Ateneo - UPO

The integrated course addresses the impact of diet on human health from a multidisciplinary perspective, weaving together endocrine-metabolic pathophysiology linked to nutritional and environmental factors, the main clinical implications of nutrition in internal medicine, and the concepts of prevention and health promotion, with particular attention to healthy and sustainable diet models - Mediterranean, plant-based, planetary diet and ketogenic. All this knowledge derives from the epidemiological studies conducted in the nutritional field: for this reason, the course also provides the statistical and epidemiological tools needed to understand how such studies are conducted and to critically interpret their results.

• Endocrine and metabolic diseases: Greenspan's Basic and Clinical Endocrinology, Decima Edizione, D. Gardner e D. Shoback, McGraw-Hill Education, 2017; lecturer's slides• Introduction to statistical and epidemiological methods: G. Pounis, Analysis in Nutrition Research: Principles of Statistical Methodology and Interpretation of Results, Academic Press.• Nutrition in internal medicine: Linee guida della Società Europea di Nutrizione Clinica e Metabolismo (ESPEN).• Promotion of healthy diet and disease prevention: course slides and scientific articles provided in class.

The integrated course aims to provide students with a multidisciplinary preparation on the relationship between diet and human health, integrating:• knowledge of endocrine-metabolic pathophysiology in relation to nutrition and environment;• statistical and epidemiological foundations for critically reading the scientific literature in nutritional epidemiology;• skills to recognize the main internal-medicine conditions relevant to nutritional consultation and identify the most appropriate dietary treatment;• the ability to understand and apply concepts of prevention and health promotion, critically evaluating evidence-based nutritional interventions.

Essential notions of anatomy, chemistry, biochemistry and physiology (module "Endocrine and metabolic diseases"); no specific prerequisites (module "Introduction to statistical and epidemiological methods"); knowledge of body composition and of a normal, balanced meal (module "Nutrition in internal medicine: implications for health and disease"); basic notions of epidemiology, medical statistics and human nutrition (module "Promotion of healthy diet and disease prevention").

Lectures supported by slides; critical reading and discussion of peer-reviewed scientific articles; discussion of clinical cases and in-class exercises; literature database searches (Medline, Cochrane Library); interactive games to verify learning.

If necessary, in-depth sessions preparatory to the exam will be offered, to be agreed directly with the individual lecturers. Students with physical disabilities, Learning Disabilities or Special Education Needs can request specific services and tools via the Staff Sviluppo e Coordinamento Carriere e Servizi alle Studentesse e agli Studenti, consulting the University webpage (https://www.uniupo.it/en/services/services-students-physical-or-learning-disabilities) and subsequently contacting the individual lecturers regarding the teaching aspects of the exam. Gender mainstreaming: approaches to grant equal benefits in actions and activities for women and men and to eliminate gender inequalities.

The exam of the integrated course "Impact of diet on human health" consists of 34 questions (10 multiple choice questions for the modules: Promotion of healthy diet and disease prevention, Introduction to statistical and epidemiological methods and endocrine and metabolic disease and 4 (3 open and 1 multiple choice) for the nutrition in internal medicine: implication for health and disease module. The pass mark will be achieved if the student correctly answers 60% of the exam questions of the entire integrated course

ENDOCRINE AND METABOLIC DISEASESOrganization of the endocrine system and external factors (pollutants, infective agents, social factors, working shifts); hypothalamic-pituitary system and related diseases, environmental tumorigenesis, stress and epigenetic mechanisms, endocrine disruptors and pituitary tumors; thyroid physiology, iodine and nutraceuticals, thyroid dysfunctions and tumors; adrenal hormones, hyper- and hypo-corticosurrenalism; diabetes and environment, adipose tissue pathophysiology, brain control of feeding behavior, determinants of obesity, metabolic syndrome, obesogens.INTRODUCTION TO STATISTICAL AND EPIDEMIOLOGICAL METHODSDescriptive statistics; basics of probability; introduction to statistical inference; chi-square test; t-test for independent and paired samples; study designs (RCTs, cohort, case-control, cross-sectional, meta-analyses); disease frequency and association measures; data collection and exposure definition in nutritional epidemiology.NUTRITION IN INTERNAL MEDICINE: IMPLICATIONS FOR HEALTH AND DISEASERole of nutrition in health; hypertension and the DASH diet; fatty liver disease; cirrhosis; chronic kidney disease; unintentional weight loss; anemia; chronic abdominal pain (IBD and low FODMAP diet); celiac disease; introduction to VLCKD.PROMOTION OF HEALTHY DIET AND DISEASE PREVENTIONAims of scientific research; natural history of disease; primary, secondary and tertiary prevention and health promotion; disease determinants and risk factors; measures of the impact of preventive interventions; Global Burden of Disease project; sources of evidence (Medline, Cochrane Library); systematic reviews, meta-analyses and PICO questions; public health guidelines; nutrition and physical activity; Mediterranean, plant-based, planetary and ketogenic diets.

Knowledge and understanding
Students will know and understand:
- the pathophysiology of the endocrine system and of the main endocrine-metabolic diseases in relation to nutritional and environmental factors
- the main study designs, disease frequency measures and measures of association between diet and disease
- the main internal-medicine syndromes relevant to nutritional consultation practice
- the concepts of prevention and health promotion and the main healthy and sustainable diet models

Applying knowledge and understanding
Students will be able to:
- critically read and interpret the content of a scientific article in nutritional epidemiology
- recognize the clinical signs requiring nutritional assessment and identify the most appropriate dietary treatment
- identify prevention and health-promotion needs in a population and evaluate the effectiveness of nutritional interventions

Transversal skills
Students will be able to:
- critically read the scientific literature to inform their practice or research
- integrate knowledge from different disciplines (endocrinology, medical statistics, internal medicine, hygiene) into a multidisciplinary approach to nutrition