CONTENTS
PART ONE Basic Nutrition
CHAPTER ONE Perspectives on Health and Nutrition = 1
Food Choices = 3
The Nutrients = 7
Nutrition Standards and Guidelines = 9
Dietary Reference Intakes = 9
Dietary Guidelines = 12
Diet-Planning Principles = 12
Food Group Plans = 14
Nutrition Surveys = 18
Food Labels = 20
NUTRITION IN PRACTICE : Finding the Truth about Nutrition = 28
CHAPTER TWO Carbohydrates = 33
The Chemist's View of Carbohydrates = 34
Monosaccharides(Single Sugars) = 34
Disaccharides(Double Sugars) = 35
Starch and Glycogen(Energy-Yielding Polysaccharides) = 36
The Fibers = 37
Health Effects of Sugars and Alternative Sweetners = 38
Sugars = 38
Alternative Sweetners : Sugar Alcohols = 40
Alternative Sweetners : Artificial Sweetners = 41
Health Effects of Complex Carbohydrates = 43
Fibers = 43
Carbohydrates : Food Sources and Recommendations = 45
Energy Nutrients in Perspective = 47
NUTRITION IN PRACTICE : Nutrition and Dental Health = 52
CHAPTER THREE Lipids = 55
The Chemist's View of Lipids = 57
Triglycerides = 57
Fatty Acids = 57
Phospholipids = 61
Sterols = 61
Fats and Health = 62
Fats and Fatty Acids = 62
Recommendations = 64
Fats in Foods = 64
Finding the Fats in Foods = 65
Cutting Fat Intake and Choosing Unsaturated Fats = 66
NUTRITION IN PRACTICE : Fat Replacers = 71
CHAPTER FOUR Proteins and Amino Acids = 75
The Chemist's View of Proteins = 76
The Structure of Proteins = 76
Essential Amino Acids = 77
Proteins in the Body = 77
Protein and Health = 81
Protein-Energy Malnutrition = 81
Protein Excess = 84
Amino Acid Supplements = 84
Protein Recommendations = 85
Protein in Foods = 85
NUTRITION IN PRACTICE : Vegetarian Diets = 91
CHAPTER FIVE Digestion and Absorption = 95
Anatomy of the Digestive Tract = 96
The Digestive Organs = 96
The Involuntary Muscles and the Glands = 97
The Process of Digestion = 102
Digestion in the Mouth = 102
Digestion in the Stomach = 103
Digestion in the Small and Large Intestines = 103
The Absorptive System = 105
The Small Intestine = 105
Release of Absorbed Nutrients = 107
Transport of Nutrients = 107
The Vascular System = 107
The Lymphatic System = 108
Transport of Lipids : Lipoproteins = 108
The System at Its Best = 109
NUTRITION IN PRACTICE : Common Digestive Problems = 113
CHAPTER SIX Metabolism and Energy Balance = 119
The Organs and Their Metabolic Roles = 120
The Principal Organs = 120
Energy for Metabolic Work = 121
The Body's Energy Metabolism = 122
Building up Body Compounds = 122
Breaking down Nutrients for Energy = 122
The Body's Energy Budget = 124
The Economics of Feasting = 124
The Economics of Fasting = 125
Energy Balance = 127
NUTRITION IN PRACTICE : Hunger and Community Nutrition = 133
CHAPTER SEVEN Overweight, Underweight, and Weight Control = 139
Body Weight and Body Composition = 140
Healthy Body Weight and BMI = 140
Body Composition = 141
How Much Is Too Much Body Fat? = 142
Risks of Overweight and Obesity = 143
Causes of Obesity = 144
Obesity Treatment : Who Should Lose? = 147
Aggressive Treatments of Obesity = 148
Obesity Drugs = 148
Surgery = 149
Reasonable Strategies for Weight Loss = 150
A Healthful Eating Plan = 150
Physical Activity = 152
Behavior and Attitude = 154
Underweight = 156
Strategies for Weight Gain = 156
NUTRITION IN PRACTICE : Eating Disorders = 162
CHAPTER EIGHT The Vitamins = 169
The Vitamins-An Overview = 170
The Fat Soluble Vitamins = 171
Vitamin A and Beta-Carotene = 171
Vitamin D = 175
Vitamin E = 177
Vitamin K = 179
The Water-Soluble Vitamins = 180
The B Vitamins = 180
Thiamin = 184
Riboflavin = 184
Niacin = 185
Pantothenic Acid and Biotin = 185
Vitamin $$B_6$$ = 185
Folate = 187
Vitamin $$B_{12}$$ = 188
Non-B Vitamins = 189
Vitamin C = 190
NUTRITION IN PRACTICE : Phytochemicals = 201
CHAPTER NINE Water and the Minerals = 207
Water and Body Fluids = 208
Water Balance = 208
Fluid and Electrolyte Balance = 209
Acid-Base Balance = 210
The Major Minerals = 210
Sodium = 210
Chloride = 211
Potassium = 212
Calcium = 212
Phosphorus = 216
Magnesium = 216
Sulfur = 218
The Trace Minerals = 218
Iron = 218
Zinc = 222
Selenium = 224
Iodine = 225
Copper = 226
Manganese = 226
Fluoride = 226
Chromium = 227
Other Trace Minerals = 227
NUTRITION IN PRACTICE : Vitamin and Mineral Supplements = 232
CHAPTER TEN Fitness and Nutrition = 235
Fitness = 236
Definitions of Fitness = 236
Benefits of Fitness = 237
Components of Fitness = 238
Conditioning by Training = 239
Cardiorespiratory Endurance = 240
The Active Body's Use of Fuels = 242
Glucose Use during Physical Activity = 243
Fat Use during Physical Activity = 246
Protein and Physical Activity = 248
Vitamins and Minerals = 250
Supplements = 250
Iron Deficiency in Female Athletes = 250
Fluids and Electrolytes in Physical Activity = 251
Fluid Losses = 252
Fluid Needs during Physical Activity = 252
Poor Beverage Choices = 253
Food for Fitness = 254
Choosing a Diet to Support Physical Activity = 254
Planning an Athlete's Meals = 256
NUTRITION IN PRACTICE : Supplements and Ergogenic Aids Athletes Use = 262
CHAPTER ELEVEN Food Safety = 269
Food-Borne Illness = 270
Food-Borne Infections and Intoxications = 270
Food Safety in the Marketplace = 273
Food Safety in the Kitchen = 274
Troublesome Foods = 276
Picnics = 278
If Illness Occurs = 278
Travel = 278
Water = 278
Advances in Food Technology and Safety = 279
Natural Toxins in Foods = 280
Environmental Contaminants in Foods = 281
Harmfulness of Environmental Contaminants = 281
Mercury = 281
Pesticides = 282
Hazards and Regulation of Pesticides = 283
Monitoring Pesticides = 283
Incidental Food Additives = 285
Microwave Packaging = 285
Dioxins = 285
Food Additives = 285
Regulations Governing Additives = 286
Some Intentional Additives = 287
Food Biotechnology = 289
Genetic Engineering = 289
Regulations and Labeling = 290
NUTRITION IN PRACTICE : Environmentally Conscious Foodways = 294
PART TWO Nutrition Throughout Life
CHAPTER TWELVE Nutrition Through the Life Span : Pregnancy and Infancy = 299
Pregnancy : The Impact of Nutrition on the Future = 300
Preparing for Pregnancy = 300
Nutrient Needs during Pregnancy = 301
Weight Gain = 306
Physical Activity = 306
Problems in Pregnancy = 307
Practices to Avoid = 309
Adolescent Pregnancy = 312
Breastfeeding = 312
Nutrition during Lactation = 313
Contraindications to Breastfeeding = 314
Nutrition of the Infant = 315
Nutrient Needs during Infancy = 315
Breast Milk = 317
Infant Formula = 319
The Transition to Cow's Milk = 320
Introducing First Foods = 320
Looking Ahead = 323
Mealtimes = 324
NUTRITION IN PRACTICE : Encouraging Successful Breastfeeding = 330
CHAPTER THIRTEEN Nutrition Through the Life Span : Childhood and Adolescence = 333
Early and Middle Childhood = 334
Energy and Nutrient Needs = 334
Malnutrition in Children = 335
Lead Poisoning in Children = 338
Food Allergies = 339
Hyperactivity = 342
Food Choices and Eating Habits of Children = 343
Mealtimes at Home = 343
Nutrition at School = 345
The Teen Years = 347
Growth and Development during Adolescence = 348
Energy and Nutrient Needs = 348
Food Choices and Health Habits = 349
Problems Adolescents Face = 350
NUTRITION IN PRACTICE : Childhood Obesity and the Early Development of Chronic Diseases = 357
CHAPTER FOURTEEN Nutrition Through the Life Span : Later Adulthood = 363
Nutrition and Longevity = 364
Slowing the Aging Process = 364
Nutrition and Disease Prevention = 366
Nutrition-Related Concerns during Late Adulthood = 367
Cataracts = 368
Arthritis = 368
The Aging Brain = 369
Energy and Nutrient Needs during Late Adulthood = 371
Energy and Energy Nutrients = 372
Water = 373
Vitamins and Minerals = 373
Nutrient Supplements for Older Adults = 374
The Effects of Drugs on Nutrients = 375
Food Choices and Eating Habits of Older Adults = 376
NUTRITION IN PRACTICE : Food for Singles = 383
PART THREE Nutrition in Health Care
CHAPTER FIFTEEN Health Problems, Medications, and Complementary Therapies = 387
What Causes Health Problems? = 388
Free Radicals and Disease = 388
Inflammations = 389
Nutrition in Health Care = 389
Health Problems and Treatments : Effects on Nutrition Status = 390
Responsibility for Nutrition Care = 390
Medications and Complementary Therapies = 392
Conventional and Complementary Therapies = 392
Medications = 394
Dietary Supplements = 394
Weighing Risks and Benefits = 396
Learning about Benefits and Risks = 396
Limiting Risks = 398
Diet-Drug Interrelationships = 399
Medications and Food Intake = 399
Diet-Drug Interactions and Absorption = 401
Diet-Drug Interactions and Metabolism = 402
Diet-Drug Interactions and Excretion = 404
Other Ingredients in Medications = 404
NUTRITION IN PRACTICE : A Closer Look at the Immune System = 408
CHAPTER SIXTEEN Nutrition Screening and Assessment = 413
Identifying Nutrition Needs = 414
Histories = 416
Food Intake Data = 418
Identifying Potential Food Intake Problems = 418
Other Tools for Gathering Food Intake Data = 419
Anthropometric Measurements = 421
Laboratory Tests of Nutrition Status = 426
Physical Signs of Malnutrition = 429
NUTRITION IN PRACTICE : Nutrition and Mental Health = 433
CHAPTER SEVENTEEN Nutrition Intervention = 437
Identifying Nutrient Needs = 438
Medical Nutrition Therapy = 440
Standard and Modified Diets = 441
Diet Modifications = 441
Feeding Routes = 443
The Medical Record = 444
NUTRITION IN PRACTICE : The New Genetics : Implications for Nutrition Intervention = 447
PART FOUR Diet Therapy
CHAPTER EIGHTEEN Consistency-Modified and Other Diets for Upper GI Tract Disorders = 451
Consistency-Modified Diets = 452
Routine Progressive Diets = 452
Surgery and Routine Progressive Diets = 453
Mechanical Soft Diets = 455
Dysphagia = 457
Diets to Treat Gastric-Related Problems = 459
Gastroesophageal Reflux Disease(GERD) = 459
Gastritis = 460
Ulcers = 462
NUTRITION IN PRACTICE : Helping People with Feeding Disabilities = 468
CHAPTER NINETEEN Fiber-Modified Diets for Lower GI Tract Disorders = 473
Fiber-Modified Diets = 474
Motility Disorders = 476
Delayed Gastric Emptying = 476
Constipation = 477
Diarrhea and Dehydration = 477
Irritable Bowel Syndrome = 478
Intestinal Obstructions = 479
Inflammatory Bowel Diseases = 481
Diverticular Disease = 483
Colostomies and Ileostomies = 483
NUTRITION IN PRACTICE : Foods and Foodservice in Health Care Facilities = 490
CHAPTER TWENTY Enteral Formuals = 495
Enteral Formulas : What Are They? = 496
Types of Formulas = 496
Distinguishing Characteristics = 497
Enteral Formulas : Who Needs What? = 498
Enteral Formulas Provided Orally = 498
Tube Feedings = 498
Formula Selection = 502
Tube Feedings : How Are They Given? = 503
Safe Handling = 504
Initiating and Progressing a Tube Feeding = 505
From Tube Feedings to Table Foods = 511
NUTRITION IN PRACTICE : Enteral Formulas for Inborn Errors of Metabolism = 515
CHAPTER TWENTY-ONE Parenteral Nutrition = 519
Intravenous Solutions : What Are They? = 520
Intravenous Nutrients = 520
Types of Intravenous Formulations = 522
Intravenous Nutrition : Who Needs What? = 524
Intravenous Solutions : How Are They Given? = 526
Insertion and Care of Intravenous Catheters = 527
Administration of Complete Nutrient Solutions = 527
Discontinuing Intravenous Nutrition = 528
Specialized Nutrition Support at Home = 529
The Basics of Home Programs = 529
How Home Enteral and Parenteral Nutrition Programs Work = 530
NUTRITION IN PRACTICE : Nutrition in the Changing Health Care Environment = 535
CHAPTER TWENTY-TWO Carbohydrate- and Fat-Modified Diets for Malabsorption = 541
Malabsorption Syndromes = 542
Carbohydrate-Modified Diets for Malabsorption Syndromes = 543
Lactose-Restricted Diets = 544
The Postgastrectomy Diet = 545
Gluten-Free Diets = 550
Fat-Modified Diets for Malabsorption Syndromes = 552
Diet Plans = 552
Bacterial Overgrowth = 552
Intestinal Surgeries and Short-Bowel Syndrome = 555
NUTRITION IN PRACTICE : Probiotics and Intestinal Health = 561
CHAPTER TWENTY-THREE Energy-, Fat-, and Protein-Modified Diets for Diseases of the Gallbladder, Pancreas, and Liver = 565
Gallstones = 566
Types of Gallstones = 566
Causes of Gallstones = 566
Consequences of Gallstones = 568
Prevention and Treatment of Gallstones = 568
Pancreatitis = 569
Acute Pancreatitis = 569
Chronic Pancreatitis = 570
Cystic Fibrosis = 570
Consequences of Cystic Fibrosis = 570
Medical Nutrition Therapy for Cystic Fibrosis = 571
Fatty Liver and Hepatitis = 571
Fatty Liver = 572
Hepatitis = 573
Cirrhosis = 574
Consequences of Cirrhosis = 574
Treatment of Cirrhosis = 577
Liver Transplantation = 583
NUTRITION IN PRACTICE : Alcohol Abuse : Effects on Nutrition Status = 589
CHAPTER TWENTY-FOUR Carbohydrate-Modified Diets for Diabetes = 595
What Is Diabetes Mellitus? = 596
Types of Diabetes = 596
Acute Complications of Diabetes = 597
Chronic Complications of Diabetes = 600
Treatment of Diabetes Mellitus = 601
Treatment Goals = 601
Evaluating Diabetes Control = 602
Medical Nutrition Therapy for Diabetes = 604
Energy and Nutrients = 604
Other Dietary Considerations = 606
Meal-Planning Strategies = 607
Drug Therapy for Diabetes = 611
Actions of Medicaitons = 611
Insulin Administration = 614
Coordinating Medications, Diet, and Physical Activity = 616
Diabetes Management in Pregnancy = 618
Diabetes during Pregnancy = 618
Treatment of Diabetes during Pregnancy = 618
NUTRITION IN PRACTICE : Hype or Hypoglycemia? = 625
CHAPTER TWENTY-FIVE Fat-Controlled, Mineral-Modified Diets for Cardiovascular Diseases = 629
Atherosclerosis = 630
Hypertension = 632
Major Risk Factors and Protective Factors = 633
Prevention and Treatment of Coronary Heart Disease = 636
Diet Strategies = 637
Drug Therapy = 642
Heart Failure and Strokes = 642
Heart Attacks = 642
Chronic Heart Failure = 643
Strokes = 645
NUTRITION IN PRACTICE : More About the Metabolic Syndrome = 652
CHAPTER TWENTY-SIX Protein-, Mineral-, and Fluid-Modified Diets for Disorders of the Kidneys and Urinary Tract = 657
Kidney Stones = 658
Causes of Kidney Stones = 659
Consequences of Kidney Stones = 660
Prevention and Treatment of Kidney Stones = 661
The Nephrotic Syndrome = 663
Consequences of the Nephrotic Syndrome = 663
Treatment of the Nephrotic Syndrome = 664
Renal Failure = 665
Causes of Renal Failure = 665
Consequences of Renal Failure = 665
Treatment of Renal Failure = 666
Chronic Renal Failure = 666
Consequences of Chronic Renal Failure = 666
Medical Nutrition Therapy for Chronic Renal Disease = 667
Diets following Kidney Transplants = 671
NUTRITION IN PRACTICE : Dialysis and Nutrition = 679
CHAPTER TWENTY-SEVEN Energy- and Protein-Modified Diets for Acute Stress = 683
Types of Stress = 684
The Body's Responses to Acute Stress = 684
Immune System Responses = 68
Hormonal Responses = 685
Consequences of Severe Stress = 686
Medical Nutrition Therapy for Acute Stress = 689
Effect of Acute Stress on Nutrient Needs = 690
Replenishing Fluids and Electrolytes = 690
Energy Needs = 691
Protein Needs = 692
Carbohydrates adn Lipids = 693
Micronutrients = 694
Delivery of Nutrients following Stress = 694
NUTRITION IN PRACTICE : Nutrition and Multiple Organ Failure = 701
CHAPTER TWENTY-EIGHT Energy- and Protein-Modified Diets for Wasting Syndrome = 705
kCalorie-Modified, High-Protein Diets in Wasting versus Stress = 706
Chronic Obstructive Pulmonary Diseases = 707
Cancer = 710
How Cancers Develop = 710
Wasting Associated with Cancer = 711
Treatments for Cancer = 714
Medical Nutrition Therapy = 716
HIV Infection = 718
How HIV Develops = 719
Consequences of HIV Infection = 719
Treatments for HIV Infection = 721
Medical Nutrition Therapy = 721
NUTRITION IN PRACTICE : Ethical Issues in Nutrition Care = 729
