Understanding Nutrition, Fifteenth Edition
By Ellie Whitney and Sharon Rady Rolfes
Table of Content:
Preface xiii
Acknowledgments xvii
Reviewers of Recent Editions xviii
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
Fitness: Physical Activity, Nutrients, and Body
Adaptations 424
14.1 Fitness 425
Benefits of Fitness 425
Developing Fitness 428
The Components of Fitness 429
Cardiorespiratory Endurance 429
Muscle Strength and Endurance 430
14.2 Energy Systems and Fuels to Support Activity 431
The Energy Systems of Physical Activity 431
Glucose Use during Physical Activity 433
Fat Use during Physical Activity 436
Protein Use during Physical Activity—and between
Times 437
14.3 Vitamins and Minerals to Support Activity 440
Dietary Supplements 440
Nutrients of Concern 440
14.4 Fluids and Electrolytes to Support Activity 442
Temperature Regulation 442
Sports Drinks 444
Poor Beverage Choices: Caffeine and Alcohol 446
14.5 Diets for Physically Active People 447
Choosing a Diet to Support Fitness 447
Meals before and after Competition 448
Highlight 14 > Supplements as Ergogenic Aids 452
Chapter 15
Life Cycle Nutrition: Pregnancy and Lactation 458
15.1 Nutrition prior to Pregnancy 459
15.2 Growth and Development during Pregnancy 460
Placental Development 460
Fetal Growth and Development 460
Critical Periods 462
15.3 Maternal Weight 465
Weight prior to Conception 465
Weight Gain during Pregnancy 466
Exercise during Pregnancy 468
15.4 Nutrition during Pregnancy 469
Energy and Nutrient Needs during Pregnancy 469
Common Nutrition-Related Concerns of Pregnancy 472
15.5 High-Risk Pregnancies 474
The Infant’s Birthweight 474
Malnutrition and Pregnancy 475
Food Assistance Programs 475
Maternal Health 476
The Mother’s Age 477
Practices Incompatible with Pregnancy 478
15.6 Nutrition during Lactation 481
Lactation: A Physiological Process 482
Breastfeeding: A Learned Behavior 482
Maternal Energy and Nutrient Needs
during Lactation 483
Maternal Health 484
Practices Incompatible with Lactation 485
Highlight 15 > Fetal Alcohol Syndrome 489
Chapter 16
Life Cycle Nutrition: Infancy, Childhood,
and Adolescence 492
16.1 Nutrition during Infancy 493
Energy and Nutrient Needs 493
Breast Milk 495
Infant Formula 498
Special Needs of Preterm Infants 500
Introducing Cow’s Milk 500
Introducing First Foods 501
Mealtimes with Toddlers 504
16.2 Nutrition during Childhood 504
Energy and Nutrient Needs 505
Hunger and Malnutrition in Children 507
The Malnutrition-Lead Connection 509
Hyperactivity and “Hyper” Behavior 510
Food Allergy and Intolerance 511
Childhood Obesity 513
Mealtimes at Home 518
Nutrition at School 521
16.3 Nutrition during Adolescence 523
Growth and Development 523
Energy and Nutrient Needs 524
Food Choices and Health Habits 525
Highlight 16 > Childhood Obesity and the Early Development of
Chronic Diseases 531
Chapter 17
Life Cycle Nutrition: Adulthood and the
Later Years 536
17.1 Nutrition and Longevity 537
Observation of Older Adults 538
Manipulation of Diet 540
17.2 The Aging Process 542
Physiological Changes 542
Other Changes 544
17.3 Energy and Nutrient Needs of Older Adults 545
Water 546
Energy and Energy Nutrients 546
Vitamins and Minerals 547
Dietary Supplements 548
17.4 Nutrition-Related Concerns of Older Adults 549
Vision 549
Arthritis 550
The Aging Brain 550
Alcohol 553
17.5 Food Choices and Eating Habits of Older Adults 554
Malnutrition 555
Food Assistance Programs 555
Meals for Singles 556
Highlight 17 > Nutrient-Drug Interactions 560
Chapter 18
Diet and Health 566
18.1 Nutrition and Infectious Diseases 567
The Immune System 568
Nutrition and Immunity 569
Inflammation and Chronic Diseases 570
18.2 Nutrition and Chronic Diseases 570
18.3 Cardiovascular Disease 572
How Atherosclerosis Develops 572
Risk Factors for Coronary Heart Disease 574
Recommendations for Reducing Cardiovascular Disease
Risk 577
18.4 Hypertension 578
How Hypertension Develops 580
Risk Factors for Hypertension 580
Treatment of Hypertension 580
18.5 Diabetes Mellitus 582
How Diabetes Develops 583
Complications of Diabetes 584
Recommendations for Diabetes 586
18.6 Cancer 588
How Cancer Develops 589
Recommendations for Reducing Cancer Risks 592
18.7 Recommendations for Chronic Diseases 593
Highlight 18 > Complementary and Alternative Medicine 600
Chapter 19
Consumer Concerns about Foods and Water 608
19.1 Food Safety and Foodborne Illnesses 609
Foodborne Infections and Food Intoxications 610
Food Safety in the Marketplace 611
Food Safety in the Kitchen 613
Food Safety while Traveling 617
Advances in Food Safety 618
19.2 Nutritional Adequacy of Foods and Diets 620
Obtaining Nutrient Information 620
Minimizing Nutrient Losses 620
19.3 Environmental Contaminants 621
Harmfulness of Environmental Contaminants 621
Guidelines for Consumers 622
19.4 Natural Toxicants in Foods 623
19.5 Pesticides 624
Hazards and Regulation of Pesticides 624
Monitoring Pesticides 625
Consumer Concerns 625
19.6 Food Additives 628
Regulations Governing Additives 628
Intentional Food Additives 630
Indirect Food Additives 633
19.7 Consumer Concerns about Water 635
Sources of Drinking Water 635
Water Systems and Regulations 635
Highlight 19 > Food Biotechnology 638
Chapter 20
Hunger and the Global Environment 644
20.1 Hunger in the United States 645
Defining Hunger in the United States 645
Relieving Hunger in the United States 647
20.2 World Hunger 650
Food Shortages 650
Population Needs 651
20.3 Malnutrition 651
Nutrient Deficiencies 652
Growth Failure 652
Rehabilitation 654
20.4 Agriculture and the Environment 654
Agricultural Consequences 655
Sustainable Solutions 657
Highlight 20 > Environmentally Friendly Food Choices 662
Appendix A
Cells, Hormones, and Nerves
Appendix B
Basic Chemistry Concepts
Appendix C
Biochemical Structures and Pathways
Appendix D
Measures of Protein Quality
Appendix E
Nutrition Assessment
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
Glossary GL-1
Index IN-1
Inser ts
Dietary Reference Intakes (DRI) A
Daily Values (DV) for Food Labels Y
Body Mass Index (BMI) Z
Acknowledgments xvii
Reviewers of Recent Editions xviii
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
Fitness: Physical Activity, Nutrients, and Body
Adaptations 424
14.1 Fitness 425
Benefits of Fitness 425
Developing Fitness 428
The Components of Fitness 429
Cardiorespiratory Endurance 429
Muscle Strength and Endurance 430
14.2 Energy Systems and Fuels to Support Activity 431
The Energy Systems of Physical Activity 431
Glucose Use during Physical Activity 433
Fat Use during Physical Activity 436
Protein Use during Physical Activity—and between
Times 437
14.3 Vitamins and Minerals to Support Activity 440
Dietary Supplements 440
Nutrients of Concern 440
14.4 Fluids and Electrolytes to Support Activity 442
Temperature Regulation 442
Sports Drinks 444
Poor Beverage Choices: Caffeine and Alcohol 446
14.5 Diets for Physically Active People 447
Choosing a Diet to Support Fitness 447
Meals before and after Competition 448
Highlight 14 > Supplements as Ergogenic Aids 452
Chapter 15
Life Cycle Nutrition: Pregnancy and Lactation 458
15.1 Nutrition prior to Pregnancy 459
15.2 Growth and Development during Pregnancy 460
Placental Development 460
Fetal Growth and Development 460
Critical Periods 462
15.3 Maternal Weight 465
Weight prior to Conception 465
Weight Gain during Pregnancy 466
Exercise during Pregnancy 468
15.4 Nutrition during Pregnancy 469
Energy and Nutrient Needs during Pregnancy 469
Common Nutrition-Related Concerns of Pregnancy 472
15.5 High-Risk Pregnancies 474
The Infant’s Birthweight 474
Malnutrition and Pregnancy 475
Food Assistance Programs 475
Maternal Health 476
The Mother’s Age 477
Practices Incompatible with Pregnancy 478
15.6 Nutrition during Lactation 481
Lactation: A Physiological Process 482
Breastfeeding: A Learned Behavior 482
Maternal Energy and Nutrient Needs
during Lactation 483
Maternal Health 484
Practices Incompatible with Lactation 485
Highlight 15 > Fetal Alcohol Syndrome 489
Chapter 16
Life Cycle Nutrition: Infancy, Childhood,
and Adolescence 492
16.1 Nutrition during Infancy 493
Energy and Nutrient Needs 493
Breast Milk 495
Infant Formula 498
Special Needs of Preterm Infants 500
Introducing Cow’s Milk 500
Introducing First Foods 501
Mealtimes with Toddlers 504
16.2 Nutrition during Childhood 504
Energy and Nutrient Needs 505
Hunger and Malnutrition in Children 507
The Malnutrition-Lead Connection 509
Hyperactivity and “Hyper” Behavior 510
Food Allergy and Intolerance 511
Childhood Obesity 513
Mealtimes at Home 518
Nutrition at School 521
16.3 Nutrition during Adolescence 523
Growth and Development 523
Energy and Nutrient Needs 524
Food Choices and Health Habits 525
Highlight 16 > Childhood Obesity and the Early Development of
Chronic Diseases 531
Chapter 17
Life Cycle Nutrition: Adulthood and the
Later Years 536
17.1 Nutrition and Longevity 537
Observation of Older Adults 538
Manipulation of Diet 540
17.2 The Aging Process 542
Physiological Changes 542
Other Changes 544
17.3 Energy and Nutrient Needs of Older Adults 545
Water 546
Energy and Energy Nutrients 546
Vitamins and Minerals 547
Dietary Supplements 548
17.4 Nutrition-Related Concerns of Older Adults 549
Vision 549
Arthritis 550
The Aging Brain 550
Alcohol 553
17.5 Food Choices and Eating Habits of Older Adults 554
Malnutrition 555
Food Assistance Programs 555
Meals for Singles 556
Highlight 17 > Nutrient-Drug Interactions 560
Chapter 18
Diet and Health 566
18.1 Nutrition and Infectious Diseases 567
The Immune System 568
Nutrition and Immunity 569
Inflammation and Chronic Diseases 570
18.2 Nutrition and Chronic Diseases 570
18.3 Cardiovascular Disease 572
How Atherosclerosis Develops 572
Risk Factors for Coronary Heart Disease 574
Recommendations for Reducing Cardiovascular Disease
Risk 577
18.4 Hypertension 578
How Hypertension Develops 580
Risk Factors for Hypertension 580
Treatment of Hypertension 580
18.5 Diabetes Mellitus 582
How Diabetes Develops 583
Complications of Diabetes 584
Recommendations for Diabetes 586
18.6 Cancer 588
How Cancer Develops 589
Recommendations for Reducing Cancer Risks 592
18.7 Recommendations for Chronic Diseases 593
Highlight 18 > Complementary and Alternative Medicine 600
Chapter 19
Consumer Concerns about Foods and Water 608
19.1 Food Safety and Foodborne Illnesses 609
Foodborne Infections and Food Intoxications 610
Food Safety in the Marketplace 611
Food Safety in the Kitchen 613
Food Safety while Traveling 617
Advances in Food Safety 618
19.2 Nutritional Adequacy of Foods and Diets 620
Obtaining Nutrient Information 620
Minimizing Nutrient Losses 620
19.3 Environmental Contaminants 621
Harmfulness of Environmental Contaminants 621
Guidelines for Consumers 622
19.4 Natural Toxicants in Foods 623
19.5 Pesticides 624
Hazards and Regulation of Pesticides 624
Monitoring Pesticides 625
Consumer Concerns 625
19.6 Food Additives 628
Regulations Governing Additives 628
Intentional Food Additives 630
Indirect Food Additives 633
19.7 Consumer Concerns about Water 635
Sources of Drinking Water 635
Water Systems and Regulations 635
Highlight 19 > Food Biotechnology 638
Chapter 20
Hunger and the Global Environment 644
20.1 Hunger in the United States 645
Defining Hunger in the United States 645
Relieving Hunger in the United States 647
20.2 World Hunger 650
Food Shortages 650
Population Needs 651
20.3 Malnutrition 651
Nutrient Deficiencies 652
Growth Failure 652
Rehabilitation 654
20.4 Agriculture and the Environment 654
Agricultural Consequences 655
Sustainable Solutions 657
Highlight 20 > Environmentally Friendly Food Choices 662
Appendix A
Cells, Hormones, and Nerves
Appendix B
Basic Chemistry Concepts
Appendix C
Biochemical Structures and Pathways
Appendix D
Measures of Protein Quality
Appendix E
Nutrition Assessment
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
Glossary GL-1
Index IN-1
Inser ts
Dietary Reference Intakes (DRI) A
Daily Values (DV) for Food Labels Y
Body Mass Index (BMI) Z