Nutrition Through the Life Cycle, 8th Edition
Judith E. Brown
Contents
Preface xvii
All chapters include Resources and References
Chapter 1
Nutrition Basics 1
Introduction 2
1.1 Principles of the Science of Nutrition 2
Essential and Nonessential Nutrients 3
Dietary Intake Standards 3
Standards of Nutrient Intake
for Nutrition Labels 4
Carbohydrates 4
Protein 5
Fats (Lipids) 8
Vitamins 10
Phytochemicals 13
Minerals 13
Water 23
Nutrient Functions at the Cellular Level 23
1.2 Nutrition Labeling 36
Nutrition Facts Panel 37
Ingredient Label 37
Dietary Supplement Labeling 37
Herbal Remedies 38
1.3 The Life-Course Approach to
Nutrition and Health 38
Meeting Nutritional Needs Across
the Life Cycle 39
Dietary Considerations Based on Country
of Origin 39
Dietary Considerations Based on Religion 39
1.4 Nutrition Assessment 40
Community-Level Assessment 40
Individual-Level Nutrition Assessment 40
Clinical/Physical Assessment 40
Dietary Assessment 40
Anthropometric Assessment 42
Biochemical Assessment 42
Monitoring the Nation’s Nutritional Health 42
1.5 Public Food and Nutrition Programs 42
WIC 43
Nationwide Priorities for Improvements
in Nutritional Health 43
1.6 Nutrition and Health Guidelines
for Americans 44
Dietary Guidelines for Americans 44
MyPlate.gov 44
USDA’s Food Groups 45
Chapter 2
Preconception Nutrition 49
Introduction 50
2.1 Preconception Overview 50
2030 Nutrition Objectives for the Nation
Related to Preconception 50
2.2 Reproductive Physiology 51
Female Reproductive System 51
Male Reproductive System 54
2.3 Nutrition and Fertility 56
Undernutrition and Fertility 56
Body Fat and Fertility 56
Case Study 2.1 Cyclic Infertility with
Weight Loss and Gain 57
Nutrient Status and Fertility 57
2.4 Nutrition During the
Periconceptional Period 60
Periconceptional Folate Status 60
Periconceptional Iron Status 62
2.5 Recommended Dietary Intake
and Healthy Dietary Patterns for
Preconceptional Women 62
2.6 Influence of Contraceptives
on Preconceptional Nutrition Status 64
Nutritional Side Effects of Hormonal
Contraception 64
2.7 Model Preconceptional
Health and Nutrition Programs 64
Preconceptional Benefits of WIC 64
Decreasing Iron Deficiency in Preconceptional
Women in Indonesia 65
Preconception Care: Preparing
for Pregnancy 65
2.8 The Nutrition Care Process 65
The Nutrition Care Process Related to
the Preconception Period 66
Nutrition Care Process (NCP)
Case Study 2.2 Male Infertility 67
Chapter 3
Preconception Nutrition 70
Conditions and Interventions
Introduction 71
3.1 Weight Status and Fertility 71
Obesity, Body Fat Distribution, and Fertility 71
Case Study 3.1 Weight Changes and
Fertility Status 73
3.2 Underweight and Fertility 73
Anorexia Nervosa, Bulimia Nervosa,
and Fertility 74
Women, Exercise, and Fertility 74
3.3 Diabetes Prior to Pregnancy 75
Nutritional Management of Diabetes
Prior to Pregnancy 76
3.4 Polycystic Ovary Syndrome
and Fertility 77
Nutritional Management of PCOS 78
3.5 Phenylketonuria (PKU) 78
Maternal PKU 79
Nutritional Management of PKU 79
3.6 Celiac Disease 80
Case Study 3.2 Celiac Disease 80
Nutritional Management of Celiac Disease 81
3.7 Premenstrual Syndrome 83
Treatment of PMS 84
Chapter 4
Nutrition During Pregnancy 86
Introduction 87
4.1 The Status of Pregnancy Outcomes 87
Infant Mortality 87
Low Birthweight, Preterm Delivery,
and Infant Mortality 89
Reducing Infant Mortality and Morbidity 89
4.2 Physiology of Pregnancy 90
Maternal Physiology 90
Normal Physiological Changes
During Pregnancy 91
The Placenta 94
4.3 Embryonic and Fetal Growth
and Development 96
Critical Periods of Growth and Development 96
Fetal Body Composition 98
Nutrition, Miscarriage, and Preterm
Delivery 100
Developmental Origins of Health and
Disease 101
4.4 Pregnancy Weight Gain 103
Pregnancy Weight Gain Recommendations 103
4.5 Nutrition and the Course and
Outcome of Pregnancy 106
Famine and Pregnancy Outcome 106
4.6 Energy and Nutrient Needs
During Pregnancy 107
The Need for Energy 107
The Need for Protein 109
The Need for Fat 109
The Need for Vitamins and Minerals
During Pregnancy 112
Calcium 115
Bioactive Components of Food 118
The Need for Water 119
4.7 Factors Affecting Dietary Intake
During Pregnancy 119
Effect of Taste and Smell Changes on
Dietary Intake During Pregnancy 119
Cultural Considerations 119
4.8 Healthy Dietary Patterns
for Pregnancy 120
Vegetarian Diets in Pregnancy 122
Dietary Supplements During Pregnancy 123
Case Study 4.1 Vegan Dietary Patterns
During Pregnancy 124
4.9 Food Safety During Pregnancy 124
4.10 Assessment of Nutritional
Status During Pregnancy 126
Dietary Assessment During Pregnancy 126
Nutrition Biomarker Assessment 126
4.11 Exercise and Pregnancy Outcome 127
4.12 Common Health Problems
During Pregnancy 127
Nausea and Vomiting 127
Heartburn 128
Constipation 128
4.13 Model Nutrition Programs for
Risk Reduction in Pregnancy 128
Fit Moms/Mamás Activas 128
The WIC Program 128
Chapter 5
Nutrition During Pregnancy 132
Conditions and Interventions
Introduction 133
5.1 Obesity and Pregnancy 133
Nutritional Recommendations and
Interventions for Obesity During Pregnancy 134
5.2 Hypertensive Disorders of Pregnancy 135
Hypertensive Disorders of Pregnancy,
Oxidative Stress, and Nutrition 135
Chronic Hypertension 136
Gestational Hypertension 136
Preeclampsia 136
Nutritional Recommendations and
Interventions for Preeclampsia 137
Case Study 5.1 A Case of Preeclampsia 138
5.3 Diabetes in Pregnancy 138
Gestational Diabetes 138
Case Study 5.2 Lauren’s Story:
Gestational Diabetes 141
Type 2 Diabetes in Pregnancy 142
Management of Type 2 Diabetes in Pregnancy 142
Type 1 Diabetes During Pregnancy 143
Nutritional Management of Type 1
Diabetes in Pregnancy 143
5.4 Multifetal Pregnancies 143
Background Information about
Multiple Fetuses 144
Risks Associated with a Multifetal Pregnancy 145
Nutrition and the Outcome of a
Multifetal Pregnancy 146
Dietary Intake in a Twin Pregnancy 147
Case Study 5.3 Twin Pregnancy and the
Nutrition Care Process 148
Nutritional Recommendations for Women
with a Multifetal Pregnancy 148
5.5 Eating Disorders in Pregnancy 148
Consequences of Eating Disorders
During Pregnancy 149
Treatment of Women with Eating
Disorders During Pregnancy 149
Nutritional Interventions for Women
with Eating Disorders During Pregnancy 150
5.6 Fetal Alcohol Syndrome 150
5.7 Nutrition and Adolescent Pregnancy 150
Obesity, Excess Weight Gain, and
Adolescent Pregnancy 151
Nutritional Recommendations for
Pregnant Adolescents 151
SARS-CoV-2 (COVID-19) 151
Evidence-Based Practice 151
Chapter 6
Nutrition During Lactation 154
Introduction 155
6.1 Lactation Physiology 156
Functional Units of the Mammary Gland 156
Mammary Gland Development 156
Lactogenesis 156
Hormonal Control of Lactation 157
Secretion of Milk 157
The Letdown Reflex 158
6.2 Human Milk Composition 158
Colostrum 159
Water 159
Energy 159
Lipids 161
Protein 162
Milk Carbohydrates 162
Fat-Soluble Vitamins 162
Water-Soluble Vitamins 163
Minerals in Human Milk 163
Taste of Human Milk 164
6.3 Benefits of Breastfeeding 164
Breastfeeding Benefits for Mothers 164
Breastfeeding Benefits for Infants 164
Benefits 166
6.4 Breast Milk Supply and Demand 167
Establishing a Good Milk Supply in the
First Month 167
Can Women Make Enough Milk? 167
Does the Size of the Breast Limit
a Woman’s Ability to Nurse Her Infant? 167
Is Feeding Frequency Related to the
Amount of Milk a Woman Can Make? 167
Can Women Pump or Express Enough Milk? 168
Can Women Breastfeed after Breast
Reduction or Augmentation Surgery? 168
6.5 The Breastfeeding Process 168
Preparing the Breast for Breastfeeding 168
Breastfeeding Positioning 168
Presenting the Breast to the Suckling Infant 168
6.6 The Breastfeeding Infant 169
Infant Reflexes 169
Mechanics of Breastfeeding 169
Identifying Hunger and Satiety 170
Feeding Frequency 170
Identifying Breastfeeding Malnutrition 170
Case Study 6.1 Breastfeeding and
Adequate Nourishment 171
Tooth Decay 171
Vitamin Supplements for Breastfeeding Infants 172
6.7 Maternal Diet 172
Nutrition Assessment of Breastfeeding Women 172
Energy and Nutrient Needs 173
Maternal Energy Balance and Milk
Composition 174
Weight Loss During Breastfeeding 175
Exercise and Breastfeeding 175
Vitamin and Mineral Supplements 175
Vitamin and Mineral Intakes 175
Functional Foods 175
Fluids 175
Vegetarian Diets 176
Infant Colic 176
6.8 Public Food and Nutrition Programs 176
6.9 Optimal Duration, Influential Factors,
and U.S. Goals for Breastfeeding 176
Optimal Breastfeeding Duration 176
Breastfeeding Goals for the United States 177
The Surgeon General’s Call to Action to
Support Breastfeeding 177
Breastfeeding Rates in the United States 177
6.10 Breastfeeding Promotion,
Facilitation, and Support 179
Prenatal Breastfeeding Education and Support 179
Breastfeeding Support for Individuals 180
Role of the Health-Care System in
Supporting Breastfeeding 180
Lactation Support in Hospitals and
Birthing Centers 181
Model U.S. Baby-Friendly Hospital Programs 181
Lactation Support after Discharge 183
The Workplace 183
The Business Case for Breastfeeding 184
The Community 184
Public Health Support of Breastfeeding 185
6.11 Model Breastfeeding Promotion
Programs 185
WIC National Breastfeeding Promotion
Project—Loving Support Makes
Breastfeeding Work 185
Texas 10 Steps to Successful Breastfeeding 186
Stanford University Breastfeeding
Support Program 186
University of California San Francisco
Motivating Interdisciplinary Lactation
Knowledge (MILK) Research Lab 186
Chapter 7
Nutrition During Lactation 189
Conditions and Interventions
Introduction 190
7.1 Common Breastfeeding Conditions 190
Sore Nipples 190
Flat or Inverted Nipples 191
Small or Large Nipples 191
Letdown Failure 191
Hyperactive Letdown 191
Hyperlactation 192
Engorgement 192
Plugged Duct 192
Mastitis 193
Case Study 7.1 Chronic Mastitis 194
Low Milk Supply 195
7.2 Maternal Medications 195
7.3 Herbal Remedies 198
Specific Herbs Used in the United States 200
7.4 Alcohol and Other Drugs
and Exposures 201
Alcohol 201
Nicotine (Smoking Cigarettes) 202
Electronic Cigarettes (e-Cigarettes) 203
Marijuana 203
Caffeine 204
Other Drugs of Abuse 204
Opioids 204
Methadone 205
Environmental Exposures 205
7.5 Neonatal Jaundice
and Kernicterus 206
Bilirubin Metabolism 207
Physiologic Versus Pathologic
Newborn Jaundice 207
Hyperbilirubinemia and Breastfeeding 208
Prevention and Treatment for Severe Jaundice 210
Information for Parents 210
7.6 Breastfeeding Multiples 210
7.7 Infant Allergies 211
Food Allergy (Hypersensitivity) 211
Food Intolerance 212
7.8 Late-Preterm Infants 212
Case Study 7.2 Breastfeeding Premature
Infants 213
7.9 Human Milk and Preterm Infants 213
7.10 Medical Contraindications
to Breastfeeding 214
Breastfeeding and HIV Infection 215
7.11 Human Milk Collection and Storage 215
Milk Banking 216
7.12 Model Programs 217
Breastfeeding Promotion in Physicians’
Office Practices (BPPOP) 217
Hear Her Campaign 218
The Rush Mothers’ Milk Club 218
Chapter 8
Infant Nutrition 220
Introduction 221
8.1 Assessing Newborn Health 221
Birthweight and Gestational Age as
Outcome Measures 221
Infant Mortality 221
Combating Infant Mortality 222
Newborn Growth Assessment 222
Normal Physical Growth and Development 222
Motor Development 223
Critical Periods 223
Cognitive Development 223
Digestive System Development 224
Parenting 225
8.2 Energy and Nutrient Needs 226
Energy Needs 226
Protein Needs 226
Fat Needs 226
Metabolic Rate, Energy, Fats, and
Protein—How Do They All Tie Together? 227
Other Nutrient and Non-Nutrient Needs 227
Zinc 228
8.3 Growth Assessment 228
Interpretation of Growth Data 228
8.4 Feeding in Early Infancy 230
Breast Milk and Formula 230
8.5 Development of Infant
Feeding Skills 230
Complementary Feeding and
Complementary Foods 232
Water 234
The Importance of Infant Feeding Position 234
Case Study 8.1 Baby Stella Will Not Eat 234
Preparing for Drinking from a Cup 234
Inappropriate and Unsafe Food Choices 235
Foods That Can Cause Choking 236
Recognizing Infants’ Hunger and
Satiety Cues 236
Influence of Food Preferences on
Feeding Behavior 236
8.6 Nutrition Guidance 236
The Infant’s Home Environment 237
Supplements for Infants: Special
Circumstances 237
Cross-Cultural Considerations 237
8.7 Common Nutritional Issues
and Concerns 237
Infantile Colic 237
Iron Deficiency and Iron-Deficiency Anemia 238
Diarrhea and Constipation 238
Fluid Needs During Illness 238
Early Childhood Caries (ECC) 238
Food Allergies 239
Lactose Intolerance 239
Peanut Allergy 240
Vegetarian and Vegan Diets 240
8.8 Nutrition Intervention for Risk
Reduction 241
Primary Prevention of Obesity During
Infancy 241
Model Programs 241
Chapter 9
Infant Nutrition 243
Conditions and Interventions
Introduction 244
9.1 Infants at Risk 244
Families of Infants with Special
Health-Care Needs 245
9.2 Energy and Nutrient Needs
of Preterm Infants and Infants with
Special Health-Care Needs and/or
Developmental Delay 245
Energy Needs 245
Protein Requirements 246
Forms of Protein 246
Fat 246
Vitamins and Minerals 246
9.3 Growth of Infants at Risk or
with Special Health-Care Needs 247
Growth in Preterm Infants 247
Corrected Age 248
Does Intrauterine Growth Predict
Extrauterine Growth? 248
Interpretation of Growth 250
9.4 Nutrition for Infants with Special
Health-Care Needs 250
Nutrition Risks to Development 250
9.5 Severe Preterm Birth
and Nutrition 251
How Sick Babies Are Fed 251
Food Safety 251
What to Feed Preterm Infants 252
9.6 Infants with Congenital Anomalies
and Chronic Illness 253
Case Study 9.1 Premature Birth at
27 Weeks Gestation 254
Infants with Genetic Disorders 254
Case Study 9.2 Noah’s Cardiac Condition 255
9.7 Nutrition Interventions 256
9.8 Nutrition Services 256
Chapter 10
Toddler and Preschooler Nutrition 258
Introduction 259
Definitions of the Life-Cycle Stage 259
Importance of Nutrition 259
10.1 Tracking Toddler and
Preschooler Health 259
Healthy People 2030 259
10.2 Normal Growth and Development 259
Measuring Growth 260
The WHO and CDC Growth Charts 260
WHO Growth Standards 262
Common Problems with Measuring
and Plotting Growth Data 262
10.3 Physiological and Cognitive
Development 263
Toddlers 263
Preschool-Age Children 264
Case Study 10.1 Mealtime with a Toddler 264
Temperament Differences 265
Food Preference Development, Appetite,
and Satiety 266
10.4 Energy and Nutrient Needs 268
Energy Needs 268
Protein 268
Vitamins and Minerals 268
10.5 Common Nutrition Problems 269
Iron-Deficiency Anemia 269
Dental Caries 270
Constipation 270
Elevated Blood Lead Levels 271
Food Security 272
Food Safety 272
10.6 Prevention of Nutrition-Related
Disorders 272
Toddlers and Pre-schoolers Who Have Higher
Weight and Those with Obesity 273
Assessment of Overweight and Obesity 273
Prevention of Overweight and Obesity 273
Treatment of Overweight and Obesity
Expert Committee: Recommendations 273
Dietary Guidelines for Americans
2020–2025 274
Nutrition and Prevention of Cardiovascular
Disease in Toddlers and Preschoolers 274
Vitamin and Mineral Supplements 275
Herbal Supplements 277
10.7 Dietary and Physical Activity
Recommendations 277
Dietary Guidelines for Americans 2020–2025 277
MyPlate 278
Recommendations for Intake of Iron,
Fiber, Fat, and Calcium 278
Fat-Soluble Vitamins 280
Recommended Versus Actual Food Intake 281
Cross-Cultural Considerations 281
Vegetarian Diets 281
Child Care Nutrition Standards 282
Physical Activity Recommendations 282
10.8 Nutrition Intervention for Risk
Reduction 283
Nutrition Assessment 283
Bright Futures: Nutrition 283
10.9 Public Food and Nutrition Programs 284
WIC (https://www.fns.usda.gov/wic/eligibility
-and-coverage-rates) 284
WIC’s Farmers’ Market Nutrition Program 284
Head Start and Early Head Start 284
Supplemental Nutrition Assistance Program 284
Chapter 11
Toddler and Preschooler Nutrition 286
Conditions and Interventions
Introduction 287
11.1 Who Are Children with Special
Health-Care Needs? 287
11.2 Nutrition Needs of Toddlers and
Preschoolers with Chronic Conditions 289
11.3 Growth Assessment 290
11.4 Feeding Problems 290
Behavioral Feeding Problems 291
Case Study 11.1 A Picky Eater 292
Excessive Fluid Intake 292
Feeding Challenges and Food Safety 292
Feeding Challenges from Disabilities
Involving Neuromuscular Control 293
11.5 Nutrition-Related Conditions 294
Failure to Thrive 294
Toddler Diarrhea and Celiac Disease 295
Autism Spectrum Disorders 296
Muscle Coordination Problems and
Cerebral Palsy 296
Case Study 11.2 Early Intervention Services
for a Boy at Risk for Nutrition Support 297
Pulmonary Problems 297
Food Allergies and Intolerance 298
Dietary Supplements and Herbal Remedies 299
COVID-19 Pandemic 299
Sources of Nutrition Services 299
Chapter 12
Child and Preadolescent Nutrition 302
Introduction 303
Definitions of the Life-Cycle Stage 303
Importance of Nutrition 303
12.1 Tracking Child and Preadolescent
Health 303
Healthy People 2030 304
12.2 School-Age Growth and
Development 304
The 2000 CDC Growth Charts 304
WHO Growth References 305
12.3 Physiological and Cognitive
Development of School-Age Children 306
Physiological Development 306
Cognitive Development 307
Development of Feeding Skills and
Eating Behaviors 307
12.4 Energy and Nutrient Needs of
School-Age Children 310
Energy Needs 310
Protein 310
Vitamins and Minerals 310
12.5 Common Nutrition Problems 310
Iron Deficiency 310
Dental Caries 311
12.6 Prevention of Nutrition-Related
Disorders in School-Age Children 311
Overweight and Obesity in School-Age
Children 311
Addressing the Problem of Overweight
and Obesity in Children 314
Case Study 12.1 Overweight 315
Nutrition and Prevention of Cardiovascular
Disease in School-Age Children 315
Dietary Supplements 316
12.7 Dietary Recommendations 316
Recommended Versus Actual Food Intake 318
Cross-Cultural Considerations 318
Vegetarian Diets 319
12.8 Physical Activity Recommendations 321
Recommendations Versus Actual Activity 321
Determinants of Physical Activity 322
Organized Sports 322
12.9 Nutrition Intervention for
Risk Reduction 323
School Wellness Policies 323
Nutrition Education and Promotion 323
Competitive Foods and Food Marketing 323
12.10 Public Food and Nutrition Programs 324
The National School Lunch Program 324
School Breakfast Program 325
Impact of the Healthy, Hunger-Free Kids Act 325
Summer Food Service Program 326
Farm to Schools 326
Impact of COVID-19 Pandemic on Food
Security of School-Aged Children 326
Chapter 13
Child and Preadolescent Nutrition 328
Conditions and Interventions
Introduction 329
13.1 “Children Are Children First”—
What Does That Mean? 329
Including Children with Special
Health-Care Needs 329
13.2 Nutritional Requirements of
Children with Special Health-Care Needs 330
Energy Needs 330
Protein Needs 330
Other Nutrients 331
13.3 Growth Assessment 331
Growth Interpretation in Children with
Chronic Conditions 332
Body Composition and Growth 332
Case Study 13.1 Adjusting Energy Intake
for a Child with Spina Bifida 333
Specialized Growth Charts 333
13.4 Nutrition Recommendations 334
Methods of Meeting Nutritional Requirements 335
Fluids 336
13.5 Feeding Disorders in Children with
Special Health-Care Needs 336
Feeding Challenges for Children with
Health-Care Needs 337
13.6 Nutrition Needs of Children with
Specific Disorders 337
Food Allergies 342
13.7 Dietary Supplements and Herbal
Remedies 343
13.8 Sources of Nutrition Services 343
Case Study 13.2 Dealing with Food
Allergies in School Settings 344
Chapter 14
Adolescent Nutrition 347
Introduction 348
Nutritional Needs in a Time of Change 348
14.1 Normal Physical Growth
and Development 348
Changes in Weight, Body Composition,
and Skeletal Mass 350
14.2 Psychosocial and Cognitive
Development 351
14.3 Health and Nutrition-Related
Behaviors During Adolescence 352
Snacking 353
Meal Skipping 353
Eating Away from Home and Family Meals 354
Vegetarian Diets 354
Case Study 14.1 Moral and Ethical Dietary
Considerations Leading to Changes in
Dietary Habits in Late Adolescence 355
Physical Activity 356
14.4 Dietary Requirements, Intake,
and Adequacy Among Adolescents 356
Energy and Nutrient Requirements of
Adolescents 356
Energy 357
Protein 358
Carbohydrates 359
Dietary Fiber 359
Fat 359
Calcium 359
Iron 359
Vitamin D 360
Dietary Intake and Nutritional Adequacy 360
14.5 Nutrition Screening, Assessment,
and Intervention 361
Dietary Assessment and Screening 361
Nutrition Education and Counseling 366
14.6 Promoting Healthy Eating and
Physical Activity Behaviors 367
The Home Environment
and Parental Involvement 367
School-Based Education, School Meals,
and Wellness Activities 368
Community Engagement to Create
Nutritionally Supportive Environments 372
Chapter 15
Adolescent Nutrition 375
Conditions and Interventions
Introduction 376
15.1 Overweight and Obesity 376
Health Implications of Adolescent
Overweight and Obesity 378
Assessment and Treatment of
Adolescent Overweight and Obesity 378
Effective Approaches to Obesity
Prevention and Treatment 380
15.2 Dieting, Disordered Eating,
and Eating Disorders 381
Disordered Eating Behaviors and Eating
Disorders 382
15.3 Nutrition for Adolescent Athletes 387
Case Study 15.1 Following Ava’s Medical History 390
15.4 Special Dietary Concerns
Among Adolescents 391
Hyperlipidemia 391
Hypertension 391
Diabetes and Metabolic Syndrome 393
Substance Use 394
Iron-Deficiency Anemia 394
Chapter 16
Adult Nutrition 397
Introduction 398
Importance of Nutrition 398
16.1 Tracking Adult Nutritional Health
and Its Determinants 398
Health Objectives for the Nation 399
Health Disparities Among Groups of Adults 400
16.2 Physiological Changes During
the Adult Years 402
Hormonal and Climacteric Changes 402
Body Composition Changes in Adults 402
Continuum of Nutritional Health 403
States of Nutritional Health 404
16.3 Energy Recommendations 405
Age-Related Changes in Energy Expenditure 405
Estimating Energy Needs in Adults 405
Energy Adjustments for Weight Change 407
Tracking Energy Expenditure 407
Energy Balance 407
16.4 Nutrient Recommendations 407
Macro- and Micronutrient Recommendations 407
Risk Nutrients 407
16.5 Dietary Recommendations for Adults 409
Total Diet Approach 410
Water Intake Recommendations 411
Beverage Intake Recommendations 411
Caffeine and Coffee Intake 411
Alcoholic Beverages 412
Dietary Supplements and Functional Foods 412
Phenolic Compounds: Everyday
Functional Foods 412
The Eating Competence Model 413
16.6 Physical Activity Recommendations 414
Guidelines for Physical Activity 415
Promotion of Physical Activity 415
Physical Activity, Body Composition, and
Metabolic Change 415
Case Study 16.1 Run, Jamilah, Run 416
Diet and Physical Activity 416
16.7 Nutrition Intervention for Risk
Reduction 417
A Model Health-Promotion Program 417
Public Food and Nutrition Programs 418
Putting It All Together 419
Chapter 17
Adult Nutrition 421
Conditions and Interventions
Introduction 422
17.1 Overweight and Obesity 422
Prevalence of Obesity and Overweight 422
Etiology of Obesity 423
Effects of Obesity 424
Screening and Assessment 425
Nutrition Assessment 426
Intervention in Obesity and Overweight 426
Comprehensive Weight Management Program 426
Weight-Loss Goals 426
Lifestyle Intervention Program
for Weight Management 428
Physical Activity for Weight Management 429
The Challenge of Weight Maintenance 429
Pharmacotherapy for Weight Loss 429
Case Study 17.1 Maintaining a Healthy Weight 430
Metabolic/Bariatric Surgery 430
17.2 Cardiovascular Diseases 430
Prevalence of CVD 431
Etiology of Atherosclerosis 432
Physiological Effects of Atherosclerosis 432
Risk Factors for CVD 432
Screening and Assessment of CVD 432
Nutrition Assessment 434
Nutrition Interventions for CVD 434
Pharmacotherapy of CVD 436
17.3 Metabolic Syndrome 436
Prevalence of Metabolic Syndrome 436
Etiology of Metabolic Syndrome 437
Effects of Metabolic Syndrome 437
Screening and Assessment 437
Nutrition Interventions
for Metabolic Syndrome 437
17.4 Diabetes Mellitus 437
Case Study 17.2 Managing Metabolic
Syndrome in Adults: Dante Goes Dancing 438
Prediabetes 438
Prevalence of Diabetes 438
Etiology of Diabetes 439
Physiological Effects of Diabetes 439
Screening and Assessment 439
Nutrition Assessment 440
Interventions for Diabetes 440
Carbohydrate Management 442
Self-Monitored Blood Glucose 442
Physical Activity in Diabetes Management 443
Pharmacotherapy for Type 2 Diabetes 443
Metabolic Surgery 444
Herbal Remedies and Other
Dietary Supplements 444
17.5 Cancer 444
Prevalence of Cancer 444
Etiology of Cancer 445
Physiological and Psychological
Effects of Cancer 445
Screening and Assessment 445
Nutrition Interventions for Cancer 446
Complementary and Alternative
Medicine in Cancer Treatment 447
Chapter 18
Nutrition and Older Adults 449
Introduction 450
What Counts as Old Depends
on Who Is Counting 450
Food Matters: Nutrition Contributes
to a Long and Healthy Life 450
18.1 A Picture of the Aging Population:
Vital Statistics 451
Global Population Trends: Life Expectancy
and Life Span 451
Health Objectives for Older Adults 452
18.2 Theories of Aging 453
Programmed Aging 454
Wear-and-Tear Theories of Aging 454
Calorie Restriction to Increase Longevity 454
18.3 Physiological Changes 455
Body-Composition Changes 455
Changing Sensual Awareness: Taste and Smell,
Chewing and Swallowing, Appetite
and Thirst 457
18.4 Nutritional Risk Factors 458
18.5 Dietary Recommendations
for Older Adults 463
18.6 Nutrient Recommendations 464
Estimating Energy Needs 464
Nutrient Recommendations for Older
Adults: Energy Sources 464
Age-Associated Changes:
Nutrients of Concern 468
Nutrient Supplements: When, Why,
Who, What, and How Much? 471
Dietary Supplements, Functional Foods,
and Complementary Medicine 472
Nutrient Recommendations:
Using the Food Label 473
Cross-Cultural Considerations in Making
Dietary Recommendations 473
18.7 Food-Safety Recommendations 475
18.8 Physical Activity Recommendations 475
Physical Activity Guidelines 475
18.9 Nutrition Policy and Intervention
for Risk Reduction 475
Nutrition Education 475
Case Study 18.1 Richard—Spiraling Out
of Control? 477
18.10 Community Food and Nutrition
Programs 477
OAANP: Promoting Socialization
and Improved Nutrition 478
The Promise of Prevention: Health Promotion 478
Chapter 19
Nutrition and Older Adults 481
Conditions and Interventions
Introduction: The Importance of Nutrition 482
19.1 Nutrition and Health 483
19.2 Heart Disease 484
Prevalence 484
Risk Factors 484
Nutritional Remedies for
Cardiovascular Diseases 484
19.3 Stroke 485
Prevalence 485
Etiology 485
Effects of Stroke 485
Risk Factors 486
Nutritional Remedies 486
19.4 Hypertension 486
Prevalence 486
Etiology 487
Effects of Hypertension 487
Risk Factors 487
Nutritional Remedies 487
19.5 Diabetes: Special Concerns
for Older Adults 488
Effects of Diabetes 489
Nutritional Interventions 489
19.6 Obesity 490
Definition 490
Prevalence 490
Etiology, Effects, and Risk Factors of Obesity 490
Nutritional Remedies 492
19.7 Osteoporosis 492
Definition 492
Prevalence 492
Etiology 493
Effects of Osteoporosis 493
Nutritional Remedies 494
Other Issues Affecting Nutritional Remedies 495
19.8 Oral Health 495
19.9 Gastrointestinal Diseases 496
Gastroesophageal Reflux Disease (GERD) 496
Stomach Conditions Affect Nutrient
Availability: Vitamin B12 Malabsorption 497
Constipation 499
19.10 Inflammatory Diseases: Osteoarthritis 500
Etiology 501
Effects of Osteoarthritis 501
Case Study 19.1 Bridget Doyle
Remembers Laura 501
Risk Factors 501
19.11 Cognitive Impairment, Dementia,
and Alzheimer’s Disease 502
Definition 502
Prevalence 503
Etiology of Cognitive Impairment 503
Effects of Cognitive Impairment 504
Nutrition Interventions for Cognitive
Impairment 504
19.12 Polypharmacy: Prescription and
Over-the-Counter Medications 504
Medication Effects on Physical, Mental,
and Financial Status 505
Medication Effects on Food Consumption 505
19.13 Low Body Weight/Unintentional
Weight Loss 506
Definition 506
Etiology and Effects 506
Case Study 19.2 Ms. Dawson: A Senior
Suffering Through a Bad Stretch 507
Nutrition Interventions 507
19.14 Dehydration 508
Definition 508
Etiology 508
Effects of Dehydration 508
Nutritional Interventions 508
Rehydrate Slowly 509
Dehydration at End of Life 509
19.15 Bereavement 509
Answers to Review Questions 511
Appendix A
Measurement Abbreviations
and Equivalents 517
Appendix B
Body Mass Index (BMI) 519
References 521
Glossary 573
Index 585