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Contents<br/><br/>Part one: Nutrition Basics<br/>1 What Nourishes You? 1<br/>Case Scenario 1<br/>Refresh Your Memory 2<br/>Chapter Objectives 2<br/>Nutrition and Your Health 3<br/>What Actually Is Nutrition? 3<br/>Nutrients Come from Food 3<br/>Why Study Nutrition? 3<br/>Classes and Sources of Nutrients 5<br/>Carbohydrates 6<br/>Lipids 7<br/>Proteins 8<br/>Vitamins 8<br/>Minerals 9<br/>Water 9<br/>Nutrient Composition of Diets and the Human Body 9<br/>Energy Sources and Uses 10<br/>Interest in the Field of Nutrition Has a Long History 12<br/>Current State of the North American Diet 13<br/>Assessing the Current North American Diet 14<br/>What Influences These Food Choices? 14<br/>Improving Our Diets 16<br/>Health Objectives for the United States for the Year 2010 Include<br/>Numerous Nutrition Objectives 16<br/>Using Scientific Research to Determine Nutrient Needs 19<br/>Expert Opinion Who Are North America?s Nutrition Experts? Anne M. Smith, Ph.D., <br/>R.D. 20<br/>Asking Questions and Generating Hypotheses 22<br/>Laboratory Animal Experiments 22<br/>Human Experiments 23<br/>Peer Review of Experimental Results 24<br/>Follow-up Studies 25<br/>How to Use This Knowledge to Evaluate Nutrition Claims and Advice 25<br/>Summary 28<br/>Study Questions 28<br/>Annotated References 28<br/>Take Action 30<br/>Nutrition Perspective Genetics and Nutrition 31<br/><br/>2. The Basis of a Healthy Diet 35<br/>Case Scenario 35<br/>Refresh Your Memory 36<br/>Chapter Objectives 36<br/>A Food Philosophy That Works 37<br/>Variety Contributes to Diet Adequacy 37<br/>Balance Means Not Overconsuming Any One Food 38<br/>Moderation Refers Mostly to Portion Size 39<br/>Nutrient Density Can Also Help Guide Food Choice 40<br/>Energy Density Especially Influences Energy Intake 41<br/>States of Nutritional Health 42<br/>Desirable Nutrition 42<br/>Undernutrition 42<br/>Overnutrition 43<br/>How Could Your Nutritional State Be Measured? 44<br/>Analyzing Background Factors 44<br/>Evaluating the ABCDEs 44<br/>Recognizing the Limitations of Nutritional Assessment 45<br/>Concern About Your Nutritional State of Health Is Important 46<br/>Setting Nutrient Needs--Dietary Reference Intakes (DRIs) 46<br/>Estimated Average Requirements (EARs) 47<br/>Recommended Dietary Allowances (RDAs) 48<br/>Adequate Intakes (AIs) 48<br/>Estimated Energy Requirements (EERs) 49<br/>Tolerable Upper Intake Levels (Upper Levels or ULs) 49<br/>Appropriate Uses of the DRIs 49<br/>Daily Values (DVs): The Standards Used for Food Labeling 50<br/>Reference Daily Intakes (RDIs) 50<br/>Daily Reference Values (DRVs) 50<br/>Daily Values in Perspective 52<br/>From Nutrient Recommendations to Food Choices 53<br/>The Food Guide Pyramid--A Menu-Planning Tool 53<br/>Dietary Guidelines for Americans--Another Tool for Menu Planning 59<br/>Expert Opinion What Should I Eat to Live Longer? David Klurfeld, Ph.D. 62<br/>Case Scenario Follow-up 62<br/>What Do Food Labels Have to Offer Diet Planning? 64<br/>Exceptions to Food Labeling 67<br/>Health Claims on Food Labels 67<br/>Summary 68<br/>Study Questions 69<br/>Annotated References 69<br/>Take Action 71<br/>Nutrition Perspective Ethnic Influences on the North American Diet 73<br/><br/>3. Human Digestion and Absorption 79<br/>Case Scenario 79<br/>Refresh Your Memory 80<br/>Chapter Objectives 80<br/>The Cell Is the Basis of Human Physiology 81<br/>Organization of the Human Body 82<br/>The Physiology of Digestion 83<br/>The Flow of Digestion 84<br/>A Closer Look at Enzymes in Digestion 89<br/>Gastrointestinal Hormones--A Key to Orchestrating Digestion 90<br/>Gastrointestinal Control Valves: Sphincters 90<br/>Gastrointestinal Muscularity: Mixing and Propulsion 91<br/>The Physiology of Absorption 93<br/>Absorptive Cells 94<br/>Types of Absorption 94<br/>Portal and Lymphatic Circulation in Absorption 94<br/>Enterohepatic Circulation 95<br/>Absorption Is Completed in the Large Intestine 96<br/>Storage Capabilities of the Body 97<br/>Expert Opinion Probiotics, Prebiotics, and Human Health, Steve Hertzler, Ph.D., <br/>R.D. 98<br/>Summary 100<br/>Study Questions 100<br/>Annotated References 101<br/>Take Action 102<br/>Nutrition Perspective When the Digestive Processes Go Awry 103<br/>Case Scenario Follow-up 104<br/><br/>4. Metabolism 107<br/>Case Scenario 107<br/>Refresh Your Memory 108<br/>Chapter Objectives 108<br/>Metabolism? Chemical Reactions in the Body 109<br/>Energy for the Cell 109<br/>Cells Use Adenosine Triphosphate (ATP) as an Energy Source 110<br/>Oxidation-Reduction Reactions/Key Processes in Energy Metabolism 112<br/>Carbohydrate Metabolism Begins with Glycolysis 113<br/>Glycolysis? Glucose to Pyruvate 113<br/>Where Is the ATP? 114<br/>Lactate Production Is the Endpoint of Anaerobic Glycolysis 115<br/>The Citric Acid Cycle Completes Glucose Catabolism 117<br/>Pyruvate to Acetyl-CoA Is an Irreversible Step 117<br/>The Citric Acid Cycle 117<br/>The Electron Transport Chain Is the Primary Site for ATP Synthesis 120<br/>Glycogen Metabolism 122<br/>Lypolysis: Fat Breakdown 122<br/>Carbohydrate Aids Fat Metabolism 123<br/>Ketogenesis: Producing Ketone Bodies from Fatty Acids 123<br/>Lipogenesis: Building Fatty Acids 124<br/>Case Scenario Follow-up 124<br/>Protein Metabolism 125<br/>Gluconeogenesis: Producing New Glucose Molecules from Amino Acids and Other <br/>Compounds 125<br/>Expert Opinion Why Is an Understanding of Energy Metabolism Important? Michael <br/>Keenan Ph.D. 126<br/>Disposing of Excess Amino Groups from Amino Acid Metabolism 128<br/>What Happens Where? A Review 129<br/>Regulating Metabolism 130<br/>Summary 131<br/>Study Questions 133<br/>Annotated References 133<br/>Take Action 134<br/>Nutrition Perspective Inborn Errors of Metabolism 135<br/><br/>Part two: The energy-yielding nutrients and alcohol<br/>5. Carbohydrates 137<br/>Case Scenario 137<br/>Refresh Your Memory 138<br/>Chapter Objectives 138<br/>Carbohydrates?An Introduction 139<br/>Structures and Functions of Simple Carbohydrates 139<br/>Monosaccharides: Glucose, Fructose, and Galactose 139<br/>Disaccharides: Maltose, Sucrose, and Lactose 140<br/>Oligosaccharides: Raffinose and Stachyose 142<br/>Structures and Functions of the More Complex Carbohydrates 142<br/>Digestible Polysaccharides: Starch and Glycogen 142<br/>Indigestible Polysaccharides: Fibers 144<br/>Carbohydrate Digestion and Absorption 146<br/>Digestion 146<br/>Absorption 147<br/>Functions of Glucose and Other Sugars in the Body 149<br/>Yielding Energy 149<br/>Sparing Proteins from Use as an Energy Source 149<br/>Preventing Ketosis 149<br/>Expert Opinion The Benefits of a High-Carbohydrate Diet, William E. Connor, M.D. <br/>150<br/>Functions of Fiber 151<br/>Carbohydrate Needs 153<br/>How Much Fiber Do We Need? 153<br/>Problems with High-Fiber Diets 157<br/>Moderating Intake of Simple Sugars Is Important for Many of Us 157<br/>Problems with High-Sugar Diets 157<br/>Moderation in Lactose Intake Is Important for Some People 162<br/>Case Scenario Follow-up 163<br/>Carbohydrates in Foods: Food Sweeteners 163<br/>Nutritive Sweeteners 163<br/>Alternative Sweeteners 164<br/>Summary 167<br/>Study Questions 167<br/>Annotated References 167<br/>Take Action 169<br/>Nutrition Perspective When Blood Glucose Regulation Fails 171<br/><br/>6. Lipids 177<br/>Case Scenario 177<br/>Refresh Your Memory 178<br/>Chapter Objectives 178<br/>Lipids: Common Properties and Main Types 179<br/>Fatty Acids: The Simplest Form of Lipids 179<br/>Essential Fatty Acids 181<br/>Effects of a Deficiency of Essential Fatty Acids 182<br/>Triglycerides 183<br/>Expert Opinion A Closer Look at Omega-3 and Omega-6 Fatty<br/>Acids and Related Eicosanoids, Kenneth S. Broughton, Ph.D. 184<br/>Providing Energy for the Body 186<br/>Storing Energy for Later Use 186<br/>Insulating and Protecting the Body 187<br/>Transporting Fat-Soluble Vitamins 187<br/>Phospholipids 187<br/>Sterols 188<br/>Fat Digestion and Absorption 189<br/>Digestion 190<br/>Absorption 192<br/>Fats Carried in the Bloodstream 192<br/>Carrying Dietary Fats Utilizes Chylomicrons 192<br/>Transporting Lipids Mostly Made by the Body Uses Very-Low-Density Lipoproteins <br/>Another Dimension of Fat?Properties in Food 197<br/>Fat in Food Provides Satiety and Flavor 197<br/>Hydrogenation of Fatty Acids Aids in Food Formulation but Increases Trans Fatty <br/>Acid Content 197<br/>Fat Rancidity Limits Shelf Life of Foods 200<br/>Fats Act as Emulsifiers 200<br/>Recommendations for Fat Intake 201<br/>Fats in Food 205<br/>Fat Replacement Strategies 206<br/>Hidden Fat 207<br/>Wise Use of Reduced-Fat Foods 209<br/>Case Scenario Follow-up 209<br/>Summary 210<br/>Study Questions 210<br/>Annotated References 211<br/>Take Action 213<br/>Nutrition Perspective Cardiovascular Disease 215<br/><br/>7. Proteins 223<br/>Case Scenario 223<br/>Refresh Your Memory 224<br/>Chapter Objectives 224<br/>Protein--An Introduction 225<br/>Proteins--Vital to Life 225<br/>Amino Acid Form Determines Function 225<br/>Transamination and Deamination 227<br/>Putting Essential and Nonessential Amino Acids in Perspective 227<br/>part two The Energy-Yielding Nutrients and Alcohol Proteins--Amino Acids Bonded <br/>Together 229<br/>Protein Synthesis 230<br/>Protein Turnover 232<br/>Protein Organization 232<br/>Denaturation of Proteins 234<br/>Protein Digestion and Absorption 235<br/>Digestion 235<br/>Absorption 236<br/>Functions of Proteins 237<br/>Producing Vital Body Constituents 237<br/>Maintaining Fluid Balance 238<br/>Contributing to Acid-Base Balance 239<br/>Forming Hormones and Enzymes 239<br/>Contributing to Immune Function 239<br/>Forming Glucose 239<br/>Providing Energy 239<br/>Protein Needs 240<br/>Does Eating a High-Protein Diet Harm You? 243<br/>Expert Opinion A New Appreciation for the Nut in Nutrition, Penny M. Kris-<br/>Etherton, Ph.D., R.D. 244<br/>Protein in Foods 244<br/>The Value of Plant Protein 245<br/>A Closer Look at Soy Protein in Particular 246<br/>Evaluation of Protein Quality 246<br/>Protein-Energy Malnutrition 248<br/>Kwashiorkor 248<br/>Marasmus 249<br/>Kwashiorkor and Marasmus Malnutrition in the Hospital 250<br/>Summary 251<br/>Study Questions 251<br/>Annotated References 252<br/>Take Action 253<br/>Nutrition Perspective Vegetarian Diets 255<br/>Case Scenario Follow-up 258<br/><br/>8. Alcohol 259<br/>Case Scenario 259<br/>Refresh Your Memory 260<br/>Chapter Objectives 260<br/>Alcohol?An Introduction 261<br/>How Alcoholic Beverages Are Produced 261<br/>Alcohol Metabolism 262<br/>Alcohol Dehydrogenase Pathway 263<br/>Microsomal Ethanol Oxidizing System (MEOS) 265<br/>Benefits of Moderate Alcohol Use 266<br/>Health Problems from Alcohol Use 268<br/>A Closer Look at Cirrhosis 268<br/>Expert Opinion Alcohol and Nutrition, Charles H. Halsted, M.D. 270<br/>Other Problems Associated with Alcohol Abuse 272<br/>Problem Drinking in the Workplace 272<br/>Operation of Motor Vehicles and Related Equipment 272<br/>Sexually Transmitted Diseases 272<br/>Unplanned Pregnancy 272<br/>Children of Alcoholics 273<br/>Guidance Regarding Alcohol Use 273<br/>Alcohol Dependency and Abuse 273<br/>Alcoholism Diagnosis 275<br/>Do You Have a Problem with Alcohol? 275<br/>Treatment of Alcoholism 276<br/>Case Scenario Follow-up 277<br/>Summary 278<br/>Study Questions 278<br/>Annotated References 278<br/>Take Action 280<br/>Nutrition Perspective Binge Drinking 282<br/>Contents vii<br/><br/>part three: The Vitamins and Minerals <br/>9. The Fat-Soluble Vitamins 285<br/>Case Scenario 285<br/>Refresh Your Memory 286<br/>Chapter Objectives 286<br/>Vitamins: Vital Dietary Components 287<br/>Historical Perspective on the Vitamins 287<br/>Storage of Vitamins in the Body 288<br/>Vitamin Toxicity 288<br/>Malabsorption of Vitamins 288<br/>Preservation of Vitamins in Foods 289<br/>Absorption of the Fat-Soluble Vitamins 289<br/>Vitamin A 291<br/>Absorption, Transport, Storage, and Excretion of Vitamin A 292<br/>Cellular Retinoid-Binding Proteins 292<br/>Nuclear Retinoid Receptors 293<br/>Functions of Vitamin A 293<br/>Vitamin A in Foods 295<br/>Expert Opinion Carotenoids and Human Health: Beyond Conversion to Vitamin A, <br/>Thomas W.-M. Boileau, Ph.D., and John<br/>W. Erdman, Jr., Ph.D. 296<br/>Vitamin A Needs 297<br/>Vitamin A Deficiency 298<br/>Vitamin A Toxicity 298<br/>Vitamin D 300<br/>Vitamin D Formation in the Skin 301<br/>Absorption and Formation of Vitamin D from Food 302<br/>Metabolism, Transport, and Storage of Vitamin D 302<br/>Functions of Vitamin D 302<br/>Vitamin D in Foods 303<br/>Vitamin D Needs 304<br/>Vitamin D Deficiency 304<br/>Pharmacologic Use of Vitamin D 305<br/>Vitamin D Toxicity 305<br/>Vitamin E 305<br/>Absorption, Transport, Storage, and Excretion of Vitamin E 306<br/>Functions of Vitamin E 306<br/>Vitamin E in Foods 309<br/>Vitamin E Needs 309<br/>Vitamin E Deficiency 310<br/>Vitamin E Toxicity 310<br/>Vitamin K 310<br/>Absorption, Transport, Storage, and Excretion of Vitamin K 311<br/>Functions of Vitamin K 311<br/>Vitamin K in Foods 311<br/>Vitamin K Needs 311<br/>Vitamin K Deficiency 313<br/>Summary 314<br/>Study Questions 314<br/>Annotated References 315<br/>Take Action 317<br/>Nutrition Perspective Nutrient Supplements: Who Needs Them? 319<br/>Case Scenario Follow-up 321<br/><br/>10. The Water-Soluble Vitamins 323<br/>Case Scenario 323<br/>Refresh Your Memory 324<br/>Chapter Objectives 324<br/>General Properties of the Water-Soluble Vitamins 325<br/>B-Vitamin and Vitamin C Status of North Americans 325<br/>Enrichment and Fortification of Foods with B-Vitamins 326<br/>Thiamin 327<br/>Absorption, Transport, Metabolism, and Excretion of Thiamin 327<br/>Functions of Thiamin 327<br/>Expert Opinion Looking Beyond the Water-Soluable Vitamins: Phytochemicals in <br/>Health Promotion and Disease Prevention, Clare M. Hasler, Ph.D. 328<br/>Thiamin in Foods 330<br/>Thiamin Needs 330<br/>Thiamin?Deficiency Diseases 331<br/>Riboflavin 331<br/>Absorption, Transport, Metabolism, and Excretion of Riboflavin 331<br/>Functions of Riboflavin 332<br/>Riboflavin in Foods 332<br/>Riboflavin Needs 332<br/>Riboflavin Deficiency 332<br/>Niacin 333<br/>Absorption, Transport, Storage, and Excretion of Niacin 333<br/>Functions of Niacin 333<br/>Niacin in Foods 334<br/>Niacin Needs 335<br/>Niacin Deficiency 335<br/>Pharmacologic Use and Toxicity of Niacin 336<br/>Pantothenic Acid 336<br/>Functions of Pantothenic Acid 336<br/>Pantothenic Acid in Foods 337<br/>Pantothenic Acid Needs 337<br/>Biotin 337<br/>Functions of Biotin 338<br/>Sources of Biotin: Food and Microbial Synthesis 338<br/>Biotin Needs 338<br/>Biotin Deficiency 339<br/>Vitamin B-6 339<br/>Absorption, Metabolism, Excretion, and Storage of Vitamin B-6 339<br/>Functions of Vitamin B-6 339<br/>Vitamin B-6 in Foods 340<br/>Vitamin B-6 Needs 340<br/>Vitamin B-6 Deficiency 340<br/>Pharmacologic Use of Vitamin B-6 and Toxicity 341<br/>Folate 341<br/>Metabolism, Absorption, Storage, and Excretion of Folate 342<br/>Functions of Folate 342<br/>Folate in Foods 343<br/>Folate Needs and Dietary Folate Equivalents 343<br/>Folate Deficiency 344<br/>Case Scenario Follow-up 346<br/>Toxicity of Folate 346<br/>Vitamin B-12 347<br/>Absorption, Transport, and Storage of Vitamin B-12 347<br/>Functions of Vitamin B-12 348<br/>Vitamin B-12 in Foods 349<br/>Vitamin B-12 Needs 349<br/>Vitamin B-12 Deficiency 349<br/>A Closer Look at Homocysteine Metabolism: Integrating Your Nutrition Knowledge <br/>350<br/>Choline 350<br/>Absorption, Metabolism, and Excretion of Choline 352<br/>Functions of Choline 352<br/>Choline in Foods 352<br/>Choline Needs 352<br/>Choline Deficiency 352<br/>Choline Toxicity 352<br/>Vitamin C 352<br/>Absorption, Metabolism, Storage, and Excretion of Vitamin C 353<br/>Functions of Vitamin C 353<br/>Vitamin C in Foods 355<br/>Vitamin C Needs 355<br/>Vitamin C Deficiency 356<br/>Vitamin C Intake Above the RDA 356<br/>Toxicity of Vitamin C 356<br/>Vitamin-Like Compounds 357<br/>Carnitine 357<br/>Inositol 358<br/>Taurine 359<br/>Lipoic Acid 360<br/>Summary 360<br/>Study Questions 361<br/>Annotated References 361<br/>Take Action 363<br/>Nutrition Perspective Nutrition and Cancer 364<br/><br/>11. Water and the Major Minerals 371<br/>Case Scenario 371<br/>Refresh Your Memory 372<br/>Chapter Objectives 372<br/>Water 373<br/>Water in the Body--Intracellular and Extracellular Fluid 373<br/>Functions of Water 375<br/>Water in Foods 376<br/>Water Needs 376<br/>Water Deficiency 378<br/>Water Toxicity 380<br/>Minerals 381<br/>Absorption, Transport, and Excretion of Minerals 381<br/>Functions of Minerals 382<br/>Food Sources of Minerals 383<br/>North Americans at Risk for Mineral Deficiencies 383<br/>Toxicity of Minerals 383<br/>Sodium (Na) 383<br/>Absorption, Transport, Storage, and Excretion of Sodium 383<br/>Functions of Sodium 384<br/>Sodium in Foods 384<br/>Sodium Needs 385<br/>Sodium Deficiency 385<br/>Toxicity of Sodium 386<br/>Potassium (K) 387<br/>Absorption, Transport, and Excretion of Potassium 387<br/>Functions of Potassium 387<br/>Potassium in Foods 387<br/>Potassium Needs 387<br/>Potassium Deficiency 387<br/>Toxicity of Potassium 387<br/>Chloride (Cl) 388<br/>Absorption, Transport, and Excretion of Chloride 388<br/>Functions of Chloride 388<br/>Chloride in Foods 388<br/>Chloride Needs 388<br/>Chloride Deficiency 388<br/>Toxicity of Chloride 388<br/>Calcium (Ca) 389<br/>Absorption, Transport, Storage, and Excretion of Calcium 389<br/>Functions of Calcium 390<br/>Calcium in Foods 393<br/>Calcium Supplements 393<br/>Calcium Needs 396<br/>Calcium Deficiency 396<br/>Toxicity of Calcium 399<br/>Expert Opinion The Many Benefits of Calcium in Your Diet, Gregory Miller, Ph.D., <br/>F.A.C.N. 394<br/>Case Scenario Follow-up 399<br/>Phosphorus (P) 400<br/>Absorption, Transport, and Excretion of Phosphorus 400<br/>Functions of Phosphorus 400<br/>Phosphorus in Foods 400<br/>Phosphorus Needs 400<br/>Phosphorus Deficiency 401<br/>Toxicity of Phosphorus 401<br/>Magnesium (Mg) 401<br/>Absorption, Transport, Storage, and Excretion of Magnesium 401<br/>Functions of Magnesium 401<br/>Magnesium in Foods 402<br/>Magnesium Needs 402<br/>Magnesium Deficiency 402<br/>Toxicity of Magnesium 402<br/>Sulfur (S) 404<br/>Summary 404<br/>Study Questions 404<br/>Annotated References 405<br/>Take Action 407<br/>Nutrition Perspective Minerals and Hypertension 409<br/><br/>12. Trace Minerals 413<br/>Case Scenario 413<br/>Refresh Your Memory 414<br/>Chapter Objectives 414<br/>Trace Minerals--An Introduction 415<br/>Research on Trace Minerals 415<br/>Difficulties in Studying Trace Minerals 415<br/>Nutrient Needs for Trace Minerals 416<br/>Trace Minerals in Foods 416<br/>Iron (Fe) 417<br/>Absorption, Transport, Storage, and Excretion of Iron 417<br/>Functions of Iron 419<br/>Iron in Foods 420<br/>Iron Needs 420<br/>Iron Deficiency 421<br/>Iron Toxicity 422<br/>Expert Opinion Iron Overload: Too Much of A Good Thing, Barbara A. Bowman, Ph.D. <br/>and Giuseppina Imperatore, M.D., Ph.D. 424<br/>Zinc (Zn) 423<br/>Absorption, Transport, Storage, and Excretion of Zinc 423<br/>Functions of Zinc 426<br/>Zinc in Foods 426<br/>Zinc Needs 426<br/>Zinc Deficiency 426<br/>Toxicity of Zinc 427<br/>Copper (Cu) 427<br/>Absorption, Transport, Storage, and Excretion of Copper 428<br/>Functions of Copper 428<br/>Copper in Foods 428<br/>Copper Needs 429<br/>Copper Deficiency 429<br/>Toxicity of Copper 429<br/>Selenium (Se) 430<br/>Absorption, Transport, Storage, and Excretion of Selenium 430<br/>Functions of Selenium 430<br/>Selenium in Foods 431<br/>Selenium Needs 431<br/>Selenium Deficiency 431<br/>Toxicity of Selenium 432<br/>Case Scenario Follow-Up 432<br/>Iodide (I) 432<br/>Absorption, Transport, Storage, and Excretion of Iodide 433<br/>Functions of Iodide 433<br/>Iodide in Foods 433<br/>Iodide Needs 434<br/>Iodide Deficiency 434<br/>Toxicity of Iodide 435<br/>Fluoride (F) 435<br/>Absorption, Transport, Storage, and Excretion of Fluoride 436<br/>Functions of Fluoride 436<br/>Fluoride in Foods 437<br/>Fluoride Needs 437<br/>Toxicity of Fluoride 437<br/>Chromium (Cr) 438<br/>Absorption, Transport, Storage, and Excretion of Chromium 438<br/>Functions of Chromium 438<br/>Chromium in Foods 438<br/>Chromium Needs 438<br/>Chromium Deficiency 438<br/>Toxicity of Chromium 439<br/>Manganese (Mn) 439<br/>Molybdenum (Mo) 439<br/>Ultratrace Minerals 440<br/>Boron (B) 440<br/>Nickel (N) 440<br/>Silicon (Si) 442<br/>Arsenic (As) 442<br/>Vanadium (V) 442<br/>Summary 443<br/>Study Questions 444<br/>Annotated References 444<br/>Take Action 446<br/>Nutrition Perspective Modern Mineral Status Research: Searching for Subtleties <br/>447<br/><br/><br/>part four Energy Production and Energy Balance <br/>13. Energy Balance and Weight <br/>Control 451<br/>Case Scenario 451<br/>Refresh Your Memory 452<br/>Chapter Objectives 452<br/>Energy Balance 453<br/>Positive and Negative Energy Balance 453<br/>Energy Intake 453<br/>Energy Use 455<br/>Determination of Energy Use by the Body 457<br/>Direct and Indirect Calorimetry 458<br/>Estimates of Energy Needs 459<br/>Why Am I Hungry? 460<br/>Hypothalamus: A Satiety Regulator 460<br/>Satiety Regulation at Other Body Sites 462<br/>Control of Feeding Through Body Composition 463<br/>Does Appetite Regulate What We Eat? 463<br/>Hormones That Affect Satiety 463<br/>Nutrients in the Blood That Affect Satiety 464<br/>Hunger and Appetite in Perspective 464<br/>Estimation of a Healthy Weight 464<br/>Using Body Mass Index (BMI) to Set Healthy Weight 465<br/>Putting Healthy Weight into Perspective 466<br/>Energy Imbalance 467<br/>Estimating Body Fat Content and Diagnosing Obesity 468<br/>Using Body Fat Distribution to Establish Obesity 471<br/>Using Age of Onset in the Evaluation of Obesity 471<br/>Why Some People Are Obese--Nature Versus Nurture 472<br/>How Does Nature Contribute to Obesity? 472<br/>Does the Body Have a Set Point for Weight? 473<br/>Does Nurture Have a Role? 474<br/>Nature and Nurture Together 474<br/>Treatment of Obesity 476<br/>Some Basic Premises 476<br/>Wishful Shrinking--Why Can?t Quick Weight Loss Be Mostly Fat? 477<br/>What to Look for in a Sound Weight-Loss Diet 478<br/>Expert Opinion Why Is Weight Management So Difficult? Sachiko St. Jeor, Ph.D., <br/>R.D. 478<br/>What to Look for in a Sound Weight-Loss Diet 478<br/>Control of Energy Intake--The First Key to Weight Loss 481<br/>Regular Physical Activity--A Second Key to Weight Loss and Especially Important <br/>for Later Weight Maintenance 482<br/>Behavior Modification--A Third Strategy for Weight Loss 484<br/>Relapse Prevention Is Important 484<br/>Social Support Aids Behavioral Change 486<br/>Professional Help for Weight Loss 486<br/>Pharmacotherapy for Weight Loss 486<br/>Treatment of Severe Obesity 487<br/>Treatment of Underweight 489<br/>Summary 490<br/>Study Questions 491<br/>Annotated References 491<br/>Take Action 493<br/>Nutrition Perspective Popular Diets--Why All the Commotion? 499<br/>Case Scenario Follow-up 502<br/><br/>14. Nutrition for Fitness and Sports 503<br/>Case Scenario 503<br/>Refresh Your Memory 504<br/>Chapter Objectives 504<br/>The Close Relationship Between Nutrition and Fitness 505<br/>Energy Sources for Muscle Use 506<br/>Adenosine Triphosphate (ATP)--Immediately Usable Energy 506<br/>Phosphocreatine: The Initial Resupply of Muscle ATP 507<br/>Expert Opinion Your Exercise Prescription, Sheri A. Melton, Ph.D. 508<br/>Glucose: Major Fuel for Short-Term, High-Intensity and Medium-Term Exercise 509<br/>Fat: The Main Fuel for Prolonged Low-Intensity Exercise 513<br/>Protein: A Minor Fuel Source, Primarily for Endurance Exercise 514<br/>The Body?s Response to Physical Activity 515<br/>Specialized Functions of Skeletal Muscle Fiber Types 515<br/>Adaptation of Muscles and Body Physiology to Exercise 515<br/>Power Food: Dietary Advice for Athletes 516<br/>Energy Needs 516<br/>Carbohydrate Needs 517<br/>Fat Needs 520<br/>Protein Needs 520<br/>Vitamin and Mineral Needs 521<br/>Fluid Needs 523<br/>Meals Before Endurance Events Should Emphasize Carbohydrate 526<br/>Carbohydrate Intake During Recovery from Prolonged Exercise 527<br/>Case Scenario Follow-up 528<br/>Summary 528<br/>Study Questions 529<br/>Annotated References 529<br/>Take Action 531<br/>Nutrition Perspective Evaluating Ergogenic Aids to Enhance Athletic Performance <br/>534<br/><br/>15. Eating Disorders: Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder, <br/>and Other Conditions 539<br/>Case Scenario 539<br/>Refresh Your Memory 540<br/>Chapter Objectives 540<br/>From Ordered to Disordered Eating Habits 541<br/>Food: More Than Just a Source of Nutrients 541<br/>Overview of Anorexia Nervosa and Bulimia Nervosa 542<br/>Is There a Genetic Connection to Eating Disorders? 544<br/>Anorexia Nervosa 545<br/>Profile of the Typical Person with Anorexia Nervosa 546<br/>Early Warning Signs 547<br/>Physical Effects of Anorexia Nervosa 548<br/>Treatment of Anorexia Nervosa 550<br/>Case Scenario Follow-up 552<br/>Bulimia Nervosa 552<br/>Typical Behavior in Bulimia Nervosa 553<br/>Health Problems Stemming from Bulimia Nervosa 554<br/>Treatment of Bulimia Nervosa 555<br/>Eating Disorders Not Otherwise Specified (EDNOS) 556<br/>Binge-Eating Disorder 556<br/>Other Examples of Disordered Eating 558<br/>Female Athlete Triad 558<br/>Baryophobia 559<br/>Expert Opinion A Closer Look at the Female Athlete Triad, Jackie Berning, Ph.D., <br/>R.D. 560<br/>Prevention of Eating Disorders 561<br/>Books and Organizations to Help You Understand More About Eating Disorders 562<br/>Books 562<br/>Organizations and Self-Help Groups 563<br/>Summary 563<br/>Study Questions 564<br/>Annotated References 564<br/>Take Action 566<br/>Nutrition Perspective Eating Disorders: A Sociological Perspective 567<br/><br/>16. Pregnancy and Breastfeeding 569<br/>Case Scenario 569<br/>Refresh Your Memory 570<br/>Chapter Objectives 570<br/>Planned Pregnancy 571<br/>Prenatal Growth and Development 571<br/>Early Growth--The First Trimester Is a Very Critical Time 572<br/>Second Trimester 573<br/>Third Trimester 574<br/>Definition of a Successful Pregnancy 574<br/>Increased Nutrient Needs to Support Pregnancy 575<br/>Increased Energy Needs 575<br/>Increased Protein and Carbohydrate Needs 577<br/>Increased Vitamin Needs 577<br/>Increased Mineral Needs 578<br/>Is There an Instinctive Drive During Pregnancy to Consume More Nutrients? 578<br/>Food Plan for Pregnant Women 579<br/>Use of Prenatal Vitamin and Mineral Supplements 579<br/>Pregnant Vegetarians 580<br/>Effect of Nutrition on the Success of Pregnancy 581<br/>Effects of Nutritional and Other Factors on Pregnancy Outcome 582<br/>Beyond the Nutrients 582<br/>Prenatal Care and Counseling 584<br/>Case Scenario Follow-up 585<br/>Physiological Changes That Can Cause Discomfort in Pregnancy 585<br/>Heartburn, Constipation, and Hemorrhoids 585<br/>Edema 586<br/>Morning Sickness 586<br/>Anemia 586<br/>Gestational Diabetes 587<br/>Pregnancy-Induced Hypertension 587<br/>Breastfeeding 588<br/>Ability to Breastfeed 588<br/>Production of Human Milk 588<br/>Let-Down Reflex 589<br/>Nutritional Qualities of Human Milk 590<br/>Food Plan for Women Who Breastfeed 592<br/>Breastfeeding Today 593<br/>Expert Opinion Supporting Breastfeeding, Mary Ellen Rivero, M.S., R.D. 594<br/>Environmental Contaminants in Human Milk 597<br/>Can a Preterm Infant Be Breastfed? 597<br/>Summary 598<br/>Study Questions 598<br/>Annotated References 599<br/>Take Action 601<br/>Nutrition Perspective Fetal Alcohol Syndrome 603<br/><br/>17. Nutrition from Infancy Through Adolescence 605<br/>Case Scenario 605<br/>Refresh Your Memory 606<br/>Chapter Objectives 606<br/>Nutrition and Child Health--An Introduction 607<br/>Infant Growth and Physiological Development 607<br/>The Growing Infant 607<br/>Effect of Under nutrition on Growth 608<br/>Assessment of Infant Growth and Development 608<br/>Brain Growth 610<br/>Adipose Tissue Growth 610<br/>Failure to Thrive 610<br/>Infant Nutritional Needs 611<br/>Formula Feeding for Infants 615<br/>Development of Feeding Skills in Older Infants 617<br/>Introduction of Solid Foods at About 6 Months of Age 618<br/>Case Scenario Follow-up 621<br/>Health Problems Related to Infant Nutrition 622<br/>Preschool Children 624<br/>How to Help a Child Choose Nutritious Foods 625<br/>Childhood Feeding Problems 626<br/>Do Children Need a Multivitamin and Mineral Supplement? 628<br/>Nutritional Problems in Preschool Children 630<br/>Modifications of Childhood Diets to Reduce Future Disease Risk 631<br/>Vegetarianism in Childhood 631<br/>School-Age Children 632<br/>Breakfast, Fat Intake, and Snacks 632<br/>Type 2 Diabetes 633<br/>Obesity 633<br/>Expert Opinion Obesity and Type 2 Diabetes in Childhood: Lessons from the Pima <br/>Indians, Arline D. Salbe, Ph.D., R.D. 634<br/>The Teenage Years 636<br/>Nutritional Problems and Concerns of Teens 637<br/>A Closer Look at the Diets of Teenage Girls 638<br/>Helping Teens Eat More Nutritious Foods 638<br/>Overcoming the Teenage Mind-Set 638<br/>Are Teenage Snacking Practices Harmful? 639<br/>Summary 639<br/>Study Questions 640<br/>Annotated References 640<br/>Take Action 642<br/>Nutrition Perspective Food Allergies and Intolerances 644<br/><br/>part six Putting Nutrition Knowledge into Practice <br/>19. Food Safety 681<br/>Case Scenario 681<br/>Refresh Your Memory 682<br/>Chapter Objectives 682<br/>Setting the Stage 683<br/>Effects of Foodborne Illness 683<br/>Why Is Foodborne Illness So Common? 683<br/>Food Preservation--Past, Present, and Future 685<br/>Foodborne Illness: When Undesirable Microorganisms Alter Foods 689<br/>General Rules for Preventing Foodborne Illness 689<br/>Expert Opinion Food Safety--Why Should You Care? Lydia Medeiros, Ph.D., R.D. 690<br/>A Closer Look at the Primary Microorganisms That Cause Foodborne Illness 695<br/>Case Scenario Follow-up 701<br/>Food Additives 702<br/>Why Are Food Additives Used? 702<br/>Intentional Versus Incidental Food Additives 702<br/>The GRAS List 702<br/>Are Synthetic Compounds Always Harmful? 703<br/>Tests of Food Additives for Safety 703<br/>Approval for a New Food Additive 703<br/>Common Food Additives 704<br/>Substances That Occur Naturally in Foods and Can Cause Illness 708<br/>Environmental Contaminants in Foods 709<br/>Lead 709<br/>Dioxin 710<br/>Mercury 710<br/>Urethane in Some Alcoholic Beverages 711<br/>Polychlorinated Biphenyls (PCBs) 711<br/>Protection from Environmental Toxins in Foods 711<br/>Summary 711<br/>Study Questions 712<br/>Annotated References 712<br/>Take Action 714<br/>Nutrition Perspective Pesticides in Food 715<br/><br/>18. Nutrition During Adulthood 647<br/>Case Scenario 647<br/>Refresh Your Memory 648<br/>Chapter Objectives 648<br/>Nutrition and Adulthood--An Introduction 649<br/>Compression of Morbidity 649<br/>Diet for the Adult Years 650<br/>Are Adults Following Current Dietary Recommendations? 653<br/>Middle and Older Adulthood 653<br/>Life Span 654<br/>Life Expectancy 654<br/>The Graying of North America 654<br/>What Actually Is Aging? 655<br/>Hypotheses About the Causes of Aging 656<br/>Effects of Aging on Nutritional Health 656<br/>Decreased Appetite and Food Intake 657<br/>Decline in Dental Health 659<br/>Reduced Thirst Sensation 659<br/>Fall in Gastrointestinal Tract Function 659<br/>Changes in Liver, Gallbladder, and Pancreatic Function 659<br/>Decline in Kidney Function 660<br/>Reduced Immune Function 660<br/>Reduced Lung Function 660<br/>Reduced Hearing and Vision 660<br/>Decrease in Lean Tissue 661<br/>Increases in Fat Stores 661<br/>Reduced Cardiovascular Health 661<br/>Decline in Bone Health 662<br/>Other Factors That Influence Nutrient Needs in Aging 663<br/>Depression in Older Adults 664<br/>Alcoholism in Older Adults 664<br/>Alzheimer?s Disease 664<br/>Nutrient Needs in Middle and Older Adulthood 665<br/>Expert Opinion Nutrition and Older Adults--Why Should You Care? Nancy S. <br/>Wellman, Ph.D., R.D., F.A.D.A. 666<br/>Community Nutrition Services for Older Adults 669<br/>Case Scenario Follow-up 669<br/>Summary 671<br/>Study Questions 671<br/>Annotated References 671<br/>Take Action 673<br/>Nutrition Perspective Complementary and Alternative Medicine Practices 675<br/><br/>20. Undernutrition Throughout the World 719<br/>Case Scenario 719<br/>Refresh Your Memory 720<br/>Chapter Objectives 720<br/>World Hunger: A Continuing Plague 721<br/>World Hunger Today 721<br/>Critical Life Stages When Undernutrition Is Particularly Devastating 724<br/>General Effects of Semistarvation 726<br/>Case Scenario Follow-up 727<br/>Undernutrition in the United States 727<br/>Helping the Hungry in the United States: A Historical Perspective 728<br/>Socioeconomic Factors Related to Undernutrition 730<br/>Possible Solutions to Hunger in the United States 731<br/>Expert Opinion Food Security, David H. Holben, Ph.D., R.D. 732<br/>Undernutrition in the Developing World 734<br/>Food/Population Ratio 734<br/>War and Political/Civil Unrest 737<br/>Rapid Depletion of Natural Resources 738<br/>Cultural Attitudes Toward Certain Foods 739<br/>Inadequate Shelter and Sanitation 739<br/>High External Debt 741<br/>The Impact of AIDS 741<br/>Reducing Undernutrition in the Developing World 743<br/>Some Concluding Thoughts 744<br/>Summary 745<br/>Study Questions 746<br/>Annotated References 746<br/>Take Action 748<br/>Nutrition Perspective The Role of Biotechnology in Expanding Worldwide Food <br/>Availability 750<br/>Appendixes<br/>A Chemistry: A Tool for Understanding Nutrition A-2<br/>B Detailed Depictions of Glycolysis, the Citric Acid Cycle, and the Electron <br/>Transport Chain A-28<br/>C Human Physiology: A Tool for Understanding Nutrition A-32<br/>D Dietary Advice for Canadians A-56<br/>E The Exchange System: A Helpful Menu-Planning Tool A-65<br/>F Exchange System Lists A-70<br/>G Dietary Intake and Energy Expenditure Assessment A-78<br/>H Fatty Acids, Including Omega-3, Fatty Acids in Foods A-89<br/>I The 1983 Metropolitan Life Insurance Company Height-Weight Table and <br/>Determination of Frame Size A-91<br/>J Caffeine Content of Foods A-94<br/>K Sources of Nutrition Information A-96<br/>L English-Metric Conversions and Metric and Household Units A-101<br/>M Estimated Average Requirements for Macronutrients and Micronutrients A-103<br/>N Food Composition Table A-106<br/>Answers to Critical Thinking Questions NA-1 |
