A healthy diet is a diet with a nutrient composition that results in an optimal health, both with respect to macronutrients (carbohydrates, fats and proteins) and micronutrients (vitamins and minerals). A balanced diet will prevent deficiency diseases like rachitis and osteoporosis. An unhealthy diet is an important risk factor for the development of chronic metabolic diseases like obesity, type 2 diabetes mellitus, cardiovascular disease and several types of cancer. Due to the increasing prevalence of these diseases the topic of nutrition has become an essential part of the bachelor degree health sciences, providing relevant knowledge for a later career in several public and private settings like public health, industry, research and hospitals.

This module focuses on nutrition, and nutrient digestion, how food is converted into energy within our body and how this energy is stored in the form of chemical bounds. An excess or altered intake of the major macronutrients, carbohydrates, fat and proteins may play a role in the development of obesity, diabetes and cardiovascular disease, diseases that are currently reaching epidemic proportions worldwide. It will be discussed how modulation of dietary carbohydrate, fat and protein intake may affect our health and may prevent the development of these chronic metabolic diseases. For an effective and targeted prevention and treatment of disease it is very important to have adequate biomarkers, reflecting either dietary intake and/or risk for the development of disease. In this context, biomarkers of macronutrient intake and disease risk will be discussed.

Key competencies:

After this module the student is able to:

1.    To describe basic aspects on nutrition, nutrient absorption, transport and storage into energy as well as the involved tissues and pathways.

2.    To be able to explain the basic metabolic pathways of nutrient handling.

3.    To integrate disturbances in nutrient handling in the etiology of chronic metabolic diseases and to understand the concept of biomarkers of disease risk.

4.    To present a self-designed experiment on the relation between diet, energy expenditure and substrate oxidation.

Knowledge and insight in:

After this module the student has knowledge and insight in:

        · Nutrition (macro and-micronutrients), emphasis on macronutrient metabolism, but role of micronutrients (vitamins, minerals) will also be addressed:

1.    Different types of carbohydrates (monosacharides, disaccharides and polysaccharides, available and indigestible carbohydrates), fats (simple lipid, compound and derived lipids, unsaturated and saturated fatty acids).

2.    Chemical composition, food sources and list the general functions of macronutrients within the body.

3.    What dietary macronutrient composition is and what the recommendations are.

4.    General classification of vitamins in water soluble and fat soluble.

5.    Knowledge of the function of water and fat soluble vitamins and the broad role of minerals in macronutrient catabolism and anabolism.

        · Physiology and anatomy of the gastro-intestinal tract;

        · Nutrient absorption, transport and storage into energy as well as the involved tissues and metabolic pathways:

1.    Carbohydrate digestion and absorption, transport from in the blood, storage and metabolic pathways (involved in transport, oxidation and storage).

2.    Role of carbohydrate as energy source, protein sparer and central nervous system fuel.

3.    Blood glucose regulation.

4.    Fat digestion and transport (dietary fats and endogenous fats), fat storage and involved metabolic pathways.

5.    Protein digestion and absorption, transport and the involved metabolic pathways, protein turnover, deamination and transanimation, nitrogen balance, urea cycle.

6.    Integrative view of regulation carbohydrate, protein and fat metabolism during fasting and postprandial conditions.

        · Disturbances in macronutrient handling in the etiology of chronic metabolic disease (obesity and obesity-associated insulin resistance, cardiovascular disease):

1. Disturbed blood glucose regulation, hyperglycemia and diabetes.
2. Disturbed lipoprotein metabolism in cardiovascular disease.
3. Disturbed adipose tissue, liver and muscle fat storage in insulin resistance and chronic metabolic diseases.

       · The application of biomarkers in epidemiological research, biomarkers of disease risk;

       · Basic principles of the measurement of dietary intake and dietary status;

       · Insight in the design and most important component of dietary intervention research.

Application of knowledge and insight:

After this module the student is able to:

       · Understand the process of carbohydrate, fat and protein digestion transport and further metabolism and the interaction with diet and bioactive substances;

       · Understand the relationship between disturbances in blood glucose regulation, lipoprotein metabolism and fat storage in the etiology of chronic metabolic disease;

       · Understand the use of biomarkers , the sources of variation and the application of biomarkers in epidemiological research;

       · Understand the design and relevant factors for a dietary intervention study.

Forming opinions:

After this module the student is able to form an opinion on:

       · The importance of food, and nutrient handling in health and disease.

Communication:

After this module the student can express knowledge and insight:

       · With respect to giving an overview of the metabolic pathways involved in substrate handling and storage and is able to make an animation/movie to explain one of the metabolic pathways in more detail.

Learning skills:

After this module the student has skills to:

        · Find arguments, using the recommended literature, to support a certain point of view;

        · Combine and integrate knowledge from different metabolic pathways in relation to diet and apply this knowledge towards relevance for chronic metabolic diseases and related preventive strategies.