Page 1 CHS 231: Maternal and child nutrition Syllabus, Fall 2010 Course # 840-186-200 LECTURE Mondays and Wednesdays, 2-4 p.m., Room 14-214U CHS (this is the Administrative Conference Room in the same hallway as the CafeMed). On October 27 th, the class will instead meet in the Brentwood Room in the same corridor. INSTRUCTORS Gail Harrison, PhD Office: 21-245 CHS Office Hours: 11-1 Wednesdays, 1-3 on some but not all Tuesdays, and by appointment (wise to check the signup sheet) Voicemail: (310) 825-3738 (not checked routinely) E-mail: gailh@ucla.edu Marion Taylor Baer, PhD, RD Office: 26-078B CHS Office Hours: 1-2 Mondays, 10-12 Thursdays, and by appointment (signup sheet outside office suite) (310) 825-8196 (323) 361-3823 (UCEDD/CHLA) E-mail: mtbaer@ucla.edu E-mail: mbaer@chla.usc.edu LEARNING OBJECTIVES and PUBLIC HEALTH COMPETENCIES ADDRESSED (Note: The numbered competencies refer to those published by the Association of Schools of Public Health, and available on their website.) This course is intended to enable students to: 1) Learn about the main nutritional problems of families, with emphasis on women and children in less technically developed countries and disadvantaged populations in industrialized countries and their impact on the individual and community. (Competencies C3, C6, C9, G1, I1-8, J6) 2) Understand the underlying factors and those amenable to change. (Competencies E2,3,4,6,8) 3) Learn about and devise appropriate preventive and intervention programs and policies. (Competencies D8, D9, G10, J10, J11) This course can be taken separately or as the first course of a series of nutrition courses in CHS. These courses cover topics such as community nutrition assessment; nutrition policy and programs; food security; diet and chronic disease; and social determinants of nutrition and health.
Page 2 PREREQUISITES The course is intended for graduate students in public health or relevant disciplines, with some bioscience courses in their backgrounds. Students without knowledge of basic nutrition are required to familiarize themselves with basic nutrition concepts by reading a recommended introductory human nutrition text. For those students who have not completed an upper-division or graduate course in nutrition or metabolism, we expect that within the first month of the quarter, they will have read or skimmed Across the Life Span by Mary Kay Mitchell (WB Saunders Company, 2003), or a comparable introductory nutrition textbook. Across the Life Span is on reserve in the Biomedical Library. REQUIRED READINGS 1) Required articles will be made available ahead of class sessions via attachments to email messages sent through the instructor version of the MyUCLA website. (Make sure you have a current email address registered with the UCLA system). The required articles include selected articles and readings from journals, reports, and reviews. At least one required article will be distributed to enrolled students ahead of the first class; please read it at your earliest convenience. 2) Gibney MJ, Margetts B, Kearney J, & Arab L. Public Health Nutrition. Oxford, UK: Blackwell NS, 2004. RECOMMENDED READINGS FOR BACKGROUND INFORMATION 1) Kaufman M. Nutrition in Promoting the Public s Health. Sudbury, MA: Jones and Bartlott, 2007. 2) Semba RD & Bloem MW. Nutrition and Health in Developing Countries, 2nd edition. New Jersey: Humana Press, 2008. 3) King FS & Burgess A. Nutrition for Developing Countries. Oxford: Oxford University Press, 2008. 4) Brown, JE. Nutrition through the life cycle, 3rd edition. Belmont, CA: Thomas Higher Education. Wadworth, 2008. (A book to skim for students with little or no background in bioscience or nutrition) All the books should be on reserve in the Biomedical Library. ASSIGNMENTS AND EVALUATION Readings: Appropriate reading should be completed before each class whenever possible. Midterm: There will be a 2/3-term examination (short-answer), based on class material and readings, on Tuesday, November 10, 2010.
Page 3 Class presentation: Each student will be required to make a brief (15-minute) class presentation on a topic related to the class lecture. Each student should select a topic of his/her own choosing, with guidance from the instructor. You must discuss your topic with the instructor prior to your presentation so that there is no duplication with the scheduled lecture. The student is to pick a topic with which they have had firsthand experience with, or a topic they wish to learn more about from the literature. STUDENTS CANNOT GIVE A LECTURE THAT THE INSTRUCTOR HAS ALREADY GIVEN. Depending on class size, there may be several student presentations on a given day. Final examination: A take-home examination will consist of a problem-solving assignment. The maximum length of the paper is 12-pages, double-spaced. The examination will be handed out on Thursday, November 24, 2010, and is due by Monday, December 6, 2010 at 5pm. Place the final exam in the Department Office, room 36-071, labeled CHS 231, Final Papers. Grades: Course grades will be approximately based on: 1) Class participation (20%) 2) Midterm examination (35%) 3) Final examination (45%)
Page 4 SCHEDULE Session Date Instructor Topic 1 9/27 Baer & Harrison Background discussion of course mechanics Concepts, philosophy, public health view of nutrition, 2 9/29 Harrison Maternal and child malnutrition: exposure and consequences 3 10/4 Harrison Assessment of nutritional status Indirect and direct assessment of nutrition status at the level of populations and communities 4 10/6 Harrison Problem of fetal malnutrition and low birth weight Determinants and challenges of low birth weight; longterm consequences of low birth weight for child and adult health and disease 5 10/11 Visiting Nelida Duran 6 10/13 Visiting Kiran Saluja 7 10/18 Visiting Hope Wills 8 10/20 Visiting Wendelin Slusser 9 10/25 Visiting Vanessa Annibali Nutrition and reproduction Overview of nutritional needs for pre-pregnancy, pregnancy, and lactation; relationship of nutritional status to pregnancy outcomes Supporting Breastfeeding in the Community Formula feeding Infant formulas; overview of their development, composition, and utilization. Feeding the prematurely born and low birth weight infant; role of breast milk enhancers Lactation and breastfeeding The physiological and psychological process involved in lactation and breastfeeding; nutritional needs of the breastfeeding mother and the breast-fed infant; the Baby- Friendly Hospital WIC programs
Page 5 10 10/27 Harrison Protein-energy malnutrition: Mechanisms, etiology Special developmental, biological, psychosocial, cultural risk factors in children passing through the weaning or transitional period; nutrition and infection; programmatic approaches 11 11/1 Harrison Micronutrients: Vitamin A, Iodine, Zinc, riboflavin 12 11/3 Baer Micronutrients: Iron, folate, vitamin B 12 (anemiaassociated micronutrients) 13 11/8 Baer Micronutrients: Calcium, Vitamin D 14 11/10 Baer Nutrition challenges and needs for children with special needs 15 11/15 2/3 Examination 16 11/17 Harrison or Neumann Principles of young child feeding Feeding young children; principles of multi-mixes and appropriate weaning diets; optimal complementary feeding 17 11/22 Harrison Overweight and obesity 18 11/24 Class cancelled Afternoon before Thanksgiving break 19 11/29 Wang Childhood obesity: School initiatives to improve nutrition and prevent overweight and obesity 20 12/1 Baer US Nutrition programs for disadvantaged groups (other than WIC) All final examination papers are due on Monday, December 6, 2010 by 5pm. Please place the final exam in the box in the Department Office, room 36-071, labeled CHS 231, Final Papers. Have a wonderful winter break and a happy new year!
Page 6 CHS 231: Maternal and child nutrition Class presentation and discussion: Signups Students will make a 15-minute presentation followed by a brief class discussion relevant to the scheduled lecture. The presentation should be based on personal experience or on the literature. Students should consult the faculty member who will be lecturing on the assigned day in advance so as to avoid duplication. The presentation is meant to augment or illustrate the lecture material, not to be comprehensive or a rehash of the scheduled lecture. The following is a list of suggested topics. Students may substitute a topic of their own choice, which must be cleared by the instructor. Depending on class size, there may be more than one presenter per session. Session Date Topic Student names 2 9/29 Maternal and child malnutrition (e.g. Cultural or other factors affecting the nutrition of women and children) 3 10/4 Examples of ecological, geographic, manmade factors 4 10/6 Fetal malnutrition and low birth weight (e.g. Consequences of intrauterine malnutrition in childhood, OR the role of smoking, alcohol, etc. in low birth weight) 5 10/11 Nutrition and reproduction (e.g. Nutritional challenges: teenage pregnancy OR gestational diabetes) 6 10/13 Supporting breastfeeding in the community. (e.g. Self-help groups to support nursing mothers. Examples: La Leche League, WABA) 7 10/18 Formula feeding (e.g. Formula marketing code) 8 10/20 Lactation and breastfeeding (e.g. Contraindications to breastfeeding: Recommendations for feeding infants of HIVpositive mothers)
Page 7 9 10/25 WIC Programs 10 10/27 Protein-energy malnutrition (e.g. Prevention of PEM: Critique of nutrition rehabilitation centers) 11 11/1 Vitamin A, iodine, zinc, roboflavin (e.g. Community-based approaches to combat Vitamin A deficiency OR iodine deficiency in hard-to-reach populations) 12 11/3 Iron, folate, vitamin B 12 (e.g. Cognitive function and iron deficiency: Prevention of neural tube defects) 13 11/8 Calcium, Vitamin D (e.g. Rickets in the US and UK: Risk factors) 14 11/10 Children with special needs (e.g. Special problems of children with cerebral palsy OR diets for children with inborn errors OF metabolism Example: PKU) 16 11/17 Overweight and obesity (e.g. Appropriate technology: Fermentation and germination to improve weaning diets) 17 11/22 Nutrition and parasites: HIV and nutrition impact 19 11/29 School initiatives to prevent overweight and obesity (e.g. Obesity: programs to prevent childhood obesity. Example: school-based programs; other) 20 12/1 US Nutrition programs for disadvantaged groups (e.g. Experiences with school feeding, food stamps, and other US government programs)