|
YES |
POINTS |
| Have you been hospitalized, in a nursing home or had any serious health episodes or illnesses in the last year? |
|
2 |
| Do you have a chronic illness and/or pain that affects what you eat? |
| 2 |
| Do you eat less than 5 servings of any combination of fruit, vegetables, or juice per day? |
|
2 |
| Do you eat less than 2 servings of protein rich foods daily? |
|
2 |
| Do you consume less than 2 servings of calcium rich foods and/or a calcium supplement daily? |
|
2 |
| Do you drink less than 6 (8 oz.) glasses of caffeine free fluids regularly throughout the day? |
|
2 |
| Is it hard for you to chew, swallow, or taste your food? |
|
3 |
| Is eating not enjoyable for you? |
|
1 |
| Do you take 3 or more medications daily, including prescription or over-the-counter drugs, vitamins, or herbal supplements? |
|
1 |
| Have you lost or gained 10 or more pounds in the last 6 months without wanting to? |
|
3 |
| Do you lack regular physical activity on a daily basis? |
|
1 |
| Do you drink 3 or more glasses of beer, wine or liquor almost every day? |
|
1 |
|
|
|
| Total your Nutritional Score. If it's - 0-4: Good!
Your score indicates you do not need to make changes in your eating habits. Check your score every year.
5-9: You may need to make some changes in your diet and activity level to help you remain strong, healthy, and independent. Check your score again in 6 months.
10+: You may be at risk for nutrition problems. You are encouraged to make changes in your diet and activity level to help you maintain or improve your health. You may want to talk to your physician, dietitian, or other qualified health professional about your score. Check your score again in 3 to 6 months. |
Remember that warning signs
suggest risk, but do not represent diagnosis of any condition. |
[Dane County Home Page] [Commission
on Aging Home Page]
Date Updated: March 25, 2002