Interpreting NRVs and putting your findings into practice
A quick refresher on working with Nutrient Reference Values (NRVs) in FoodWorks to assess your client’s nutritional adequacy.
Please note: This article assumes you are familiar with creating Meal Plans, Food Records or 24hr Recall documents in FoodWorks. For more information, see Chapter 3 – Analyse a Dietary Intake in the Learning FoodWorks Professional: Basic Tutorial.
The Nutrient Reference Values (NRVs) for Australia and New Zealand are a set of recommendations for nutritional intake based on the current evidence. NRV analyses offer rich insight into your clients’ eating.
In FoodWorks Professional, when you are creating both prospective and retrospective diet documents, such as Meal Plans, Food Records or 24hr Recalls, you can compare your client’s food intake against the NRVs.
Here’s how to compare a dietary intake to NRVs
We’ll illustrate using an example client, John Smith, and his multi-day food record.
For your client, create a Food Record or Meal Plan, then:
Enter their personal details such as age, gender and weight on the General tab of the Food Record, Meal Plan or 24hr Recall document. These details are used to calculate their NRVs.
Here are John’s personal details:
You can see he is a very active individual, and his Estimated Energy Requirements (EER) are high – 15,872kJ.
Now you can view the NRVs analyses to see how your client’s intake compares to their estimated energy and nutrient requirements.
To focus on the NRVs analyses, in the Analysis Pane, click ‘NRVs’.
Here are the NRV analyses for John’s Food Record. We are viewing the analyses as an average per day (Avg/Day) to give an indication of his intake over time:
The complete list of NRVs in the Analysis Pane is long, so you need to scroll to see them all.
To quickly navigate to a particular type of NRV, such as Recommended Dietary Intake (RDI), click its name on the left of the Analysis Pane, as shown here:
You can also view individual graphs for the different types of NRVs.
To view an NRV graph, on the toolbar, click ‘Graph’:
Then click the tab for the type of NRV you want, for example, RDI.
Here is the graph for RDIs for John’s Food Record:
Which NRV analyses to use?
There are a variety of Nutrient Reference Values to choose from. Here’s a quick review of the types of NRVs available to you in FoodWorks 10 so you can use them appropriately to explore your client’s intake:
Understanding and using the results
The colour coding in the FoodWorks NRVs analyses makes it easy for you to see any nutrients that may be of concern for your client. You can use your findings from FoodWorks to help inform your nutrition diagnoses and therefore your nutrition interventions.
We can form a nutrition diagnosis for the example client, John Smith. For simplicity let’s focus on his energy intake. We saw that John was meeting only 71% of his Estimated Energy Requirements (EER) on average per day based on his Food Record. During our dietetic consult with this client, we determined that he was experiencing a low appetite and lacked the desire to shop and cook for himself. This has resulted in some unintentional weight loss.
Therefore, the following nutrition diagnosis (PES statement) was developed:
Inadequate energy (kilojoule) intake related to low appetite and decreased desire to shop and cook as evidenced by patient meeting ~70% of estimated energy requirements (EER) for weight maintenance.
Based on the FoodWorks findings, further nutrition diagnoses could be explored such as inadequate fluid intake (AI) or inadequate mineral (calcium) (RDI) intake.
FoodWorks and its NRV analyses can be a valuable tool in providing evidence for nutritional diagnoses and therefore interventions. We hope this article provides some ideas/inspiration for how you might use FoodWorks in your own practice.