Dr. Darwin Dennison

      HEA 466 Therapeutic Nutrition

Course Description

HEA 466 is an online course. There are no face to face class meetings, however, there will be synchronous activity including tests scheduled periodically throughout the course. These activities will be scheduled from 1 to 3 hours, usually on Wednesdays late afternoon or early evening. All students must be available, complete tests or participate online during these synchronous meetings.

HEA 466enhances students’ knowledge regarding the role of food and nutrition and applying this knowledge to therapeutic diets. The course will include a study of the basic principles of nutrition including: nutrition in the community, the role of nutrients in the maintenance of normal health, and nutrition in the life cycle. Also included is the application of these principles for diet modification during illness. The course will enhance students’ knowledge regarding the role of food and nutrition and an application of therapeutic diets.  Course units will coordinate with the textbook to allow students with a limited background in nutrition-related sciences the opportunity to assimilate new information.

Content is organized around basic human needs, physiology and population trends. Students will have the opportunity to analyze their dietary habits and identify dietary deficiencies/excesses. A psychometric diet composite system (DINE Healthy: Diet Improvement Software) is required and used for assignments and projects.  This information will be organized in a format, which may empower individuals toward dietary change. Diet and Nutrition Therapy, the required text, provides detail for online nutrition related activities including, but not limited to chapter assignments, WebBoard discussion, Excel analyses, PowerPoint reports, and other Internet-based assignments.  HEA 466 satisfies the nutrition requirement for students entering health related professions.

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Course Policies and Agreement

During the first two days of class you must respond via Blackboard e-mail to attest that you have read the Course Policies and Agreement. You must send an e-mail in Blackboard, a simple “OK,” that you agree to the following six mandatory conditions of this class:

1. HARDWARE AND SKILLS.You must have daily access to a PC-based computer, Pentium 3 or higher with DSL or cable Internet connections. When you first log on to Blackboard please determine if your browser is ready for online use. If it is not ready, you must make it ready by completing the checklist on your screen. If you have difficulty please consult with tac@uncw.edu.  You must allow pop-ups on your browser to successfully complete the course. You should also have JAVA installed on your computer (go to www.sun.com to download the free version). You must use version 6 or higher. If you have questions regarding hardware and skills go to http://www.uncw.edu/online/techreq.html .  If you have difficulties during the course contact tac@uncw.edu, phone 962-HELP (962-4357).

2. TESTS. You understand that there will be multiple online tests, plus quizzes. All tests are timed; that is, you must complete the test in a designated number of minutes from the time you log on. Each test is scheduled on one day usually on Wednesdays, no exceptions. You can take the test any time within the scheduled period usually 1 to 3 hours. The tests are electronic and tests that are past due cannot be made up. In general, tests include data from the text, the labs, outside readings and assignments. Tests must be taken as an individual effort. Electronic surveillance methods are used to identify cheating and plagiarism through computer IP addresses, file resource numbers and specialized software.

3. ASSIGNMENTS. All assignment files must be electronically uploaded using the correct file format into Blackboard for full credit. Assignments sent via email in Blackboard or campus email do not receive credit. Late assignments do not receive credit. You understand that it is your responsibility to learn to download your assignments to your desktop, complete the assignment and then upload your completed assignments into Blackboard, on time and complete, for full credit. There are no exceptions. Posting assignments correctly with complete and accurate information on time is a determinant of your grade. All assignments are due as posted usually on Wednesdays. New assignments are posted Thursday or Friday. When the time period is closed, it is done. If you wait until the last day to complete your assignments, over time you will have crashes, the site will be down, and/or other issues may cause you to submit your assignments late and you will not receive credit or you will lose points. Submitting early is to your advantage.

4. SERVER DOWN/DRIVE CRASHED. You understand that there are information technology issues that you must personally deal with and resolve to successfully complete the course including but not limited to server being down, or viruses / crashes destroying your work before it is uploaded into Blackboard. It is your responsibility to backup your work and resolve any computer related issues so that your assignments and tests are submitted on time. You are advised not to wait until the deadline to submit your assignments, quizzes, or tests. If you wish to be safe from a technology standpoint, use UNCW microcomputer lab computers. Although Dr. Dennison is knowledgeable in technology, please keep in mind that his expertise is nutrition and that you must use UNCW information technology support (TAC) to answer navigation, browser, file management, and server related issues.

5. PARTICIPATION.You understand that the course professor can view your participation statistics, that is, how much time you spent online. You understand that if you have an issue that prevents you from being online for more than 3-days, you must provide rationale or risk being dropped from the class. Each week there are assignments due and/or tests. These tasks must be electronically submitted on or before the due date for credit. Electronic assignments that are past due cannot be made up.

6. E-MAIL. The assignments and procedures in this online class are designed to be clear and precise.  If you need to ask a question, you must use the Blackboard e-mail system. In Blackboard, go to Mail, Create Message, and then Browse for Recipients, select Darwin Dennison, enter message and select Send.

Agreement
If you agree with these conditions, simply send me an e-mail in Blackboard with an "OK" within 48 hours of the beginning date of the class OR within 48 hours of registering for the class. You will be dropped from the class if I do not receive your Blackboard e-mail. And, I reserve the right to drop you from the class if you do not agree with or consistently do not follow any of these conditions.

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Performance Indictors

1. Identify characteristics of the following models for planning diets including Recommended Dietary Allowances (RDA), USDA Food Guide Pyramid, Spark People, the Dietary Guidelines for Americans, and DINE Healthy.
   
2. Describe the mechanical and chemical digestion that occurs in the mouth, stomach, small and large intestines.
   
3. Identify the functions, classifications, food sources, and deficiency diseases of: carbohydrates, fats, proteins, vitamins, minerals and water.
4. Describe the role of various nutrition and nutrition-related professionals in health care.
5. Determine individual energy requirements, energy balance and nutritional homeostasis.
6. Relate social, psychological, and cultural factors to the development of personal food habits.
7. Identify the diet therapy as it relates to the definition and symptoms of the following conditions: weight management, stress management, gastrointestinal disorders, coronary heart disease and hypertension, diabetes mellitus, renal disease and cancer
8. Describe factors involved in metabolism and weight control, including causes of obesity, methods of assessing body weight and composition.
9. Explain differences between major and minor minerals, their functions in the body and food sources.
10. Explain the need for possible vitamin and mineral supplementation.
11. Discuss vitamin and mineral toxicity and deficiency syndromes.
12. State the benefits associated with physical activity and the components of a sound health/fitness program.
13. Explain the impact of nutrition and lifestyle choices on health throughout the lifecycle.
14. Explain the impact of nutrition and lifestyle choices in disease states.
15. Identify and discern nutritional facts and fallacies regarding food safety, food additives and diet programs and other consumer concerns.
16. Discuss proper food handling, storage and preparation.
17. Analyze knowledge gained for personal insight into the development of a personal nutrition care plan.

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Grading

Complete class assignments and upload into Blackboard assignment pages. Assignment score is based upon the completion of nutrition labs, reports, and course assignments. Points are not given for late assignments or e-mailed assignments. Partial credit may be given for incomplete assignments submitted on time.
Complete online tests during the testing period, no exceptions. Tests are scheduled from 1 to 3 hours usually on Wednesday late afternoon or early evening.
Final grade is based on average scores: including tests plus total assignment score.

Grading is based upon the final score: A 93-100, A- 90-92, B+ 87-89, B 83-86, B- 80-82, C+ 77-79, C 73-76, C- 70-72, D+ 67-69, D 63-66, D- 60-62, F 0-69.

Required Software

Student Version - DINE Healthy: Diet Improvement Software. You may purchase the DINE Healthy Diet Improvement Software student version, a full featured, electronically delivered version to complete course assignments. It may be installed on a single computer only and will remain accessible for 180 days from the date of registration. The software will run on PC-based computers and will not run on Macs.  A high speed Internet connection (DSL) or cable connection is required to download and use this software. You must select a computer that you have exclusive access.

Please Note: You may also download the software from Tealware or use the software in the Trask Computer Lab (119A). The software in the Trask Lab and on Tealware can be accessed without cost.

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Required Text

Peggy Stanfield and Y.H. Hui, Nutrition and Diet Therapy, (Check Bookstore for latest edition), Jones and Bartlett Publishers, ISBN-10: 0-7637-6137-0, 2010. Purchase the latest edition at the bookstore.

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Course Outline

HEA 466 Therapeutic Nutrition Course Objectives and Outline

Introduction

Major concepts and terms used in nutritional science.
Guidelines and rationale used for planning and evaluating food intake.
Major concerns about the American diet.
Appropriate sources and services to obtain reliable nutrition information.

Food Habits

1. Cultural, social, and psychological factors that influence food behavior.

a. Distinguish between biological necessity and cultural patterning.
b. Identify the use of food in a culture.
c. Explain the symbolism of food in a culture.
d. Identify the social influences of food in a culture.
e. Evaluate the psychological influence of food.

2. Determine the economic considerations that affect food intake.
3. Identify some common problems in the nutritional status of individuals in the United States.
4. Explain the ways that illness affects food acceptance.
5. Identify the dietary patterns of some ethnic, cultural, and religious groups in the United States.

Proteins

1. Identify the structure of proteins and their fuel value.
2. Define complete and incomplete protein and essential amino acids.
3. Discuss protein quality and the concept of limiting amino acids.
4. Describe the amino acid requirements of humans and their RDAs for protein.
5. Explain the method of measuring protein in the body.
6. Summarize the major functions and food sources of protein.
7. Analyze the all-or-none law in protein metabolism and the concept of protein sparing.
8. Recognize various vegetarian diet regimes and their relationship to adequate protein intake.
9. Compare the effects on health of inadequate or excessive protein intake.
10. Specify certain conditions where alteration in protein intake may be needed.

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Carbohydrates and Fats: Implications

Carbohydrates and Health

1. Identify the types of carbohydrates, their fuel value, and storage methods.
2. Summarize the major functions and food sources of carbohydrates.
3. Discuss nutritive and nonnutritive sweeteners.
4. Evaluate blood glucose level as an indicator of certain body conditions.
5. Define fiber and list its functions and food sources.
6. Discuss health problems associated with excess sugar or low-fiber intake.
7. Describe the effects of carbohydrate consumption on athletic activity.

Fats and Health

1. Classify fats and state their fuel value.
2. List the major functions and food sources of fats.
3. Discuss body utilization of essential fatty acids and cholesterol.
4. Explain the difference between saturated and unsaturated fatty acids and identify their food sources.
5. Evaluate storage of fat in the body and the relationship of fat to normal body weight.
6. Relate a body’s health to excess total fat intake and excess saturated fat intake.

Vitamins and Health

1. Describe the general characteristics of vitamins.
2. Identify the fat-soluble vitamins and list:

a. their functions
b. their food sources
c. the results of a deficiency or excess
d. the conditions requiring an increase
e. the specific characteristics of each

3. Identify the water-soluble vitamins and list:

a. their functions
b. their food sources
c. the results of a deficiency or excess
d. the conditions requiring an increase
e. the specific characteristics of each

4. State RDA/DRIs for selected vitamins and discuss amounts of foods needed to meet the requirements.
5. Discuss health risks associated with massive intake of vitamins to prevent or treat disease.
6. Evaluate the effectiveness of megavitamin intake.
7. Indicate population groups for whom vitamin/mineral supplements may be necessary.

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Minerals and Water

1. Explain the role of minerals in regulating body processes.
2. List the essential minerals and their major functions.
3. Describe the characteristics of the minerals and the difference between macro- and micro-minerals.
4. Identify major food sources of each mineral.
5. List the minerals for which there are RDAs and the amounts required to maintain health.
6. Discuss factors that affect the absorption of minerals.
7. Describe the clinical effects of a deficiency or excess of each mineral.
8. Summarize food-handling procedures that minimize mineral loss.
9. Identify the major sources and functions of water in the body.
10. Evaluate the routes by which water is lost from the body.
11. Explain how fluid and electrolyte balance is maintained.
12. Analyze the recommended practices to maintain fluid and electrolyte balance during athletic activity.

Meeting Energy Needs

1. Describe how energy is measured.
2. Define energy balance.
3. Identify the energy-producing nutrients and state their fuel value.
4. Calculate the calorie content of foods based on their carbohydrate, protein, fat, and/or alcohol content.
5. Relate food and activity to weight control.
6. List techniques for evaluating body weight.
7. Discuss methods for controlling body weight.
8. Evaluate the effects of under- and overnutrition.
9. State the health implications of being underweight.
10. Differentiate between overweight and obesity.
11. Analyze health problems associated with fad dieting and obesity.
12. Describe the differences between ideal versus healthy weight.
13. Determine weight by using the body mass index (BMI).

Nutritional Assessment

1. Identify some physical signs of malnutrition.
2. Describe tools used in the assessment of nutritional status, such as:

a. diagnostic tests (radiologic/laboratory data).
b. anthropometric measurements.
c. dietary history and recalls.
d. physical findings and sociological data.

3. Recognize some common nutrition problems, and propose corrective measures.
4. Be familiar with the responsibilities of health personnel in educating clients about nutritional needs.

Nutrition and Life Cycle

1. Identify factors that influence the course and outcome of pregnancy, with special reference to the client’s health history, nutritional status, and food habits.
2. Describe the nutritional needs of women during pregnancy and lactation.
3. Explain the recommended weight-gain pattern for a pregnant woman.
4. List health concerns during pregnancy and lactation.
5. Summarize the nutritional needs of the neonate/infant.
6. Compare the advantages and disadvantages of breastfeeding.
7. Discuss the introduction of solid foods to an infant’s diet in relation to the sequence, process, and need for supplements.
8. Analyze the health concerns of the infant.

1. Describe the body changes that occur in the stages of:

a. Early childhood: toddler, preschooler
b. Middle childhood: school age to adolescence
c. Adolescence

2. Identify the nutritional needs of children and adolescents.
3. Discuss the health problems that often occur during childhood and adolescence.
4. Analyze areas of concern regarding eating behaviors of children and adolescents.
5. List ways to promote sound nutritional practices among children and adolescents.

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1. Describe the body changes that occur during the span of the adult years.
2. Identify the nutritional needs during early, middle, and late adulthood.
3. Explain the health concerns of early, middle, and late adulthood.
4. Analyze the psychosocial, physiological, and economic influences on eating behaviors.
5. Evaluate the importance of maintaining a regular exercise program throughout the adult years.
6. List the effects of drugs, including alcohol, on nutrients and health.
7. Propose measures to promote healthful eating habits during adulthood, especially the later years.

1. Describe the major health concerns of adulthood.
2. Identify the nutritional components of keeping fit.
3. Describe the key elements of an exercise program.
4. Discuss the effects of nutrition and controlled exercise.
5. Describe an effective dietary regime for a person interested in staying healthy into old age.
6. Recognize the biological, psychological, and sociological factors that promote stress.
7. Counsel patients on techniques of stress reduction, relaxation, exercise, and optimal nutrition at any stage of the life cycle.
8. Follow the principles of a healthy lifestyle.

Drugs and Nutrition

1. Describe the effects of drugs on the utilization of nutrients.
2. Describe the effects of nutrients on the utilization of drugs.
3. Identify food and drug incompatibilities.
4. Accurately assess a client’s response to food and drug interactions.
5. Provide specific instructions to clients regarding their diet and drug therapy.

Dietary Supplements

1. Describe how the 1994 Dietary Supplements Health and Education Act (DSHEA) changed the regulation of dietary supplements.
2. List the five criteria that define a supplement according to the DSHEA.
3. Explain the difference in a traditional dietary supplement and the present dietary supplement.
4. List three examples of a structure-function claim.
5. Describe how the FDA regulates claims made for advertising dietary supplements.
6. Identify at least five health claims made for ginseng, and five side effects that may be encountered from its use.
7. Identify the major uses of Ginkgo biloba and three possible side effects.
8. Describe five major health claims and five possible side effects of saw palmetto.
9. List five proposed benefits for valerian, and five possible side effects that can occur when valerian is taken for more than 2–3 weeks, or in large doses.
10. Discuss the interactions of supplements with medications.
11. Recognize fraudulent products.
12. Provide clients with information on reputable Web sites for information on supplements, and how to recognize unreliable sources.
13. Become familiar with the FDA’s enforcement in dealing with manufacturers of dietary supplements that make illegal health claims and pose danger to the consumers who use their products.

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Alternative Medicine

1. Identify five healing philosophies, approaches, and therapies not taught in medical schools.
2. Define complementary and alternative medicine (CAM):

a. Describe the five domains or categories of CAM.
b. List at least two examples in each domain and state the principal methods used in each.

3. Name at least five products or devices related to alternative medicine.
4. Describe the principle involved in using acupuncture as a complementary therapy in Western medicine.
5. Discuss ways to evaluate and provide reliable information to clients regarding the use of alternative medical treatment and practices.

Food Ecology

1. Describe the appropriate methods for the safe handling, storage, and preparation of food to prevent illness by:

a. recognizing agents that cause food-borne illness.
b. knowing ways to minimize contamination.
c. becoming familiar with regulations regarding the protection of food.

2. Describe the appropriate methods for handling, storing, and preparing food to conserve nutrients by becoming knowledgeable about:

a. nutrition labeling.
b. pasteurization, enrichment, and fortification of foods.

Overview of Basic Principles

1. Define the principles of diet therapy.
2. Explain the objectives of diet therapy.
3. Describe the methods used to adapt a normal diet to treat a specific clinical disorder.
4. Identify the most common therapeutic diets used in clinical care.

Special Topics in Diet Therapy

Surgical Conditions
Cardiovascular Disease
Ingestion, Digestion and Absorption
Diabetes Mellitus
Diet and Disorders of the Liver, Gallbladder and Pancreas
Renal Disorders
Cancer Patients and Patients with HIV Infections
Burns and Immobilized Patients
Eating Disorders and Anorexia Nervosa
Cystic Fibrosis
Celiac Disease
Congenital Heart Disease
Food Allergy
Phenylketonuria
Constipation, Diarrhea

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Students with Disabilities

If you have a diagnosed disability (physical, learning or psychological) which will make it difficult for you to carry out the course work as outlined, please advise me during the first two weeks of the course so we may review possible arrangements for reasonable accommodations. You must also contact and register with the Office of Disability Services in Westside Hall (ext. 3746) and obtain an Accommodation Letter.

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UNCW Honor Code

All tests and assignments are to be completed on an individual basis. Assignments and tests should be your own work exclusively and there should be no collaboration on assignments and tests. Questions regarding assignments and tests must be directed to the instructor of the course. You are not to send or receive or communicate in any manner, any information related to tests with any other persons. Please review the Honor Code to make certain that you are adhering to all policies.