case study on food and nutrition

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2020 CASE STUDY 3

Promoting food security, resilience and equity during climate-related disasters.

The U.S. is often viewed as a nation of abundance , yet paradoxically, one in ten households were “food insecure” in 2019, meaning that they struggle to get the proper nutrition to keep their family healthy. CS_77

These challenges are not borne equally. Rates of food insecurity were nearly three times higher for low-income and single mother-headed households and nearly twice as high for Black and Latino households than for White households.

Early research has found a doubling of the average food insecurity rate across the U.S. linked to the COVID-19 pandemic, with even greater increases among vulnerable populations. CS_78 , CS_79 , CS_80 , CS_81 Disruptive events, whether climate-related disasters or the COVID-19 pandemic, can exacerbate existing barriers to securing healthy food for vulnerable populations and further widen food and health disparities. CS_82

Food insecurity has clear health implications. Adults who are food-insecure may be at an increased risk of health problems, including obesity, heart disease, diabetes, depression, and increased susceptibility to COVID-19. CS_83 , CS_84 , CS_85 Food insecurity also puts children at a higher risk of asthma, anemia, and obesity, as well as behavioral, developmental, and emotional problems. CS_83 , CS_86

Climate-intensified extreme events are compounding existing food insecurity

Climate change is anticipated to worsen existing food insecurity as climate-related disasters, such as drought and flooding, become more frequent and severe and as agricultural pests become more persistent. CS_72 , CS_87 In 2019, there were fourteen climate-related disasters within the U.S. that each caused over a billion dollars in damages. CS_52

Historic floods in the Midwest destroyed millions of acres of agriculture and caused widespread infrastructure damage ( see  the Case Study ). In addition, an above-normal Atlantic hurricane season inundated coastlines with unprecedented rainfall, high winds, and storm surge; and wildfires in California and Alaska caused widespread energy disruptions, compromising the health and well-being of residents. CS_52

The mechanisms of food system disruption

Disasters such as these threaten all aspects of food production, distribution, and accessibility, with subsequent impacts for affordability that can further exacerbate food insecurity for vulnerable populations. When food is not consumed where it is produced, it must be processed, stored, transported, and then sold or donated. These processes involve complex interdependent, and at times, international systems. Roads, bridges, warehouses, airports, energy grids, and other transportation or telecommunication infrastructure are at risk of direct damage from climate change, severely disrupting the food system as a whole. CS_88 , CS_89

For example, following the 2019 floods in the Central states, the flood waters caused more than forty state and federal highways to close, hydroelectric dams to be breached, and threatened nuclear power stations (see Case Study). CS_90 , CS_91 These disturbances limited the movement and storage of goods throughout the region and prevented consumers from accessing food sources. CS_91 , CS_92 In the midst of an extreme fire season in California that same year, utility providers turned off power to millions of homes and businesses, plunging low-income households into hunger and financial crisis as their food spoiled. CS_93

Recent climate disasters decreased food security

Climate disasters can lead to acute food insecurity in the short-term and exacerbate chronic food insecurity in the long-term (see Table 1). Populations already struggling from chronic insecurity, or those who are only marginally food secure, are particularly vulnerable to the socioeconomic impacts of disasters, such as loss of livelihood, rising food prices, forced migration, loss of social support, and health-related impacts. Data from the aftermath of 2019 disasters is still scarce, but the impacts from previous disasters that are similar in nature are well documented.

Individual, household and community level risk factors to food insecurity following climate-related disasters.

For example, nearly five years after Hurricane Katrina, many of the households heavily impacted by the hurricane in Louisiana and Mississippi remained food insecure. This was especially true for women, Black households, and those living with chronic illness, mental health issues, or low social support. CS_94 Similar impacts were demonstrated in New York City following Hurricane Sandy, where one-third of surveyed households in the heavily impacted Rockaway Peninsula reported difficulty obtaining food due to economic hardship, disruption of public transportation, and long-term closure of grocery stores months after the storm. CS_95

A path towards equitable food security

Learning from baltimore.

In the era of complex disasters, community-level resilience is essential, as federal relief is often too slow and under-equipped to meet the immediate needs of individuals and households. A growing number of U.S. cities are working to protect and improve food security in the aftermath of climate-related disasters and help build climate-resilient local and regional food systems.

For example, officials from Baltimore, Maryland worked with researchers at the Johns Hopkins University in 2017 to assess the resilience of the city’s food supply to climate-related disruptions and to identify ways to support communities at risk of experiencing food insecurity both before and after disasters. CS_96 This is a wonderful example of the power of academic and public partnerships.

Baltimore also designated a food liaison to sit within the Office of Emergency Management during crises. This city received funding from FEMA to coordinate a collaborative regional food and water resilience plan with surrounding jurisdictions. When COVID-19 spread to Baltimore in early 2020 — closing schools and many businesses — the city quickly put its food resilience planning into action and convened a group of food assistance stakeholders to better coordinate responses supporting food access for residents.

Adaptive actions for health and equity

Local and state governments across the country can take similar steps to incorporate food insecurity risk analysis and adaptive planning into emergency management and climate adaptation planning ( see Table 2 ). Local governments and community partners can ensure food assistance programs provide well-balanced meals and are targeted to reach vulnerable individuals and communities.

It is critical to support federal and state assistance programs during non-disaster times, such as the Supplemental Nutritional Assistance Program (SNAP), Women, Infants and Children (WIC), and school lunches. As an example, SNAP and WIC services have been pathways to try to meet the rise in food insecurity during the pandemic, and many schools have attempted to continue to provide meals to children most in need. CS_97 , CS_98 Thus, ongoing support can ensure that these programs are even more adaptable, optimally funded, and able to be rapidly mobilized during a disaster of any kind, thus reducing vulnerability and supporting food security in the short- and long-term.

Simultaneously, addressing food insecurity in the wake of disasters goes hand in hand with combating the root causes of food insecurity and health disparities, such as poverty and food deserts. CS_99 Structural racism is also deeply interconnected through complex pathways, including through the creation of disadvantaged social and economic factors that contribute to food insecurity. CS_100 Yet, even when these factors are removed, some evidence suggests food insecurity remains for people of color, highlighting the need for further research. CS_100 Finally, applying a food systems approach to food security after disasters, such as production of and access to healthy foods, and supporting diverse, local, and regional agriculture, is an important long-term strategy with clear benefits for both health and climate change.

Suggested adaptive actions for communities and organizations.

Adaptive actions for communities and organizations.

• Identify and address the impact of systematic racism and discrimination in food insecurity and food distribution systems CS_100 , CS_114
• Assess and consider public access to food for people with limited capacity to travel CS_94
• Promote policies and practices to enhance access to affordability of nutritious foods, including food diversion programs that reduce food waste CS_115
• Increase flexibility and access to emergency food for vulnerable populations (D-SNAP, WIC, food banks, and school meals)
• Screen for food insecurity in the healthcare setting
• Address food sovereignty for tribal and Indigenous people116
• Identify and address food deserts within communities CS_99
• Foster partnerships with local food producers through community cooperatives in order to promote food access and local economic resilience
• Create community collaborations for resource sharing CS_117
• Strengthen social support networks among vulnerable populations CS_117
• Undertake risk assessments to understand climate change threats and the current state of preparedness, specifically with regard to food supply CS_118
• Undertake food vulnerability mapping to understand risk profiles among neighborhoods CS_119
• Promote resilient local and regional agricultural practices, including urban agriculture and community gardens CS_120
• Urban food chain supply resilience CS_121
• Local food system resilience and food insecurity CS_122
• A food systems approach to climate change preparedness CS_103

Introduction Compounding Food Insecurity Mechanisms of Food System Disruption Decreased Food Security A Path Towards Equitable Food Security – Table 1: Food Insecurity Risk Factors Adaptive Actions for Health and Equity – Table 2: Adaptive Actions

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Medical Nutrition Therapy: A Case Based Approach

• Kathryn M. Kolasa, PhD, RDN, LDN Kathryn M. Kolasa Affiliations Brody School of Medicine at East Carolina University, 3080 Dartmouth Dr, Greenville, NC 27858 Search for articles by this author

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DOI: https://doi.org/10.1016/j.jneb.2022.02.003

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Use Case Studies to Bring Life Into Your Nutrition Course

NutritionCalc Case studies are a helpful way for students to bring life to the information in their textbook and Connect offers a variety of different topics to be used in your class.

Case Studies are great as a stand-alone project but they can also be built into assignments or even expanded upon in a variety of ways.  No matter how you use the case studies your students will gain a deeper understanding of the topic while increasing their critical thinking skills.

Here are a couple of ways you can use the auto-graded Case Study assignment in your classroom, whether virtual or in seated class.

Alternative to a personal 3-day record

A case study can be an alternative assignment for students who feel uncomfortable analyzing their diet and/or have a history of an eating disorder. The case study takes the focus off analyzing a personal record.

If needed, you can adjust the questions to focus more on the quality of the diet versus analyzing numbers like calories or grams of protein etc. You could also add more open-ended questions that include students looking for recipes that are suitable for that case study scenario.

Delve deeper to spark conversation into the topic

Use the case studies as an opportunity to have your students delve deeper into the topic with a discussion. If your students are in person, you can have them work in small groups and then discuss the case study. Alternatively, an online class may use discussion boards.

For example, the case study “Staying Energized When Stressed” could be a great case study to have at the beginning of the semester. This case study is a good starting point for students to bring self-awareness and begin to make connections with how college life can impact their eating habits.

Combine with another assignment

Each case study has 10 auto-graded questions that can be an excellent addition to an assignment you already have.

A nutrition article review assignment where students analyze the credibility of the article’s information can be a nice complement to many of the different case studies in Connect. By having an article review at the start of the assignment and then ending with a case study students can better demonstrate understanding and comprehension of the topic.

Add an AI menu planning feature

Take the case study one step further by incorporating a meal plan that is created using AI. Artificial intelligence will not always be accurate but one of the cool things about it is that it can create sample meal plans.

AI platforms can quickly create meal plans for various concerns or medical conditions; the accuracy of these plans is another story. Use an AI meal plan as a learning moment for students.

For example, assign the Polycystic Ovary Syndrome case study and then add an open-ended question where you instruct students to create an AI-generated meal plan. You can have the students write in their thoughts on the accuracy and feasibility of the meal plan. For your in-seat classes, you could have them bring their laptops and discuss in a small group.

Available Case Studies in NutritionCalc Plus: Nutrient Density, Keto Diet, Dietary Guidelines, Whole vs. Refined Grains, Diabetes, Mediterranean Diet, High Protein Diet, Vegan Dietary Pattern, DASH Diet, Weight Management, 5,000-calorie Diet, Breastfeeding Diet, School-Age Dietary Pattern, Okinawan Diet, WIC, Bone Health, Female Athlete Triad RED-S, Constipation.

New Cases coming Summer 2024: Celiac Disease, Elderly, Irritable Bowel Syndrome, Polycystic Ovary Syndrome, Fermented/Probiotic Foods, Heart Health, Anemia, Supporting Detox, Staying Energized when Stressed, Metabolic Support.

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The human body is the most complex machine on the face of the Earth. Like any machine, it requires an input of fuel to function along with a variety of chemicals for proper maintenance. In this case, those requirements are met by food. But food is incredibly complex, even a simple meal is composed of hundreds of compounds. It is folly to think that simple predictions can be made about what may happen when something as complex as food is introduced into an organism as complex as a living body, especially given that the living bodies concerned can differ in genetics, gender, age and health status. Yet simple nutritional advice is routinely given!

For example, to reduce the risk of heart disease, we are told to replace saturated fats, as found in red meat, dairy products and tropical oils such as coconut with unsaturated ones found in seed oils. Unfortunately, the story is much more complicated. (A quick chemistry lesson here: saturated fats contain no carbon-carbon double bonds in their molecular structure, while unsaturated fats contain one or more double bonds.)

This discussion was prompted by a study I came across in which researchers in Nigeria determined the fat composition of insects, specifically bees, winged termites, soldier termites and mopane worms. Since such insects are eaten in some parts of Africa, their nutritional content is of interest. What caught my attention in this report was the following statement: “The higher the polyunsaturated fatty acid (PUFA) to saturated fatty acid (SFA) ratio, the more the nutritional usefulness of a dietary oil and the PUFA/SFA ratios in the present study are good enough to discourage atherosclerotic tendency.” Atherosclerosis is the buildup of plaque in arteries that can lead to cardiovascular disease. The implied message in this study is that eating insects is “heart healthy.”

This study really has no practical relevance for us since insects are not an option in the western diet. But portraying polyunsaturated fats as angelic and saturated fats as demons is way too simplistic. For example, a large study across nine European countries found no strong association between dietary saturated fats and heart disease. Neither was the incidence of heart disease decreased by substituting unsaturated fats for saturated ones. However, the situation turned out to be different when sources of the saturated fats were considered. Saturated fat in red meat or butter increased heart disease risk, but saturated fat in yogurt or cheese actually decreased it.

The standard advice for years has been to replace saturated fats with unsaturated vegetable fats. That seems to be justified when we consider the “heart healthy” Mediterranean diet in which unsaturated fats come mostly from olives, nuts and fish. But the story is different when saturated fats are replaced by seed oils such as soy, sunflower, cottonseed or corn, as is common in the western diet. The prominent fatty acid in these oils is linoleic acid (a so-called omega-6 fatty acid due to the presence of a double bond on the sixth carbon from the end of the molecule).

Uncomfortably, studies have shown that replacing saturated fats with vegetable oils that contain linoleic acid actually increases heart disease risk. This despite total cholesterol and LDL cholesterol being decreased! That is surprising since reducing blood cholesterol is generally thought to be desirable. Indeed, numerous studies have shown that decreasing elevated cholesterol with the use of drugs such as the statins reduces the risk of heart disease, but studies that have focused on reducing cholesterol via diet have been inconclusive. This may be because statins also have an antioxidant effect that can mitigate the risk of heart disease.

The problem with linoleic acid is its susceptibility to attack by oxygen, in other words to be oxidized. When linoleic acid gets incorporated into LDL particles, as happens with fatty acids, it undergoes reaction with oxygen and breaks down to form “oxidation products” such as malondialdehyde and 4-hydroxynonenal. When LDL containing these oxidation products deposits in the walls of arteries to form plaque, it causes inflammation that in turn makes the plaque prone to rupture. When that happens, a blood clot can form, precipitating a heart attack or stroke. By contrast, omega-3 fats, as found in fish, are also polyunsaturated fats but are not prone to oxidation and replacing saturated fats with these appears to be protective.

Now back to the insects. Their fat content is mostly linoleic acid. So, the suggestion that eating insects may reduce the risk of heart disease because of a “favourable PUFA/SFA profile” is wrong. If the polyunsaturated fatty acids are mostly linoleic acid, the profile is not favourable.

Obviously, the link between diet and heart disease is frustratingly complex, but labeling polyunsaturated seed oils, increasingly found in processed foods, as “healthy,” is misguided. So is labelling all saturated fats as “unhealthy.” While in general they do raise cholesterol, the extent to which they do this depends on their molecular structure. The ones that contain 14 or 16 carbon atoms, namely myristic and palmitic acids, raise cholesterol, while lauric and stearic acids with their 12 and 18 carbon chains are relatively innocuous.

To complicate the picture further, saturated fats also raise HDL cholesterol, the so-called “good cholesterol.” Actually, the best measure of risk is not LDL, but the ratio of total cholesterol to HDL. To insert some practical numbers here, total cholesterol should be less than 5.2 mmol/L and HDL should be above 1.5mmol/L meaning that the ratio should ideally be less than 3.5. However, a diet in which saturated fats are substituted by seed oils high in linoleic acid can decrease this ratio but still increase the risk of heart disease!

If that isn’t complicated enough, determining the number of LDL particles in the blood is a better measure of risk than just measuring LDL cholesterol levels. Apolipoprotein B, or ApoB, is a protein found in LDL particles and the extent of its presence is indicative of the number of LDL particles. Levels above 1.2 grams/L are deemed to be elevated.

Now let’s try to uncomplicate things. Talking about total intake of saturated and unsaturated fats is not meaningful because fatty acids differ in their effects, and the effects are also dependent on the matrix of the food in which they are present. Therefore, it is much more meaningful to speak in terms of food rather than specific nutrients. Here goes. Limit red meat, white flour, sugar, salt, soft drinks and be wary of anything that comes in a box. Use oils such as canola, olive, safflower or avocado that are low in linoleic acid and in saturated fats. Eat 5-7 servings of fruits and vegetables a day with at least one of berries. Cheese and yogurt are fine. Emphasize fish and whole grains. Exercise 30 minutes at least five times a week. Not so complicated. And oh yes, select your parents carefully.

@JoeSchwarcz

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Creative Steps to Write a Nutrition Case Study

Table of Contents

Nutrition plays a vital role in improving a patient’s health. However, each patient has unique nutritional needs requiring a personalized healthcare approach. That’s where nutrition case studies come in. These case studies comprehensively assess a patient’s nutritional status and help develop an individualized nutrition plan. They also help to monitor and evaluate the patient’s progress toward their health goals over time. In this article, we will provide a step-by-step guide on  how to write a nutrition case study . This post will help you understand the importance of nutrition case studies, whether you are a healthcare professional or a student.

What Is a Nutrition Case Study?

A nutrition case study comprehensively reports an individual’s nutritional status, dietary habits, and health outcomes . Healthcare professionals typically use these case studies to evaluate and treat patients. This is with various nutritional concerns, such as obesity, malnutrition, or chronic diseases. If you are a nutrition student or practitioner, learning how to write a nutrition case study is an essential skill to have. 

Importance of Nutrition Case Study

Nutrition case studies are a crucial tool for healthcare professionals in nutrition and dietetics. Here are some of the reasons why nutrition case studies are essential:

Provides a Comprehensive Assessment of a Patient’s Nutritional Status

 Nutrition case studies involve a detailed analysis of a patient’s dietary intake, medical history, and lifestyle factors that may impact their nutritional status. This information is used to develop a personalized nutrition plan tailored to the patient’s needs.

Develops an Individualized Nutrition Plan

A nutrition case study’s personalized approach to healthcare leads to an individualized nutrition plan. This approach can lead to better patient outcomes, improved health outcomes, and a higher quality of life for the patient.

Monitors and Evaluates Progress Over Time

Nutrition case studies track a patient’s food intake, weight, body composition, and other health outcomes over time. This enables healthcare professionals to monitor and evaluate the patient’s progress toward their health goals and adjust the nutrition plan as needed.

Provides Education About Healthy Eating Habits and Lifestyle Changes

Nutrition case studies can help educate patients about healthy eating habits and lifestyle changes. By providing a detailed assessment of a patient’s nutritional status, healthcare professionals can help patients make sustainable changes to their diet and lifestyle.

Supports Evidence-Based Practice

Nutrition case studies are based on evidence-based practice, meaning the nutrition plan is grounded in scientific research and clinical expertise. This approach ensures that the patient receives the best care based on the latest research and clinical knowledge.

Steps on How to Write a Nutrition Case Study

Selecting the patient.

The first step in writing a nutrition case study is selecting the patient. Typically, the patient has sought out nutritional counseling or treatment for a specific reason. These reasons include weight management, a chronic disease, or a food allergy. The patient should be willing to participate in the case study and provide detailed information about their diet, health history, and lifestyle habits. When selecting a patient, obtaining their written consent to participate in the case study is essential. This should include an explanation of the purpose of the case study and how their information will be used. It should also add any potential risks or benefits of participating. The patient should know that they can stop participating in the research at any moment if they don’t want to.

Gathering Information

The next step in writing a nutrition case study is gathering information about the patient. This includes a comprehensive assessment of their dietary habits, health status, medical history, and lifestyle factors that may impact their nutrition. To gather this information, you may need to conduct a nutrition assessment, which typically includes the following components:

Anthropometric Measurements

This involves measuring the patient’s height, weight, body mass index (BMI), and other body composition measures.

Dietary Intake Assessment

This involves collecting information about the patient’s dietary habits, including food preferences, allergies, and cultural or religious dietary restrictions.

Biochemical Assessment

This involves analyzing the patient’s blood, urine, or other biological samples to assess their nutritional status.

Medical History

This involves collecting information about the patient’s past and current medical conditions, medications, and surgeries.

Lifestyle Assessment

This involves collecting information about the patient’s physical activity, stress, and other lifestyle factors that may impact their nutrition status. Gathering as much information as possible is essential to create a comprehensive nutrition case study. This information will help you develop an individualized nutrition plan addressing the patient’s needs and concerns.

Developing a Nutrition Plan

Once you have gathered all the necessary information, the next step is to develop a nutrition plan for the patient. The nutrition plan should be based on the patient’s dietary needs, health goals, and lifestyle factors. It should also consider any medical conditions or medications that may impact the patient’s nutritional status. The nutrition plan should include the following components:

Macronutrient and Micronutrient Recommendations

This involves recommending specific amounts of carbohydrates, protein, fat, and other essential nutrients the patient should consume daily.

Food Group Recommendations

This involves recommending specific food groups for the patient, such as fruits, vegetables, whole grains, and lean proteins.

Meal and Snack Recommendations

This involves recommending specific meals and snacks for the patient to meet their nutritional needs throughout the day.

Nutritional Supplements

This involves recommending specific nutritional supplements, such as vitamins, minerals, or protein powders, that may help patients meet their nutritional needs.

Behavioral Recommendations

This involves recommending specific behavioral changes that may impact the patient’s nutrition status, such as increasing physical activity or reducing stress. The nutrition plan should be individualized to the patient’s needs and preferences. It should also be realistic and achievable, considering any barriers the patient may face in following the plan.

Implementing the Nutrition Plan

Once the nutrition plan has been developed, the next step is implementing it with the patient. This may involve educating the patient about healthy eating habits and strategies for making dietary changes. The patient should also be encouraged to track their food intake and monitor their progress toward their health goals. Working collaboratively with the patient throughout the implementation process is essential, as ongoing support and guidance are needed. This may involve regular follow-up appointments or communication via phone or email. The patient should be encouraged to ask questions and share any concerns or challenges they may be experiencing.

Monitoring and Evaluating Progress

The final step in writing a nutrition case study is monitoring and evaluating the patient’s progress. This involves tracking the patient’s food intake, weight, body composition, and other health outcomes. The patient’s progress should be regularly assessed, and adjustments made to the nutrition plan as needed. Objective measures such as laboratory values or body composition assessments are essential to evaluate the patient’s progress. This can help ensure that the nutrition plan is effective and that the patient is progressing toward their health goals.

How to Write a Nutrition Case Study

Once the nutrition plan has been implemented and the patient’s progress has been evaluated, it is time to write the case study. The case study should be organized in a logical and easy-to-read format, and should include the following sections:

Introduction

This should provide an overview of the patient’s case and outline the purpose of the case study.

Patient History

You should provide a comprehensive overview of the patient’s medical history, dietary habits, and lifestyle factors that may impact their nutritional status.

Nutrition Assessment

This should provide a detailed assessment of the patient’s nutritional status, including anthropometric measurements, dietary intake, biochemical markers, and medical history.

Nutrition Plan

This should provide a comprehensive overview of the patient’s individualized nutrition plan. They include macronutrient and micronutrient recommendations, food group recommendations, meal and snack recommendations, nutritional supplement recommendations, and behavioral recommendations.

Implementation and Follow-Up

This should provide an overview of the patient’s progress in implementing the nutrition plan, including any challenges or barriers encountered. It should also outline the follow-up appointments or communication that took place between the patient and healthcare provider.

This should provide an overview of the patient’s progress towards their health goals, including any changes in weight, body composition, or laboratory values.

This should provide an interpretation of the patient’s results, including any limitations or strengths of the case study. It should also provide a summary of the key takeaways and implications for future practice.

Writing a nutrition case study may not be the most exciting task in the world, but it is a crucial one. By following these steps and using a bit of wit and creativity, healthcare professionals can effectively communicate their patient’s nutritional needs . This shows progress toward their health goals. Who knows, maybe writing a nutrition case study will be more fun than you thought!

Abir Ghenaiet

Abir is a data analyst and researcher. Among her interests are artificial intelligence, machine learning, and natural language processing. As a humanitarian and educator, she actively supports women in tech and promotes diversity.

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