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N
utrition
assessment
– H
ome
-
based
nutritional
therapy
R
ev
A
ssoc
M
ed
B
ras
2016; 62(8):711-717
711
GUIDELINES IN FOCUS
Nutrition assessment – Home-based nutritional therapy
A
valiação
nutrológica
–
N
utroterapia
domiciliar
Authorship:
Associação Brasileira de Nutrologia (Abran)
Participants:
Ribas DF
1
, Buzzini RF
2
, Simões RS
2
, Kelman G
2
, Bernardo WM
2
Final draft:
April 2, 2016
1
Sociedade Brasileira de Nutrologia (Abran)
2
Programa Diretrizes, Brazilian Medical Association (AMB)
http://dx.doi.org/10.1590/1806-9282.62.08.711The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize
procedures to assist the reasoning and decision-making of doctors.
The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending
on the conditions and the clinical status of each patient.
E
vidence
collection method
This policy followed the pattern of a systematic review
with retrieval of evidence based on the principles of evi-
dence-based medicine (EBM), according to which clinical
experience is integrated with the ability to critically ana-
lyze and rationally apply scientific information, thus
improving the quality of medical care. EBM uses existing
scientific evidence available at the time, with good inter-
nal and external validity, applying its results to the clini-
cal practice.
1,2
(
D
)
Systematic reviews are considered today as level I
evidence for any clinical question as systematically sum-
marize information on a particular topic based on pri-
mary studies (clinical trials, cohort studies, case-control
or cross-sectional studies). The method used for this is
reproducible and integrates information on effectiveness,
efficiency, efficacy, and safety.
1,2
(
D
)
We use a structured way to ask the question, sum-
marized by the acronym PICO, where P is the patient or
population; I, the intervention or indicator; C, compari-
son or control; and O, the outcome. Based on structured
question, the keywords or descriptors that will form the
basis of the search for evidence in the various available
databases are identified (Annex I).
1,2
(
D
)
C
linical
question
What are the indications, benefits and risks of home-based
nutritional therapy in newborns, children, adolescents or
the elderly?
G
rade
of
recommendation
and
strength
of
evidence
•
•
A: Experimental or observational studies of high-
er consistency.
•
•
B: Experimental or observational studies of lower
consistency.
•
•
C: Case reports/non-controlled studies.
•
•
D: Opinions without critical evaluation, based on con-
sensus, physiological studies, or animal models.
O
bjective
To determine the role of home-based nutritional therapy
in the guidance, diagnosis, and nutritional management
of children, adolescents, and adults.
C
onflict
of
interest
No conflict of interest was declared by the participants
in the development of this guideline.
I
ntroduction
Nutritional therapy assessments involve the individual-
ized preparation of nutritional guidance with counseling,
nutritional education and dietary intervention for healthy
or sick individuals. In the clinical appointment, the patient
is examined individually, with data collected on the patho-
physiological situation, past, present and family clinical
history, nutritional, physical and biochemical status, so
that the nutritional diagnosis and nutritional conduct
can be formulated.
B
reastfeeding
The importance of breastfeeding and a healthy supple-
mentary diet are factors that promote maternal and child
health. It has become common to start the introduction
of water, teas, and other types of milk during the first
month of life, and the consumption of coffee, soft drinks,
and cookies among children between 9 and 12 months
of age is high, factors that are harmful to health.
3
(
B
)