Nutrition Diagnosis Etiology Matrix

Category Etiology Diagnosis

Attitude Altered body image Poor nutrition quality of life (NQOL) (NB-
2.5)

Attitude Changes in taste, appetite or preference Excessive fat intake (NI-5.6.2), Inappropriate
intake of fats (specify) (NI-5.6.3),
Undesirable food choices (NB-1.7)

Attitude Denial of need to change Not ready for diet/lifestyle change (NB-1.3)

Attitude Desire for a cure for a chronic disease Harmful beliefs/attitudes about food or
through the use of alternative therapy nutrition-related topics (NB-1.2)

Attitude Disbelief in science-based food and nutrition Harmful beliefs/attitudes about food or
information nutrition-related topics (NB-1.2)

Attitude End-of-life care if patient/client or family do Inappropriate infusion of enteral or

not desire nutrition support parenteral nutrition (NI-2.5)

Attitude Familial, societal, biological/genetic, and/or Disordered eating pattern (NB-1.5)

environmental related obsessive desire to be
thin

Attitude Harmful beliefs/attitudes about food,
nutrition, and nutrition-related information
Excessive energy intake (NI-1.5), Excessive
oral food/beverage intake (NI-2.2), Excessive
alcohol intake (NI-4.3), Imbalance of
nutrients (NI-5.5), Excessive fat intake (NI-
5.6.2), Inappropriate intake of fats (NI-5.6.3),
Excessive protein intake (NI-5.7.2),
Inappropriate intake of amino acids (NI-
5.7.3), Excessive fiber intake (NI-5.8.6),
Excessive mineral intake (NI-5.10.2),
Underweight (NC-3.1), Food- and nutrition-
related knowledge deficit (NB-1.1), Not
ready for diet/lifestyle change (NB-1.3),
Physical inactivity (NB-2.1), Excessive
physical activity (NB-2.2)

Attitude Irritability Breastfeeding difficulty (NC-1.3)

Attitude Lack of self-efficacy for making change or Not ready for diet/lifestyle change (NB-1.3),
demoralization from previous failures at Limited adherence to nutrition-related
change recommendations (NB-1.6), Poor nutrition
quality of life (NQOL) (NB-2.5)

Attitude Lack of value for behavior change or Excessive energy intake (NI-1.5), Excessive
competing values oral food/beverage intake (NI-2.2), Excessive
alcohol intake (NI-4.3), Excessive fat intake
(NI-5.6.2) Inappropriate intake of fats
(specify) (NI-5.6.3), Self-monitoring deficit
(NB-1.4), Limited adherence to nutrition-
related recommendations (NB-1.6), Physical
inactivity (NB-2.1), Inability or lack of desire
to manage self-care (NB-2.3)

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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Nutrition Diagnosis Etiology Matrix
Category Etiology Diagnosis
Attitude Lacks motivation and or readiness to apply Undesirable food choices (NB-1.7)
or support systems change
Attitude Negative impact of current or previous Poor nutrition quality of life (NQOL) (NB-
medical nutrition therapy (MNT) 2.5)

Attitude Not ready for diet/lifestyle change Overweight/Obesity (NC-3.3), Self-monitor-

ing deficit (NB-1.4), Inability or lack of desire
to manage self-care (NB-2.3), Poor nutrition
quality of life (NQOL) (NB-2.5)
Attitude Perception of inadequate milk supply Breastfeeding difficulty (NC-1.3)

Attitude Perception that lack of resources (e.g., time,

financial, or interpersonal) prevent:
• Selection/food choices consistent with
recommendations
• Changes
• Sufficient level of activity
Undesirable food choices (NB-1.7)
Not ready for diet/lifestyle change (NB-1.3),
Limited adherence to nutrition-related
recommendations (NB-1.6)
Physical inactivity (NB-2.1)

• Self-monitoring Self-monitoring deficit (NB-1.4), Inability or

lack of desire to manage self-care (NB-2.3)
Attitude Unwilling or disinterested in:

• Learning/applying information Food- and nutrition-related knowledge deficit

(NB-1.1), Not ready for diet/lifestyle change
(NB-1.3), Limited adherence to nutrition-
related recommendations (NB-1.6), Undesir-
able food choices (NB-1.7), Inability or lack
of desire to manage self-care (NB-2.3)
• Reducing energy intake Excessive energy intake (NI-1.5)
• Reducing intake Excessive oral food/beverage intake (NI-2.2)
• Tracking progress Self-monitoring deficit (NB-1.4)
Attitude Unwillingness to consume fiber-containing Inadequate fiber intake (NI-5.8.5)
foods
Attitude Weight regulation/preoccupation significant- Disordered eating pattern (NB-1.5)
ly influences self-esteem
Behavior Addictive behavior Excessive exercise (NB-2.2)
Behavior Consumption of high-dose nutrient supple- Imbalance of nutrients (NI-5.5)
ments
Behavior Eating behavior serves a purpose other than Harmful beliefs/attitudes about food or
nourishment (e.g., pica) nutrition-related topics (NB-1.2)
Behavior Excess energy intake Overweight/Obesity (NC-3.3)
Behavior Excessive physical activity Underweight (NC-3.1)

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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Nutrition Diagnosis Etiology Matrix
Category Etiology Diagnosis
Behavior Food and nutrition compliance limitations Excessive carbohydrate intake (NI-5.8.2),
inappropriate intake of types of
carbohydrates (specify) (NI-5.8.3),
Inconsistent carbohydrate intake (NI-5.8.4)
Behavior Food or activity behavior-related difficulty Poor nutrition quality of life (NQOL) (NB-
2.5)
Behavior Food preparation or eating patterns that Excessive fiber intake (NI-5.8.6)
involve only high-fiber foods to the
exclusion of other nutrient-dense foods
Behavior Disordered eating pattern Excessive physical activity(NB-2.2),
Underweight (NC-3.1), Overweight/Obesity
(NC-3.3)
Behavior Frequent intake of foods containing Excessive bioactive substance intake (NI-
bioactive substances 4.2)
Behavior Inability to limit or refuse offered foods Excessive oral food/beverage intake (NI-2.2)
Behavior Inadequate energy intake Underweight (NC-3.1)
Behavior Lack of focus and attention to detail, Self-monitoring deficit (NB-1.4)
difficulty with time management and/or
organization
Behavior Over consumption of a limited variety of Excessive mineral intake (specify) (NI-
foods 5.10.2)
Behavior Poor or inappropriate food planning, Excessive oral food/beverage intake (NI-
purchasing and preparation practices 2.2), Inadequate fiber intake (NI-5.8.5),
Limited access to food (NB-3.2)
Behavior Reluctance or avoidance of self-feeding Self-feeding difficulty (NB-2.6)
Culture Cultural practices that affect ability to:

• Access food variety Inadequate protein–energy intake (NI-5.3),

Inadequate fat intake (NI-5.6.1)
• Breastfeed Breastfeeding difficulty (NC-1.3)
• Learn/apply information Food- and nutrition-related knowledge
deficit (NB-1.1), Undesirable food choices
(NB-1.7)
• Manage self-care Inability or lack of desire to manage self-
care (NB-2.3)
• Reduce carbohydrate intake Excessive carbohydrate intake (NI-5.8.2)
• Regulate timing of carbohydrate Inconsistent carbohydrate intake (NI-5.8.4)
consumption
• Regulate types of carbohydrate Inappropriate intake of types of
consumed carbohydrates (specify) (NI-5.8.3)
• Track personal progress Self-monitoring deficit (NB-1.4)

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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Nutrition Diagnosis Etiology Matrix
Category Etiology Diagnosis

Access Access to foods and supplements in excess Excessive vitamin intake (specify) (NI-5.9.2)
of needs
Access Caregiver intentionally or unintentionally not Limited access to food (NB-3.2)
providing access to food
Access Community and geographical constraints for Limited access to food (NB-3.2)
shopping and transportation
Access Environmental causes, e.g., inadequately Inadequate mineral intake (specify) (NI-
tested nutrient bioavailability of fortified 5.10.1)
foods, beverages, and supplements; inapp-
ropriate marketing of fortified foods,
beverages, supplements as a substitute for
natural food source of nutrient(s)
Access Exposure to contaminated water or food, Intake of unsafe food (NB-3.1)
e.g., community outbreak of illness
documented by surveillance and/or response
agency
Access Failure to participate in federal food Limited access to food (NB-3.2)
programs such as WIC, National School
Breakfast/Lunch Program, food stamps
Access Financial constraints that may prevent Physical inactivity (NB-2.1)
sufficient level of activity (e.g., to address
cost of equipment or shoes or club
membership to gain access)
Access Food insecurity Poor nutrition quality of life (NQOL) (NB-
2.5)
Access Lack of, or limited access to:

• Adaptive eating devices conducive for Self-feeding difficulty (NB-2.6)

self-feeding
• Available and safe exercise space and/or Physical inactivity (NB-2.1)
equipment
• Fluid Inadequate fluid intake (NI-3.1), Inadequate
fiber intake (NI-5.8.5)
• Fortified foods and beverages Inadequate mineral intake (specify) (NI-
5.10.1)
• Specialized protein products Excessive protein intake (NI-5.7.2)

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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Nutrition Diagnosis Etiology Matrix
Category Etiology Diagnosis

Access Lack of, or limited access to, cont’d:

• Food or artificial nutrition Inadequate energy intake (NI-1.4),

Inadequate oral food/beverage intake (NI-
2.1), Malnutrition (NI-5.2), Inadequate
protein-energy intake (NI-5.3), Inadequate
protein intake (NI-5.7.1), Inadequate
carbohydrate intake (NI-5.8.1), Inadequate
vitamin intake (specify) (NI-5.9.1),
Inadequate mineral intake (specify) (NI-
5.10.1), Involuntary weight loss (NC-3.2)
• Food Underweight (NC-3.1)

• Fiber-containing foods Inadequate fiber intake (NI-5.8.5)

• Food that contains a bioactive substance Inadequate bioactive substance intake (NI-
4.1)
• Healthy food choices Excessive energy intake (NI-1.5), Excessive
oral food/beverage intake (NI-2.2),
Excessive fat intake (NI-5.6.2),
Inappropriate intake of fats (specify) (NI-
5.6.3)
• Recommended foods Undesirable food choices (NB-1.7)

• Sufficient quantity or variety of Limited access to food (NB-3.2)

culturally appropriate healthful food
• Safe food supply Intake of unsafe food (NB-3.1)

• Food storage equipment/facilities Intake of unsafe food (NB-3.1)

• Self-management tools or decision Inability or lack of desire to manage self-

guides care (NB-2.3)
Access Limited, absent, or failure to participate in Limited access to food (NB-3.2)
community supplemental food programs
such as food pantries, emergency kitchens,
or shelters, with a sufficient variety of
culturally appropriate healthful foods
Access Schools lacking nutrition/wellness policies Limited access to food (NB-3.2)
or application of policies ensuring
convenient, appetizing, competitively priced
culturally appropriate healthful foods at
meals, snacks, and school sponsored
activities

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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Nutrition Diagnosis Etiology Matrix
Category Etiology
Knowledge Food and nutrition knowledge deficit
Knowledge Food and nutrition knowledge deficit
concerning:
• Sufficient oral food/beverage intake
• Consumption of an appropriate variety
of foods
• Potentially unsafe food
• Proper infant feeding, food/feeding
preparation and storage
• Adequate energy intake
• Appropriate amount and types of dietary Malnutrition (NI-5.2), Inadequate protein
protein
• Appropriate type of dietary fat
• Prolonged adherence to a very low-fat diet Inadequate fat intake (NI-5.6.1)
• Appropriate amount and types of dietary Excessive carbohydrate intake (NI-5.8.2),
carbohydrate
• Appropriate timing of carbohydrate
intake
• Physiological causes requiring careful
timing and consistency in the amount of
carbohydrate
• Physiological causes requiring use of
modified carbohydrate
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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Diagnosis
Inadequate energy intake (NI-1.4), Excessive
energy intake (NI-1.5), Excessive oral
food/beverage intake (NI-2.2), Inadequate
fluid intake (NI-3.1), Excessive fluid intake
(NI-3.2), Inadequate bioactive substance
intake (NI-4.1), Excessive bioactive
substance intake (NI-4.2), Excessive alcohol
intake (NI-4.3), Malnutrition (NI-5.2),
Imbalance of nutrients (NI-5.5), Excessive
fat intake (NI-5.6.2), Inadequate protein
intake (NI-5.7.1), Inadequate carbohydrate
intake (NI-5.8.1), Inadequate fiber intake
(NI-5.8.5), Excessive mineral intake
(specify) (NI-5.10.2), Overweight/obesity
(NC-3.3), Self-monitoring deficit (NB-1.4),
Inability or lack of desire to manage self-
care (NB-2.3), Poor nutrition quality of life
(NQOL) (NB-2.5), Limited access to food
(NB-3.2)
Inadequate oral food/beverage intake (NI-2.1)
Excessive mineral intake (specify) (NI-
5.10.2)
Intake of unsafe food (NB-3.1)
Intake of unsafe food (NB-3.1)
Underweight (NC-3.1)
intake (NI-5.7.1)
Inappropriate intake of fats (NI-5.6.3)
Inappropriate intake of types of
carbohydrates (specify) (NI-5.8.3)
Inconsistent carbohydrate intake (NI-5.8.4)
Inconsistent carbohydrate intake (NI-5.8.4)
Inappropriate intake of types of
carbohydrates (specify) (NI-5.8.3)
Nutrition Diagnosis Etiology Matrix
Category Etiology
Knowledge Food and nutrition knowledge deficit
concerning, cont’d:
• Physiological causes requiring use of
modified carbohydrate intake
• Desirable quantities of fiber
• Correct enteral formula needed
• Food and supplemental sources of
vitamins
• Food and supplemental sources of
minerals
• Recommended dose of vitamin and
mineral supplements
• Management of diagnosis requiring
mineral restriction
• Management of diagnosed genetic
disorder altering mineral homeostasis
• Correct amount of enteral formula
• Correct parenteral nutrition components
• Appropriate/correct access for delivering Inadequate intake from enteral/parenteral
EN/PN
• Health benefits of physical activity
• How to make nutrition-related changes
• Food-drug interactions
• On the part of the caregiver
Knowledge Lack of prior exposure to accurate nutrition-
related information
Knowledge Lack of prior exposure to accurate
information regarding physical activity
Knowledge Misunderstanding of information
Knowledge Failure to adjust for lifestyle changes and
decreased metabolism
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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Diagnosis
Excessive carbohydrate intake (NI-5.8.2)
Excessive fiber intake (NI-5.8.6)
Inadequate intake from enteral/parenteral
(EN/PN) nutrition (NI-2.3)
Inadequate vitamin intake (specify) (NI-
5.9.1), Excessive vitamin intake (specify)
(NI-5.9.2)
Inadequate mineral intake (specify) (NI-
5.10.1)
Imbalance of nutrients (NI-5.5)
Excessive mineral intake (specify) (NI-
5.10.2)
Excessive mineral intake (specify) (NI-
5.10.2)
Excessive energy intake (NI-1.5)
Inadequate intake from enteral/parenteral
(EN/PN) nutrition (NI-2.3)
(EN/PN) nutrition (NI-2.3)
Physical inactivity (NB-2.1)
Limited adherence to nutrition-related
recommendations (NB-1.6)
Food-Medication Interaction (NC-2.3)
Excessive intake from enteral/parenteral (EN/
PN) nutrition (NI-2.4), Inappropriate infusion
of Enteral or Parenteral Nutrition (NI-2.5)
Food- and nutrition-related knowledge deficit
(NB-1.1), Harmful beliefs/attitudes about
food or nutrition-related topics (NB-1.2),
Self-monitoring deficit (NB-1.4), Inability or
lack of desire to manage self-care (NB-2.3)
Physical inactivity (NB-2.1)
Undesirable food choices (NB-1.7)
Excessive energy intake (NI-1.5)
Nutrition Diagnosis Etiology Matrix
Category Etiology Diagnosis

Medical/Surgical Addictive personality Excessive physical activity (NB-2.2)

Medical/Surgical Alcohol addiction
Medical/Surgical Alteration in gastrointestinal tract
• Decreased functional length of intestine
• Decreased functional length of GI tract
• Alteration in GI anatomical structure
• Alteration in GI function
• Change in GI tract motility
Excessive alcohol intake (NI-4.3)
Malnutrition (NI-5.2)
Altered gastrointestinal (GI) function (NC-
1.4), Impaired nutrient utilization (NC-2.1)
Altered gastrointestinal (GI) function (NC-
1.4), Inadequate fat intake (NI-5.6.1)
Inadequate bioactive substance intake (NI-
4.1), Excessive bioactive substance intake
(NI-4.2), Inadequate fat intake (NI-5.6.1),
Altered gastrointestinal (GI) function (NC-
1.4), Impaired nutrient utilization (NC-2.1)
Altered gastrointestinal (GI) function (NC-1.4)

Medical/Surgical Altered cholesterol metabolism/regulation Decreased nutrient needs (specify) (NI-5.4)

Medical/Surgical Breast or nipple abnormality Breastfeeding difficulty (NC-1.3)

Medical/Surgical Changes in taste, appetite or preference Excessive fat intake (NI-5.6.2), Inappro-
priate intake of fats (specify) (NI-5.6.3)
Medical/Surgical Chronic use of medications known to cause Involuntary weight gain (NC-3.4)
weight gain, such as use of certain
antidepressants, antipsychotics, corticoster-
oids, certain HIV medications
Medical/Surgical Condition leading to excessive fluid weight Involuntary weight gain (NC-3.4)
gains
Medical/Surgical Conditions leading to excess fluid loss Excessive fluid intake (NI-3.2)
Medical/Surgical Craniofacial malformations Biting/Chewing (masticatory) difficulty (NC-1.2)

Medical/Surgical Decreased energy needs Overweight/Obesity (NC-3.3)

Medical/Surgical Decreased nutrient needs related to low Excessive intake from enteral or parenteral
activity levels due to chronic disease or nutrition (NI-2.4), Excessive vitamin intake
organ failure (specify) (NI-5.9.2)
Medical/Surgical Difficulty chewing or swallowing high-fiber Inadequate fiber intake (NI-5.8.5)
foods
Medical/Surgical Difficulty latching on Breastfeeding difficulty (NC-1.3)

Medical/Surgical Food allergies and aversions impeding food Undesirable food choices (NB-1.7)
choices consistent with guidelines
Medical/Surgical Food intolerances Decreased nutrient needs (specify) (NI-5.4)

Medical/Surgical Heart failure Decreased nutrient needs (specify) (NI-5.4)

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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Nutrition Diagnosis Etiology Matrix
Category Etiology Diagnosis

Medical/Surgical High level of fatigue or other side effect of
therapy
Medical/Surgical Illness causing unexpected weight gain
because of head trauma, immobility,
paralysis or related condition
Medical/Surgical Impaired cognitive ability, including
learning disabilities, neurological or sensory
impairment, and dementia
Medical/Surgical Improvement in patient/client status,
allowing return to total or partial oral diet;
changes in the course of disease resulting in
changes in nutrient requirements
Medical/Surgical Increased energy needs
Undesirable food choices (NB-1.7), Impaired
ability to prepare foods/meals (NB-2.4)
Involuntary weight gain (NC-3.4)
Inadequate fluid intake (NI-3.1), Food- and
nutrition-related knowledge deficit (NB-1.1),
Not ready for diet/lifestyle change (NB-1.3),
Self-monitoring deficit (NB-1.4), Undesir-
able food choices (NB-1.7), Inability or lack
of desire to manage self-care (NB-2.3),
Impaired ability to prepare foods/meals (NB-
2.4), Self-feeding difficulty (NB-2.6),
Limited access to food (NB-3.2)
Inappropriate infusion of enteral or
parenteral nutrition (NI-2.5)
Underweight (NC-3.1)

Medical/Surgical Injury, lifestyle change, condition, physical Physical inactivity (NB-2.1)

disability or limitation that reduces physical
activity or activities of daily living
Medical/Surgical Intolerance of EN/PN Inadequate intake from enteral/parenteral
(EN/PN) nutrition (NI-2.3)
Medical/Surgical Kidney, liver, cardiac, endocrine, neurologic, Excessive fluid intake (NI-3.2), Altered
and/or pulmonary dysfunction nutrition-related laboratory values (specify)
(NC-2.2)
Medical/Surgical Lack of developmental readiness to perform Inability or lack of desire to manage self-
self-management tasks care (NB-2.3)
Medical/Surgical Lethargy, sleepiness Breastfeeding difficulty (NC-1.3)

Medical/Surgical Limited vision Self-feeding difficulty (NB-2.6)

Medical/Surgical Liver dysfunction Decreased nutrient needs (specify) (NI-5.4),

Excessive protein intake (NI-5.7.2), Inappro-
priate intake of amino acids (specify) (NI-
5.7.3)
Medical/Surgical Loss of appetite awareness Excessive oral food/beverage intake (NI-2.2)

Medical/Surgical Malnutrition/malabsorption Breastfeeding difficulty (NC-1.3)

Medical/Surgical Mastitis and/or painful breasts, nipples Breastfeeding difficulty (NC-1.3)

Medical/Surgical Mechanical issues such as inflammation, Swallowing difficulty (NC-1.1), Biting/

surgery, stricture, or oral, pharyngeal and Chewing (masticatory) difficulty (NC-1.2)
esophageal tumors, mechanical ventilation

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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Nutrition Diagnosis Etiology Matrix
Category Etiology Diagnosis

Medical/Surgical Medications that increase appetite Excessive energy intake (NI-1.5), Excessive
oral food/beverage intake (NI-2.2),
Excessive fat intake (NI-5.6.2), Inappro-
priate intake of fats (specify) (NI-5.6.3)
Medical/Surgical Mental illness, confusion, altered awareness Intake of unsafe food (NB-3.1), Excessive
or depression oral food/beverage intake (NI-2.2)
Medical/Surgical Inborn errors of metabolism Inappropriate intake of amino acids (specify)
(NI-5.7.3)
Medical/Surgical Metabolic abnormality Excessive protein intake (NI-5.7.2), Inappro-
priate intake of amino acids (specify) (NI-
5.7.3)
Medical/Surgical Metabolic disorders Impaired nutrient utilization (NC-2.1)

Medical/Surgical Motor causes related to neurological or Swallowing difficulty (NC-1.1)

muscular disorders
Medical/Surgical Oral pain Breastfeeding difficulty (NC-1.3)

Medical/Surgical Other organ dysfunction that leads to Altered nutrition-related laboratory values
biochemical changes (specify) (NC-2.2)
Medical/Surgical Partial or complete edentulism Biting/Chewing (masticatory) difficulty (NC-1.2)

Medical/Surgical Physical disability Impaired ability to prepare foods/meals (NB-

Medical/Surgical Physiological causes increasing nutrient
needs due to:
• Accelerated growth or anabolism
• Altered absorption or metabolism
• Disease/condition
• Maintenance of body temperature
2.4), Limited access to food (NB-3.2)
Increased energy expenditure (NI-1.2),
Inadequate intake from enteral/parenteral
(EN/PN) nutrition (NI-2.3)
Inadequate protein intake (NI-5.7.1),
Inadequate vitamin intake (specify) (NI-
5.9.1), Inadequate mineral intake (specify)
(NI-5.10.1), Malnutrition (NI-5.2),
Inadequate protein–energy intake (NI-5.3),
Involuntary weight loss (NC-3.2)
Inadequate intake from enteral/parenteral
(EN/PN) nutrition (NI-2.3), Inadequate
protein intake (NI-5.7.1), Inadequate vitamin
intake (specify) (NI-5.9.1), Involuntary
weight loss (NC-3.2)
Increased energy expenditure (NI-1.2)

• Nutrient/nutrient interaction and/or Malnutrition (NI-5.2), Inadequate intake

drug/nutrient interaction from enteral/parenteral (EN/PN) nutrition
(NI-2.3), Inadequate vitamin intake (specify)
(NI-5.9.1), Inadequate mineral intake
(specify) (NI-5.10.1)
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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Nutrition Diagnosis Etiology Matrix
Category Etiology Diagnosis

Medical/Surgical Physiological causes increasing nutrient Inadequate energy intake (NI-1.4),

needs due to, cont'd: Inadequate oral food/beverage intake (NI-
• Prolonged catabolic illness 2.1), Malnutrition (NI-5.2), Inadequate
protein–energy intake (NI-5.3), Inadequate
protein intake (NI-5.7.1), Inadequate vitamin
intake (specify) (NI-5.9.1), Inadequate
mineral intake (specify) (NI-5.10.1),
Involuntary weight loss (NC-3.2)
Medical/Surgical Poor sucking ability Breastfeeding difficulty (NC-1.3)

Medical/Surgical Prematurely Altered nutrition-related laboratory values

(NC-2.2)
Medical/Surgical Prolonged adherence to a low-fiber or low- Inadequate fiber intake (NI-5.8.5)
residue diet
Medical/Surgical Prolonged hospitalization Involuntary weight loss (NC-3.2)

Medical/Surgical Renal dysfunction Decreased nutrient needs (specify) (NI-5.4),

Medical/Surgical Small for gestational age, intrauterine growth Underweight (NC-3.1)
retardation/restriction and/or lack of
progress/appropriate weight gain per day
Medical/Surgical Soft tissue disease (primary or oral
manifestations of a systemic disease)
Medical/Surgical Swallowing difficulty, and altered suck and
breathing patterns in infants
Medical/Surgical Xerostomia
Excessive protein intake (NI-5.7.2), Inappro-
priate intake of amino acids (specify) (NI-
5.7.3)
Biting/Chewing (masticatory) difficulty (NC-1.2)
Swallowing difficulty (NC-1.1),
Breastfeeding difficulty (NC-1.3)
Biting/Chewing (masticatory) difficulty (NC-1.2)

Physical Inadequate milk supply Breastfeeding difficulty (NC-1.3)

activity/function
Physical Physiological difficulty causing inability to Self-feeding difficulty (NB-2.6)
activity/function physically:
• Bend elbow at wrist
• Grasp cups and utensils
• Sit with hips square and back straight
• Support neck and/or control head and
neck
• Coordinate hand movement to mouth
Physical Lack of self-feeding ability Involuntary weight loss (NC-3.2)
activity/function
Physical Limited physical strength or range of motion Self-feeding difficulty (NB-2.6)
activity/function
Physical Physical inactivity Overweight/Obesity (NC-3.3)
activity/function

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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
Nutrition Diagnosis Etiology Matrix
Category Etiology Diagnosis

Physical Voluntary or involuntary physical Increased energy expenditure (NI-1.2)

activity/function activity/movement
Policy/Procedure Accidental vitamin and/or mineral overdose Excessive vitamin intake (specify) (NI-
from enteral or parenteral sources 5.9.2), Excessive mineral intake (specify)
(NI-5.10.2)
Policy/Procedure Calories unaccounted for from IV infusion Excessive energy intake (NI-1.5)
and/or medications
Policy/Procedure Combined ingestion or administration of Food–medication interaction (NC-2.3)
medication and food that results in
undesirable/harmful interaction
Policy/Procedure Infusion volume not reached or schedule for Inadequate intake from enteral/parenteral
infusion interrupted (EN/PN) nutrition (NI-2.3)
Policy/Procedure Insufficient electrolyte replacement when Imbalance of nutrients (NI-5.5)
initiating feeding (PN/EN, including oral)
Policy/Procedure Lack of, compromised, or incorrect access Inadequate intake from enteral/parenteral
for delivering EN/PN (EN/PN) nutrition (NI-2.3)
Policy/Procedure Misused specialized protein products Inappropriate intake of amino acids (specify)
(NI-5.7.3)
Policy/Procedure Overfeeding of parenteral/enteral nutrition Excessive energy intake (NI-1.5)
(PN/EN)
Psychological Psychological causes such as depression and Inadequate energy intake (NI-1.4),
disordered eating Inadequate oral food/beverage intake (NI-
2.1), Excessive fluid intake (NI-3.2),
Inadequate protein–energy intake (NI-5.3),
Inadequate fat intake (NI-5.6.1), Inadequate
protein intake (NI-5.7.1), Inadequate carbo-
hydrate intake (NI-5.8.1), Excessive
carbohydrate intake (NI-5.8.2), Inappropriate
intake of types of carbohydrates (NI-5.8.3),
Inconsistent carbohydrate intake (NI-5.8.4),
Inadequate fiber intake (NI-5.8.5), Involunt-
ary weight loss, (NC-3.2) Undesirable food
choices (NB-1.7), Limited access to food
(NB-3.2)
Social Lack of role models Breastfeeding difficulty (NC-1.3), Physical
Inactivity (NB-2.1)
Social Lack of social support for implementing Breastfeeding difficulty (NC-1.3), Not ready
changes for diet/lifestyle change (NB-1.3), Self-
monitoring deficit (NB-1.4), Limited
adherence to nutrition-related
recommendations (NB-1.6), Physical
inactivity (NB-2.1), Inability or lack of
desire to manage self-care (NB-2.3), Poor
nutrition quality of life (NQOL) (NB-2.5)

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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.
 Social Increased psychological/life stress Overweight/Obesity (NC-3.3)

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Supplemental material for International Dietetics and Nutrition Terminology (IDNT) Reference Manual, Second Edition. Copyright 2009
American Dietetic Association.