HSC 4572 Clinical Nutrition Valerie Schulz, MMSc, RD, LD/N, CDE

Introductions Instructor Students: Pair up, preferably with someone you do not yet know Find out: First name Fact remembered from HUN 2002 Discipline they are aiming for Say your name first, then your partner (I’m ______, and this is _______)

The Diet and Health Connection Nutrition profoundly affects health. Chronic diseases have a connection to a poor diet. Which of these diseases are chronic?

Selected portions Chapter One Diet –Health connection Debilitating conditions that could have been prevented, if the persons had known and applied the nutrition principles Heart disease Diabetes Some varieties of cancer Dental disease Adult bone loss

Selected portions Chapter One So as health professionals, it IS our job, (even though not a dietitian) to inform and encourage all patients/ clients we come in contact with to Eat healthier to reduce those chronic issues It is NOT appropriate to chuckle and gloss over the attempts at humor by the client. “I don’t like that rabbit food, I want my 12 oz steak – he-he-he”

Selected portions Chapter One “Mr. Jones, what if you had a little bit of that steak sliced thin into your salad? Or, how about a small amount of the steak sliced thin and sautéed with a good portion of vegetables? Either of those options would help reduce your blood pressure…”

Genetics and Individuality Inherited disease - condition that is passed from a parent to a child Hemophilia, sickle cell anemia, Down syndrome, cystic fibrosis, and many others Acquired disease - condition that is associated with infections, lifestyle behaviors or diet Heart attack, diabetes, stroke, mineral or vitamin deficiencies

Genetics and Individuality Choice of diet influences long-term health within the range set by genetic inheritance. Nutrition has little influence on some diseases but strongly affects others.

Other Lifestyle Choices Other Lifestyle Choices Only two common lifestyle habits have a stronger influence on long-term health than dietary choices. Can you guess which?

Other Lifestyle Choices Other Lifestyle Choices Only two common lifestyle habits have a stronger influence on long-term health than dietary choices. Can you guess which? Smoking & other tobacco use Excessive alcohol consumption

Healthy People 2020 http://www.healthypeople.gov/2020/topicsobjectives2020/default.aspx

THE SCIENCE OF NUTRITION Nutrition is a science so scientists and dietitians work together to develop studies that are well designed, controlled, and reviewed by other experts Many studies take a long time to complete so information may not be available as quickly as most people would like it to be

The Scientific Approach

The Scientific Approach: Research Designs – 4 types Examples of research design Epidemiological study This country’s food supply has more olive oil and they have less heart disease. Lab study Let’s prove that a vitamin C deficiency leads to scurvy in these rats.

The Scientific Approach: Research Designs – 4 types Case study: This person eats too little iodine and has goiter Intervention study: Let’s add foods with vitamin C to his diet and see if he gets fewer colds.

The Science of Nutrition Review the research design terms in Table 1-7 on page 15 AND The anatomy of a research article, Table 1-8, page 15

Once a finding is published, it is still only preliminary Scientific Challenge Once a finding is published, it is still only preliminary One experiment does not “prove” or “disprove” anything Must be duplicated, supported, and challenged by other scientists A finding that has stood up to repeated rigorous testing may become a theory

Consumer Corner: Reading Nutrition News with an Educated Eye Refereed journals: Review journals examine all available evidence on major topics; research journals report details of the methods, results and conclusions of recently completed experiments.

Behavior Change: Making Diet Changes Nutrition knowledge is useful IF it helps people improve their diets. People need to change behaviors.

Behavior change: Taking inventory and setting goals Track food intake over several days and compare to standards Set small, achievable goals in areas that need changing

Behavior change: Stages Read the stages in Table 1-9, pg 18 Precontemplation Contemplation Preparation Action Maintenance Adoption/Moving On

Motivation is based on rewards Rewards are affected by: The Concept of Rewards Motivation is based on rewards Rewards are affected by: Value Timing Costs Probability

Summary: Behavior Change Behavior change follows a predictable pattern. Motivation is the force that moves people to act. It is affected by the weights people give to the rewards and the consequences that will follow the action.

Nutrition on the Net

Nutrition on the Net PUBMED (www.pubmed.org) Internet resource

Prepare for Class Two Referring to syllabus, read the selected portions of Chapter One and Two