Nutritional Epidemiology (EPID 607)
EPID 607 Margaret McLellan, MS, RD, CDE
Methods of Nutritional Epidemiology
Semester course; 3 lecture hours. 3 credits. This course focuses on methods
of measuring exposures to dietary factors for epidemiological investigations
of diet-disease relationships and risk assessment. An introductory course
in basic epidemiology is a prerequisite. Students learn to select the most
appropriate method(s) of collecting and analyzing food intake and to evaluate
the adequacy of dietary assessment methods used in published epidemiological
studies. Spring semester
| Faculty: | Margaret McLellan, M.S. R.D. C.D.E. |
| Office: | Room 147 AD Williams |
| Phone: | (w) 828-0970 and 828-0907 hours 8:00 - 4:30 |
| (h) 748-8373 may call after 6:30 AM , not after 9:00 PM | |
| FAX: | 628-0204 |
| mmclella@MCVH-vcu.edu, NutAgBio@aol.com | |
| Please send any e-mails to both addresses, in case one is down. | |
| Pager: | 828-4999, 4312 0r 905-1356 |
Virginia Commonwealth University is an equal opportunity/affirmative action institution providing access to education and employment without regard to age, race, color, national origin, gender, religion, sexual orientation, veteran’s status, political affiliation or disability. If special accommodations are needed, please contact .
Course Description : This is a graduate level course in nutritional epidemiology for students in the MPH program and other graduate programs related to health sciences.
An introductory course in basic epidemiology is a prerequisite. The course focuses on methods of measuring exposures to dietary factors for epidemiologic investigations of diet-disease relationships and risk assessment.
Course Objectives: upon completion of this course, the student will be able to:
- Describe the various methods for measuring dietary exposures
- Identify the strengths and limitations of each method of collecting and analyzing food intake data and be able to select the most appropriate method(s) for a given situation
- Evaluate the appropriateness of food composition data bases and nutrient calculation software
- Evaluate the adequacy of the dietary assessment methods used in published epidemiologic studies and interpret the study results with respect to the appropriateness of the methods used.
- Recognize the sources of error in collecting and analyzing dietary data and use this information in interpreting study results
- Conduct a literature search related to a specific diet-disease relationship, evaluate the strength of the association, and present findings.
Text: Willett W: Nutritional Epidemiology. 2nd edition. Oxford University Press ,1998
Other References:
Margettes BM and Nelson M, eds. Design Concepts in Nutritional Epidemiology, 2nd edition, Oxford University Press, 1997
Buzzard, I.M. and Willett, W. ed. American Journal of Clinical Nutrition Supplement 1, 1994: Dietary Assessment Methods.
Mahan, L. Kathleen and Escott-Stump ,Sylvia. Krause’s Food, Nutrition and DietTherapy, ed. 2004
Shill, M.E. Olson, J ,A, Shihe, M. Ross, A.C. Modern Nutrition in Health and Disease, 9 th ed. Williams & Wilkins 1999.
Suggested Journals
- American Journal of Clinical Nutrition
- American Journal of Epidemiology
- American Journal of Public Health
- British Journal of Nutrition
- Epidemiology
- European Journal of Epidemiology
- International Journal of Cancer
- International Journal of Epidemiology
- International Journal of Obesity
- Journal of the American Dietetic Association
- Journal of the American Medical Association
- Journal of Nutrition
- Journal of Nutritional Biochemistry
- New England Journal of Medicine
- Nutrition Reviews
Grading : final grades will be weighted as follows
|
|
Diet analysis project |
20% |
Mid-term exam |
20% |
Research Project: paper and presentation |
20% |
Evaluation of Presentations |
10% |
Second-Exam |
20% |
Class Participation |
10% |
Diet Analysis Project :
For this project, students will collect 24-hour diet recall, 3 day food record and food frequency questionnaire on one individual. Students will enter the results in a nutrient data base and present the results in a paper which compares and contrasts the three methods. Include analysis of why the results do vary and/or why they are similar.
Research Project :
You will select one diet/disease topic under current investigation and evaluate the recent literature on the topic. Topic must be approved, so we do not have two individuals doing the same topic. Paper should include a summary of the findings , the methods used in collecting data and comment on the strength of the diet/disease relationship and the validity of the methods used to determine dietary exposure. The paper should conclude with a proposed study design for further research to expand our knowledge of this particular diet/disease relationship. The paper will be presented to the class.
Classes:
Week 1: Introduction to Nutritional Epidemiology Chapter 1
Assign research project and diet analysis project
- Define the term nutritional epidemiology
- Give three examples of nutritional epidemiological research
- Describe the current focus of the field of nutritional epidemiology
- Describe some of the factors which make the research in field challenging/difficult
- List and describe the type of studies used in Nutritional epidemiology
- Briefly discuss the interpretation of nutritional epidemiological data
Week 2: Food and Nutrients,
Chapter 2 Nature of Variation in Diet,
Chapter 3 and Nutrient data Software
- Discuss why food consumption data are collected
- List 10 different classes of food constituents
- Differentiate between the nutrient, food and food group method of conducting nutritional epidemiological research
- Discuss the advantages and disadvantages of the nutrient method of conducting nutritional epidemiological research
- Discuss the advantages and disadvantages of the food method and food group method of conducting nutritional epidemiological research
- List the features to look for in a nutrient data base
- What questions to ask to determine the accuracy of a data base
- List some sources of food composition data
- List and discuss features to look for in a nutrient composition system and database
- List sources of variation in diet
- Discuss methods of dealing with individual variation in diet
- Discuss methods of dealing with between-person variation in diet
- List some socio-demographic and psycho-social variables that influence variation in dietary intake
Week 3: Overview of Dietary Assessment methods,
24-hour diet recall and Food Record methods Chapter 4
- Name and describe methods to collect dietary data
- Describe the advantages of the 24-hour diet recall and food record methods
- Describe the disadvantages of the 24-hour diet recall and food record methods
- Discuss the number of days and which days of recall or record to collect
- List some steps to take to reduce the error in data collecting in the food recall and record
- Name some factors which can cause error in the nutrient calculation of data collected from diet surveys
- Name the three areas of validation in collection of dietary data
Week 4: Food FrequencyQuestionnaires Chapter 5
- Discuss the development of the FFQ method of collecting dietary intake data
- What basic assumption is behind the use of the FFQ?
- List the parts of the FFQ
- How does a researcher determine which foods to include on a FFQ
- What characteristics should a food item have to be included on a FFQ?
- List several methods used in compiling a food list for a FFQ
- Describe some considerations in how a FFQ is organized.
- Discuss some considerations in how a FFQ is formatted
- When and how would you include portion size in a FFQ
- Explain methods of determining nutrient intakes from FFQ
- When would it and when would it not be useful to rank ( ie by quintiles) responses?
- List some sources of bias in the FFQ.
Week 5: Evaluation and Interpretation of Dietary Data .
Chapter 6
Demonstration of Nutrient Data System
- Be able to define reproducibility, validity and calibration
- List approaches to evaluating dietary questionnaires
- How would you check reproducibility?
- How would you measure Validity?
- What use is comparison of biochemical indicators?
- Discuss the three way (triad) comparison method of evaluating FFQ instrument
- What are the objectives of a validation study?
- How would you choose a population for a validation study?
- Discuss the importance of a) choice of comparison method, b) choice of time frame and c) sequence of data collection in validation studies
- How do you determine number of subjects for a validation study?
- Become familiar with Nutrient data system
Week 6: Anthropometrics Chapter 10
- List the primary anthropometric variables collected in nutritional epidemiological studies
- Discuss the reproducibility and validity of height and weight measures in research
- Discuss the major body components and their measurement
- Name and describe at least three ways to look at height and weight comparatively
- Describe the role and measurement of frame size.
- Discuss the reproducibility and validity of skinfold measures
- Discuss various ways to measures of body fat composition and the relative usefulness of each
- Define DEXA and discuss ways it can be used in research
- Discuss Bioelectrical Impedance
- Practice a few measurements and their reproducibility
Measurement of Energy Intake and Expenditure Chapter 11
- Why is energy intake be measured in almost every nutritional epidemiological study?
- What are the components of energy expenditure?
- What are the energy nutrients and their relative caloric value?
- What determines between person variation in energy expenditure?
- Define nutrient density
- How and why would adjustments be made for energy intake?
- Be able to list and describe several ways to determine caloric needs.
- Be able to describe/define the residual method, standard multivariate method, energy decomposition method and multivariate nutrient density method of adjusting for total energy intake
Diet Analysis Project Due
Week 7:Biochemical Indicators Chapter 9
- Why use biochemical parameters in dietary intake studies?
- List some factors which influence biochemical indicators
- Name three types of analytical procedures in measuring biochemical parameters
- What considerations in study design are necessaty for valid biochemical data to be obtained for a study?
- What considerations are there in the analysis of biochemical data?
- How would you validate biochemical parameters?
Week 8: Midterm
Week 9: Spring Break no class
Week 10: Nutrition Surveillance and Sample paper and presentation
Chapter 14
- Define nutritional surveillance
- Discuss the purpose of a nutritional surveillance system,
- Describe the methods used in nutritional surveillance
- Discuss several Nutritional surveillance systems in effect today
- Discuss the application of the findings of nutritional surveillance systems to public policy formation and implementation
- Differentiate between monitoring and surveillance
- By presentation of a sample paper “Does seafood lower the incidence of premature birth?” have a model to use in preparing term paper and presentation for the class.
Week 11: Ecological and Cross Sectional studies
Cohort and Case-Control studies
Exposure Outcome studies
chapters 15 – 18 Willett
chapter 1 Margettes
- Be able to distinguish between nutritional epidemiological studies which are a) ecological, b) cross sectional, c)cohort, d) case-controlled, and e) exposure outcome
- Be able to give an example of each type of study
- Be able to describe the advantages/disadvantages of each and when each would be used.
Week 12: Large Nutritional Epidemiological Studies
- Be able to describe the population, type of data collected, the agency conducting the study, some major results and applications for the following surveys:
NHANES I, II, III NHEFS NHIS NCEP Nationwide food consumption survey SLAITS Framingham Heart Study Framingman offspring Cohorts Framingham Generation III Omni Study of Minorities Seven day Adventist Health studies Nurses Health Study Health professionals Study Health professionals follow-up study
EPIC (European prospective investigation of cancer)
Week 13: Guest lecturer , Diane Wilson, PhD.
Diet and Breast Cancer
- Be able to list some of the studies done on diet and breast cancer
- List some nutrient and /or diet and breast cancer correlations
- Discuss the role of education and knowledge on behaviors which influence breast cancer incidence
Week 14: Genetics and Nutritional Epidemiology , Directions for further research
Margettes , chapter 11 and Mahan, Chapter 16 Willet, Chapter 19
- Be able to define the term “ Nutrigenomics”
- Discuss what role/influence genetics has on data collected in nutritional epidemiological surveys and studies
- Be able to list the four types of gene-nutrient interactions
- Discuss design issues in studying gene-nutrient interactions retrospectively and prospectively
- What are the ethical issues in studying gene-nutrient interactions
- Why will it become important, as it becomes possible, to study pre-clinical and intermediate endpoints (pre-morbid)?
- Be able to list some areas of human nutrition that are likely to be studied in greater depth
- Why will methods of using nutritional epidemiology in clinical trials and measuring group compliance become more important?
Week 15: Student Presentations
Week 16: Student Presentations
Week 17: Final/ Second Exam
