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Summary Nutrition in Health and Disease - all lectures
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HC Nutrition in Health and Disease SummaryTable of contents
HC Nutrition in Health and Disease Summary........................................................................................1
Table of contents....................................................................................................................................1
HC 1: Introduction..............................................................................................................................2
HC 2: Rules and Regulations...............................................................................................................3
HC 3: Protein and Energy Requirements............................................................................................6
HC 4: Sports Nutrition.......................................................................................................................18
HC 5: Nutrition and Mental Health...................................................................................................28
HC 6: Malnutrition in Disease and Ageing........................................................................................31
HC 8: Nutrition in Early Life...............................................................................................................47
HC 9: Nutrition and Cardiovascular Health.......................................................................................53
HC 10: (Patho)physiology GI tract.....................................................................................................57
HC 11: Nutrition and Cancer.............................................................................................................64
,HC 1: Introduction
Evaluating and designing scientific research:
Clinical vs public health nutrition:
1) Clinical nutrition - nutritional care for individual patients or patient groups
= Changes in nutritional requirements due to illness, treatment and malnutrition
Physiology
Body composition
‘What is the most optimal nutrition for this patient?’
2) Public Health Nutrition - health control and prevention of disease
= Nutrition policy and local or (inter)national guidelines
Health claims
Functional Foods
Obesity, elderly, prevention
‘What is a healthy diet?’
Base your research proposal on existing scientific evidence and/or relevant theories an concepts.
Good methodology:
Choices in the research proposal should be justified
Taking into account feasibility, practical and ethical issues as well
Bodycomposition:
Bodpod = air displacement plethysmography (densitometry)
Bodystat = bio impedance analysis (BIA)
Nutritional treatment mainly focused on maintaining FFM
Techniques have assumption/limitations
Vary measurement conditions (water)
3)
2
,HC 2: Rules and Regulations
Preparation phase of clinical research form A-Z with extra attention to rules, regulations and ethics
GAP
PICO
Colonut study: example structure of research
QoL: quility of life
To do before you can start your study
1. Write protocol
2. Present protocol to departmens(s) involved
3. Prepare protocol and other files for Scientific Research Committee
4. Prepare protocol and other files for Medical Research Ethical Committee (MREC/dutch:
METC)
5. Prepare logistics
Wortkout research questions:
1. Study population: in- and exclusion criteria
Why calculate sample size:
N= too small False negative conclusion
N= too large Intervention effective: too many subjects have missed out on this
intervention
Intervention ineffective: too many have been exposed to this ineffective
intervention
> so you want your sample size to not be too small or too large
What information do you need?:
Desired power of the study (1-β): How certain do you want to be of preventing a type 2 error
(failing to reject H0 that is actually false: false negative)?
Desired significance level (α): How certain do you want to be preventing a type 1 error (H0
gets rejected even though it’s actually true: false positive)
Desired test direction: One or two sided?
2-sided: treatment A better than treatment B// treatment B better than treatment A
Clinically relevant (or expected) difference (v): Which difference or which effect are u trying
to find (from literature)
3
, Expected variance/standard deviation (σ): How much variation is expected in subjects
belonging to the same study group? (from pilot data or literature)
Attrition rate: Anticipate on the number of included subjects who will not be available for the
study analysis (expected drop-out/withdrawal from previous studies)
Body composition
Why measuring body composition?
- Determine health risk
- Monitor change in body composition associated with specific diseases
- Provide dietary/training advice
- Determine effect of dietary/exercise intervention
- Monitor growth and development
Levels of body composition
- Atomic, molecular, cellular, tissue and whole body
- Molecular: fat, protein, CHO, water, mineral
- Tissue model: adipose tissue, muscle, organs, bone, other
- 2-component model: Fat mass and Fat-free mass
4
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