This course has been specifically designed to meet the needs of clinicians who wish to enhance their knowledge of nutrition; as well as learners who have previously undertaken our introductory programme in diet, nutrition and health, and who are now seeking to develop a deeper, more comprehensive understanding of the role which diet and nutrition play in common diseases. This streamlined, online learning experience will provide participants with a detailed knowledge of how diet and lifestyle can contribute to or protect against serious chronic disorders including obesity, diabetes, cardiovascular disease, cancer and osteoporosis. Additionally, areas such as the fetal programming of disease, malnutrition and nutrition support and socio-economic health inequalities will be explored to highlight the important role that these factors play in population health.
Session 1 focusses on the issue of obesity. The measurement and definitions by which bodyweight are assessed are explored in detail, as are the population prevalence of obesity and its changing trends and patterns in Ireland and across the globe. Lecture 2 in this section outlines the pathology of obesity – how and why it occurs and the psycho-social and behavioural factors which precipitate it. Lecture 3 explores effective interventions for the prevention and treatment of obesity, focussing on dietary, nutritional and lifestyle interventions which are known to yield successful weight loss in overweight and obese patients. This lecture also examines behavioural change models which can be applied in the clinical setting to optimise patients’ weight management outcomes. Lecture 4 in this section discusses the pharmacological management of obesity, in terms of existing and new drug therapies.
Session 2 discusses diabetes mellitus. Lecture 1 in this section addresses the prevalence, diagnosis and pathogenesis of diabetes from an international and local perspective, as well as exploring the clinical effects of this condition. Lecture 2 covers the dietary, nutritional and lifestyle management of both type 1 and type 2 diabetes, integrating intervention options such as carbohydrate counting, glycaemic index, glycaemic load, physical activity, oral hypoglycaemic agents and insulin to achieve improved glycaemic control. The goals of treatment are also examined in this lecture.
Session 3 discusses cardiovascular disease. Lecture 1 in this section outlines the prevalence and pathogenesis of cardiovascular disease, with reference to the key modifiable risk factors which prevail in modern societies. Lecture 2 discusses the role of hypertension in cardiovascular disease, describing the dietary and lifestyle factors which precipitate this risk factor, and how they can be effectively addressed. Lecture 3 describes the role of dyslipidaemia in cardiovascular disease, explaining how this can be effectively addressed through dietary, nutritional and lifestyle interventions. Lecture 4 in this section examines new directions in the nutritional and dietary treatment of cardiovascular disease, exploring the evidence underpinning interventions with single nutrients such as vitamin D and Omega-3 fatty acids. The fifth and final lecture in this section describes how other lifestyle factors such as physical inactivity, smoking and high alcohol intake can adversely impact cardiovascular health, and how these issues can be most effectively addressed with cardiovascular patients.
Session 4 examines the role of nutrition and diet in cancer. The processes of oncogenesis are initially described, followed by a detailed discussion of the foods and nutrients associated with increased cancer risk, and those associated with reduced cancer risk. In each case, the most robust, up to date literature is cited to form an overview of the main nutritional players in cancer development. This discussion is framed in the context of prevailing diet and health behaviours in Ireland, to illuminate some of the dietary and nutritional factors underpinning these high incidence rates.
Session 5 reviews the role of diet, nutrition and lifestyle in osteoporosis. The nutritional and lifestyle patterns associated with increased risk, and those which are thought to be protective against osteoporosis are discussed in detail, again with reference to the latest peer-reviewed literature in the area. Like the other modules, this section concludes with a practical guide for clinicians showing which foods and nutrients to highlight when advising their patients in this area.
Session 6 covers the fetal programming of chronic disease, initially outlining how this concept was discovered before going on to highlight the nutrients of key importance in this area, and the maternal dietary and lifestyle patterns associated with increased long-term risk to the fetus. These analyses are framed in the context of the unfavourable prevailing diet and nutrient intakes, lifestyle patterns and obesity and gestational diabetes trends currently observed among young women in Ireland and other industrialised countries. Again, effective practical dietary guidelines for clinicians to use with their patients are outlined at the end of the lecture.
Session 7 discusses the problem of malnutrition. The prevalence and clinical implications of malnutrition are described in relation to adverse patient outcomes and increased healthcare expenditure, citing both local and international literature. The factors which predispose to malnutrition in the community and hospital settings are also described, as are enhanced protocols for the screening, identification and early treatment of malnutrition in the clinical setting. Lecture 2 in this section focusses on nutrition support for those who have been identified to be malnourished or at risk of malnutrition. The factors underpinning the choice of feeding route (oral, enteral, parenteral etc.) are described, as are the monitoring protocols around the time of feeding commencement. A comprehensive protocol for maintenance monitoring of both enterally and parenterally fed patients is then described in detail, explaining the different parameters to be assessed in managing these vulnerable patients.
Session 8 addresses the area of vitamin D. The protective health effects of vitamin D against osteoporosis, but also against other common serious disorders including metabolic syndrome, cardiovascular disease, cancer and auto-immune disease are highlighted. This discussion is framed in the context of the persisting high rates of vitamin D insufficiency in Ireland and the coincident high prevalence of many of these serious chronic illnesses in Ireland and other northern countries. Options for intervention are discussed at the conclusion of the lecture.
Session 9 covers the issue of socio-economic variation in diet, health behaviours and health outcomes in Ireland and other countries. The measurement of social disadvantage and the constitutional, ecological, psycho-social, material and structural issues which predispose those from low socio-economic environments to poorer health behaviours and health outcomes are comprehensively described. Effective options for preventative intervention at the local and national level to redress the poorer health outcomes observed among low SES groups are finally described.
This evidence-based, up to date programme provides learners with a comprehensive and detailed knowledge and understanding of the role which diet, nutrition and lifestyle play in common chronic diseases. The practical elements at the end of each lecture give clinicians the tools they need to effectively and efficiently address these issues of diet-related ill-health with their patients and clients. Our case-based learning elements also give learners the opportunity to apply their new knowledge in a practical, “real world” context. This programme will help learners to separate fact from fallacy in the area of nutrition by referencing the most robust and current scientific evidence in these different clinical areas.