Robert Karp, MD
Professor of Pediatrics at SUNY-Downstate Medical Center in Brooklyn, NY.

He is a Diplomate of the American Boards of both Pediatrics and Physician Nutrition Specialists.  Dr. Karp is a Fellow of the American Academy of Pediatrics and the American Society for Clinical Nutrition.



A
TEACHER'S
GUIDE
TO
PEDIATRIC
NUTRITION
TABLE OF CONTENTS

Table of Contents


   - Feeding Practices

   - Macronutrients

   - Micronutrients: Minerals

   - Micronutrients: Vitamins

   - Prevention

   - Postscript & References


   - Assess Diet and Behavior

   - Assess Nutritional Status

   - Food Costs and Culture

   - Anticipatory Guidance

   - Introduction to the Cycle of Obesity


   - Section 1. - Meeting the infant    
     "at-risk" for obesity.

  - Section 2. - Importance of
     delaying supplementation.

  - Section 3. - A booklet
     "Healthy Weight Gain for Healthy
     Children".

   - Section 4 - The
     pathophysiology of obesity.

   - Section 5. - The 
     phenomenon of Adiposity Rebound.

   - Section 6. - Biologic,
     cultural, and economic interactions.

   - Section 7. - Evaluation and
     management.

   - Section 8. - Diet and
     behaviors needed maintain body
     weight.
   - Section 9. - A Section of Questions and Answers

     S1. Early Life - birth to 2 weeks of age
             a. Nutrition and NICU care
             b. Breastfeeding
             c. Fetal Alcohol Syndrome
             d. Infant of a diabetic mother (See also Section 8e)
      S2. Infancy and early months - 2 weeks to 4 months
            a. Failure to Thrive
            b. Inborn errors of metabolism
            c. Celiac disease
            d. Gastroesophageal reflux
      S3. Later infancy - 4 months to a year of age
            a. Rickets and Calcium needs
            b. Classic Nutritional Deficiency
            c. Food intolerance/food allergy
            d. Acute gastroenteritis
            e. Nutrition and child development
            f. Lead poisoning
            g. The Macrobiotic Mom & Vegetarianism
      S4. Toddler - 1 to 2 years of age
            a. PICU care and nutrition
            b. Iron deficiency
            c. Dental health
            d. HIV and nutrition
            e. Care of Handicapped Children
            f.  Nutrition and Infection
      S5. Pre-School - 2 to 5 years of age
            a. Hypercholesterolemia
            b. Prader-Willi syndrome
            c. Fiber needs/constipation
            d. Vitamin A and the eye
            e. Chronic diarrhea
            f.  Type 1 DM       
      S6. Early school - 5 years to Pre-adolescent
            a. Micronutrient deficiency at early school age
            b. Probiotics
            c. Adult onset diabetes
            d. The ketogenic diet
            e.  Nutrition and oncology
      S7. Adolescent - Pubertal
            a. Eating disorders
            b. Sports nutrition
            c. Folate needs in potential pregnancy
            d. Nonalcoholic liver disease
            e. Nutrition and teen pregnancy
      S8. Post-adolescent -Young adult
            a. Nutrition in chronic illness
            b. Cystic fibrosis
            c. Hypertension
            d. Vitamin excess and hormonal misuse
            e. The diabetic mother

Part V:Public Health and Preventive Nutrition:
An International Perspective

Introduction to the basics

  - Section 1 - Nutrition Surveillance
Approaching the "5-worlds" of economic dvelopment.


  - Section 2 - Reduction of perinatal morbidity and mortality
a. Prenatal.
b. In-utero and the first months of life.
c. At weening through the first year of life.

  - Section 3 - Effective public policy
a. Insuring an availability of quality diet: Protein energy and Micronutrients.
b. promoting effective use: Addressing the microsocial environment.

  - Summary
a. What the health care provider can do.


Preface for Evaluation Theory and Practice

Section 1: An Overview of Evaluation Theory

Section 2: Applications in clinical practice

Section 3: Using active learning techniques to establish a "working memory"


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Website Developer:  sebastian_stanescu@yahoo.com
Dear Colleagues,
In the past 15 to 20 years,  emphasis in medical education has shifted from didactic teaching to active, case-based learning. The response of the community of medical educators with myself included, has followed Mark Twain's aphorism:
"I'm all for progress. It's change I'm afraid of"
The Teacher's Guide project is based on a theory of 'stepping stone-education.' Pediatric Nutrition Notes provides essential information. The case-based modules that follow permit teachers to present and discuss material developed for resident and physician education. The modules were developed for use by non-expert teachers as well as by physicians and residents for self-learning and CME credits.
The Teacher's Guide to Pediatric Nutrition provides tools to promote active learning based on clinical experiences with patients for those teaching nutrition to fellow pediatricians, residents and medical students.
The goals for this project are:

1. To provide the essential vocabulary and knowledge of
    pediatric nutrition, and

2. To enable use of that vocabulary and knowledge in clinical settings.


The Teacher's Guide consists of five parts beginning with Pediatric Nutrition Notes, a primer written originally for 3rd year medical students. The Notes provide the essential language of nutrition as well as a matrix  into which subsequent learning can be fit. The Guide continues with Introductions on "How to", including assess diet and nutritional status and provide guidance.  An Obesity Cycle  follows. It includes eight sections on obesity including its genetic, social, and cultural origins, prevention, assessment and treatment tools, and a handout for parents on healthy weight gain through the life cycle. Part IV of the Guide, Teaching Modules, is an eight section set of teaching modules based on nutrition related disorders, developed to address various medical conditions with important nutritional contributions as they occur through the human life cycle -- neonatal, early infancy, later infancy, toddler and pre-school, etc. The final part, Part V, Evaluation provides tools with which to design and evaluate active learning projects. 
The editorial staff hopes that you find this material useful in the ongoing education of our residents and physicians alike!
Sincerely,
Robert Karp, MD
Professor of Pediatrics


2007, Academic Pediatric Association, Washington, D.C.
SUNY-Downstate Medical Center, Brooklyn, N.Y.
Contact information: Rkarp@downstate.edu
Permission for resident and student education: Such use is freely granted and encouraged. Commercial use is strictly prohibited. Contact Dr. Karp for more information.