CRITICAL ANALYSIS OF POPULAR DIETS AND DIETARY SUPPLEMENTS Syllabus

410.675.01 | AY 2013-2014 - 4th Term | 3 Credit(s)
MW 3:30:00 PM
  • Contact Information
    Faculty
    Lawrence Cheskin
  • Course Learning Objectives

    Upon successfully completing this course, students will be able to:

    • describe the complex interrelationships that control appetite and feeding in humans
    • critically appraise the scientific literature pertaining to both diets and dietary supplements, and provide an opinion based on the evidence as to whether the diet or supplement is worthy of recommendation
  • Course Description
    Focuses on the dietary supplements and diets purporting to promote health, induce weight loss, or treat specific health concerns are widely used by Americans, which are often minimally regulated. Students apply the tools of nutritional science to a critical analysis of popular diets and supplements. Students explore the following: nutrient analysis, dissecting several example diets and supplements in class discussions, preparing a comprehensive written analysis of a specific diet or supplement of their choosing, and presenting their findings orally.
  • Intended Audience

    Master's and doctoral students interested in the application of nutritional science to a critical analysis of popular diets and supplements.  Highly motivated undergraduates are welcomed, with instructor approval.

  • Methods of Assessment

    Class participation, tests, final analysis of a diet/supplement and oral class presentation.

    Additional Faculty Notes:

    GRADING

    Grading will be based on participation, two tests (one midterm and one final) and a class project.  Grades will be broken down in the following manner:

    Class participation—20%

    • You will receive 20/20 points for participation if you contribute in a worthwhile manner to each class meeting.
    • You will receive 19 points if you participate in essentially every class and at least half of what you say is worthwhile.
    • You will receive 18 points if you participate in the majority of classes.
    • You will receive 17 points if you participate occasionally.
    • You will receive 15 points if you do not say anything unless you’re directly asked a question.
    • You will receive 10 points for showing up most classes—you don’t speak, even when directly queried.

     

    Midterm quiz on physiology topics—20% 

                The quiz will consist of short essay and multiple-choice questions.

     Class project—35%

                 See the description below.

     Questions for final—5%

                 Turn in 5 thoughtful questions of varying levels of difficulty on your presentation, to be included (at instructor's discretion) in the final exam.  These questions should be multiple-choice or answerable with 1-3 sentences.  No long essay questions!  You will not receive all 5 points automatically just for turning in the questions.  They will be judged on originality and quality.

     Final—20%

                 The final will consist of multiple-choice questions or short-answers.

     EXPLANATION OF ASSIGNMENTS 

    After you’ve chosen the diet/weight control plan you’d like to study and analyze, you will prepare a presentation on that diet, based on a comination of a literature review, and your personal experience and nutritional analysis in trying to follow the diet. 

    For the review, you will prepare an overview of the diet, including the rationale behind it, description of the diet and literature review of any studies published about this particular diet or similar diets.  You will also need to evaluate/analyze the nutritional quality of the diet.  What are its pros and cons? What sorts of studies are missing?  What studies would you design to evaluate the effectiveness of this diet? You will prepare a powerpoint slideshow of your findings, which will be presented in front of the class.  The class will ask you questions about your chosen diet. 

     If you choose a supplementinstead of a diet, the first part of the presentation will be similar.  Outline the rationale of why this particular supplement is used for weight loss, its active ingredients and mode of action.

    For your testing of the chosen diet or supplement, you will design/choose 7 days of menus(including breakfast, lunch, dinner and snacks) and conduct a nutrient analysis of the diet to come up with the diet’s nutritional profile.  If you choose to work on a supplement, you will base your nutrient analysis on seven 24-hour recalls or logs of your own diet while using that particular supplement.  

    During your class presentation, you will report on the macronutrient and micronutrient make-up of the diet to answer the following-questions:

     What are the main sources of energy in this diet? 

    • What is the breakdown of macronutrient energy sources (% carbohydrate, % fat and % protein).
    • What is the breakdown of fats (saturated, unsaturated, monounsaturated, polyunsaturated)?
    • What is the breakdown of carbohydrates (sugars, fiber)?
    • How much cholesterol and sodium does the diet provide?
    • Is the diet a sufficient source of micronutrients and vitamins?  Is an individual following this diet at risk for micronutrient deficiency?

      POSSIBLE PROJECT TOPICS 

    Diets

    Eades, M.R. and Eades, M.D.  Protein Power

    They identify insulin as the culprit for obesity.  They believe that high levels of insulin cause metabolic disturbances and result in elevated blood pressure, cholesterol and triglycerides, diabetes and obesity.  They suggest restricting carbohydrate intake to overcome metabolic disturbances and alleviate medical problems.  Guidelines concentrate on the amount of protein consumed. 

    Steward, H.L., Bethea, M.C., Andrews, S.S. and Balart, L.A.  Sugar Busters!  New York:  Ballantine.

    They believe that “sugar is toxic!” and that insulin insensitivity causes obesity and non-insulin-dependent diabetes.  Their diet plan focuses on reducing high-glycemic carbohydrates (insulin stimulating carbohydrates) to lower insulin levels and decrease insulin resistance.  They also believe that calories themselves are not as important as the types of foods we eat and how we eat them.  Their concept is to consume foods with a low glycemic index (high fiber begetables, fruits and whole grains), lean meats and fats in moderation. 

    Sears, B. and Lawren, B.  The Zone Diet.  New York:  Harper Collins.

    This diet promotes high-protein, modestly restricted carbohydrate meals.  Sears states that “eating fat does not make you fat,” but “it is your body’s response to excess carbohydrate in your diet that makes you fat”.  He believes that specific eicosanoids produced by the body determine an “optimal metabolic state”.  He further postulates that production of health-promoting eicosanoids results from consumption of the appropriate balance of micronutrients at each meal (30% protein, 40% carbohydrate and 30% fat).

     American Diabetes Association, The American Dietetic Association:  Exchange Lists For Weight Maintenance.  Alexandria, VA:  American Diabetes Association.

    This is the official recommendation of the two authoring associations and many dieticians use these principles for weight-loss and weight-maintenance diet prescriptions.  The recommendation is to consume approximately 50-55% of calories from carbohydrates, 10-20% from protein and <30% from fats.  Foods are categorized into exchanges of fruits, vegetables, meats, dairy, carbohydrates and fats.  Individuals are encouraged to consume a specified number of items from each exchange depending on the person’s caloric intake and individualized need.  High fat animal products and oils should be limited.

    Ornish, D.  Eat More, Weigh Less.  New York:  Harper Collins, 1993.

    This diet is plant-based and vegetarian and is low in fat and high in complex carbohydrates and fiber.  Ornish recommends that individuals consume <10% of their energy intake from fat.  He suggests that fat is the culprit for weight gain because the body converts dietary fat into fat stores more readily and efficiently. 

    Weight-Watchers (from their website www.weightwatchers.com).

    For 40 years, Weight Watchers has helped millions reach their weight loss goals. With the successful Winning Points plan, you can eat your favorite foods and get the tools and motivation to help you reach your personal weight loss goals.

    Weight Watchers has always believed that dieting is just one part of long-term weight management. A healthy body results from a healthy lifestyle — which means mental, emotional, and physical health. Weight Watchers does not tell you what you can or can't eat — we provide information, knowledge, tools and motivation to help you make the decisions that are right for you about nutrition and exercise. We help you to make healthy eating decisions, and we encourage you to enjoy yourself by becoming more active. To provide motivation, mutual support, and encouragement and instruction from our leaders, Weight Watchers organizes group meetings around the world.

    All foods have a POINTS value, depending on the food's number of calories, grams of fat, and grams of fiber.  You have a Daily POINTS Range to use on any of the foods you want to eat.  Simply stick within your Daily POINTS Range and you will lose weight.

    Jenny Craig (from their website www.jennycraig.com).

    Ours is a proven program based on: healthy food choices, an active lifestyle and emotional balance.  We have a plan for every lifestyle, taste and budget. A proven, "non-diet" approach offering flexible program, menu and activity choices.  Lose weight (1-2 pounds per week) and keep it off.

    The Jenny Craig program is designed by Registered Dietitians in consultation with our Medical Advisory Board and is based on the USDA Food Pyramid Guidelines.  Meals are low in fat and cholesterol, high in fiber and taste great. By following the Jenny Craig Menus, you'll be practicing healthy habits, like portion control, that are essential for healthy weight loss and successful weight management.  Menus model three key factors for healthy eating -- balance, variety and moderation.

    During the Maintenance portion of your program, you'll learn more about meal planning and healthy, low fat eating, positive coping skills, and ways to incorporate frequent activity into your lifestyle.  The Jenny Craig weight loss program is stronger than ever: With the support and education you need to lose weight and keep it off! No fad diets here, just an emphasis on healthy choices and emotional balance.

    Slim Fast (www.slim-fast.com).

    South Beach Diet

               

    Supplements:

     Ephedra substitutes (Citrus aurantium, etc)

     Chitosan and other “fat blockers,” including orlistat

     Fiber supplements

     Chromium picolinate

     Hoodia gordonii

     Human chorionic gonadoptropin (HCG) 

  • Prerequisites

    Basic knowlege of nutrition; preferably from prior coursework, such as Introduction to Human Nutrition.

  • Required Text(s)

    Additional Faculty Notes:

    No textbook - the scientific literature will be searched as questions arise during the course.

  • Course Schedule

    Please see the course Session for a full list of dates and items for this course.

  • Files from the Online Library
  • 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 topics

     

    Class 1
    March 24
    Introduction to the class: aims, grading; Obesity lecture
     
    2
    March 26
    Ingestive science-the control of eating and measurement of hunger and satiety
     
    3
    March 31
    Digestion and dieting options
     
    4
    April 2
    Metabolism and its control
     
    5
    April 7
    Physical activity- the other side of the energy balance equation; weight maintenance
     
    6
    April 9
    Dietary supplements; miscellaneous topics: underreporting, placebo effect in dieting, drugs
    Last date to choose topic for presentation
    7
    April 14
    How-to on dietary analysis; review for midterm; Questions on Project assignment
     
    8
    April 16
    Midterm
     
    9
    April 21
    Student Presentations
     
    10
    April 23
    Student Presentations
     
    11
    April 28
    Student Presentations
     
    12
    April 30
    Student Presentations
     
    13
    May 5
    Student Presentations
     
    14
    May 7
    Student Presentations
     
    15
    May 12
    Student Presentations
    Test questions due
    16
    May 14
    Final exam: based on student presentations
     

     

  • Contact Information(from old syllabus)

    Larry Cheskin
    Email: lcheski1@jhmi.edu
    Office: 550 N Broadway, Suite 1001
    Tel: 410 502-0145

  • Attendance Policy

    Because there is no textbook or required readings, attendance is particularly important.  Please email the instructor if you will need to skip any class, so that, if possible, arrangements can be made so you do not miss anything important. Thanks.

  • Disability Support Services
    If you are a student with a documented disability who requires an academic accommodation, please contact the Office of Student Life Services at 410-955-3034 or via email at dss@jhsph.edu.