What is Picture Your Plate?
Picture Your PlateTM is a brief (48-question) food frequency questionnaire developed to assess how well an individual’s eating habits align with current evidence-based recommendations. As described below, these recommendations aim for a dietary pattern that reduces cardiovascular disease risk and promotes overall health. Picture Your Plate provides a total score ranging from 0 to 96, and sub-scores for specific categories of food choices.
This tool was designed to meet cardiac rehabilitation programs’ needs for content and ease of use (including only 15-20 minutes to administer). It is one of the dietary assessment tools authorized for tracking cardiac rehab outcomes in the program registry of the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). However, it is also useful for work with a variety of other people, since it fits with overall nutrition recommendations and is not aligned with any single dietary pattern.
Reference citations: Please scroll to the bottom of this page for published research on the validation of this tool and the association of scores with recognized dietary pattern indexes. Also included are citations and links to studies using previous versions of the DRA tool.
How to Use Picture Your Plate
Scoring of this food frequency questionnaire awards points for food choices that support a dietary pattern that:
- Emphasizes vegetables, fruits, whole grains, and other high-fiber foods;
- Limits foods high in saturated fat, added sugars (including sugar-sweetened beverages), and sodium;
- And allows for a range of unsaturated fat intake that is reflective of current dietary guidelines.
Picture Your Plate does not directly address overall caloric intake, but it does address several categories of calorie-dense foods that can promote excessive calorie consumption.
Total score is associated with recognized dietary pattern indexes that score diet quality.
Guidance on scoring is included in the scoring worksheet provided, which can also be used to evaluate change in scores over time. Interpretation of scores is addressed in the document “Interim Guidance for Interpreting PYP Scores.”
Category sub-scores: In the context of nutrition counseling, Picture Your Plate category sub-scores can be used to inform discussions about identifying food choices that may benefit from further attention but are not recommended as dietary assessment outcomes themselves.
Spanish Translation Available
A Spanish translation of Picture Your Plate, Piense en su Platillo, is also available.
· English and Spanish forms reflect the same content and context.
· The translation used Spanish natural language techniques that can be understood by all Hispanic cultures.
· Every sentence was carefully evaluated with the most scientific approach to assure accuracy, intercultural understanding, and respect.
Translation and adaptation to Hispanic culture was provided by Sylvia Klinger, DBA, MS, RDN, in collaboration with the certified bilingual interpreters at Spanish Horizons. Ms. Klinger is a global registered dietitian, founder of Hispanic Food Communications, Inc., and a leading expert in cross-cultural Hispanic nutrition and health.
When you access a copy of Picture Your Plate, you will also see options to download the dietary assessment form and a scoring worksheet in Spanish.
Permission to Use Picture Your Plate
Permission for Use
Picture Your Plate is a copyrighted document. The authors grant permission to use Picture Your Plate, as long as the following conditions are met:
- Print format: Picture Your Plate may be printed for use only if the tool is used in its entirety and without changes. This is important to maintain a consistent tool for potential future research.
- Electronic format: Picture Your Plate may be used in an electronic patient care portal, electronic health record, or other private online platform only under the following conditions:
- Picture Your Plate must be used in its entirety without changes in content or structure, including the copyright permission statement and version number.
- Use of Picture Your Plate via your electronic patient portal does not make Picture Your Plate the property of your institution or of your electronic patient portal company.
- To support staff ability to interpret and use these scores appropriately, they will see some reminder of how to view or access the two support documents we have developed: the scoring worksheet for calculating a score and the interim guidance on interpreting scores.
How to Access Picture Your Plate
Picture Your Plate is now freely available as an open-access resource — no separate registration required.
Dietitians and other health professionals can now download Picture Your Plate and all supporting materials free of charge directly from the website of the Cardiovascular Health and Well-being dietetic practice group of the Academy of Nutrition and Dietetics here.
About Development of Picture Your Plate
Picture Your Plate was developed by Karen K. Collins, MS, RDN, CDN, FAND and Ellen S. Aberegg MA, LD, RDN, FAACVPR, in collaboration with two dietitians specializing in cardiac rehabilitation, Judith M. Hinderliter, MPH, RD and Sharon L. Smalling, MPH, RD, LD. It is a revision of the Dietary Risk Assessment (DRA) tool developed by Alice S. Ammerman, DrPH, and Thomas C. Keyserling, MD, MPH. This revision was undertaken with their permission, and they were actively involved in its validation study (see below).
Picture Your Plate was developed as a revision of a previous DRA tool to better reflect the 2015-2020 Dietary Guidelines for Americans and the 2016 AHA Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines.
Contact: For questions about Picture Your Plate, please contact Ellen Aberegg, MA, LD, RDN, FAACVPR, or Karen Collins, MS, RDN, CDN, FAND at PictureYourPlate@gmail.com.
References
Picture Your Plate
Aberegg ES, Collins KK, Hinderliter JM, Smalling SL, Fung TT, Gizlice Z, Johnston LF, Ammerman AS, Keyserling TC. Validity and Reliability of a Brief Dietary Assessment Questionnaire in a Cardiac Rehabilitation Program. J Cardiopulm Rehabil Prev. 2020;40(4):280-283. doi:10.1097/HCR.
Dietary Risk Assessment (DRA) Earlier Versions
Ammerman AS, Haines PS, DeVellis RF, et al. A brief dietary assessment to guide cholesterol reduction in low-income individuals: design and validation. J Am Diet Assoc. 1991;91(11):1385-1390.
Jilcott SB, Keyserling TC, Samuel-Hodge CD, Johnston LF, Gross MD, Ammerman AS. Validation of a brief dietary assessment to guide counseling for cardiovascular disease risk reduction in an underserved population. J Am Diet Assoc. 2007;107(2):246-255.
Rosamond WD, Ammerman AS, Holliday JL, et al. Cardiovascular disease risk factor intervention in low-income women: the North Carolina WISEWOMAN project. Prev Med. 2000;31(4):370-379.
Information on this website is not intended as a substitute for consultation with a healthcare professional. Picture Your PlateTM is a separate entity that is not part of Karen Collins Nutrition.
Copyright: Unless otherwise noted, the design, content and all components of this webpage are protected by United States and international copyright laws and should not be reused or republished without express written permission from Karen K Collins or Ellen S Aberegg. Conditions for printing and patient use of Picture Your Plate are noted above.
