Nutrition: Concepts and Controversies, 15th Edition
By Frances Sienkiewicz Sizer and Ellie Whitney
By Frances Sienkiewicz Sizer and Ellie Whitney
Contents
Preface xiv
Chapter 1
Food Choices and Human
Health 1
A Lifetime of Nourishment 2
The Diet–Health Connection 3
Genetics, Nutrition, and Individuality 3
Thin k Fitness : Why Be Physically Active? 4
Other Lifestyle Choices 5
The Nation’s Nutrition Objectives 5
The Human Body and Its Food 5
Meet the Nutrients 7
Can I Live on Just Supplements? 8
The Challenge of Choosing Foods 9
The Abundance of Foods to Choose From 9
How, Exactly, Can I Recognize a Nutritious Diet? 11
Why People Choose Foods 12
The Science of Nutrition 13
The Scientific Approach 14
Scientific Challenge 14
Can I Trust the Media for Nutrition Information? 16
National Nutrition Research 17
Changing Behaviors 17
The Process of Change 18
Taking Stock and Setting Goals 18
Start Now 18
Chapter 1
Food Choices and Human
Health 1
A Lifetime of Nourishment 2
The Diet–Health Connection 3
Genetics, Nutrition, and Individuality 3
Thin k Fitness : Why Be Physically Active? 4
Other Lifestyle Choices 5
The Nation’s Nutrition Objectives 5
The Human Body and Its Food 5
Meet the Nutrients 7
Can I Live on Just Supplements? 8
The Challenge of Choosing Foods 9
The Abundance of Foods to Choose From 9
How, Exactly, Can I Recognize a Nutritious Diet? 11
Why People Choose Foods 12
The Science of Nutrition 13
The Scientific Approach 14
Scientific Challenge 14
Can I Trust the Media for Nutrition Information? 16
National Nutrition Research 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
Contents
Self Check 22
CONTROVERSY 1: Sorting Imposters 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 33
How the Committee Establishes DRI Values—
An RDA Example 34
Determining Individual Requirements 35
Setting Energy Requirements 35
Why Are Daily Values Used on Labels? 36
Dietary Guidelines for Americans 36
Thin k Fitness : Recommendations for Daily
Physical Activity 39
Diet Planning Using the USDA Eating
Patterns 39
Reading Nutrition News 19
Food feature :
Nutrient Density:
How to Get
Enough Nutrients
without Too Many
Calories 20
Contents
Self Check 22
CONTROVERSY 1: Sorting Imposters 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 33
How the Committee Establishes DRI Values—
An RDA Example 34
Determining Individual Requirements 35
Setting Energy Requirements 35
Why Are Daily Values Used on Labels? 36
Dietary Guidelines for Americans 36
Thin k Fitness : Recommendations for Daily
Physical Activity 39
Diet Planning Using the USDA Eating
Patterns 39
The Food Groups and Subgroups 39
Choosing Nutrient-Dense Foods 42
Diet Planning 43
MyPlate Educational Tool 45
Flexibility of the USDA Eating Patterns 45
Food Lists for Weight Management 46
A CONSUMER’S GUIDE TO: Controlling Portion
Sizes at Home and Away 48
The Last Word on Diet Planning 50
Checking Out Food Labels 50
What Food Labels Must Include 50
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 67
The Body’s Cells 68
Genes Control Functions 69
Cells, Tissues, Organs, Systems 70
The Body Fluids and the Circulatory
System 70
The Hormonal and Nervous Systems 73
What Do Hormones Have to Do with Nutrition? 73
How Does the Nervous System Interact
with Nutrition? 74
The Digestive System 76
Why Do People Like Sugar, Salt, and Fat? 76
The Digestive Tract Structures 77
The Mechanical Aspect of Digestion 77
The Chemical Aspect of Digestion 80
Microbes in the Digestive Tract 81
Are Some Food Combinations More Easily
Digested than Others? 82
If “I Am What I Eat,” Then How Does a Peanut
Butter Sandwich Become “Me”? 83
Absorption and Transport of Nutrients 84
A Letter from Your Digestive
Tract 86
The Excretory System 91
Storage Systems 92
When I Eat More than My Body
Needs, What Happens to the Extra
Nutrients? 92
Variations in Nutrient Stores 92
Conclusion 92
Self Check 94
CONTROVERSY 3:
Alcohol Use: Risks and
Benefits 95
Chapter 4
The Carbohydrates: Sugar,
Starch, Glycogen, and Fiber 104
A Close Look at Carbohydrates 105
Sugars 105
Starch 107
Glycogen 108
Fibers 109
Summary 109
The Need for Carbohydrates 109
If I Want to Lose Weight and Stay Healthy, Should I Avoid
Carbohydrates? 110
Why Do Nutrition Experts Recommend
Fiber-Rich Foods? 111
Fiber Intakes and Excesses 115
Whole Grains 116
From Carbohydrates to Glucose 119
Digestion and Absorption of Carbohydrate 119
A CONSUMER’S GUIDE TO: Finding Whole-Grain
Foods 120
Why Do Some People Have Trouble Digesting Milk? 124
The Body’s Use of Glucose 124
Splitting Glucose for Energy 125
How Is Glucose Regulated in the Body? 126
Excess Glucose and Body Fatness 127
Thin k Fitness : What Can I Eat to Make
Workouts Easier? 129
The Glycemic Index of Food 129
What Happens If Blood Glucose Regulation
Fails? 131
Diabetes 131
Hypoglycemia 131
Conclusion 132
Food feature : Finding the
Carbohydrates in Foods 132
Self Check 137
CONTROVERSY 4: Are Added Sugars
“Bad” for You? 139
Chapter 5
The Lipids: Fats, Oils,
Phospholipids, and
Sterols 144
Introducing the Lipids 145
How Are Fats Useful to the Body? 145
How Are Fats Useful in Food? 147
A Close Look at Lipids 148
Triglycerides: Fatty Acids and Glycerol 148
Saturated vs. Unsaturated Fatty Acids 149
Phospholipids and Sterols 151
Lipids in the Body 152
How Are Fats Digested and Absorbed? 152
Transport of Fats 153
Storing and Using the Body’s Fat 154
Dietary Fat, Cholesterol, and Health 156
Recommendations for Lipid Intakes 156
Lipoproteins and Heart Disease Risk 158
What Does Food Cholesterol Have to Do
with Blood Cholesterol? 159
Recommendations Applied 160
Thin k Fitness : Why Exercise the Body
for the Health of the Heart? 160
Essential Polyunsaturated Fatty Acids 161
Why Do I Need Essential Fatty Acids? 162
Omega-6 and Omega-3 Fatty Acid Families 162
Omega-3 Fatty Acids 162
Requirements and Sources 163
A CONSUMER’S GUIDE TO: Weighing Seafood’s
Risks and Benefits 164
The Effects of Processing on Unsaturated
Fats 165
What Is “Hydrogenated Vegetable Oil,” and What’s
It Doing in My Chocolate Chip Cookies? 165
What Are Trans-Fatty Acids, and Are They Harmful? 166
Fat in the Diet 167
Get to Know the Fats in Foods 167
Fats in Protein Foods 168
Milk and Milk Products 169
Grains 170
FOOD FEATURE: Defensive
Dining 171
Self Check 176
CONTROVERSY 5: Is Butter Really
Back? The Lipid Guidelines Debate 178
Chapter 6
The Proteins and Amino
Acids 182
The Structure of Proteins 183
Amino Acids 183
How Do Amino Acids Build Proteins? 185
The Variety of Proteins 186
Thin k Fitness : Can Eating Extra Protein Make
Muscles Grow Stronger? 189
Denaturation of Proteins 189
Digestion and Absorption of Dietary
Protein 190
Protein Digestion 190
What Happens to Amino Acids after Protein Is
Digested? 192
The Importance of Protein 192
The Roles of Body Proteins 193
Providing Energy and Glucose 196
The Fate of an Amino Acid 197
A CONSUMER’S GUIDE TO: Evaluating Protein and
Amino Acid Supplements 198
Food Protein: Need and Quality 200
How Much Protein Do People Need? 200
Nitrogen Balance 200
Protein Quality 202
Protein Deficiency and Excess 204
What Happens When People Consume
Too Little Protein? 204
Is It Possible to Consume Too Much Protein? 205
Is a Gluten-Free Diet Best for Health? 206
FOOD FEATURE: Getting Enough but Not
Too Much Protein 207
Self Check 211
CONTROVERSY 6: Are Vegetarian or
Meat-Containing Diets Better for
Health? 212
Chapter 7
The Vitamins 218
Definition and Classification of
Vitamins 219
Vitamin Precursors 220
Two Classes of Vitamins: Fat-Soluble and Water-
Soluble 220
The Fat-Soluble Vitamins 220
Vitamin A 221
Roles of Vitamin A and Consequences of
Deficiency 222
Vitamin A Toxicity 224
Vitamin A Recommendations and Sources 225
Beta-Carotene 226
Vitamin D 227
Roles of Vitamin D 227
Too Little Vitamin D—A Danger to Bones 228
Too Much Vitamin D—A Danger to Soft Tissues 229
Vitamin D from Sunlight 230
Vitamin D Intake Recommendations 231
Vitamin D Food Sources 231
Vitamin E 232
Roles of Vitamin E 232
Vitamin E Deficiency 232
Toxicity of Vitamin E 233
Vitamin E Recommendations and U.S. Intakes 233
Vitamin E Food Sources 234
Vitamin K 234
Roles of Vitamin K 234
Vitamin K Deficiency 235
Vitamin K Toxicity 235
Vitamin K Requirements and Sources 235
The Water-Soluble Vitamins 236
Think Fitness : Vitamins for Athletes 237
The Roles of Vitamin C 237
Deficiency Symptoms and Intakes 239
Vitamin C Toxicity 239
Vitamin C Recommendations 239
Vitamin C Food Sources 240
The B Vitamins in Unison 240
B Vitamin Roles in Metabolism 241
B Vitamin Deficiencies 241
The B Vitamins as Individuals 243
Thiamin 243
A CONSUMER’S GUIDE TO: The Effects of Food
Processing on Vitamins 244
Riboflavin Roles 246
Niacin 247
Folate 248
Vitamin B12 250
Vitamin B6 251
Biotin and Pantothenic Acid 253
Non–B Vitamins 253
FOOD FEATURE: Choosing Foods Rich in
Vitamins 259
Self Check 262
CONTROVERSY 7: Vitamin Supplements: What are
the Benefits and Risks? 264
Chapter 8
Water and Minerals 270
Water 272
Why Is Water the Most Indispensable Nutrient? 273
The Body’s Water Balance 274
Quenching Thirst and Balancing Losses 274
How Much Water Do I Need to Drink in a Day? 276
A CONSUMER’S GUIDE TO: Liquid Calories 277
Drinking Water: Types, Safety, and Sources 279
Hard Water or Soft Water—Which Is Best? 279
Water Safety and Sources 279
Body Fluids and Minerals 280
Water Follows Salt 281
Fluid and Electrolyte Balance 281
Acid-Base Balance 282
The Major Minerals 282
Calcium 282
Phosphorus 285
Magnesium 287
Sodium 288
Potassium 292
Chloride 293
Sulfate 293
The Trace Minerals 294
Iodine 294
Iron 295
Thin k Fitness : Exercise-Deficiency
Fatigue 297
Zinc 300
Selenium 302
Fluoride 302
Chromium 303
Copper 304
Other Trace Minerals and Some Candidates 304
FOOD FEATURE: Meeting the Need for
Calcium 307
Self Check 310
CONTROVERSY 8 Osteoporosis: Can Lifestyle
Choices Reduce the Risk? 311
Chapter 9
Energy Balance and
Healthy Body Weight 317
The Problems of Too Little or Too Much
Body Fat 318
What Are the Risks from
Underweight? 319
What Are the Risks from Too Much Body
Fat? 319
What Are the Risks from Central
Obesity? 320
How Fat Is Too Fat? 321
The Body’s Energy Balance 322
Energy In and Energy Out 323
How Many Calories Do I Need Each
Day? 323
Estimated Energy Requirements (EER) 325
The DRI Method of Estimating Energy
Requirements 325
Body Weight vs. Body Fatness 326
Using the Body Mass Index (BMI) 326
Measuring Body Composition and Fat
Distribution 326
How Much Body Fat Is Ideal? 328
The Appetite and Its Control 328
Hunger and Appetite—“Go” Signals 328
Satiation and Satiety—“Stop” Signals 330
Inside-the-Body Theories of Obesity 332
Outside-the-Body Theories of Obesity 333
Thin k Fitness : Activity for a Healthy Body
Weight 335
How the Body Loses and Gains Weight 336
The Body’s Response to Energy Deficit 337
The Body’s Response to Energy Surplus 338
Achieving and Maintaining a Healthy Body
Weight 340
A CONSUMER’S GUIDE TO: Fad Diets 342
What Food Strategies Are Best for
Weight Loss? 344
Physical Activity Strategies 347
What Strategies Are Best for Weight Gain? 348
Medical Treatment of Obesity 349
Obesity Medications 349
Obesity Surgery 349
Herbal Products and Gimmicks 351
Once I’ve Changed My Weight,
How Can I Stay Changed? 352
Conclusion 353
FOOD FEATURE: Behavior Modification for
Weight Control 354
Self Check 356
CONTROVERSY 9: The Perils of Eating
Disorders 358
Chapter 10
Performance
Nutrition 365
The Benefits of Fitness 366
The Nature of Fitness 366
Physical Activity Guidelines 368
The Essentials of Fitness 369
How Do Muscles Adapt to Physical Activity? 369
How Does Aerobic Training Benefit the Heart? 371
Thin k Fitness : Exercise Safety 372
Three Energy Systems 372
The Muscles’ Energy Reservoir 372
The Anaerobic Energy System 374
The Aerobic Energy System 374
The Active Body’s Use of Fuels 374
The Need for Food Energy 375
Carbohydrate: Vital for Exercisers 376
Carbohydrate Recommendations for Athletes 379
Fat as Fuel for Physical Activity 380
Fat Recommendations for Athletes 381
Protein for Building Muscles and for Fuel 382
Protein Recommendations for Athletes 383
Vitamins and Minerals—Keys to Performance 384
Do Athletes Need Nutrient Supplements? 384
Iron—A Mineral of Concern 385
Fluids and Temperature Regulation in Physical
Activity 386
Water Losses during Physical Activity 386
Fluid and Electrolyte Needs during Physical Activity 387
A CONSUMER’S GUIDE TO: Selecting Sports
Drinks 389
Other Beverages 390
Putting It All Together 391
FOOD FEATURE: Choosing a Performance
Diet 392
Self Check 396
CONTROVERSY 10: Ergogenic Aids: Breakthroughs,
Gimmicks, or Dangers? 398
Chapter 11
Nutrition and Chronic
Diseases 404
Causation of Chronic Diseases 405
Cardiovascular Diseases (CVD) 407
Atherosclerosis and Hypertension 407
Risk Factors for Cardiovascular Disease 410
Preventive Measures against CVD 413
Thin k Fitness : Ways to Include Physical
Activity in a Day 414
Diabetes 418
How Does Type 2 Diabetes Develop? 419
Harms from Diabetes 420
Diabetes Prevention and Management 421
Cancer 423
The Cancer Disease Process 423
A CONSUMER’S GUIDE TO: Deciding about
CAM 424
Cancer Risk Factors 426
Cancer Prevention 428
Conclusion 430
FOOD FEATURE: The DASH Diet: Preventive
Medicine 431
Self Check 433
CONTROVERSY 11: Nutritional Genomics: Can
It Deliver on Its Promises? 435
Chapter 12
Food Safety and Food
Technology 440
Microbes and Food Safety 442
How Do Microbes in Food Cause Illness in the
Body? 442
Food Safety from Farm to Plate 444
Safe Food Practices for Individuals 447
Which Foods Are Most Likely to Cause
Illness? 450
Protein Foods 451
Raw Produce 453
Other Foods 454
Advances in Microbial Food Safety 456
Is Irradiation Safe? 456
Other Technologies 457
Toxins, Residues, and Contaminants in Foods 458
Natural Toxins in Foods 458
Pesticides 458
A CONS UMER’S GUIDE TO: Understanding
Organic Foods 461
Animal Drugs—What Are the Risks? 463
Environmental Contaminants 464
Are Food Additives Safe? 466
Regulations Governing Additives 466
Additives to Improve Safety and Quality 468
Flavoring Agents 468
Fat Replacers and Artificial Fats 471
Incidental Food Additives 471
Conclusion 472
FOOD FEATURE: Handling Real-Life Challenges
to Food Safety 472
Self Check 475
CONTROVERSY 12: Genetically Engineered Foods:
What Are the Pros and Cons? 477
Chapter 13
Life Cycle Nutrition: Mother
and Infant 484
Pregnancy: The Impact of Nutrition on the
Future 485
Preparing for Pregnancy 485
The Events of Pregnancy 487
Increased Need for Nutrients 489
Food Assistance Programs 494
How Much Weight Should a Woman
Gain during Pregnancy? 494
Weight Loss after Pregnancy 495
Should Pregnant Women Be Physically
Active? 496
Teen Pregnancy 496
Think Fitness: Physical Activities for Pregnant
Women 497
Why Do Some Women Crave Pickles and Ice Cream While
Others Can’t Keep Anything Down? 497
Some Cautions for Pregnant Women 498
Drinking during Pregnancy 500
Alcohol’s Effects 500
Fetal Alcohol Syndrome 501
Experts’ Advice 501
Troubleshooting 502
Diabetes 502
Hypertension 503
Preeclampsia 503
Lactation 503
Nutrition during Lactation 503
When Should a Woman Not Breastfeed? 505
Feeding the Infant 506
Nutrient Needs 506
Why Is Breast Milk So Good for Babies? 507
Formula Feeding 510
A CONS UMER’S GUIDE TO: Formula Advertising
versus Breastfeeding Advocacy 511
An Infant’s First Solid Foods 512
Looking Ahead 515
FOOD FEATURE: Mealtimes with Infants 516
Self Check 517
CONTROVERSY 13: Childhood Obesity and Early
Chronic Diseases 519
Chapter 14
Child, Teen, and Older
Adult 526
Early and Middle Childhood 527
Feeding a Healthy Young Child 527
Mealtimes and Snacking 531
How Do Nutrient Deficiencies
Affect a Child’s Brain? 534
The Problem of Lead 535
Food Allergies, Intolerances, and Aversions 537
Can Diet Make a Child Hyperactive? 539
Dental Caries 540
Is Breakfast Really the Most Important Meal of the
Day for Children? 540
How Nourishing Are the Meals Served at
School? 541
Nutrition in Adolescence 543
Nutrient Needs 543
Common Concerns 545
Eating Patterns and Nutrient Intakes 545
The Later Years 546
A CONSUMER’S GUIDE TO: Nutrition for PMS
Relief 547
Nutrition in the Later Years 548
Energy, Activity, and the Muscles 548
Protein Needs 549
Thin k Fitness : Benefits of Physical Activity
for the Older Adult 550
Carbohydrates and Fiber 550
Fats and Arthritis 551
Vitamin Needs 551
Water and the Minerals 552
Can Diet Choices Lengthen Life? 554
Aging, Immunity, and Inflammation 555
Can Diet Affect the Course of Alzheimer’s Disease? 555
Food Choices of Older Adults 556
FOOD FEATURE: Single Survival and Nutrition
on the Run 558
Self Check 560
CONTROVERSY 14: Nutrient–Drug Interactions:
Who Should Be Concerned? 562
Cha pter 15
Hunger and the Future of
Food 567
U.S. Food Insecurity 568
Food Poverty in the United States 568
What U.S. Food Programs Address Low Food Security? 570
World Poverty and Hunger 572
The Malnutrition of Extreme
Poverty 574
Hidden Hunger—Vitamin and Mineral
Deficiencies 574
Two Faces of Childhood Malnutrition 574
Medical Nutrition Therapy 576
The Future Food Supply
and the Environment 576
Threats to the Food Supply 576
Fisheries and Food Waste 578
How Can People Help? 580
Government Action 580
Private and Community Enterprises 581
Educators and Students 581
Food and Nutrition Professionals 581
Individuals 581
Conclusion 581
A CONSUMER’S GUIDE TO: Making “Green”
Choices (Without Getting “Greenwashed”) 582
Self Check 584
CONTROVERSY 15: How Can We Feed Ourselves
Sustainably? 585
Appendixes
A Chemical Structures: Carbohydrates,
Lipids, and Amino Acids A-1
B World Health Organization
Guidelines B-1
C Aids to Calculations C-1
D Food Lists for Diabetes and Weight
Management D-1
E Eating 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
Choosing Nutrient-Dense Foods 42
Diet Planning 43
MyPlate Educational Tool 45
Flexibility of the USDA Eating Patterns 45
Food Lists for Weight Management 46
A CONSUMER’S GUIDE TO: Controlling Portion
Sizes at Home and Away 48
The Last Word on Diet Planning 50
Checking Out Food Labels 50
What Food Labels Must Include 50
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 67
The Body’s Cells 68
Genes Control Functions 69
Cells, Tissues, Organs, Systems 70
The Body Fluids and the Circulatory
System 70
The Hormonal and Nervous Systems 73
What Do Hormones Have to Do with Nutrition? 73
How Does the Nervous System Interact
with Nutrition? 74
The Digestive System 76
Why Do People Like Sugar, Salt, and Fat? 76
The Digestive Tract Structures 77
The Mechanical Aspect of Digestion 77
The Chemical Aspect of Digestion 80
Microbes in the Digestive Tract 81
Are Some Food Combinations More Easily
Digested than Others? 82
If “I Am What I Eat,” Then How Does a Peanut
Butter Sandwich Become “Me”? 83
Absorption and Transport of Nutrients 84
A Letter from Your Digestive
Tract 86
The Excretory System 91
Storage Systems 92
When I Eat More than My Body
Needs, What Happens to the Extra
Nutrients? 92
Variations in Nutrient Stores 92
Conclusion 92
Self Check 94
CONTROVERSY 3:
Alcohol Use: Risks and
Benefits 95
Chapter 4
The Carbohydrates: Sugar,
Starch, Glycogen, and Fiber 104
A Close Look at Carbohydrates 105
Sugars 105
Starch 107
Glycogen 108
Fibers 109
Summary 109
The Need for Carbohydrates 109
If I Want to Lose Weight and Stay Healthy, Should I Avoid
Carbohydrates? 110
Why Do Nutrition Experts Recommend
Fiber-Rich Foods? 111
Fiber Intakes and Excesses 115
Whole Grains 116
From Carbohydrates to Glucose 119
Digestion and Absorption of Carbohydrate 119
A CONSUMER’S GUIDE TO: Finding Whole-Grain
Foods 120
Why Do Some People Have Trouble Digesting Milk? 124
The Body’s Use of Glucose 124
Splitting Glucose for Energy 125
How Is Glucose Regulated in the Body? 126
Excess Glucose and Body Fatness 127
Thin k Fitness : What Can I Eat to Make
Workouts Easier? 129
The Glycemic Index of Food 129
What Happens If Blood Glucose Regulation
Fails? 131
Diabetes 131
Hypoglycemia 131
Conclusion 132
Food feature : Finding the
Carbohydrates in Foods 132
Self Check 137
CONTROVERSY 4: Are Added Sugars
“Bad” for You? 139
Chapter 5
The Lipids: Fats, Oils,
Phospholipids, and
Sterols 144
Introducing the Lipids 145
How Are Fats Useful to the Body? 145
How Are Fats Useful in Food? 147
A Close Look at Lipids 148
Triglycerides: Fatty Acids and Glycerol 148
Saturated vs. Unsaturated Fatty Acids 149
Phospholipids and Sterols 151
Lipids in the Body 152
How Are Fats Digested and Absorbed? 152
Transport of Fats 153
Storing and Using the Body’s Fat 154
Dietary Fat, Cholesterol, and Health 156
Recommendations for Lipid Intakes 156
Lipoproteins and Heart Disease Risk 158
What Does Food Cholesterol Have to Do
with Blood Cholesterol? 159
Recommendations Applied 160
Thin k Fitness : Why Exercise the Body
for the Health of the Heart? 160
Essential Polyunsaturated Fatty Acids 161
Why Do I Need Essential Fatty Acids? 162
Omega-6 and Omega-3 Fatty Acid Families 162
Omega-3 Fatty Acids 162
Requirements and Sources 163
A CONSUMER’S GUIDE TO: Weighing Seafood’s
Risks and Benefits 164
The Effects of Processing on Unsaturated
Fats 165
What Is “Hydrogenated Vegetable Oil,” and What’s
It Doing in My Chocolate Chip Cookies? 165
What Are Trans-Fatty Acids, and Are They Harmful? 166
Fat in the Diet 167
Get to Know the Fats in Foods 167
Fats in Protein Foods 168
Milk and Milk Products 169
Grains 170
FOOD FEATURE: Defensive
Dining 171
Self Check 176
CONTROVERSY 5: Is Butter Really
Back? The Lipid Guidelines Debate 178
Chapter 6
The Proteins and Amino
Acids 182
The Structure of Proteins 183
Amino Acids 183
How Do Amino Acids Build Proteins? 185
The Variety of Proteins 186
Thin k Fitness : Can Eating Extra Protein Make
Muscles Grow Stronger? 189
Denaturation of Proteins 189
Digestion and Absorption of Dietary
Protein 190
Protein Digestion 190
What Happens to Amino Acids after Protein Is
Digested? 192
The Importance of Protein 192
The Roles of Body Proteins 193
Providing Energy and Glucose 196
The Fate of an Amino Acid 197
A CONSUMER’S GUIDE TO: Evaluating Protein and
Amino Acid Supplements 198
Food Protein: Need and Quality 200
How Much Protein Do People Need? 200
Nitrogen Balance 200
Protein Quality 202
Protein Deficiency and Excess 204
What Happens When People Consume
Too Little Protein? 204
Is It Possible to Consume Too Much Protein? 205
Is a Gluten-Free Diet Best for Health? 206
FOOD FEATURE: Getting Enough but Not
Too Much Protein 207
Self Check 211
CONTROVERSY 6: Are Vegetarian or
Meat-Containing Diets Better for
Health? 212
Chapter 7
The Vitamins 218
Definition and Classification of
Vitamins 219
Vitamin Precursors 220
Two Classes of Vitamins: Fat-Soluble and Water-
Soluble 220
The Fat-Soluble Vitamins 220
Vitamin A 221
Roles of Vitamin A and Consequences of
Deficiency 222
Vitamin A Toxicity 224
Vitamin A Recommendations and Sources 225
Beta-Carotene 226
Vitamin D 227
Roles of Vitamin D 227
Too Little Vitamin D—A Danger to Bones 228
Too Much Vitamin D—A Danger to Soft Tissues 229
Vitamin D from Sunlight 230
Vitamin D Intake Recommendations 231
Vitamin D Food Sources 231
Vitamin E 232
Roles of Vitamin E 232
Vitamin E Deficiency 232
Toxicity of Vitamin E 233
Vitamin E Recommendations and U.S. Intakes 233
Vitamin E Food Sources 234
Vitamin K 234
Roles of Vitamin K 234
Vitamin K Deficiency 235
Vitamin K Toxicity 235
Vitamin K Requirements and Sources 235
The Water-Soluble Vitamins 236
Think Fitness : Vitamins for Athletes 237
The Roles of Vitamin C 237
Deficiency Symptoms and Intakes 239
Vitamin C Toxicity 239
Vitamin C Recommendations 239
Vitamin C Food Sources 240
The B Vitamins in Unison 240
B Vitamin Roles in Metabolism 241
B Vitamin Deficiencies 241
The B Vitamins as Individuals 243
Thiamin 243
A CONSUMER’S GUIDE TO: The Effects of Food
Processing on Vitamins 244
Riboflavin Roles 246
Niacin 247
Folate 248
Vitamin B12 250
Vitamin B6 251
Biotin and Pantothenic Acid 253
Non–B Vitamins 253
FOOD FEATURE: Choosing Foods Rich in
Vitamins 259
Self Check 262
CONTROVERSY 7: Vitamin Supplements: What are
the Benefits and Risks? 264
Chapter 8
Water and Minerals 270
Water 272
Why Is Water the Most Indispensable Nutrient? 273
The Body’s Water Balance 274
Quenching Thirst and Balancing Losses 274
How Much Water Do I Need to Drink in a Day? 276
A CONSUMER’S GUIDE TO: Liquid Calories 277
Drinking Water: Types, Safety, and Sources 279
Hard Water or Soft Water—Which Is Best? 279
Water Safety and Sources 279
Body Fluids and Minerals 280
Water Follows Salt 281
Fluid and Electrolyte Balance 281
Acid-Base Balance 282
The Major Minerals 282
Calcium 282
Phosphorus 285
Magnesium 287
Sodium 288
Potassium 292
Chloride 293
Sulfate 293
The Trace Minerals 294
Iodine 294
Iron 295
Thin k Fitness : Exercise-Deficiency
Fatigue 297
Zinc 300
Selenium 302
Fluoride 302
Chromium 303
Copper 304
Other Trace Minerals and Some Candidates 304
FOOD FEATURE: Meeting the Need for
Calcium 307
Self Check 310
CONTROVERSY 8 Osteoporosis: Can Lifestyle
Choices Reduce the Risk? 311
Chapter 9
Energy Balance and
Healthy Body Weight 317
The Problems of Too Little or Too Much
Body Fat 318
What Are the Risks from
Underweight? 319
What Are the Risks from Too Much Body
Fat? 319
What Are the Risks from Central
Obesity? 320
How Fat Is Too Fat? 321
The Body’s Energy Balance 322
Energy In and Energy Out 323
How Many Calories Do I Need Each
Day? 323
Estimated Energy Requirements (EER) 325
The DRI Method of Estimating Energy
Requirements 325
Body Weight vs. Body Fatness 326
Using the Body Mass Index (BMI) 326
Measuring Body Composition and Fat
Distribution 326
How Much Body Fat Is Ideal? 328
The Appetite and Its Control 328
Hunger and Appetite—“Go” Signals 328
Satiation and Satiety—“Stop” Signals 330
Inside-the-Body Theories of Obesity 332
Outside-the-Body Theories of Obesity 333
Thin k Fitness : Activity for a Healthy Body
Weight 335
How the Body Loses and Gains Weight 336
The Body’s Response to Energy Deficit 337
The Body’s Response to Energy Surplus 338
Achieving and Maintaining a Healthy Body
Weight 340
A CONSUMER’S GUIDE TO: Fad Diets 342
What Food Strategies Are Best for
Weight Loss? 344
Physical Activity Strategies 347
What Strategies Are Best for Weight Gain? 348
Medical Treatment of Obesity 349
Obesity Medications 349
Obesity Surgery 349
Herbal Products and Gimmicks 351
Once I’ve Changed My Weight,
How Can I Stay Changed? 352
Conclusion 353
FOOD FEATURE: Behavior Modification for
Weight Control 354
Self Check 356
CONTROVERSY 9: The Perils of Eating
Disorders 358
Chapter 10
Performance
Nutrition 365
The Benefits of Fitness 366
The Nature of Fitness 366
Physical Activity Guidelines 368
The Essentials of Fitness 369
How Do Muscles Adapt to Physical Activity? 369
How Does Aerobic Training Benefit the Heart? 371
Thin k Fitness : Exercise Safety 372
Three Energy Systems 372
The Muscles’ Energy Reservoir 372
The Anaerobic Energy System 374
The Aerobic Energy System 374
The Active Body’s Use of Fuels 374
The Need for Food Energy 375
Carbohydrate: Vital for Exercisers 376
Carbohydrate Recommendations for Athletes 379
Fat as Fuel for Physical Activity 380
Fat Recommendations for Athletes 381
Protein for Building Muscles and for Fuel 382
Protein Recommendations for Athletes 383
Vitamins and Minerals—Keys to Performance 384
Do Athletes Need Nutrient Supplements? 384
Iron—A Mineral of Concern 385
Fluids and Temperature Regulation in Physical
Activity 386
Water Losses during Physical Activity 386
Fluid and Electrolyte Needs during Physical Activity 387
A CONSUMER’S GUIDE TO: Selecting Sports
Drinks 389
Other Beverages 390
Putting It All Together 391
FOOD FEATURE: Choosing a Performance
Diet 392
Self Check 396
CONTROVERSY 10: Ergogenic Aids: Breakthroughs,
Gimmicks, or Dangers? 398
Chapter 11
Nutrition and Chronic
Diseases 404
Causation of Chronic Diseases 405
Cardiovascular Diseases (CVD) 407
Atherosclerosis and Hypertension 407
Risk Factors for Cardiovascular Disease 410
Preventive Measures against CVD 413
Thin k Fitness : Ways to Include Physical
Activity in a Day 414
Diabetes 418
How Does Type 2 Diabetes Develop? 419
Harms from Diabetes 420
Diabetes Prevention and Management 421
Cancer 423
The Cancer Disease Process 423
A CONSUMER’S GUIDE TO: Deciding about
CAM 424
Cancer Risk Factors 426
Cancer Prevention 428
Conclusion 430
FOOD FEATURE: The DASH Diet: Preventive
Medicine 431
Self Check 433
CONTROVERSY 11: Nutritional Genomics: Can
It Deliver on Its Promises? 435
Chapter 12
Food Safety and Food
Technology 440
Microbes and Food Safety 442
How Do Microbes in Food Cause Illness in the
Body? 442
Food Safety from Farm to Plate 444
Safe Food Practices for Individuals 447
Which Foods Are Most Likely to Cause
Illness? 450
Protein Foods 451
Raw Produce 453
Other Foods 454
Advances in Microbial Food Safety 456
Is Irradiation Safe? 456
Other Technologies 457
Toxins, Residues, and Contaminants in Foods 458
Natural Toxins in Foods 458
Pesticides 458
A CONS UMER’S GUIDE TO: Understanding
Organic Foods 461
Animal Drugs—What Are the Risks? 463
Environmental Contaminants 464
Are Food Additives Safe? 466
Regulations Governing Additives 466
Additives to Improve Safety and Quality 468
Flavoring Agents 468
Fat Replacers and Artificial Fats 471
Incidental Food Additives 471
Conclusion 472
FOOD FEATURE: Handling Real-Life Challenges
to Food Safety 472
Self Check 475
CONTROVERSY 12: Genetically Engineered Foods:
What Are the Pros and Cons? 477
Chapter 13
Life Cycle Nutrition: Mother
and Infant 484
Pregnancy: The Impact of Nutrition on the
Future 485
Preparing for Pregnancy 485
The Events of Pregnancy 487
Increased Need for Nutrients 489
Food Assistance Programs 494
How Much Weight Should a Woman
Gain during Pregnancy? 494
Weight Loss after Pregnancy 495
Should Pregnant Women Be Physically
Active? 496
Teen Pregnancy 496
Think Fitness: Physical Activities for Pregnant
Women 497
Why Do Some Women Crave Pickles and Ice Cream While
Others Can’t Keep Anything Down? 497
Some Cautions for Pregnant Women 498
Drinking during Pregnancy 500
Alcohol’s Effects 500
Fetal Alcohol Syndrome 501
Experts’ Advice 501
Troubleshooting 502
Diabetes 502
Hypertension 503
Preeclampsia 503
Lactation 503
Nutrition during Lactation 503
When Should a Woman Not Breastfeed? 505
Feeding the Infant 506
Nutrient Needs 506
Why Is Breast Milk So Good for Babies? 507
Formula Feeding 510
A CONS UMER’S GUIDE TO: Formula Advertising
versus Breastfeeding Advocacy 511
An Infant’s First Solid Foods 512
Looking Ahead 515
FOOD FEATURE: Mealtimes with Infants 516
Self Check 517
CONTROVERSY 13: Childhood Obesity and Early
Chronic Diseases 519
Chapter 14
Child, Teen, and Older
Adult 526
Early and Middle Childhood 527
Feeding a Healthy Young Child 527
Mealtimes and Snacking 531
How Do Nutrient Deficiencies
Affect a Child’s Brain? 534
The Problem of Lead 535
Food Allergies, Intolerances, and Aversions 537
Can Diet Make a Child Hyperactive? 539
Dental Caries 540
Is Breakfast Really the Most Important Meal of the
Day for Children? 540
How Nourishing Are the Meals Served at
School? 541
Nutrition in Adolescence 543
Nutrient Needs 543
Common Concerns 545
Eating Patterns and Nutrient Intakes 545
The Later Years 546
A CONSUMER’S GUIDE TO: Nutrition for PMS
Relief 547
Nutrition in the Later Years 548
Energy, Activity, and the Muscles 548
Protein Needs 549
Thin k Fitness : Benefits of Physical Activity
for the Older Adult 550
Carbohydrates and Fiber 550
Fats and Arthritis 551
Vitamin Needs 551
Water and the Minerals 552
Can Diet Choices Lengthen Life? 554
Aging, Immunity, and Inflammation 555
Can Diet Affect the Course of Alzheimer’s Disease? 555
Food Choices of Older Adults 556
FOOD FEATURE: Single Survival and Nutrition
on the Run 558
Self Check 560
CONTROVERSY 14: Nutrient–Drug Interactions:
Who Should Be Concerned? 562
Cha pter 15
Hunger and the Future of
Food 567
U.S. Food Insecurity 568
Food Poverty in the United States 568
What U.S. Food Programs Address Low Food Security? 570
World Poverty and Hunger 572
The Malnutrition of Extreme
Poverty 574
Hidden Hunger—Vitamin and Mineral
Deficiencies 574
Two Faces of Childhood Malnutrition 574
Medical Nutrition Therapy 576
The Future Food Supply
and the Environment 576
Threats to the Food Supply 576
Fisheries and Food Waste 578
How Can People Help? 580
Government Action 580
Private and Community Enterprises 581
Educators and Students 581
Food and Nutrition Professionals 581
Individuals 581
Conclusion 581
A CONSUMER’S GUIDE TO: Making “Green”
Choices (Without Getting “Greenwashed”) 582
Self Check 584
CONTROVERSY 15: How Can We Feed Ourselves
Sustainably? 585
Appendixes
A Chemical Structures: Carbohydrates,
Lipids, and Amino Acids A-1
B World Health Organization
Guidelines B-1
C Aids to Calculations C-1
D Food Lists for Diabetes and Weight
Management D-1
E Eating 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