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Microsoft PowerPoint - SELECTIVE BiomedSc 2014 Intro Nutritional Epidemiology (Compatibility Mode)
Microsoft PowerPoint - SELECTIVE BiomedSc 2014 Intro Nutritional Epidemiology (Compatibility Mode)
Selective:
Nutritional Epidemiology-
Introduction
Lecture by:
A/P Dr Tony Ng
IMU
1
Lesson Outcomes
At the end of this lesson the student should
be able to:
1. describe the purpose and components of epidemiology.
2. state the three disease descriptors in epidemiology.
3. describe nutritional epidemiology- What is it? How is it
important?
4. state the goals of nutritional epidemiology.
5. describe the advantages and disadvantages of
nutritional epidemiology.
6. explain the relationship between exposure, outcome
and confounder
7. state the limitations in nutritional epidemiology
research. 2
What is epidemiology?
Epidemiology is the study of
the distribution and determinants
of health-related states or events
(including disease frequency),
2. Analytic epidemiology
Observational (cohort, case control, cross-
sectional, ecologic study) researcher
observes association between exposure and
disease, estimates and tests it
Experimental (RCT, quasi experiment)
researcher assigns intervention (treatment),
and estimates and tests its effect on health
outcome
6
Basic Triad of Descriptive
Epidemiology
The three essential characteristics
(descriptors) of disease we look for
in descriptive epidemiology are:
PERSON
PLACE
TIME
Analytic epidemiology
Study design: cohorts & case control
& cross-sectional studies
Choice of a reference group
Biases
Impact Stratification
Causal inference - Effect modification
- Confounding
Matching
Multivariable analysis
Nutritional epidemiology
What is it?
How is it important?
(Reference: Nutrition Epidemiology
by Walter Willet)
9
Nutritional epidemiology-
the study of the impact of nutritional
exposures on populations/
individuals and related health/
nutritional outcomes.
Concept:
diet influences occurrence of diseases
11
Nutritional
epidemiology
16
Goals of nutritional
epidemiology
1.
The most basic goal is
monitoring the food
consumption, nutrient intake
and nutritional status of a
population.
17
Goals of nutritional
epidemiology
2.
To generate new hypotheses
about diet and disease, to
produce evidence that supports
or refutes existing hypotheses
and to assess the strength of diet-
disease associations. 18
Goals of nutritional
epidemiology
3.
The overall goal is to contribute
to the prevention of disease and
the improvement of public
health.
19
Advantages of nutritional
epidemiology
1.
The key advantage is
its direct relevance to
human health.
Epidemiologists study real life. They do not
need to extrapolate from animal models or in
vitro systems. The results of their work are often
used to calculate direct estimates of risk, which
can then be translated into specific
recommendations for changes in nutrient
intakes or food consumption patterns. 20
Advantages of nutritional
epidemiology
2.
Findings from nutritional
epidemiology can even have direct
implications for food processing
and technology.
21
Industrially produced
trans fats
Clear Solid or
vegetable oils semi-solid fats
40 diabetes!
CHD risk
17 Overall:
20 TFAs 2 to
2
0 10 times
worse than
TRANS SFAs MONO PUFA Total the C12-16
-20
2% 5% -19 Fat SFAs when
-40 kcal kcal 5% 5% impact on
kcal -38
kcal other risk
-60 5%
factors
kcal
considered!
For eg., recent epidemiological studies
found that high intakes of trans fatty
acids (found in margarine/ hardened or
processed vegetable fats) is associated
with an increased risk of coronary
heart disease
Margarine manufacturers sought
alternative ways to reformulate their
products to reduce their trans fatty acid
content.
(Re: Inter-esterification
of fats to replace
commercial
hydrogenation) 24
Disadvantages of Nutritional
Epidemiology
1.
The most important one is the potential for
many kinds of bias.
31
For example,
Intakes of several types of fatty acids influence blood
cholesterol levels and
Intakes of three different B vitamins influence
homocysteine levels.
33
The methods used in nutritional
epidemiology focus on measuring
the exposure to nutritional factors, the
frequency and distribution of disease, and the
exposure to other factors that could confound the
hypothesized association.
Smoking
(confounder)
Exposure Outcome
Third variable
41