Nutrition: Concepts & Controversies, 16th Edition PDF Frances Sienkiewicz Sizer and Ellie Whitney


Nutrition: Concepts & Controversies

Frances Sienkiewicz Sizer and Ellie Whitney

Nutrition concepts & controversies


Preface xiv

Chapter 1

Food Choices and Human

Health 2

A Lifetime of Nourishment 3

The Diet–Health Connection 4

Other Lifestyle Choices 4

Genetics, Nutrition, and

Individuality 5

Think Fitness: Why Be Physically Active? 5

The Human Body and Its Food 6

Meet the Nutrients 6

Can I Live on Just Supplements? 8

The Challenge of Choosing Foods 9

An Abundance of Foods 9

How, Exactly, Can I Recognize a

Nutritious Diet? 10

Why People Choose Foods 12

The Science of Nutrition 13

The Scientific Approach 13

Scientific Challenge 14

Can I Trust the Media for Nutrition

Information? 16

National Nutrition Research 17

Healthy People Objectives for the Nation 17

Changing Behaviors 17

The Process of Change 18

Taking Stock and Setting Goals 18

Start Now 18

A Consumer’s Guide to: Reading

Nutrition News 19

Food Feature: Nutrient Density: How to

Get Enough Nutrients without Too Many

Calories 20

Self Check 21

Controversy 1: Sorting Impostors from Real Nutrition

Experts 23

Chapter 2

Nutrition Tools—Standards and

Guidelines 30

Nutrient Recommendations 31

Two Sets of Standards 31

The DRI Lists and Purposes 32

Understanding the DRI 34

How the Committee Establishes DRI Values—

An RDA Example 35

Determining Individual Requirements 35

Setting Energy Requirements 36

Why Are Daily Values Used on Labels? 36

Dietary Guidelines for Americans 36

Think Fitness: Recommendations for Daily Physical

Activity 39

Diet Planning Using the USDA

Dietary Patterns 40

The Food Groups and Subgroups 40

Choosing Nutrient-Dense Foods 43

Diet Planning in Action 44

MyPlate Educational Tool 46

Flexibility of the USDA Dietary Patterns 46

Food Lists for Weight Management 47

The Last Word on Diet Planning 48

A Consumer’s Guide to: Controlling Portion Sizes at

Home and Away 49

Checking Out Food Labels 51

What Food Labels Must Include 51

What Food Labels May Include 53

Food Feature: Getting a Feel for the Nutrients

in Foods 56

Self Check 59

Controversy 2: Are Some Foods “Superfoods” for

Health? 61

Chapter 3

The Remarkable Body 66

The Body’s Cells 67

Genes Control Functions 67

Cells, Tissues, Organs, and Systems 68

The Body Fluids and the Circulatory System 69

The Hormonal and Nervous Systems 72

What Do Hormones Have to Do with Nutrition? 72

How Does the Nervous System Interact

with Nutrition? 73

The Digestive System 75

Why Do People Like Sugar, Salt, and Fat? 75

The Digestive Tract Structures 76

The Mechanical Aspect of Digestion 76

The Chemical Aspect of Digestion 79

Microbes in the Digestive Tract 80

Are Some Food Combinations More Easily

Digested than Others? 81

If “I Am What I Eat,” Then How Does a Peanut

Butter Sandwich Become “Me”? 82

Absorption and Transport of Nutrients 83

A Letter from Your Digestive

Tract 85

The Excretory System 89

Storage Systems 90

When I Eat More than My Body

Needs, What Happens to the Extra

Nutrients? 90

Variations in Nutrient Stores 91

Conclusion 91

Self Check 92

Controversy 3:

Alcohol 93

Chapter 4

The Carbohydrates: Sugar,

Starch, Glycogen, and Fiber 102

A Close Look at Carbohydrates 103

Sugars 104

Starch 105

Glycogen 106

Fibers 107

Summary 107

The Need for Carbohydrates 107

If I Want to Lose Weight and Stay Healthy, Should I Avoid

Carbohydrates? 108

Why Do Nutrition Experts Recommend

Fiber-Rich Foods? 109

Fiber Intakes and Excesses 113

Whole Grains 114

From Carbohydrates to Glucose 117

Digestion and Absorption of Carbohydrates 117

A Consumer’s Guide to: Finding Whole-Grain

Foods 118

Why Do Some People Have Trouble Digesting Milk? 122

The Body’s Use of Glucose 122

Splitting Glucose for Energy 123

How Is Glucose Regulated in the Body? 124

Excess Glucose and Gain of Body Fat 126

Think Fitness: What Can I Eat to Make Workouts

Easier? 127

The Glycemic Response 128

What Happens If Blood Glucose

Regulation Fails? 129

Diabetes 129

Hypoglycemia 129

Conclusion 130

Food Feature: Finding the

Carbohydrates in Foods 130

Self Check 135

Controversy 4: Are Added Sugars “Bad”

for You? 136

Chapter 5

The Lipids: Fats,

Oils, Phospholipids,

and Sterols 140

Introducing the Lipids 141

How Are Fats Useful to the Body? 141

How Are Fats Useful in Food? 143

A Close Look at Lipids 144

Triglycerides: Fatty Acids and Glycerol 144

Saturated vs. Unsaturated Fatty Acids 145

Phospholipids and Sterols 147

Lipids in the Body 148

How Are Fats Digested and Absorbed? 148

How Does Fat Travel Around the Body? 149

Storing and Using the Body’s Fat 150

Dietary Fat, Cholesterol, and Health 152

Recommendations for Lipid Intakes 152

Lipoproteins and Heart Disease Risk 154

What Does Food Cholesterol Have to Do

with Blood Cholesterol? 155

Recommendations Applied 156

Think Fitness: Why Exercise the Body for the

Health of the Heart? 156

Essential Polyunsaturated Fatty Acids 157

Why Do I Need Essential Fatty Acids? 157

Omega-6 and Omega-3 Fatty Acid Families 158

Omega-3 Fatty Acids 158

Requirements and Sources 159

A Consumer’s Guide to: Weighing Seafood’s Risks

and Benefits 160

The Effects of Processing on Unsaturated Fats 161

What Is “Hydrogenated Vegetable Oil,” and What’s

It Doing in My Chocolate Chip Cookies? 161

What Are Trans-Fatty Acids, and Are They Harmful? 162

Fat in the Diet 163

Get to Know the Fats in Foods 163

Fats in Protein Foods 164

Dairy Products 165

Grains 166

Food Feature: Defensive

Dining 167

Self Check 172

Controversy 5: The Lipid Guidelines

Debate 174

Chapter 6

The Proteins and

Amino Acids 178

The Structure of Proteins 179

Amino Acids 179

How Do Amino Acids Build Proteins? 181

The Variety of Proteins 182

Think Fitness: Can Eating Extra Protein Make

Muscles Grow Stronger? 184

Denaturation of Proteins 186

Digestion and Absorption of Dietary Protein 186

Protein Digestion 186

What Happens to Amino Acids

after Protein Is Digested? 187

The Importance of Protein 187

The Roles of Body Proteins 189

Providing Energy and Glucose 192

The Fate of an Amino Acid 193

A Consumer’s Guide to: Evaluating Protein and

Amino Acid Supplements 194

Food Protein: Need and Quality 196

How Much Protein Do People Need? 196

Nitrogen Balance 196

Protein Quality 198

Protein Deficiency and Excess 200

What Happens When People Consume

Too Little Protein? 200

Is It Possible to Consume Too Much Protein? 201

Is a Gluten-Free Diet Best for Health? 202

Food Feature: Getting Enough but Not Too Much

Protein 203

Self Check 205

Controversy 6: Are Plant-Based

or Meat-Based Diets Better for

Health? 207

Chapter 7

The Vitamins 214

Definition and Classification

of Vitamins 215

Vitamin Precursors 216

Two Classes of Vitamins: Fat-Soluble and Water-

Soluble 216

The Fat-Soluble Vitamins 216

Vitamin A 217

What Are the Roles of Vitamin A? 218

Vitamin A Deficiency Around the World 219

Can Vitamin A Cause Toxicity? 220

Vitamin A Recommendations and Sources 220

Beta-Carotene 221

Vitamin D 223

What Are the Roles of Vitamin D? 223

Too Little Vitamin D—A Danger to Bones 224

Too Much Vitamin D—A Danger to Soft Tissues 225

Is Vitamin D Really the Sunshine Vitamin? 226

Vitamin D Intake Recommendations 227

Which Foods Supply Vitamin D? 227

Vitamin E 228

Vitamin K 230

Roles, Deficiency, and Toxicity of Vitamin K 230

Vitamin K Requirements and Food Sources 231

The Water-Soluble Vitamins 231

Vitamin C 232

Think Fitness: Vitamins for Athletes 233

What Are the Roles of Vitamin C in the Body? 233

Deficiency Symptoms and Intakes 235

Can Vitamin C Cause Toxicity? 235

Vitamin C Recommendations 235

Which Foods Supply Vitamin C? 236

The B Vitamins in Unison 236

What Are the Roles of B Vitamins in

Metabolism? 236

B Vitamin Deficiencies 237

The B Vitamins as

Individuals 239

Thiamin 239

A Consumer’s Guide to: The Effects of Food

Processing on Vitamins 240

Riboflavin 242

Niacin 243

Folate 243

Vitamin B12 246

Vitamin B6 247

Biotin and Pantothenic Acid 249

Choline 249

Nonvitamins 250

Food Feature: Choosing Foods Rich in

Vitamins 255

Self Check 258

Controversy 7: Vitamin Supplements: What Are the

Benefits and Risks? 260

Chapter 8

Water and Minerals 266

Water 268

Why Is Water the Most Indispensable Nutrient? 269

The Body’s Water Balance 270

Quenching Thirst and Balancing Losses 270

How Much Water Do I Need to Drink in a Day? 271

A Consumer’s Guide to: Liquid Calories 273

Body Fluids and Minerals 275

Water Follows Salt 275

Fluid and Electrolyte Balance 276

Acid–Base Balance 276

The Major Minerals 277

Calcium 277

Phosphorus 281

Magnesium 281

Sodium 283

Potassium 287

Chloride 288

Sulfate 288

The Trace Minerals 289

Iodine 289

Iron 290

Think Fitness: Exercise-Deficiency

Fatigue 292

Zinc 295

Selenium 297

Fluoride 297

Chromium 298

Copper 299

Other Trace Minerals and Some Candidates 299

Food Feature: Meeting the Need

for Calcium 302

Self Check 305

Controversy 8: Osteoporosis: Can Lifestyle Choices

Reduce the Risk? 306

Chapter 9

Energy Balance and Healthy

Body Weight 312

The Problems of Too Little

or Too Much Body Fat 313

What Are the Risks from

Underweight? 314

What Are the Risks from Too Much

Body Fat? 314

What Are the Risks from Central

Obesity? 315

How Fat Is Too Fat? 316

The Body’s Energy Balance 318

Energy in and Energy Out 318

How Many Calories Do I Need

Each Day? 318

Estimated Energy Requirements (EER) 320

How Can I Calculate My EER Range? 320

Body Weight vs. Body Composition 321

Using the Body Mass Index (BMI) 321

Measuring Body Composition and

Fat Distribution 322

How Much Body Fat Is Ideal? 323

The Appetite and

Its Regulation 323

Hunger and Appetite—“Go” Signals 324

Satiation and Satiety—“Stop” Signals 325

Inside-the-Body Theories

of Obesity 327

Outside-the-Body Theories

of Obesity 328

Think Fitness: Activity for a Healthy Body

Weight 329

How the Body Loses

and Gains Weight 331

The Body’s Response to Energy Deficit 332

The Body’s Response to Energy Surplus 334

Achieving and Maintaining

a Healthy Body Weight 335

A Consumer’s Guide to: Fad Diets 337

What Food Strategies Are Best for

Weight Loss? 339

Physical Activity Strategies 342

What Strategies Are Best for

Weight Gain? 343

Medical Treatment of Obesity 344

Obesity Medications 344

Obesity Surgery 344

Dietary Supplements and Gimmicks 345

Once I’ve Changed My Weight,

How Can I Stay Changed? 346

Conclusion 347

Food Feature: Behavior Change Methods for

Weight Management 348

Self Check 351

Controversy 9: The Perils of Eating

Disorders 352

Chapter 10


Nutrition 360

The Benefits of Fitness 361

The Nature of Fitness 361

Physical Activity Guidelines 362

The Essentials of Fitness 364

How Do Muscles Adapt to Physical Activity? 364

How Does Aerobic Training Benefit the Heart? 366

Think Fitness: Exercise Safety 367

Three Energy Systems 367

The Muscles’ Energy Reservoir 367

The Anaerobic Energy System 369

The Aerobic Energy System 370

The Active Body’s Use of Fuels 370

The Need for Food Energy 370

Carbohydrate: Vital for Exercisers 371

Carbohydrate Recommendations for Athletes 374

Fat as Fuel for Physical Activity 375

Fat Recommendations for Athletes 376

Protein for Building Muscles and for Fuel 377

Protein Recommendations for Athletes 378

Vitamins and Minerals—

Keys to Performance 378

Do Athletes Need Nutrient Supplements? 379

Iron—A Mineral of Concern 379

Fluids and Temperature Regulation in Physical

Activity 380

Water Losses during Physical Activity 380

Fluid and Electrolyte Needs during Physical Activity 382

Other Beverages 383

A Consumer’s Guide to: Selecting Sports

Drinks 384

Putting It All Together 385

Food Feature: Choosing a Performance Diet 387

Self Check 391

Controversy 10: Ergogenic Aids: Breakthroughs,

Gimmicks, or Dangers? 392

Chapter 11

Nutrition and Chronic

Diseases 396

Causation of Chronic Diseases 398

Cardiovascular Diseases (CVD) 399

Atherosclerosis and Hypertension 400

Risk Factors for Cardiovascular Disease 402

Preventive Measures against CVD 405

Think Fitness: Ways to Include Physical Activity in

a Day 406

A Consumer’s Guide to: Nutrition and the Immune

System 410

Diabetes 412

How Does Type 2 Diabetes Develop? 413

Harms from Diabetes 413

Diabetes Prevention and Management 415

Cancer 417

The Cancer Disease Process 417

Cancer Risk Factors 418

Cancer Prevention 420

Conclusion 422

Food Feature: The DASH Diet: Preventive

Medicine 422

Self Check 425

Controversy 11: Nutrient–Drug Interactions: Who Should

Be Concerned? 426

Chapter 12

Food and Water Safety and

Food Technology 432

Microbes and Food Safety 434

How Do Microbes in Food Cause Illness in the Body? 434

Food Safety from Farm to Plate 436

Safe Food Practices for Individuals 439

Which Foods Are Most Likely to Cause Illness? 442

Protein Foods 443

Raw Produce 445

Other Foods 446

Advances in Microbial Food Safety 448

Is Irradiation Safe? 448

Modified Atmosphere Packaging 449

Toxins, Residues, and Contaminants in Foods 449

Natural Toxins in Foods 449

Pesticides 450

Animal Drugs—What Are the Risks? 452

A Consumer’s Guide to: Understanding Organic

Foods 453

Environmental Contaminants 455

Water Safety and Sources 457

Drinking Water 457

Is Tap Water Safe to Drink? 458

Is Bottled Water Safest? 458

Are Food Additives Safe? 458

Regulations Governing Additives 458

Additives to Improve Safety and Quality 460

Flavoring Agents 460

Fat Replacers and Artificial Fats 463

Incidental Food Additives 463

Conclusion 464

Food Feature: Handling Real-Life Challenges

to Food Safety 464

Self Check 467

Controversy 12: Bioengineered Foods: What Are the

Pros and Cons? 469

Chapter 13

Life Cycle Nutrition: Mother

and Infant 476

Pregnancy: The Impact

of Nutrition on the Future 477

Preparing for Pregnancy 477

The Events of Pregnancy 480

Increased Needs for Nutrients 481

Food Assistance Programs 486

How Much Weight Gain Is Ideal during Pregnancy? 486

Weight Loss after Pregnancy 487

Should Pregnant Women Be Physically Active? 488

Teen Pregnancy 488

Think Fitness: Physical Activities for Pregnant

Women 489

Why Do Some Women Crave Pickles and Ice Cream While

Others Can’t Keep Anything Down? 489

Some Cautions for Pregnant Women 490

Drinking during Pregnancy 492

Alcohol’s Effects 492

Fetal Alcohol Syndrome 493

Experts’ Advice 493

Troubleshooting 494

Diabetes 494

Hypertension 495

Preeclampsia 495

Lactation 495

Nutrition during Lactation 496

When Should a Woman Not Breastfeed? 497

Feeding the Infant 498

Nutrient Needs 498

Why Is Breast Milk So Good for Babies? 500

Formula Feeding 503

A Consumer’s Guide to: Formula Advertising versus

Breastfeeding Advocacy 504

An Infant’s First Solid Foods 505

Looking Ahead 509

Food Feature: Mealtimes with Infants 510

Self Check 511

Controversy 13: How Do Today’s Food Choices Affect

Future Generations? 512

Chapter 14

Child, Teen, and

Older Adult 516

Early and Middle Childhood 518

Feeding a Healthy Young Child 518

Mealtimes and Snacking 522

How Do Nutrient Deficiencies

Affect a Child’s Brain? 525

The Problem of Lead 526

Food Allergies, Intolerances, and

Aversions 528

Can Diet Make a Child

Hyperactive? 530

Dental Caries 531

Is Breakfast Really the Most Important

Meal of the Day for Children? 532

How Nourishing Are the Meals Served at School? 533

Nutrition in Adolescence 534

Nutrient Needs 535

Menstruation and Acne 536

A Consumer’s Guide to: Acne and Diet 537

Dietary Patterns and Nutrient Intakes 538

The Later Years 539

Nutrition in the Later Years 540

Energy, Activity, and the Muscles 540

Protein Needs 541

Think Fitness: Physical Activity for the Older

Adult 542

Carbohydrates and Fiber 542

Fats and Arthritis 543

Vitamin Needs 543

Water and the Minerals 544

Can Diet Choices Lengthen Life? 545

Aging and Inflammation 547

Can Diet Affect the Course of Alzheimer’s Disease? 548

Food Choices of Older Adults 548

Food Feature: Single Survival and Nutrition

on the Run 550

Self Check 552

Controversy 14: Childhood Obesity and Early Chronic

Diseases 554

Chapter 15

Hunger and the Future of

Food 562

U.S. Food Insecurity 563

Food Poverty in the United States 564

What U.S. Food Programs Address

Low Food Security? 566

World Poverty and Hunger 567

The Malnutrition of Extreme

Poverty 569

Hidden Hunger—Vitamin and Mineral

Deficiencies 569

Consequences of Childhood Malnutrition 570

Medical Nutrition Therapy 571

The Future Food Supply

and the Environment 571

Threats to the Food Supply 572

Food Loss and Food Waste 573

How Can People Help? 575

Government Action 575

Private and Community Enterprises 576

Educators and Students 576

Food and Nutrition Professionals 576

Individuals 576

Conclusion 576

A Consumer’s Guide to: Making “Green” Choices

(Without Getting “Greenwashed”) 577

Self Check 579

Controversy 15: How Can We Feed Ourselves

Sustainably? 580


A Chemical Structures: Carbohydrates,

Lipids, and Amino Acids A-3

B World Health Organization

Guidelines B-1

C Aids to Calculations C-1

D Choose Your Foods: Food Lists for

Diabetes and Weight Management D-1

E Dietary Patterns to Meet the Dietary

Guidelines for Americans E-1

F Notes F-1

G Answers to Chapter Questions G-1

H Physical Activity Levels and Energy

Requirements H-1

Glossary GL-1

Index IN-1

Dietary Reference Intakes (DRI)

(at the back of the book)

Estimated Energy Requirements (EER),

Recommended Dietary Allowances (RDA),

and Adequate Intakes (AI) for Water,

Energy, and the Energy Nutrients

Recommended Dietary Allowances (RDA)

and Adequate Intakes (AI) for Vitamins

Recommended Dietary Allowances (RDA)

and Adequate Intakes (AI) for Minerals

Tolerable Upper Intake Levels (UL) for


Tolerable Upper Intake Levels (UL) for

Minerals and Chronic Disease Risk

Reduction Intakes (CDRR) for Sodium

Daily Values (DV) for Food Labels

Glossary of Nutrient Measures

Body Mass Index (BMI)

Body Mass Index-for-Age Percentiles:

Boys and Girls, Age 2 to 20

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