Project 5: Your Healthy Eating Plan Name:      

Purpose: With this final project you will develop a 1-day healthy eating plan that meets the dietary standards and guidelines that have been presented in this class. For examples of what this might look like, go to: http://www.choosemyplate.gov/healthy-eating-tips/sample-menus-recipes.html

Reports to save, use, and submit to the ANGEL drop box along with this document (4 total files, this document + 3 reports):

FORMCHECKBOX Nutrients Report for 1-day healthy eating plan (1 report).

FORMCHECKBOX Food Groups and Calories--run report for 1 day plan, and then click on the plus sign (+) to the left of Added sugars row, before exporting to PDF file. (1 report)

FORMCHECKBOX Meal Summary Report for 1-day healthy eating plan. (1 report)

Directions:

1. Navigate to: www.supertracker.usda.gov and log in to your profile. Click on My Plan. Look at the Daily Food Group Targets for each food group. See the sample picture below:

2. These are food group goals for the 1-day eating plan that you will create. Record these target values for each food group in the table under the header “Summary of your 1-day Healthy Eating Plan” found on page 4, question/table #1.

3. Use the recommendations from MyPlate (daily food group targets as above); the Dietary Guidelines for Americans, healthful eating practices you learned from this class, as well as your own food preferences and cultural practices to create a 1-day eating plan that meets the criteria described below under #6 of the directions.

4. Type each food and beverage into the 1-Day Personalized Healthy Eating Plan on page 3 below. List the amount or quantity of food and identify the food group each item falls within.

5. Enter each food item on your 1-day eating plan into SuperTracker using “food tracker”. As you add foods to Super Tracker, you can look at the bar graph (below) and see your progress towards meeting the food group goals. Once you have met the food group goals, you can click on “Related links: Nutrient Intake Report” to see if you have met the rest of your goals for this assignment (further described below in #6 of these directions).

6. Your 1-day Healthy Eating Plan must meet the criteria outlined in this checklist:

FORMCHECKBOX Meet a minimum of 95% of the target amounts for My Plate (the Daily Food Group Targets). This includes at least 3 ounces of whole grain foods and 3-cup equivalents from the milk group. It is acceptable to exceed 95% for the target groups. Note: If you follow a vegan diet or cannot tolerate dairy products, make a note on the assignment submission.

FORMCHECKBOX Select a reasonable energy (calorie) level that is similar to your SuperTracker My Plan Daily Calorie Allowance.

FORMCHECKBOX Meet these heart healthy goals:

· 20-35% of total calories from fat

· <10% of total fat calories from saturated fat

· (2,300 mg of sodium. If you are very active and your energy needs are 3000+ calories per day, try to keep it under 3200 mg.

· (4700 mg of potassium per day

FORMCHECKBOX Meet <10% of kcals from added sugars.

FORMCHECKBOX Meet at least 90% of the recommended (target) amounts for fiber, vitamins and minerals. Going over 90% is fine. (Only for nutrients listed in question #4, table. Note that the RDA for vitamin D is 5 ug, which is what we are using in this class since you all do get some sunshine exposure.)

FORMCHECKBOX Rules for your food selection:

· You cannot eat any more than 1 cup of a fortified breakfast cereal or a fortified bar or shake.

· Do not choose a product that has 100% of all vitamins and minerals such as Total breakfast cereals, Product 19, raisin bran, complete cereals, power bars, protein shakes, and instant breakfast drinks.

· Juices must be 100% juice and must be limited to no more than 1 cup.

· Do not include a vitamin or mineral supplement.

FORMCHECKBOX Choose foods that you enjoy eating. Healthy does not mean boring. Including some treats or a dessert on your menu is acceptable and encouraged.

FORMCHECKBOX If you have a health condition which makes it difficult to meet recommendations such as a food allergy or intolerance or digestive disease etc., please just write a note to your instructor.

7. You may have to “tweak” your 1-day eating plan a few times to create the “perfect” plan that meets all of the criteria outlined above.

8. Once you are satisfied with the plan you’ve created, complete Summary of Your Healthy Diet Plan tables and questions on pages 4 and 5. Report to use: Nutrients Report for 1-day eating plan.

9. Submit the following into the drop on ANGEL:

FORMCHECKBOX The completed Project 5 document

FORMCHECKBOX Nutrients Report for 1-day eating plan.

FORMCHECKBOX Meal Summary Report for 1-day eating plan.

1-Day Personalized Healthy Eating Plan

The MyPlate food groups include: vegetables, fruits, dairy, protein, grains, or oils. Once you’ve perfected your healthy diet plan, make sure this menu is completed by listing each food/description, amount and food group that it falls in for each meal.

SUMMARY of 1-day Healthy Eating Plan

1. Meet Daily Food Group Targets. You must meet at least 95% of the target amounts for My Plate (Daily Food Group Targets).

Report to use: using Super Tracker My Plan, record the Daily Food Group Target amounts for each food group in the table below. Enter actual food group amounts in the 1-day eating plan and the total percentage of target which can be identified using the bar graph data (see # 5 in the directions above).

*Estimate your dairy consumption yourself since Supertracker may be inaccurate for this group. (1 serving =1 c milk or yogurt, 1.5 oz cheese, 2 c cottage cheese, 1.5 c ice cream)

2. Meet your energy needs: Select a reasonable energy (kilocalorie) level for 1-day eating plan that is similar to your SuperTracker My Plan Daily Calorie Allowance

3. Your eating plan must be heart healthy for all nutrients, except sodium. For sodium, try to reach the goal or comment in question #3 below on some food modifications you would make to get closer to the goal for sodium.

Report to use: Nutrients Report for 1-day healthy meal plan.

4. Added Sugars—eating plan must meet dietary guideline of <10% kcals from added sugars.

Report to use: Food Groups and Calories--run report for 1 day plan, and then click on the plus sign (+) to the left of Added sugars row.

5. You must meet at least 90% of the target amounts for each nutrient listed in the table below (fiber, vitamins and minerals). Going over 90% is fine.

Report to use: Nutrients Report for 1-day eating plan.

a Females 25g/day; males 38g/day. Those with high energy needs should try not to exceed 40 g/d of dietary fiber.

b The Target for vitamin D is 15ug, which includes the vitamin D we synthesize from sun exposure and from our diets. We are assuming you need to consume ~5ug of vitamin D from food for this assignment, thus you will use 5ug as the target for Vitamin D.

c calculate the % of target by dividing 1-day Eating Plan Average into the Target (example: vitamin D target =5ug; 1-day eating plan average for vitamin D =7ug: 7ug / 5ug=1.4 x100=140% of target)

5. SUMMARY: Type your responses to the following questions. Answer in complete sentences and do not use abbreviations. Correct grammar and spelling will be considered as part of your grade. You will be graded on the thoughtfulness of your answers. You should be able to answer these questions in 1-2 pages. Please be succinct in your responses.

A. Was it difficult for you to create this diet? Explain why or why not. Were you able to include favorite foods, “treat foods,” and realistic foods that you know you may eat? Explain.

B. Using what you have learned from this course, discuss your reasons for wanting to improve your diet (or not). For example discuss what motivates you to select the foods you eat (i.e., is it family history of a disease? To feel better or age gracefully? To maximize performance at the gym?) Briefly discuss why your food choices and nutrient levels will help you towards this goal. Your discussion should summarize the link between diet and your health goals from what you learned in this class.

C. Discuss how meeting the DRI for the following nutrients will help with your current health status and future risk for chronic diseases: Dietary Fiber, Added Sugars, Total Fat, Saturated Fat, Sodium, Potassium, and Calcium.

D. Comment on what you were eating at the beginning of the semester and what you need to change or maintain to achieve your healthy diet plan. Set 3 realistic goals for the future that will help you move towards a healthier diet or maintain your healthy diet. Your goals should be specific. For example, write “to include one fruit at breakfast” rather than a general statement “to eat more healthful foods.” Discuss 2-3 barriers you may encounter that could interfere with meeting these goals, and provide a plan of action describing how you could overcome them.

OUTBREAK INVESTIGATION 1

OUTBREAK INVESTIGATION 2

Outbreak Investigation

Introduction

Epidemiology deals with the study of the determinants and distribution of disability or disease in the population groups (Szklo & Nieto, 2014). Epidemiology is one of the core areas in public health study and is essential for the evaluation of the efficacy of the new therapeutic and preventive modalities as well in the new organizational health care delivery patterns. I have for a long time developed a lot of interest in the area towards learning more on finding the causes of diseases and health outcomes in populations. Epidemiology views the individuals collectively, and the community is considered to be patient. The area of public health study is systematic, scientific, and data-driven in analyzing the pattern or frequency of the distributions and the risk factors or causes of specific diseases in the neighborhood, city, school, country, and global levels. Epidemiology handles various areas including environmental exposures, infectious diseases, injuries, non-infectious diseases, natural disasters and terrorism (Szklo & Nieto, 2014). Specifically, this paper explores epidemiology in addressing infectious disease, food-borne illness in the community. Also, the paper examines outbreak investigations as an intervention towards addressing the foodborne illness in the society. Further, an evaluation of the intervention and the expected results are discussed to examine or analyze the contributions of the intervention.

Foodborne Illness

Foodborne illness is any illness that results from food spoilage of the contaminated food. Food can be contaminated by the pathogenic bacteria, contaminated food, parasites, or viruses, as well as natural or chemical toxins including several species of beans, and poisonous mushrooms. In the United States, food-borne illness is estimated to impact negatively over 76 million people annually (Jones, McMillian, Scallan et al., 2007). This is translated to 5,2000 deaths, and 325,000 hospitalizations. However, the true incidence of food-borne illness is unknown. The majority of food-borne illness and most of the deaths are linked to “unknown agents” following the difficulties encountered in the diagnosis a foodborne disease. An estimated $7 billion is lost regarding productivity and medical expenses and is attributed to the most prevalent but diagnosable foodborne illnesses. Comment by Vetter-Smith, Molly J: Reference needed for this statement Comment by Vetter-Smith, Molly J: References needed for these statements

The under diagnosis in foodborne illnesses is further contributed by the majority who has the symptoms and signs of the disease but totally fail to seek medical attention. This circumstance coupled with the global and national distribution of food make it difficult or impossible to detect the large foodborne outbreaks in good time towards limiting the impact of the illness. In most of the situations, the foodborne outbreak investigations are conducted late after the impact is felt rendering the society to the dangers associated with the spread of such diseases while offering little support. Comment by Vetter-Smith, Molly J: References needed for statement in this paragraph.

The illness is related to foodborne threats that expose the community to different problems. New food production methods and new types of food are introduced into the society more often following the changing tastes and the varied cultural traditions. Therefore, the foodborne diseases follow the contaminated food supply with several toxins and microbes present in the evolving challenges. New foodborne illness emerges if previously unknown pathogens appear in reservoirs related to the food suppliers or transmissions through new foodborne pathways (Addis & Sisay, 2015). The appearance of the new foodborne diseases is challenging regarding description and detections subjecting the society in a lot of silent sufferings and eventual deaths that the medical practitioners fail to identify or categorize. The public health sector and the society as a whole faces a challenge in conducting a diagnosis of the new foodborne diseases as well as in their treatments. From investigations, reservoirs, transmission pathways, to prevention stratagems, foodborne illness have subjected the community and the public health into a lot of challenges that have never been fully solved. Foodborne diseases have a dynamic spectrum with a range of threats (Rooney, Cramer, Mantha et al., 2004). Comment by Vetter-Smith, Molly J: References needed.

Today, an array of viral, parasitic, and bacterial pathogens that are known to cause the foodborne infections are recognized challenges to the public health in the U.S. In the last 30 years, some these pathogens have been associated with the foodborne outbreaks. Some of the pathogens were identified as pathogens that are currently creating the whole mess in the society and are likely to represent evolving new combinations of the virulence properties. For instance, the pathogen E. coli O157: H7 that was only recognized later in 1982 became one of the major foodborne diseases. The several phage-induced mutations must have accelerated the evolution of the pathogen to the creation of the large bovine reservoir found in many continents in the 1990s. Comment by Vetter-Smith, Molly J: References needed for these statements.

The burden of foodborne diseases is estimated to include the hospitalization and morbidity it causes, the mortality, and the resulting medical care, among others (McLinden, Sargeant, & Thomas et al., 2014). May children fall victims of the foodborne diseases and die of the disease yearly. These are potential young members of the society that are lost creating gaps in the future labor supply and other areas of production. The similar scenario is witnessed when the society loses its members to foodborne illnesses. The society becomes short of manpower in different productions lines while the individuals and families incur losses whenever the disease attacks the bread winner. To the government, a lot of funds have to be put in place to help curb the outbreak of the diseases as well as take care of the affected. This is expensive and the money used could be diverted to other productive ventures in the community such as the development programs. Comment by Vetter-Smith, Molly J: Many? Comment by Vetter-Smith, Molly J: References needed for statements in this paragraph

Outbreak Investigation To Prevent Emerging Foodborne Threats

The process of preventing the foodborne illness involves multiple efforts by incorporating different actors along the production chain, starting from the farms to the food service. Many pathogens are involved, and none of these pathogens are vaccine preventable when the effects are felt in the final consumers. It is important to educate food handlers, consumers, and producers, and consumers about their responsibilities in preventing the foodborne diseases in the society. However, educating the different parties on their roles is still not sufficient. The food contamination can take place at several points from the farms to the table. Therefore, what is critical in preventing the foodborne outbreaks is understanding the various points along the production chain that are likely to expose the food to the dangerous pathogens and working towards getting solutions to ensure safety in those areas. Understanding the different mechanisms of food contamination involves investigation of the contamination events. Specifically, investigation of the foodborne outbreaks is critical in re-engineering the various food policies and processes for safety. However, the focus should be on a particular pathogen or food. Comment by Vetter-Smith, Molly J: Reference?

Foodborne outbreak investigation can enhance the overall food safety. Whenever there is an outbreak, the immediate action should always to prevent the illness from spreading to some other areas or other people by ensuring that the impacts are controlled. This makes it easy to diagnose the illness eventually and even find solutions. Also important is to conduct research to find out more concerning the disease to determine the needs for new regulations or processes. Outbreak investigations go beyond the locally apparent and large outbreaks and examine the foodborne illnesses that are rather considered minor cases in the society. What people fail to understand that is that even the pathogens that are today causing the large outbreaks were once minor and of little impacts to the public health. However, it is necessary to investigate all the cases since the pathogens are subjects to evolution in which they develop to become more dangerous in the long run compared to the initial stages. Outbreak investigation takes into consideration even the outbreak that involves an individual in a single city or town taking a meal with a substantial rate of attack. Rather than ignoring such cases that might appear of little importance before many people, the intervention focuses on such cases so that the potential threats of the outbreak are handled effectively in the initial stages.

Outbreak investigation employs the use of the network models and network theory that are today the most significant tools for predicting and understanding the epidemics in general. Here, the intervention focuses on the spatial disease systems that are dynamic and the networks quantify facilitates the quantification of the coupling transportation and strength fluxes presented between the spatially distributed populations. Also, the aim will be at forecasting and understand the future of the foodborne illness depending on the connectivity of the different underlying transmission pathways (transport networks). Apart from the focus on the human-to-human transmissible diseases and the spatial disease systems that are dynamic, the intervention strategy involving the outbreak investigation will contribute significantly to look at the inverse problem, which is also known as ‘zero patient’ problem in epidemiology (Shah & Zaman, n.d). Comment by Vetter-Smith, Molly J: Provide a reference for the network model and network theory. Also, provide a brief summary of your specific chosen model/theory. Comment by Vetter-Smith, Molly J: Could you explain this a little more?? Comment by Vetter-Smith, Molly J: Reference this.

Universal source detections maximum likelihood estimates are adopted to derive the theoretical thresholds about the detection probabilities based on the assumption of the viral spread. The relationship between the node centrality and source estimation is of great significance in the intervention. The only challenge here is that the one must understand the comprehensive knowledge about transmission network. Many people have not been in a position to successfully implement the procedure due to its demands. In this case, however, there is the option of adopting the network-geometric approach for the reconstruction of the epicenter to food-borne diseases (Brockmann & Helbing, 2013). The intervention takes the approach in which the focus is on the introduction of effective distance redefinition of the spatial separations. The method is effective in analyzing the underlying food distribution networks as well as the viewing of the contagious process with consideration to specific nodes in the food distribution network. The complex spreading patterns can thus be mapped onto regular, simpler wave propagation patterns only in scenarios in which the origin of the actual outbreak is the reference node. Here, the underlying network will capture the underlying transmission pathways used in to transport the contaminated food and not the human mobility patterns. Comment by Vetter-Smith, Molly J: Could you explain this more as well? Comment by Vetter-Smith, Molly J: References needed for these statements.

Evaluation Of The Intervention And The Expected Results

Adopting the outbreak investigation using the network models and network theories is a sure way to prevent food-borne threats compared to the standard public strategies or procedures that use tracings along the food shipping chains and case-control studies. These methods or interventions are biased in data collection and time-consuming. The network in this intervention program will capture the different transportation routes or transmission pathways that are the major points along the food production chain identified to result in food poisoning (Meyers, Newman, Martin et al., 2003). We have learned in the earlier sections that the best approach to preventing food-borne illness is understanding the mechanisms of food poisoning and developing strategies that can control such points along the chain of production. The technique employed will only require spatial information on the case reports that are regularly collected by the public health institutions. Therefore, the self-report survey will be analyzed in this case. Also important will be the model used for the food distribution networks. The approach that is based on the concept of replacing the geographic distance (conventional) with effective distance efficiently identifies the most probable epicenters that are the origins of the food-borne illness outbreaks. Comment by Vetter-Smith, Molly J: Again, you need to be more specific about which model or theory you are employing for your intervention. Comment by Vetter-Smith, Molly J: Explain this in more detail of what you mean by spatial information Comment by Vetter-Smith, Molly J: What type of questions will be asked on this self-report survey?

Conclusion

Epidemiology still finds a lot of challenges in handling infectious diseases such as the food-borne diseases. What makes the matter worse is the fact that these diseases are primarily caused by pathogens that evolve overtime into new generations and thus making it difficult to establish a conventional vaccine to prevent the outbreak of food-borne illness. While several interventions have been brought forward to prevent the outbreak of food-borne diseases, most of the approaches have not been effective enough in identifying the outbreak origin and then acting immediately to control any potential spread of the disease. Also, most of the methods adopted have been time-consuming. Adopting the outbreak investigation in the prevention of food-borne disease outbreak is more efficient than the other methods when there is a focus on the network models and networks theory, especially the new network-geometric approach that only require spatial information to identifying the outbreak origin based on the effective distance method.

References Comment by Vetter-Smith, Molly J: Your references are not in correct APA format. Review APA style.

Brockmann, D., & Helbing, D. (December 2013).The Hidden Geometry of Complex, Network- Driven Contagion Phenomena. Science;342(6164):1337-1342. [PubMed]

Shah D, Zaman T. Rumor centrality: A Universal Source Detector. In: Proceedings of the ACM SIGMETRICS'12. 199-210.

Jones TF, McMillian MB, Scallan E, Frenzen PD, Cronquist AB, Thomas S, Angulo F.J. (Feb 2007). A population-based estimate of the substantial burden of diarrhoeal disease in the United States; FoodNet, 1996-2003. Epidemiol Infect;135(2):293-301. PubMed PMID:17291364. [PMC free article] [PubMed]

Addis, M., & Sisay, D. (2015). A Review on Major Food-Borne Bacterial Illnesses. Journal of Tropical Diseases & Public Health, 2015.

McLinden, T., Sargeant, J. M., Thomas, M. K., Papadopoulos, A., & Fazil, A. (2014). Component Costs Of Foodborne Illness: A Scoping Review. BMC public health, 14(1), 1.

Rooney, R. M., Cramer, E. H., Mantha, S., Nichols, G., Bartram, J. K., Farber, J. M., & Benembarek, P. K. (2004). A Review Of Outbreaks Of Foodborne Disease Associated With Passenger Ships: Evidence For Risk Management. Public health reports, 119(4), 427. Szklo, M., & Nieto, F. J. (2014). Epidemiology: Beyond the Basics. Burlington, Mass: Jones & Bartlett Learning.

Meyers, L. A., Newman, M. E. J., Martin, M., & Schrag, S. (2003). Applying Network Theory To Epidemics: Control Measures For Mycoplasma Pneumonia Outbreaks. Emerging infectious diseases, 9(2), 204-210.