NUTR-GE 2111: International Issues in Nutrition & Food: Cuba Department of Nutrition & Food Studies Steinhardt School of Culture, Education, and Human Development New York University January 2018 COURSE INSTRUCTOR Kristie Lancaster, PhD, RD 3 POINTS COURSE DESCRIPTION Students will examine the main factors affecting food, nutrition, and health practices in Cuba. Students will learn about traditional nutrition and health practices, nutrition programs and the Cuban nutrition and health care systems through a combination of lectures, seminars, field trips, fieldwork, and research. COURSE OBJECTIVES 1. To examine and understand through in-class and observational learning: a. The history and culture of Cuba b. Issues and challenges associated with nutrition and food in Cuba as it relates to history, culture, and health c. Cuba s nutrition and food policies and programs d. Factors outside of policy and government that influence diet and nutrition in Cuba e. The association between changes in dietary practices and chronic diseases 2. To compare nutrition and health care in Cuba and the U.S. 3. Encourage creativity and critical thinking in comparing nutrition and health issues, delivery of health services, and policies across borders. LEARNING OBJECTIVES By the end of this course students will develop the ability to: 1. Describe the components of public health nutrition and their application on a global level 2. Describe the major nutritional problems and dietary guidance in Cuba 3. Compare the nutritional programs and access to care in the U.S. and Cuba FORMAT This experiential course will take place in Cuba. There is a combination of in-class lectures and interactive exercises/discussions, site-visits and fieldtrips, and assignments. The in-class component serves as the basis for the experiential site visits and field trips. The assignments provide students with an opportunity to integrate the class content with the hands-on experience through their final project and group presentation. REQUIREMENTS, ASSIGNMENTS & GRADING CRITERIA 1. Pre-class assignment 10%: Students will submit a tentative proposal for the course final project (two-pages, double spaced, 12 font size, 1 in. margins). 2. In-class Activities and Participation 30%: Students are expected to attend and actively participate in all lectures and in-class exercises, discussions, debriefing sessions and site
visits. If you cannot attend a certain class/activity, it is your responsibility to notify the instructor beforehand. All other absences will be considered unexcused and will impact the final grade (see section on Grading). In addition, students are expected to come to class on time to prevent disrupting the lecture and classroom activities. 3. Thought Paper 10%: Write a thought paper, which will synthesize course readings, lectures, discussion, and experiences, with the course theme. (the thought paper must be three-pages, double spaced, 12 font, 1-inch margins, cite sources) 4. Final project/group Presentation 50%: Working in groups of three, students will compare a nutritional health or food problem and/or policy across borders (Cuba - New York City). The final project and presentation should include: Background and Significance Section detailing a cross-country comparison of a health topic. Data Section: Students will use secondary data (qualitative and/or quantitative), compile observational data (if appropriate), and use informal data collection methods (if appropriate). Findings: Analysis of data findings Discussion & Recommendations Section. NYU GRADE CATEGORIES No A+ A 93 A- 90 and < 93 B+ 87 and < 90 B 83 and < 87 B- 80 and < 83 C+ 77 and < 80 C 73 and < 77 C- 70 and < 73 D+ 65 and < 70 D 60 and < 65 No D- F < 60 Readings Nutrition and Chronic Diseases US Dietary Guidelines: https://health.gov/dietaryguidelines/2015/guidelines/. Accessed January 25, 2016. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016;315(21):2284-2291. doi:10.1001/jama.2016.6458 Perez R. The public health sector and nutrition in Cuba. MEDICC Rev. 2009;11(4):6-8.
Roth GA, Johnson C, Abajobir A, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol 2017; Health in Cuba de Fatima Marinho de Souza M, Gawryszewski VP, Orduñez P, Sanhueza A, Espinal MA. Cardiovascular disease mortality in the Americas: current trends and disparities. Heart. 2012;98(16):1207-1212. doi: 10.1136/heartjnl-2012-301828. Franco M, Bilal U, Orduñez P, et al. Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010: repeated cross sectional surveys and ecological comparison of secular trends. BMJ. 2013;346:f1515. doi: 10.1136/bmj.f1515. García O. Exercise: the first prescription for Cubans of all ages. MEDICC Rev. 2014;16(1):48. Sanger-Katz M. Can Cuba escape poverty but stay healthy? The New York Times, December 18, 2014. Suri A. The art of medicine: Social medicine: lessons from Cuba. Lancet. 2016;387(10019):641-642. Food Barclay E. Food for Thought: What the Change in U.S.-Cuban relations Might Mean for Food. 2014. http://www.npr.org/sections/thesalt/2014/12/18/371478629/what-the-change-in-u-s-cubarelations-might-mean-for-food. Accessed June 30, 2017 Cope S. Nitza Villapol: The woman who taught Cubans to cook with just about anything. http://www.npr.org/sections/thesalt/2016/06/16/481397800/nitza-villapol-the-woman-whotaught-cubans-to-cook-with-just-about-anything. Accessed June 30, 2017 Agriculture Zanheiser S, Cooke B. U.S.-Cuba Agricultural Trade: Past, Present, and Possible Future. https://www.ers.usda.gov/amber-waves/2015/august/us-cuba-agricultural-trade-past-present-andpossible-future/. Accessed May 8, 2017. Cuban History and Culture The Cuba Reader: History, Culture, Politics. Chomsky A, Carr B, Smorkaloff PM, editors. Duke University Press. Durham and London, 2003, Selected Readings Determinants of diet and health Díaz-Perera G, Bacallao J, Alemañy E. Contextual and individual influences on diabetes and heart disease in Havana primary care catchment areas. MEDICC Rev. 2013;15(2):10-15. Havranek EP, Mujahid MS, Barr D, et al. Social determinants of risk and outcomes for cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2015;132:00-00. DOI: 10.1161/CIR.0000000000000228.
Pérez LM, García K, Herrera R. Psychological, behavioral and familial factors in obese Cuban children and adolescents. MEDICC Rev. 2013;15(4):24-28. Willett W. Weight changes and health in Cuba. BMJ. 2013;346:f1777. doi: 10.1136/bmj.f1777. COURSE SCHEDULE Date Topic Site/Activity December Orientation & What to Expect NYU Nutrition Dept. 1/2 Tuesday 1/3 Wednesday 1/4 Thursday 1/5 Friday 1/6 Saturday 1/7 Sunday 1/8 Monday 1/9 Tuesday 1/10 Wednesday Group travels together to Cuba Course Introduction & Syllabus Overview of health and nutrition in general The nutrition transition Cuban History Cuban Culture The Arts Cuban Cuisine Access to food in Cuba and the U.S. Visit to an urban organic farm On your own Health of the Cuban people Nutrition status and nutrition guidelines and initiatives in Cuba The food system and agriculture in Cuba Lecture: Sustainability & organic farming Influences on food nutrition and health in Cuba Cuban political system Cultural norms and attitudes Old Havana Walking Tour Visit Outdoor Market UBPC Vivero Organoponico Alamar National Institute of Hygiene, Epidemiology & Microbiology Las Terrazas, Cuba s first ecovillage Lunch at the vegetarian restaurant in Las Terrazas Optional Activity: Salsa lesson
1/11 Thursday 1/12 Friday 1/13 Saturday 1/14 Sunday 1/15 Monday 1/16 Tuesday Lecture: Traditional healing and Santeria Lecture: Rum industry Tobacco industry Restaurant industry in Cuba Culinary workshop On your own Lecture: The role of sugar in Cuban history and culture Group Departure from Cuba Site Visit: community health clinic Site Visit: Rum factory Dinner at a private restaurant Site Visit: Sugar Plantation GROUP RESEARCH PROJECT Our goal, while you are in Cuba, is to expose you to as many different aspects of Cuban food, nutrition, and health as possible. It is our hope that at the end, you will not only gain insight into Cuban culture, but that your experiences will also give you new insights into your culture back home in the U.S. Your experience in Cuba should be more than lectures and readings. You need to observe and experience the culture in order to really understand anything about it. This project includes an observation/research component in Cuba, and a similar component in the U.S. Prior to coming to Cuba, you should choose a food- or nutrition-related topic that will draw on your personal and scholarly interests. The options for topics are unlimited, but they should adhere to the following parameters: 1. The topic you choose must be a bona fide topic of cultural interest that pertains to food or nutrition and that has been studied or written about to some extent. 2. The topic should be approachable both from a Cuban and an American perspective, i.e., you will have to find evidence/data and information in both countries. 3. There should also be an experiential component, which will not only help keep your interests focused, but will also make your writing more engaging.
4. The topic should allow for some creative conceptualization and interpretation to give your finished project some color and interest. You will turn in a brief proposal describing your topic. And you should do some preliminary research before you get there so you don t have to waste any time floundering about. Here are some possible topics: What makes a meal in Cuba vs. the U.S.? Mealtimes/meal patterns/snacking Dietary guidelines, history, promotion Food security Availability of healthy food Vegetarianism Health claims and product labeling Vegetables, Italian-style Convenience foods Roadside food The culture of professional cooking Shopping for food Cultural representations of food s relationship to disease Sustainable eating, food and the environment Food portrayal in film and other pop culture Cuban attitudes about food Sustainability in farming, food production, etc Obesity: Is it an issue? Health care systems While in Cuba, you should observe and investigate various angles of your topic, keeping a notebook of observations and insights. (Taking photographs will also help.) Be creative. Hang out in coffee shops, flip through magazines, take photos of billboards, walk through grocery stores, watch TV with the sound off, look at artwork, look at people looking at artwork, talk to fellow students about their experiences, etc. Upon your return to the United States, you should conduct similar observations on the same topic. Look for similarities and differences between the two countries in cultural representations. Make notes and take pictures again to jog your memory when you go to write up your paper. (You will have to turn in your notebooks, photographs, etc., along with your paper.) The final paper should compare and contrast your observations in Cuba and the United States. It should include a discussion of what might account for the differences and similarities. The best papers will weave description, history, and theory into a tight, creative, and informative representation of this important cultural aspect of food, nutrition, and/or health. Remember that must incorporate your observations in Cuba and the U.S., and should be clear enough to be understood by someone who did not go to Cuba. You need to use peer reviewed journals, books, to support your research. All your sources should be documented in the paper.