Houston Community College System Nutrition Benefit Worksheet

  • Post category:Nursing
  • Reading time:11 mins read
  • Post author:

Houston Community College System Nutrition Benefit Worksheet

Nursing homework help

Active Learning — Benefit-Risk Decision-Making for Seafood This activity is inspired by a discussion in our NUTR101 Intro to Nutrition course at Montgomery College and informed in part by the 2017 article by Edward Groth, III in Environmental Research, “Scientific foundations of fish-consumption advice for pregnant women: Epidemiological evidence, benefit-risk modeling, and an integrated approach.” The goal of the author was to combine (integrate) epidemiology and benefit-risk analysis to come up with advice that is more scientifically sound than that based on either one, solely. It is my hope that this discussion can help students to develop “a tolerance for ambiguity,” an aspect of integrative learning. Benefits of Consuming Seafood Risks of Consuming Seafood Seafood (fish and shellfish) is the principal dietary source of the omega-3 (n-3) polyunsaturated fatty acids Docosahexaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA). Seafood is a dietary source of methylmercury (MeHg), a potent neurotoxin. These fatty acids are essential for the healthy development of the prenatal nervous system (J.R. Hibbeln, 2007). A pregnancy that is “underfed” with these fatty acids will produce a baby who is less cognitively capable than if he/she was fed sufficient DHA and EPA. The harm may be manifest as a lower IQ, poor language development and behavioral and attention changes. In other words, if you don’t consume these essential n-3 fatty acids the fetus is harmed. MeHg is formed in the environment from inorganic mercury (Hg) which has been emitted from natural (volcanic) and anthropogenic (mancaused) sources, of which coal-burning is a major contributor. MeHg bio accumulates in aquatic food webs, and then poses a risk to those who consume tainted seafood. The MeHg is harmful to all of us, but it is particularly devastating if the exposure occurs to a developing fetus (Karagas, 2012). Seafood contains other valuable nutrients to support health, including easily digestible proteins, trace minerals such as selenium, zinc and iron and myriad vitamins. The author of this article relies on two disciplines to support this advice. They are: epidemiology and benefit-risk modeling. Epidemiology (epi) deals with associations between environmental exposures (e.g. to n-3 s and to MeHg) and to outcomes. Multiple epi studies finding concordant (similar) outcomes are required to strengthen the hypothesized association(s). A vulnerability of epi studies is that they rely upon the participants’ ability to accurately recall how much, and which types of, fish they have eaten in the past. In the case of seafood, there is also something called, “mutual negative confounding,” which is to say that the beneficial and harmful effects may offset or obscure each other, making it difficult to measure 1 outcomes in either direction. This occurs because they both influence the same (nervous) system. Currently, the epidemiological studies indicate risk at lower seafood intakes than do the benefit-risk models. Benefit-risk Modeling takes advantage of epidemiological data, plus assumptions and data relevant to seafood constituents and intakes, to estimate the benefits, harms and net effects of different seafood consumption patterns. Currently, the benefit-risk models indicate risk at a much higher seafood intake than do epidemiological models. FDA’s Generic Benefit-risk Model1 Fish intake increases along the x axis; changes in IQ increase or decrease along the Y axis, with “zero effect” at the x axis, shown in black ink. Beneficial effects shown in green ink, increases steeply at low fish intakes then levels off, because the model assumes these effects reach a plateau. Methylmercury adverse effects shown in red increases linearly with dose, in proportion to the amount of fish eaten. FISH CONSUMPTION → Legend: Red = adverse effects Green= beneficial effects Blue = “net IQ effect” Black = “zero effect” (baseline from which IQ will vary) Positive effects (IQ gain) and adverse effects (IQ loss) combine to produce “net IQ effects,” shown by the center, blue curve. The optimal point is where the consumer has maximized benefit and minimized harm. With increased fish consumption there is a point of “crossover” is where the increased fish consumption shifts to a net negative, from the positive. 1 FDA’s Generic Benefit-risk Model was developed by Philip Spiller. It depicts the interaction between beneficial and harmful effects on cognitive development for any seafood combination variety consumed during pregnancy. 2 Omega-3 and mercury content of selected popular fish and shellfish varieties (Source of data, US FDA (2014) Seafood Item Sardines Salmon Herring, Anchovies Shrimp Pollock Clams Tilapia Flounder, Sole Tuna, Canned Albacore Tuna, Canned Light Cod Lobster Swordfish Shark Orange Roughy n-3 fatty acids, mg/100g 1190 1180 2020 350 530 200 90 300 860 270 160 200 900 690 30 Hg µg/100g 2 2 5 1 4 2 1 8 35 13 9 11 100 98 57 The author constructed this next table after combining the epidemiological data with the benefit-risk modeling. He cautions that this “is not the last word on this subject; there is no one “best” way to craft and present seafood consumption advice. But, it may contribute to a national conversation on how public health policy can optimize both (increase seafood/ decrease mercury) of these vital objectives. Seafood Consumption Recommendations for Women of Childbearing Age Approximate standard serving size = 4-6 ounces Eat ALL YOU LIKE Eat OFTEN Eat OCCASIONALLY Eat RARELY DO NOT EAT (3 or more meals/week) (2-3 meals/week) (1-2 meals/week) (less than 1 meal/week) (0 meals/week) Crabs Butterfish Herring Shad Atlantic Mackerel Atka Mackerel Pollock Crawfish Freshwater Trout Salmon (all types) Clams Sardines Catfish Pengasius Oysters & Mussels Tilapia Shrimp Scallops American Lobster Spiny Lobster Atlantic Tilefish Whitefish Cod Chub Mackerel Atlantic Croaker Sole & Plaice Flounder Squid Haddock Hake Monkfish Smelt Halibut Carp Buffalo fish Snapper Porgy Sheepshead Ocean Perch Rockfish Mullet Skate Canned Light Tuna Grouper Fresh Tuna Spanish Mackerel Sablefish Bluefish Canned Albacore Tuna Pacific Croaker Lingcod Scorpionfish Sea Trout Sea Bass Gulf Tilefish Swordfish Shark King Mackerel Orange Roughy 3 1) The Dietary Guidelines for Americans (DGA) urge 2-3 seafood meals (about 8-12 ounces) per week, but the average American woman of child-bearing age currently eats less than half that amount. What are some possible reasons women for this “under-consumption” of seafood? 2) List some of the risks of under-consuming n-3 fatty acids during pregnancy. 3) Summarize the risks of consuming MeHg-contaminated seafood during pregnancy: 4) Using information in the table, Seafood Consumption Recommendations for Women of Childbearing Age, to suggest various seafood amounts and combinations for a woman of childbearing age. Week #1 Seafood Intake Recommendation #2 #3 #4 5)) Comment on this quote by statistician and modeler George Box, from the Groth, III article. “All models are flawed, but some models are also useful.” 5) Do you feel more confident to offer advice about seafood consumption? 6) What more do you need to know about this topic, so that I can improve this handout? 4

  Excellent Good Fair Poor
Main Posting 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

 

Supported by at least three current, credible sources.

 

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

 

At least 75% of post has exceptional depth and breadth.

 

Supported by at least three credible sources.

 

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

 

One or two criteria are not addressed or are superficially addressed.

 

Is somewhat lacking reflection and critical analysis and synthesis.

 

Somewhat represents knowledge gained from the course readings for the module.

 

Post is cited with two credible sources.

 

Written somewhat concisely; may contain more than two spelling or grammatical errors.

 

Contains some APA formatting errors.

0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

 

Lacks depth or superficially addresses criteria.

 

Lacks reflection and critical analysis and synthesis.

 

Does not represent knowledge gained from the course readings for the module.

 

Contains only one or no credible sources.

 

Not written clearly or concisely.

 

Contains more than two spelling or grammatical errors.

 

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness 10 (10%) – 10 (10%)

Posts main post by day 3.

0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%)

Does not post by day 3.

First Response 17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

 

Responds fully to questions posed by faculty.

 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

 

Demonstrates synthesis and understanding of learning objectives.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are fully answered, if posed.

 

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are answered, if posed.

 

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

 

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)

Response is on topic and may have some depth.

 

Responses posted in the discussion may lack effective professional communication.

 

Responses to faculty questions are somewhat answered, if posed.

 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

 

Responses posted in the discussion lack effective professional communication.

 

Responses to faculty questions are missing.

 

No credible sources are cited.

Second Response 16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

 

Responds fully to questions posed by faculty.

 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

 

Demonstrates synthesis and understanding of learning objectives.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are fully answered, if posed.

 

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

 

Communication is professional and respectful to colleagues.

 

Responses to faculty questions are answered, if posed.

 

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

 

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)

Response is on topic and may have some depth.

 

Responses posted in the discussion may lack effective professional communication.

 

Responses to faculty questions are somewhat answered, if posed.

 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

 

Responses posted in the discussion lack effective professional communication.

 

Responses to faculty questions are missing.

 

No credible sources are cited.

Participation 5 (5%) – 5 (5%)

Meets requirements for participation by posting on three different days.

0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%)

Does not meet requirements for participation by posting on 3 different days.

Total Points: 100