ASSESSMENT OF NUTRITIONAL STATUS Syllabus
Sun eun (Sunny) Lee
Office hours: by appointment
The course will cover dietary and physical activity assessment, anthropometry, body composition, and micronutrient status through lectures, in-class discussions, assignments, and data collection, analysis, and presentation. It is particularly oriented to techniques that are relevant for the assessment of populations and vulnerable groups. Laboratory sessions will be used to teach and apply techniques of dietary data collection and interpretation, anthropometry (weight, height, skinfolds, and circumferences) and body composition (bioelectrical impedance analysis). An emphasis is placed on using the topics as a basis for exploring the selection, reliability, applicability, and interpretation of different techniques in field settings.
Previous biology or nutrition class, Principles of Human Nutrition, IH 222.641 preferred
Required Text(s): none
Gibson RS. Principles of Nutritional Assessment, 2nd Ed. Oxford University Press, 2005 OR Lee RD and Nieman DC. Nutritional Assessment 5th Edition, McGraw-Hill, 2009
Required Materials: thumb drive
The course will be taught by several faculty from the Division of Human Nutrition and Department of International Health (Kerry Schulze, PhD; Ann McDermott, PhD; Sameera Talegawkar, PhD; Bobbie Henry, RD, LDN; Irwin Shorr, MPH, MPS; Mohsin Yakub, PhD, Sunny Lee, PhD candidate). The course will involve lectures, in-class activities and data collection, demonstrations, discussion sessions, and a final group project that will allow groups to analyze and present nutritional status data collected among classmates. Grading will be based on class participation, homework, and individual and group components of the final project.
Lecture and reading materials, as well as course assignments, will be posted on CoursePlus.
Course Learning Objectives
Upon successfully completing this course, students will be able to:
- Understand questions that can be addressed in populations using nutritional status indicators
- Describe performance characteristics (validity, reliability, dependability, sensitivity and specificity) of nutritional status indicators and measures and how they are assessed
- Know means of assessing diet, energy expenditure and physical activity, body composition and growth, and micronutrient status and under what circumstances they would be used
- Participate in discussions about current controversies in nutritional status assessment
- Articulate a position in an essay question
- Collect, analyze, interpret nutritional status data and be able to summarize findings in an abstract and powerpoint presentation
· Attendance: While attendance will not be taken except during mandatory classes (dietary data collection, anthropometry lab, class presentations), it is advised that students be in attendance and engaged during lectures to enhance their understanding of the material as well as to assure an optimal grade for participation.
· Definition of Participation: Students must participate in all group activities and discussions in order to received full credit for participation.
· Late submissions/ make-ups: Assignments are generally submitted online, and they may be submitted by midnight of their due date; late submissions will be addressed on a case-by-case basis; there will be no opportunity to make up missed work or for extra credit.
· Use of cell phones/laptops during class: Cell phones are not to be used in class; laptops may be used to follow/annotate electronic versions of lecture materials or for specific activities that require their use; please be mindful of other students and do not use your class time for surfing the web or checking email, etc.
· Modes of communication : Class emails will be sent weekly to remind students of the coming week’s activities; the TA will monitor course bulletin board.
· Course reading information: Students must come prepared for class by having read the required readings, particularly when they will be the topic of class discussions. Other readings are available to complement and enhance course material and the students’ personal reference “libraries”.
· Group work guidelines: This class presents opportunities to work independently and as a group. In general, any written work MUST be done independently—this includes answers to homework assignments, the essays, and the abstract from the class project (see below); students may discuss the analytic work required for the anthropometry assignment but the micronutrient assignment should be done independently; for the class project, it is assumed that all students will contribute equally to the group presentation.
· Source guidelines : Work should be properly cited where appropriate; generally, citations should be sourced from the peer reviewed literature; websites cited should be authoritative sources (eg. WHO, USDA)
Methods of Evaluation
This class will evaluate students in a variety of ways. There will be 2 homework assignments that cover main aspects of the course material and 2 essays. There will also be an ongoing Class Assessment Project (CAP) that will require data collection throughout the quarter, culminating in a class presentation at the end of the term
Essays (2-3 page opinion on 2 of 3 topics)
Micronutrients/Biochemical & Clinical Indicators
Class Assessment Project (CAP)
Data Entry (24-h recall, anthro/body comp, EE), 5%
Slides & Presentation (group), 15%
“Grading” of fellow student’s essay and slides, 5%
Grades will be determined as
Course Grading Scale, 90-100% A; 80-89.9% B; 70-79.9% C
Academic Ethics Code
Students enrolled in the Bloomberg School of Public Health of The Johns Hopkins University assume an obligation to conduct themselves in a manner appropriate to the University's mission as an institution of higher education. A student is obligated to refrain from acts which he or she knows, or under the circumstances has reason to know, impair the academic integrity of the University. Violations of academic integrity include, but are not limited to: cheating; plagiarism; knowingly furnishing false information to any agent of the University for inclusion in the academic record; violation of the rights and welfare of animal or human subjects in research; and misconduct as a member of either School or University committees or recognized groups or organizations.
Please see the course Session for a full list of dates and items for this course.
Assignment Descriptions and Guidelines
Assignment Descriptions and Guidelines (these will be addressed in greater detail throughout the quarter):
- Homework 1—Use WHO’s Anthro software to assess the nutritional status of children from Baltimore and Nepal
- Homework 2—Answer questions about micronutrient status indicators; this assignment will test your comprehension of the lecture material for micronutrient status assessment and will require you to interpret data from the literature.
- Homework 3—You will turn in two 2-3 page (double-spaced, 11 or 12 font size) essays addressing two of the three questions of your choosing below, using readings and insights from class discussion periods (questions subject to slight changes). Start each essay with an introductory paragraph and end with a concluding paragraph that consolidates your main points.
1. Dietary data may be summarized into a healthy eating index (HEI) score and/or a dietary diversity score. For both of these approaches a) summarize how the approach is implemented, b) describe a situation or setting in which it may be useful, and c) describe an advantage and disadvantage of the approach.
2. Some authors have questioned the value of characterizing the “metabolic syndrome”. Address the following points in your essay: a) the key components of the metabolic syndrome, b) the advantages and disadvantages of the use of the term metabolic syndrome, and c) your thoughts on whether it is a useful classification, providing examples of the situations under which it may and/or may not be useful.
3. The interpretation of the assessment of several key nutrients can be dramatically affected by the presence of infection in the individual or population being evaluated. Some researchers have advocated using factors to “correct” nutritional status indicators for the presence of infection/inflammation. Using a specific nutrient as an example, discuss the following: a) how does concurrent infection/inflammation affect the interpretation of a common indicator for this nutrient, b) how could one account for the effect of infection/inflammation, and c) what are advantages and disadvantages of doing so?
- Class Assessment Project—(CAP) You will collect data throughout the term on your own nutritional status (eg. physical activity level and estimated energy expenditure; dietary intake from a 24-h recall; anthropometry and body composition) that will be anonymously entered into a class data set. You will work in groups of 3-4 and will be assigned a question to investigate in the data. Based on your analysis of the data, you will come up with a 5 minute slide presentation as a group, and will independently write an abstract (no more than 250 words) summarizing your findings. Presentations will be pooled on the second-to-last day of class and formally shared by each group.
- Welch Library
- Writing Support
- Purdue OWL: http://owl.english.purdue.edu/)
- Public Speaking:
- Citing Sources (AMA): http://ajph.aphapublications.org/misc/ama_references.shtml
- Citing Sources (APA): http://owl.english.purdue.edu/owl/resource/560/02/
- JHSPH Presentation templates: http://www.jhsph.edu/identity/downloadResources/downloadResources.shtml
- PowerPoint Tips :
Intended AudienceMHS and PhD students in Human Nutrition
T Oct 29
Intro—Course content, structure, grading & background
Th Oct 31
Pedometer check-out begins
T Nov 5
Dietary assessment interpretation and discussion
Essay 1 material covered
Th Nov 7
24 h recall activity with NDSR software (begin 8:30 am)
Data collection for CAP: 24 h recall, EER and physical activity questionnaire
T Nov 12
Anthropometry-Evolution of growth curves
Homework 1: Anthropometry in children assignment available
Th Nov 14
Anthropometry-WHO growth standard; development and interpretation of child anthro data
T Nov 19
Energy expenditure and physical activity assessment
Th Nov 21
(begin 8:30 am)
In-class anthropometry data collection for CAP
DUE: Homework 1
T Nov 26
Metabolic syndrome discussion
Essay 2 material covered
DUE: All data entry for CAP (energy expend/PA; pedometers; 24 h recall; anthropometry)
T Dec 3
Field and laboratory exercise for biochemical indicator collection and assessment
Homework 2: Biochemical assessment of nutritional status assignment available
Th Dec 5
T Dec 10
Th Dec 12
Interpretation of micronutrient indicators, role of concurrent inflammation
Essay 3 material covered
DUE: Homework 2
T Dec 17
(begin 8:30 am)
DUE: Group PPT presentations; Individual Abstracts
Th Dec 19
”Omics” approaches & wrap-up
DUE: Completed rubric and grade for your peer’s CAP project
DUE: All Essays
Disability Support ServicesIf you are a student with a documented disability who requires an academic accommodation, please contact Betty H. Addison in the Office of Student Life Services: email@example.com, 410-955-3034, or 2017 E. Monument Street.