The Importance of A Needs Analysis For Nutrition

I commonly get questions like this:

“Should I increase my carbs to help with my performance”

“What do you think of the keto diet”

“I’m eating 190g of protein per day, is that too much”

In every example listed above the thing that’s missing is context. Without enough context I have no way of knowing what any of these people should do. It’s like going to the mechanic and saying “My car isn’t working, should I change the spark plug”? Without a proper needs analysis the mechanic will have no way of knowing what the issue is, and therefore any suggestion they make will be purely based on speculation. 

As coaches and athletes, we can and should do better than speculation. So where do we start? Here is a non-exhaustive list of questions that will help clarify the objectives and subsequent intervention:

1. What is your age?
2. Are you male or female?
3. What is your bodyweight?
4. What is your occupation?
5. Rate your daily stress on a scale of 1-10 (10 being the most stressed).
6. List your top three goals in order of priority.
7. Have you previously or are you currently using PED’s?
8. How many times per week do you train?
9. What is your daily step count?
10. Describe your relationship with food.
11. Describe your previous month of diet in general.
12. Where do you feel you need to improve the most?
13. List any protocols or strategies you have used in the past that worked and why you feel they were successful?
14. List any protocols or strategies you have used in the past that were unsuccessful and why you feel they didn’t work?
15. Do you have any food intolerances, allergies, or dislikes?
16. Please indicate foods you love and would like to continue eating.
17. Please provide a 3 day food journal from MyFitnessPal or MyMacros+
18. How many hours of sleep do you get per night?
19. Is there anything else I should know?

After reviewing the above list of questions it’s easy to see how much information was missing from the initial questions that were posed to me at the start of this email. Let’s take it one step further and run a hypothetical case study using some of the above questions.

1. What is your age?
   37
   
   
2. Are you male or female?
   Female
   
   
3. What is your bodyweight?
   265Lb
   
   
4. What is your occupation?
   HR advisor
   
   
5. Rate your daily stress on a scale of 1-10 (10 being the most stressed).
   6-7
   
   
6. List your top three goals in order of priority.
   Lose weight, get healthy, increase energy
   
   
7. What is your daily step count?
   1000-2000 steps per day
   
   
8. Describe your previous month of diet in general.
   I eat breakfast at home, but then lunch I eat at a restaurant with my colleagues, and for dinner I usually pick something up on the way home from work
   
   
9. Where do you feel you need to improve the most?
   Eating out less
   
   
10. List any protocols or strategies you have used in the past that worked and why you feel they were successful?
    Nothing I’ve tried has worked
    
    

• How many hours of sleep do you get per night?

6-7 but I’m usually pretty tired

A proper needs analysis is much more in-depth than this, but for simplicity's sake, we’ll stick to this. The primary objective of any nutrition intervention is adherence. And adherence is best accomplished when the changes we make have the largest impact on desirable outcomes while creating the least amount of friction in their daily life. The above example shows this particular individual has a poor track record with dieting, she is obese, lives a sedentary lifestyle, and is very stressed, and is sleep restricted. So, what are three things we can do immediately that are simple yet have a profound impact on the individual's weight loss goals and subsequently self-efficacy?

1. She does not get many steps in and this is a huge opportunity to increase NEPA (non-exercise physical activity) and standardize energy expenditure through a daily step target.
   
   
2. She is sleep restricted which will increase stress, can alter hunger signaling, nutrient partitioning, deter you from difficult tasks, etc. All of this relates to eating behavior and can be managed by slowly increasing sleep duration, quality, and consistency via sleep hygiene practices.
   
   
3. She believes she needs to eat out less, which may be true down the road but if we want to maximize adherence we need to minimize friction. Rather than telling her to stop eating out or even reduce the frequency of eating out, we may instead come up with a strategy for what foods she will order while eating out.

The above intervention is tailored to her goals and current lifestyle. But without all the information collected I would have no way of knowing what sort of intervention would be appropriate. I would also have no way of designing an effective progression model as her competency increases. A thorough needs analysis is critical in the development of an individualized nutrition intervention. It’s not enough to just collect the data. You really have to understand the person you’re working with, even if the person you’re coaching is yourself. Take an honest inventory of your lifestyle and all the variables that impact dietary adherence. Then you’ll have all the information you need to start, and course-correct along the way to your goals. 

Good luck!