Nutrition Diagnosis Examples: Masterclass for Dietitians

If you’re looking for only nutrition diagnosis examples and want to know which diagnosis to pick, this is the article for you!

Finding the right nutrition diagnosis and supporting evidence can seem difficult. But once you know the reasons to choose a diagnosis, it’s really quite simple.

I’ve made a simple step-by-step guide here to picking the right nutrition diagnosis by giving you examples of when and how to use them.

The Nutritions Diagnosis and The Nutrition Care Process

The nutrition diagnosis is a part of the nutrition care process.

The nutrition care process is a formula for figuring out what’s wrong with your patient. It is a standardized procedure about the process for assessing a patient, diagnosing, treating and monitoring.

The nutrition diagnosis will come as a result of a full nutrition assessment. It will also help you come up with a PES statement and targeted nutrition interventions to address the problem.

Find some helpful PES statement articles here:

Perfecting PES Statements: Free RD Guide.

PES statement examples for Dietitians.

7 Malnutrition PES Statements.

What is a Nutrition Diagnosis?

The nutrition diagnosis is the nutrition problem that is uncovered as a result of a full nutrition assessment. It is the nutrition problem that the Dietitian will be trying to resolve.

This is different from a medical diagnosis which is something that only a Medical Doctor is allowed to do.

A nutrition diagnosis is developed from the list of standardized nutrition diagnostic terminology developed by the Academy of Nutrition and Dietetics.

The Academy of Nutrition and Dietetics states that a nutrition diagnosis is:

“A nutrition and dietetics practitioner identification and labeling of an existing nutrition problem(s) that the practitioner is responsible for treating.”

Three Nutrition Diagnosis Categories

There are three overall domains in the nutrition diagnostic terminology list that are central themes a nutrition diagnosis can come from:

  1. Food and/or Nutrient Intake
  2. Clinical
  3. Behavioural and Environmental
three domains of the nutrition diagnosis.

Depending on the area that a Dietitian works in, some domains will be used more heavily than others.

Working with the older adult population it would be rare to choose a nutrition diagnosis from the behavioural and environmental category.

Dementia is so prevalent that to blame their inadequate food choices on a conscious choice would be a difficult and slightly disrespectful choice to make.

It is more likely that an older adult with intake issues is having some sort of physical reason for not eating.

But if a Dietitian works in outpatient, the behavioural area would like be a common area for the nutrition diagnosis.

Here is a closer look at when and why a Dietitian would select from the different domains.

Food and/or Nutrient Intake

This domain covers everything to do with food intake, that includes:

Amount of intake
Type of intake
Macronutrient distribution
Vitamin/Mineral distribution
Fluid intake

An example of food and/or nutrient intake domain would be Inadequate Energy Intake. This could be used when someone is eating below their daily estimated energy requirements.

Using it in a PES statement example would be:

Inadequate energy intake related to insufficient oral intake due to loss of appetite and early satiety, as evidenced by a significant unintentional weight loss of 8% over the past 3 months, complaints of fatigue and reduced intake of all macronutrients, and decreased muscle mass and strength (reported).

Clinical

This appears to be a ‘catch all’ category where problems don’t fit into the food and/or nutrient domain or behavioural domain.

This ranges from a physical obstruction like chewing problems, nutrient interactions to weight loss. It is categorized as medical or physical conditions affecting nutrition.

I would comment that there is not an over-arching theme behind the clinical domain. It is simply three subdomains that are selected from.

These subdomains are:

Functional
Biochemical
Weight

Using it in a PES statement example would be:

Swallowing Difficulty (Dysphagia) related to neurological impairment affecting the coordination of swallowing muscles, as evidenced by frequent coughing and choking during meals, prolonged meal times requiring multiple swallows, complaints of food sticking in the throat, reduced oral intake of solid foods and liquids, and a weight loss of 5% over the past 2 months.

Behavioural and Environmental

This domain is relatively self explanatory, choosing a nutrition diagnosis from here occurs whenever a behavioural or environmental factor is affecting nutrition status.

I like to think of this category as both conscious and unconscious decisions that are made by an individual that negatively affects their intake. I always caution Dietitians when they choose from this category that they better be very sure of the nutrition diagnosis.

If a patient has Dementia, I recommend avoiding this category as we can never be fully sure the reason behind them declining a meal. So we choose a nutrition diagnosis that we can be sure about, such as weight loss or inadequate intake.

Using it in a PES statement example would be:

Self feeding difficulty related to recent stroke as evidenced by inability to pick up a fork, food spillage and requests for assistance at meals.

How to Pick the Nutrition Diagnosis Domain

Picking the right domain will be determined by what the result of the nutrition assessment is.

flow chart for choosing a nutrition diagnosis from an article on nutrition diagnosis examples.

First you have to pick the domain, here’s a simple way to determine which domain to choose:

First ask:

What is the root cause of the nutrition problem?

Choose from: Food and fluid intake, Clinical issue (Physical, medical or medication), or an Environmental/Behavioural problem?

Secondly:

Within each domain, look at the different categories. Each domain has between 3-10 different categories of nutrition problems.

When looking at each category, ask:

Of all the categories, what is the number one root problem that needs to be addressed or prevented from progressing?

Lastly ask:

Now that I have a nutrition category within the domain, what is the most dominant issue that the patient is facing?

Choose the nutrition diagnosis that is the problem that needs to be prevented from further progressing. This will be the issue that will be addressed through nutrition interventions.

Nutrition Diagnosis Examples

If you still need help, here are my top 20 nutrition diagnosis examples that I think will help you formulate yours! They’re all formatted into PES statement examples which should help you think through how I got to that statement.

  1. Inadequate oral intake of food and fluids related to decreased appetite and fatigue during meals as evidenced by a reported weight loss of 10% over the past 6 months.
  2. Excessive intake of energy from high-calorie, low-nutrient foods related to frequent consumption of sugary snacks and beverages as evidenced by a body mass index (BMI) above recommended range, and weight increase of 15% in 3/12.
  3. Swallowing difficulty related to weak oral and pharyngeal muscles as evidenced by reports of choking and prolonged meal times, leading to inadequate food and fluid intake.
  4. Altered gastrointestinal function related to chronic constipation and irregular bowel habits as evidenced by fewer than three bowel movements per week and abdominal discomfort.
  5. Impaired nutrient utilization related to malabsorption secondary to celiac disease as evidenced by low serum iron, ferritin, and vitamin B12 levels.
  6. Excessive sodium intake related to frequent consumption of highly processed foods as evidenced by elevated blood pressure readings consistently above the normal range.
  7. Unintended weight loss related to hypermetabolism and increased energy expenditure following a major burn injury, as evidenced by a decrease in body weight by 15% since hospital admission.
  8. Inadequate intake of vitamin B12 related to pernicious anemia and limited consumption of animal products as evidenced by low serum vitamin B12 levels.
  9. Inadequate intake of vitamin D related to limited sun exposure and dietary choices as evidenced by low serum 25-hydroxyvitamin D levels.
  10. Inadequate fiber intake related to limited consumption of whole grains and fruits as evidenced by irregular bowel habits and bloating.
  11. Inadequate protein intake related to increased protein needs as evidenced by stage 3 pressure injury and increased needs of 1.5 grams/kg BW.
  12. Altered hydration status related to inadequate fluid intake and excessive fluid loss through sweating as evidenced by dark yellow urine and reports of dizziness.
  13. Inadequate fluid intake related to decreased ability to independently drink as evidenced by meal observation screen and recent requests for assistance drinking.
  14. Altered potassium balance related to chronic kidney disease and reduced kidney function as evidenced by elevated serum potassium levels.
  15. Malnutrition related to inadequate energy intake as evidenced by <50% intake at meals and significant weight loss of 10.9% in 6/12.
  16. Inadequate dietary fiber intake related to low consumption of whole grains and fruits as evidenced by irregular bowel habits and reports of bloating.
  17. Malnutrition related to colon cancer as evidenced by reduced muscle mass, significant weight loss (7.6% in 1/12) and BMI 17.7.
  18. Inadequate intake of omega-3 fatty acids related to limited consumption of fatty fish as evidenced by low serum levels of EPA and DHA and increased inflammatory markers.
  19. Swallowing difficulty related to neurological impairment and weakened throat muscles as evidenced by choking episodes and prolonged meal times.
  20. Inadequate intake of potassium related to low consumption of potassium-rich foods as evidenced by muscle weakness and elevated blood pressure.

Frequently Asked Questions

How Does the Nutrition Diagnosis Fit into the PES Statement

The nutrition diagnosis always goes at the front of the PES statement. I’ve gone over this in this article, but the nutrition diagnosis represents the P in PES.

How Do You Write a Nutrition Diagnosis?

You take word for word from the nutrition diagnostic terminology form, you can find a great resource for it here.

I don’t recommend changing the wording from the form, but there may be circumstances where you will alter slightly. An example of this could be ‘altered nutrition related laboratory (specify)’. The phrasing comes off a little funny.

Another way to phrase this could be, “Altered A1C Laboratory value”. It makes more sense in a sentence and is likely to be better understood by others on the team when reading it.

What is the Difference Between a Medical Diagnosis and a Nutrition Diagnosis?

A medical diagnosis differs from a nutrition diagnosis in that only Doctors can give a medical diagnosis, and only Dietitians can give a nutrition diagnosis.

There may be some intersections as a Doctor can diagnose malnutrition. But it would be highly unlikely that a Doctor would use any other nutrition diagnosis.

What is the Value in Giving a Nutrition Diagnosis?

A nutrition diagnosis allows a Dietitian to have a clear path to what nutrition interventions are needed to cure/relieve the symptoms of a nutrition related problem.

If found these nutrition diagnosis examples helpful be sure to sign up for the e-mail list to get more great resources!

Michelle saari dietitian
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Michelle Saari is a Registered Dietitian based in Canada. She has a Master's Degree in Human Nutritional Sciences and is a passionate advocate for spreading easy to understand, reliable, and trustworthy nutrition information. She is currently a full time online entrepreneur with two nutrition focused websites.

5 thoughts on “Nutrition Diagnosis Examples: Masterclass for Dietitians”

  1. Michelle Smith

    I commonly see dietitians writing statements such as chewing/swallowing difficulty r/t dysphagia dx AEB pureed diet. My question is, if they had a chewing/swallowing problem and they were downgraded to a pureed diet and now are not having issues chewing or swallowing the provided meals, would we then not create a nutrition problem? I see what they are saying, they have a chewing/swallowing problem with regular textures but to me the problem was resolved by changing to a texture they can better tolerate.

    1. That’s a great question!

      Once a nutrition problem is resolved by the nutrition intervention then we consider the nutrition diagnosis as resolved and it can be removed. Initially the nutrition diagnosis may have been chewing/swallowing issues, so then you walk through the nutrition care process and propose nutrition interventions, such as you mentioned a pureed diet. In your monitoring/evaluation plan then you put a date/time when you will reevaluate. At that time, if the problem has been resolved, you would chart that the nutrition diagnosis has been resolved. You don’t need to create another PES statement if there is no nutrition problem. You could write something such as, “No nutrition diagnosis at this time, RD will continue to monitor quarterly or as new nutrition consults are received.”

  2. Excessive sodium intake related to frequent consumption of highly processed foods as evidenced by elevated blood pressure readings consistently above the normal range

    the etiology that you write I Think is a sign. I am wrong?
    I am an italian dietitian

    1. Hi Gabriella,

      Thanks for the comment! I personally think that frequent consumption of highly processed foods is more an etiology than a sign or symptom, but you could use it as a sign and symptom. I like to use signs and symptoms that can largely be supported by data such as blood pressure readings, but there are also some subjective things you could put as a sign/symptom as well. Great thought though!

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