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Evidence in Public Health Nutrition

1.    Briefly describe the major types of measurement errors associated with dietary assessment and how to reduce them. What would be their impact in studies assessing the relationship between diet and disease? Finally, describe two biochemical markers that are known as the “gold standard” to measure the relative validity of dietary assessment

2.    Fortification of flour with folic acid is mandatory in Australia. However, mandatory fortification remains controversial. Write two arguments, one against and another in favour of folate fortification of foods.  How would you monitor folate fortification programs?

3.    The WHO Child Growth Standards describe how all children should grow, and is currently used in more than 100 countries around the world. What are some strengths and limitations of the WHO Child Growth Standards? (WORD LIMIT: 300 words) [4 marks]http://www.who.int/childgrowth/standards/en/

4.    The National Nutrition and Physical Activity Survey 2011/12 (as part of the Australian Health Survey) assessed food security by asking two questions:
In the past 12 months was there any time when you ran out of food and couldn’t afford to buy more?
When this happened, did you go without food?
Why is it important to monitor food security in Australia? What are the strengths and limitations of these indicators? Comment on the validity and sensitivity of those questions for identifying food insecurity in Australia.

5.    Briefly describe the recommendations given by Gibson to estimate the population percentage “at risk” of inadequate nutrient intake.  What is the reasoning behind these recommendations? Were these recommendations followed in the design of the Australian National Nutrition Survey 2011/12? (WORD LIMIT: 300 words) [4 marks]

6.    George et al (2012) evaluated the prevalence of iron deficiency in young Cambodian children.  What laboratory assays were used to determine the iron status of the children? Which assays would be the best to assess the iron status of this population? Justify your answer.  What other factors must be taken into account when assessing iron status of a population? (WORD LIMIT: 300 words)[4 marks]
George et al (2012). Genetic hemoglobin disorders, infection, and deficiencies or iron and vitamin A determine anemia in young Cambodian children.  J. Nutr 142(4): 781-787.

7.    In the study by Jensen et al (2008), the authors conclude, “adherence to a healthy diet was associated with a lower risk of ACS (acute cardiovascular disease)”. Briefly discuss the validity of the Mediterranean Diet Score used by Jensen et al (2008) to estimate the adherence to a heart healthy diet by the sampled population. Do you agree with the authors’ conclusion? Briefly justify your answer.(WORD LIMIT: 300 words)[4 marks]
Jensen M.K. et al (2008). Obesity, behavioural lifestyle factors, and risk of acute coronary events.Circulation 117: 3062 – 3069.

8.    Briefly explain why the Recommended Dietary Intake (RDI) is inappropriate to assess the nutrient adequacy of groups.  What would be a better approach?

9.    Refer to the following article:
Jeffery, R. W., Linde, J. A., Simon, G. E., Ludman, E. J., Rhode, P., Ichikawa, L. E. and E. A. Finch (2009). Reported food choices in older women in relation to body mass index anddepressive symptoms. Appetite 52: 238-240.
(This article is available via the Assessment tab).
•    What is the research question?
•    What is the study design?
•    How was the exposure measured? (Do not include any psychological measurements). Briefly discuss the validity of the measures used to collect the data.
•    Did the authors consider any potential confounders that might have influenced the final result? [1 mark]
•    Do you agree with the authors’ conclusion?

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