Nutrition for Health and Health Care, Eighth Edition
By Linda Kelly DeBruyne, Kathryn Pinna
Contents:
Preface xvi
Acknowledgments xx
Chapter 1
Overview of Nutrition and Health 1
1.1 Food Choices 2
1.2 The Nutrients 6
Six Classes of Nutrients 6
kCalories: A Measure of Energy 7
1.3 Nutrient Recommendations 8
Dietary Reference Intakes 9
Acceptable Macronutrient Distribution Ranges 11
1.4 National Nutrition Surveys 12
National Health Goals 12
National Trends 12
1.5 Dietary Guidelines, Fitness Guidelines, and Food Guides 13
Dietary Ideals 13
Dietary Guidelines for Americans 15
Fitness Guidelines 16
The USDA Dietary Patterns 18
MyPlate 24
1.6 Food Labels 25
The Ingredient List 25
Nutrition Facts Panel 25
Claims on Labels 27
Nutrition in Practice Finding the Truth about
Nutrition 33
Chapter 2
Digestion and Absorption 37
2.1 Anatomy of the Digestive Tract 38
The Digestive Organs 39
The Involuntary Muscles and the Glands 40
2.2 The Process of Digestion 43
Digestion in the Mouth 43
Digestion in the Stomach 43
Digestion in the Small and Large Intestines 44
2.3 The Absorptive System 46
The Small Intestine 46
Absorption of Nutrients 47
2.4 Transport of Nutrients 48
The Vascular System 48
The Lymphatic System 48
Transport of Lipids: Lipoproteins 48
2.5 The Health and Regulation of the GI Tract 51
Gastrointestinal Hormones and Nerve Pathways 51
Gastrointestinal Microbes 52
The System at Its Best 52
Nutrition in Practice Food Safety 55
Chapter 3
Carbohydrates 65
3.1 The Chemist’s View of Carbohydrates 66
Monosaccharides 66
Disaccharides 67
Polysaccharides 67
3.2 Digestion and Absorption of Carbohydrates 70
3.3 Glucose in the Body 71
Storing Glucose as Glycogen 71
Using Glucose for Energy 71
Regulation of Blood Glucose 72
3.4 Health Effects of Sugars and Alternative Sweeteners 73
Sugars 73
Alternative Sweeteners: Sugar Alcohols 77
Alternative Sweeteners: Nonnutritive Sweeteners 78
3.5 Health Effects of Starch and Dietary Fibers 80
Carbohydrates: Disease Prevention and
Recommendations 80
Carbohydrates: Food Sources 83
Carbohydrates: Food Labels and Health Claims 85
Nutrition in Practice The Glycemic Index in Nutrition
Practice 88
Chapter 4
Lipids 93
4.1 The Chemist’s View of Lipids 94
Triglycerides 94
Fatty Acids 94
Phospholipids 97
Sterols 98
4.2 Digestion and Absorption of Lipids 99
4.3 Roles of Body Fat 100
4.4 Health Effects and Recommended
Intakes of Fats 101
Fats and Heart Health 101
Recommendations 105
4.5 Fats in Foods 106
Finding the Fats in Foods 106
Cutting Saturated Fats and Choosing Unsaturated
Fats 108
Nutrition in Practice Figuring out Fats 114
Chapter 5
Protein 121
5.1 The Chemist’s View of Proteins 122
The Structure of Proteins 122
Nonessential and Essential Amino Acids 123
5.2 Protein Digestion and Absorption 124
5.3 Protein Turnover and Nitrogen Balance 124
Protein Turnover 125
Nitrogen Balance 125
5.4 Roles of Body Proteins 125
5.5 Protein and Health 129
Protein Deficiency 129
Malnutrition 129
Protein Excess 131
Protein and Amino Acid Supplements 131
Protein Recommendations and Intakes 132
5.6 Protein in Foods 133
Protein Quality 133
Protein Sparing 135
Protein on Food Labels 135
Nutrition in Practice Plant-Based Diets 138
Chapter 6
Energy Balance and Body Composition 145
6.1 Energy Imbalance 146
Feasting 146
The Economics of Fasting 147
6.2 Energy Balance 150
Energy In 150
Energy Out 150
Estimating Energy Requirements 153
6.3 Body Weight and Body Composition 155
Defining Healthy Body Weight 155
Body Composition 156
How Much Body Fat Is Too Much? 159
6.4 Health Risks of Underweight and Obesity 160
Health Risks of Underweight 160
Health Risks of Overweight and Obesity 160
Guidelines for Identifying Individuals at Risk from
Obesity 161
Other Risks of Obesity 161
Nutrition in Practice Eating Disorders 165
Chapter 7
Weight Management 171
7.1 Causes of Obesity 172
Genetics and Weight 172
Environmental Stimuli 175
7.2 Obesity Treatment: Who Should Lose? 177
7.3 Ineffective Obesity Treatments 178
Over-the-Counter Weight-Loss Products 178
Other Gimmicks 178
7.4 Aggressive Treatments of Obesity 179
Obesity Drugs 179
Surgery 179
7.5 Reasonable Strategies for Weight Loss 179
A Healthful Eating Plan 180
Physical Activity 183
Behavior and Attitude 184
Weight Maintenance 186
7.6 Strategies for Weight Gain 187
Nutrition in Practice Fad Diets 192
Chapter 8
The Vitamins 195
8.1 The Vitamins: An Overview 196
8.2 The Fat-Soluble Vitamins 198
Vitamin A and Beta-Carotene 198
Vitamin D 203
Vitamin E 207
Vitamin K 208
8.3 The Water-Soluble Vitamins 210
The B Vitamins 210
Thiamin 212
Riboflavin 212
Niacin 213
Pantothenic Acid and Biotin 214
Vitamin B6 214
Folate 215
Vitamin B12 216
Non–B Vitamins 218
Vitamin C 218
Nutrition in Practice Phytochemicals and Functional
Foods 225
Chapter 9
Water and the Minerals 231
9.1 Water and Body Fluids 232
Water Balance 232
Fluid and Electrolyte Balance 234
Acid–Base Balance 235
9.2 The Major Minerals 236
Sodium 236
Chloride 238
Potassium 238
Calcium 239
Phosphorus 243
Magnesium 243
Sulfate 245
9.3 The Trace Minerals 245
Iron 245
Zinc 250
Selenium 252
Iodine 253
Copper 254
Manganese 254
Fluoride 254
Chromium 255
Other Trace Minerals 255
Nutrition in Practice Vitamin and Mineral
Supplements 259
Chapter 10
Nutrition through the Life Span: Pregnancy and
Lactation 263
10.1 Pregnancy: The Impact of Nutrition on the Future 264
Nutrition Prior to Pregnancy 264
Prepregnancy Weight 264
Healthy Support Tissues 265
The Events of Pregnancy 266
Nutrient Needs during Pregnancy 268
Food Assistance Programs 274
Weight Gain 274
Weight Loss after Pregnancy 276
Physical Activity 276
Common Nutrition-Related Concerns of
Pregnancy 277
Problems in Pregnancy 279
Practices to Avoid 280
Adolescent Pregnancy 284
10.2 Breastfeeding 285
Nutrition during Lactation 285
Contraindications to Breastfeeding 287
Nutrition in Practice Encouraging Successful
Breastfeeding 293
Chapter 11
Nutrition through the Life Span: Infancy,
Childhood, and Adolescence 297
11.1 Nutrition of the Infant 298
Nutrient Needs during Infancy 298
Breast Milk 300
Infant Formula 304
The Transition to Cow’s Milk 305
Introducing First Foods 306
Looking Ahead 309
Mealtimes 309
11.2 Nutrition during Childhood 310
Energy and Nutrient Needs 311
Hunger and Malnutrition in Children 314
Lead Poisoning in Children 316
Food Allergy 316
Hyperactivity 318
Childhood Obesity 320
Mealtimes at Home 324
Nutrition at School 329
11.3 Nutrition during Adolescence 330
Growth and Development during Adolescence 330
Energy and Nutrient Needs 331
Food Choices and Health Habits 332
Nutrition in Practice Childhood Obesity and the Early
Development of Chronic Diseases 339
Chapter 12
Nutrition through the Life Span: Later
Adulthood 345
12.1 Nutrition and Longevity 346
Slowing the Aging Process 347
Nutrition and Disease Prevention 348
12.2 Nutrition-Related Concerns during
Late Adulthood 350
Cataracts and Macular Degeneration 350
Arthritis 350
The Aging Brain 351
12.3 Energy and Nutrient Needs during
Late Adulthood 354
Energy and Energy Nutrients 354
Vitamins and Minerals 356
Nutrient Supplements for Older Adults 357
The Effects of Drugs on Nutrients 359
12.4 Food Choices and Eating Habits of Older Adults 359
Individual Preferences 360
Meal Setting 360
Depression 360
Food Assistance Programs 361
Meals for Singles 361
Nutrition in Practice Hunger and Community
Nutrition 367
Chapter 13
Nutrition Care and Assessment 373
13.1 Nutrition in Health Care 374
How Illness Affects Nutrition Status 374
Responsibility for Nutrition Care 375
Identifying Risk for Malnutrition 376
The Nutrition Care Process 377
13.2 Nutrition Assessment 379
Historical Information 379
Dietary Assessment 380
Anthropometric Data 383
Biochemical Analyses 386
Nutrition-Focused Physical Examination 389
Nutrition in Practice Nutritional Genomics 393
Chapter 14
Nutrition Intervention
and Diet-Drug Interactions 397
14.1 Implementing Nutrition Care 398
Care Planning 398
Approaches to Nutrition Care 400
14.2 Dietary Modifications 402
Energy Intakes in Hospital Patients 402
Modified Diets 402
Variations in the Diet Order 406
14.3 Foodservice 408
Food Selection 408
Food Safety 408
Improving Food Intake 408
14.4 Diet-Drug Interactions 411
Drug Effects on Food Intake 411
Drug Effects on Nutrient Absorption 411
Dietary Effects on Drug Absorption 411
Drug Effects on Nutrient Metabolism 412
Dietary Effects on Drug Metabolism 413
Drug Effects on Nutrient Excretion 414
Dietary Effects on Drug Excretion 414
Drug-Nutrient Interactions and Toxicity 414
Nutrition in Practice Complementary and Alternative
Therapies 419
Chapter 15
Enteral and Parenteral Nutrition Support 427
15.1 Enteral Nutrition 428
Oral Supplements 429
Candidates for Tube Feedings 429
Tube Feeding Routes 430
Enteral Formulas 432
Administration of Tube Feedings 435
Medication Delivery during Tube Feedings 439
Tube Feeding Complications 440
Transition to Table Foods 440
15.2 Parenteral Nutrition 442
Candidates for Parenteral Nutrition 442
Venous Access 443
Parenteral Solutions 444
Administering Parenteral Nutrition 448
Managing Metabolic Complications 449
15.3 Nutrition Support at Home 451
Candidates for Home Nutrition Support 451
Planning Home Nutrition Care 451
Quality-of-Life Issues 452
Nutrition in Practice Inborn Errors of
Metabolism 457
Chapter 16
Nutrition in Metabolic and Respiratory
Stress 463
16.1 The Body’s Responses to Stress and Injury 464
Hormonal Responses to Stress 465
The Inflammatory Response 466
16.2 Nutrition Treatment of Acute Stress 467
Determining Nutritional Requirements 468
Approaches to Nutrition Care in Acute Stress 470
16.3 Nutrition and Respiratory Stress 471
Chronic Obstructive Pulmonary Disease 472
Respiratory Failure 474
Nutrition in Practice Multiple Organ Dysfunction
Syndrome 480
Chapter 17
Nutrition and Upper Gastrointestinal
Disorders 483
17.1 Conditions Affecting the Mouth and Esophagus 484
Dry Mouth 484
Dysphagia 484
Gastroesophageal Reflux Disease 488
17.2 Conditions Affecting the Stomach 491
Dyspepsia 491
Nausea and Vomiting 492
Gastroparesis 492
Gastritis 493
Peptic Ulcer Disease 493
17.3 Gastric Surgery 495
Gastrectomy 495
Bariatric Surgery 498
Nutrition in Practice Nutrition and Oral Health 505
Chapter 18
Nutrition and Lower Gastrointestinal
Disorders 509
18.1 Common Intestinal Problems 510
Constipation 510
Intestinal Gas 511
Diarrhea 512
18.2 Malabsorption 514
Fat Malabsorption 515
Bacterial Overgrowth 517
Lactose Intolerance 517
18.3 Disorders of the Pancreas 519
Pancreatitis 519
Cystic Fibrosis 520
18.4 Disorders of the Small Intestine 522
Celiac Disease 522
Inflammatory Bowel Diseases 524
Short Bowel Syndrome 527
18.5 Disorders of the Large Intestine 530
Irritable Bowel Syndrome 530
Diverticular Disease of the Colon 531
Colostomies and Ileostomies 532
Nutrition in Practice Probiotics and Intestinal
Health 538
Chapter 19
Nutrition and Liver Diseases 541
19.1 Fatty Liver and Hepatitis 542
Fatty Liver 542
Hepatitis 543
19.2 Cirrhosis 544
Consequences of Cirrhosis 545
Treatment of Cirrhosis 548
Nutrition Therapy for Cirrhosis 548
19.3 Liver Transplantation 552
Nutrition in Practice Alcohol in Health and
Disease 557
Chapter 20
Nutrition and Diabetes Mellitus 561
20.1 Overview of Diabetes Mellitus 562
Symptoms of Diabetes Mellitus 562
Diagnosis of Diabetes Mellitus 563
Types of Diabetes Mellitus 563
Prevention of Type 2 Diabetes Mellitus 565
Acute Complications of Diabetes Mellitus 565
Chronic Complications of Diabetes Mellitus 567
20.2 Treatment of Diabetes Mellitus 569
Treatment Goals 569
Evaluating Diabetes Treatment 570
Nutrition Therapy: Dietary Recommendations 571
Nutrition Therapy: Meal-Planning Strategies 573
Insulin Therapy 576
Antidiabetic Drugs 579
Physical Activity and Diabetes Management 580
Sick-Day Management 581
20.3 Diabetes Management in Pregnancy 582
Pregnancy in Women with Type 1 or Type 2
Diabetes 582
Gestational Diabetes 582
Nutrition in Practice The Metabolic Syndrome 587
Chapter 21
Nutrition and Cardiovascular Diseases 591
21.1 Atherosclerosis 593
Consequences of Atherosclerosis 593
Causes of Atherosclerosis 593
21.2 Coronary Heart Disease 595
Symptoms of Coronary Heart Disease 595
Evaluating Risk for Coronary Heart
Disease 595
Lifestyle Management to Reduce CHD Risk 596
Vitamin Supplementation and CHD Risk 600
Lifestyle Changes for Hypertriglyceridemia 601
Drug Therapies for CHD Prevention 601
Treatment of Heart Attack 603
21.3 Stroke 603
Stroke Prevention 604
Stroke Management 604
21.4 Hypertension 605
Factors That Influence Blood Pressure 605
Factors That Contribute to Hypertension 605
Treatment of Hypertension 607
21.5 Heart Failure 610
Consequences of Heart Failure 610
Medical Management of Heart Failure 611
Nutrition in Practice Helping People with Feeding
Disabilities 616
Chapter 22
Nutrition and Renal Diseases 621
22.1 Nephrotic Syndrome 623
Consequences of the Nephrotic Syndrome 623
Treatment of the Nephrotic Syndrome 623
22.2 Acute Kidney Injury 626
Causes of Acute Kidney Injury 626
Consequences of Acute Kidney Injury 626
Treatment of Acute Kidney Injury 627
22.3 Chronic Kidney Disease 629
Consequences of Chronic Kidney Disease 629
Treatment of Chronic Kidney Disease 631
Kidney Transplantation 636
22.4 Kidney Stones 638
Formation of Kidney Stones 638
Consequences of Kidney Stones 639
Prevention and Treatment of Kidney Stones 639
Nutrition in Practice Dialysis 644
Chapter 23
Nutrition, Cancer, and HIV Infection 649
23.1 Cancer 650
How Cancer Develops 650
Nutrition and Cancer Risk 651
Consequences of Cancer 654
Treatments for Cancer 654
Nutrition Therapy for Cancer 657
23.2 HIV Infection 661
Prevention of HIV Infection 661
Consequences of HIV Infection 662
Treatments for HIV Infection 664
Nutrition Therapy for HIV Infection 665
Nutrition in Practice Ethical Issues in Nutrition
Care 671
Appendix A Aids to Calculation A-2
A.1 Conversion Factors A-2
A.2 Percentages A-2
A.3 Weights and Measures A-3
Appendix B WHO: Nutrition Recommendations B-1
Appendix C Choose Your Foods: Food Lists
for Diabetes and Weight Management C-1
C.1 The Food Lists C-1
C.2 Choices C-2
C.3 The Foods on the Lists C-2
C.4 Managing Energy, Carbohydrate, Fat, and Sodium C-2
Appendix D Physical Activity and Energy
Requirements D-1
Appendix E Nutrition Assessment: Supplemental
Information E-1
E.1 Weight Gain during Pregnancy E-1
E.2 Growth Charts E-1
E.3 Measures of Body Fat and Lean Tissue E-2
E.4 Nutritional Anemias E-8
E.5 Cautions about Nutrition Assessment E-12
Appendix F Enteral Formulas F-1
Appendix G Dysphagia Diets: IDDSI Framework G-1
Appendix H Dietary Reference Intakes (DRI) H-1
Appendix I Daily Values for Food Labels I-1
Appendix J Body Mass Index (BMI) J-1
Glossary GL-1
Index IN-1
Case Studies
Chapter 10
Woman in Her First Pregnancy 287
Chapter 11
Boy with Disruptive Behavior 319
Chapter 12
Older Man with a Poor Diet 360
Chapter 13
Nutrition Screening and Assessment 390
Chapter 14
Implementing Nutrition Care 401
Chapter 15
Injured Hiker Requiring Enteral Nutrition Support 442
Patient with Intestinal Disease Requiring Parenteral
Nutrition 450
Chapter 16
Patient with a Severe Burn 471
Elderly Man with Emphysema 475
Chapter 17
Woman with GERD 491
Nutrition Care after Gastric Surgery 498
Chapter 18
Patient with Short Bowel Syndrome 529
Young Adult with Irritable Bowel Syndrome 531
Chapter 19
Man with Cirrhosis 552
Chapter 20
Child with Type 1 Diabetes 581
Woman with Type 2 Diabetes 583
Chapter 21
Patient with Cardiovascular Disease 610
Chapter 22
Woman with Acute Kidney Injury 628
Man with Chronic Kidney Disease 636
Chapter 23
Woman with Cancer 660
Man with HIV Infection 667
How To Features
Chapter 1
Calculate the Energy a Food Provides 8
Chapter 3
Reduce Intakes of Added Sugars 75
Chapter 4
Make Heart-Healthy Choices—by Food Group 108
Chapter 5
Calculate Recommended Protein Intakes 133
Chapter 6
Estimate Energy Requirements 154
Chapter 7
Apply Behavior Modification to Manage Body
Fatness 185
Chapter 9
Cut Salt Intake 237
Add Calcium to Daily Meals 243
Add Iron to Daily Meals 251
Chapter 11
Protect against Lead Toxicity 317
Chapter 12
Turn Convenience Foods into Nutritious Meals 363
Stretch Food Dollars and Reduce Waste 370
Chapter 13
Measure Length and Height 384
Measure Weight 384
Estimate and Evaluate Changes in Body Weight 386
Chapter 14
Estimate Appropriate Energy Intakes for Hospital Patients 403
Help Hospital Patients Improve Their Food
Intakes 409
Prevent Diet-Drug Interactions 415
Chapter 15
Help Patients Improve Intakes with Oral Supplements 429
Help Patients Cope with Tube Feedings 436
Plan a Tube Feeding Schedule 438
Administer Medications to Patients Receiving Tube
Feedings 440
Express the Osmolar Concentration of a Solution 443
Calculate the Macronutrient and Energy Content of a
Parenteral Solution 447
Chapter 16
Estimate Energy Needs Using Disease-Specific Stress
Factors 469
Chapter 17
Improve Acceptance of Mechanically Altered Foods 487
Manage Gastroesophageal Reflux Disease 490
Alter the Diet to Reduce Symptoms of Dumping Syndrome 497
Alter Dietary Habits to Achieve and Maintain Weight Loss after
Bariatric Surgery 500
Chapter 18
Follow a Fat-Restricted Diet 518
Chapter 19
Help the Cirrhosis Patient Eat Enough Food 550
Chapter 20
Use Carbohydrate Counting in Clinical Practice 574
Chapter 21
Implement a Heart-Healthy Diet 600
Reduce Sodium Intake 609
Chapter 22
Help Patients Comply with a Renal Diet 636
Chapter 23
Increase the Energy and Protein Content of Meals 658
Help Patients Handle Food-Related Problems 659