Table 3.

Nutrition Questionnaire and Motivational Interviewing Discussion Points to Facilitate Effective Lifestyle Optimization¹⁰²

Lifestyle Interview Nutrition Questionnaire	Assessment	Are you interested in having a healthier lifestyle?
How many servings of fruits and vegetables do you eat per day?		Are you concerned about the effects your diet is having on your health?
How many servings of whole grains do you eat per day?		On a scale of 1-10, how do you rate your diet from poor to optimal?
How many servings of fish do you eat per week?		On a scale of 1-10, how confident are you in your ability to make a change to your diet?
Do you eat desserts? If so, how often?		What does a typical day look like for you in terms of your eating?
What are your favorite snack foods?		Is there anything you are hoping or have been trying to change about your eating?
Do you eat because you're hungry?	Affirmation & Reflective Listening	I can tell that you have already started to think about making some changes. You are doing a great job with X, Y and Z.
Do you weigh the most now that you've ever weighed?		It sounds like you are working hard to eat more fruits and vegetables into your diet AND I'm hearing that you would really like to eat less fast food.
Are you interested in losing weight?	Barriers	What do you believe are the barriers to making a change in your diet?
	Commit	What would it take to change your diet before our next appointment?
	Demonstrate	How do you suggest we monitor your dietary progress?

Reproduced with permission from [Preventive cardiology by lifestyle intervention: opportunity and/or challenge? 2006. 113(22): 2657-2661]. Copyright 2006. American Medical Association. All rights reserved.