Master of Science in Nutrition and Integrative Health Maryland University of Integrative Health NUTR 636: Applied Clinical Nutrition

II Summer 2013 2 credits Faculty: Lead Faculty: Rebecca Snow, MS, CNS, LDN Email: rsnow@muih.edu, 410.888.9048 x6653 on M / Th Other Faculty: Liz Lipski, Dart Clancy and Lauren Mirkin Purpose: The purpose of this course is to prepare the nutritionist for professional work, whether it is clinical or educational in nature. This course guides the senior nutrition student in problem solving nutrition interventions for various health and disease states, integrating various behavioral and dietary tools learned in the program and advancing the students understanding of how to use these tools effectively. Objectives: To successfully pass this course, the student shall: Demonstrate critical thinking and research skills when evaluating and responding to written case studies Be able to articulate nutritional assessments using a variety of data sources Be able to articulate goals and strategies that are aligned with an individualized assessment Be able to articulate short and long term plan for catalyzing change from a whole person perspective, using whole food, supplements and behavior recommendations Identify red flags and medical concerns, knowing when to refer out to another medical professional Outcomes: At the end of this course the student will: Have an emerging confidence and capability for assessing a clients nutritional status and overall health and wellbeing. Develop the confidence and capability to communicate nutrition assessments and recommendations to a variety of audiences Build confidence researching and strategizing in order to develop specific plan for individuals

Schedule: CLASS SCHEDULE

Date Time Lecture Corresponding Reading & Assignments Faculty

5/17/13

5:00-9:00 PM

6/23/13

8:30-11:10 AM

7/20/13

8:30 AM 12:35 PM

8/2/13

5:00-9:00 PM

8/4/13

8:30-11:10 AM

8/4/13

11:20 AM12:35 PM; 1:25-2:40 PM 2:50-5:30 PM

8/4/13

8/16/13

5:00-9:00 PM

Course Intro, Assignment Review, Dietary Supplements: A primer for the advanced student Case Study: Eating Disorder clinical strategies and interventions; review of Neurotransmitter testing and key supplements: GABA, 5HTP, L-theanine, lithium oratate and zinc Case Study: IBS clinical strategies and interventions; review Organic acid testing, hydrogen breath test; and key supplements: probiotics, prebiotics Case Study: GERD and osteoporosis; clinical strategies and interventions; Review Gastrointestinal Health Panel, stool; and key supplements: bitters, vinegars, Ca/Mg/D Case Study: Lyme disease with neurological involvement clinical strategies and interventions; review relevant labs and key supplements: antimicrobial herbs Case Study: Weight loss clinical strategies and interventions; review key supplements: Fibers, meal replacements, L-tyrosine Case Study: CFIDS: Chronic fatigue and immune dysfunction syndrome clinical strategies and interventions; Review methods for food allergy testing and key supplements: Adaptogens, medicinal mushrooms Case Study: Breast Cancer clinical strategies and interventions; review Female Hormone Panel and key supplements: CoQ10, green tea, soy & phytoestrogens, antioxidants

Marra and Boyar, 2009 on weebly Nelms pp 268-275 (Eating disorders)

Snow

Lauren Mirkin

Murray & Pizzorno pp 436-441 (IBS)

Liz Lipski

Nelms pp 352-354 (GERD), pp 777786 (osteoporosis); Murray & Pizzorno pp 565-580 (osteoporosis) Snow, 2007 on weebly

Snow

Snow

Murray & Pizzorno, pp 538-551 (Obesity), Nelms pp 253-268 (Obesity) Murray & Pizzorno pp 167-176 (CFS); 255-266 (Fibromyalgia)

Snow

Snow

Murray & Pizzorno pp 119-135 (Cancer), Nelms pp 702-727 (Cancer), Braun & Cohen pp 126-148 on Weebly

Dart Clancy

Prerequisites: NUTR 612 (Human Nutrition II: Micronutrients), ISci 646B (Health and Wellness Physiology I), NUTR 622 (Advanced Nutritional Biochemistry and Assessment) Reading list: Required Reading: 1. Pizzorno, Joseph, Murray, Michael, & Joiner-Bey, Herb. (2007). The Clinician's Handbook of Natural Medicine. New York: Churchill Livingstone. 2. Nelms, Marcia, Sucher, Kathryn, Lacey, Karen, & Roth, Sara Long. (2007). Nutrition Therapy and Pathophysiology (2nd Edition ed.). Belmont: Wadsworth, Cengage Learning. Readings on Weebly 1. Braun, Lesley, & Cohen, Marc. (2007). Herbs and Natural Supplements: An Evidence Based Guide (2nd Edition ed.). Marickville: Elsevier, pp 126-148. 2. Marra, Melissa Ventura , & Boyar, Andrea P. . (2009). Position of the American Dietetic Association: Nutrient Supplementation. Journal of the AMERICAN DIETETIC ASSOCIATION, 109(12), 2073-2085. 3. Snow, R. (2007). Chronic Lyme Disease and Co-infections. Herbal Medicine Beyond the
Basics. Presented at the 18th Annual American Herbalist Guild Symposium, October 26-28, 2007, Columbia, MD.

Recommended Reading 1. Braun, Lesley, & Cohen, Marc. (2007). Herbs and Natural Supplements: An Evidence Based Guide (2nd Edition ed.). Marickville: Elsevier. 2. Dickinson, Annette. (2012). The Benefits of Nutritional Supplements (4th ed.). Washington DC: Council for Responsible Nutrition. Retrieved from http://www.crnusa.org/benefits/. 3. Gaby, Alan. (2011). Nutritional Medicine. Concord: Fritz Perlberg Publishing. 4. Hancock, John N. (2004). Vitamin and Mineral Safety (2nd Edition ed.). Washington DC: Council for Responsible Nutrition. Retrieved from http://www.crnusa.org/safety.html. 5. Natural Standard Database: www.naturalstandard.com, accessible from campus only. 6. Stargrove, Mitchel B, Treasure, Jonathan, & McKee, Dwight. (2008). Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies. St. Louis: Mosby Elsevier. 7. Weatherby, Richard, & Ferguson, Scott. (2002). Blood Chemistry and CBC Analysis. Jacksonville: Vis Medicatrix Press. Materials: None needed Assignments Case Study Paper

Write a detailed assessment and plan for one of the cases presented. The paper provides an opportunity for you to demonstrate a researched, evidence-based understanding of a specific health condition and strategies for intervention. A rubric will be distributed on the first day of class that will be used to assess your paper. Your paper should include o A discussion of pathophysiology and biochemistry as it relates to the case and specific health condition(s). o Clearly articulated assessment of dietary and health inputs. o Clearly articulated short and long term goals, strategies, and recommendations that includes dietary, lifestyle and supplements o 2-day sample menu/meal plan specific for the client with recipes and shopping list In addition to the use of academic textbooks and required and recommended reading in this course, your paper should include no less than 3 peer-reviewed references, preferably metaanalyses, systematic reviews, randomized controlled trials, epidemiological studies and/or other clinically relevant research. Your paper should be between 1,500-2,500 words, excluding the meal plan with recipes and shopping list. In-text citations and references should be in APA-style format. DUE August 1st 2013 to rsnow@muih.edu. 10% off for late papers, 20% off for papers turned in more than 1 week late.

Dietary Supplement Fact Sheet for Health Professionals This two-part assignment provides the opportunity to research a specific dietary supplement, receive and provide constructive feedback to a classmate. You will be developing resources that you can use in the future professional work. Part I: Write a 1-page (front and back, including reference list) fact sheet on one dietary supplement. You will be assigned a supplement to research in class. In addition to the use of academic textbooks and required / recommended reading in this course, your paper should include no less than 3 peer-reviewed references. Your review should include 1. evidence-based information on health effects, 2. bioavailability/form, 3. dosing, 4. safety, 5. drug/nutrient interactions. A sample fact sheet will be provided in class. Part II: Provide input to one of your classmates, as assigned in class. Your feedback should be given electronically through tracking changes/comments in Word or comments in Adobe. Guidelines for Peer Feedback: o Provide positive feedback, always start and end with the positive. o Be specific with feedback, i.e. I am unclear which form of chromium is more bioavailable? o Point out any key elements that are missing from the paper, i.e. is there a safe upper limit for dosing Vitamin E? o Evaluate the resources and references used. i.e. Have you checked out Natural Standard database on this topic? o Point out any spelling, grammatical or referencing errors of note.

o Feedback is only directed to your peer and not made public. Timeline: o Submit first draft Fact Sheet to your assigned peer no later than June 15th 2013. o Review your assigned peers Fact Sheet and provide input no later than June 22nd 2013 o Submit original Fact Sheet with peers constructive feedback and revised final version of your Fact Sheet to rsnow@muih.edu by July 1st 2013. 10% off for late papers, 20% off for papers turned in more than 1 week late.

Class Discussion For every case study presented, students should come to class prepared to discuss the case. You may be asked to write your recommendations for the client on the board or share them in class. Students will review and discuss each others recommendations. Your participation will be noted. This is a great opportunity to vet your theoretical ideas with an experienced nutritionist.

Evaluation Due to the interactive nature of this course, attendance and participation are strongly encouraged. Case Study Research Paper 40% of your total grade Participation 25% of your total grade Dietary Supplement Fact Sheet 25% of your total grade Dietary Supplement Critique 10% of your total grade

Attendance & Tardiness Policy: Attendance and participation in class are essential for meeting the outcomes and objectives of this course and the program as a whole. Arriving late to class is a disturbance to your classmates and your instructor. It is the students responsibility to stay up-to-date on any missed coursework, regularly checking the course website for updates. If you miss a class, you are encouraged to contact a classmate so they can collect handouts for you. Absences may require that students do extra work to make up for missed material. Plagiarism, Information Literacy & Appropriate Referencing of Sources: Plagiarism: Plagiarism, defined as using the published or unpublished works or ideas of another without properly citing the material used and its source, or presenting another persons work as your own, is an infraction of Tai Sophia Institutes academic honesty policy. Please carefully note all reference sources on your assignments. Information Literacy: Students who are unable to complete homework because of challenges with information literacy skills are asked to seek assistance in the library. The library offers training sessions and support for development of these skills. In some cases, students may be required to complete training sessions in order to pass a course if they demonstrate an inability to meet the demands of the assigned coursework.

Americans with Disabilities Act of 1990 Students are responsible for formally requesting, in advance, reasonable accommodations for a documented disability and for providing documentation of this disability to the Student Development and Engagement Advisor as described in the Disability Services section of the student handbook.

Withdraw Policy Students are eligible to withdraw from a course up to two weeks before a course ends. The final day of a course is based on the last due date of an assignment or the final day of classes. Submit the withdrawal form (found on the Intranet) to the Registrars Office to withdraw from a course(s) you are unable to complete after the course has begun. Please note: A course withdrawal is reflected as a W on the official transcript. The student is refunded in accordance with the institutional refund policy. Monies due to the student or to a student loan lender will be returned within thirty (30) days from the day of withdrawal. The date of written notice by the Institute or by the student is the effective date. The deadline for withdraw varies by program. Students are eligible to withdraw from a course up to two weeks before a course ends or up to 80% of the courses completion date. The final day of a course is based on the last due date of an assignment or the final day of classes.