Promoting Preventive Nutrition

Nutrition plays an essential role in veterinary medicine and is recognized as the 5th vital assessment. A nutrition evaluation and recommendation should be performed for every patient at every appointment.¹

The goal of preventive nutrition is to maintain a patient’s health as long as possible by integrating nutrition into preventive wellness plans. Wellness diets meet the patient’s current lifestage, lifestyle, and nutrient requirements while helping avoid other diseases. 

However, wellness diets following the lifestage nutrition concept are often underused, despite projected growth in pet food sales showing that most clients recognize the importance of nutrition and are willing to pay a premium price for their pet’s food.^2,3 A 2003 AAHA compliance study found that 90% of clients want a nutrition recommendation from the veterinary team, yet only 15% reported receiving one.⁴To best plan and promote preventive nutrition, the veterinary team should start by developing a potential problem list rather than a current list. The team can then match key nutrition factors in veterinary wellness diets to address and minimize the patient’s potential problems.⁵

Therapeutic vs Preventive Nutrition

Therapeutic nutrition treats or manages disease, whereas preventive nutrition addresses environmental or genetic risk factors to prevent or minimize disease. 

The veterinarian formulates a therapeutic nutrition plan by creating a problem list and matching the diet with the appropriate key nutrition factors to address each condition as part of a complete treatment plan. To increase client compliance with a therapeutic diet, the veterinary team should clearly communicate the diet’s benefits. Caloric intake and output are key discussion points.

Patient Assessment

Veterinary nurses take a leading role in providing preventive nutrition, beginning before the patient is presented and continuing through file review. While obtaining the patient’s history, the veterinary nurse should perform a nutrition assessment, which should include: 

• Medical history: Previous conditions or injuries may indicate a potential concern

• Breed: Consider common breed-related predispositions

• Environment

• Gender

• Body and muscle condition and weight: Small changes can indicate a trend toward malnutrition (eg, obesity)

• Nutrition history: Feeding method and patient preferences may dictate potential limitations.

Diet Calculations

Step 1: Calculate resting energy requirement (RER) = 70 x (ideal body weight in kg)0.75

Step 2: Calculate daily resting energy requirements = RER x Lifestage factor

Lifestage Factors^7,8:

Dogs:

• Neutered adult = 1.6

• Intact adult = 1.8

• Obese prone = 1.2-1.4

• Weight loss = 0.8-1.0

• Growth

  • <4 months = 3.0

  • >4 months to adult = 2.0

Cats:

• Neutered adult = 1.2

• Intact adult = 1.4

• Obese prone = 1.0

• Growth = 2.5

Build Client Compliance

Preventive nutrition involves client education about certain nutrients’ roles in disease prevention. Without clear communication and understanding, clients may not see the benefits, and compliance may decrease. In most families, pets are considered essential members of the family.⁶  To maximize client compliance, focus on customization. Unlike grocery and pet supply stores, which offer life-sustaining foods that appeal to trends, sometimes in specialized flavors, shapes, and sizes, the veterinary team provides individual nutritional recommendations based on a thorough understanding of species- and breed-specific needs as well as the needs of each patient.

Ask clients what is most important about their pet’s nutrition and what drives their food purchases. Often their decisions are based on misinformation driven by powerful marketing campaigns or on trends in human nutrition. These discussions provide an opportunity to educate clients about the correct tools and resources and help them make an informed choice for their pet. 

Further improve compliance with the team’s recommendation by providing a nutrition prescription that briefly conveys the relevance of the diet’s features for the patient and client. Include a specific diet and the exact feeding amount based on a diet calculation. Simply listing the range on the side of the bag does not provide any additional services to the client and may contribute to overfeeding and obesity. Ask the veterinarian to provide his or her signature to further highlight the importance of the proposed nutrition plan.