KING’S COLLEGE LONDON MSc Nutrition Course Handbook 2009-2010 Course Tutor: Professor Peter Emery (Room 4.42, Franklin-Wilkins Building) (tel. 0207848-4415) E-mail: peter.emery@kcl.ac.uk This document contains a lot of information about the course and about the arrangements made by the Department to support your studies. Further information about support at School and College level and about some of the formal procedures relating to enrolment and examinations is contained in the School of Biomedical and Health Sciences Taught Graduate Handbook, which is available at enrolment. Please read both documents and keep them safe for future reference. Department of Nutrition and Dietetics Name and Email Major Responsibilities Room Extn. Prof Peter W Emery peter.emery@kcl.ac.uk Head of Department, MSc Nutrition Tutor 4.42 4415 Dr Christine Baldwin christine.baldwin@kcl.ac.uk UG B401 1st Year Tutor 4.04 4318 Dr Sarah Berry sarah.e.berry@kcl.ac.uk Dr Christopher Corpe Dr Wendy L Hall wendy.hall@kcl.ac.uk Mrs Annemarie Knight Annemarie.knight@kcl.ac.uk Intercalated BSc Tutor 4.22 4088 Maternity Leave 4.11 4.108 4269 4197 UG B401 2nd Year Tutor [Part-time] 4.05 4259 Dr Yemisi Latunde-Dada Yemisi.latunde-dada@kcl.ac.uk Dr Miranda Lomer Miranda.lomer@kcl.ac.uk UG B400 1st Year Tutor 4.45 4256 Joint appointment with Guy’s and St Thomas’ NHS Foundation Trust 4.103 4978 4.13 4081 3.87 3177 4.101 4255 Dr Anne Mullen Anne.mullen@kcl.ac.uk Dr Michael Nelson Michael.nelson@kcl.ac.uk Dr Sandra O’Dell sandra.o'dell@kcl.ac.uk Prof Victor R Preedy victor.preedy@kcl.ac.uk Dr Maria Pufulete maria.pufulete@kcl.ac.uk Seconded to School Food Trust MSc Nutrition Admissions Tutor PG Exam Board Chair UG B400 3rd Year Tutor Maternity Leave 1 Miss Dianne Reidlinger Dianne.reidlinger@kcl.ac.uk Prof Thomas A Sanders tom.sanders@kcl.ac.uk Placement Education Tutor 4.10 4512 Head of Nutritional Sciences Research Division 4.68 4273 Dr Paul A Sharp paul.a.sharp@kcl.ac.uk UG Exam Board Chair 3.70 4481 Ms Jane E Thomas jane.thomas@kcl.ac.uk UG B401 4th Year Tutor and MSc/PG Diploma in Dietetics Tutor 4.41 4350 4.09 4270 Dr Simon Wheeler Dr Kevin Whelan kevin.whelan@kcl.ac.uk UG Admissions Tutor 4.06 3858 Dr Helen Wiseman helen.wiseman@kcl.ac.uk 4.12 4437 Prof Catherine Geissler UG B400 2nd Year Tutor and PhD Admissions Tutor Emeritus Professor Prof D J Naismith Emeritus Professor Catherine Edeam 3.54 4394 Diane Nicholson 3.54 4191 Nisha Riat 3.54 4271 Laura Male 3.54 4324/ 6341 Administrative Staff Undergraduate administration Nutrition-admin@kcl.ac.uk Postgraduate administration postgrad-biomed@kcl.ac.uk Placement administration dietetics@kcl.ac.uk Professional Programmes Administrator Laura.male@kcl.ac.uk Contacting academic staff To contact staff send them an e-mail message, telephone or leave a note in the person’s pigeonhole. Student email All students who are enrolled in the College are given a free e-mail account. Messages to students concerning changes to timetables and other important information is usually sent by e-mail, so you are expected to check your College e-mail regularly. You should also check your own pigeon holes, in room 4.67. Attendance and absence In order to qualify for admission to University examinations and for payment of awards or grants, the Head of the Department must be satisfied that you have attended sufficient 2 lectures, classes and tutorials. If you are absent from College through illness for a period of a week or more or for any period involving absence from an examination or timetabled assessment, you must obtain a medical certificate from your doctor. If your performance in an examination has been affected by illness or other circumstances beyond your control you should go to the Academic Centre, fill in a Mitigating Circumstances Form and hand it in with the medical certificate as soon as possible after the exam. Further information about mitigation and absence from examinations can be found in the School of Biomedical and Health Sciences Graduate Student Handbook - Taught Programmes 2009-10. Note that your marks will not be altered as a result of mitigation. If mitigation is accepted you may be offered a replacement examination at a later date. Change of address If you change your address during the year, please inform the Academic Centre as soon as possible, or alternatively change it on OneSpace. It is important that we know how to get in touch with you. Personal tutors At the beginning of the year you will be allocated a personal tutor in this Department who will be available to help with any problems, whether academic or personal, that you may wish to discuss during your time at the College. Feedback The Department values feedback from students on their experience of the course. You will be asked to elect two class representatives to the staff/student liaison committee, which normally meets twice during the year. Your views will also be sought using a course evaluation form which will be distributed towards the end of the course. Any urgent issues should be communicated to the Course Tutor as soon as they arise. Student Lockers Students in Nutrition usually use the lockers that are based in blocks, near the Dietetics Kitchen. Lockers will be opened for use on 1 September. Students should contact Mr David Lincoln, Room 4.81 or 4.161, FWB to book a locker. Usually around mid-July every year students are requested to empty their lockers of all contents. AIMS AND OBJECTIVES OF THE COURSE The MSc in Nutrition is an intensive one year course designed to provide broad coverage of all the major aspects of human nutrition. As well as providing a sound knowledge and understanding of nutrition the course aims to develop students’ scientific skills to a level beyond those expected of a first degree graduate. It is designed as a conversion course, and is intended primarily for graduates in other biological science subjects. However, it is also beneficial for those whose first degree included some nutrition and who now wish to study the subject in more breadth or depth, or to bring their knowledge up to date. At the end of the course all students are expected to have developed a broad and systematic understanding of nutrition, and in some areas a critical awareness of issues at the forefront of current nutritional research. 3 The learning outcomes for the MSc course are to know the principles of nutrition, including the sources and functions of the essential nutrients and other major dietary components and the effects of deficiencies and excesses; to understand the main factors which affect the production, acquisition and consumption of food and nutrients; to understand the role of diet in the causation, prevention and treatment of disease and the promotion of health; to be able to evaluate scientific literature relating to nutrition; to be able to design and carry out nutritional research; to be able to apply nutritional knowledge in a way which would be valued by an employer. No course can be all things to all people, and each student is encouraged, through reading, essays, seminars and a major research project, to explore their own special interests. That said, there is a core of essential material in the first two terms which dominates the lecture timetable and without which the course would become unbalanced. Because this is a conversion course, designed to introduce a great deal of basic information, many of the lectures are shared with second and third year undergraduate students; tutorials, seminars and practical classes are, however, held separately, and MSc students are expected to reach a deeper level of understanding by reading more extensively. Over the year as a whole most of the time is spent on work devised specifically for MSc students. The Postgraduate Diploma in Nutrition is a shorter course consisting of the taught part of the MSc course without the research project. The learning outcomes for the Diploma course are to know the principles of nutrition, including the sources and functions of the essential nutrients and other major dietary components and the effects of deficiencies and excesses; to understand some of the factors which affect the production, acquisition and consumption of food and nutrients; to understand the role of diet in the causation, prevention and treatment of disease and the promotion of health; to be able to evaluate scientific literature relating to nutrition; to be able to apply nutritional knowledge in a way which would be valued by an employer. COURSE STRUCTURE Dates The MSc programme consists of five modules (see below). Teaching on the first four modules takes place from 28 September to 18 December and 11 January to19 March. The written exams are held around the third week in April. The summer term (from the beginning of May) is devoted to the fifth module, a research project (MSc only). The project must be submitted by a date in early August. Full details of all timetables will be given at the induction session on September 25th. Modules 4 1. Principles of Nutrition (Masters) 2. Public Health Nutrition 3. Clinical Nutrition (Masters) 4. Nutrition Research Skills 5. MSc Nutrition Research Project Information about the aims, objectives and content of these modules can be found at the end of this handbook. Lectures The content of modules 1-3 is delivered mainly through lectures. References for further reading will be given during lectures. You are unlikely to have time to read every reference, so you should decide which topics to study in more detail according to your own interests. In general, however, you should at least read the relevant chapters in Human Nutrition (see list of textbooks), preferably before the lecture. Workshops Basic aspects of energy and the macronutrients is covered in workshops in the Principles of Nutrition module. Reading material is given out before the session, then the class meets with the lecturer to discuss the material. Tutorials These are designed to provide opportunities to clarify and expand lecture material. Students are encouraged to influence the agenda for these sessions, to ensure that topics they want to discuss are covered. The class will be divided in half, so that groups of about a dozen students will meet with the appropriate member of staff. Extra reading or other preparatory work may be required before attending the tutorial Seminars Seminars are intended to explore certain topics in greater depth, and to allow every student to present the results of their own critical reading to the rest of the class. There will be a short introductory session on each topic in the first term, then the class will be divided into small groups. Each group will be asked to study the literature on one topic and then present their findings to the rest of the class during the second term. Practicals These form part of the Nutrition Research Skills module. There are two series of practicals: Laboratory practicals are intended to introduce you to all the major investigative techniques currently in use by nutritional scientists, from anthropometry to the analysis of food. In the course of this work you will learn a great deal about your own dietary habits and nutritional status. The laboratory practicals must be written up and handed in for assessment by the end of each of the first two terms. For the practicals, you will need a copy of “McCance and Widdowson’s The Composition of Foods”, and a copy of the Dietary Reference Values (see list of required texts). You will be provided with a laboratory coat, which should be worn at all times in the laboratory, and with gloves and safety glasses which MUST be worn when handling any chemicals. Please make sure you read the Safety Notes which will be given to you at the first laboratory class. 5 Statistics and computing practicals are designed to help you to master the basic statistical techniques discussed in the lectures, and to learn how to use computers for the analysis of experimental results. This part of the course will be assessed by a series of in-course tests and assignments. Essays You will be required to write three essays in the first two terms. A list of titles will be given early in the first term. One essay will relate to the topics of food and nutrition policy and one will relate to the sociological and psychological aspects of nutrition. These topics will not appear in the final written examination papers. These two essays are both part of the Public Health Nutrition module. The third essay is part of the Clinical Nutrition module. The essay that you write during the first term will be marked and returned to you at an essay tutorial early in the second term, which will allow further discussion of the essay topic and consideration of how to improve essay writing. Research project This comprises a major piece of “real” research, carried out under the supervision of a member of staff. The aim is to introduce you to the issues of designing and analysing research outside the safe confines of laboratory practicals. Upon completion of the project you are required to write it up as a thesis for assessment. You are free to suggest your own topic for a research project, but you should approach the course tutor at an early stage if you wish to do so. Alternatively, you may choose a project from a list which will be circulated around the end of January. Research usually begins at the beginning of May (after the written exams), and the thesis is submitted in early August. In preparation for the project, there will be a series of workshops to develop key research skills. This will be held in February and March. Nutrition Profession Study Days There will be two days of talks and group work designed to help you understand some of the areas in which nutritionists are employed and to develop the ethics and values of a competent nutrition professional. This work will be assessed as part of the Public Health Nutrition module by a reflective report of a case study discussion. Examination and assessment There will be a mid-sessional examination early in January. This will not count towards the final assessment, but will be a very useful guide to your progress as well as offering you the chance to practise writing exam answers. Attendance is compulsory. The final written examinations are held in April. The scripts from these exams are all marked anonymously, ie they are identified only by a candidate number rather than your name. Each answer is first marked by a subject specialist examiner, then the scripts are reviewed and the marks moderated by a second examiner. Finally a sample of the scripts are reviewed again by the External Examiner. 6 The project report is marked independently by two internal examiners. The supervisor also awards a mark for your performance in carrying out the project. Under exceptional circumstances, you may also be offered a viva voce (oral) examination. This would only occur if there were mitigating circumstances that could not be dealt with in any other way. Results will be published after the School Examination Board has met, usually in late September. You will receive official notification of your result by post later in the year. At this stage you will receive a detailed breakdown of your marks for each module. Degree award To be awarded the MSc degree you need to pass all five modules. The pass mark for each module is 50%. The weighting for each exam paper and assignment is shown within the module information at the end of this handbook. To achieve a Merit you need a weighted average mark of 60% overall and 60% in the project. To achieve a Distinction you need a weighted average mark of 70% overall, and 70% in the project. Failure If you fail any of the modules you will be allowed one resit, which must normally be on the next occasion the exam papers are set (ie the following April). Marks for reassessed modules are capped at 50%. COURSEWORK Course work is an integral part of this course and must be handed in on or before the date specified. The work should be handed in to the Academic Centre, Room 3.54, 3rd Floor, Franklin-Wilkins Building. The final deadline for submitting coursework is 4.00pm on the day stated in the module handbook. All coursework must be accompanied by a completed coursework coversheet, which can be downloaded from the web. College regulations state “Assessed course work not submitted by the stated deadline is liable to be failed with a mark of zero.” This regulation will be strictly observed. If you do not hand the work in on time you will get zero for that part of the module, and this will normally mean that you fail the module overall. In order to allow for last minute problems, you should aim to have the work finished well before the deadline. There is no penalty for handing work in early! This strict approach to work deadlines is in your interest - the selfdiscipline and organisation you need to meet our requirements will help you prepare for your future career. However, we appreciate that student life can be stressful and you may be unwell or unable to meet a deadline for good reason. In this case you should fill in an Extension Request Form, indicating how much extra time you want and including supporting documentation, such as a medical certificate, and hand it in to the Academic Centre. This should be done well before the deadline. The Programme Examination Board Chair (Dr O’Dell) will then decide whether to grant an extension and you will be notified by the Academic Centre. If you are unwell on the day the work is due to be handed in, you should submit a Mitigating Circumstances Form. These forms are available from the Academic Centre and on the web. 7 Handing in Course Work Any course work that is handed in needs to have a cover sheet stapled to it. The coversheet not only carries details of the student and the item of coursework but also carries barcodes that allow the Academic Centre to track the work. To download a coversheet, go the Virtual Campus, select Biomedical & Health Sciences and then Print Coversheet. This will take you to the following page: In most cases, you will be recognised from your log in so your student number, family and other name will appear automatically. If you have not been recognised then you will need to fill in these details by hand. Your Student Number is the 7 digit number under the bar code on your swipe card. You will then need to select the course code module and the item of course work for which you are printing the coversheet. When you click on Print Cover Sheet, a pdf of the cover sheet will be generated which you can then print. Please ensure that all the details are correct since choosing the wrong course module or some such other mistake may mean that your work will not be properly tracked. For some courses, your name may be omitted from the coversheet and only your student number will be shown as evidence of your identity. This will be the case for those courses where your work is marked anonymously. There is a tear-off receipt at the bottom which you can have signed and stamped when you hand in your course work. This receipt is not valid unless it has been signed and stamped. If you have not been recognised and therefore have to fill in your details by hand, please notify the Academic Centre front desk so that we can update our database. When it comes to handing in your coursework: Do not put it in a plastic wallet any other container. Do make sure the coversheet is the top sheet Do staple all the sheets together A NOTE OF GUIDANCE ON PLAGIARISM Plagiarism is the taking of another person's thoughts, words, results, judgements, ideas, etc, and presenting them as your own. 8 Plagiarism is a form of cheating and a serious academic offence. All allegations of plagiarism will be investigated and may result in action being taken under the College's Misconduct regulations. A substantiated charge of plagiarism will result in a penalty being ordered ranging from a mark of zero for the assessed work to expulsion from the College. Collusion is another form of cheating and is the unacknowledged use of material prepared by several persons working together. Students are reminded that all work that they submit as part of the requirements for any examination or assessment of the College or of the University of London must be expressed in their own words and incorporate their own ideas and judgements. Direct quotations from the published or unpublished work of others, including that of other students, must always be identified as such by being placed inside quotation marks with a full reference to the source provided in the proper form. Paraphrasing - using other words to express another person's ideas or judgements - must also be acknowledged (in a footnote or bracket following the paraphrasing) and referenced. In the same way, the authors of images and audiovisual presentations must be acknowledged. Students should take particular care to avoid plagiarism and collusion in coursework, essays and reports, especially when using electronic sources or when working in a group. Students should also take care in the use of their own work. Credit can only be given once for a particular piece of assessed work. Submitting the same piece of work (or a significant part thereof) twice for assessment will be regarded as cheating. Unacknowledged collaboration may result in a charge of plagiarism or in a charge of collusion. Students are advised to consult School and departmental guidance on the proper presentation of work and the most appropriate way to reference sources; they are required to sign and attach a statement to each piece of work submitted for assessment indicating that they have read and understood the College regulations on plagiarism. Students should be aware that academic staff have considerable expertise in identifying plagiarism and have access to electronic detection services to assist them. TEXTBOOKS The principal text which is recommended for the course is Human Nutrition (see below), although there are other nutrition texts which you may prefer. You should purchase a copy by the start of the course, if possible. The other texts listed will be required at various stages of the course, and you are strongly recommended to buy them, although you may prefer to look at them in the library here before deciding to buy. Geissler CA & Powers HJ. Human Nutrition. 11th edition. Elsevier, 2005 (previously Garrow, James & Ralph. Human Nutrition & Dietetics 10th edition). This book is often referred to in the Department as “Davidson and Passmore”, after the authors of the earliest editions. 9 Sanders TAB and Emery PW. “The molecular basis of human nutrition”. London, Taylor & Francis, 2003. Department of Health. “Dietary Reference Values for Food Energy and Nutrients for the United Kingdom”. London, HMSO, 1991. “McCance and Widdowson’s The Composition of Foods”. Sixth edition. London, Royal Society of Chemistry, 2002. Barker DJP, Cooper C and Rose G. “Epidemiology in Medical Practice”. 5th edition. London. Churchill Livingstone Bland, M. “An introduction to medical statistics”. Oxford University Press. Second edition All these books are available at Blackwells Bookshop which has branches in the Macadam Building of the College’s Strand Campus and Boland House on the Guy’s Campus. Preliminary Reading It is assumed that everyone taking the course has some basic knowledge of human physiology and biochemistry. Anyone who is concerned that their knowledge in these areas may be slightly deficient, or perhaps a little rusty, (this means most of you!) is advised to do some preliminary reading. It is difficult to find books which concentrate on the topics most relevant to nutrition, and which are written at the right level, but some suggestions are set out below. You should not attempt to learn the details, but you should try to understand the basic concepts and become familiar with the terminology. Do not be put off by the seemingly enormous amount of information! Books are given as Title / Authors / Publisher. They should be available in public libraries and major bookshops (eg Waterstones). If you have your own copies you will certainly find them useful during the course. Biochemistry “Principles of Biochemistry” / H. Horton, L. Moran and 3 others / Prentice Hall “Biochemistry for the Medical Sciences” / E. Newsholme and A. Leech / John Wiley "Biochemistry and Molecular Biology" / Elliott and Elliott / Oxford University Press Physiology “Fundamentals of Anatomy and Physiology” / F. Martini / Prentice Hall “Essentials of Physiology” / Lamb, Johnson, Ingrams and Pitman / Blackwell “Human Physiology” / Vander, Sherman and Luciano / McGraw Hill Nutrition “An introduction to nutrition and metabolism” / DA Bender / 4th edition, Taylor & Francis Study Skills “The sciences good study guide” / Northedge, Thomas, Lane, Peasegood / Open University Library and computing resources You will be given a talk on the use of the library (Information Services Centre) at the 10 beginning of the course. When you visit the library you will find leaflets explaining what is in the library and how to find the material you need. In addition to the library at this campus, and the other campuses of King’s College London, there are several other libraries which, as University of London students, you are entitled to use (although not to take books out). Consult the University of London Union List of Serials in our own library to find out where journals that you may want are held. Another very useful library which houses medical, nutritional and epidemiological journals is located at: The London School of Hygiene and Tropical Medicine, Keppel St, WC1 (nearest tube stations: Tottenham Court Road and Goodge Street). Another very comprehensive library, which now houses the University Library’s science collection is: University College Library, Gower Street, London WC1 (nearest tube stations: Goodge Street, Warren Street or Euston Square). A lot of useful material is also available on the internet, but you will need to be selective as some of it is of very dubious quality. A starting point for some of the more reliable nutritionrelated sites is the Departmental resource page at http://www.kcl.ac.uk/schools/biohealth/depts/nutrition/internet.html Student computing facilities are available in the Library and in the Public Access Workstation (PAWS) rooms. These provide free access to e-mail and the internet as well as word processing and common office-type software. You may use the PAWS rooms on any of the College campuses. Other activities The Nutrition Society This is the national forum for nutritionists in the UK. One major meeting is held in the summer each year, with a smaller meeting in London in February and other meetings, often in collaboration with other societies throughout the year. Student membership is available for a nominal fee. For further information, contact: The Nutrition Society 10 Cambridge Court 210 Shepherd’s Bush Road London W6 7NJ Tel: 020-7602-0228 or visit their website at www.nutsoc.org.uk Student Nutrition Society (Nutrition Extra) The undergraduate students organise a Nutrition Society in the College to which speakers on popular topics in nutrition are invited. Meetings are held roughly every fortnight during term time (usually at 5:30), the topic and speaker being advertised by poster and/or e-mail in the previous week. All members of the Department (staff and students) are invited to the Society’s activities. Research Seminars The Nutritional Sciences Research Division holds a series of research seminars throughout the year. These will be advertised by e-mail. Invited speakers present 11 up-to-date research findings and are usually specialists in their fields. They are often challenging in their science or outlook, and these meetings provide a lively forum for indepth discussion of a wide variety of topics. All staff and postgraduate students in the Department are invited to attend. English Language Centre The ELC offers different types of Academic English and Study Skills support that should cover the challenges that all King’s students, whatever stage they are at in their education, are facing. All the provision is free and runs throughout the academic year. We divide the lectures and classes into two different streams; In-sessional and Study Skills support. In-sessional Support This support is for you if your first language is not English, and: You are concerned about areas of your academic English and how you will cope in the University You have little or no experience of studying in an academic English environment For full information on the courses and support available, please follow this link http://www.kcl.ac.uk/schools/humanities/depts/elc/kings/support/ Study Skills Support This support is for you if you feel the challenges you are facing at King’s are not necessarily to do with academic English expectations. For example: You may be worried about methodology in dissertations You might be confused by the expectations placed upon you to organise your own study time Your tutors may be referring to academic ‘style’ and how you must improve this, but it is not clear to you what this exactly is… For information on how we can help you in these areas (and many more), please follow this link: http://www.kcl.ac.uk/schools/humanities/depts/elc/kings/study/ Tutorials From Term 2, the English Language Centre also offers KCL students individual writing tutorials focussing on a piece of work in progress and ways in which it can be improved. You can either meet tutors face to face or discuss work via email. For more information on these tutorials, please follow this link. http://www.kcl.ac.uk/schools/humanities/depts/elc/kings/writingtutorials/ 12 Please note that these tutorials start in Term 2. We hope that you can find the answers to many of the new challenges you face by registering for the classes the Centre puts on during Term 1. If you have any further questions, please do not hesitate to contact us: English Language Centre 26-29 Drury Lane, London WC2B 2RL. Telephone: Fax: Email: Website: 020 7848 1600 02 07848 1601 elc@kcl.ac.uk www.kcl.ac.uk/elc 13 APPENDIX – MODULE INFORMATION 1. PRINCIPLES OF NUTRITION (MASTERS) 7BBN0004 Credit value: 40 credits Assessment: Two written exam papers, 2 hours each (45% each); one seminar (10%). One of the written papers will require short answers, one will require essay answers. Aim: To build on students’ existing knowledge of biological sciences to provide a broad knowledge of nutrition and an in-depth understanding of the principles of nutritional science. Learning outcomes: At the end of the module the student will have: detailed knowledge of the sources and functions of the essential nutrients and other major dietary components, detailed knowledge of the effects of deficiencies and excesses of the essential nutrients, understanding of the factors that determine the chemical composition, production and supply of food, increased knowledge of the methods used for acquiring and interpreting nutritional, biological and epidemiological information, improved ability to analyse, synthesise and summarise information critically, improved ability to recognise the moral, ethical and social implications of scientific investigations and human intervention in the food chain. Content: lectures, workshops and tutorials on the following topics (number of lectures in brackets). NB this is only a guide, details of the coverage of each topic may change slightly from year to year: Sources of energy (1) Types of energy. Dietary sources of energy. Methods of measurement. Gross, digestible and metabolisable energy. Food tables. Commodities (4) Lectures on the major groups of foods consumed around the world – cereals, roots and tubers, dairy products, meat and fish, legumes, fruit and vegetables. The contribution of each group to a complete diet with reference to composition, amount consumed and nutritional implications of storage, processing and preparation methods. Energy (Workshop) Definition of energy requirements; principles of respiration/combustion, direct and indirect calorimetry; components of energy expenditure, techniques of measurement, short-term and habitual daily expenditure; energy reference values, basis of assessment for children, adolescents, adults, pregnancy, lactation; glossary of terms. Assessment of Nutritional Status (6) Anthropometric, clinical, biochemical and dietary assessment of nutritional status. 14 Reading: Gibson RS. Principles of Nutritional Assessment. 2nd ed. Oxford: Oxford University Press; 2005. Gibson RS “Nutritional assessment: a laboratory manual” Oxford: OUP 1993 Geissler C and Powers H, editors. Human Nutrition. 11th ed. Edinburgh: Elsevier Churchill Livingston; 2005. Bates et al. Biochemical markers of nutrient intake. In Margetts B and Nelson M, editors. Design concepts in Nutritional Epidemiology. 2nd edition. 1997. Jelliffe DB “Community nutritional assessment: with special reference to technically less developed countries” Oxford: Oxford Medical Publications, 1989. Wright RA and Heymsfeld S (eds) “Nutritional assessment” Oxford: Blackwell Scientific Publications, 1984. Dietary assessment (1) Techniques for assessment of food consumption and nutrient intake at national, regional, household and individual level. Strengths and weaknesses of different approaches. Anthropometry (1) Commonly used measurements and indices of linear growth and body composition in individuals and population groups and their interpretation according existing reference standards; Principles of use in the assessment of under and over nutrition and for standardisation of other biological parameters; Biochemical assessment (2) Choices of tissues and body fluids samples used in biochemical assessment. Types of biochemical tests. Overview of biochemical markers of nutritional status and intake. Biochemical markers of nutritional status for individual nutrients (proteins, iron, vitamin A, vitamin E, vitamin D, vitamin C, B vitamins). Biochemical markers of dietary intake (recovery, concentration biomarkers). Clinical assessment (1) Taking medical history; Physical examination – limitations, overview of physical signs and their interpretation; Functional status assessment. Growth (1) Patterns of normal human growth in males and females; normal range and distribution, growth charts; growth in height, weight, adiposity, and in specific organs and cells; critical periods, comparison with other species. Carbohvdrates (Workshop) Roles of carbohydrates in the diet. Chemistry and classification of carbohydrates - sugars, starch and non-starch polysaccharides. Analytical methods. Food sources. Digestion, absorption and metabolism. Introduction to applied aspects including dietary fibre, dental caries, obesity. Fats (Workshop + 1 lecture on essential fatty acids)) Role of fat in the diet and upper and lower estimates of desirable levels in the diet. Chemistry of fats; saturated, unsaturated fatty acids. Essential fatty acid deficiency . Eicosanoids. Health effects Reading: Sanders T & Emery P. The Molecular Basis of Human Nutrition. Taylor Francis, London, 2003. 15 http://www.lipid.co.uk Role fat in human nutrition http://www.kcl.ac.uk/kis/schools/life_sciences/health/nutrition/academics_staff/tabs/fatfao.ht ml Proteins (Workshop) Structure and functions of proteins and amino acids. Analytical methods. Food sources. Digestion, absorption and metabolism. Essential and non-essential amino acids. Protein quality definition and measurement - nitrogen balance, biological value and chemical score. Requirements and recommendations. Effects of high and low intakes. Nutritional anaemias (3) Prevalence. Iron absorption, transport, stores, losses. Nutritional deficiency. Assessment of iron deficiency. Anaemia in pregnancy, Anaemia of chronic disease. Role of folate and vitamin Bl2. Reading: British Nutrition Foundation. “Iron: nutritional and physiological significance” London: Chapman Hall, 1995 Vitamin C (1) Historical background used to illustrate the concept of a clinical trial. Chemistry and dietary sources. Influence of food preparation on vitamin C content. Scurvy. Biochemical function of ascorbic acid in hydroxylation reactions. Pharmacological effects of large amounts of vitamin C. Reference: Carpenter, K.J. The History of Scurvy and Vitamin C (1986). Cambridge University Press. B-vitamins (6) Thiamin. History of discovery of vitamins. Clinical features of beri-beri. Biochemical function of thiamin. Dietary aetiology of thiamin deficiency. Niacin. Pellagra, clinical features, non-nutritional pellagra. Metabolism, interactions of tryptophan, leucine, pyridoxine. Food sources - effect of processing. Functions of NAD and NADP. Riboflavin. Discovery; functions of flavoproteins; glutathione reductase test; deficiency; food sources. Pyridoxine. Metabolic function; deficiency and dependency states; tryptophan load test; effect of oestrogens on pyridoxine status; toxicity. Biotin. Metabolic functions; deficiency; avidin as an anti-vitamin. Metabolism, food sources Folate and B12. Metabolic functions. B12 and folate deficiency and how B12 deficiency can be masked by folate. B12 deficiency in vegans. Folate and neural tube defects; folate, homocysteine and cardiovascular risk; the case for food fortification. Vitamin A (1) Historical background. Night blindness and xerosis. Xeropthalmia and keratomalacia. Chemistry and metabolism of retinol and carotenoids. Dietary sources. Somatic, visual and reproductive functions of retinol. Toxicity. Assessment of requirement - retinol is used as a model to explain the concept. 16 Retinol and cancer. Therapeutic use of retinoids and beta-carotene in skin disorders and cancer - used as an example of the pharmacological use of a vitamin. Reading: Sight and Life Manual. Basel, Switzerland www.sightandlife.org Sanders T and Emery P. The Molecular Basis of Human Nutrition. Taylor Frances: London, 2003 Vitamin E and K (1) Deficiency. Chemistry and occurrence in foods and assay. Examples of vitamin that can occur in several forms. Role of vitamin E as a chain-breaking anti-oxidant. Free radicals and disease. Role of vitamin E in protection against oxidative stress. Role of vitamin K in synthesis of gamma carboxyglutamate in the synthesis glycoproteins and clotting factors. Antagonist of vitamin K metabolism. Pharmacological uses of vitamin K. References: Diplock, A.T. (1985) Vitamin E. In Fat-soluble vitamins p154-224. Heineman: London Suttie, J.W. (1985) Vitamin K. In Fat-soluble vitamins p225-311. Heineman: London Nutrition and infestation (1) Definition, classification and characteristics of parasites. Interactions between parasitic infestation, immunity and nutritional status. Illustrated with real specimens, slides and videotape. Reference: Cox FEG “Modern parasitology”. Oxford: Blackwell Science, 1993. Nutrition and Infection (1) Calcium.Phosphate and vitamin D (2) Dietary sources. Recommended intakes. Role in bone formation. Rickets, osteomalacia, hypercalcaemia. Reference: Theobald, H.E. (2005) Dietary calcium and health. British Nutrition Foundation Nutrition Bulletin 30, 237-277 Dietary Reference Values (2) Definition. Theoretical considerations: requirements and recommendations. Methods for determining requirements and setting recommendations. Applications. Minerals (8) Physiological roles of minerals and trace elements. Introduction to mineral balances; units; methodology, Nutritional significance of the following minerals: Sodium. Contribution of different sources of sodium in the diet; low sodium diets. Deficiency and excess of sodium; control of sodium excretion. Association of high sodium intake with hypertension and gastric cancer; scope for reduction of sodium intake. Potassium. Physiological roles; food sources; depletion and excess. Potassium and hypertension. Fluoride. Range of intakes - fluorosis. Fluoride and dental caries; bone health. Iodine. Food sources; metabolism; control of thyroid function. Goitre classification, incidence, complication, goitrogens, treatment and prevention. 17 Zinc. Functions, food sources, metabolism, assessment of status. Deficiencies - acute and chronic. Selenium. Abundance in foods - deficiencies and excesses in animals. Biochemistry glutathione peroxidase, Selenoproteins. Keshan disease. Copper. Role in anaemia-ceruloplasmin. Wilson's disease, Menkes disease. Copper containing enzymes.Copper deficiency. Chromium. Glucose tolerance factor. toxicity. Iron. Functions, food sources, absorption, transport, stores, losses. Iron deficiency and overload. Diet and dental health (1) Epidemiology, process of dental decay, age of tooth development. Role of bacteria, dietary, genetic and structural factors. Relative cariogenicity of carbohydrates, importance of CHO form and frequency. Fluoride and other protective factors. Reference: BNF Oral Health - Diet and other factors. British Nutrition Foundation 1999 Adverse reactions to food (1) Definitions of food intolerance, food allergy and food aversion. Mechanisms. Characteristic presentation of cases in childhood and adult life. Investigations - blood tests and elimination diets. Key points from RCP report: prevalence, problems (diagnostic methods, defining cases, determining prevalence). Animal Nutrition (4) Nutrition of commercially important farm animals compared with man. Economic considerations in animal production. Consumer pressures and development of animal products to meet human nutritional targets. Xerophthalmia (1) The prevalence and causes of vitamin A deficiency disease. Strategies to prevent VADD. Supplementation, fortification and increasing dietary diversity. Interaction with infection Sight and Life Manual www.sightandlife.org Rickets and osteomalacia (1) Iodine deficiency diseases (1) Protein Energy Malnutrition (1) Definitions, assessment, clinical signs, causes, approaches to management. Nutritional Effects of Food Processing (2) Introduction - nutrient losses and the compositional changes. Reasons for processing. Principles - the balanced view. Effects of processing on specific nutrients. Effects of specific processes, irradiation as an example. Food Toxicants, Xenobiotics, Drug Nutrient Interaction, Food Safety and Food Legislation (8) 18 Presence of foreign compounds in foods. Metabolism of foreign compounds and detoxification. Techniques for quantifying toxicity and parameters used to measure toxicity LD50 and ED50. Naturally occurring food toxins: bacteriological and protozoal toxins, role of food chain. Toxic fungi. Contamination of food by fungi and conditions of growth - mycotoxins. Toxic lipids. Toxic plants and animals. Drug nutrient interactions. Food adulteration. Food additives. Food legislation and toxicological testing. References: Sanders T and Emery P. The Molecular Basis of Human Nutrition. Taylor Frances: London, 2003 Sanders,T.A. (1999) Food production and food safety, BMJ 318, 1689-1693. Diarrhoea and oral rehydration (1) Incidence and implications of diarrhoeal diseases in developing countries. Practical skills required in identifying and treating dehydration. GI Structure and Function (1) Revision of the basic gross anatomy of the gut and the mechanisms of nutrient absorption Biochemistry (10) Revision lectures on selected topics including intermediary metabolism, enzymology and protein synthesis. Biomedical Science (6) Revision lectures on selected topics including lipoprotein metabolism, haemostasis, molecular genetics, immune system. There will also be student-led seminars on selected topics. Each topic is introduced by one lecture. Topics change from year to year, but current topics are: Sports nutrition; Nutrient absorption; Alcohol; Nutrition and genetics; Organic foods; Iron metabolism; Postprandial metabolism. 19 2. PUBLIC HEALTH NUTRITION 7BBN0003 Credit value: 45 credits Assessment: Two written exam papers, 2 hours each (37.5% each); two coursework essays (10% each); one case study report (5%). Both written papers will require essay answers. Aim: To develop an understanding of the role of nutrition in the promotion of public health. Learning outcomes: At the end of the module the student will: understand the factors that determine nutritional needs throughout the life-cycle, understand the role of nutrition in the aetiology of health problems of widespread importance in industrialised and non-industrialised countries, be able to critically appraise food and nutrition policies and direct and indirect interventions implemented to address public nutrition problems in developed and developing countries, understand the role of cultural, social and psychological factors in shaping the eating habits of an individual and the influences which may contribute to changing eating patterns, have increased knowledge of the methods used for acquiring and interpreting nutritional, biological and epidemiological information, have improved ability to analyse, synthesise and summarise information critically, have improved ability to recognise the moral, ethical and social implications of scientific investigations and human intervention in the food chain have improved written and oral communication skills and information retrieval skills have developed the ethics and values of a competent nutrition professional. Content: There are 5 main blocks of lectures: 1. Methodology – epidemiology and systematic reviews 2. Nutrition through the lifecycle 3. Diet and disease 4. Public nutrition 5. Eating habits There are also two nutrition profession study days. Further details on each block of lectures is shown here: 1. Methodology – epidemiology and systematic reviews Nutritional Epidemiology (4) Principles of epidemiology. Causality. Tools for epidemiological investigations. Rates. Sensitivity and specificity. Relative risk. Case-control and cohort studies. Confounding. Validation of dietary assessment. Adjusting for measurement error in nutritional epidemiology. Systematic reviews and evidence-based practice; 2 lectures; How the scientific literature can be evaluated systematically to arrive at evidence-based conclusions on the relationships between diet and disease. 20 2. Nutrition through the lifecycle Maternal Nutrition; 2 lectures; Nutritional costs of pregnancy; evidence of fetal protection against malnutrition; explanations in terms of placental function and maternal physiological adjustments; fat storage, fertility and lactation; nutritional costs of lactation. Infant Nutrition; 2 lectures; Factors affecting fetal growth and development (comparative); inborn errors of metabolism; the nature of pre-natal and post-natal growth; long-term effects of early malnutrition; feeding the newborn (breast and bottle feeding). Nutrition in childhood; 1 lecture; Requirements; eating habits and nutrient intakes in childhood; associations between childhood risk factors and health in childhood, adolescence and adulthood. Adolescence; 1 lecture; Requirements, formation of food habits, food habits and nutrient intakes, health problems anaemia, obesity, factors affecting blood lipids, etc Elderly ;1 lecture; Diet and the ageing process; changes in nutritional requirements with increasing age. Nutritional status of elderly people. Factors associated with malnutrition in the elderly and strategies for prevention Vegetarian diets; 1 lecture; Definitions of vegan and vegetarian diets. Reasons for following vegetarian diets. Nutrient intakes, hazards of vegan diets – bulk for children, vitamin B12 deficiency, mineral bioavailability, Health of vegetarians – influence of confounding factors, effects of vegan and vegetarian diets on risk factors for CHD, CHD and cancer incidence in vegetarians compared with non-vegetarians. 3. Diet and disease Diet cardiovascular disesease (atherosclerosis, coronary heart disease and stroke) and influence on diet on risk factors (lipoproteins; blood pressure and metabolic syndrome). 6 lectures; The epidemiology and pathology of atherosclerosis, CHD and stroke. Direct evidence linking dietary intake to risk and dietary interventions. Major risk factos for cardiovascular disease – modifiable and unmodifiable. Influence of dietary intake on plasma lipoprotein concentrations and blood pressure. Definition of metabolic syndrome. Influence of metabolic syndrome on cardiovascular disease. Dietary and lifestyle factors influence metabolic syndrome. Current dietary guideline for the prevention of cardiovascular disease. Ethnic minorities; 1 lecture; Definition of ethnic minorities. Food habits and diets of ethnic minorities with emphasis on South Asian. Nutritional problems and health. Diet and Cancer; 2 lectures; Cancer as a disease entity - its characteristics eg. Distinction between benign and malignant tumours. Types of evidence for relating dietary variables and cancers: epidemiological evidence and experimental evidence and its limitations. Extent to which available evidence allows recommendations to be made. The WCRF Report and the COMA report on nutritional aspects of cancer. Alcohol; 1 lecture: Physiological and pathological effects of alcohol. Effects on health, benefits and hazards Energy balance and obesity; 6 lectures; 21 Concept of energy balance, intake and expenditure; review of measurement techniques; Genetic and environmental factors affecting components of energy expenditure; regulation of energy balance, adaptation. Obesity: definition, epidemiology, health risks, causes, prevention and treatment. Dietary Fibre (Applied aspects of CHO); 2 lectures; Definitions; DF, NSP, R.S. Complex CHO. Analysis. Sources and intakes of D.F. (Poss R.D.A.) Properties of diets high in DF, Foods high in DF and DF components related to poss physical effects. Digestion of DF and energy availability. Epidemiology - Dietary Fibre Hypothesis. Possible effects of high fibre diets, fibre components in DM, cholesterol metabolism, obesity, diseases of large and small intestine. Possible ill-effects of high intakes of fibre Protein-energy malnutrition; 1 lecture; Definition; assessment; prevalence; metabolic aspects; interaction with infection; dietary causes; management. Diet and bone health; 2 lectures Concept of bone health; definition and burden of osteoporosis, osteomalacia, rickets and stunting; measurement of bone mineral status; determinants of bone mass; role of diet in bone health; review of evidence in relation to calcium and vitamin D; policy considerations at UK and global level. Diet and genetic interactions; 1 lecture; Common gene polymorphisms and diet-related disease. Examples include apolipoprotein genes, dietary fat intake and CHD risk; biotransformation enzymes, cruciferous vegetable intake and cancer risk; genes involved in one carbon metabolism, folate intake and risk of cancer and CHD; genes involved in the immune response and diet related inflammatory diseases. Nutrition and behaviour; 1 lecture; Free radicals and disease; 2 lectures; Role of free radicals and associated reactive oxygen and nitrogen species in cancer, cardiovascular disease and ageing. Damage to DNA, membranes and low density lipoproteins, modulation of cell signalling pathways and link with subsequent pathogenesis. Evidence for a protective role for dietary antioxidants including phytochemicals and vitamins C and E. Nutrition and Diabetes; 2 lectures Inborn errors of metabolism; 1 lecture Nutrition and HIV/AIDS; 1 lecture 4. Public nutrition World Food Supply (3) The objectives for these lectures is to enable students to appreciate how biological and environmental factors affect global and national level food supply and demand; to describe how the adequacy of global and national level food supplies are assessed; to examine the evolution of agricultural research and technology and its impact on global and national level food supply; to appreciate the inter-relationships between food and agricultural policy and nutritional status using the Common Agricultural Policy (CAP) as a case study; and to identify how globalisation impacts on the food system. Factors affecting food supply (2) 22 Social and economic factors including: systems of agriculture, subsistence and commercial; land and water tenure arrangements; availability of credit; research and extension services; marketing, trade and aid. Public Nutrition; 6 lectures; The objectives for these lectures are to describe the extent and distribution of all forms of malnutrition worldwide, to examine the biological, economic and social determinants of malnutrition within population groups using a causality conceptual framework, and to critically appraise food and nutrition policies and direct and indirect interventions implemented to address public nutrition problems in developed and developing countries. Health claims; 1 lecture Rehabilitation and Emergency Nutrition; 1 lecture This lecture gives an introduction to the types of nutritional support that is carried out in emergency settings, with particular focus on the most vulnerable groups, ie children under 5, pregnant and lactating women. 5. Eating habits (20 lectures) Food & Culture, Effects of migration on food habits, Economics of food choice, Nutritional knowledge & food choice, Advertising & food choice, Patterns of Infant Feeding, Eating habits of Children & Adolescents, Eating patterns of Elderly people, Hunger, appetite & satiety, Food selection, Psychological aspects of Obesity, Anorexia & Bulimia, Treatment of Eating Disorders, Nutrition Education & Health Promotion. NB this is only a guide, details of the coverage of each topic may change slightly from year to year 23 3. CLINICAL NUTRITION (MASTERS) 7BBN0002 Credit value: 15 credits Assessment: one 2 hour exam (70%), one essay (30%) Aim: To develop an understanding of the effect of disease on nutritional status and the role of nutrition in the management of disease. Objectives: At the end of the module the student will: understand the framework of therapeutic options for the management of specific diseases and know where diet fits in, be able to critically evaluate the evidence concerning the role of diet in the causation of specific diseases, understand the effects of specific diseases on the nutritional status of patients, have improved ability to analyse, synthesise and summarise information critically, have improved ability to recognise the moral, ethical and social implications of scientific investigations and human intervention in the food chain have improved written communication skills and information retrieval skills. Content: The course consists of a series of lectures and tutorials plus a visit to King’s College Hospital Lecture topics: 1. Malnutrition Causes, incidence and consequences Assessment and screening - To evaluate the epidemiological evidence for malnutrition in the hospital environment - To summarise assessment tools currently in use Metabolic aspects of trauma - To understand the methods used for the investigation of metabolism in acutely ill patients - To describe the metabolic response to trauma - To discuss the effects of trauma and sepsis on the metabolism of energy, protein, carbohydrate and fat Cancer cachexia - To describe the causes and consequences of cancer cachexia - To understand the methods used for the investigation of metabolism in cancer patients - To discuss the effects of cancer on the metabolism of energy, protein, carbohydrate and fat Nutritional support (food, supplements, enteral and parental) - To describe conditions where nutritional support is required, and the relevant nutritional support options. - To evaluate recent evidence from clinical trials for specific current nutritional interventions - To identify practical issues relating to the administration of oral, enteral and parenteral nutritional support 24 - To identify the nature of adverse outcomes, including re-feeding syndrome, and how these may be prevented and treated Management of cancer cachexia 2. Diet and the Gut Oesophagus, stomach, small intestine and colon - To understand / revise the structure of the compartments of the gut - To understand / revise the functions of the compartments of the gut - To identify the nutritional consequences of loss of gut function (e.g. gastrectomy, coeliac disease, inflammatory bowel disease) - To identify the nutritional management of loss of gut function (e.g. gastrectomy, coeliac disease, inflammatory bowel disease) Liver - To understand how physiology is disturbed in liver disease - To understand the functions of the liver – synthesis, storage, excretion, detoxification - To briefly review common liver diseases - To discuss what role dietary intervention has in the management of liver disease - To understand why nutritional impairment is a feature of chronic liver disease Gut hormones Bariatric surgery 3. Metabolic syndrome and cardiovascular disease Obesity - To summarise methods of measurement of obesity and understand criteria for diagnosis - To identify the potential therapeutic interventions (dietary, lifestyle, drug and surgery) and the situations when each is used in current practice, their limitations and the evidence for their efficacy - To identify potential new therapies in the near future Hyperlipidaemia - To understand the causation, nature and consequences of the common and less common forms of hyperlipidaemia. - To evaluate the efficacy of drug and non-drug interventions and develop a critical approach to the scientific evidence for these - To summarise current guidelines on blood lipid management and other cardiac risk factors and be aware of any current controversies regarding lipid management Diabetes - To understand criteria for diagnosis and classification - To summarise recent diabetes management guidelines - To evaluate the potential therapeutic interventions (dietary, lifestyle and drug) and the situations when each is used in current practice, their limitations and the evidence for their efficacy - To identify potential new therapies in the near future Hypertension - To summarise current hypertension classification and recent changes - To summarise recent hypertension management guidelines - To identify the options for dietary and non-dietary interventions in hypertension management 25 - To evaluate the level of evidence and key clinical trials supporting the role of diet in prevention and treatment of hypertension Diet and renal disease - To summarise dietary and non-dietary causation of renal disease and potential for therapeutic manipulation - To evaluate the role for dietary therapy in renal disease, especially in conjunction with dialysis and transplantation. - To identify how diets in renal patients are managed on a daily basis. 26 4. NUTRITION RESEARCH SKILLS 7BBN0005 Credit value: 20 credits Assessment: Two sets of practical write-ups (40% each); statistics workbook (10%); on-line statistics tests (10%). Aims: To develop practical skills that are relevant to nutritional research; To develop an understanding of the principles of research design and the analysis and interpretation of scientific data at postgraduate level. Learning outcomes: At the end of the module the student will: be familiar with techniques used to assess nutritional status of individuals and populations; be familiar with methods used to analyse the composition of foods; be able to plan, conduct and report on investigations in the laboratory in a responsible and safe manner; be able to record, collate, analyse and interpret data using appropriate quantitative and statistical methods. Content: Laboratory Practicals Introduction – calculations, pipetting, spectrophotometry Weighed food intake and nutrient analysis Effect of food processing on Vitamin C GLC of fatty acids Bomb calorimetry Kjeldahl Urine minerals Blood lipids Haemoglobin, haematocrit, erythrocyte glutathione reductase activation coefficient HPLC of fat soluble vitamins Anthropometry Appetite, satiety and blood glucose Statistics (lectures plus practicals) Summarising and presenting data Populations and samples Probability, confidence limits and statistical inference Statistical tests: t-tests, Mann-Whitney, Wilcoxon, sign, chi-square, correlation, regression, one-way analysis of variance 27 5. MSc NUTRITION RESEARCH PROJECT 7BBN0001 Credit Value: 60 credits Assessment: dissertation (80%), supervisor’s assessment of student performance (20%) Aims: To develop research skills by carrying out a supervised research project; To develop detailed understanding of one aspect of nutrition at the level of current research. Learning outcomes: At the end of the module the student will: be able to formulate a hypothesis and design an investigation to test it; be able to plan, conduct and report on investigations in the laboratory or in the field in a responsible and safe manner; be able to carry out relevant research techniques reliably, accurately and reproducibly; be able to record, collate, analyse and interpret data using appropriate quantitative and statistical methods; be able to manage their own time and activities effectively; have further developed problem solving skills; have further developed information retrieval and written communication skills. Content: Introductory lectures and seminars on research design, research ethics, questionnaire design and reference management, followed by supervised work on an individual project. 28