LIST OF TABLES
SECTION 1
1-1 Public Health: Ten Achievements and Ten Essential Services 2
1-2 Dietary Guideline Systems 3
1-3 Prenatal Risk Assessment 7
1-4 Special Issues in Pregnancy 9
1-5 Recommendations for Pregnant Women 10
1-6 March of Dimes Campaign to Reduce Preterm Births 11
1-7 Content of Mature Human Milk 14
1-8 Recommendations for Lactation 16
1-9 Common Breastfeeding Difficulties and Reasons Why Women Discontinue Breastfeeding 18
1-10 Recommendations for Infants Ages 0 to 6 Months 21
1-11 Special Problems in Infant Feeding 22
1-12 Feeding Babies in the First Year of Life 25
1-13 Recommendation for Infants Ages 6 Months to 1 Year 26
1-14 Recommendation for Children Ages 1 to 13 30
1-15 Estimated Calorie Needs per Day by Age, Gender, and Physical Activity Level 30
1-16 General Dietary Recommendations for Children Ages 2 Years and Older 31
1-17 Special Considerations in Childhood: Lead Poisoning and Measles 32
1-18 Tips for Encouraging Children to Enjoy Nutrition and Physical Activity 32
1-19 Recommendation for Males and Females Ages 14 to 18 36
1-20 Special Considerations for Adolescent Pregnancy 36
1-21 International Society of Sports Nutrition Position Statements 40
1-22 Percent Body Fat Standards 41
1-23 Protein Intake for Athletes 41
1-24 Guidelines for Planning Meals for Athletes 42
1-25 Supplements Commonly Used by Athletes 43
1-26 Leading Causes of Death and Nutritional Implications for Men in the United States 45
1-27 Disorders and Their Related Genes 46
1-28 Special Nutrition-Related Concerns of Adult Women 48
1-29 Nutrient Recommendations for Adults 49
1-30 Functional Foods and Ingredients 50
1-31 Medications and Nutrients Commonly Used by Adults 52
1-32 Tips for Eating More Fruits and Vegetables 54
1-33 Key Nutrients in Fruits and Vegetables 55
1-34 Food Labeling Terms 56
1-35 Health Claims 57
1-36 Summary of Nutrition Screening and Assessment Tools for the Elderly 61
1-37 Dietary Reference Intakes for Older Adults 64
1-38 Formula for Calculating Stature Using Knee Height 66
SECTION 2
2-1 Herbal, Botanical, and Dietary Supplement Intake 71
2-2 Herbs, Botanicals, and Spices: Common Uses and Adverse Effects 72
2-3 Common Religious Food Practices 86
2-4 Potential Complications of a Vegetarian Diet 90
2-5 Nutrients Needed for Proper Oral Tissue Synthesis and Dental Care 98
2-6
Dental Problems, Treatment, and Prevention 100
2-7 Nutrients for Healthy Vision 111
2-8
Skin Changes with Aging and Pressure Ulcer Stages 117
2-9 Vitamin Deficiency Summary 120
2-10
Gastrointestinal Allergic Manifestations 124
2-11 Major Food Allergens and Nutritional Consequences 127
2-12 Specifics of Food Allergies 128
2-13 Tips for Educating Individuals about Food Allergies 130
2-14 Sources, Symptoms, and Pathogens That Cause Food Poisoning 133
2-15 Safe Food Handling and Food Safety Guidelines 136
2-16 Refrigerator and Freezer Food Storage 137
SECTION 3
3-1 Useful Assessments in Pediatrics 140
3-2 Nutritional Risks Associated with Selected Pediatric Disorders 142
3-3 Adequate Intakes of Water in Infancy and Early Childhood 143
3-4 ADHD Medications Approved by the FDA 147
3-5 Glycogen Storage Diseases: Deficiency of a Glycogen Synthase That Normally Converts Glycogen to Glucose 157
3-6 Signs and Symptoms of Cerebral Palsy 159
3-7 Medications for Congenital Heart Disease 165
3-8
Normal Growth Rates for Height and Weight in Children 171
3-9 Grading for Hirschsprung Enterocolitis 177
3-10 Laxative Foods for Children 178
3-11
3-12
3-13
Nutritional Deficits in the Premature or Low-Birth-Weight Infant 188
Nutrient Needs of Preterm Infants 190
Parenteral Vitamin and Mineral Needs in Preterm Infants 190
3-14 Types of and Nutrition Interventions for Maple Syrup Urine Disease 192
3-15 Causes of Childhood Obesity 204
3-16 When to Initiate Weight Loss Diets in Children 205
3-17 Components of Successful Weight Loss for Children 206
3-18 Risk Factors for Developing Intrauterine Growth Restriction in Pregnancy 217
3-19 Urea Cycle Disorders 221
SECTION 4
4-1 Brain Parts and Their Functions 230
4-2
4-3
4-4
4-5
Cranial Nerves and Those Specifically Affecting Mastication and Swallowing 230
Disorders of Mental Health and Their Relevance to Nutrition 231
Neurotransmitters and Their Nutritional Relevance 233
Nutrients for Brain Health 234
4-6 Medications for Alzheimer’s Disease and Possible Side Effects 238
4-7 Consequences of Withholding Food and Fluid in Terminally Ill Patients 246
4-8 Medications Used in Epilepsy 250
4-9 Foods Implicated in Various Types of Headaches 257
4-10 Types of Multiple Sclerosis 259
4-11 Medications for Parkinson’s Disease and Possible Side Effects 265
4-12 Expected Functional Level of Spinal Cord Disruption 266
4-13 Most Common Stroke Symptoms 269
4-14 Strategies Used to Prevent Strokes 271
4-15 Average Woman versus “Fashion Woman” 276
4-16 Tips for Helping Patients with Eating Disorders 277
4-17 Assessment of Oral Manifestations in Bulimia Nervosa 281
4-18 Other Disordered Eating Patterns 282
4-19 The Bipolar Spectrum and Symptoms 284
4-20 Antipsychotic Medications and Possible Side Effects 292
4-21 Medications for Depression and Mood Disorders and Potential Side Effects 293
4-22 Common Addictions and Issues 298
SECTION 5
5-1 Causes of Malnutrition in Patients with Pulmonary Disease 305
5-2 Respiratory Quotient and Nutrients 305
5-3 Early Warning Signs of Asthma 306
5-4 Nutrients and Their Potential Mechanisms in Asthma 307
5-5 Medications Used in Asthma 309
5-6 Tips for Adding Calories to a Diet 316
5-7 Tips for Adding Protein to a Diet 316
5-8 Nutritional Management for Cystic Fibrosis 323
5-9 Medications Used in Cystic Fibrosis and Potential Side Effects 325
5-10 Types of Pneumonia 329
5-11 Causes of Respiratory Failure 335
5-12 Ventilatory Dependency Feeding Stages 335
5-13 Medications Used for Lung Transplant Patients 345
5-14 Medications Used for Tuberculosis 349
SECTION 6
6-1 Level I—Best Evidence in Dietary Recommendations for Heart Disease 353
6-2 Key Influences and Factors Related to Heart Disease 353
6-3 Herbs and Supplements Commonly Used in Heart Disease 355
6-4 Key Sources of Folate, Potassium, Calcium, and Magnesium 356
6-5 The DASH Diet Principles 357
6-6 Signs of the Metabolic Syndrome (Any Three of the Following) 359
6-7 Drugs Affecting Lipoprotein Metabolism 366
6-8 Sodium Content of Common Foods 375
6-9 Tips for Lowering Sodium in the Diet 375
6-10 Medications Used in Heart Failure 376
6-11 Medications Used after Transplantation 379
6-12 Categories for Blood Pressure Levels in Adults (Ages 18 Years and Older) 383
6-13 Sodium and Potassium in Salt, Salt Substitutes, and Herbal Seasonings 385
6-14 Medications for Hypertension 386
6-15 Risk Factors for Myocardial Infarction 388
6-16 Complications after Myocardial Infarction 389
6-17 Sites Where Peripheral Arterial Disease Produces Symptoms 393
6-18 Common Causes of Thrombophlebitis 395
SECTION 7
7-1 Gastrointestinal Conditions That May Lead to Malnutrition 400
7-2 Enteral Nutrition, Prebiotics, Probiotics, and Synbiotics in Gastrointestinal Tract Function 401
7-3 Conditions That May Benefit from Use of Intestinal Fuels 401
7-4 Knowledge and Skills of Dietitians in Gastrointestinal Specialty 401
7-5 Standard Questions in the Evaluation of Dysphagia 403
7-6 Common Causes of Dysphagia 404
7-7 Typical Caffeine Content of Beverages and Medications 425
7-8 Medications Used in Peptic Ulcer Disease 426
7-9 Grains and Starches to Use Freely in Celiac Disease 433
7-10 Medications for Constipation 436
7-11 Diarrhea: Etiologies and Comments 438
7-12 Bristol Stool Scale 440
7-13 UNICEF/WHO Oral Rehydration Therapy 440
7-14 How to Eat More Fiber 443
7-15 Altered Stools and Related Disorders 445
7-16 Fecal Fat Study 445
7-17 Medium-Chain Triglycerides 446
7-18 Medications Used after Intestinal Transplantation 459
7-19 Foods to Limit on the FODMAPS Diet 461
7-20 Types of Lactose Maldigestion 464
7-21 Lactose Content of and Substitutes for Common Foods 464
7-22 Types of Colostomies 468
7-23 Implications of Bowel Resections 474
7-24 Malabsorption Concerns in Short Bowel Syndrome 474
7-25 Medications Used in Short Bowel Syndrome 476
7-26 Fecal Incontinence: Causes and Comments 481
7-27 Fiber Content of Common Foods 483
SECTION 8
8-1 Liver, Gallbladder, and Pancreatic Functions 489
8-2 Stages of Alcoholic Liver Disease and Related Effects 492
8-3 Hepatitis Symptoms, Transmission, and Treatment 497
8-4 Causes of Malnutrition in Cirrhosis 501
8-5 Medications Used in Cirrhosis 503
8-6 Stages of Hepatic Encephalopathy—West Haven Classification 505
8-7 Nutrient Relationships in Hepatic Failure and Hepatic Encephalopathy 506
8-8 Medications Used for Hepatic Encephalopathy 507
8-9 Prebiotics, Probiotics, and Healthy Foods Shopping List 508
8-10 Post–Transplant (Liver or Pancreas) Nutrition Guidelines 512
8-11 Medications Used after Liver Transplantation 513
8-12 Medications Used in Acute and Chronic Pancreatitis 516
8-13 Antioxidants and Sources 517
8-14 Oxygen Radical Absorbance Capacity (ORAC) Rating of Foods 519
8-15
Medications Used after Pancreatic Transplantation 524
SECTION 9
9-1
Etiologic Classification of Diabetes Mellitus 539
9-2 Types of Diabetes in Children and Teens 539
9-3 Assessment of Diabetes 540
9-4 Potential Complications of Diabetes 541
9-5 Key Concepts in Diabetes Management 544
9-6 Recommended Medical Nutrition Therapy Visits for Diabetes 547
9-7 Sugar and Sweetener Summary 549
9-8 Insulin Onset, Peaks, and Duration 550
9-9 Herbs and Supplements in Diabetes Management 552
9-10 Glycemic Index and Glycemic Load 553
9-11 General Guidelines for Regulating Exercise in Diabetes 553
9-12 Glucose Testing for Gestational Diabetes Mellitus 555
9-13 Prediabetes Classifications and Tests 558
9-14 Number of Nutrition Visits Reimbursed by Medicare for Type 2 Diabetes 562
9-15 Medications Used for Type 2 Diabetes 563
9-16 Quick Sources of Glucose 576
9-17 Endocrine Glands and Their Functions 584
9-18 Symptoms of a Pituitary Disorder 586
9-19 Causes of Syndrome of Inappropriate Antidiuretic Hormone (SIADH) 594
9-20 Catecholamines 603
9-21 Thyroid Test Results 605
9-22 Symptoms of Hypothyroidism by Life Stage 609
9-23 Phosphorus Facts 614
SECTION 10
10-1 Concerns with Undernutrition 618
10-2 Concerns with Overnutrition 621
10-3 Weight Calculations and Body Mass Index Guidelines 621
10-4 Calculations of Ideal Body Weight Range 623
10-5 Body Mass Index Table for Adults 624
10-6 Short Methods for Calculating Energy Needs 624
10-7 Suggested Weights for Initiation of Weight Management Counseling 627
10-8 Calculation of Fat Grams 627
10-9 Night Eating Syndrome Description and Questionnaire 628
10-10 Power of Food Scale 628
10-11 Medications That Cause Weight Gain 632
10-12 Medications Used for Weight Reduction in the United States 633
10-13 Portion Adjustments Using Everyday Objects 634
10-14 Physical Activity Equivalents 634
10-15 Weight Management for Sleep Apnea and Pickwickian Syndrome 635
10-16 Managing Weight Gain after Smoking Cessation 635
10-17
Diet Program Comparisons 636
10-18 Strengthening Tips 640
10-19 Indicators of Malnutrition 641
10-20
10-21
10-22
Complicating Effects of Chronic Malnutrition on Body Systems 644
Malnutrition Universal Screening Tool 647
Severe and Nonsevere Malnutrition in Adults 648
10-23 Selected Biochemical Changes Observed in Severe Malnutrition 649
10-24 Poor Prognosis and Consequences of Not Feeding a Patient 650
10-25 Conditions with High Risk for Refeeding Syndrome 652
SECTION 11
11-1 Body Systems Affected by Autoimmune Disorders 656
11-2 Phytochemicals and Dietary Factors Affecting Rheumatic Disorders 657
11-3
Recommendations for the Prevention of Osteoporosis 660
11-4 Acquired Causes of Hyperuricemia 661
11-5
11-6
Clinical, Metabolic, and Endocrine Issues in Muscular Dystrophies 668
Medications Commonly Used for Osteoarthritis 675
11-7 Side Effects of Herbs, Supplements, and Extracts Commonly Used for Arthritis 676
11-8
Food, Nutrients, and Bone Health 680
11-9 Risk Factors for Osteoporosis 682
11-10 Tips on Calcium Supplements 684
11-11
Medications Commonly Used for Management of Osteoporosis 685
11-12 Features of Rheumatic Arthritis 692
11-13 Variant Forms of Rheumatic Arthritis 692
11-14 Medications Used in Rheumatoid Arthritis 695
SECTION 12
12-1
Nutritional Factors in Blood Formation 705
12-2 Anemia Definitions 706
12-3
12-4
Iron Tests 706
General Signs and Symptoms of Anemia 706
12-5 Signs and Symptoms of Aplastic or Fanconi Anemias 713
12-6 Symptoms of Copper Insufficiency and Anemia 716
12-7
12-8
12-9
Food Sources of Copper 717
Conditions and Medications That Deplete Folic Acid 718
Folic Acid Sources 719
12-10 Types of Hemolytic Anemia 721
12-11 Stages of Iron Deficiency 722
12-12
Normal Iron Distribution in the Body 722
12-13 Factors That Modify Iron Absorption 722
12-14 Medications to Correct Iron Deficiency Anemia 725
12-15
12-16
12-17
12-18
12-19
12-20
Micronutrient Deficiencies in Parasitic Anemias Such as Malaria 728
Risks and Causes of Pernicious Anemia or Vitamin B12
Deficiency Anemia 730
Equation to Predict Energy Needs in Adolescents with Sickle Cell Disease 735
Blood Clotting Cascade 738
Food Sources of Vitamin K 740
Iron Overloading and Hemochromatosis 741
SECTION 13
13-1 Cancer Definitions 751
13-2 Phytochemicals, Functional Food Ingredients, and Cancer 753
13-3 Cancer Risk Factors by Site 757
13-4 Use of Nutrition Support in Cancer Patients 759
13-5 Side Effects of Cancer Treatment and Common Nutrition-Related Problems of Cancer 760
13-6 Cancer Drugs and Chemotherapy Agents 764
13-7 Antineoplastic Agents: Generic and Brand Names 765
13-8 Herbs, Dietary Supplements, and Cancer 765
13-9 General Patient Education Tips 769
13-10 Neutropenic Diet Guidelines 773
13-11 Drugs Commonly Used in Bone Marrow or Stem Cell Transplantation 774
13-12 Types of Brain Tumors 776
13-13 Risks and Protective Factors for Colorectal Cancer 780
13-14 Key Factors in Types of Head and Neck Cancer 782
13-15 Risks for Gastric Cancer 785
13-16 Risk Factors for Liver Cancer 790
13-17 Staging of Breast Cancer 802
13-18 Preventive Dietary Factors for Prostate Cancer 807
13-19 Antioxidant Color Link 809
13-20 Types of Leukemia 811
SECTION 14
14-1 Postsurgical Phases in Nutrition 820
14-2 Time Required to Deplete Body Nutrient Reserves in Well-Nourished Individuals 821
14-3 Measuring Energy Expenditure in Critical Illness 823
14-4 The Small Intestine after Surgery 824
14-5 Managing Fluid and Electrolyte Imbalances 824
14-6 Signs and Symptoms of Fluid and Electrolyte Imbalances and Nutritional Concerns 825
14-7 Herbal Medications and Recommendations for Discontinued Use before Surgery 828
14-8 Percentage of Body Weight in Amputees 829
14-9 Surgeries, Level of Nutritional Acuity, and Nutritional Recommendations 829
14-10 Tips for Diet after Gastric Bypass 834
SECTION 15
15-1 How the Immune System Works 843
15-2 Immunocompetence Concerns 844
15-3 Nutritional and Host Factors in Immunity 845
15-4 Factors of Importance in Critical Care 846
15-5 Infections, Febrile Conditions, and Nutritional Implications 847
15-6 Virulence Increased by Iron 851
15-7 WHO Clinical Staging of HIV/AIDS for Adults and Adolescents 853
15-8 Guidelines for Nutrition Therapy in HIV Management 855
15-9 Medications Used for HIV Infections and AIDS 858
15-10 Pharmacotherapy for Burns 864
15-11 Intestinal Parasites and Treatments 870
15-12 Stages of Sepsis 877
SECTION 16
16-1 Human Kidney Functions 886
16-2 Renal Abbreviations 887
16-3 Stages, Symptoms, and Preventive Measures for Chronic Kidney Disease 890
16-4 Protein–Energy Malnutrition in Renal Patients 892
16-5 Spice and Condiment Substitutes for Salt 894
16-6 Tips for Managing Potassium and Phosphorous in the Diet 894
16-7 Drugs Used in Chronic Kidney Disease and Dialysis Patients 895
16-8 Tips for Managing Thirst and Fluid Restrictions 896
16-9 Nutrition Therapy for Dialysis Patients 899
16-10 Vitamin D3 Repletion 900
16-11 Role of the Renal Dietitian in Dialysis Care 900
16-12 Risk Factors for Developing Kidney Stones 906
16-13 Dietary Treatment of Specific Renal Stones 908
16-14 Complications after Renal Transplantation 916
16-15 Immunosuppressant Drugs Used after Renal Transplantation 918
SECTION 17
17-1 American Society for Parenteral and Enteral Nutrition Definition of Terms Related to Nutrition Support 925
17-2 Ethics of Nutrition Support Therapy and End-of-Life Care 926
17-3 Consequence Statement: Not Feeding a Resident/ Patient When Oral Intake Is Inadequate 929
17-4 Clinical Practice Guidelines for Nutrition Support 930
17-5 Sample Formula Types 931
17-6 Key Enteral Issues 932
17-7 Critical Control Point Checklist for Tube Feedings 933
17-8 Candidates for Central Parenteral Nutrition in Adults 936
17-9 Sample Basic Adult Daily Requirements for Central Parenteral Nutrition 939
17-10 Complications in Parenteral Nutrition 940
APPENDIX A
A-1 Carbohydrate and Fiber 946
A-2 Food Sources of Dietary Fiber 947
A-3 Fats and Lipids 948
A-4 Amino Acids 949
A-5 Biological Value of Proteins 951
A-6 Protein Sources 951
A-7 Food Sources of Calcium 953
A-8 Food Sources of Magnesium 954
A-9 Food Sources of Potassium 955
A-10 Food Sources of Iron 959
A-11 Food Sources of Vitamin A 963
A-12 Food Sources of Vitamin D 964
A-13 Food Sources of Vitamin E 965
A-14 Food Sources of Vitamin K 966
A-15 Food Sources of Folic Acid 969
A-16 Food Sources of Vitamin B12 970
A-17 Food Sources of Vitamin C 971
APPENDIX B
B-1 Advantages of Interdisciplinary Team Care 974
B-2 Sample Hospital Nutrition Department Scope of Services 978
B-3 Dietary Intake Assessment and Nutrition History 980
B-4 Initial Adult Nutrition Assessment 981
B-5 Clinical Signs of Malnutrition and the NutritionFocused Physical Examination 982
B-6 Calculation of Adult Energy Requirements 983
B-7 Calculations of Adult Protein Requirements 985
B-8 Pediatric Nutrition Assessment 985
B-9 Interpretation of Lab Values 986
B-10 Quick Reference: Food–Drug Interactions 997
B-11 Sample Worksheet for Using Standardized Nutrition Terminology 998
B-12 Clinical Case Review and Audit 999
B-13 Tips for Adult Education and Counseling 1000
B-14 Terms and Phrases Useful in Open-Ended Questioning 1004
B-15 Health-Promotion Intervention Models 1004
B-16 Monitoring and Evaluation for Patient Education/ Counseling Outcomes 1007
APPENDIX C
C-1 Nutrition Acuity and Medical Diagnosis–Related Survey Questions 1011
C-2 Acuity for Dietitian Roles in Medical Diagnoses 1011
CONTENTS
Foreword v
Preface vii
Acknowledgments ix
Reviewers xi
Common Abbreviations xiii
List of Tables xv
Alphabetical List of Topics xxv
SECTION 1
NORMAL LIFE STAGES 1
Pregnancy and Lactation 5
Pregnancy 5
Lactation 13
Infancy, Childhood, and Adolescence 19
Infant (0 to 6 Months) 19
Infant (6 to 12 Months) 23
Childhood 27
Adolescence 34
Physical Fitness and Stages of Adulthood 39
Sports Nutrition 39
Adulthood 44
Nutrition in Aging 59
SECTION 2
NUTRITION PRACTICES, FOOD SAFETY, ALLERGIES, SKIN, AND MISCELLANEOUS CONDITIONS 69
Complementary-Alternative or Traditional Nutrition 70
Complementary-Alternative or Traditional Nutrition 70
Cultural Food Patterns, Vegetarianism, and Religious Practices 85
Cultural Food Patterns 85
Vegetarianism 89
Eastern Religious Dietary Practices 92
Western Religious Dietary Practices 94
Middle Eastern Religious Dietary Practices 96
Orofacial Conditions 98
Dental and Oral Disorders 98
Periodontal Disease and Gingivitis 103
Temporomandibular Joint Dysfunction 106
Sensory Impairment 107
Sensory Impairments: Vision, Coordination, Chewing, and Hearing 107
Skin Conditions, Pressure Ulcers, and Vitamin Deficiencies 113
Skin Disorders 113
Pressure Ulcers 116
Vitamin Deficiencies 119
Food Allergy and Autoimmune Inner Ear Syndrome 122
Food Allergy 122
Autoimmune Inner Ear Disease (Ménière Syndrome) 131
Food Poisoning 132
Food Poisoning 132
SECTION 3
PEDIATRICS: BIRTH DEFECTS AND GENETIC AND ACQUIRED DISORDERS 139
Abetalipoproteinemia 144
Attention Deficit Disorders 145
Autism Spectrum Disorder 148
Biliary Atresia 151
Bronchopulmonary Dysplasia 153
Carbohydrate Metabolic Disorders 156
Cerebral Palsy 159
Cleft Lip and Palate 162
Congenital Heart Disease 164
Cystinosis and Fanconi Syndrome 166
Down’s Syndrome 168
Failure to Thrive 170
Fatty Acid Oxidation Disorders 173
Fetal Alcohol Syndrome 175
Hirschsprung Disease (Congenital Megacolon) 177
HIV Infection, Pediatric 179
Homocystinuria and Inborn Errors of Cobalamin and Folate 181
Large for Gestational Age (Macrosomia) 184
Leukodystrophies 186
Low Birth Weight or Prematurity 188
Maple Syrup Urine Disease 192
Mucopolysaccharidoses 194
Necrotizing Enterocolitis 197
Neural Tube Defects: Spina Bifida and Melomeningocele 199
Obesity, Childhood 202
Otitis Media 208
Phenylketonuria 209
Prader-Willi Syndrome 212
Rickets 214
Small for Gestational Age and Intrauterine Growth Restriction 216
Tyrosinemia 218
Urea Cycle Disorders 220
Wilson Disease 224
SECTION 4
NEUROPSYCHIATRIC CONDITIONS 227
Neurologic Disorders 235
Alzheimer’s Disease and Dementias 235
Amyotrophic Lateral Sclerosis 239
Brain Trauma 241
Cerebral Aneurysm 244
Coma or Persistent Vegetative State 246
Epilepsy and Seizure Disorders 248
Guillain–Barré Syndrome 251
Huntington Disease 252
Migraine 255
Multiple Sclerosis 258
Myasthenia Gravis and Neuromuscular Junction Disorders 261
Parkinson’s Disease 263
Spinal Cord Injury and Paralysis 266
Stroke (Cerebrovascular Accident) 269
Trigeminal Neuralgia 273
Psychiatric Disorders—Eating Disorders 275
Anorexia Nervosa 275
Binge Eating Disorder 278
Bulimia Nervosa 280
Psychiatric Disorders–Other 283
Bipolar Disorder 283
Depression 288
Schizophrenia 291
Sleep and Circadian Rhythm Disorders 294
Substance Use Disorder and Addiction 297
Tardive Dyskinesia 300
SECTION 5
PULMONARY DISORDERS 303
Asthma 306
Bronchiectasis 310
Bronchitis 312
Chronic Obstructive Pulmonary Disease 315
Chylothorax 319
Cor Pulmonale 320
Cystic Fibrosis 322
Interstitial Lung Disease 326
Pneumonia 328
Pulmonary Embolism 331
Respiratory Distress Syndrome 333
Respiratory Failure and Ventilator Dependency 335
Sarcoidosis 337
Sleep Apnea 340
Thoracic Empyema 342
Transplantation, Lung 344
Tuberculosis 346
SECTION 6
CARDIOVASCULAR DISORDERS 351
Angina Pectoris 358
Arteritis and Vasculitis 361
Atherosclerotic Cardiovascular Disease 363
Cardiac Cachexia 368
Cardiomyopathies 370
Heart Failure 373
Heart or Heart–Lung Transplantation 378
Heart Valve Diseases 380
Hypertension 383
Myocardial Infarction 388
Pericarditis and Cardiac Tamponade 391
Peripheral Artery Disease 393
Thrombophlebitis 395
SECTION 7
GASTROINTESTINAL DISORDERS 399
Upper GI: Esophagus 403
Dysphagia 403
Esophageal Disorders 406
Esophageal Trauma 408
Esophageal Varices 409
Esophagitis, GERD, and Hiatal Hernia 411
Stomach 414
Dyspepsia, Indigestion, or Bezoar Formation 414
Gastrectomy and Vagotomy 416
Gastritis and Gastroenteritis 418
Gastroparesis and Gastric Retention 420
Giant Hypertrophic Gastritis and Ménétrier Disease 422
Peptic Ulcer Disease 423
Vomiting, Pernicious 427
Lower GI: Intestinal Disorders 429
Carcinoid Syndrome 429
Celiac Disease 431
Constipation 435
Diarrhea, Dysentery, and Traveler’s Diarrhea 437
Diverticular Diseases 442
Fat Malabsorption Syndrome 444
Inflammatory Bowel Disease: Crohn’s Disease 447
Inflammatory Bowel Disease: Ulcerative Colitis 451
Intestinal Fistula 454
Intestinal Lymphangiectasia 456
Intestinal Transplantation 457
Irritable Bowel Syndrome 460
Lactose Maldigestion 463
Megacolon 466
Ostomy: Colostomy 467
Ostomy: Ileostomy 470
Peritonitis 472
Short Bowel Syndrome and Intestinal Failure 473
Tropical Sprue 477
Whipple Disease (Intestinal Lipodystrophy) 479
Rectal Disorders 480
Fecal Incontinence 480
Hemorrhoids 484
Proctitis 485
SECTION 8
HEPATIC, PANCREATIC, AND BILIARY DISORDERS 487
Liver Disorders 490
Alcoholic Liver Disease 490
Ascites and Chylous Ascites 494
Hepatitis 496
Hepatic Cirrhosis 500
Hepatic Failure, Encephalopathy, and Coma 504
Liver Transplantation 511
Pancreatic Disorders 514
Pancreatitis, Acute 514
Pancreatitis, Chronic 522
Pancreatic Insufficiency 525
Pancreatic Islet Cell Transplantation 527
Zollinger–Ellison Syndrome 529
Biliary Disorders 531
Biliary Cirrhosis 531
Cholestasis 532
Gallbladder Disease 534
SECTION 9
ENDOCRINE DISORDERS 537
Diabetes Mellitus 545
Diabetes Mellitus, Type 1 545
Gestational Diabetes 554
Prediabetes 558
Type 2 Diabetes in Adults 560
Type 2 Diabetes in Children and Teens 565
Diabetes Complications and Related Conditions 568
Diabetic Gastroparesis 568
Diabetic Ketoacidosis 570
Hyperosmolar Hyperglycemic Syndrome 573
Hypoglycemia 575
Hypoglycemia with Hyperinsulinism 577
Metabolic Syndrome 579
Preeclampsia and Hypertensive Disorders in Pregnancy 581
Pituitary Gland (Anterior) 587
Acromegaly 587
Pituitary Gland (Anterior) 588
Cushing Syndrome 588
Pituitary Gland (Posterior) 590
Diabetes Insipidus 590
Pituitary Gland 592
Hypopituitarism 592
Pituitary Gland 594
Syndrome of Inappropriate Antidiuretic Hormone 594
Ovary 596
Polycystic Ovarian Syndrome 596
Adrenal Gland (Cortex) 598
Adrenocortical Insufficiency and Addison Disease 598
Adrenal Gland (Cortex) 600
Hyperaldosteronism 600
Adrenal Gland (Medulla) 602
Pheochromocytoma 602
Thyroid Gland 604
Hyperthyroidism 604
Thyroid Gland 607
Hypothyroidism 607
Parathyroid Glands 610
Hypoparathyroidism and Hypocalcemia 611
Hyperparathyroidism and Hypercalcemia 613
SECTION 10
MALNUTRITION: OVERNUTRITION AND UNDERNUTRITION 617
Overnutrition 625
Overweight and Obesity 625
Undernutrition 637
Underweight, Unintentional Weight Loss, and Sarcopenia 637
Undernutrition and Malnutrition in Children and Adults 643
Refeeding Syndrome 651
SECTION 11
MUSCULOSKELETAL AND COLLAGEN DISORDERS 655
Gout 660
Immobilization 663
Lupus 665
Muscular Dystrophy 668
Myofascial Pain Syndromes: Fibromyalgia and Polymyalgia Rheumatica 671
Osteoarthritis 673
Osteomyelitis 677
Osteomalacia 679
Osteopenia and Osteoporosis 681
Paget Disease (Osteitis Deformans) 686
Polyarteritis Nodosa 688
Rhabdomyolysis 690
Rheumatoid Arthritis 691
Ruptured or Herniated Disk 697
Scleroderma (Systemic Sclerosis) 699
Spondyloarthritis 701
SECTION 12
HEMATOLOGY: ANEMIAS AND BLOOD DISORDERS 703
Anemias 707
Anemia of Chronic Disease 707
Anemias in Neonates 709
Anemia of Renal Disease 711
Aplastic Anemia and Fanconi Anemia 713
Copper Deficiency Anemia 715
Folic Acid Deficiency Anemia 717
Hemolytic Anemias 720
Iron Deficiency Anemia 722
Malaria and Parasitic Anemias 726
Megaloblastic Anemias 729
Pernicious and Vitamin B12 Deficiency Anemias 729
Sideroblastic Anemia 732
Hemoglobinopathies 733
Sickle Cell Anemia 733
Thalassemias 736
Other Blood Disorders 738
Bleeding Disorders: Hemorrhage and Hemophilia 738
Hemochromatosis and Iron Overload 741
Polycythemia Vera 743
Thrombocytopenia 745
SECTION 13
CANCER 749
Cancer Treatment and Survival 758
Cancer: Treatment Guidelines 758
Bone Cancer and Osteosarcoma 770
Bone Marrow or Hematopoietic Stem Cell Transplantation 772
Brain Tumor 776
Colorectal Cancer 778
Esophageal, Head-Neck, and Thyroid Cancers 782
Gastric Cancer 785
Kidney, Bladder, and Urinary Tract Cancers 787
Liver Cancer 790
Lung Cancer 793
Pancreatic Cancer 795
Skin Cancers 798
Hormonal Cancers 802
Breast Cancer 802
Choriocarcinoma 805
Prostate Cancer 807
Hematological Cancers 810
Leukemias 810
Lymphomas 814
Myeloma 816
SECTION 14
SURGICAL DISORDERS 819
General Surgical Guidelines 820 Surgery 820
Gastrointestinal Surgeries 832
Bariatric and Weight Loss Surgeries 832
Bowel Surgery 837
SECTION 15
HIV-AIDS AND IMMUNOLOGY, BURNS, SEPSIS, AND TRAUMA 841
AIDS and HIV Infection 853
Burn Injury 861
Fractures 866
Intestinal Parasite Infections 868
Multiple Organ Dysfunction Syndrome 873
Sepsis and Systemic Inflammatory Response Syndrome 876
Trauma 881
SECTION 16
RENAL DISORDERS 885
Chronic Kidney Disease and Renal Failure 888
Dialysis 897
Glomerular and Autoimmune Kidney Diseases 901
Glomerular Basement Membrane Disorders 904
Kidney Stones 906
Nephrotic Syndrome 909
Renal Metabolic Disorders: Hypophosphatemic Rickets and Hartnup Disorder 912
Polycystic Kidney Disease 914
Renal Transplantation 916
Urinary Tract Infections 919
SECTION 17
ENTERAL AND PARENTERAL NUTRITION THERAPY 923
Enteral Nutrition 927
Parenteral Nutrition 935
APPENDIX A
Nutritional Review 943
Recommended Dietary Allowances and Dietary Reference Intakes 943
Macronutrients 943
Micronutrients 952
Vitamins 961
APPENDIX B
Nutrition Care Process and Forms 973
Introduction to the Practice of Dietetics 973
Nutrition Care Process Tools and Documentation Forms 978
APPENDIX C
Acuity Ranking for Dietitian Services 1011
Index 1017
ALPHABETICAL LIST OF TOPICS
Abetalipoproteinemia 144
Acromegaly 587
Adolescence 34
Adrenocortical Insufficiency and Addison Disease 598
Adulthood 44
AIDS and HIV Infection 853
Alcoholic Liver Disease 490
Alzheimer’s Disease and Dementias 235
Amyotrophic Lateral Sclerosis 239
Anemia of Chronic Disease 707
Anemia of Renal Disease 711
Anemias in Neonates 709
Angina Pectoris 358
Anorexia Nervosa 275
Aplastic Anemia and Fanconi Anemia 713
Arteritis and Vasculitis 361
Ascites and Chylous Ascites 494
Asthma 306
Atherosclerotic Cardiovascular Disease 363
Attention Deficit Disorders 145
Autism Spectrum Disorder 148
Autoimmune Inner Ear Disease (Ménière Syndrome) 131
Bariatric and Weight Loss Surgeries 832
Biliary Atresia 151
Biliary Cirrhosis 531
Binge Eating Disorder 278
Bipolar Disorder 283
Bleeding Disorders: Hemorrhage and Hemophilia 738
Bone Cancer and Osteosarcoma 770
Bone Marrow or Hematopoietic Stem Cell Transplantation 772
Bowel Surgery 837
Brain Trauma 241
Brain Tumor 776
Breast Cancer 802
Bronchiectasis 310
Bronchitis 312
Bronchopulmonary Dysplasia 153
Bulimia Nervosa 280
Burn Injury 861
Cancer: Treatment Guidelines 758
Carbohydrate Metabolic Disorders 156
Carcinoid Syndrome 429
Cardiac Cachexia 368
Cardiomyopathies 370
Celiac Disease 431
Cerebral Aneurysm 244
Cerebral Palsy 159
Childhood 27
Cholestasis 532
Choriocarcinoma 805
Chronic Kidney Disease and Renal Failure 888
Chronic Obstructive Pulmonary Disease 315
Chylothorax 319
Cleft Lip and Palate 162
Colorectal Cancer 778
Coma or Persistent Vegetative State 246
Complementary-Alternative or Traditional Nutrition 70
Congenital Heart Disease 164
Constipation 435
Copper Deficiency Anemia 715
Cor Pulmonale 320
Cultural Food Patterns 85
Cushing Syndrome 588
Cystic Fibrosis 322
Cystinosis and Fanconi Syndrome 166
Dental and Oral Disorders 98
Depression 288
Diabetes Insipidus 590
Diabetes Mellitus, Type 1 545
Diabetic Gastroparesis 568
Diabetic Ketoacidosis 570
Dialysis 897
Diarrhea, Dysentery, and Traveler’s Diarrhea 437
Diverticular Diseases 442
Down’s Syndrome 168
Dyspepsia, Indigestion, or Bezoar Formation 414
Dysphagia 403
Eastern Religious Dietary Practices 92
Enteral Nutrition 927
Epilepsy and Seizure Disorders 248
Esophageal Disorders 406
Esophageal Trauma 408
Esophageal Varices 409
Esophageal, Head-Neck, and Thyroid Cancers 782
Esophagitis, GERD, and Hiatal Hernia 411
Failure to Thrive 170
Fat Malabsorption Syndrome 444
Fatty Acid Oxidation Disorders 173
Fecal Incontinence 480
Fetal Alcohol Syndrome 175
Folic Acid Deficiency Anemia 717
Food Allergy 122
Food Poisoning 132
Fractures 866
Gallbladder Disease 534
Gastrectomy and Vagotomy 416
Gastric Cancer 785
Gastritis and Gastroenteritis 418
Gastroparesis and Gastric Retention 420
Gestational Diabetes 554
Giant Hypertrophic Gastritis and Ménétrier Disease 422
Glomerular and Autoimmune Kidney Diseases 901
Glomerular Basement Membrane Disorders 904
Gout 660
Guillain–Barré Syndrome 251
Heart Failure 373
Heart or Heart–Lung Transplantation 378
Heart Valve Diseases 380
Hemochromatosis and Iron Overload 741
Hemolytic Anemias 720
Hemorrhoids 484
Hepatic Cirrhosis 500
Hepatic Failure, Encephalopathy, and Coma 504
Hepatitis 496
Hirschsprung Disease (Congenital Megacolon) 177
HIV Infection, Pediatric 179
Homocystinuria and Inborn Errors of Cobalamin and Folate 181
Huntington Disease 252
Hyperaldosteronism 600
Hyperosmolar Hyperglycemic Syndrome 573
Hyperparathyroidism and Hypercalcemia 613
Hypertension 383
Hyperthyroidism 604
Hypoglycemia 575
Hypoglycemia with Hyperinsulinism 577
Hypoparathyroidism and Hypocalcemia 611
Hypopituitarism 592
Hypothyroidism 607
Immobilization 663
Infant (0 to 6 Months) 19
Infant (6 to 12 Months) 23
Inflammatory Bowel Disease: Crohn’s Disease 447
Inflammatory Bowel Disease: Ulcerative Colitis 451
Interstitial Lung Disease 326
Intestinal Fistula 454
Intestinal Lymphangiectasia 456
Intestinal Parasite Infections 868
Intestinal Transplantation 457
Iron Deficiency Anemia 722
Irritable Bowel Syndrome 460
Kidney Stones 906
Kidney, Bladder, and Urinary Tract Cancers 787
Lactation 13
Lactose Maldigestion 463
Large for Gestational Age (Macrosomia) 184
Leukemias 810
Leukodystrophies 186
Liver Cancer 790
Liver Transplantation 511
Low Birth Weight or Prematurity 188
Lung Cancer 793
Lupus 665
Lymphomas 814
Macronutrients 943
Malaria and Parasitic Anemias 726
Maple Syrup Urine Disease 192
Megacolon 466
Metabolic Syndrome 579
Micronutrients 952
Middle Eastern Religious Dietary Practices 96
Migraine 255
Mucopolysaccharidoses 194
Multiple Organ Dysfunction Syndrome 873
Multiple Sclerosis 258
Muscular Dystrophy 668
Myasthenia Gravis and Neuromuscular Junction Disorders 261
Myeloma 816
Myocardial Infarction 388
Myofascial Pain Syndromes: Fibromyalgia and Polymyalgia
Rheumatica 671
Necrotizing Enterocolitis 197
Nephrotic Syndrome 909
Neural Tube Defects: Spina Bifida, and Melomeningocele 199
Nutrition in Aging 59
Obesity, Childhood 202
Osteoarthritis 673
Osteomalacia 679
Osteomyelitis 677
Osteopenia and Osteoporosis 681
Ostomy: Colostomy 467
Ostomy: Ileostomy 470
Otitis Media 208
Overweight and Obesity 625
Paget Disease (Osteitis Deformans) 686
Pancreatic Cancer 795
Pancreatic Insufficiency 525
Pancreatic Islet Cell Transplantation 527
Pancreatitis, Acute 514
Pancreatitis, Chronic 522
Parenteral Nutrition 935
Parkinson’s Disease 263
Peptic Ulcer Disease 423
Pericarditis and Cardiac Tamponade 391
Periodontal Disease and Gingivitis 103
Peripheral Artery Disease 393
Peritonitis 472
Pernicious and Vitamin B12 Deficiency Anemias 729
Phenylketonuria 209
Pheochromocytoma 602
Pneumonia 328
Polyarteritis Nodosa 688
Polycystic Kidney Disease 914
Polycystic Ovarian Syndrome 596
Polycythemia Vera 743
Prader-Willi Syndrome 212
Prediabetes 558
Preeclampsia and Hypertensive Disorders in Pregnancy 581
Pregnancy 5
Pressure Ulcers 116
Proctitis 485
Prostate Cancer 807
Pulmonary Embolism 331
Recommended Dietary Allowances and Dietary Reference Intakes 943
Refeeding Syndrome 651
Renal Metabolic Disorders: Hypophosphatemic Rickets and Hartnup Disorder 912
Renal Transplantation 916
Respiratory Distress Syndrome 333
Respiratory Failure and Ventilator Dependency 335
Rhabdomyolysis 690
Rheumatoid Arthritis 691
Rickets 214
Ruptured or Herniated Disk 697
Sarcoidosis 337
Schizophrenia 291
Scleroderma (Systemic Sclerosis) 699
Sensory Impairments: Vision, Coordination, Chewing, Hearing 107
Sepsis and Systemic Inflammatory Response Syndrome 876
Short Bowel Syndrome and Intestinal Failure 473
Sickle Cell Anemia 733
Sideroblastic Anemia 732
Skin Cancers 798
Skin Disorders 113
Sleep and Circadian Rhythm Disorders 294
Sleep Apnea 340
Small for Gestational Age and Intrauterine Growth Restriction 216
Spinal Cord Injury and Paralysis 266
Spondyloarthritis 701
Sports Nutrition 39
Stroke (Cerebrovascular Accident) 269
Substance Use Disorder and Addiction 297
Surgery 820
Syndrome of Inappropriate Antidiuretic Hormone 594
Tardive Dyskinesia 300
Temporomandibular Joint Dysfunction 106
Thalassemias 736
Thoracic Empyema 342
Thrombocytopenia 745
Thrombophlebitis 395
Transplantation, Lung 344
Trauma 881
Trigeminal Neuralgia 273
Tropical Sprue 477
Tuberculosis 346
Type 2 Diabetes in Adults 560
Type 2 Diabetes in Children and Teens 565
Tyrosinemia 218
Undernutrition and Malnutrition in Children and Adults 643
Underweight, Unintentional Weight Loss, and Sarcopenia 637
Urea Cycle Disorders 220
Urinary Tract Infections 919
Vegetarianism 89
Vitamin Deficiencies 119
Vitamins 961
Vomiting, Pernicious 427
Western Religious Dietary Practices 94
Whipple Disease (Intestinal Lipodystrophy) 479
Wilson Disease 224
Zollinger–Ellison Syndrome 529
1
● Priority factors: unintentional weight loss with appetite changes in adults, protein-energy deficiency or growth retardation in children
● Body fat and muscle mass: weight, height, body mass index (BMI), percentage of healthy body weight (HBW) for height, loss of lean body mass (LBM), previous weight percentile or curve, weight changes, waist circumference, skinfold measurements, visceral proteins, estimated basal energy expenditure, and nitrogen balance
● Illiteracy or low educational level: low socioeconomic status, food insecurity
● Hair or nails: changes, rashes, itching, lesions, turgor, petechiae, pallor
● Eyes: glasses, blurred vision, glaucoma, cataracts, or macular degeneration
● Ears, nose: hearing loss, chronic otitis media, altered sense of smell, nasal obstruction, sinusitis
● Dental and mouth: ill-fitting dentures, loose or missing teeth, caries, bleeding gums, severe gum disease, poor oral hygiene, taste alterations, dysphagia
● Neurologic: headache, seizures, convulsions, altered speech, paralysis, altered gait, anxiety, memory loss, altered sleep patterns, depression, substance abuse, low motivation, fatigue, weakness, fever or chills, excessive sweating, tremors
● Heart: chest pain, dyspnea, wheezing, cough, hemoptysis, ventilator support, altered blood gas levels, abnormal blood pressure, electrolyte imbalance, cyanosis, edema, ascites, low cardiac output
● Blood: anemias, altered heart rate, arrhythmias, blood loss
● Gastrointestinal (GI): cachexia, anorexia, nausea, diarrhea, vomiting, jaundice, constipation, indigestion, ulcers, hemorrhoids, melena, altered stool characteristics, gluten intolerance, lactase insufficiency
● Therapies: radiation, chemotherapy, physical therapy, dialysis, recent surgery or hospitalizations
● Urinary and renal: hematuria, fluid requirements, specific gravity, urinary tract infections, renal disease or stones
● Hormonal balance: altered blood glucose, hyper- or hypothyroidism, goiter, glucose intolerance or metabolic syndrome
● Immunity: food allergies or intolerances, sensitivities, cellular immunity, HIV or other chronic infections, inflammation
● Musculoskeletal system: pain, arthritis, numbness, amputations, limited range of motion or muscular strength
● Phenotype or genotype
● Nutrition: any special diets or nutrition support, dietary pattern, typical intake of food and alcohol, use of vitamin/minerals/herbs/botanicals/supplements, overthe-counter and prescribed medications, knowledge of food and nutrition
OVERVIEW
Noncommunicable diseases (NCD) contribute to morbidity and mortality in both developed and developing countries; most are preventable through modification of lifestyle and nutrition. Alleviating undernutrition, correcting nutritional deficiencies, promoting better quality diets, and incorporating functional foods may alleviate chronic disease burden (Lenoir-Wijnkoop et al, 2013). Food intake, lifestyle behaviors, and obesity are linked to the development of chronic diseases and certain life stages are especially important for health promotion efforts (Fitzgerald et al, 2013). Public health measures have been established to promote wellness and reduce disease for all ages (Table 1-1).
Demographic shifts in the age and racial/ethnic composition of the U.S. population will require new medical nutrition therapies that are cost effective, health promoting, and culturally appropriate (Haughton and Stang, 2012). Because primary prevention is the most effective, affordable method to prevent chronic disease, the Nutrition Care Process should be used by Registered Dietitians (RDs) and dietetic technicians, registered (DTRs) for carrying out these steps (Fitzgerald et al, 2013).
Positive influence can be applied across the spectrum of engagement: at intrapersonal, interpersonal, institutional, community, and public policy levels (Slawson et al, 2013). Two of the most important aspects will be the avoidance of obesity and the consumption of an anti-inflammatory diet. These will help to protect against cancer and heart disease, as well as metabolic disorders.
TABLE 1-1 Public Health: Ten Achievements and Ten Essential Services
10 PUBLIC HEALTH ACHIEVEMENTS IN THE 20TH CENTURY
• Development of immunizations
• Increased motor vehicle safety
• Safer workplaces
• Control of infectious diseases
• Decline in deaths from heart disease and stroke
• Safer and healthier foods
• Healthier mothers and babies
• Family planning
• Fluoridation of drinking water
• Recognition of tobacco as a health hazard
10 ESSENTIAL PUBLIC HEALTH SERVICES
• Monitor health status to identify community health problems.
• Diagnose and investigate health problems and hazards in the community.
• Inform, educate, and empower people about health issues.
• Mobilize community partnerships to identify and solve health problems.
• Develop policies and plans that support individual and community health efforts.
• Enforce laws and regulations that protect health and ensure safety.
• Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
• Assure competent public health and personal health care workforce.
• Evaluate effectiveness, accessibility, and quality of personal and populationbased health services.
• Research for new insights and innovative solutions to health problems.
Adapted from: Centers for Disease Control and Prevention. Ten great public health achievements in the 20th century. Available at: http://www.cdc.gov/about/history/tengpha.htm. Accessed June 15, 2014; and from American Public Health Association. Available at: http:// www.health.gov/phfunctions/public.htm. Accessed June 15, 2014.
HOT TOPIC
HInflammation
Obesity leads to a chronic low-grade inflammation of adipose tissue, which disrupts endocrine function and results in metabolic derangements, including type 2 diabetes (Siriwardhana et al, 2013). Dietary bioactive compounds can be eaten to suppress both systemic and adipose tissue inflammation. Curcumin, resveratrol, catechins (tea-polyphenols), quercetin, and isoflavones suppress nuclear factor- B (NF- B) and other inflammatory pathways (Siriwardhana et al, 2013). Dietary polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), conjugated linoleic acid (CLA), and monounsaturated oleic acid have anti-inflammatory effects by down-regulating tumor necrosis factor (TNF)alpha and other inflammation markers (Murumalla et al, 2012). Thus, eating an anti-inflammatory diet should be a major focus of public health messaging by RDs.
International and U.S. regulatory, policy, and clinical practitioners are working together on a variety of topics, including clinical guidelines (Wong et al, 2011). The field of “nutrition economics” merges nutrition, influences on health outcomes, and economics to estimate the monetary impact of health measures (Lenoir-Wijnkoop et al, 2011).
The Food and Agriculture Organization (FAO) and the World Health Organization (WHO) have frequently brought together scientists and experts in agriculture to address nutrition and malnutrition (FAO, 2013). Dietary guidelines offer dietary advice for the population to promote overall nutritional wellbeing. As a result, many countries have established food-based dietary guidelines. Table 1-2 highlights several key principles. The MyPlate campaign (Fig. 1-1) provides a simplified illustration of the U.S. guidelines. MyPlate is divided into sections of approximately 30% grains, 30% vegetables, 20% fruits, and 20% protein-rich foods. A smaller circle represents dairy foods like a glass of low-fat/nonfat milk or a cup of yogurt.
REFERENCES
Fitzgerald N, et al. Practice paper of the Academy of Nutrition and Dietetics abstract: the role of nutrition in health promotion and chronic disease prevention. J Acad Nutr Diet. 2013;113:983.
Food and Agriculture Organization (FAO). The International Conference on Nutrition. Available at: http://www.fao.org/docrep/v7700t/v7700t02.htm. Accessed June 13, 2014.
Haughton B, Stang J. Population risk factors and trends in health care and public policy. J Acad Nutr Diet. 2012;112:35S.
Lenoir-Wijnkoop I, et al. Nutrition economics—characterising the economic and health impact of nutrition. Br J Nutr. 2011;105:157.
Lenoir-Wijnkoop I, et al. Nutrition economics—food as an ally of public health. Br J Nutr. 2013;109:777.
Murumalla RK, et al. Fatty acids do not pay the toll: effect of SFA and PUFA on human adipose tissue and mature adipocytes inflammation. Lipids Health Dis 2012;11:175.
Siriwardhana N, et al. Modulation of adipose tissue inflammation by bioactive food compounds. J Nutr Biochem. 2013;24:613.
Slawson DL, et al. Position of the Academy of Nutrition and Dietetics: the role of nutrition in health promotion and chronic disease prevention. J Acad Nutr Diet. 2013;113:972.
Wong JB, et al. Economic analysis of nutrition interventions for chronic disease prevention: methods, research, and policy. Nutr Rev. 2011;69:533.
