Department of Nutrition, UNC Gillings School of Global Public Health

Transcription

1 Department of Nutrition, UNC Gillings School of Global Public Health Instructors NUTRITION 611: Nutrition Across the Life Cycle Fall 2017: Tu / Th, 2:00-3:15 pm Rosenau Credits Amanda Holliday, M.S., R.D, LDN 2211 McGavran-Greenberg Hall, School of Public Health, Dept. of Nutrition Phone: ( ) amanda_holliday@unc.edu Blog: Office hours by appointment Heather M. Wasser, PhD, MPH, RD, IBCLC 2221 McGavran-Greenberg Hall School of Public Health, Dept. of Nutrition Phone: ( ) wasser@ .unc.edu Office hours by appointment Teaching Assistants Katherine Moser, MPH/RD Student kmoser@ .unc.edu Ella Stephan, MPH/RD Student estephan@ .unc.edu Course Description This course is concerned with nutrition during major phases of the life cycle. It will include modules on nutrition during (1) preconception, pregnancy, and lactation (2) infancy, childhood, and adolescence (3) adulthood, and (4) older adulthood (65+). Class sessions are meant to be engaging and include lectures, class debates, discussion questions, and presentations by students. Course Objectives The student will: 1. Understand the biological basis of energy and nutrient requirements during preconception, pregnancy and lactation, infancy, childhood, adolescence, adulthood, and older adulthood (65+). 1

2 2. Understand the consequences of energy and nutrient inadequacies and excesses, and identify major public health problems related to each phase of the life cycle. 3. Be able to identify socioeconomic, cultural and environmental barriers to meeting nutrient needs, and be aware of and value these critical determinants of health in informing the development of nutrition programs and policies targeted to different phases of the life cycle. 4. Analyze and evaluate scientific evidence related to nutritional needs, requirements and health issues during each major phase of the life cycle. 5. Integrate information from a variety of sources to develop a comprehensive understanding of nutrition as it relates to the different phases of the life cycle. Student Learning Outcomes covered in this course: KRD 5.2 The physical and biological science foundation of the dietetics profession must be evident in the curriculum. Course content may include organic chemistry, biochemistry, physiology, genetics, microbiology, pharmacology, statistics, nutrition metabolism and nutrition across the lifecycle. Readings Class readings will be from the required textbook, review articles, original research articles, and government reports. All of the readings except those from the required textbook will be available on Sakai. Class podcasts, videos and interactive content links will also be posted on Sakai. Required Textbook Melissa Bernstein and Kimberley McMahon. Nutrition across life stages. Jones & Bartlett Learning, This is a new textbook. We have placed a request for the HSL to purchase the textbook and place on reserve, but it is not likely to be available by the beginning of the semester. You can purchase the book through UNC Student Stores or purchase the ebook or rent the text for a reduced price at or on Amazon. Course Requirements and Grades Final grades will be based upon the completion of the following assignments: Task Value Percent of Grade Chapter Assessments 775 (~50 each) 52% Ensuring Evidence-Based Practice % Lifecycle Interview % Total 1, % Letter grades are assigned according to the following scale: 2

3 Graduate students: H ( ); P ( ); L ( ); F (<900) Undergraduate students: A ( ); A- ( ); B+ ( ); B ( ); B- ( ); C+ ( ); C ( ); C- ( ); D+ ( ) D ( ); D- ( ); F (<900) Note: Students who have a documented disability from the UNC Office of Accessibility will be provided alternative testing arrangements. Late projects and papers will not be accepted. Students are required to take final examinations (group projects) as scheduled. The only exceptions are for illness as documented by being on infirmary list at Campus Health Services or for other medically-documented or family or personal emergency situations. A student must meet with an academic dean to request permission for an examination excuse and documentation will be required. Honor System As part of the UNC Honor Code, Carolina students pledge to maintain ideals of academic honesty, personal integrity, and responsible citizenship. These ideals are embodied in the Honor Code set forth in the Instrument, with the support of students, faculty, and staff. When a student applies to Carolina, he undertakes a commitment to the principles embodied in the Honor Code. The University endeavors to instill in each student a love of learning, a commitment to fair and honorable conduct, and respect for the safety and welfare of others. It also strives to protect the community from those who, for whatever reason, do not embody these values in their conduct, and to protect the integrity of the University and its property for the benefit of all. Online Course Evaluation UNC uses an online evaluation system to assess the quality of instruction and learning of the courses offered. During the last few weeks of the course, an will notify you that the system is open with a link to access the form. This evaluation system is anonymous. The instructors will only see the aggregate data with any comments at the end of the course after grades are turned in. It is your responsibility as a student to complete the evaluations. You will be sent multiple s until it is completed. Laptop Policy We are pleased to have students take notes via laptops. However, we expect that students who bring their laptops to class will use them for academic purposes and not for surfing the internet or other extracurricular activities not related to the class discussion. Please remember that engaging in such activities during class time is disruptive to fellow students who can see your screen. It is also unacceptable for any of our esteemed visiting guest lecturers to see such non-academic activities during class time. Requesting Accommodations The University of North Carolina at Chapel Hill facilitates the implementation of reasonable accommodations, including resources and services, for students with disabilities, chronic medical conditions, a temporary disability or pregnancy complications resulting in difficulties with accessing learning opportunities. All accommodations are coordinated through the Accessibility Resources and Service Office, Tel or - accessibility@unc.edu. Relevant policy documents as they relate to registration and accommodations determinations and the student registration form are available at: 3

4 Course Components 1. Chapter Assessments Chapter Assessments will be released at the beginning of each module. Due dates for Chapter Assessments are outlined below and noted on the syllabus and Sakai. Chapter Assessments are due by 12:00pm (before class) on the date listed. Late submissions will not be accepted; however, if you began the Chapter Assessment and did not submit, you will automatically be given partial credit for any responses answered correctly. Chapter (in order assigned) Release Date Due Date Chapter 1 August 22 nd August 29 th Chapter 2 August 22 nd August 29 th Chapter 3 August 31 st September 5 th Chapter 5 August 31 st September 7 th Chapter 4 August 31 st September 12 th Chapter 6 September 19 th September 21 st Chapter 7 September 19 th September 26 th Chapter 8 September 19 th October 3 rd Chapter 9 September 19 th October 5 th Chapter 10 September 19 th October 10 th Chapter 11 September 19 th October 12 th Chapter 12 October 26 th October 31 st Chapter 13 October 26 th November 2 nd Chapter 14 November 2 nd November 7 th Chapter 15 November 2 nd November 9 th Chapter 16 November 2 nd November 21 st 2. Lifecycle Interview Please choose one life phase to complete a lifecycle project. Students may sign up for the life phase that interests them during the first day of class. The goal of this project is to provide students with an opportunity to interview someone in their interested life phase and write a 2-pager to outline what you learned in the interview and then reflect on how this was similar or different than what you learned or thought about this life phase. Please see Sakai for further instructions and the rubric. 3. Ensuring Evidence-Based Practice Group Project The purpose of this project is to develop skills in analyzing and evaluating scientific evidence related to a given life phase and nutrition topic. The exercise will help students develop critical thinking skills important for future professional practice. During the first week of class, students will choose a preferred life phase and topic and be placed in groups composed of 3-4 members. On the presentation date (see list below), each group will prepare and give a 10-minute presentation that includes: 4

5 A. a summary of the evidence for the given topic, pulling from a variety of sources (e.g. published literature, systematic reviews, government reports, expert consensus documents); B. a critique of the textbook as related to the given topic (i.e. the extent to which the information provided is evidence-based and current); and, C. practice-based resources (i.e. leading government and non-governmental organizations that collate evidence, prepare consensus reports, and/or provide materials for health professionals and the public). Presentation dates and topics are listed below. Because it is a large class, it is unlikely we can match students to their first or even second choice, so we ask that you choose and rank three of the following topics. Please see Sakai for further instructions and the rubric. Preconception, Pregnancy, and Lactation Student Presentations on September 14 th ***Upload presentation to Sakai by 12:00pm September 13 th Obesity and reproduction/fertility outcomes Folic acid supplementation for prevention of neural tube defects Treatments for nausea and vomiting during pregnancy Nutrition management of gestational diabetes HIV and breastfeeding Infancy, Childhood, and Adolescence Student Presentations on October 26 th ***Upload presentation to Sakai by 12:00pm October 25 th Timing of the introduction of complementary foods Complementary and alternative treatments for autism (nutrition-related, e.g. elimination diets) Prevention and treatment of food allergies Food advertising and child dietary outcomes Nutrition management of pediatric diabetes Adulthood Student Presentations on November 2 nd ***Upload presentation to Sakai by 12:00pm November 1 st Nutrition management of irritable bowel syndrome Nutrition management of irritable bowel disease (ulcerative colitis and Crohn s disease) Dietary recommendations for prevention of cardiovascular disease Dietary recommendations for prevention of Type 2 diabetes Dietary recommendations for cancer prevention Older Adulthood (65+) Student Presentations on December 9 th ***Upload presentation to Sakai by 12:00pm December 8 th Nutrition management of Alzheimer s disease Nutrition Management of COPD Dietary recommendations for skeletal health Dietary recommendations for weight control/obesity management in older adults Dietary recommendations for geriatric malnutrition Schedule of Class Sessions Note: Students are expected to stay current with the Sakai course site as it contains much more detail for each session and will be updated throughout the semester. Date Topics 5

6 Aug 22 Course Introduction Review Syllabus and Sakai Holliday Module 1: Preconception, Pregnancy, and Lactation Wasser Aug 24 The Role of Nutrition in Health Promotion and Chronic Disease Prevention Textbook Chapter 1: Nutrition Overview Aug 29 Preconception Care: Nutritional Risks and Interventions Textbook Chapter 2: Nutrition Needs During Preconception Chapter 1 and 2 Assessment submit each in Sakai by 12:00pm (before class) Aug 31 Preconception Condition Management During class, students will apply principles of nutrition assessment to preconception case studies. Sep 5 Nutrition and Lifestyle for a Healthy Pregnancy Outcome Textbook Chapter 3: Nutrition Needs During Pregnancy Chapter 3 Assessment submit in Sakai by 12:00pm (before class) Sep 7 Pregnancy Condition Management During class, students will apply principles of nutrition assessment to pregnancy case studies. Textbook Chapter 5: Pregnancy and Lactation: Nutrition-Related Conditions and Diseases Chapter 5 Assessment submit in Sakai by 12:00pm (before class) Sep 12 Promoting and Supporting Breastfeeding Textbook Chapter 4: Nutrition Needs During Lactation 6

7 Centers for Disease Control and Prevention. Breastfeeding Report Card: United States/2014. Atlanta: U.S. Department of Health and Human Services; Watch video: Breast Anatomy and Lactation Chapter 4 Assessment submit in Sakai by 12:00pm (before class) Sep 14 Ensuring Evidence-based Practice Student Presentations Group presentations must be uploaded to Sakai by 12:00pm September 13 th Sep 19 The 4th Trimester Project Guest Lecturer Kristin Tully Bass JL, Gartley T, Kleinman R. Unintended Consequences of Current Breastfeeding Initiatives. JAMA Pediatr. Published online August 22, Meek J, Noble L. Implementation of the Ten Steps to Successful Breastfeeding Saves Lives. JAMA Pediatr. Published online August 22, Wasser HM, Heinig MJ, Tully KP. The Importance of the Baby-Friendly Hospital Initiative. JAMA Pediatr. 2017;171(3): Module 2: Infancy, Childhood, and Adolescence Wasser Sep 21 Guidelines for Infant and Toddler Feeding Textbook Chapter 6: Infant Nutrition American Academy of Pediatrics, Pediatric Nutrition Handbook, Chapter 3, Formula Feeding of Term Infants, and Chapter Chapter 6 Assessment submit in Sakai by 12:00pm (before class) Sep 26 Nutrition Guidance for Healthy Children Ages 2 to 11 Years Textbook Chapter 7: Early Childhood Nutrition Chapter 7 Assessment submit in Sakai by 12:00pm (before class) 7

8 Sep 28 Assessing Child Growth WHO Growth Charts Complete the Centers for Disease Control and Prevention, Growth Chart Training (Parts 1-6): Do not complete case examples. We will review and discuss these together in class. Assignment: Oct 3 Infant and Early Childhood Condition Management During class, students will apply principles of nutrition assessment to infant and early childhood case studies Textbook Chapter 8: Nutrition for Health and Disease in Infancy Through Early Childhood Chapter 8 Assessment submit in Sakai by 12:00pm (before class) Oct 5 Psychosocial Factors in Child Feeding Textbook Chapter 9: Childhood and Preadolescent Nutrition Chapter 9 Assessment submit in Sakai by 12:00pm (before class) Oct 10 Eating Disorders Guest Lecture (Elysse Thebner-Miller and Colie Taico) Textbook Chapter 10: Adolescent Nutrition Chapter 10 Assessment submit in Sakai by 12:00pm (before class) Oct 12 Childhood and Adolescent Condition Management During class, students will apply principles of nutrition assessment to childhood and adolescent case studies Textbook Chapter 11: Nutrition for Health and Disease in Childhood and Adolescence Chapter 11 Assessment submit in Sakai by 12:00pm (before class) 8

9 Oct 17 Childhood Overweight and Obesity Prevention and Treatment Ogden CL, Carroll MD, Lawman HG, Fryar CD, Kruszon-Moran D, Kit BK, Flegal KM. Trends in Obesity Prevalence Among Children and Adolescents in the United States, Through JAMA. 2016;315(21): O Connor EA, Evans CV, Burda BU, Walsh ES, Eder M, Lozano P. Screening for Obesity and Intervention for Weight Management in Children and AdolescentsEvidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2017;317(23): Oct 19 Fall Break Oct 24 Public Food and Nutrition Programs for Children Ann L Yaktine, Suzanne P Murphy; Aligning nutrition assistance programs with the Dietary Guidelines for Americans, Nutrition Reviews, Volume 71, Issue 9, 1 September 2013, Pages Food Research & Action Center. Understanding the connections: Food insecurity and obesity. October Oct 26 Ensuring Evidence-based Practice Student Presentations Group presentations must be uploaded to Sakai by 12:00pm October 25 th Module 3: Adulthood Holliday Oct 31 Adult Condition Management During class, students will apply principles of nutrition assessment to adult case studies Textbook Chapter 12: Adult Nutrition Chapter 12 Assessment submit in Sakai by 12:00pm (before class) 9

10 Nov 2 Ensuring Evidence-based Practice Student Presentations Textbook Chapter 13: Nutrition for Health and Disease in Adults Chapter 13 Assessment submit in Sakai by 12:00pm (before class) Group presentations must be uploaded to Sakai by 12:00pm November 1 st Module 4: Older Adults (65+) Holliday Nov 7 Understanding Global Aging and Physiological Changes During Aging Textbook Chapter 14: Older Adult Nutrition Normal Changes of Aging PBS video: Aging (12:36) PBS: The Impact of Aging Populations Administration on Aging: A Profile of Older Americans: 2015 Global Age-friendly Cities: A Guide (enjoy looking through) The 90+ Study Chapter 14 Assessment submit in Sakai by 12:00pm (before class) Nov 9 Physiological Changes During Aging Continued Textbook Chapter 15: Geriatric Nutrition Frontline Living Old (watch the full program/6 Chapters, 60 mins) NY Times Article and Video: Experiencing Life, Briefly, Inside A Nursing Home-A Personal Lesson in Geriatric Care (5:22) Area Agency on Aging. What is normal aging? Chapter 15 Assessment submit in Sakai by 12:00pm (before class) Nov 14 Older Adult Nutrition Screening, Assessment and Nutrient Recommendations Chernoff, Ronni. Normal Aging, Nutrition Assessment, and Clinical Practice, Nutr Clin Pract 2003; 18; 12. Kenney, L and Chiu, P. Influence of age on thirst and fluid intake. Medicine&Science in Sports & Exercise 33: , Administering the MNA on an older patient (12:32) Nutritional Care for Older People (22:14) 10

11 Nov 16 Food Selection, Taste, Smell and Oral Health in Older Adults Swallow: A Documentary Dysphagia (15:00) Huang, H, et al. An Integrated Model to Measure Service Management and Physical Constraints Effect on Food Consumption in Assisted-Living Facilities. JADA 2008; 108: Swallowing disorders - interpretation of radiographic studies Hormel Health Labs Take some time to learn about all the products available to individuals with dysphagia. Nov 21 Older Adult Nutrition Condition Management Textbook Chapter 16: Nutrition for Health and Disease in Older Adults and Geriatrics ABC News: Virtual Dementia Tour (8:04) Inside the Brain: An Interactive Tour Diabetes in Older Adults: A Consensus Report (ADA and AGS, 2012) Video: Mini Mental State Examination (9:17), Actual Exam Feart, C. Samieri, C., Rondeau, V. et al. Adherence to a Mediterranean diet, cognitive decline and risk of dementia. JAMA 2009; 302 (6) "Letting Go" by Atul Gawande. The New Yorker, August 2, Stopping artificial nutrition and hydration: the-end-oflife Nov 23 Nov 28 Chapter 16 Assessment submit in Sakai by 12:00pm (before class) Thanksgiving Older Adult Condition Management Continued Academy Position Statement: Food and Nutrition for Older Adults: Promoting Health and Wellness Academy Position Statement: Food and Nutrition Programs for Community- Residing Older Adults Castellanors, V, et al. Nutrition Issues in the Home, Community, and Long-Term Care Setting. Nutr Clin Pract 2003; 18; 21. Elder Nutrition Programs: Overview 11

12 Nov 30 Older Adult Condition Management Continued Dec 5 End of Life Care and Nutrition Lifecycle Interview Dec 9 Final Exam 12:00pm (noon) 228 Rosenau Hall Ensuring Evidence-based Practice Student Presentations Group presentations must be uploaded to Sakai by 12:00pm December 8 th 12