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Anna-leila Williams, PhD, MPH
Education Demonstration: the Influence of Socioeconomics, Industry, and Policy on Dietary Lipid Consumption NCEAS Annual Conference, Chicago May 7, 2019 Anna-leila Williams, PhD, MPH Frank H. Netter MD School of Medicine Quinnipiac University
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Place educational session in context of overall curriculum
Complete two educational activities Toggle between role of learner and educator discuss experience as learner apply meta-cognitive lens of educator Workshop Overview
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Curricular Context Year 1 Medical school
A Place at the Table (documentary film and discussion) Introduction to Food Insecurity (collaborative classroom) Health Policy: School Nutrition Programs (case study) Dietary Lipids: Who’s in Control? Lifestyle and Hypertension (collaborative classroom) Obesity: Epidemiology, Pathogenesis, & Consequences (lecture) Obesity: Assessment & Management (collaborative classroom)
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Dietary Lipids: Who’s in Control?
50-minute event [collaborative classroom or seminar] Pre-event video [“voice over slides”] 2 in class activities [we will experience today] Dietary Lipids: Who’s in Control?
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Pre-event Video Describe the interdependent relationships among basic science, health policy, the food industry, and health outcomes; Review key recommendations from the National Dietary Guidelines; Investigate the influence of socio- economics and environment on food access and dietary lipid consumption. Learning Objectives In Class Activities
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Pre-event video summary
In seven slides
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Pre-event Video Summary
Dietary Lipids and Health Pre-event Video Summary Healthy Fats: MUFA and PUFA Saturated Fats, Trans Fats, and LDL 600,000 deaths/year in US Leading cause of death $$$$ CDC.gov; Mozzafarian et al. Circulation. 2016;133:e38-e360.
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Code of Federal Regulations
Blood Cholesterol CHD Health Outcomes Lipid Metabolism Epidemiology Environment “Choice” Basic Science Behavior FDA Code of Federal Regulations Nutrition Guidelines Regulations/Industry Policy
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http://health. gov/dietaryguidelines/2015/; Health
Health.gov/dietaryguidelines/2015/guidelines/
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Dietary Intake Compared to Recommendations
Health.gov/dietaryguidelines/2015/guidelines/chaper-2 [Figure 2-1]
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Recommendations criticized by nutrition community vague
yielded to food industry pressures World Health Organization’s classification processed meat - CARCINOGEN bacon, sausage, and hot dogs red meat – PROBABLE CARCINOGEN beef, pork, and lamb
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McDonald’s $1.4 billion Pepsico $1.2 billion General Mills $866 million Nestle $819 million Hershey $745 million Kellogg $666 million Coca-Cola $664 million Kraft Heinz $569 million Dr. Pepper $414 million ConAgra $392 million Dunkin Donuts $382 million Wendy’s $347 million
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Food Access Food Insecurity Acculturation
Guidelines: “Support Healthy Eating Patterns for All” Food Access Food Insecurity Acculturation
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Opening: “Any Questions about Pre-event video?”
Move into first small group activity
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Learners Small Group Work INTRO 1
A diet low in saturated fat helps reduce the risk of heart disease. Because much of the food consumed in the United States is processed, government regulations have been enacted to help people know the ingredients and nutritional content of what they are eating. Small Group Work INTRO 1
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Small Group Work [10 mins] see HANDOUT
Learners Small Group Work [10 mins] see HANDOUT Use the FDA – Code of Federal Regulations Health Claims: Dietary Saturated Fat and Cholesterol and Risk of Coronary Heart Disease [Subpart E Requirements] idx?SID=eaf8b05f4c36e7c40fabb0d8c089b05e&mc=true&node=pt &rgn=div5#se _175 describe criteria for health claims and advertising related to dietary saturated fat and cholesterol; discuss whether you think the criteria for labeling is sufficient for most people to make informed decisions about food purchase.
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Health Claims Images: https://www.change.org/ topsimages.com
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Educators Small Group Discussion [5 mins] What do you think of the content and andragogic approach used to investigate the Code of Federal Regulations ?
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Small Groups Report to All [5 mins]
Educators Small Groups Report to All [5 mins]
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Learners Small Group Work INTRO 2
“Food environment factors—such as store/restaurant proximity, food prices, nutrition assistance programs, and community characteristics—interact to influence food choices and diet quality. Researchers are beginning to document the complexity of these interactions, however, more research is needed to identify causal relationships and effective policy interventions. The Food Environment Atlas assembles statistics on food environment indicators, and provides a spatial overview of a community's ability to access healthy food and its success in doing so.” Small Group Work INTRO 2
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Small Group Work [15 mins]
Learners Small Group Work [15 mins] Open the USDA ERS Food Environment Atlas: products/food-environment- atlas/go-to-the-atlas.aspx SEE HANDOUT FOR INSTRUCTIONS
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Develop a summary statement about the inter- relationship among economics, geographic location, food access, and health outcomes for the US county of your choice. Please include the following: socioeconomic characteristics of the county’s population (include poverty rate; childhood poverty rate; percent of population who are WIC participants; percent of population who are National School Lunch Program and School Breakfast Program participants); population’s access to a grocery store (include sub-populations - children, seniors); county’s local food availability (farms, farmer’s markets, etc.); county’s adult obesity rate; county’s adult diabetes rate. As a physician, how might you use these population-level data to improve the health of your patients?
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Small groups share summary statements with all [5 mins]
Learners Small groups share summary statements with all [5 mins]
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Educators Small Group Discussion [5 mins] What dO you think of the content and andragogic approach used to investigate the Food Environment Atlas and write the summary statement?
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Small Groups Report to All [10 mins]
Educators Small Groups Report to All [10 mins]
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Learners KEY SUMMARY POINTS National Dietary Guidelines for Fats
Criteria for food labeling and advertising (dietary saturated fat and cholesterol) Ways to use Food Environment Atlas data Lobby government to assure access to quality food Tailor patient nutrition education Develop culturally and linguistically appropriate patient education materials Advise school districts
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KEY SUMMARY POINTS Educators Experiential Collaborative Integrated
Practical Memorable Perspective-taking Framework for lifelong learning for health professionals in understanding and addressing the social determinants of health.
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Session Evaluation Thank you
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