Course Description

The course is intended to teach students about the critical role of nutrition in longevity and diseases related to aging. The Mediterranean Diet is a type of diet located geographically in countries bordering the Mediterranean Sea. This diet has unique characteristics since it combines excellent gastronomic properties with a high and highly healthy nutritional value. However, false myths or fiction created around the Mediterranean diet devalues its favorable properties. That situation does not help increase the MD's adherence, which is crucial to improving health in general and promoting longevity. This course aims to show the composition of the authentic Mediterranean Diet and study from a biological point of view the components responsible for the positive effects on health.

A critical point:

An introductory knowledge of biology, biochemistry, or organic chemistry is required to follow this course adequately. For students to know their level, a placement test will be given on the first day of class.

Course Goals and Methodology

The course aims to introduce students to the Mediterranean Diet from a double point of view, a) the biological reasons for its positive effects on health and longevity and b) the nature and properties of specific nutrients in this diet. This study will be complemented by elaborating dishes containing foods of the MD.

Goals:

• Know what the Mediterranean Diet (MD) is.
• Analyze the components of the Mediterranean Diet.
• Identify the biological effects of nutrients included in the MD.
• Determine how MD nutrients can promote good health.
• Evaluate how MD nutrients can retard aging.
• Analyze some Spanish dishes containing components of the MD.

Students will have the syllabus as a starting material at the beginning of the course. No reference textbook is available since topics included in the course are not included in only one book. Students will have access to materials to follow the course at the eLearning platform Virtual Classroom or Aula Virtual (https://campusvirtual.upo.es/) using the login/password provided during the course enrollment.

This course uses an inverted class or flipped class methodology. It implies that students must prepare for the class beforehand using varied materials indicated by the teacher. These materials can be videos, papers, and web pages. Students must answer one questionnaire to help the teacher prepare for the class session using these materials. The answers in the questionnaires are required to evaluate participation and prepare classes.

The evaluation in this course is continuous. In each lesson, we will include evaluation activities accumulated throughout the course. The following list contains mandatory course activities:

• Online exams: Before each lesson in Blackboard
• Class activities: Individual or group activities performed in the classroom.
• Lab work: Laboratory activities
• Basilippo visit: Group visit to an almazara, a traditional olive oil factory. It is free for NUTR301E students and is mandatory
• Classbook: To monitor attendance and participation in class
• Kitchen class: To learn how to prepare MD dishes

Learning Objectives

Through this course, students will:

• Describe the origins of the Mediterranean Diet (MD).
• List the essential components of the MD  Analyze if a diet fits the criteria of MD using MD scores
• Transfer the MD to a different geographical location
• Design dishes adjusted to the MD  Analyze epidemiological studies about the effects of MD
• Describe the effects of MD on the health  Describe the diseases on which MD acts positively
• Explain how MD prevents or mitigates the effects of human diseases
• Describe the active ingredients found in MD foods to fight against disease or aging
• Analyze the molecular function target of the active ingredients of MD foods

Required Texts

Books of General Biochemistry:

• Principles of biochemistry. Lehninger, Albert L. ; Nelson, David L. (David Lee), 1942- ; Cox, Michael M. ; New York : Freeman; 2013

• Biochemistry. Berg, Jeremy M. ; Tymoczko, John L. ; Stryer, Lubert ; New York : W. H. Freeman and Company; cop. 2002

Books of Nutrition:

• Clinical nutrition Nutrition Society (Great Britain) ; Elia, Marinos ; Chichester, West Sussex : Wiley-Blackwell; c2013 

• Molecular basis of nutrition and aging Malavolta, Marco.; Mocchegiani, Eugenio; London : Academic Press; 2016

Other sources:

• Olive : a global history. Lanza, Fabrizia. London : Reaktion Books; 2011

• Olive oil and health Quiles, Jose L.; Ramırez-Tortosa, M. Carmen.; Yaqoob, Parveen.; Wallingford, UK ; Cambridge, MA : CABI Pub.; c2006

• Cereals and pulses nutraceutical properties and health benefits Yu, Liangli.; Cao, Rong.; Shahidi, Fereidoon, 1951-; Ames, Iowa : Wiley-Blackwell; 2012

• Phytochemicals of Nutraceutical Importance Prakash, D. ;Sharma, G. ;Prakash, Dhan ; Sharma, Girish Wallingford: CABI; 2014

• Olives. Ioannis Therios, CABI, 2008. ProQuest Ebook Central

• The Mediterranean diet: culture, health and science. Lorenzo M. Donini, Lluis Serra-Majem, Monica Bullo, Angel Gil, Jordi Salas-Salvado, British Journal of Nutrition, https://doi.org/10.1017/S0007114515001087

• The Mediterranean diet: health, science and society. Mariette Gerber and Richard Hoffman. British Journal of Nutrition (2015), 113, S4–S10 doi:10.1017/S0007114514003912.

The origin of the graphic materials is indicated in the corresponding documents or slides. 

Course Requirements and Grading

The final grade will be calculated as follows:

• Participation (20%): Online exams 15% and video watching 5%

• Classbook (10%)

• Midterm exam (20%)

• Class activities and lab reports: Regular classes and lab activities (20%)

• Final exam (30%) 

Course contents

Lesson 1: What is the Mediterranean diet?

1. The historical origin of the Mediterranean diet (MD)
2. The traditional Mediterranean diet
3. The seven countries study and MD pattern
4. The pyramid of the Mediterranean diet
5. The food composition of the Mediterranean diet
6. Benefits of MD
7. MD versus Standard Western diet
8. The Mediterranean diet score (MDS)
9. Transferring MD to other countries
10. Ultra-processed foods in MD

Lesson 2: How to analyze MD effects

1. Epidemiological studies classification
   • a. Case-control
   • b. Cohort studies
   • c. Random Controlled Trials (RCT)
2. Cohort studies in MD
3. RCT in MD
4. Survival studies versus epidemiologic studies
5. Components of epidemiological studies
6. Proven effects of MD foods

Lesson 3: Biological mechanisms of MD effects

1. A general view of metabolism
   • Main features of metabolism
   • Functions of metabolism
   • Nutrient's digestion d. Fuel for organs
2. Nutrient's assimilation
   • Carbohydrates
   • Proteins
   • Fats
3. Effects of MD foods on metabolism
4. Definition of aging
5. Metabolic pathways modified by MD
6. Mitochondrial improvement generated by MD
7. Epigenetics changes of MD
8. Caloric restriction in MD

Lesson 4: Aging-related diseases: targets of MD

• Metabolic syndrome, diabetes, and obesity
• Vascular inflammation, dyslipidemia, and CVD
• Cancer
• Degenerative diseases

Lesson 5: Olive oil as the best source of MUFA

1. The olive and olive tree
   • Olive tree culture
   • Structure and fruit development
2. Methods to produce olive oil
   • Procedure
   • Types of olive oil
   • The composition of the olive oil
     • Fatty acids
     • Triacylglycerols (TAGs)
     • Polyphenols
     • Sterols
     • Odorant molecules
   • Quality parameters in olive oil
     • Acidity
     • Peroxidation
3. Epidemiological studies of EVOO effects
4. Biological effects of EVOO

Lesson 6: The role of PUFA in the MD action

• Nutritional value of fish
  • Sources of PUFA
    • Oily fish and nuts
  • Omega-3 and omega-6 PUFA
  • Effects of PUFA on the health
  • The negative effect of fish consumption
    • Toxic compound accumulation
    • Peroxidation
  • The ratio ω3/ω6
    • Meaning of the ratio
    • The anti-inflammatory action of ω3

Lesson 7: How to avoid meat in MD as a source of proteins

1. Protein function and structure
   • Amino acid's structure
   • Type of amino acids
   • Proteogenic and essential amino acids
2. Amino acid requirements in the diet
   • Animal sources in MD
   • Plant sources in MD
3. Legumes in MD as a protein source
   • Nutritional
   • Cost
   • Environmental
4. The savvy combination of legumes and cereals in MD

Lesson 8: The hidden role of fiber in MD goodness

• a. Sources of edible fiber in MD
• b. Fiber classification
• c. Fiber properties
• d. Physiological effects of fiber

Lesson 9: MD is an antioxidant diet

1. Antioxidants in fruits, vegetables, and spices
   • Redox reactions and redox stress
   • Free radicals
     • Definition
     • Formation
   • Effects of oxidative stress
   • Antioxidant's classification
   • The action of antioxidants to block oxidative stress
2. Epidemiologic studies about fruits
3. Examples of antioxidants
   • Carotenoids
   • Vitamin C
   • Resveratrol

*Course content subject to change