RECORDED WEBINAR: Nutrition-Focused Physical Examinations in Behavioral Health Treatment Environments





BHN Webinar:

“Nutrition-Focused Physical Examinations in Behavioral Health Treatment Environments”

RECORDED ON June 14, 2016

CPEU Certificate Expired 6/14/2019


Webinar presented by: Ruth Leyse-Wallace, PhD

Synopsis:   RDNS are being encouraged to include a Nutrition-Focused Physical Examination (NFPE) in the nutritional assessment of patients. An RDN survey indicated RDNs report lack of training as a barrier to conducting NFPEs.

Individuals in treatment for behavioral health matters often have issues of paranoia, emotional sensitivity re: being touched, and diminished mental clarity, but are also often interested in nutrition and the observations made during a physical exam. This presentation suggests approaches to patients to enlist their interest and provide a sense of safety.

It includes descriptions of the “normal appearance” of examined areas and examples of documentation of observations. Available handouts (see number 2 below) provide the terminology and resources needed to support the process of completing NFPEs.


  1. After this presentation attendees will have a description of a “least invasive” approach for conducting a nutrition-focused physical examination on a behavioral health patient to a) minimize fear of an unknown process and b) increase patient understanding of how nutrition may be affecting his/her health.
  1. After this presentation attendees will have clear descriptions and vocabulary to use for evaluating and documenting observations made while conducting a nutrition-focused physical examination.
  1. After this presentation attendees will know the essential equipment and materials needed when incorporating nutrition-focused physical examinations into nutritional assessments made in a behavioral health environment.

CPE level: Level 2: General knowledge of literature and professional practice in areas covered.

Learning Needs: 3010 Nutrition Diagnosis Assessment methodology, 5320 Psychiatric disorders, anxiety (disease/disorder), 5280 Nutrient deficiencies, Failure to thrive (disease/disorder)



Speaker Biography: My internship class at the University of Kansas tested the first registration examination and was the first class to graduate as “Registered Dietitians”. I practiced clinical dietetics with a MS, RD credential in full-service psychiatric hospitals for 20 years, then returned to the doctoral program at the University of Arizona to study under Mary Ann Kight, RD, PhD. At that time (1990’s) conducting nutritional physical examinations was new for dietitians. I was excited to put this knowledge into use as a part-time dietitian in an out-patient clinic during graduate school. I was amazed at how often nutrition issues are observed.

After graduation I moved to San Diego, practiced part-time and served as an adjunct faculty member at Mesa Community College. Through all these years I collected clippings and journal articles about how nutrients affect mental health but I couldn’t see whether or how it was being applied to patient care. I retired and started gathering the literature from a growing number of journals and scientists reporting research on how nutritional status and nutrients affect mental health and the brain, publishing two books on the subject. As interest and methodology developed over the years, the number of publications has grown exponentially. It is extremely gratifying to have been a part of this movement and to share this work at conferences and through writing. I am most interested to see what RDNs will add to this body of knowledge.