NUTRITION AND LIFE STAGES Syllabus
Course Learning Objectives
Upon successfully completing this course, students will be able to:
- apply principles of nutrition in the context of human growth and development
- integrate human physiology and development, psychosocial factors, and nutrition through in-depth study of a nutrition/life stage issue
- interpret and critique scientific literature
Course DescriptionReviews stages of human development as a prism for understanding human nutrition. Discussions focus on various life stages, highlighting the biological, social and behavioral changes that influence the transitions in nutrition between life stages. Identifies key nutritional considerations for optimal human growth and development. Discusses early nutritional influences on health and well-being later in life.
Methods of AssessmentStudent evaluation based on class participation and written assignments.
Please see the course Session for a full list of dates and items for this course.
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.
Course format follows a lecture and discussion class session per life/stage topical area. The first class is a lecture and the second class is a participatory discusion session. Required readings for each topic are discussed in the second session.
Assignment Descriptions and Guidelines
Required readings, consisting of recent publications in the peer-reviewed literature, are the primary text for this course. All papers will be posted on the Course website from where students can access them. You are responsible for making your own copies of those readings. I expect you to complete the readings for each topic of the course (e.g. pregnancy, lactation, etc.) before the first class discussion on that topic.
Required writing assignment (i.e. the paper) and the presentation:
- Integrate human physiology, development, and nutrition through in-depth study of a nutrition/life-stage issue that you select.
- Gain further skills in interpreting and critiquing scientific literature.
- Practice the art of scientific writing, especially structuring a review manuscript and citing the literature.
- Practice public speaking by summarizing the salient aspects of the review done for the review paper using a conceptual diagram.
Write a scientific review manuscript that describes and integrates the physiological and socio-behavioral processes of a particular nutrition topic linked to a particular life stage.
The paper should be scientifically referenced in the style of the New England Journal of Medicine (see example below), and should be no more than 12 pages in length (Times New Roman, 12 point font, double spaced). In the text references should be cited consecutively using Arabic numerals in parentheses, e.g. (1) etc.
Siega-Riz AM, Hartzema AG, Turnbull C, Thorp J, McDonald T, Cogswell ME. The effects of prophylactic iron given in prenatal supplements on iron status and birth outcomes: a randomized controlled trial. Am J Obstet Gynecol 2006;194:512-9.
You may consider any life stage. Because all life stages will be covered in class, choose a topic that is not substantially covered in class.
Example topics are:
Eating disorders in primary school
Eating disorders in adolescence
Calcium balance in adolescence
Protein nutrition in the young male athlete (define young)
Iron nutrition and adolescent pregnancy
Linear growth in the preschooler/toddler
Adiposity rebound at age 4-8 years
Zinc and aging
- Introduction: Public health importance of the topic - 2-3 pages
Explain why the topic/issue identified for your paper has public health relevance. Provide estimates of the burden of the problem (prevalence, incidence, total burden etc.) globally or in a specific setting as appropriate and why urgent attention is needed to address the problem. If appropriate describe some basic differences by region, and sex. This section should be appropriately referenced providing the latest statistics.
- Physiological processes in this life stage that affect your nutritional topic -3-4 pages
This section should examine all the relevant physiologic factors that play a role in determining the nutritional status of a population group. And what are main nutritional influences on these changes. If the topic is related to a specific disease or condition, the physiological processes involved in causing the condition should be discussed, but also providing the context for the life stage being addressed.
- Social and behavioral processes in this life stage that affect your nutritional topic - 3-4 pages
In this section describe contextual factors that may influence the nutritional issue/concern pertaining to the life stage under consideration. Socioeconomic, demographic, ethnic, life style and such other factors (usually viewed as "risk factors") should be examined in the literature and discussed. Specific behavioral issues related to diet, care, feeding etc. may also be relevant to discuss.
- Integration of 2 & 3 using a conceptual diagram Up to 2 pages
- Summary of key issues, from a public health perspective (brief) - up to 1 page
Use of published figures and tables is encouraged and they should appear at the end of the manuscript. However, these will not be counted in the 12 page limit for the paper. They should also not be used to fill the manuscript to meet the page count.
A conceptual diagram should capture the main elements of factors and processes that are discussed in the paper, with the life stage or outcome being central to the framework. Use of arrows should be done with careful thought. The following arrows are illustrative for capturing different epidemiologic relationships. Please cite the conceptual diagram as a Figure in the review paper and build the topics and subtopics of your paper around this.
→ to depict a causal relationship between two factors
↔ to depict an association
------| to show effect modification
Several examples of conceptual diagram will be shown in lectures or in required readings.
Each student will do a 5 minute summary presentation of the paper using the conceptual diagram developed as part of the paper writing assignment. This will be followed by 1-2 minutes of questions from the students.
Class discussion 25%
Class attendance 5%
Paper presentation 10%
Optional Reading and Text Books
- Goldman AS, Chheda S, Garofalo R. Evolution of immunologic functions of the mammary gland and the postnatal development of immunity. Pediatr Res 1998; 43:155-162.
- Hartmann PE, Sherriff JL, Mitoulas LR. Homeostatic mechanisms that regulate lactation during energetic stress. J Nutr 1998; 128(suppl):394S-399S.
- Sibley CP, Birdsey TJ, Brownbill P, et al. Mechanism of maternofetal exchange across the human placenta. Biochemical Society Transactions 1998;26:86-91.
- Burton GJ, Jaunaiux E. Maternal vascularisation of the human placenta: does the embryo develop in a hypoxic environment? Gynecol Obstet Fertil 2001;29(7-8):503-508.
- King JC. Physiology of pregnancy and nutrient metabolism. Am J Clin Nutr 2000;71(suppl):1218S-1225S.
- Handbook of Nutrition and Pregnancy. Eds. Lammi-Keefe CJ, Couch S, Philipson E. Humana Press, NJ, USA. 2008.
- Institute of Medicine. Nutrition During Pregnancy: Part I: Weight Gain, Part II: Nutrient Supplements. 1990.
- Institute of Medicine. Nutrition During Lactation. 1990.
- Polin RA, Fox WW, Abman SH, eds. Fetal and Neonatal Physiology, 3rd ed. Saunders, USA, 2006.
- Weight Gain During Pregnancy: Reexamining the Guidelines. Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines; Rasmussen KM, Yaktine AL, editors. Washington (DC): National Academies Press (US); 2009.
- Symonds ME, Ramsay MM (eds). Maternal-Fetal Nutrition during Pregnancy and Lactation. Cambridge University Press, Cambridge, UK, 2010.
- Brown JE (ed). Nutrition through the Life Cycle. 3rd ed. Thomson Wadsworth, USA. 2008.
- Langley-Evans SC (ed). Fetal nutrition and adult disease. Programming of Chronic Disease through Fetal Exposure to Undernutrition. CABI Publishing in association with The Nutrition Society, Cambridge, USA 2004.
- Symonds ME, Sebert SP, Hyatt MA, Budge H. Nutritional programming of the metabolic syndrome. Nat Rev Endocrinol 2009; 5:604-10.
- Barker DJP, Bergmann RL, Ogra PL. The window of opportunity:Pre-pregnancy to 24 months of age. Nestle Nutrition Workshop Series. Pediatric Program, Vol. 61. Nestle Nutrition Institute 2008.
- Martorell R, Haschke F. Nutrition and growth. Nestle Nutrition Workshop Series. Pediatric Program, Vol. 47. Nestle Nutrition Institute 2001.
- Bales CW and Ritchie CR eds. Handbook of Clinical Nutrition and Aging
2nd edition, Humana Press, Totowa, NJ, USA. 2004.
Definition of Participation
Class discussion of the readings and lecture materials are a critical part of the course. Therefore, class attendance will be recorded, and regular and constructive participation in class discussions is a major part of the course evaluation. Constructive participation does not mean that you will know all the answers to the questions you are asked. It does however mean that you have read the articles and are prepared to bring your questions and insights to the class.
Class attendance will be recorded, and regular and constructive participation in class discussions is a major part of the course evaluation.
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.