Obesity, lipids and cardiovascular disease

On successful completion of this course, you will be able to:

• Explain the physiological regulation of energy intake and expenditure.
• Define the global importance of obesity in epidemiological terms and describe the epidemiology of obesity, dietary lipids and disease.
• Debate the influence of nutritional factors versus environmental factors in the pathogenesis of obesity and related diseases.
• Compare and contrast the effectiveness of various obesity treatment and management strategies, including prevention policies and bariatric surgery.
• Describe major dietary issues and the scientific rationale underlying the current consensus on dietary guidelines for lipids and essential fatty acids.
• Explain lipid biochemistry and lipid-mediated cardiovascular risk and how dietary lipids modify the course and outcome of disease, including role of dietary fatty acids as therapeutic agents.
• Discuss the need to avoid stigmatizing language and images for obesity in public health, clinical practice and research.
• Develop the skills to examine/write a case study involving obesity and lipid-related risk factors that could be improved with dietary/lifestyle advice.

• Definitions and epidemiology of obesity, including maternal and child obesity: effects of age, sex, ethnicity, geography and socio-economic status.
• Aetiology of obesity: genetic factors; environmental effects, dietary patterns; endocrine abnormalities; energy balance regulation; hormonal, metabolic and physiological influences on energy expenditure; appetite regulation; theories of satiety; abnormal eating patterns.
• Distribution of body fat: android and gynoid obesity; genetic and hormonal influences.
• Obesity management: implementing diet and lifestyle changes; bariatric surgery and physical interventions; effectiveness of treatment strategies; very low-calorie diets; fad diets.
• Consequences of obesity and dietary fat intake: including aspects of morbidity; insulin resistance; type 2 diabetes; Non-alcoholic fatty liver disease, cardiovascular disease.  
• Lipids: structure and functional roles; fatty acid biochemistry and nature of essentiality; sources of lipids in the diet; n-3:n-6 ratio; efficiency of conversion to long-chain n-3 PUFAs. Sustainability issues with regard to fish oil fatty acids/alternative sources.
• Lipid, lipoprotein and cholesterol metabolism.
• Pathogenesis of atherosclerosis and thrombosis: atherogenicity of lipoproteins.
• Dietary fat and disease epidemiology with emphasis on cardiovascular disease.
• Dyslipidaemia and cardiovascular disease; influence of type of dietary fat; lipid-lowering strategies.
• Membrane structure and function and effects of diet; role of essential fatty acids in brain and retinal development; eicosanoid metabolism; prostaglandins, leukotrienes and cytokines - role in the modulation of inflammatory and immunological responses; dietary n-3:n-6 ratios in relation to eicosanoids and inflammation.
• Clinical applications of dietary fatty acids.
• The effect of food structure and macronutrient composition on dietary lipid metabolism.
• Current public-health policies relevant to obesity, and dietary guidelines for dietary fat and fatty acid composition.

Learning and teaching methods include:

• Lectures
• Class discussions – these are vital to students’ understanding and sharing of their experience and perspectives.
• Case reports – students may be able to participate in these.
• Journal club with student interaction.
• Being exposed to foods important to the brain at the “Brain-food” dinner.
• Student presentations on the points discussed – this should help students relate to future interaction with employers.

Coursework - 5000 words.