Exploring the Nutrition Care Process (NCP) and International Dietetics and Nutrition Terminology (IDNT)

What is the Nutrition Care Process?

The Nutrition Care Process (NCP) is a framework of practice developed in 2002 by the American Dietetic Association (ADA), now the Academy of Nutrition and Dietetics (AND). It is a systematic approach to Nutrition Care that is client-centred and clarifies the role of dietitians, as well as their skills and the environment in which they practice.1

The NCP is currently being incorporated into practice by many dietitians working in Nutrition Care in Canada and has been recommended by the International Confederation of Dietetic Associations (ICDA) as a framework for practice.2

By providing a framework for critical thinking and decision making, the goal of the NCP is to provide better outcomes for patients.3

It should be noted that a standardized process does not mean that all individuals will receive the same nutritional care. A standardized process means that individuals will receive nutrition care in a standardized fashion according to best practice or accepted guidelines. The care itself remains individualized based on a patient’s needs.

What are the steps involved in the Nutrition Care Process?

The Nutrition Care Process (NCP) has four independent, but interrelated steps. They are:

  1. Nutrition Assessment and Reassessment
  2. Nutrition Diagnosis*
  3. Nutrition Intervention
  4. Nutrition Monitoring and Evaluation

*A nutrition diagnosis is not the same as a medical diagnosis. Communicating a medical diagnosis is the responsibility of physicians, and in some cases, nurse practitioners.4 A nutrition diagnosis is unique to a dietitian and one that can be improved or resolved with his or her specific intervention. For example, diabetes mellitus is a medical diagnosis whereas ‘inconsistent carbohydrate intake’ is a nutrition diagnosis.

You will notice that the steps in the NCP are similar to the four steps outlined above (i.e. assess, plan, implement and evaluate). The process is cyclic and each step relies on the completion of the one before it.

Once a dietitian completes a thorough nutrition assessment, he or she is then able to provide a nutrition diagnosis, which integrates the key elements of the assessment. With a clear nutrition diagnosis, dietitians are able to plan an appropriate intervention in collaboration with the client, which will set out clear parameters for monitoring and evaluating the intervention. Being a cyclical process, part of the monitoring and evaluation is a reassessment of the plan and the patient.

What is International Dietetics and Nutrition Terminology (IDNT)?

IDNT is a standardized language, with standardized nutrition care terms and definitions, that can be used in the NCP. This ensures a reliable definition of terms regardless of where a dietitian is practicing.

IDNT has begun being implemented in many Canadian health provider organizations and is recommended by the International Confederation of Dietetic Associations (ICDA) as a tool for practice.5


1 Lacey, K. & Pritchett, E. (2003). Nutrition Care Process and Model: ADA adopts a road map to quality care and outcomes management. Journal of the American Dietetic Association, 103(8):1061-72.

2 Dietitians of Canada (2015). Nutrition Care Process. Retrieved November 10, 2015 from http://www.dietitians.ca/Dietitians-Views/Health-Care-System/NCP-and-IDNT.aspx

3 Lacey, K. & Pritchett, E. (2003). Nutrition Care Process and Model: ADA adopts a road map to quality care and outcomes management. Journal of the American Dietetic Association, 103(8):1061-72.

4 College of Physicians and Surgeons of Ontario (2012).Delegation of Controlled Acts. Retrieved September 27, 2015 from http://www.cpso.on.ca/CPSO/media/uploadedfiles/policies/policies/policyitems/delegation.pdf?ext=.pdf

5 Dietitians of Canada (2015). Nutrition Care Process. Retrieved November 10, 2015 from http://www.dietitians.ca/Dietitians-Views/Health-Care-System/NCP-and-IDNT.aspx