals and make some healthy changes. Rather than making severe changes in your diet, consider where modest changes could be made to provide you with healthier meals. Also consider the guidelines for physical activity. Again, instead of making severe changes that are not sustainable, think about your typical daily activities and try to come up with a workable plan that will increase your activity. Little additions in activity can really add up, for example, parking farther at the far end of a parking lot instead of trying to get the closet spot to your destination. Try to add time for activities that you enjoy - anything that gets you moving - biking, walking, golf, gardening....

Remember also that Registered Dietitians can provide valuable help, particularly if you are confused about what changes to make in order to improve your nutrition. Dietary assessments are useful for initial evaluations and a great way for you to start a conversation about diet and exercise habits.  Patients with diet-related concerns or conditions should be referred to a Registered Dietitian for a thorough assessment and continuing care.

Additional Resources