Ahn7102 Nutrition in Health and Disease (3 Cu)

AHN7102 NUTRITION IN HEALTH AND DISEASE (3 CU)

COURSE INSTRUCTORS  Magala-Nyago C. [Bed. Home Economics; MSc. Human Nutrition.; (PhD. Nutrition)  Resource persons: Doctors at Mulago Hospital

COURSE TYPE  Core course for MSc Applied Human Nutrition

1. COURSE STRUCTURE Course is 3 credit units (3 CU): 2 lecture hours and 2 practical hours per week for 15 study weeks; [i.e. 30 lecture hours & 30 practical hours equivalent to 45 contact hours].

2. COURSE DESCRIPTION Perspectives on healthy eating, lifestyles and disease. The nutrition care process in the management of human diseases such as obesity, diabetes mellitus, and hypertension, diseases of the gastrointestinal tract, liver diseases, renal disease, cardiovascular diseases, gout and HIV/AIDS. Dietary deficiency diseases common in the tropics such as Iron deficiency anemia (IDA), Osteoporosis, Protein-energy malnutrition (PEM), Vitamin A deficiency Diseases (VAD), Iodine deficiency disorders (IDD) and others.

3. COURSE OBJECTIVES General objective

This course is aimed at equipping the student with knowledge and skills to maintain health by preventing and correcting malnutrition, alleviating symptoms or side effects of the treatment and preventing complications of the diseases.

Specific Objectives

1. Able to promote health and prevent diseases 2. Identify nutritional and dietetic diagnosis for individuals with different diseases 3. Develop appropriate and practical advice for individuals with differing backgrounds to achieve the required modification in diet and lifestyle

3. RECOMMENEDED REFERENCES

.a Manual of dietetic practice. Thomas B and Bishop J (Eds). Blackwell publishing. (Current edition) .b Principles of Nutritional Assessment. Gibson RS. Oxford University press. (Current edition) .c Nutrition and Diet Therapy. DeBruyne C and Whitney. (Current Edition) .d Applications in medical nutrition therapy. Zeman FJ and Ney DM. Merrill, Prentice Hall. (Current edition) .e Journal of clinical Nutrition and dietetics. .f American Diabetes Association Journal

4. COURSE CONTENT, METHODS OF INSTRUCTION, TOOLS AND EQUIPMENT TOPIC CONTENT METHOD OF TOOLS/ INSTRUCTION/ Equipment Time allocation needed (i.e. contact hours) 1. Perspective  The characteristics of good -Interactive LCD projector/ s on Health health lectures White boards and  Current dietary/nutrition (2 hr) Food pyramids Nutrition guidelines - Group & personal National dietary  Critique different national dietary assignments guidelines standards and guidelines Discussions charts 2. Obesity  Definition and prevalence of Interactive lectures LCD projector/ obesity (2 hr) with case White boards  Aetiology and risk factors presentation Case study  Complications of obesity discussions, equipments  Assessment of obesity  Nutrition care process Lab practical (1hr)  Anthropometric measurements of and assignment Anthropometric obese/overweight adults and equipment children in the community Growth centile Interactive lectures charts (2 hr)  Energy/caloric requirements in LCD projector/ growth, pregnancy and lactation Lab practical (2 White boards  Role of physical activity and hrs) and health assignment BMR Tables  Calculation of BMR for men and women Gymnasium  Application of physical activity to Doubly labeled achieve and maintain healthy water weight equipment  Estimating Total energy Gymnasium expenditure (TEE) equipment  Estimating physical activity levels equipment (PAL) for different activity levels Douglas bag or  Counseling of obese/overweight respirometer clients Foods  Developing weight reduction Cookers diets and weight maintenance Cooking utensils diets  Weight assessment & counseling the community 3. Diabetes  Definition and prevalence Interactive lectures LCD projector/ mellitus  Pathophysiology (4 hr) with case White boards  Types of diabetes mellitus presentation at  Signs and symptoms Diabetic  Aetiology and risk factors ward/clinic  Nutrient metabolism as affected by uncontrolled diabetes  Glycemic index and glycemic load  Nutrition care process  Micro and macrovascular complications of diabetes mellitus Lab practical (2 hrs) Foods  Diagnostic tests for diabetes Cookers  Test of local foods for glycemic Food scales index (GI) and load (GL)of meals Glucometer with  Fasting plasma glucose testing accessories  Glucose tolerance test (GTT) Reagents  Analysis of dietary fiber  Monitoring of blood sugar within the community & counseling 4. Coronary  Pathogenesis Interactive lectures LCD projector/ heart  Aetiology and risk factors (2 hr) with case White boards disease  Disease complications studies at the Visual aids (CHD  Dietary treatment in the different Uganda Heart (patients) patterns of dyslipidaemia Institute  Nutrition care process  Dietary recommendations Lab practical (2  Diagnostic techniques for hrs) Accutrend plus dyslipidaemia Ward rounds to with accessories  Assessing electrical activity of assess and counsel Electrocardiogra the heart patients at the m (ECG)  Assessing structure (anatomy) heart Institute. Ecocardiography and function (Physiology) of the (ECHO) heart Nutrition  Assessment of coronary heart disease patients  Monitoring blood pressure of the University community and counseling 5. Hypertensio  Definition and blood pressure Interactive lectures LCD projector/ n (high generation (2 hr) with case White boards blood  Classification of blood pressure studies pressure) levels presentation  Causes of hypertension Invited speaker  Dietetic care process Lab practical (2  Monitoring of blood pressure of hrs) Equipment for people in community Nutrition lab Blood pressure  Dietetic care process equipment  Low sodium high potassium diets (visomat) Foods 6. Kidney  Definition Interactive lectures LCD projector/ diseases  Kidney and urinary tract function (2 hr) White boards  Disease and conditions affecting the kidney  Signs and symptoms  Diagnostic tests  Treatment Lab practical (2  Creatinine test and dialysis hrs) at Mulago Reagents  Procedure in calculating renal hospital Creatinine diets Beckman analyser Mid term test 7. Liver  Types Interactive lectures LCD projector/ disease  Signs and symptoms (1 hr). Guest White boards  Aetiology and risk factors speaker  Treatment Lab practical (2  History taking hrs) at vet labs Microscope  Histology Slides

8. Gout  Definition Interactive lectures LCD projector/  Risk factors (1 hr) Case study White boards  Symptoms  Diagnosis  Treatment and prevention Lab practical (1 hrs) Case study  Identifying symptoms from Questionnaires clients  Taking diet history of clients with gout from the community 9. Gastrointest  Overview of diseases of the GIT Interactive lectures LCD projector/ inal tract  Types of diseases (2 hr) White boards (GIT)  Causes diseases  Signs and symptoms 9.1 Diseases of  Management the upper and  Therapeutic indications of foods lower abdomen Lab practical (2  Special diets hrs) at the Foods and pilot plant cooking  Types of diseases equipment 9.2 Diseases of  Causes the upper and  Signs and symptoms lower colon  Management  Therapeutic indications of foods Lab practical (2  Special diets hrs) at the Foods and Pilot plant cooking equipment 10. Cancer  Types of tumors Interactive lectures LCD projector/  Signs and symptoms (1 hr) Visit to White boards  Aetiology and risk factors cancer ward and  Effect of cancer on nutrition clinic. Discussions  Effect of cancer treatments on nutrition  Feeding methods Lab practical (2 hrs) at the  Develop food products suitable Pilot plant Foods for cancer patients Pasteurizer Blenders Strainers Food mixers

11. HIV/AIDS  Effects of HIV/AIDS on nutrition Interactive lectures LCD projector/  Metabolic effect of HIV/AIDS (2 hr) Visit to TASO White boards  Macro & micronutrients  Effect of Nutrition on HIV/AIDS  HIV/AIDS related diseases and nutrition Practical (2 hrs) Pilot plant  Nutrition care process Bioelectrical  Counseling of HIV/AIDS Impedance  Food product development analysis  Clear liquid and full liquid diets, equipment (BIA)  Soft diet for clients with mouth Foods ulcers and for those with mouth Oven dryness Pasteurizer  Bland diet Blenders Strainers Food mixers 12. Protein  Signs and symptoms Interactive lectures LCD projector/ Energy  Pathophysiology (2 hr) with case White boards Malnutrition  Causes of PEM study (PEM)  Dietary treatment and management of PEM in the hospital  Methods of feeding  Assessment of children with kwashiorkor and marasmus  Classification of PEM children according to weight and height  Catch up growth Lab practical (2  Testing for edema hrs) at Foods  Plasma albumin analysis mwanamugimu Reagents  Ready to use therapeutic diets nutrition unit and Anthropometric  Food preparation for community equipment rehabilitation phase  Growth monitoring of children in the community 13. Deficiency  General overview Interactive lectures LCD projector/ diseases  Factors influencing vitamin A (1 hr) White boards status Ward Assignments 13.1 Vitamin A  Signs and symptoms of VAD deficiency  Aetiology and risk factors of VAD (VAD)  Vitamin A bioavailability  Vitamin A requirements  Dietary management of VAD  How to increase vitamin A intake Lab practical (1hr)  Determination of vitamin A HPLC  Determination of serum retinol Foods  Clinical assessment for VAD in Reagents the community Interactive lectures (1 hr) 13.2 Iron  Introduction LCD projector/ deficiency  Enhancers and inhibitors of iron White boards anemia absorption (IDA)  Iron interactions  Signs and symptoms  Aetiology and risk factors for IDA  Increasing iron absorption  Iron requirements Lab practical (2hr)

 Preparation of meals to increase iron intake Foods  Determination of iron content in Atomic foods absorption  Analysis of serum iron spectrophotome  Clinical assessment of IDA Interactive lectures ter  Identifying such disorders in the (1 hr) Case study Hemocues community Reagents

 Introduction- The thyroid gland 13.3 Iodine  Prevalence of IDD deficiency  Iodine metabolism disorder  Physiological effects of thyroid (IDD) gland Lab practical (1hr)  Signs and symptoms  Aetiology and risk factors  Interventions  Iodine requirements Interactive lectures (1hr)  Diagnosis of IDD Foods  Identifying such disorders in the Atomic community absorption spectrophotome Lab practical (2hr) ter with assignment LCD projector/  Definition White boards  Signs and symptoms 13.4  Aetiology and risk factors Osteoporos  Prevention of osteoporosis is  Meal planning to prevent Nutrient osteoporosis analysis  Analysis of foods for calcium programmes content Foods  Identifying symptoms among elderly in the community

Final examination

5. SUMMARY OF TIME (as contact hours)  Lecture hours 30 hr  Practicals 30 hr

6. OVERALL COURSE EVALUATION  Assignments (at least three assignments) 10%  Practical and class attendance 10%  Field trips and case studies 20%  Mid semester Course tests (one course test) 10%  Final examination 50%