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HEALTH IMPLICATIONS OF SODIUM.


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Paper instructions:
Course: Nutrition
Subject Name: LIFESPAN NUTRITION
Level: Undergraduate year 2
Reference: VANCOUVER (4-5)
LENGTH: 700 WORDS, WRITE IN THE PAST TENSE.

TOPIC: HEALTH IMPLICATIONS OF SODIUM.

(700 WORDS – 230 WORDS FOR EACH ARTICLE)

IDENTIFY AND CRITICALLY EVALUATE 3 ORIGINAL PEER REVIEW JOURNAL ARTICLES LINKING SODIUM INTAKE WITH ONE ADVERSE HEALTH OUTCOME IN CHILDREN AND ADOLESCENTS (AGED 5-18 YEARS).

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TO START:
– Review content covered in TOPIC 1 METHODS IN NUTRITIONAL ASSESSMENT
– Review THESE resources:
1) SEARCHING FOR NUTRITION LITERATURE AND USING ENDNOTE
2) CRITICAL EVALUATION OF THE LITERATURE

WHAT TO DO:
•    Search scientific literature
•    Find 3 original peer reviewed articles
•    Steps to critical evaluation of scientific literature
•    Brief description of the study
•    Critical analysis of the study
•    Your critical evaluation can be part of your description of the 
study. eg “This study used a randomised control design (description) which is considered the strongest study design (critical analysis)”. “This study had a small sample (description), this may have reduced the power of the study (critical analysis)”. Your basic description of the study and the results can be inter mixed with critical analysis

TO REFERENCE:
• In text citations:
– Citation needs to be in brackets (1) after the full stop and they need to be in numerical order.
• Bibliography:
–  All text must be plain, no italics or bold, use of quotes.
–  No “&” before the last author.
–  Journal name needs to be abbreviated.
–  2002;347:284-7. Note there are no spaces, placement of 
colon and semi colon.

EXAMPLE:

1. Halpern SD, Ubel PA, Caplan AL. Solid-organ 
transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

EXAMPLE:

Cognitive impairment is common among older people. Mild cognitive impairment (MCI), is a frequently used diagnostic concept, defined by objective cognitive impairment in combination with subjective decline but without dementia. (1) Individuals with MCI have higher risk of nursing home placement and disability, higher risk of developing dementia, most commonly Alzheimer’s disease (2) and higher rates of mortality. (3) There has been increasing interest in the influence of dietary patterns on cognition. The Mediterranean diet, characterised by a diet rich in fish, fruits and vegetables rich in antioxidants, has been associated with a reduction in the risk of Alzheimer disease in an elderly population. (4)

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REFERENCES
1. Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, et al. Mild cognitive impairment–beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med. 2004;256:240-6.
2. Bennett DA. Update on mild cognitive impairment. Curr Neurol Neurosci Rep. 2003;3:379-84.
3. Guehne U, Luck T, Busse A, Angermeyer MC, Riedel-Heller SG. Mortality in individuals with mild cognitive impairment. Results of the Leipzig Longitudinal Study of the Aged (LEILA75+). Neuroepidemiology. 2007;29:226-34.
4. Donini LM, De Felice MR, Cannella C. Nutritional status determinants and cognition in the elderly. Arch Gerontol Geriatr. 2007;44 Suppl 1:143-53.

IMPORTANT INFORMATION:

1) the age range for this section: you should discuss studies using children and adolescents aged 5-18 years. You can include studies which have recruited children from a wider age range eg birth to 18 years, but you need to focus on reporting the results from children aged 5-18 years.

2) The three peer reviewed journal article need to be in humans- children and adolescents aged 5- 18 years. The three journal articles can have different age ranges. They can be of any study design eg cross sectional, randomised controlled trial.

3) need to describe the sampling method: You will need to provide some detail about the studies. eg you could say the study used a RCT study design and this is considered the strongest study design.

4) In what order should the information be presented: describing each study in turn (eg study design, results) and then any strengths and limitations. This will make it clear what study you are referring to. The description of each study should be approximately 230 words.

5) demonstrate critical analysis: Your critical evaluation can be part of your description of the study.
eg “This study used a randomised control design (description) which is considered the strongest study design (critical analysis)”. Your basic description of the study and the results can be intermixed with critical analysis. You will need to refer to “Steps to critical evaluation of scientific articles” which is available.

EXAMPLE where the students looked at zinc intake in children and adolescents.

“A study by DiGirolamo et al (8) looked at the effectiveness of zinc supplementation at a community level in an at risk group for zinc deficiency on mental health outcomes. This study looked at 750 school-aged children aged 6-11 years old from public schools in low income communities from Guatemala measuring serum zinc levels with both self-reported anxiety symptoms and parental reported child behavioural symptoms. This included anxiety, attention, internalising symptoms and hyperactivity. The large sample size allows a greater ability to apply outcomes generally to the population, which is a strength of this study. Additionally the study design, a randomised control trial (RCT), provides the strongest evidence allowing cause and effect to be determined. The participants in the treatment group were given 10mg chewable zinc tables while the control group received a placebo, the trial ran for 5 days a week over a 5.8 month period. Results indicated that there were no statistical differences between the 2 groups at the end of the intervention, however both groups showed statistically significant increases in serum zinc levels, with a concurrent decline in parental reported anxiety and internalising symptoms. Interestingly there is a decrease in socialisation skills. At the commencement of the study a school based program of supplying zinc fortified milk was implemented in the community. This unforseen variable is a major limitation within the trial as while there appears to be some effect of zinc supplementation, it cannot be determined if this is solely the result of the intervention or has been aided by the fortified milk program.”

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6) IF Some studies don’t clearly define the study design: You need to report the study design and you can determine this from the methods.

7) Do we need to have studies that have actually assessed dietary sodium intake using a FFQ, 24- hour recall etc. or can we include studies that have determined sodium status by measuring urinary sodium excretion? You can use either for the assignment.

8) For one of our articles for critical analysis, can we use a meta-analysis or systematic review?
You can’t use any sort of reviews (eg meta analysis or systematic review) for the three journal articles that you need to include in Health implications of sodium. These 3 journal articles need to have an introduction, methods, results and discussion.

9) detail should be included for each study: You have 230 words to discuss each article. For each paragraph you need to explain the study and provide critical analysis. Two separate points on critical analysis per article will be sufficient. This can be two strengths or two weaknesses or one strength and one weakness.

10) You can include studies with different findings with regards to the health outcome. Eg you could include one study that has an improvement in the health outcome, a deterioration in the health outcome or no change in the health outcome.

11) Regarding the peer-reviewed studies, if sodium was one of two or three micronutrients studied can this be included or must the study look exclusively at sodium only?
You can include these studies and just discuss the results from sodium only.

12) Can I use a journal article that has included participants aged from 5 years to 60 years?  You can include these studies and just discuss the results from the 5-18 year age group.

13) gender need to present: can include studies on boys only, girls only or boys and girls.

TO GET HIGH MARKS:
Provides clear, accurate and insightful critique of the quality of nutritional evidence. Demonstrates understanding of deeper and more subtle aspects of the topic which supports the formation of 
sound conclusions reflecting the quality of the available evidence linking sodium to health status in children and adolescents.

MATERIALS PROVIDED:
1)    Topic 1 Nutritional Assessment.pdf
2)    Searching for Nutrition Literature and using Endnote.pdf
3)    Critical evaluation of the literature.pdf
4)    List of nutrition grey literature sites.pdf

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