Presentations:
times (22 Oct (week 6) and 19
November-week 10), groups, format
clarify criteria-outline
presentation includes asking
and answering of questions
Format of test- 6 short answer questions (5
marks each)-class time- 60 minutes-date=6
Nov 2012- first six weeks of class (ie weeks 1
to 6 inclusive(lectures 1-6)- today is week 3)
CBDHA’s Nutrition Services department is starting a brand new volunteer
programme for their department called the Dial-to-Dine program. The purpose of
the program is to assist patients in choosing their menus for the week while they’re
in hospital. Many of our patients do not have a lot of family or friends visiting and
find it difficult to fill out their own menus. This means that they end up receiving
standard trays which can become pretty bland and boring after awhile. The Dialto-Dine menus offer a much larger variety for the patients.
We were hoping that some of your Nutrition students might be interested in doing
some volunteer work with this program. This would be something they could do
once a week on weekends for just a couple of hours. It is a fantastic opportunity
for the students to become acquainted with the hospital and how the Nutrition
Services Department works. The staff would provide an orientation to their
service and to the Dial-to-Dine program. It is also a great way for the students to
get used to interacting with different types of patients with a variety of dietary
requirements.
If anyone is interested in learning more about the program or would like to signup, please ask them to give Lisa McNeil-Campbell a call at 567-8160 or email
pcvolunteers@cbdha.nshealth.ca
Suggestion box
Question of the week
See lecture 2 for changed
definitions of functional food
and nutraceutical
The
Lecture 3- 24 September 2013
Type 1 Diabetes
Outline of today’s talk
I.
Pathology
II.
Socioeconomic factors contributing to the disease
III. Elementary nutritional approaches to be taken to
avoid and treat these diseases including foods
available to those at risk
IV.
First Nations and other Cape Breton individuals at
risk
V.
How is nutritional assessment made for type I
diabetes?
VI.
How would one assess from a nutritional perspective
the socioeconomics, pathology and success of
nutritional interventions relative to type I diabetes?
Type I diabetes
I. Pathology
Autoimmune response that b-cells in the
pancreas
b-cells produce insulin
Cow’s milk, viruses, nitrosamines may
all attack b-cells
Food and hence nutritional choices depend on:
Personal preference
acceptance of certain foods
Habit
-caregiver should be careful here- why?
Food and hence nutritional choices depend on:
Ethnic heritage or tradition
which groups would avoid the offending
foods?
Social interaction
impact of this on viral implications
-food borne
social interaction and communicable
viruses
Food and hence nutritional choices depend on:
Availability of food
if only offending foods available this can
be concern
food borne viruses may be an issue here
Convenience of food
prepared meats- are convenient but
many contain nitrosamines
Food and hence nutritional choices depend on:
Economy of food
-this may encourage type I diabetes
due milk being an inexpensive food
relative to formula
Positive and negative association
-child may have associations of milk
with pleasant experiences
-other examples
-negative- examples?
Food and hence nutritional choices depend on:
Emotional conflict
-comfort food-suggestions for this?
Values
-restrictions on prepared beef, pork may
lower incidence of type I diabetes
-contrast this point to values that allow
prepared beef, pork
Food and hence nutritional choices depend on:
Body image
if meats believed to be fattening then
may avoid these items
Advertising
food companies for milk and
nitrosamine containing foods spend lots
of money to promote via ease and price,
the use of such foods- how might such
tactics be overcome?
More on socioeconomic factors
Prestige
-occupational
food choices are better?
-societal perceptions
people listen about food choices
-education
-more highly educated read more
and make more informed
choices about food?
More on socioeconomic factors
Power
power to influence-what about the political
agenda here in Cape Breton-who
has influence over the political agenda
in Cape Breton regarding nutrition?
Income
given that incomes are on average lower
here in Cape Breton compared to some other
regions of Canada one may say that this
dictates certain food choices
More on socioeconomic factors
Wealth
Cape Breton-impact of economic transition
from industrial to knowledge based
Power
given that Cape Breton is less wealthy in
monetary terms than some other regions of
Canada-food choices may be less
More on socioeconomic factors
Education
tuition is higher in Nova Scotia than in other
parts of the country- this may make it
more difficult for persons to achieve a level of
education that would place them in a position
to make more informed choices about foods
More on socioeconomic factors
Social stratification
-ancestry
-gender-women in Cape Breton-cow’s milk
issue
-race-Aboriginals, Blacks
-ethnicity-immigration to industrial Cape
Breton
-mobility-ability to get to food sources
-mental and physical illness- mental illness
induced disbelief about what one is being
told can lead to type I diabetes
More on socioeconomic factors
Class
-uppers
-lower uppers
-upper middles
-average middles
-working class
-lower class
discussion impact on type I diabetes
More on socioeconomic factors
Global economy
poor becoming poorer- issue of viruses and
b cell attacking chemicals
Government
•
running nutritional assessment programmes
•
providing nutritional advice
•
providing food programmes
-how would this affect type I diabetes?
More on socioeconomic factors
Business
advertising, promotion of profits
Psychology
eg eating habits and social engagement
-cured meats in some cultures
History
in time of war-food availability and quality
How would each of these 3 affect type I diabetes?
Elementary nutritional biochemistry of
nutritional approaches that use foods
available to those at risk
Planning a healthy diet
To do this bear in mind
Adequacy
Balance
Energy control
Nutrient density
Moderation
Variety
Elementary nutritional biochemistry of
nutritional approaches that use foods
available to those at risk
Prevention-cows milk, nitrosamines, viruses
Post-onset-eat at times synchronised with
action of insulin
-monitor blood glucose levels
-adjust insulin levels for
amount of food usually eaten
and required
Elementary nutritional biochemistry of
nutritional approaches that use foods
available to those at risk
Post-onset
-carbohydrate-glycemic index not an issue
-fibre-glycemic index is not an issue
-fat-not an issue- in those with similar blood
fat levels to non-diabetics
-alcohol-blocks gluconeogenesis-hypoglycemia
-sodium-hypertension not an issue
-vitamins and minerals-not indicated as
supplements
Elementary nutritional biochemistry of nutritional
approaches that use foods available to those at risk
Post-onset-obesity
-protein-convert to carbohydrate
depends on insulin resistance
IV. First nations and other Cape Breton
individuals at risk.
Aboriginals
Retired
Unemployed
Genetics
Others?
How is nutritional assessment made for type I
diabetes?
Nutrient intake analysis
studies can be done where food eaten
is observed and assess for nitrosamines,
cows’ milk and viruses
How is nutritional assessment made for type I
diabetes?
Daily food record/Diary
studies can be done where food eaten
is observed and assess for nitrosamines,
cows’ milk and viruses
How is nutritional assessment made for type I
diabetes?
Retrospective data
food frequency questionaire
24-hour recall
do both to act as cross check
against each other
assess nitrosamines, cows’ milk and
viruses
How is nutritional assessment made for type I
diabetes?
Anthropometry
weight loss is the main issue herewhy?
How is nutritional assessment made for type I
diabetes?
Nutrition focussed physical exam
-does not apply significantly to type
I diabetes
How is nutritional assessment made for type I
diabetes?
Skin testing
may come into play for understanding
what has caused the type I diabetes-ie
exploring for autoimmune response and what
might trigger it or have triggered it- this is
probably an unlikely approach- why?
How is nutritional assessment made for type I
diabetes?
Biochemical analysis
blood glucose-fasting
-post-prandial
glycated hemoglobin- only
after 3 months-fasting
How is nutritional assessment made for type I
diabetes?
CLASSIFYING MALNUTRITION
weight loss a possibility
VI. GROUP DISCUSSION-HOW WOULD
ONE ASSESS FROM NUTRITIONAL
PERSPECTIVE THE SOCIOECONOMICS,
PATHOLOGY AND SUCCESS OF
NUTRITIONAL INTERVENTIONS
RELATIVE TO TYPE I DIABETES ?