Handbook ERN3120
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1. Introduction
2. Reading material useful contacts in the Nutrition Department
3. Semester leaders, lecturers, PBL leaders and
4. Obligatory elements of the course, and course evaluation
5. Details of lecture-weeks
6. Special diets
7. Timetable
Internet address for Department of Nutrition: http://www.med.uio.no/imb/nutri/index.html
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The course
‘Minerals, vitamins and clinical nutrition’
takes place in the spring semester, starting January 5 2005 and lasting for 21 weeks. It is worth 30 study points.
The course finishes with a 6-hour written exam (June 13 2005) assessed by grades
(passes A-E).
The course is broader than the short title suggests. As well as covering all the essential vitamins and minerals, it deals with a variety of so-called micronutrients, i.e. compounds (mainly from plant-based foods) that are not essential but are believed to be beneficial to health. On the other hand, components of food can be harmful, and food toxicology is the subject of a set of lectures. The influence of nutrition on immunology, and allergies, are included in this course, as well as nutrition and physical exercise, and the special nutritional needs of different sections of the population.
There is a strong emphasis on clinical nutrition, with lectures from clinical pracititioners, and practical experience in different aspects of nutrition in specialist clinics. Special feeding techniques, monitoring and measuring procedures are demonstrated. A course on nutrition and cancer includes practical work in the laboratory. Finally, students will be expected to research and debate controversial and topical issues in nutrition, and should acquire experience in judging, and explaining, the scientific merits (or otherwise) of nutritional issues.
To summarise, teaching will take the form of lectures, PBL-assignments, literature searches and reporting, practical experience in the clinic and the laboratory, group work and seminar presentations. The course is organised as blocks of one or two weeks on a particular topic. Certain elements of the course are obligatory, and must be completed before proceeding to the examination (see section 4).
Brief descriptions of these topics follow, together with specific learning goals.
The following reference and text-books are recommended:
Shils, M.E., Olson, J.A. & Shike, M. (1998) Modern Nutrition in Health and
Disease , 9 th
edition, Lea & Febinger, Philadelphia, PA, USA (ISBN 0-8121-1485-X)
Garrow, J.S., James, W.P.T. & Ralph, A. (2000) Human Nutrition and Dietetics , 10 th edition, Churchill Livingstone, Edinburgh, UK. (ISBN 0-443-05627-7)
Mahan, L.K., Escotte-Stump, S. (2004) Krause’s Food Nutrition and Diet Therapy ,
11 th
edition, Elsevier USA (ISBN 0-7216-9784-4)
Thomas, B., Manual of Dietetic Practice , 3 rd
edition, Blackwell Publishing, Oxford,
UK (ISBN 0-632-05524-3)
Statens Ernæringsråds
Retningslinjer for Kostholdet i Helseinstitusjoner
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Bjørneboe, G-E. Aa. and Drevon, C.A. (1999)
Mat og Medisin, HøyskoleForlaget
AS, Kristiansand
Nordiska Näringsrekommendationer
(1996) (NNR), Nordisk Ministerråd Forlagshus
Nord 1996:28 (skrevet på svensk) (229 sider).
Dietary Reference Intakes (DRI) - see http://www.nal.usda.gov/fnic/etext/000105.html
In addition, other more specialised books are listed in connection with some lecture courses; they may be worth buying if you are especially interested in the topic, but check with the lecturer first. You may be able to borrow the book.
Review and research articles (provided as reprints or available via the Internet) may be suggested by lecturers, either as background to lectures or as material for assignments.
Semester leaders:
Professor Andrew Collins
(Room 2197)
Email: a.r.collins@medisin.uio.no
and
Tel. 22 85 13 60, 92 24 81 53 (mobile)
University Lecturer Kristin R. Kardel
(Room 2185)
Tel. 22 85 13 43, 99 01 02 44 (mobile)
Email: k.r.kardel@medisin.uio.no
Responsible for teaching blocks:
Nutrition biology
Liv Austenaa (LA)
Kirsti Bjerkan (KB)
Rune Blomhoff (RB)
Andrew Collins (AC)
Mária Dušinská (MD)
Asim Duttaroy (ADR)
Per Ole Iversen (POI)
Svein Olav Kolset (SOK)
Tone Omsland (TO)
Jan I Pedersen (JIP)
Bjørn Skålhegg (BS)
Giske Ursin (GU)
Clinical nutrition
Åse Andresen (AA)
Liv Førli (LF)
Anne Ulla Gjøen (AUG)
Ragnhild Haaland (RH)
Kristin R. Kardel (KK)
Astrid Løvik (AL)
Inger Elisabeth Moen (IEM)
Vigdis Brit Skulberg (VBS)
Malene Slott (MS)
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PBL leaders:
Marit Hilsen: marit.hilsen@studmed.uio.no
Tlf:51369
Ågot Lia Amundsen: a.l.amundsen@medisin.uio.no
Tlf: 51342
Ingrid Fange: ingrid.fange@fhi.no
Tlf: 91103428
Nutrition Teaching Committee (Undervisnings utvalget):
Halvor Holm: t.h.a.holm@medisin.uio.no
, Tlf: 51335, Rom: 1182
Margareta Wandel: margareta.wandel@medisin.uio.no
, Tlf: 51370, Rom 3134
Kerstin Trygg: kerstin.trygg@medisin.uio.no
, Tlf: 51373, Rom 3137
Bjørn Skålhegg: bjorn.skalhegg@medisin.uio.no
, Tlf: 51548, Rom 3104
Tone Omsland: t.k.omsland@ernstud.uio.no
, Tlf: 51552, Rom 4114
Cathrine Flesche: cathrine.flesche@basalmed.uio.no
, Tlf: 51340, Rom 2185
Anne Irene Larsen: a.i.larsen@medisin.uio.no
, Tlf: 51356, Rom 2200
Studentrepresentanter: Kristiane Søyland Hjelkrem: k.s.hjelkrem@ernstud.uio.no
,
Heidi Ruud: h.k.ruud@studmed.uio.no
How to find information:
Instructions on how to use the StudentWeb can be found at: http://www.uio.no/studier/studentweb/hjelp/index.html
In order to be included in the email list for this class, and to receive information that is sent to the students, it is important that you register and receive a student email address in the Nutrition Department, if you have not already done so. This is done in the Information Centre, 1 st floof, Domus Medica, through Silje Rosseland who is the responsible for IT matters.
We recommend that all students read their emails regularly (at least 3 times per week), as this is the main information channel from lecturers and others involved in teaching to the students.
Other addresses:
Student IT in the medical faculty : http://www.med.uio.no/medfak/it/student/
Student IT in the University of Oslo: http://www.usit.uio.no/it/student/
There is a lot of useful information for anyone spending time as a student in
Domus Medica at: http://www.med.uio.no/imb/studier/faq.html
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PBL assignments
All PBL assignments are compulsory, as they are in Oslo96. There are 6 PBL assignments in this course, each consisting of two sessions in a week. In exceptional circumstances, one week may be missed.
Literature assignments
Eight lecture courses have associated literature assignments, which normally involve reading specified scientific papers and giving an oral presentation. They are compulsory, and if you are absent for any reason, you will be expected to read the papers and produce a written account at a later date, by arrangement with the lecturer.
Laboratory project
A practical laboratory exercise is an integral part of the lecture course on ‘Cancer and nutrition’. You will be expected to attend the laboratory and to prepare a written report on the project.
Seminar
‘Topical issues in nutrition’ is the theme of the last week before the revision week.
You will prepare short talks on selected topics, for presentation at a seminar which will be open to members of the Department of Nutrition.
Mid-semester assignment
During the first half of the semester students will work on individual research or literature assignments under supervision of a member of the academic staff. The written reports (to be handed in by the end of March) will be assessed.
Examination
The final examination on June 13 will be a written test lasting for 6 hours. The deadline for signing up for the examination on the StudentWeb is March 15.
Evaluation of the course
A formal evaluation of the teaching will take place on four occasions during the semester. For dates, see the timetable below.
Written and oral assignments, including the examination, may be in either Norwegian or English.
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This group of vitamins comprise thiamin, riboflavin, niacin, folate, pyridoxin, vitamin
B
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, pantothenic acid, biotin and vitamin C. They have a wide variety of actions in the body, acting as co-factors for enzymes in a great many metabolic reactions. In addition, vitamin C acts as a general antioxidant. As they are water-soluble these vitamins are generally not stored but need to be frequently replenished. The uptake, metabolism and role of each will be discussed, together with the dietary sources, recommended daily intakes, and the consequences of very low or very high intake.
Learning goals:

Knowledge of the biochemisty and function of each of the vitamins in the body.

Consideration of uptake, metabolism and excretion.

Sources in food, daily intake recommendations.

Consequences of deficiency or excess.

Influences of methods of storage and preparation of food on vitamin content.
Literature:

Shils et al.
, Modern Nutrition in Health and Disease

Garrow et al.
, Human Nutrition and Dietetics
 Mat og Medisin

Dietary Reference Intakes (DRI)
Vitamin A, a lipid-soluble vitamin, is formed by cleavage of certain carotenoids, and is therefore obtained as pro-vitamin A from a range of green and orange fruits and vegetables. It is important as a chromophore in the retina, and also acts as a regulator of transcription of genes encoding proteins involved in embryogenesis, differentiation, reproduction, hematopoiesis and the immune response. Vitamin A deficiency affects over 100 million children in the developing world. Vitamin A is used in the treatment of certain forms of cancer. A high intake of vitamin A from supplements has in some studies been associated with an increase in the risk of osteoporosis.
Learning goals:

Absorption, transportation, metabolism, storage and degradation of vitamin A.

Role of vitamin A in the visual process.

Regulation of gene expression by vitamin A.

Sources of vitamin A in the diet; recommended intake.

Effects of deficiency; practical measures to correct deficiency.

Vitamin A toxicity.

Vitamin A and cancer; vitamin A and osteoporosis.
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Literature:

Shils et al.
, Modern Nutrition in Health and Disease

Garrow et al.
, Human Nutrition and Dietetics

Mat og Medisin
 Nordiska Näringsrekommendationer
 Dietary Reference Intakes (DRI)

Soprano, D.R. et al . (2004) Retinoic acid receptors and cancer, Annu. Rev.
Nutr.
24 , 201-221.
During respiration in the mitochondria, a small proportion of the oxygen is released as a particularly reactive form – superoxide – which, after conversion to the hydroxyl free radical, can oxidise biological molecules including lipids, proteins and nucleic acids. This damage may contribute to cardiovascular disease, cancer and other serious diseases, and it is also thought to be a factor in aging. Cells have potent antioxidant defences, augmented by micronutrients from the diet, particularly vitamin E (αtocopherol). Vitamin E is lipid-soluble, is transported in plasma lipoproteins, is an integral part of cell membranes, and accumulates in fat-stores.
Learning goals:

Oxidative damage and protection by antioxidants.

Biochemistry of vitamin E.

Uptake, transport and storage of vitamin E.

Vitamin E and gene expression.

Role of vitamin E in maintaining health.
Literature:

Shils et al.
, Modern Nutrition in Health and Disease

Duttaroy A et al. (1994) J. Nutr. Biochem. 5, 562-570

Azzi A (2004) Eur. J. Nutr. 43, suppl. 1, 18-25.
Vitamin D has a crucial role in calcium uptake and homeostasis. Vitamin K is involved in regulation of clotting protein synthesis (part of the coagulation cascade) and also plays a part in preventing osteoporosis. Deficiency of vitamin D causes rickets (bone deformation in children) or osteomalacia in adults, both cured by exposure to sunlight or by cod liver oil. The role of calcium and vitamin D in osteoporosis and osteoporotic fractures is still unclear. Bone metabolism is central to this block of lectures.
Learning goals:

Vitamin D and vitamin K: sources, uptake, metabolism, requirements and recommended intakes.

Calcium metabolism and homeostasis; sources, absorption, requirements and recommended intakes.
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
Bone growth and remodelling; rickets, osteomalacia and osteoporosis.
Literature:

Shils et al.
, Modern Nutrition in Health and Disease

Garrow et al.
, Human Nutrition and Dietetics

Other articles to be given with PBL assignment
The role of iron in oxygen transport is well understood. The absorption, transport, storage and excretion of iron need to be taken into account when considering the development of iron deficiency and iron overload. Iron requirements vary widely at different stages of life.
Learning goals:

Metabolism of iron (uptake, utilisation and loss).

Iron-containing proteins.

Iron balance and status

Sources in food: requirements.

Reasons for and results of iron deficiency and iron overload.
Literature:

Shils et al.
, Modern Nutrition in Health and Disease
Minerals and trace elements play an essential role in human health, although some may be required in very small amounts. Iron and calcium are dealt with elsewhere in the course. In this block, we will cover magnesium, zinc, selenium, copper, chromium and iodine; their sources in foods, bioavailability, metabolism, and mechanisms of action. The effects of deficiency and of excess, and the recommendations on levels of intake, will be discussed.
Learning goals:

Essential minerals and trace elements.

Absorption, metabolism and turnover.

Normal mechanisms of action.

Methods used to determine recommendations on intake.

Potential toxic effects.
Literature:

Shils et al.
, Modern Nutrition in Health and Disease

Garrow et al.
, Human Nutrition and Dietetics
 Nordiska Näringsrekommendationer
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Many components of food are not essential for life or normal development, but are regarded as beneficial in terms of promoting health or preventing disease. They include antioxidants (carotenoids, flavonoids etc.), probiotics, salicylates, coenzyme
Q and glucosinolates. The literature on effects of these compounds is confused and contradictory. A main aim of this block of lectures is to increase critical awareness, for example in assessing whether reported effects are biologically significant. The mechanisms by which micronutrients (and non-nutrients) can act will be dealt with in detail.
Learning goals:

Different types of micronutrients and their sources.

Possible modes of action of micronutrients.

The balance between beneficial and possible harmful effects of micronutrients.

Critical examination of evidence from laboratory and animal experiments and human studies on the effects of micronutrients.
Literature:

Shils et al.
, Modern Nutrition in Health and Disease

Garrow et al.
, Human Nutrition and Dietetics

Collins, A.R. & Harrington, V. (2002) Antioxidants; not the only reason to eat fruit and vegetables, Photochemistry Reviews 1, 167-174
The immune system, and thus our resistance to disease, is affected by nutrition in various ways. Nutritional deficiencies are known to impair the immune response, and increase the incidence and severity of infectious diseases including tuberculosis and
HIV. Food is responsible for many allergies, especially in children. The process of atherosclerosis is exacerbated by inflammatory cytokines, which can be produced in response to nutritional factors.
Learning goals:

The immune system; innate immunity; cell-mediated and humoral immunity.

Nutrient-immune reactions.

Allergies.

Roles of nutrition and immune response in specific diseases.
Literature:

Gershwin et al.
, Nutrition and Immunology, Humana Press

Yaqoob, P., Proc. Nutr. Soc . 63 , 89-104 (2004)
The emphasis is on malnutrition and undernourishment in industrialised countries, in at-risk groups and in the hospital setting. Lectures will cover the reasons for
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malnourishment and its consequences, ways of recognising and quantifying it, and strategies for treatment and prevention. There will be detailed instruction in the theory and practice of enteral nutrition.
Learning goals (undernourishment):

Definition, occurrence, extent and consequences of malnutrition in industrialized countries.

Patients/groups at risk of malnutrition and the reasons for malnutrition at individual level and in health institutions

Use of different anthropometric methods for monitoring and evaluation of malnutrition; calculation of energy, protein and fluid needs

Identification and treatment of undernourishment
Learning goals (enteral nutrition):

Different kinds of sip feeds and enteral nutrition solutions

Techniques and equipment used in enteral nutrition

Procedures for deciding the most suitable mixture for different diseases

Complications with enteral nutrition
 Monitoring the patient’s nutritional status and progress when using enteral nutrition

Common procedures for fluid and food intake immediately after gastrointestinal surgery

Minimal enteral feeding

Basic principles of refeeding syndrome
Literature:

Mahan and Escotte-Stump, Krause’s Food, Nutrition and Diet Therapy
 Thomas, Manual of Dietetic Practice

Mossberg T. (2001) Klinisk nutrition och vätskebehandling. Fresenius Kabi,
10. opplag, p 9-12 & p 41-45. (The booklet will be handed out at the lecture)
 McWhirter J.P. and Pennington C.R. (1994) Incidence and recognition of malnutrition in hospital. BMJ 308 , 945-948.

Soop M. et al. (2004) Randomized clinical trial of the effects of immediate enteral nutrition on metabolic responses to major colorectal surgery in an enhanced recovery protocol. Brit. J. Surgery. 91, 1138-45
Exercise in connection with competitive sports makes nutritional demands, not just for macronutrients to supply energy, but also for micronutrients, fluid intake and electrolytes. Appropriate nutrition is important before, during and after heavy exercise and competition, to ensure performance as well as restitution. Foods and supplements designed to improve sports performance are available commercially. Exercise can significantly alter nutrient metabolism, for example of protein and fats.
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Learning goals:

Factors affecting requirements for various nutrients associated with exercise.

Nutritional recommendations applicable to athletes engaging in competitive sports.

Nutrients to meet increased energy-requirements.

Requirements for micronutrients, minerals, fluids.

The process of restitution.
Literature:

Maughan RJ, Burke LM and Coyle EF (ed) (2004) Food, Nutrition and Sports
Performance II. The International Olympic Committee Consensus on Sports
Nutrition. Routledge, London. ISBN 0 415 33907 3 (pbk).

Burke L and Deakin V (ed) (2000) Clinical Sports Nutrition.. McGraw-Hill,
Australia. ISBN 0 074 70828 7.

Burke LM. (2003) The IOC consensus on sports nutrition 2003: new guidelines for nutrition for athletes. International J Sport Nutr Exerc Metab . 13 , 549-52.

American College of Sports Medicine, American Dietetic Association,
Dietitians of Canada. (2000) Joint Position Statement: Nutrition and athletic performance. Med Sci Sports Exerc. 32 , 2130-45.
The etiology and pathogenesis of celiac disease (gluten intolerance) lead naturally to consideration of dietary control of the disease. Lactose intolerance is dealt with similarly. Preparing and consuming a gluten- and lactose-free menu provides practical experience.
Cystic fibrosis is not a nutritional disorder, but nutritional counselling contributes to successful control of the disease, and to retarding its progression and morbidity.
Lectures explaining the background to the disease, and its complications, in children, adolescents and adults, are given at the Norsk senter for Cystisk fibrose (NSCF).
Learning goals (cystic fibrosis):

Etiology, incidence, prevalence, pathogenesis and diagnosis

Common symptoms of cystic fibrosis and accompanying diseases

Medical multidisciplinary treatment of cystic fibrosis

Growth and development in cystic fibrosis patients

Nutritional recommendations for and dietary treatment of cystic fibrosis

Optimal use of pancreatic enzymes in different individuals
Learning goals (celiac disease and lactose intolerance):

Etiology, incidence, prevalence, pathogenesis and diagnosis

Common symptoms

Teatment of and follow-up of patients

Teatment of patients with dermatitis herpetiformis

Theoretical background for the dietary recommendations and advice
 Procedure for refunding increased food costs from ”Trygdekontoret”
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
The Norwegian Celiac Association (NCF) as a source of information to celiac disease patients and relatives
Literature:

Mahan and Escotte-Stump, Krause’s Food, Nutrition and Diet Therapy

Thomas, Manual of Dietetic Practice
 Shaw V., Lawson M (ed) for the paediatric Group of the British Dietetic
Association: Clinical Paediatric Dietetics. Blackwell Scientific Publications
Ltd. (2001), Chap. 10 Cystic fibrosis p. 137-157.
 Sinaasappel et al. (2002) Nutrition in patients with cystisk fibrosis: a European
Consensus . J Cystic Fibrosis 1 , 51 - 57

Lundin K E A. Artikkel i TDNL 2003.
 Statens ernæringsråd: Retningslinjer for kostholdet i helseinstitusjoner ,1995
The range of gastrointestinal diseases includes dyspepsia, constipation, irritable bowel syndrome, inflammatory bowel disease, diverticulitis, Chron’s disease and ulcerative colitis. It also encompasses the short bowel condition following surgery. For all of these, there are specific dietary needs and/or recommendations. Enteral nutrition (see week 13) is necessary in some cases.
Learning goals (short bowel disease):

Etiology, incidence, prevalence, pathogenesis and diagnosis

Need for fluid substitution and water and electrolyte balance

Diet and nutritional treatment adjusted for bowel length/bowel section

Complications and malnutrition according to degree of absorption/digestion

Background to use of fat reduced diet

Positive and negative effects of a fat reduced diet
Learning goals (reflux/dyspepsia, constipation, inflammatory bowel disease, diverticular disease, Chron’s disease and ulcerative colitis):

Etiology, incidence, prevalence, pathogenesis and diagnosis

Relief of symptoms, especially mediated by food and lifestyle

Recommendations and dietary advice given to patients; basis in scientific evidence and clinical experience

Common kinds of medical and surgical treatment for these conditions

General and special knowledge about digestion and absorption in connection with different stoma (both temporary or definite)

Dietary treatment of patients with stomas
Literature:

Mahan and Escotte-Stump, Krause’s Food, Nutrition and Diet Therapy

Thomas, Manual of Dietetic Practice

Retningslinjer for kostholdet i helseinstitusjoner, 1995
 Asplund et al.(Eds) Internmedicin. Liber AB, Stockholm 2002.

Gassull MA and Cabre E. (2001) Nutrition in inflammatory bowel disease.
Curr. Opin Clin. Nutr. Metab. Care . 4 , 561-9.
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Food is a source of toxins as well as nutrients. Pesticide residues, food additives and environmental contaminants are a common source of concern, but there are also natural toxins (generally elements of plant protection against pests) and mycotoxins produced by contaminating fungi. Cooking and processing of food can also introduce toxins.
Learning goals:

Principles of toxicology, dose-effect relationships.

Natural toxins, mycotoxins and food mutagens; acute and long-term effects.

Environmental contaminants including heavy metals

Risk assessment; hazard identification, risk management and communication.
Literature:
Shils et al.
, Modern Nutrition in Health and Disease
Introduction to Toxicology and Food, Tomris Altug, CRC Press, 2003.
It is estimated that one in three cancers has a dietary cause – whether because of something present in food that induces or promotes carcinogenesis, or because of a lack of preventive agents. The common advice to eat 5 portions of fruits and vegetables per day to avoid cancer is based on epidemiological evidence, but the reasons for the protective effect remain obscure. This set of lectures ranges from molecular mechanisms to population studies, and includes laboratory practice and a literature survey.
Learning goals:

Molecular and cellular mechanisms underlying the process of carcinogenesis.

DNA damage, DNA repair, mutation, chromosome damage: biomarkers on the road to cancer.

Nutrition and cancer: the evidence from epidemiology.

Laboratory-based project – assessing DNA damage in humans.

Recent advances in cancer research: critical reading of the literature.
Literature:

Food, Nutrition and the Prevention of Cancer, WCRF/AICR,Washington DC,
USA, 1997

Nutrition and Carcinogenesis, Mutation Research Special Issue, Vol 551.
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Nutritional needs are not constant. They vary with life-stage, and also can be affected by lifestyle, cultural and ethnic characteristics of different population groups.
Learning goals:

Nutrition in pregnancy and for nursing mothers; babies and infants.

Nutrition for children and young people.

Special nutritional needs of immigrants.

Vegetarianism.

Nutritional problems associated with alcoholism.
Literature:

Shils et al.
, Modern Nutrition in Health and Disease

Garrow et al.
, Human Nutrition and Dietetics

Mat og Medisin
 Ernæringslære
While nutrition in the elderly can be justified as a distinct topic, it is important to recognise that they are an extremely heterogeneous group, ranging from fit and active to geriatric, and their nutritional needs vary accordingly. Under- and malnutrition are not uncommon, and can be the result of physical and psychological factors. Practice as a nutritionist/dietitian in nursing homes and home care services has particular challenges; the provision of adequate nutrition is rooted in Norwegian law.
Learning goals:
 The heterogeneous group known as ‘elderly’.

Importance of food and meals for the elderly.

Factors affecting diet and nutritional status.

Strategies to prevent under- and malnutrition.

Nutrition in nursing homes and home care services.
Literature:

Mahan and Escotte-Stump, Krause’s Food, Nutrition and Diet Therapy

Thomas, Manual of Dietetic Practice
 Hva er aldersdemens? (Nationalt kompetansesenter for aldersdemens og
Hukommelsesklinikken Ullevål universitetssykehus, 2002) – available at lectures
Many issues in nutrition are controversial, either because the science underlying them is equivocal, because they raise ethical questions, because commercial rather than nutritional interests are paramount, or because the public receive unbalanced or deliberately misleading information. Obvious examples include ‘organic’ or
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‘ecological’ foods, genetically modified organisms in food, commercial promotion of foods as healthy, and diets for slimming and health. In the future, we should be concerned about issues such as matching optimal nutrition to individual genotypes.
The week will include discussion on a selection of topical issues. (Since they are meant to be topical, they will not be announced in advance, and may include topics suggested by students.) Individual research on these topics will culminate in a halfday seminar during which opposing views will be presented.
Learning goals:

Awareness of various ethical and practical questions and problems in nutrition.

Critical appraisal of common nutritional beliefs – are they simply myths?

Ability to present and debate nutritional issues.
Literature:

Shils et al.
, Modern Nutrition in Health and Disease

Lawrence F., Not on the Label, Penguin (2004)
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Every student will try out two special diets during the course. For every special diet a written report will be produced and submitted by April 29. Delivery of reports is obligatory, and reports must be approved before students can proceed to the examination.
Diets:

Diet for lactose intolerance

Gluten-free diet
Each student will design the special diet for a fellow-student, taking into account the fellow student’s normal dietary preferences, and estimating her/his energy requirements. Each diet is to be eaten on three consecutive days including a Saturday or Sunday. Menus will be devised with the help of the programme ‘Mat på data’. In case for any reason a student cannot eat one or both diets, an application must be made at least 1 month before the examination, together with documentation (e/g/ doctor’s letter of explanation), to the Undervisnings utvalget.
Reports should include the following:
1. Background of the diet, and its applications.
2. Menus for the three days described with nutritional estimations (carried out before the diet is eaten).
3. Menus for all three days: choice of ingredients and quantities. Nutrient calculations, including both energy-giving foodstuffs, and content of minerals and vitamins.
Calculate both average and values for each day and compare the results with dietary recommendations. Which nutrient requirements were difficult to achieve? Which were straightforward?
4. Personal experience from the menu planning. Give an appraisal of aspects such as purchase, availability, taste, consistency, special ingredients/equipment and their sources, social context, and your subjective experiences of eating the diets.
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Responsible: Bjørn Skålhegg bjorn.skalhegg@basalmed.uio.no
Week
1
09:00
Mon 3.1 Tues 4.1 Wed 5.1 Thur 6.1
10:00
11:00
Introduction to course
AC, KK
Water-soluble vitamins; biochemistry, requirements, recommendations. Vits
B1, B2, B3, niacin.
BS
Biochemistry, requirements, recommendations. Vit B6, pantothenic acid, biotin.
BS
12:00
13:00
Fri 7.1
Biochemistry, requirements, recommendations. Folate, vits B12, C.
BS
Literature assignment;
Large daily doses of vitamin C.
SOK and
Kerstin Trygg
Week
2
09:00
10:00
11:00
Mon 10.1
Mechanisms of action of homocysteine as risk factor for cardiovascular disease
Kirsten Holven
Information about Midsemester assignment
BS, JIP, KK,
AC
Tues 11.1
Health effects of folate with focus on neural defects
Kirsten Holven
Folate – prevention of disease. Elin
Løken
Wed 12.1 Thur 13.1
13:00
Fri 14.1
Presentations
SOK and
Kerstin Trygg
Allocation of assignments
18

Responsible: Liv Austenaa l.m.i.austenaa@ernstud.uio.no
,
Rune Blomhoff rune.blomhoff@medisin.uio.no
Tues 18.1 Wed 19.1 Thur 20.1 Week
3
09:00
10:00
11:00
13:00
14:00
Mon 17.1
Vitamin A metabolism, sources in the diet, RDI
LA
Function of vitamin A in the visual process
LA
PBL groups
1, 2
PBL group 3
Regulation of gene expression by vitamin A
LA
Vitamin A in cancer
LA
PBL leaders: Liv Austenaa (group 1), Marit Hilsen (groups 2, 3)
PBL rooms: Group 1 – 2183; Group 2 – 2180; Group 3 – 2183.
Fri 21.1
Vitamin A deficiency
LA
Vitamin A toxicity
LA
PBL groups
1, 2
PBL group 3
19

Responsible: Asim Duttaroy asimd@medisin.uio.no
Tues 25.1 Wed 26.1 Thur 27.1 Week
4
08:30
09:30
10:30
12:00
16:00
Mon 24.1
Oxidative damage and antioxidant protection
ADR
Literature assignment
ADR
Biochemistry of vitamin E
ADR
Vitamin E uptake, transport and storage
ADR
Vitamin E and gene expression
ADR
Role of vitamin E in maintaining health ADR
Presentations
Fri 28.1
20

Responsible: Jan I Pedersen j.i.pedersen@medisin.uio.no
,
Asim Duttaroy asimd@medisin.uio.no
Week
5
08:30
Mon 31.1
Vitamin K
ADR
Tues 1.2
Vitamin D
JIP
Wed 2.2
Calcium
JIP
Thur 3.2 Fri 4.2
Calcium
(cont.d)
JIP
10:30 Evaluation of course
AC, KK
12:30
Week
6
08:30
Mon 7.2
PBL, groups
2, 3
Tues 8.2
Rickets, osteomalacia,
Osteoporosis
Jan
Gordeladze
Wed 9.2 Thur 10.2
Risk factors for osteoporosis
Haakon Meyer
Fri 11.2
PBL, groups
2, 3
10:00 PBL, group 1
10:30
PBL, group 1
11:30
PBL leaders: Jan I Pedersen (group 2), Jan Gordeladze (groups 1, 3).
PBL rooms:
Monday: Group 1 – 2183; Group 2 – 2227b (DM); Group 3 – 2183.
Friday: Group 1
– 2227b (DM); Group 2 – 1128 (DM); Group 3 – 2227b
(DM).
21

Responsible: Per Ole Iversen poiversen@hotmail.com
Week
7
08:30
Mon 14.2
Metabolism of iron
POI
Tues 15.2
Iron requirements; iron and special groups
POI
Wed 16.2 Thur 17.2
10:30 PBL, groups
1, 3
12:30 PBL, group 2
14:30
PBL leaders: Per Ole Iversen ,
Ågot Lia Amundsen
PBL rooms;
Group 1
– 2180; Groups 2 and 3 – 2183.
Fri 18.2
Iron deficiency; iron overload
POI
PBL, groups
1, 3
PBL, group 2
22

Responsible: Andrew Collins a.r.collins@medisin.uio.no
Week
8
08:30
Mon 21.2
General introduction;
Zinc
AC
Tues 22.2 Wed 23.2 Thur 24.2
Selenium;
Iodine
AC
10:30
12:30
PBL, group 1 Chromium and copper
AC
PBL, group 2
PBL, group 3 14:30
16:30
PBL leader: Andrew Collins. Room: 2183.
Fri 25.2
Magnesium
AC
PBL, group 1
PBL, group 2
PBL, group 3
23

Responsible: Andrew Collins a.r.collins@medisin.uio.no
Week
9
08:30
Mon 28.2
Antioxidant and other mechanisms
AC
Tues 1.3 Wed 2.3
Flavonoids, phytoestrogens AC
Thur 3.3
Folate, salicylates, coenzyme Q etc. AC
10:30 Carotenoids
AC
Glucosinolates probiotics and prebiotics AC
12:30
14:30
Literature assignment
Fri 4.3
Literature assignment
24

[+ Additional lecture on folate epidemiology from week 2, on Friday March 18]
Responsible: Asim Duttaroy asimd@medisin.uio.no
Week
10
08:30
09:00
Mon 7.3
The immune system BS
Tues 8.3
Dietary lipids and immunity
ADR
Wed 9.3 Thur 10.3
Obesity/ diabetes and immunity
CAD
Fri 11.3
10:30
12:00
Literature assignment
ADR
Immunity in elderly populations – role of nutrition
Presentations
16:00
Week
11
08:30
09:30
10:30
12:00
Mon 14.3
Food and allergy Per
Brandtzaeg
Breast milk and immunity
Per
Brandtzaeg
Literature assignment
ADR
Tues 15.3
Nutrition and
AIDS
Knut Inge
Klepp
Wed 16.3
Antioxidants and immunity
Harald
Carlsen
Thur 17.3 Fri 18.3
Epidemiology of folate Helga
Refsum
Evaluation of course
AC, KK
Presentations
16:00
Students will work in pairs on the literature assignments. One of each pair will give the presentation on Thursday in the first week, and the other will give the presentation on the second Thursday.
Week 12: Easter
25

Responsible: Kristin R Kardel k.r.kardel@medisin.uio.no
Liv Førli, Malene Slott/Åse Andresen (Wed) Room D1 2082 (RH)
Ragnhild Haaland (Thur-Fri) Aud. KAM (UUS) – through front entrance
Other lecturers:
Bjørn Hofstad, Ellen Schlicting, Lisa Tobiassen
Week
13
09:15
10:15
11:15
11:30
Mon 28.3
Easter
Monday
Tues 29.3 Wed 30.3
Undernourishment LF
Nutritional treatment ÅA
Thur 31.3*
Introduction to enteral nutrition
RH
Post-operative enteral nutrition Ellen
Schlicting
(60 min)
Nutritional requirements, types of tube feeds RH (30 min)
Fri 1.4
Percutaneous
Endoscopic
Gastrostomy
(PEG)
Bjørn Hofstad
Overview of sip feeds
Lisa
Tobiassen
Sensory evaluation of sip feeds
Lisa
Tobiassen
12:00
12:30
13:00
13:15
13:30
Lunch
Nutritional treatment cont.d ÅA
Case studies
LF
Lunch
Refeeding syndrome RH
(40 min)
14:00
14:30
A patient’s perspective
RH (30 min)
Visit to
Endoscopy/
Gastro lab to see procedures
RH (60 min)
Lunch
Case studies
RH (60 min)
15:00
* NB The end of March is the deadline for completion of the mid-semester written assignments
26

Responsible: Kirsti Bjerkan kirsti.bjerkan@diabetes.no
Week
14
Mon 4.4 Tues 5.4 Wed 6.4 Thur 7.4
08:30
09:30
10:30
11:30
Energy-giving nutrients; carbohydrates fat and protein; before, during, and after exercise.
Recommendations for athletes
Assignment
Micronutrients; recommendations for athletes
Sports foods and sports supplements; recommendations for athletes
Sports food and sports supplements: demonstration
Fluid and electrolyte requirement and recommendations
Recovery from training and competition
Fluids; practical exercise KB
Fri 8.4
Presentations
Summing up
KB
27

Responsible: Kristin R Kardel k.r.kardel@medisin.uio.no
Inger Elisabeth Moen (Mon), Norsk senter for cystisk fibrose, Bygn. Q 2
(UUS)
Astrid Løvik (Tues, Wed), Room D1 2082 (RH); (Fri), Kjøkken, Avd. for
Ern. Fys. (RH)
Other lecturers: Per K. Knudsen, Knut E.A. Lundin
Week
15
09:15
Mon 11.4
Cystic fibrosis
Per K
Knudsen
Tues 12.4
Celiac disease
& lactose intolerance
Knut E A
Lundin
Wed 13.4
Nutritional treatment of celiac disease
AL
Thur 14.4 Fri 15.4
Gluten-free diets; practical lecture
AL
10:15 Nutritional treatment of
CF IEM
11:15
12:00
Nutritional treatment cont.d IEM
12:30 PBL, groups
2, 3
PBL, group 1
Case studies
AL
PBL, groups
2, 3
14:00 PBL, group 1
15:30
PBL leaders:
Astrid Løvik (group 2); Ingrid Fange (groups 1, 3)
PBL rooms:
Tuesday: Group 2 – D1 2082 (RH); Groups 1, 3 – 2183.
Friday: Group 2
– Kjøkken (RH); Groups 1, 3 – 2183.
28

Responsible: Kristin R Kardel k.r.kardel@medisin.uio.no
Astrid Løvik (Mon) D1 2082 (RH); (Tues) D3 3001 (RH)
Anne Ulla Gjøen (Thur-Fri) (UUS) – details to follow
Other lecturers:
Bjørn Hofstad, Anne Jønsvik, K.J. Labori, Vemund Paulsen,
Camilla Solberg, Morten Vatn
Week
16
09:15
10:15
11:15
Mon 18.4
Short bowel disease
Morten Vatn
Tues 19.4 Wed 20.4 Thur 21.4
Case studies
AL
Reflux/dyspepsia Vemund
Paulsen
Obstipation
Bjørn Hofstad
Nutritional treatment
AUG
Fri 22.4
Chron’s disease & ulcerative colitis Camilla
Solberg
Operative treatment of
IBD KJ Labori
Nutritional treatment
AUG
12:00
12:30 Nutritional treatment
AL
13:30 Fat-reduced diets AL
Nutritional treatment cont.d AUG
Diet and stomas AUG
How to to treat stomas Anne
Jønsvik
14:30
29

Responsible: Andrew Collins a.r.collins@medisin.uio.no
Lecturer: Mária Dušinská maria.dusinska@szu.sk
Week
17
08:30
Mon 25.4
General principles of toxicology
MD
Tues 26.4 Wed 27.4
Natural toxins in food
MD
Thur 28.4
Environmental contaminants, heavy metals
MD
Fri 29.4
Risk analysis and management
MD
10:30
12:30
Mycotoxins and other food mutagens
MD
Literature assignment
14:30
NB Reports of special diets are to be handed in by Friday April 29.
Literature assignment
30

10:30
12:30
14:30
16:30
Responsible: Giske Ursin giskeu@medisin.uio.no
,
Andrew Collins a.r.collins@medisin.uio.no
Week
18
Tues 3.5 Wed 4.5
08:30
10:30
12:30
15:00
Mon 2.5
Introduction
Literature assignment
Jan Øyvind
Moskaug
Evaluation of course
AC, KK
Lab. project
Group 1
DNA damage and repair AC
Lab. project
Group 2
Nutrition and cancer GU
Lab. project
Group 3
17:00
Thur 5.5
Whitsun
Week
19
08:30
Mon 9.5
Specific cancers and nutrition GU
Tues 10.5 Wed 11.5 Thur 12.5
Molecular mechanisms
Jan Øyvind
Moskaug
Preparation of presentations
Microscope work
Presentations on literature assignments
Preparation of presentations
Microscope work
Fri 6.5
Fri 13.5
Presentations on literature assignments
31

Responsible: Svein Olav Kolset s.o.kolset@medisin.uio.no
,
Tone Omsland t.k.omsland@medisin.uio.no
Week
20
08:30
Mon 16.5 Tues 17.5 Wed 18.5 Thur 19.5
National day Lovisenberg
Hospital visit; nutrition and immigrants
Tonje Mellin
Olsen
Nutrition and pregnancy
Christine
Henriksen
10:15
10:45
12:30
Group assignment;
Diet in different immigrant groups
Small children; dietary intake and recommendations Nina
Øverby
Fri 20.5
Vegetarians
ADR
Alcohol and health SOK
13:00 Evaluation of course
AC, KK
32

Monday is continuation of course from week 20
– room 2183
Lecturers: Marianne Lindmark (Franbu
– Senter for sjeldne funksjonshemninger), Tonje Melin Olsen (Lovisenberg diakonale sykehus)
Responsible for rest of week: Vigdis Brit Skulberg vigdisbrit.skulberg@hev.oslo.kommune.no
Tues and Fri, Room 2183.
Wed and Thur, Helse- og velferdsetaten (Health and Welfare Authority),
Oslo City
– Stenersg. 1 – Inngang D, 5. etasje*.
Lecturers: ; Anette Hylen Ranhoff (UUS); Marianne Brønner (Helse- og velferdsetaten); Johanne Alhaug (Lovisenberg diakonale sykehus); Daisy
Tamber (GERIA, Oslo kommune).
Week Mon 23.5
21
08:30 Nutrition and
09:00 the handicapped
ML
10:00
10:30
11:00
11:15
Presentation of group assignments
TMO
Tues 24.5
Geriatrics
AHR
[to 10:45]
Nutrition services for elderly in the community
VBS
[to 11:45]
Wed 25.5
Information & introduction to visits to Senior
Centres
MB
Visits to
Senior
Centres
[to 15:00]
Thur 26.5
Summing up, experiences from visits to
Senior
Centres
MB
[to 11:30]
Fri 27.5
The dietitian & the geriatric patient JA
[to 09:45]
Dementia
DT
[to 10:45]
PBL, groups
1, 2
12:00
12:15
12:45
13:45
14:15
15:00
PBL, groups
1, 2
PBL, group 3
Nutrition in nursing homes
MB
[to 12:45]
PBL, group 3
15:15
PBL leaders: Vigdis Brit Skulberg (group 2); Ingrid Fange (groups 1, 3).
Tues: (12:15-13:45) Group 1
– Rm 2227b (DM); Group 2 – 2183.
(13:45-15:15) Group 3 – 2183.
Fri: (11:15-12:45) Group 1 – Rm 2227b (DM); Group 2 – 2183.
(12:45-14:15) Group 3 – 2183.
*Entrance is at rear of Oslo City shopping centre (on opposite side of road from Oslo Spektrum). Switchboard: 23 48 30 00
33

Responsible: Andrew Collins a.r.collins@medisin.uio.no
Week
22
08:30
Mon 30.5
Deciding on the issues; planning seminar
Tues 31.5 Wed 1.6 Thur 2.6
10:30
12:30
Fri 3.6
Student seminar (open to members of
Dept of
Nutrition)
34

Week
23
08:30
09:30
10:30
12:30
14:30
Mon 6.6
Revision week
15:00
Week
24
Mon 13.6
09:00 Examination
Tues 7.6 Wed 8.6 Thur 9.6
Tues 14.6 Wed 15.6 Thur 16.6
Fri 10.6
Fri 17.6
35