| DIET IN HEALTH AND DISEASE
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| Dietary history should include more than the details of food intake
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| 'Dietary habits' include the pattern of meals, and the amount and composition of eaten food. Individual diet is determined by biological, psychological, sociological and cultural factors. The biological factors involved are essentially the state of the systems responsible for the intake, digestion, absorption and and metabolism of nutrients. Enzyme deficiencies such as, for instance, that of lactase (Chapter 9) cause impaired absorption of foodstuffs (in this case, milk).
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| Psychological factors play an important role in determining food ingestion patterns; eating disorders such as anorexia nervosa and bulimia nervosa may lead to severe malnutrition. The sociological factors include availability and price of food, and measures taken by the society to improve diets such as, for instance, school meals or subsidized meals for the elder or disabled persons. Cultural factors also determine eating pattern and the type of preferred foodstuffs. All the above are important when taking the nutritional/dietary history as part of the nutritional assessment. Individual food intake is assessed by food frequency questionnaires, 24-hour dietary recalls, food records, and also by direct analysis of foods and by metabolic balance studies. The newer method of diet research is the so-called structured assessment of dietary patterns.
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