Medical History

The medical history for nutritional assessment is no different from a general medical history, in which familial and past and present environmental factors and their possible association with specific diseases or disease risk are considered. For the purpose of nutritional assessment, this information will be used to determine if any nutritional finding or complaint may be caused by an underlying medical condition, particularly one that remains unrecognized at the time of the examination. Additionally, specific medical conditions and their current status are important factors altering nutrient requirements and dietary prescriptions.

One specific focus of medical history in a nutritional assessment context is the exploration of gastrointestinal function. Conditions such as chronic diarrhea, gastroesophageal reflux, and colonic disorders may be associated with reduced nutrient absorption or food avoidance that result in impaired nutritional status. Past history of gastrointestinal problems and/or surgery may also point to current alterations in nutrient digestion or absorption. Other important components of the medical history are history of weight loss or gain, past and present use of medications, use of special foods or formulas, changes in taste or smell, and food allergies and intolerances.

In children and adolescents, the medical history must also obtain information on neurodevelopmen-tal stages, history of behavioral problems, and overall school performance. Food preferences must be noted, particularly in adolescence, when adoption of unconventional dietary practices is more likely to occur.

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