Objectives To gain an understanding of global political, social, economic and environmental forces that influence

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1 Place: UHM, Bio-Med, Room D211 Time: Tuesdays Pre-requisites: Statistics and Consent Instructor: Treena Delormier, PhD Phone: Office hours: TBD University of Hawai'i at Mānoa Office of Public Health Studies Department of Public Health Sciences PH683 FSHN683: Global Nutrition (2 credits) Fall 2013 Course description and objectives In this course we will examine global nutrition issues, their public health implications and consider these in the context of indigenous populations. The first part of the course will provide an overview of current global nutrition, food and health issues. The second part will focus on the traditional and local food systems of indigenous peoples, how these are changing in relation to global influence, and their links with nutrition and health disparities. In the final section students through their own research guided by the course teachings will present the food system and nutrition issues of an indigenous population they are working with. Throughout we will explore the kinds of public health actions (policies, program, intervention, research projects) that can make an impact on the health and nutrition of Indigenous populations. Expanded Description Indigenous Peoples traditional food systems are comprised of those foods which are produced from the local environment using traditional indigenous knowledge and which reinforce indigenous cultural identity and sovereignty. By exploring Indigenous Peoples current traditional and local food systems we will study how global economic, political, social, environmental and technological forces are shaping the food choices and patterns in indigenous communities, as well as their cultural identity and self-determination. We will explore the concept of nutrition transition as a framework to examine shifts in dietary consumption and energy expenditure that coincides with global economic, demographic, and epidemiological changes. In particular we will study shifting dietary intakes and their impact upon population nutritional and health status. We focus on obesity and type 2 diabetes as key global health issues disproportionately affecting indigenous communities. A deeper understanding of how global forces impact local indigenous communities diets, nutrition and health will inform the kinds of public health interventions that will benefit indigenous communities. The course will help address the following questions. How do global nutrition issues fit into a public health agenda for indigenous peoples? What kinds of public health approaches and action will support improved population health for indigenous communities? What kinds of knowledge and research do we need to support the kinds of actions that will improve health? What are the current challenges to indigenous people nutrition health in a global context? Where are the empowering practices and examples we can take guidance from? Objectives To gain an understanding of global political, social, economic and environmental forces that influence 1

2 our current food systems and food choices. To characterise the unique features of indigenous/ traditional food systems. To understand the relationships between global and local food systems and their impacts on public health and nutrition issues. To identify the kinds of policy, program and research efforts that can improve public health and public health nutrition. Textbooks Lang, T. & Heasman, M. (2004) Food Wars: The Global Battle for Mouths, Minds and Markets, London: Earthscan. Available free online as.pdf Kuhnlein, HV., Erasmus, B., & Spigelski, D. (2009) Indigenous Peoples food systems; the many dimensions of culture, diversity and environment for nutrition and health, Rome: FAO & CINE. Kuhnlein, HV., Erasmus, B., Spigelski, D, & Burlingame, B. (2013) Indigenous Peoples food systems & well being: Interventions and policies for healthy communities, Rome: FAO & CINE. The book is available on the FAO website at: Class Readings Readings for classes will be posted on Laulima under Resources for MAN FSHN/PH-683 Group [FA13] Class Schedule and Topics* Date Topic Assignments 1 Aug 29th Course Introduction to Global Nutrition & Food Issues ASSIGNMENT 1: (dietary intake/nutrient analysis). 2 Sept 5th Delormier away Students to complete their food intake assignment and conduct interview with their partner. 3 Sept 12 th Global food systems - Food system paradigms Assign reading from Indigenous People Food Systems 4 Sept 19th Indigenous Peoples food systems & Traditional Food systems Assignment 1 due 5 Sept 26 th Food and Nutrition Security/Food Sovereignty Paper Topic to be submitted Sept 25th UN Millenium Development goals Special Event 6 Oct 3rd Food/Diet Health/Disease 7 Oct 10 th Nutrition Transition 8 Oct 17 th Obesity, Diabetes, malnutrition: global problem, public health solutions 9 Oct 24 th Indigenous Food, Culture, Identity & health and identity 2

3 Date Topic Assignments 10 Oct 31st Local responses: Hawaii Food Policy Councils Ashley Lukens Wednesday October 16th World Food Day 11 Nov 7 th Climate Change, Environmental Change, Biodiversity environmental health and traditional food systems; ocean focus and fish economy 12 Nov 14 th Local responses; Integration: Indigenous populations, nutrition transition: a human rights perspectives Malia Nobrega 13 Nov 21st Student presentations: Global food issues & public health solutions - Pacific Region case studies. Nov 28th 14 Dec 5 th Delormier away HOLIDAY: Thanksgiving Public Health Actions in Hawaii for food and health 15 December 12th Student presentations: Global food issues & public health solutions - Pacific Region case studies. Final Paper due 6 student presentations Film review Seeds of Hope or Indigenous Knowledge, and Climate Change 6 student presentations * The order of the topics is subject to change as we progress through the course if it is in the best interest of the learning objectives. Any changes will be discussed and agreed upon with the class. ** TBD there are some readings to be determined. # Cooperative teaching groups will be formed in class. Each group will be tasked to cooperatively teach one of Pacific or Indigenous Health food system classes. Student groups can use any teaching methods they are most comfortable with, and any exercises they feel will effectively teach the topic. Readings by Week Additional reading may be assigned and posted on Laulima The readings for each week are to be completed before coming to class Week 1 - Introduction Zimmet. (2000) Globalisation, coca-colonization and the chronic disease epidemic. J of Int. Med. 247:301. Week 2 Student Assignment Interview for sociocultural food choice influences Week 3 - Global food systems - Food systems paradigms Text: Lang, T. & Heasman, M. (2004) The Food Wars Thesis. (In) Food Wars: The Global Battle for Mouths, Minds and Markets, London: Earthscan, pp

4 Suggested: Hendrickson, M. K., & Heffernan, W. D. (2002). Opening spaces through relocalization: locating potential resistance in the weaknesses of the global food system. Sociologia Ruralis, 42(4), Week 4 - Indigenous Peoples food systems - Unique characteristics and implications for nutrition. Kuhnlein, HV., Erasmus, W., Spigelski, Dina. (2010) Why are Indigenous Peoples food systems important and why do they need documentation? Indigenous Peoples Food Systems: the many dimensions of culture, diversity and environment for nutrition and health. Rome: Food & Agriculture Organization of the United Nations. pp.3-7. You will each be assigned one chapter from: Kuhnlein, HV., Erasmus, W., Spigelski, Dina. (2010) Indigenous Peoples Food Systems: the many dimensions of culture, diversity and environment for nutrition and health. Rome: Food & Agriculture Organization of the United Nations. pp.3-7. Earle, L. (2011). Traditional Aboriginal Diets and Health. Prince George, British Columbia: National Collaborating Centre for Aboriginal Health. Retrieved March 2012, from Week 5 - Food and Nutrition Security; Food Sovereignty Godfray, H. C. J., et al. (2010). "Food security: the challenge of feeding 9 billion people." science 327(5967): McDonald B.L. (2010) Global Trends Impacting Food Security. (In) Food Security. Cambridge, Polity, pp Socha T, Zahaf M, Chambers L, Abraham R, & Fiddler T. (2012) Food Security in a Northern First Nations Community: An Exploratory Study on Food Availability and Accessibility. Journal of Aboriginal Peoples Health Wittman, H., Desmarais, A., & Wiebe, N. (2010). The origins and potential of food sovereignty. Food Sovereignty. Reconnecting Food, Nature and Community, Halifax: Fernwood Publishers, Week 6 - Food and Diet Health and Disease Text: Lang, T. & Heasman, M. (2004) Diet and health: diseases and food. Food Wars: The Global Battle for Mouths, Minds and Markets, London: Earthscan. Articles (Laulima) Hughes, R. G. and M. A. Lawrence (2005). "Globalisation, food and health in Pacific Island countries." Asia Pacific journal of clinical nutrition 14(4): 298. Hughes, R. G. and G. C. Marks (2009). "Against the tide of change: diet and health in the Pacific islands." Journal of the American Dietetic Association 109(10): Week 7 - Nutrition Transition 4

5 Popkin, BM (2006) Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. American Journal of Clinical Nutrition 84: O'dea, K. (1984). Marked improvement in carbohydrate and lipid metabolism in diabetic Australian Aborigines after temporary reversion to traditional lifestyle. Diabetes, 33(6), Shintani, T. T., Hughes, C. K., Beckham, S., & O'connor, H. K. (1991). Obesity and cardiovascular risk intervention through the ad libitum feeding of traditional Hawaiian diet. The American journal of clinical nutrition, 53(6), 1647S-1651S. Suggested ( not required): Egeland, G. M., et al. (2011). "Food insecurity and nutrition transition combine to affect nutrient intakes in Canadian Arctic communities." The Journal of nutrition 141(9): Week 8 Obesity, Diabetes, malnutrition: global problem, public health solutions Lang, T., Barling, D. & Caraher (2009) Nutrition. (In) Food Policy: Integrating health, environment & Society. New York: Oxford University Press, 313pp. Friel et al. (2007) unequal weight: equity oriented policy responses to the global obesity epidemic. BMJ 335:1241. Week 9 Indigenous Food, Culture, Identity and Health Text: Lang, T. & Heasman, M. (2004) The Consumer Culture War. (In) Food Wars: The Global Battle for Mouths, Minds and Markets, London: Earthscan, pp Kuhnlein, H., Erasmus, B., Creed-Kanashiro, H., Englberger, L., Okeke, C., Turner, N., Allen, L. & Bhattacharjee on behalf of the whole group, L. (2006). Indigenous peoples' food systems for health: finding interventions that work. Public Health Nutrition, 9(8), Novotny, R., et al. (2009). "US acculturation, food intake, and obesity among Asian-Pacific hotel workers." Journal of the American Dietetic Association 109(10): Week 10 Local responses: Hawaii Food Policy Councils (Guest Lecturer Ashley Lukens, PhD) Lang, T. & Heasman, M. (2004) Policy Responses to diet and disease. Food Wars: The Global Battle for Mouths, Minds and Markets, London: Earthscan. Week 11 Climate Change and Native Hawaiian Food Systems (Malia Nobrega, PhD) HLPE (2012) Food Security and Climate Change. A report by The High Level Panel of Experts on food Security and nutrition, Rome. pp

6 Schonberg, I. (2010) Opportunities for Action: Linking Climate Change Adaptation to Nutrition and Food Security Programs and Policies. SCN News early 2010(3), pp Lynn, K et al. (2013) The impacts of climate change on tribal foods. Climatic Change, pp1-12. Week 12 A Human Rights Perspective: Indigenous Peoples. Nutrition Transition Damman, S., Eide, W. B., & Kuhnlein, H. V. (2008). Indigenous peoples nutrition transition in a right to food perspective. Food Policy, 33(2), Week 13 Global food issues & public health solutions Paper presentations by students Week 14 - Public Health Actions in Hawaii for food and health (Field trip or on-line course) Week 15 - Global food issues & public health solutions - Paper presentations by students Assignments and Evaluation 1) What I Eat (30%). Paired Assignment Students will record their food intake for one day and conduct nutrient intake analysis using the Hawaii Foods website. Inspired by the methodology developed by D Alusio in What I eat, students will visually represent their food intake, with photographs, for the same day they the food intake is recorded. In pairs students will interview each other to learn about the lifestyle factors that shape the food choices represented in the photographs. From the interview information students will write a narrative about the student with whom they did the interview to illustrate, in words, the socio-cultural context and lifestyle that shapes their participant s food choices. Class exhibit or presentation is possible. 2) Case in point (5 %) Students will identify a current initiative, political development, research finding, news story, hot topic etc. that addresses a global food and nutrition issue. This current event will be presented in class as a brief report (5 to 10 minutes) and one page in the form of a press release ( words) to share with the class. 3) Final Paper - Public Health Policy, Program, Intervention or Research study (50%). In this assignment students will propose or design a public health intervention, policy, research study (or intervention relevant to their discipline or field) that addresses a global health issue of their choice. The paper should introduce a specific global health issue, provide a literature review that supports the proposed action or intervention or research question. Students will do a 20 minute presentation to expose the students to a global nutrition topic in-depth. The topic will be presented and approved by the 5 th week in class pages, 12 pt font, 1 inch margins, double spaced. If students have an idea for their paper that fits with their on-going work and would like to proceed to address a specific study related objective, this is encouraged. Please make an appointment to discuss with me. (more details on paper structure to follow) 4) Class attendance (15 points) Students are expected to attend all classes. The classes are structured around lecture and group learning so attendance in participation will greatly facilitate your learning, and contribute to 6

7 that of others. Students will be encouraged to participate in discussions, by contributing a viewpoint, sharing experiences that contribute to the classes' learning, and asking questions. Grading Scale A = points B = points C = points D = points F = <60 points Guidelines Come to class prepared with the assigned reading done. Have any points that need clarification ready as these will be taken up at the beginning of each class. Complete all assignments on time. Late assignments will have points deducted at a rate of 1 point per day. No late assignment will be accepted after 5 days. Graduate level proficiency in written and visual/oral presentation is expected. All written work must be typed, include a title page, student's name on each page with page numbers. Plagiarism is unacceptable and will result in a failing grade for assignment and possibly for the course, depending on the extent of the violation. Please be familiar with the University of Hawaii Student Conduct Code 7