Presentations: times (22 Oct (week 6) and 19 November-week 10), groups, format

Presentations:times (22 Oct (week 6) and 19

November-week 10), groups, formatclarify criteria-outlinepresentation includes asking

and answering of questions

Format of test- 6 short answer questions (5 marks each)-class time- 60 minutes-date=6 Nov 2012- first six weeks of class (ie weeks 1 to 6 inclusive(lectures 1-6)- today is week 3)

CBDHA’s Nutrition Services department is starting a brand new volunteer programme for their department called the Dial-to-Dine program. The purpose of the program is to assist patients in choosing their menus for the week while they’re in hospital. Many of our patients do not have a lot of family or friends visiting and find it difficult to fill out their own menus. This means that they end up receiving standard trays which can become pretty bland and boring after awhile. The Dial-to-Dine menus offer a much larger variety for the patients. We were hoping that some of your Nutrition students might be interested in doing some volunteer work with this program. This would be something they could do once a week on weekends for just a couple of hours. It is a fantastic opportunity for the students to become acquainted with the hospital and how the Nutrition Services Department works. The staff would provide an orientation to their service and to the Dial-to-Dine program. It is also a great way for the students to get used to interacting with different types of patients with a variety of dietary requirements. If anyone is interested in learning more about the program or would like to sign-up, please ask them to give Lisa McNeil-Campbell a call at 567-8160 or email [email protected]

mailto:[email protected]

Suggestion box

Question of the week

See lecture 2 for changed definitions of functional foodand nutraceutical

The

Lecture 3- 24 September 2013

Type 1 Diabetes

Outline of today’s talkI. Pathology

II. Socioeconomic factors contributing to the disease

III. Elementary nutritional approaches to be taken to avoid and treat these diseases including foods

available to those at risk

IV. First Nations and other Cape Breton individuals at risk

V. How is nutritional assessment made for type I diabetes?

VI. How would one assess from a nutritional perspective the socioeconomics, pathology and success of

nutritional interventions relative to type I diabetes?

Type I diabetesI. Pathology

Autoimmune response that -cells in thepancreas

-cells produce insulin

Cow’s milk, viruses, nitrosamines mayall attack -cells

Food and hence nutritional choices depend on:

Personal preference

acceptance of certain foods

Habit-caregiver should be careful here- why?

Food and hence nutritional choices depend on:Ethnic heritage or tradition

which groups would avoid the offendingfoods?

Social interactionimpact of this on viral implications

-food bornesocial interaction and communicable

viruses

Food and hence nutritional choices depend on:Availability of food

if only offending foods available this can be concern

food borne viruses may be an issue here

Convenience of food

prepared meats- are convenient but many contain nitrosamines


Economy of food-this may encourage type I diabetes

due milk being an inexpensive foodrelative to formula

Positive and negative association-child may have associations of milk

with pleasant experiences-other examples

-negative- examples?


Emotional conflict-comfort food-suggestions for this?

Values-restrictions on prepared beef, pork may

lower incidence of type I diabetes

-contrast this point to values that allowprepared beef, pork

Food and hence nutritional choices depend on:Body image

if meats believed to be fattening then may avoid these items

Advertisingfood companies for milk and nitrosamine containing foods spend lots of money to promote via ease and price,the use of such foods- how might such tactics be overcome?

More on socioeconomic factors

Prestige-occupational

food choices are better?-societal perceptions

people listen about food choices-education

-more highly educated read moreand make more informedchoices about food?


Powerpower to influence-what about the political

agenda here in Cape Breton-who has influence over the political agendain Cape Breton regarding nutrition?

Incomegiven that incomes are on average lowerhere in Cape Breton compared to some otherregions of Canada one may say that thisdictates certain food choices


WealthCape Breton-impact of economic transition

from industrial to knowledge based

Powergiven that Cape Breton is less wealthy in

monetary terms than some other regions of Canada-food choices may be less


Educationtuition is higher in Nova Scotia than in otherparts of the country- this may make itmore difficult for persons to achieve a level of education that would place them in a position to make more informed choices about foods


Social stratification-ancestry-gender-women in Cape Breton-cow’s milk

issue-race-Aboriginals, Blacks-ethnicity-immigration to industrial Cape

Breton-mobility-ability to get to food sources-mental and physical illness- mental illness induced disbelief about what one is being

told can lead to type I diabetes


Class-uppers-lower uppers-upper middles-average middles-working class-lower class

discussion impact on type I diabetes


Global economypoor becoming poorer- issue of viruses and cell attacking chemicals

Government• running nutritional assessment programmes• providing nutritional advice• providing food programmes

-how would this affect type I diabetes?


Businessadvertising, promotion of profits

Psychologyeg eating habits and social engagement

-cured meats in some cultures

Historyin time of war-food availability and quality

How would each of these 3 affect type I diabetes?

Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk

Planning a healthy diet

To do this bear in mind AdequacyBalanceEnergy controlNutrient densityModerationVariety

Elementary nutritional biochemistry of nutritional approaches that use foods available to those at riskPrevention-cows milk, nitrosamines, viruses

Post-onset-eat at times synchronised withaction of insulin

-monitor blood glucose levels

-adjust insulin levels for amount of food usually eaten and required

Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk Post-onset

-carbohydrate-glycemic index not an issue-fibre-glycemic index is not an issue-fat-not an issue- in those with similar blood

fat levels to non-diabetics -alcohol-blocks gluconeogenesis-hypoglycemia-sodium-hypertension not an issue-vitamins and minerals-not indicated as

supplements

Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk

Post-onset-obesity

-protein-convert to carbohydrate depends on insulin resistance

IV. First nations and other Cape Breton individuals at risk.

Aboriginals

Retired

Unemployed

Genetics

Others?

How is nutritional assessment made for type Idiabetes?

Nutrient intake analysisstudies can be done where food eatenis observed and assess for nitrosamines,cows’ milk and viruses


Daily food record/Diary

studies can be done where food eatenis observed and assess for nitrosamines,cows’ milk and viruses


Retrospective datafood frequency questionaire24-hour recall

do both to act as cross check against each other

assess nitrosamines, cows’ milk and viruses


Anthropometryweight loss is the main issue here- why?


Nutrition focussed physical exam-does not apply significantly to type I diabetes


Skin testingmay come into play for understandingwhat has caused the type I diabetes-ieexploring for autoimmune response and what might trigger it or have triggered it- this is probably an unlikely approach- why?


Biochemical analysisblood glucose-fasting

-post-prandial

glycated hemoglobin- onlyafter 3 months-fasting


CLASSIFYING MALNUTRITION

weight loss a possibility

VI. GROUP DISCUSSION-HOW WOULD ONE ASSESS FROM NUTRITIONAL PERSPECTIVE THE SOCIOECONOMICS, PATHOLOGY AND SUCCESS OF NUTRITIONAL INTERVENTIONS RELATIVE TO TYPE I DIABETES ?

Presentations: times (22 Oct (week 6) and 19 November-week 10), groups, format

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Transcript of Presentations: times (22 Oct (week 6) and 19 November-week 10), groups, format