AF Form 2572PG1: Nutritional Assessment of Dietary Intake

AF Form 2572PG1: Nutritional Assessment of Dietary Intake – is an official U.S. Air Force form used by Nutritional Medicine (NM) services in Military Treatment Facilities (MTFs) to evaluate the dietary intake of patients, particularly Airmen and other military personnel.

This tool helps registered dietitians and diet therapy specialists gather detailed information on eating habits, nutrient consumption, and related factors to support personalized nutrition care plans. It plays a key role in promoting warfighter readiness, managing medical conditions, and addressing nutritional risks in the Air Force community.

What Is AF Form 2572PG1?

AF Form 2572PG1 is titled Nutritional Assessment of Dietary Intake (LRA). “LRA” likely refers to a specific assessment format or limited/restricted activity context, often used for personnel on limited duty or with temporary medical conditions.

It belongs to a family of nutrition-related forms in the Air Force, including:

  • AF Form 2572 (main Nutritional Assessment of Dietary Intake)
  • AF Form 2572PG2 (continuation page)
  • AF Form 2508 (Calorie Count)
  • AF Form 2503 (Nutritional Medicine Service Patient Evaluation)

The form is part of the broader framework outlined in older AFMAN 44-144 (Medical Food Service Management) and supports clinical nutrition practices in Air Force MTFs.

Download the current version here: AF Form 2572PG1 PDF

Purpose of the Form

Air Force dietitians and nutrition teams use AF Form 2572PG1 to collect accurate data on patients’ dietary intake. This information helps:

  • Identify nutritional deficiencies or excesses.
  • Assess eating patterns, food preferences, allergies, and restrictions.
  • Evaluate intake in relation to medical conditions (e.g., diabetes, hypertension, weight management, or recovery from injury).
  • Support performance nutrition for active-duty personnel, including those in high-operational tempo environments.
  • Develop individualized nutrition care plans and education.

In military settings, dietary assessment often focuses on energy, macronutrients, and key micronutrients to maintain physical and cognitive readiness. The form complements other tools like 24-hour recalls, food frequency questionnaires, or calorie counts.

It is especially valuable for Airmen on limited duty, recovering from illness, or managing body composition under Air Force standards (such as the Body Composition Program using waist-to-height ratio).

Who Uses AF Form 2572PG1?

  • Registered Dietitians (RDs) and Diet Therapy Specialists (4D0X1) in Air Force MTFs.
  • Nutritional Medicine Service teams in inpatient and outpatient settings.
  • Providers referring patients for medical nutrition therapy (MNT).
  • Active-duty Airmen, including those in fitness or weight management programs.

Patients typically complete portions of the form (such as food diaries or intake recalls) before or during a nutrition consultation. Self-referrals or provider referrals are common for outpatient nutrition clinics.

Key Sections and Structure of the Form

While the exact layout is a fillable PDF, AF Form 2572PG1 and related versions generally collect the following types of data (based on standard Air Force nutrition assessment practices):

  • Patient demographics: Name, rank, DOB, unit, medical record number.
  • Diet order and medical history: Current diet prescription, diagnoses, medications, and nutritional risk factors.
  • Dietary intake recall: 24-hour or multi-day food and beverage records, including portion sizes.
  • Food frequency or habits: Typical consumption patterns, meal timing, snacks, and supplements.
  • Preferences and restrictions: Allergies, intolerances, cultural/religious preferences, and dislikes.
  • Anthropometric and lab data: Height, weight, BMI, relevant bloodwork (if applicable).
  • Assessment notes: Dietitian’s analysis of adequacy against Military Dietary Reference Intakes (MDRIs) or standard DRIs.
  • Recommendations and follow-up: Goals, education provided, and monitoring plan.

The form often includes space for both patient self-reporting and professional analysis. Continuation pages (like PG2) allow for more detailed logging.

Note: Always use the latest revision from the official Air Force e-Publishing site, as forms are periodically updated.

How to Complete and Use AF Form 2572PG1

  1. Patient Preparation — Record everything consumed in a typical day or specific period, including meals, snacks, drinks, and supplements. Be as accurate as possible with portions.
  2. Dietitian Review — The nutrition professional analyzes the data, often comparing it to Military Dietary Reference Intakes (MDRIs), which adapt civilian DRIs for military needs (energy, protein, vitamins, minerals, etc.).
  3. Integration with Care — Results feed into broader nutrition therapy, weight management, or performance optimization programs.
  4. Documentation — The form becomes part of the patient’s medical record (often uploaded to systems like HAIMS).

Air Force policy emphasizes evidence-based nutrition to support readiness. Accurate dietary assessment helps prevent issues like inadequate fueling during training or deployments.

Importance in Air Force Nutrition and Readiness

Proper nutrition directly impacts mission performance, recovery, and long-term health. The Air Force promotes programs like Go for Green® (G4G) to improve the nutrition environment in dining facilities, and tools like m-NEAT (Military Nutrition Environment Assessment Tool) to evaluate base-wide policies.

AF Form 2572PG1 supports individualized care within this system. Whether addressing body composition standards, managing chronic conditions, or optimizing performance for special operations, detailed dietary intake data is foundational.

Military studies show that service members’ diets are frequently assessed using methods like food frequency questionnaires and recalls, with focus on energy balance and nutrient adequacy to meet operational demands.

Tips for Airmen and Beneficiaries

  • Be honest and detailed when completing intake sections — small inaccuracies can affect recommendations.
  • Bring the form or your records to appointments.
  • Combine form data with other tools (e.g., food logs or apps) for better insights.
  • Follow up with your dietitian or clinic for questions about body composition, performance nutrition, or therapeutic diets.

Access official Air Force forms exclusively through e-Publishing.af.mil. Do not rely on unofficial copies for official use.

  • Air Force Nutritional Medicine clinics at your local MTF.
  • AFI/DAFI policies on body composition and fitness.
  • Military Dietary Reference Intakes guidance (joint service standards).
  • Go for Green® program information for dining facility choices.

For personalized advice, contact your base Nutritional Medicine Service or registered dietitian. They can guide you through the assessment process using AF Form 2572PG1 and related tools.

Keywords: AF Form 2572PG1, Air Force nutritional assessment, dietary intake form, LRA nutrition, military dietitian form, Air Force nutrition services, AF 2572 download.

This article is for informational purposes only and is based on publicly available Air Force publications and forms. Always consult official sources and qualified military medical personnel for current guidance.