Practice Consideration
Choices of Comparative Standard Reference Values
In cases where the patient is generally well, practitioners can make use of Comparative Standards and apply those against the national nutrition guidelines for healthy individuals. If the patient presents with a specific medical complaint requiring medical nutrition therapy, the dietitian will use dietary guidelines specific to the condition.
For an individual who has hypertension and is overweight, the most appropriate Comparative Standard would be a cardioprotective meal pattern, such as the DASH diet or equivalent. This allows the dietitian to make precise modifications to the patient's dietary intake.
The daily nutrient goals used in DASH studies for the 2 000 kcal plan(1) are as follows:
The daily physical activity goals used in DASH studies for the 2 000 kcal plan are:
Note — if the patient is returning for a follow-up consultation, the dietitian may use the previous Nutrition Prescription as the Comparative Standard. This would include energy requirements, ideal body weight and BMI calculated in the previous consultation.
References
1. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER 3rd, Simons-Morton DG, Karanja N, Lin PH. DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) Diet. New Engl J Med. 2001; 344: 3-10.
For an individual who has hypertension and is overweight, the most appropriate Comparative Standard would be a cardioprotective meal pattern, such as the DASH diet or equivalent. This allows the dietitian to make precise modifications to the patient's dietary intake.
The daily nutrient goals used in DASH studies for the 2 000 kcal plan(1) are as follows:
- Total fat 27% of calories
- Saturated fat 6% of calories
- Carbohydrate 55% of calories
- Protein 18% of calories
- Fiber 30 g
- Cholesterol 150 mg
- Magnesium 500 mg
- Calcium 1 250 mg
- Sodium 2 300 mg*
- Potassium 4 700 mg
- Achieve energy balance by reducing serving sizes
The daily physical activity goals used in DASH studies for the 2 000 kcal plan are:
- To increase physical activity to 150 minutes of moderate or 75 minutes of vigorous activity per week, limiting sedentary activity and getting adequate sleep
Note — if the patient is returning for a follow-up consultation, the dietitian may use the previous Nutrition Prescription as the Comparative Standard. This would include energy requirements, ideal body weight and BMI calculated in the previous consultation.
References
1. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER 3rd, Simons-Morton DG, Karanja N, Lin PH. DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) Diet. New Engl J Med. 2001; 344: 3-10.
Updated February 25, 2019