Public Health Nutrition

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cross-sectional study

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not randomized, observational study, sampleing with regard to disease or effect
time study

selects a sample from the population
measure predictor and outcome variables

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case-control study

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select a sample from the population of people with the disease
select a sample from a population at risk that is free of disease
measure predictor variables

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cohort study

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select a sample from the population
measure predictor variables
follow the cohort
measure outcome variables

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clinical trial or intervention trial

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controlled, experimental, randomized assignment

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rate

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frequency of an event in a defined population
range: 0 to maximum size of population

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proportion

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type of ration in which the numerator is included in the denominator. the ration of a part to the whole, expressed as a decimal fraction
ranges from 0.0 to 1.0

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percent

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a part of a whole expressed in hundredths
range: 0.0 to 100
10%

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distinguish between incidence and prevalence of disease

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prevalence is a percentage of something occuring in a population
incidence is the FIRST occurance of something

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types of study designs proven successful in investigating risk factors of chronic disease states such as CVD? what are strengths and weaknesses of each?

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the framingham study is an example of a ________ study

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cohort
long term

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define "confounding" in epidemiologic studies and be able to describe the consequences of confounding

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a distortion of a risk estimate that occurs when an extraneous factor is related to the "exposure" under study and to the outcome under study

ex. Vit E supplement use leads to reduced risk of heart disease
.. physically acitive, avoids tobacco, not obese, healthy diet

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how is it possible that a cohort study of a vitamin supplement intervention and a clinical trial can result in conflicting findings?

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because of the many other variables that may be present?

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major difficulties in studying the role of nutrition as causes of chronic diseases such as CVD, osteoporosis, cancer, and alzheimers disease?

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exposures complex and intercorrelated
disease-causing and protective exposures are mixed together
variability in consumption
dietary patterns evolve

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differences between established, probable, and possible links between nutrition and disease

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in the section deciphering media stories on diet, in the aritcle "nutrition research and the mass media: an intro" several key questions were listed that are helpful in assessing the quality of evidence in a news article, what are they?

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-are they reporting results of a single study?
-how large is the study?
-was the study done in animals or humans?
-did the study look at real disease endpoints like heart disease or osteoporosis?
-how was the diet assessed?

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what is evolutionary discordance

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,

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what are universal characteristics of pre-ag hominin diets that are useful in understanding how the current western diet may predispose modern populations to chronic diseases?

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what is the earliest evidence of human use of milk and milk products? (when and where)

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where and when were strains of wild wheat domesticated to give rise to early ag?

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five major food groups found in western diets were generally unavailable to pre-ag hominins? what total percent of energy intake do these foods now represent in US diets?

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consumption of sucrose in England in 1815

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kg

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consumption of sucrose in England in 1970

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kg

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consumption of refined sugar in US in 1970

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kg

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consumption of refined sugar in US in 2000

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kg

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between 1909 and 1999, US consumption of salad and cooking oils increase _____%, shortening increased ____%, and margarine increased ____%

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of total salt intake in the US diet, ____% comes from cooking and table use and ____% comes from processing by food manufacturing

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what caused the change in fatty acid composition in domesticated animal meat from the late 1800s onward compared to wild animal meat? what is the differences in fatty acid composition?

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what is glycemic load? what foods are high/low? why is GL important?

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what are the nutrients in which the following percentages of people in the US do not meet recommended allowances?

25% or less have inadequate intake of these nutrients:

25-50% have inadequate intake of these nutrients:

more than 50% have inadequate intake of these nutrients:

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what are health ramifications of teh changes in the western diet in the following:

fatty acid composition
macronutrient composition
micronutrient composition
acid-base balance
sodium-potassium ratio
fiber content

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locus

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allele

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nucleotide

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single nucleotide polymorphism

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linkage disequilibrium

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genome-wide association study (GWAS)

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copy number variation

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gene-environment interaction

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nutrigenetics

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nutrigenomics

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four techniques in functional genomics that can be used to study the interactions of dietary genetic factors and how these interactions are related to health and disease

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what is an example of a monogenic disorder with nutritional interaction? what gene is involved? what nutrient is involved? what dietary manipulation is used to treat this disorder?

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why is the role of gene-nutrient interactions in the major adult-onset chronic diseases so difficult to understand (more than monogenic disorders)? what factors are important to consider?

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what is "personalized nutrition" and why is the approach of genetics and genomics both a strength and a limitation of "personalized nutrition"

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why has the US FDA required that the company 23 and Me to stop promoting its claims related to personalized medicine and genetics?

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describe what melanin is and how it protects against harmful effects of UV radiation

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produced by melanocytes, protects against DNA damage and folate breakdown

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two different theories that explain the functional significance of darkly pigmented skin?

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what is nutrition-related theory that explains the functional significance of lightly pigmented skin?

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what geographical factors are related to skin color? are these factors specific to africa? why or why not?

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what cultural factors are related to the current distribution of skin color in various geographic areas?

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lactose is composed of what two subunits?

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glucose and galactose

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where is lactase located in the body?

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on surface of villi lining the intestine

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clinical symptoms of lactose intolerance include:

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two general explanations for the ability of adult humans to tolerate lactose? which is thought to be more accurate?

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what factors limit the production of dairy-producing livestock in southern nigeria? what genetics trait coincides with the absence of dairy animals in southern nigeria?

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genetic mutation resulting in the capability of adult humans to digest lactose probably occurred at least ________ years ago

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what is convergent evolution? how does this apply to the explanation of the role of nutrition in world wide variation in skin color and in worldwide variation in levels of lactase activity in adults?

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persistence of lactase activity into adulthood is an example of recent convergent, evolutionary genetic adaptation to a change in food supply

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what are the general conclusions of the institute of medicine report on dietary reference intakes of calcium and vit D?

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higher levels have not been shown to be beneficial and in fact have been linked to other health problems

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what is the recommended daily allowance of calcium and vit D?

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1000 mg for calcium
600 Vit D

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health consequences of hypertension?

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mean arterial blood pressure is determined by what four general physiological factors?

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aspects of vegetarian diets believed to reduce blood pressure include:

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limitations of taking a "single nutrient" approach to the study of hypertension?

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the avg. US adult consumes _____ servings of fruits and veggies per day

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the "fruits and veg diet" and the "control diet" provided how many servings of fruit and veggies per day?

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in the appel article it was estimated that a population-wide reduction in stystolic or diastolic blood pressure of the magnitude observed with the combo diet would have what effects:

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according to the appel article, what percent of the US adults have hypertension? optimal blood pressure?

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what type of research design was the DASH study?

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the three diets used in the DASH study included:

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which diet reduced blood pressure most in both subjects with hypertension and without hypertension?

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contrast the levels of the following nutrients in the three diet groups: total energy, protein, carbs, sodium, calcium, magnesium, fat (including specific types of fat)

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possible mechanisms by which the DASH diet may have lowered blood pressure levels?

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what is the current thinking on the role of sodium in hypertension, given the results of the DASH-I and the DASH-II studies?

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what five diet-related lifestyle factors are part of the current national guidelines to lower blood pressure?

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what is the current avg level of sodium intake in the US? what is recommended? compare added table salt vs intake from processed foods

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atherosclerosis

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coronary artery

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ischemia

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infarction

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myocardial infarction

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lipoprotein

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plaque

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thrombosis

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endothelium

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free radical

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seven countries study

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framingham study

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outline steps of the classic diet-heart hypothesis for the effects of dietary factors on the development of myocardial infactions

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what dietary factors may cause or prevent coronary heart disease but are not included in the classic diet-heart hypothesis?

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why are the coronary arteries so important in the development of heart disease? name two kidns of heart tissue that they supply

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describe the "response to injury" hypothesis for the development of lesions in arterties. what dietary and non-dietary factors are involed?

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in what decade did CHD rates reach a peak in the US? what factors may have led to a decline since?

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describe how the trends in rates of death from heart disease over time differ between men and women in the US

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where does Utah rank among states in rates of CHD and stroke?

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two european countries with the highest and two with the lowest rates of death from major CVD? what dietary factors might explain the differences in death rates between countries?

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what industrialized country outside of europe has the lowest rates of death from coronary heart disease?

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what value of what variable is predicted by the Kay and Hegsted equations? what are the variables P, S, and C in these equations?

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what have studies about migrant japanese revealed about serum cholesterol levels? where were they living at the time of the study? what are characteristics other than serum cholesterol that are different between migrant japanese and japanese living in japan?

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what are desireable, borderline high, and high levels of total cholesterol and LDL cholesterol?

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how do LD and HDL cholesterol differ in terms of avg diameter, density, and content of major lipids?

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how does HDL alter risk of cardiovascular disease? how does HDL do this?

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current dietary goals from the US include wha tpercent of calories from total fat intake and what percent of calories from saturate fat intake?

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how do trans fatty acids affect total cholesterol/HDL cholesterol ratio?

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possible mechanisms by which polyunsaturated fatty acids incrase or decrease risk of coronary heart disease

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evidence for or against antioxidant vitamin supplements as a means of preventing coronary heart disease? what is the relationship between vit E supplement use and total mortality?

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what is the relationship between folate, homocystein, and coronary heart disease?

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what are the dietary recommendations for the prevention of CVD? how are these recommendations different from the "old school" recommendations from the "classica diet-heart hypothesis"?

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