Integration_of_Nutritional_Genomics_into

INTEGRATION OF NUTRITIONAL GENOMICS INTO THE DIETETICS CURRICULUM AT THE UNIVERSITY OF DELAWARE by Kelly Moltzen A thesis submitted to the Faculty of the University of D elaware in partia l fulfillment of the requirements for the de gree of Honor s Bachelor of Scienc e in Nutritional Sciences and Dietetics with Distinction. Spring 2008 Copy right 2008 Kelly Moltzen All Rights Reserved INTEGRATION OF NUTRITIONAL GENOMICS INTO THE DIETETICS CURRICULUM AT THE UNIVERSITY OF DELAWAR E by Kelly Moltzen Approved: __________________________________________________________ ChengShun Fang , Ph.D. Professor in charg e of thesis on behalf of the Advisory Committee Approved: __________________________________________________________ Caroly n Manning, M.Ag. Committee member from the Nutrition and Dietetics Prog ram Approved: __________________________________________________________ Barbara Settles, Ph.D. Committee member from the Boa rd of Senior Thesis Readers Approved: __________________________________________________________ John Courtright, Ph.D. Director, University Honors Program iii ACKNOWLEDGM ENTS I would like to thank my adviser, Dr. Richard F ang, as well as Profe ssor Caroly n Manning and Dr. Barbara Settles for all of their help. I would also like to thank the entire rest of the U niversity of Delaware Nutrition and Dietetics Program, Dr. Tom I lvento, Mary Henderson from the University of California, Davis Center for Excellence in Nutritional Genomics, Dr. Ruth DeB usk, Dr. James Kaput, and Dr. Johanna Dwy er for their advice and support. L astly, I \u2018d like to thank my pare nts and my roommate for all of their support. iv TABLE OF CONTENTS LIST OF TABLES ....................................................................................................... vi LIST OF FIGUR ES .................................................................................................... vii ABSTRACT ............................................................................................................... viii Chapter 1 THE FUTURE OF P ERSONALIZED NUTRITION ......................................... 1 The Practice of D ietetics ........................................................................... 2 Genetics and Dietetics ............................................................................... 2 The \u2017 - omics\u2018 .............................................................................................. 4 Nutritional Genomics ................................................................................ 4 Considerations ........................................................................................... 5 Folate ......................................................................................................... 6 Epigenetics ................................................................................................ 7 Other Current Testing of Genes Affec ted by Bioactive Food Components ................................................................................... 7 Opportunities for Nutrition Professionals ................................................. 9 2 METHODS & MATERIALS .............................................................................. 10 Module Development .............................................................................. 10 NTDT 103 Module .................................................................................. 12 NTDT 401 Module .................................................................................. 12 3 RESULTS .............................................................................................................. 14 NTDT 103 ............................................................................................... 14 Survey Result s ............................................................................. 15 NTDT 401 ............................................................................................... 22 Survey Results ............................................................................. 22 v 4 DISCUSSION ........................................................................................................ 27 Current Modules ...................................................................................... 27 Strategies for the Future .......................................................................... 30 5 CONCLUSION ..................................................................................................... 32 REFERENCES ............................................................................................................. 33 APPENDI X A: HUMAN SUBJECTS REVIEW BOA RD APPROVAL ................... 39 APPENDI X B: NTDT 103 MODUL E ........................................................................ 45 APPENDI X C: NTDT 103 HANDOUT ..................................................................... 62 APPENDI X D: NTDT 103 PRE-SURVEY ................................................................ 65 APPENDI X E: NTDT 103 POST-SURVEY .............................................................. 67 APPENDI X F: NTDT 401 MODUL E ........................................................................ 69 APPENDI X G: NTDT 401 PRE-SURVEY .............................................................. 103 APPENDI X H: NTDT 401 POST-SURVEY ............................................................ 106 APPENDI X I: ' BL UE FOODS' NEWSL ETTER ARTICL E .................................... 108 APPENDI X J: FULL R ESUL TS SECTION ............................................................. 110 vi LIST OF TABLES 3.1 Demogra phics of NTDT 401 class ................................................................ 14 3.2 Which of these cutting-edg e areas of nutrition pra ctice is most appealing to y ou? ........................................................................................... 14 3.3 Pre & post-survey question ............................................................................ 16 3.4 Chi-square of pre- a nd post-survey question ................................................. 17 3.5 Pre-survey : Are y ou interested in learning more about nutrigenomics? ....... 20 3.6 Pre-survey & Post-survey : How important do y ou thi nk gene-nutrient interactions are to the pra ctice of nutrition and dietetics? ............................. 23 3.7 Survey question: Your client\u2018s ge netic test comes back say ing they have the MTHFR 677TT genoty pe ........................................................ 24 3.8 Percent of students in NTDT 401 cor rectly answering content-based questions ........................................................................................................ 25 vii LIST OF FIGUR ES 3.1 Pre-survey question: If y ou have heard of nutrig enomics before, where did y ou hear about it? ........................................................................ 15 3.2 Pre-survey : What jobs can you imag ine using nutrige nomics? .................. 18 3.3 Pre-survey question: How much background in g enetics do y ou have? ..... 19 3.4 Post-survey : I f y ou wanted to learn more a bout nutrigenomics, what could y ou do during college to prepa re y ourself academically ? ......... 20 3.5 Post-survey : How could this lecture have been improved? ........................ 21 3.6 Pre-survey : If so, where did y ou hear about it? ........................................... 23 3.7 Post-survey : How could this lecture have been improved? ........................ 26 viii ABSTRACT Nutritional genomics has potential to be used in both the clinical and public health practice settings. This emerging field includes the development of diet plans matched to an individual\u2018s ge netically determined abilities to use the nutrients in specific foods. Deve loping educational tools to make dietetic students aware of nutritional genomics and its prac tical applications is a critical step in increa sing the competency of future dietitians and allowing them to bring healthcare to clients at a more personalized level. Tea ching modules were de veloped to be incorporated into two nutrition courses at the University of Delaware \u2013 NTDT 103 (I ntroduction to Nutrition Professions) and NTDT 401 (Micronutr ients) \u2013 with the expectation that the students\u2018 level of knowledg e and interest in nutritional genomic s would increa se after being taug ht the lesson in each class. The eff ectiveness of the modules was eva luated with the use of pre-survey s and post-survey s, which were approved by the Human Subjects Review Board a t the University of Delaware . Minitab ® 15 Statist ical Software was used to c ompare the pre-survey and post-survey results of each student. Overall, students in both courses bec ame more interested in nutrig enomics after the lesson, and the number of students who answe red nutritional genomics-related questions correctly increased. I n addition, 79% of the students in NTDT 103 and 70% of the students in NTDT 401 said the lecture helped them understand the concept of nutrigenomics, and 74% of those in NTDT 103 said the lecture taught them valuable ix information on possible future job opportunities involving nutrigenomic s. Given that the current educ ation on nutritional genomics that is available to underg raduate dietetics students at the University of Delaware is limited, the modules developed for NTDT 103 and NTDT 401 are effective in tea ching students about this cutting-edge field. 1 Chapter 1 THE FUTURE OF P ERSONALIZED NUTRITION The future of dietetics a nd personalized healthcare lie s in the field of nutritional genomics. Nutritional genomic s is a new field which has the potential to redefine the c urrent concept of pre ventive medicine (1). I t i s based on the idea that genetic va riations between people ca n result in differing \u2015nutrie nt requirements between individuals, differe nt susceptibilities to disease, and different influence s of environmental factors on our genes and their prote ins\u2016 (2). The future applica tions have potential to be used in both the clinical and public he alth practice setting s and include \u2015improved diag nostics t o test for predisposition to disease, enhanced prediction of individual differenc es in medical therapies and dr ugs, and the development of foods or diet plans matche d to an individual\u2018s genetica lly de termined abilities to use them\u2016 (3). Additionally , the use of personalized dietary advice has grea t potential for increasing c lients\u2018 self -efficacy and compliance (4). De veloping an educational tool to make dietetics students aw are of nutritional genomics and its practical applica tions is a critical step in increasing the compete ncy of future dietitians and allowing them to bring healthcare to clients at a mor e personalized level.

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