1. Presentation: times, groups, format clarify criteria-outline presentation includes asking and answering of questions Format of midterm test- 6 short answer questions (5 marks each)-class time- 45 minutes-date-5 Nov 2013

2. The Diet technician and dietitian positions anita.binder@compass-canada.com amanda.sibley@sobeys.com

3. The Math & Science Centre Fall 2013 The Math & Science Centre will open for the term on Wednesday, September 18 th. The centre, which provides drop-in tutoring support in introductory math, science & business courses, will be open Mondays through Thursdays throughout the term from 3:00 pm – 8:00 pm. The Math & Science Centre is located in the Learning Commons. For more information, please visit: http://www.cbu.ca/academics/math-science-centre

4. A note-taker has been requested for NUTR 2101. The note-taker is a student the Nutrition 2101 class who simply photocopies (a photocopier is available here at the centre) their notes or emails them to the Centre if they are typed, from the beginning of the term and continues to do so for the remainder of the fall term 2013. They will be paid $100 at the end of the term for hand written notes or $150 for typed notes. Any interested students to come to the Jennifer Keeping AccessAbility Centre, where Ms. Campbell will further explain the process.

5. The Lecture 2- 17 Sept 2013 Introduction to Nutritional Assessment

6. Outline of todays talk Definition of Nutrition Introduction to Nutrition Impact of Nutrition Nutritional choices Nutrients Defined Energy yielding nutrients Non-energy yielding nutrients Planning a healthy diet What is pathology? What are socioeconomic factors? What is nutritional assessment? -how is nutritional assessment made?

7. I.Introduction to Nutrition Choices of quantity and quality of nutrition have a significant impact on the longevity and quality of a person’s life

8. Food and hence nutritional choices depend on: Personal preference Habit Ethnic heritage or tradition Social interaction Availability of food Convenience of food Economy of food Positive and negative associations Emotional conflict Values Body image Advertising

9. Nutrients defined: chemical substances obtained from food and used in the body to provide energy, structural materials and regulating agents to support growth, maintenance, and repair of the body: nutrients may reduce disease risk or promote reduction of ongoing pathology

10. The Issue Issue of protein causing osteoporosis -although high calcium intakes are not significantly affected by high protein intake, low calcium intakes are not generally sufficient to offset a high protein intake of protein causing osteoporosis - Energy yielding nutrients -all organic- i.e. carbon containing: Carbohydrates Lipids Proteins 4/9/4 kcal/ gram- remember calories are really kcal 17/37/17 kjoules /gram Energy is used for warmth, body maintenance(build new compounds/turnover), movement

11. Non-energy yielding nutrients-but can assist in deriving energy from energy yielding compounds Vitamins-organic Minerals-inorganic-non- carbon containing Water A disease that generally manifests itself late in life -may have its origin in early life during the period of skeletal growth and peak bone mass accumulation bone loss starts in mid-adul

12. Nutrients classified: Essential or indispensable vs non- essential primarily calcium loss- calcium is being lost faster than it is being replaced

13. Non-nutrients-helpful, neutral or harmful Alcohol 7 kcal/gm or 29 kjoules/gram Phytochemicals and chemicals from animal and other sources such as? Additives etc

15. Planning a healthy diet To do this bear in mind Adequacy Balance Energy control Nutrient density Moderation Variety

16. BREAK- 10 MINUTES

17. What is pathology? medical science concerned with all aspects of disease, but with special reference to the essential nature, causes and development of abnormal conditions, as well as the structural and functional changes that result from the disease processes

18. What are socioeconomic factors? -a combination of social and economic factors that have influence on a person’s life-distinction between social and economic factors may be blurred-why? w

19. What are socioeconomic factors? Prestige perceived value of a person to society or part(s) of society w

20. What are socioeconomic factors? What is meant by value in this case? w

21. Occupational prestige job is major source of income, wealth and power social prestige exists as well-we are evaluated on the basis of the work that we do

22. Prestige continued societal perceptions- if a person has prestige people tend to listen to them- impact of this in terms of nutrition? /nutritional assessment?

23. Prestige continued educational prestige is based what degree or training one has, the post-secondary institution where it was obtained and the money it cost to get that degree or training

24. Power- -the ability to control or influence one’s own position or the position of others in society- in part power means influencing the political agenda-what does position mean? How would such power affect nutrition and disease?/nutritional assessment?

25. Income Salary earned by a person What does salary do to influence the difference between rich and poor? Compare the United States and Canada in terms of wealth distribution- which is fairer? Compare first, second and third world- impact on nutrition and disease/nutritional assessment-

26. Wealth- -income is but one component of a person’s or family’s wealth- -wealth is the total amount of money and other assets minus outstanding debts

27. Power In Canadian society, wealth stands as an important source of power -major owners of corporate stock make decisions that create jobs or cause downsizing of companies for ordinary people- how does this affect government policy in terms of nutrition and nutritional assessment?

28. Power continued -if a few very wealthy persons control most of the nation’s wealth- can one have a true democracy? What is the impact of this on nutritional well being? What is the impact of this on nutritional assessment?

29. Education Those who are well-educated tend to make better nutritional choices What does well-educated mean and how does that influence nutritional choices and nutritional assessment?

30. Education continued Opportunities for education are influenced by what factors?

31. Social statification ancestry- the family into which one is born- aside from wealth,power, prestige etc what effect would ancestry have on nutrition and nutritional assessment?

32. Social statification gender-bias against women -Women tend not to inherit the social position of their fathers in the same way that men do? However generally there are more resources available to men and women of wealthy families compared to those less well off.

33. Social statification Ethnicity- one text suggests that- in Canada-people of Asian origin have higher levels of educational achievement than those of French or British origin and that Blacks are ahead on some educational measures and labour force participation with aboriginal persons having on average less education and access to the job market.

34. Social statification Ethnicity-one text suggests that- in Canada average incomes decline steadily going from British to French to Asian to Black to Aboriginal men Conflict between education and income? Why?

35. Social statification Ethnicity-one text suggests that- in Canada -Among women these income distinctions are not as sharp Average income of black women is greater than that of French and Asian origin-substantial education and labour force involvement is higher among black women-why?

36. Social statification Class- Upper class-much of its income from inherited wealth

37. Social statification Class- Upper uppers-assigned by birth

38. Social statification Class- Lower uppers working rich-nouveau riche though most do inherit some wealth

39. Social statification Class- Upper middles salary 50-100 K per year mostly university educated lack power of upper class to influence national or international events

40. Social statification Class- Average middles rest of middle class-eg bank tellers, middle managers and sales clerks

41. Social statification Class- Working class- work and have little or no accumulated wealth

42. Social statification Class- Lower class 20 % of population with lowest family income

43. Social statification Age Class- elderly may slip economically

44. Social statification What is the impact of social stratification on nutrition and nutritional assessment?

45. Global economy What impact does the globalisation of trade have on nutrition and nutritional assessment?

46. Government What role does government play in nutrition and nutritional assessment?

47. Business The corporate world (eg ADM) is able to influence world food supply- how? and what impact does this influence have on nutritional assessment?

48. Psychology Advertisers influence what we eat Mental illness dictates the quality of the diet What are the implications of these statements?

49. History History affects where people live, their income and all other features listed as socioeconomic factors How?

50. Group discussion How do all these socioeconomic factors relate to one another in terms of nutrition and health and nutritional assessment?

51. Group discussion What are the socioeconomic factors related to nutrition and disease in Cape Breton ?

52. BREAK 10 MINUTES

53. What is nutritional assessment? Assessment of the impact of nutritional status, intervention or lack of intervention

54. How is nutritional assessment made? History nutrient intake analysis-what is left on plate for example daily food record/diary-as it occurs retrospective data 24 hour recall food frequency questionnaire

55. How is nutritional assessment made? Anthropometry examples skin folds height weight BMI circumferences-eg waist impedance measurements

56. How is nutritional assessment made? Nutrition focussed physical exam looking for signs and symptoms of nutritional deficiencies or toxicities -eg blindness, stunted growth obesity performed frequently by a physician or nurse practitioner

57. How is nutritional assessment made? Skin testing -introduction of antigens-extent of reaction dictates nutritional status-this is riddled with problems as exact information is required on nutrient intake, metabolic state, current illness, recent exposure to infectious agents and duration of immune deficit as well as familiarity with genetic factors- in short not a good tool

58. How is nutritional assessment made? Handgrip dynamometry -hand strength

59. How is nutritional assessment made? Biochemical analyses mostly blood -eg blood sugar, lipids etc

60. How is nutritional assessment made? Classifying malnutrition we will look at each of the diseases and discuss on a case by case basis-looking for signs and symptoms of malnutrition

61. Nutritional assessment also involves assessment of socioeconomic factors affecting the various nutritional states and how those nutritional states and socioeconomic factors affect the risk of disease and the opportunities for recovery via nutritional approaches. Nutritional approaches include the presence and absence of certain foods and nutrients including nutraceuticals and functional foods in the diet

62. Functional food Health Canada definition A functional food is similar in appearance to, or may be, a conventional food that is consumed as part of a usual diet, and is demonstrated to have physiological benefits and/or reduce the risk of chronic disease beyond basic nutritional functions, i.e. they contain bioactive compound.

63. Nutraceutical Health Canada definition A nutraceutical is a product isolated or purified from foods that is generally sold in medicinal forms not usually associated with foods. A nutraceutical is demonstrated to have a physiological benefit or provide protection against chronic disease.

64. Type 1 diabetes Pathology Socioeconomics-group discussion Elementary nutritional biochemistry of nutritional approaches to be taken to avoid and treat this disease First Nations and other Cape Bretoners at risk How would one assess from a nutritional perspective the socioeconomics, pathology and success of nutritional interventions?

65. Type 2 diabetes Pathology Socioeconomics-group discussion Elementary nutritional biochemistry of nutritional approaches to be taken to avoid and treat this disease First Nations and other Cape Bretoners at risk How would one assess from a nutritional perspective the socioeconomics, pathology and success of nutritional interventions?