Understanding Normal & Clinical Nutrition, 12th Edition PDF by Sharon Rady Rolfes, Kathryn Pinna and Ellie Whitney

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Understanding Normal & Clinical Nutrition, Twelfth Edition

By Sharon Rady Rolfes, Kathryn Pinna and Ellie Whitney

Understanding Normal & Clinical Nutrition, Twelfth Edition

Table of Contents:

Preface xvii

Acknowledgments xxii

Reviewers xxiii

Chapter 1

An Overview of Nutrition 2

1.1 Food Choices 3

1.2 The Nutrients 6

Nutrients in Foods and in the Body 6

The Energy-Yielding Nutrients: Carbohydrate, Fat, and Protein 7

The Vitamins 11

The Minerals 11

Water 11

1.3 The Science of Nutrition 12

Conducting Research 12

Analyzing Research Findings 15

Publishing Research 16

1.4 Dietary Reference Intakes 17

Establishing Nutrient Recommendations 17

Establishing Energy Recommendations 19

Using Nutrient Recommendations 20

Comparing Nutrient Recommendations 21

1.5 Nutrition Assessment 21

Nutrition Assessment of Individuals 22

Nutrition Assessment of Populations 23

1.6 Diet and Health 25

Chronic Diseases 25

Risk Factors for Chronic Diseases 25

Highlight 1 > Nutrition Information and Misinformation 28

Chapter 2

Planning a Healthy Diet 34

2.1 Principles and Guidelines 35

Diet-Planning Principles 35

Dietary Guidelines for Americans 38

2.2 Diet-Planning Guides 40

USDA Food Patterns 40

Food Lists 47

Putting the Plan into Action 47

From Guidelines to Groceries 49

2.3 Food Labels 53

The Ingredient List 54

Nutrition Facts Panel 54

Claims on Labels 57

Consumer Education 58

Highlight 2 > Vegetarian Diets 62

Chapter 3

Digestion, Absorption, and Transport 68

3.1 Digestion 69

Anatomy of the Digestive Tract 70

The Muscular Action of Digestion 72

The Secretions of Digestion 73

The Final Stage 74

3.2 Absorption 76

Anatomy of the Absorptive System 77

A Closer Look at the Intestinal Cells 77

3.3 The Circulatory Systems 79

The Vascular System 79

The Lymphatic System 81

3.4 The Health and Regulation of the GI Tract 82

Gastrointestinal Microbes 82

Gastrointestinal Hormones and Nerve Pathways 83

The System at Its Best 85

Highlight 3 > Common Digestive Problems 87

Chapter 4

The Carbohydrates: Sugars, Starches, and Fibers 94

4.1 The Chemist’s View of Carbohydrates 95

Monosaccharides 96

Disaccharides 97

Polysaccharides 98

4.2 Digestion and Absorption of Carbohydrates 101

Carbohydrate Digestion 101

Carbohydrate Absorption 103

Lactose Intolerance 103

4.3 Glucose in the Body 105

A Preview of Carbohydrate Metabolism 105

The Constancy of Blood Glucose 106

4.4 Health Effects and Recommended Intakes of Sugars 109

Health Effects of Sugars 110

Recommended Intakes of Sugars 113

Alternative Sweeteners 114

4.5 Health Effects and Recommended Intakes of Starch and Fibers 116

Health Effects of Starch and Fibers 116

Recommended Intakes of Starch and Fibers 118

From Guidelines to Groceries 120

Highlight 4 > Carbs, kCalories, and Controversies 124

Chapter 5

The Lipids: Triglycerides, Phospholipids,

and Sterols 128

5.1 The Chemist’s View of Fatty Acids and Triglycerides 129

Fatty Acids 130

Triglycerides 132

Characteristics of Solid Fats and Oils 133

5.2 The Chemist’s View of Phospholipids and Sterols 136

Phospholipids 136

Sterols 137

5.3 Digestion, Absorption, and Transport of Lipids 138

Lipid Digestion 138

Lipid Absorption 141

Lipid Transport 141

5.4 Lipids in the Body 144

Roles of Triglycerides 144

Essential Fatty Acids 145

A Preview of Lipid Metabolism 146

5.5 Health Effects and Recommended Intakes of Saturated Fats, Trans Fats, and Cholesterol 147

Health Effects of Saturated Fats, Trans Fats, and Cholesterol 147

Recommended Intakes of Saturated Fat, Trans Fat,

and Cholesterol 149

5.6 Health Effects and Recommended Intakes of

Monounsaturated and Polyunsaturated Fats 149

Health Effects of Monounsaturated and Polyunsaturated Fats 149

Recommended Intakes of Monounsaturated and

Polyunsaturated Fats 151

From Guidelines to Groceries 152

Highlight 5 > High-Fat Foods—Friend or Foe? 160

Chapter 6

Protein: Amino Acids 168

6.1 The Chemist’s View of Proteins 169

Amino Acids 169

Proteins 171

6.2 Digestion and Absorption of Proteins 172

Protein Digestion 172

Protein Absorption 174

6.3 Proteins in the Body 174

Protein Synthesis 174

Roles of Proteins 177

A Preview of Protein Metabolism 180

6.4 Protein in Foods 182

Protein Quality 183

Complementary Proteins 183

6.5 Health Effects and Recommended Intakes of Protein 184

Health Effects of Protein 184

Recommended Intakes of Protein 185

From Guidelines to Groceries 187

Read Food Labels 187

Protein and Amino Acid Supplements 187

Highlight 6 > Nutritional Genomics 190

Chapter 7

Energy Metabolism 196

7.1 Chemical Reactions in the Body 197

7.2 Breaking Down Nutrients for Energy 200

Glucose 202

Glycerol and Fatty Acids 206

Amino Acids 206

The Final Steps of Energy Metabolism 207

7.3 Feasting and Fasting 213

Feasting—Excess Energy 213

The Transition from Feasting to Fasting 214

Fasting—Inadequate Energy 214

Low-Carbohydrate Diets 217

Highlight 7 > Alcohol in the Body 219

Chapter 8

Energy Balance and Body Composition 230

8.1 Energy Balance 231

8.2 Energy In: The kCalories Foods Provide 232

Food Composition 232

Food Intake 233

8.3 Energy Out: The kCalories the Body Expends 235

Components of Energy Expenditure 236

Estimating Energy Requirements 239

8.4 Body Weight and Body Composition 240

Defining Healthy Body Weight 241

Body Fat and Its Distribution 243

8.5 Health Risks Associated with Body Weight and Body Fat 246

Health Risks of Underweight 247

Health Risks of Overweight and Obesity 247

Other Considerations 249

Highlight 8 > Eating Disorders 252

Chapter 9

Weight Management: Overweight, Obesity,

and Underweight 260

9.1 Overweight and Obesity 261

Fat Cell Development 262

Fat Cell Metabolism 262

Set-Point Theory 263

9.2 Causes of Overweight and Obesity 263

Genetics and Epigenetics 263

Environment 266

9.3 Problems of Overweight and Obesity 268

Health Risks 268

Perceptions and Prejudices 268

Dangerous Interventions 269

9.4 Aggressive Treatments for Obesity 270

Drugs 270

Surgery 270

Other Medical Procedures 272

9.5 Weight-Loss Strategies 272

Changes, Losses, and Goals 272

Eating Patterns 273

Physical Activity 276

Environmental Influences 279

Behavior and Attitude 280

Weight Maintenance 282

Prevention 283

Community Programs 283

9.6 Underweight 284

Problems of Underweight 284

Weight-Gain Strategies 284

Highlight 9 > The Latest and Greatest Weight-Loss

Diet—Again 289

Chapter 10

The Water-Soluble Vitamins: B Vitamins

and Vitamin C 292

10.1 The Vitamins—An Overview 293

10.2 The B Vitamins 296

Thiamin 297

Riboflavin 300

Niacin 301

Biotin 304

Pantothenic Acid 304

Vitamin B6 305

Folate 306

Vitamin B12 311

Choline 313

Nonvitamins 313

Interactions among the B Vitamins 313

10.3 Vitamin C 317

Vitamin C Roles 318

Vitamin C Recommendations 319

Vitamin C Deficiency 320

Vitamin C Toxicity 320

Vitamin C Food Sources 321

Highlight 10 > Vitamin and Mineral Supplements 325

Chapter 11

The Fat-Soluble Vitamins: A, D, E, and K 332

11.1 Vitamin A and Beta-Carotene 333

Roles in the Body 334

Vitamin A Deficiency 336

Vitamin A Toxicity 337

Vitamin A Recommendations 338

Vitamin A in Foods 338

11.2 Vitamin D 340

Roles in the Body 341

Vitamin D Deficiency 342

Vitamin D Toxicity 343

Vitamin D Recommendations and Sources 344

11.3 Vitamin E 346

Vitamin E as an Antioxidant 347

Vitamin E Deficiency 347

Vitamin E Toxicity 347

Vitamin E Recommendations 347

Vitamin E in Foods 348

11.4 Vitamin K 348

Roles in the Body 348

Vitamin K Deficiency 349

Vitamin K Toxicity 349

Vitamin K Recommendations and Sources 350

Highlight 11 > Antioxidant Nutrients in Disease Prevention 353

Chapter 12

Water and the Major Minerals 358

12.1 Water and the Body Fluids 359

Distribution and Movement of Body Fluids 360

Regulation of Fluid Balance 362

Fluid and Electrolyte Imbalance 363

Acid–Base Balance 364

Water Balance and Recommended Intakes 366

12.2 The Minerals— An Overview 369

12.3 The Major Minerals 370

Sodium 370

Chloride 373

Potassium 374

Calcium 375

Phosphorus 380

Magnesium 381

Sulfate 383

Highlight 12 > Osteoporosis and Calcium 386

Chapter 13

The Trace Minerals 392

13.1 The Trace Minerals—An Overview 393

13.2 The Trace Minerals 395

Iron 395

Zinc 404

Iodine 407

Selenium 409

Copper 410

Manganese 411

Fluoride 412

Chromium 413

Molybdenum 413

13.3 Contaminant Minerals 414

Highlight 13 > Phytochemicals and Functional Foods 417

Chapter 14

Life Cycle Nutrition: Pregnancy and Lactation 424

14.1 Nutrition prior to Pregnancy 425

14.2 Growth and Development during Pregnancy 426

Placental Development 426

Fetal Growth and Development 426

Critical Periods 428

14.3 Maternal Weight 431

Weight prior to Conception 431

Weight Gain during Pregnancy 432

Exercise during Pregnancy 434

14.4 Nutrition during Pregnancy 435

Energy and Nutrient Needs during Pregnancy 435

Common Nutrition-Related Concerns of Pregnancy 438

14.5 High-Risk Pregnancies 440

The Infant’s Birthweight 440

Malnutrition and Pregnancy 441

Food Assistance Programs 441

Maternal Health 442

The Mother’s Age 443

Practices Incompatible with Pregnancy 444

14.6 Nutrition during Lactation 447

Lactation: A Physiological Process 448

Breastfeeding: A Learned Behavior 448

Maternal Energy and Nutrient Needs during Lactation 449

Maternal Health 450

Practices Incompatible with Lactation 451

Highlight 14 > Fetal Alcohol Syndrome 455

Chapter 15

Life Cycle Nutrition: Infancy, Childhood,

and Adolescence 458

15.1 Nutrition during Infancy 459

Energy and Nutrient Needs 459

Breast Milk 461

Infant Formula 464

Special Needs of Preterm Infants 466

Introducing Cow’s Milk 466

Introducing First Foods 467

Mealtimes with Toddlers 470

15.2 Nutrition during Childhood 470

Energy and Nutrient Needs 471

Hunger and Malnutrition in Children 473

The Malnutrition-Lead Connection 475

Hyperactivity and “Hyper” Behavior 476

Food Allergy and Intolerance 477

Childhood Obesity 479

Mealtimes at Home 484

Nutrition at School 487

15.3 Nutrition during Adolescence 489

Growth and Development 489

Energy and Nutrient Needs 490

Food Choices and Health Habits 491

Highlight 15 > Childhood Obesity and the Early Development of Chronic Diseases 497

Chapter 16

Life Cycle Nutrition: Adulthood and the Later Years 502

16.1 Nutrition and Longevity 503

Observation of Older Adults 504

Manipulation of Diet 506

16.2 The Aging Process 508

Physiological Changes 508

Other Changes 510

16.3 Energy and Nutrient Needs of Older Adults 511

Water 512

Energy and Energy Nutrients 512

Vitamins and Minerals 513

Dietary Supplements 514

16.4 Nutrition-Related Concerns of Older Adults 515

Vision 515

Arthritis 516

The Aging Brain 516

Alcohol 519

16.5 Food Choices and Eating Habits of Older Adults 520

Malnutrition 521

Food Assistance Programs 521

Meals for Singles 522

Highlight 16 > Hunger and Community Nutrition 526

Chapter 17

Nutrition Care and Assessment 532

17.1 Nutrition in Health Care 533

Effects of Illness on Nutrition Status 533

Responsibility for Nutrition Care 533

Nutrition Screening 535

The Nutrition Care Process 536

17.2 Nutrition Assessment 539

Historical Information 539

Food Intake Data 540

Anthropometric Data 543

Biochemical Data 546

Physical Examination 548

Highlight 17 > Nutrition and Immunity 552

Chapter 18

Nutrition Intervention 558

18.1 Implementing Nutrition Care 559

Approaches to Nutrition Care 560

Documenting Nutrition Care 561

18.2 Energy Intakes in Hospital Patients 563

Indirect Calorimetry 563

Predictive Equations 563

18.3 Dietary Modifications 565

Modified Diets 565

Diet Progression 568

Alternative Feeding Routes 568

Nothing by Mouth (NPO) 569

18.4 Foodservice 570

Menu Planning 570

Food Selection 570

Food Safety 570

Improving Food Intake 570

Highlight 18 > Food Allergies 573

Chapter 19

Medications, Diet-Drug Interactions, and Herbal

Products 576

19.1 Medications in Disease Treatment 577

Medication Administration 578

Risks from Medications 578

Patients at High Risk of Adverse Effects 579

19.2 Diet-Drug Interactions 580

Drug Effects on Food Intake 580

Drug Effects on Nutrient Absorption 582

Dietary Effects on Drug Absorption 582

Drug Effects on Nutrient Metabolism 583

Dietary Effects on Drug Metabolism 583

Drug Effects on Nutrient Excretion 584

Dietary Effects on Drug Excretion 584

Diet-Drug Interactions and Toxicity 585

19.3 Herbal Products 586

Effectiveness and Safety of Herbal Products 586

Use of Herbal Products in Illness 588

Highlight 19 > Complementary and Alternative Medicine 591

Chapter 20

Enteral Nutrition Support 596

20.1 Oral Supplements 597

20.2 Tube Feedings in Medical Care 598

Candidates for Tube Feedings 598

Tube-Feeding Routes 598

20.3 Enteral Formulas 601

Types of Enteral Formulas 601

Formula Characteristics 602

Formula Selection 603

20.4 Administration of Tube Feedings 604

Safe Handling of Formula 605

Initiating and Advancing a Tube Feeding 606

Meeting Water Needs 608

Medication Delivery during Tube Feedings 609

Tube-Feeding Complications 610

Transition to Table Foods 611

Highlight 20 > Inborn Errors of Metabolism 615

Chapter 21

Parenteral Nutrition Support 620

21.1 Indications for Parenteral Nutrition 621

Peripheral Parenteral Nutrition 622

Total Parenteral Nutrition 622

21.2 Parenteral Solutions 624

Parenteral Nutrients 624

Solution Preparation 625

21.3 Administering Parenteral Nutrition 628

Insertion and Care of Intravenous Catheters 628

Administration of Parenteral Solutions 629

Discontinuing Parenteral Nutrition 629

Managing Metabolic Complications 630

21.4 Nutrition Support at Home 632

Candidates for Home Nutrition Support 632

Planning Home Nutrition Care 633

Quality-of-Life Issues 633

Highlight 21 > Ethical Issues in Nutrition Care 636

Chapter 22

Metabolic and Respiratory Stress 640

22.1 The Body’s Responses to Stress and Injury 641

Hormonal Responses to Stress 641

The Inflammatory Response 642

22.2 Nutrition Treatment of Acute Stress 644

Determining Nutritional Requirements 644

Approaches to Nutrition Care in Acute Stress 647

Patients with Burn Injuries 647

22.3 Respiratory Stress 649

Chronic Obstructive Pulmonary Disease 650

Respiratory Failure 652

Highlight 22 > Multiple Organ Dysfunction Syndrome 657

Chapter 23

Upper Gastrointestinal Disorders 660

23.1 Conditions Affecting the Esophagus 662

Dysphagia 662

Gastroesophageal Reflux Disease 665

23.2 Conditions Affecting the Stomach 667

Dyspepsia 668

Nausea and Vomiting 668

Gastroparesis 669

Gastritis 669

Peptic Ulcer Disease 669

23.3 Gastric Surgery 671

Gastrectomy 671

Bariatric Surgery 674

Highlight 23 > Oral Health and Chronic Illness 679

Chapter 24

Lower Gastrointestinal Disorders 682

24.1 Common Intestinal Problems 683

Constipation 683

Intestinal Gas 685

Diarrhea 686

24.2 Malabsorption 688

Fat Malabsorption 688

Bacterial Overgrowth 689

24.3 Conditions Affecting the Pancreas 691

Pancreatitis 691

Cystic Fibrosis 693

24.4 Conditions Affecting the Small Intestine 694

Celiac Disease 695

Inflammatory Bowel Diseases 696

Short Bowel Syndrome 699

24.5 Conditions Affecting the Large Intestine 702

Irritable Bowel Syndrome 702

Diverticular Disease of the Colon 703

Colostomies and Ileostomies 704

Highlight 24 > Probiotics and Intestinal Health 709

Chapter 25

Liver Disease and Gallstones 712

25.1 Fatty Liver and Hepatitis 714

Fatty Liver 714

Hepatitis 714

25.2 Cirrhosis 716

Consequences of Cirrhosis 717

Treatment of Cirrhosis 719

Nutrition Therapy for Cirrhosis 719

25.3 Liver Transplantation 723

25.4 Gallstone Disease 724

Types of Gallstones 724

Consequences of Gallstones 725

Risk Factors for Cholesterol Gallstones 725

Treatment of Gallstones 726

Highlight 25 > Anemia in Illness 730

Chapter 26

Diabetes Mellitus 734

26.1 Overview of Diabetes Mellitus 735

Symptoms of Diabetes Mellitus 735

Diagnosis of Diabetes Mellitus 736

Types of Diabetes Mellitus 737

Prevention of Type 2 Diabetes Mellitus 738

Acute Complications of Diabetes Mellitus 739

Chronic Complications of Diabetes Mellitus 741

26.2 Treatment of Diabetes Mellitus 742

Treatment Goals 743

Evaluating Diabetes Treatment 744

Nutrition Therapy: Dietary Recommendations 745

Nutrition Therapy: Meal-Planning Strategies 746

Insulin Therapy 747

Antidiabetic Drugs 752

Physical Exercise and Diabetes Management 753

Sick-Day Management 754

26.3 Diabetes Management in Pregnancy 755

Pregnancy in Type 1 or Type 2 Diabetes 755

Gestational Diabetes 755

Highlight 26 > The Metabolic Syndrome 759

Chapter 27

Cardiovascular Diseases 762

27.1 Atherosclerosis 763

Consequences of Atherosclerosis 764

Development of Atherosclerosis 764

Causes of Atherosclerosis 765

27.2 Coronary Heart Disease (CHD) 766

Symptoms of Coronary Heart Disease 767

Evaluating Risk for Coronary Heart Disease 767

Lifestyle Management to Reduce CHD Risk 768

Vitamin Supplementation and CHD Risk 772

Lifestyle Changes for Hypertriglyceridemia 774

Drug Therapies for CHD Prevention 775

Treatment of Heart Attack 775

27.3 Stroke 776

Stroke Prevention 777

Stroke Management 777

27.4 Hypertension 778

Factors That Influence Blood Pressure 778

Factors That Contribute to Hypertension 778

Treatment of Hypertension 780

27.5 Heart Failure 783

Consequences of Heart Failure 783

Medical Management of Heart Failure 783

Highlight 27 > Coping with Feeding Disabilities 788

Chapter 28

Kidney Diseases 792

28.1 Functions of the Kidneys 793

28.2 The Nephrotic Syndrome 794

Consequences of the Nephrotic Syndrome 795

Treatment of the Nephrotic Syndrome 795

28.3 Acute Kidney Injury 796

Causes of Acute Kidney Injury 796

Consequences of Acute Kidney Injury 798

Treatment of Acute Kidney Injury 798

28.4 Chronic Kidney Disease 800

Consequences of Chronic Kidney Disease 801

Treatment of Chronic Kidney Disease 802

Kidney Transplants 806

28.5 Kidney Stones 809

Formation of Kidney Stones 809

Consequences of Kidney Stones 810

Prevention and Treatment of Kidney Stones 810

Highlight 28 > Dialysis 815

Chapter 29

Cancer and HIV Infection 818

29.1 Cancer 819

How Cancer Develops 819

Nutrition and Cancer Risk 820

Consequences of Cancer 822

Treatments for Cancer 823

Nutrition Therapy for Cancer 826

29.2 HIV Infection 830

Prevention of HIV Infection 830

Consequences of HIV Infection 830

Treatments for HIV Infection 832

Nutrition Therapy for HIV Infection 834

Highlight 29 > Foodborne Illness 839

Appendix A

Cells, Hormones, and Nerves

Appendix B

Basic Chemistry Concepts

Appendi x C

Biochemical Structures and Pathways

Appendix D

Measures of Protein Quality

Appendix E

Nutrition Assessment: Supplemental Information

Appendix F

Estimated Energy Needs

Appendix G

Choose Your Foods: Food Lists for Diabetes and Weight

Management

Appendix H

Aids to Calculation

Appendix I

WHO Nutrition Recommendations

Appendix J

Healthy People 2020

Appendix K

Enteral Formulas

Glossary GL-0

Index IN-1

Inside Covers

Dietary Reference Intakes (DRI) A

Daily Values (DV) for Food Labels Y

Body Mass Index (BMI) Z

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