Name: Williams’ Essentials of Nutrition and Diet Therapy 10th Edition by Schlenker Test Bank
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This is completed downloadable of Williams’ Essentials of Nutrition and Diet Therapy 10th Edition by Schlenker Test Bank

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ISBN-10 ‏ : ‎ 0323222749
ISBN-13 ‏ : ‎ 978-0323222747
Author: Eleanor Schlenker PhD RDN (Author), Sara Long Roth PhD RD LD (Author)

From basic nutrition principles to the latest nutrition therapies for common diseases, Williams’ Essentials of Nutrition & Diet Therapy, 10th Edition, Revised Reprint offers a solid foundation in the fundamental knowledge and skills you need to provide effective patient care. Authors Eleanor Schlenker and Sara Long address nutrition across the life span and within the community, with an emphasis on health promotion and the effects of culture and religion on nutrition. The revised edition has been updated with current government dietary guidelines, including the new MyPlate recommendations. Other key topics include childhood obesity, metabolic syndrome, diabetes, and food safety. Plus, evidence-based information and real-world case scenarios help you learn how to apply essential nutrition concepts and therapies in clinical practice.

Table of Content:

PART 1 Introduction to Human Nutrition
CHAPTER 1 Nutrition and Health
Key Terms
New challenges for nutrition professionals
The Obesity Epidemic
FIGURE 1-1 The obesity epidemic among U.S. adults. Notice the rise in the number of states in which at least one fourth (25%-29%) of the residents are obese. By 2008, only one state had an obesity prevalence below 20%, and 32 states had a prevalence of at least 25%. (Obesity is defined as a body mass index of 30 or greater, which is the equivalent of 30 lb overweight for a person 64 inches tall.)
BOX 1-1 Factors Contributing To Increased Food Intake
Shifts in Population
Number of Older Adults
FIGURE 1-2 Change in portion size of common foods. Over the last 20 years, portion sizes have almost tripled. A hamburger and roll that supplied 260 kcal may now contain 850 kcal. Visit the website of the National Heart, Lung and Blood Institute, National Institutes of Health (http://hp2010.nhlbihin.net/portion/keep.htm) to view photographs of many food items that have changed in size and kcalorie content. Take the quiz to learn how many minutes you would need to exercise to burn the extra kcalories.
Ethnic and Racial Diversity
FIGURE 1-3 Projected increases in the number of persons age 65 and older. Between 1900 and 2000, the older age group grew from 3 million to 37 million and currently makes up 12% of the general population. By 2030, this group will number 70.5 million and represent almost 20% of the general population. By 2050, 21 million people will be at least age 85.
Focus On Culture
Diversity in Food Patterns
How Food Patterns Develop
Changes in Ethnic Patterns
Bibliography
New Products in the Marketplace
Nutrition and Our Genes
The Information Explosion
The science of nutrition
Working Definitions
Functions of Food and Nutrients
Energy Sources
Carbohydrates
Fats
Proteins
Tissue Building and Repair
Protein
Minerals
Vitamins
Metabolic Regulation
Minerals
Vitamins
Water
Nutrient Interrelationships
BOX 1-2 Useful Measurements In Evaluating Nutritional Status
Dietary Intake
Biochemical Measurements
Anthropometric Measurements
Clinical Evaluation
Nutritional Status
Optimal Nutrition
TABLE 1-1 Clinical Signs of Nutritional Status
Undernutrition
Overt Malnutrition
Overnutrition
Nutrition policy and national health problems
Diet, Health, and Public Policy
Development of Nutrition Policy
Healthy People 2020
Nutrition guides for food selection
Nutrition Standards
Dietary Reference Intakes
Dietary Guidelines
Evidence-Based Practice: How Do I Use It?
Bibliography
Health promotion
Dietary Guidelines for Americans 2010
BOX 1-3 2005 Dietary Guidelines For Americans—Key Recommendations
Adequate Nutrients Within Calorie Needs
Recommendations for Specific Population Groups
Weight Management
Recommendations for Specific Population Groups
Physical Activity
Recommendations for Specific Population Groups
Food Groups to Encourage
Recommendations for Specific Population Groups
Fats
Recommendations for Specific Population Groups
Carbohydrates
Sodium and Potassium
Recommendations for Specific Population Groups
Alcoholic Beverages
Food Safety
Recommendations for Specific Population Groups
Food Guides
USDA Food Guides
MyPyramid Food Guidance System
FIGURE 1-4 MyPyramid: Steps to a Healthier You. The MyPyramid graphic emphasizes activity, moderation, personalization, proportionality, variety, and gradual improvement.
TABLE 1-2 Major Nutrients Supplied by the Mypyramid Food Groups
TABLE 1-3 Mypyramid Food Intake Patterns For Different Kcalorie Levels
FIGURE 1-5 MyPyramid food intake pattern for a 2000-kcal diet. Consumers can access a food intake pattern based on their age, gender, and level of physical activity to assist them in daily food selection.
FIGURE 1-6 Serving size card. This pocket-sized guide can be useful when choosing serving sizes at home and away from home.
Exchange Lists for Meal Planning
A safe and healthy food supply
Prevalence and Causes of Foodborne Illness
Perspective on Food Safety
Assessing food patterns
Personal Perceptions of Food
Nutritional Analysis by Nutrients and Energy Values
To sum up
Questions for review
Perspectives In Practice
My Personal Food Patterns—Do They Need Improvement?
References
Further readings and resources
Readings
Websites of Interest
CHAPTER 2 Digestion, Absorption, and Metabolism
Key terms
Human body: The role of nutrition
Food: Change and transformation
Importance for health and nutrition
FIGURE 2-1 The gastrointestinal system. Throughout the successive parts of the gastrointestinal system, multiple activities of digestion liberate and reform food nutrients for our use.
The gastrointestinal tract
Component Parts
General Functions
Sensory Stimulation and Gastrointestinal Function
Principles of digestion
Gastrointestinal Motility: Muscles and Movement
Types of Muscles
FIGURE 2-2 Muscle layers of the intestinal wall. Notice the five layers of muscle that produce the movements necessary for digestion and keeping the food mass going forward.
FIGURE 2-3 Types of movement produced by muscles of the intestine: peristaltic waves from contraction of deep circular muscle, pendular movements from small local muscles, and segmentation rings formed by alternate contraction and relaxation of circular muscle.
FIGURE 2-4 Innervation of the intestine by the intramural nerve plexus. A network of nerves controls and coordinates the movements of the intestinal muscles.
Nervous System Control
Gastrointestinal Secretions
Movement of food through the digestive tract
Mouth and esophagus: Preparation and delivery
Taste and Smell
Mastication
Swallowing
Esophagus
FIGURE 2-5 Swallowing is a highly coordinated task directed by a special nerve center in the hypothalamus.
Entry into the Stomach
Chemical Digestion
FIGURE 2-6 Stomach. The pyloric sphincter controls passage from the stomach into the duodenum, the upper section of the small intestine. See also the five layers of muscle found in the stomach wall. The mucosa lining the stomach forms folds called rugae.
TABLE 2-1 Comparative pH Values and Approximate Daily Volumes of Gastrointestinal Secretions
Stomach: Storage and initial digestion
Motility
Evidence-Based Practice
Why Are Many Older Adults Deficient in Vitamin B12?
How Can We Solve this Problem?
Bibliography
Chemical Digestion
Types of Secretions
Control of Secretions
Small intestine: Major digestion, absorption, and transport
Motility
Intestinal Muscle Layers
Types of Intestinal Muscle Action
TABLE 2-2 Summary of Digestive Processes
Chemical Digestion
Major Role of the Small Intestine
Types of Secretions
End Products of Digestion
Absorption
Surface Structures
FIGURE 2-7 Enterohepatic circulation of bile salts. Bile salts are reabsorbed from the small intestine and returned to the liver and gallbladder to be used again and again.
TABLE 2-3 End Products of Digestion
Mechanisms of Absorption
FIGURE 2-8 Absorbing structures of the intestine. Note the structures of the intestinal mucosa that increase the surface area for absorption: mucosal folds, villi, and microvilli.
TABLE 2-4 Volume of Nutrients Absorbed Daily by the Gastrointestinal System
FIGURE 2-9 Movement of molecules, water, and solutes through osmosis and diffusion.
FIGURE 2-10 Pinocytosis—the engulfing of large molecules by the cell.
Routes of Absorption
Colon (large intestine): Final absorption and waste elimination
Role in Absorption
Water Absorption
Mineral Absorption
Vitamin Absorption
Role of Intestinal Bacteria
Excessive Gas Production
Waste Elimination
BOX 2-1 Healthful Effects of Intestinal Bacteria
Complementary and Alternative Medicine (CAM)
Bismuth and Certain Herbs: A Dangerous Combination
Gastrointestinal function and clinical applications
Chronic Gastrointestinal Distress
Focus on Culture
Digestive Distress in African Americans and Hispanic Americans
References
Lactose Intolerance
BOX 2-2 Food Sources of Lactose
0 to 2 g Lactose
5 to 8 g Lactose
Health promotion
Prebiotics and Probiotics
Prebiotics
Probiotics
Perspectives in Practice
Help Your Digestive System Work for You
Reference
Metabolism
Carbohydrate Metabolism
Sources of Blood Glucose
Uses of Blood Glucose
Hormonal Controls
Lipid Metabolism
Lipid Synthesis and Breakdown
Lipoproteins
Hormonal Controls
Protein Metabolism
Anabolism (Tissue Building)
Catabolism (Tissue Breakdown)
Metabolic Interrelationships
To sum up
Questions for review
References
Further readings and resources
Readings
Websites of Interest
CHAPTER 3 Carbohydrates
Key terms
The nature of carbohydrates
Basic Fuels: Starches and Sugars
Dietary Importance
Classification of carbohydrates
FIGURE 3-1 Photosynthesis. In the presence of sunlight and the green leaf pigment chlorophyll, green plants use water and carbon dioxide (CO2) to produce glucose and starch by capturing the sun’s energy and transforming it into chemical energy in the food products stored in their roots, stems, and leaves; through this process oxygen is returned to the atmosphere.
Monosaccharides
Glucose
Focus on Food Safety
Honey
Fructose
Galactose
Disaccharides
TABLE 3-1 Physiologic and Nutritional Significance of Monosaccharides
Sucrose
Lactose
Maltose
TABLE 3-2 Physiologic and Nutritional Significance of Disaccharides
Sugar Alcohols
BOX 3-1 Food Sources of Sugar
Sources of Naturally Occurring Sugars*
Sources of Added Sugars
Polysaccharides
Starch
Resistant Starch
BOX 3-2 Food Sources of Complex Carbohydrates
Glycogen
Dextrins
BOX 3-3 Breakdown of Starch in Digestion
Oligosaccharides
Importance of carbohydrates
Perspectives in Practice
Cutting Down on Sugar
Functions of carbohydrates
Energy
Special Functions
TABLE 3-3 Carbohydrate Storage in an Adult Man (70 kg [154 lb])
Glycogen—Carbohydrate Storage
Protein-Sparing Action
Antiketogenic Effect
Heart Action
Central Nervous System
Recommended intake of carbohydrates
Dietary Reference Intakes
Acceptable Macronutrient Distribution Range
BOX 3-4 Acceptable Macronutrient Distribution Ranges
Focus on Culture
Cross-Cultural Competence
A Goal for the Health Professional
Value Diversity
Cross-Cultural Situations
Bibliography
Other resources
Nonnutritive Sweeteners
TABLE 3-4 Properties and Applications of Common Nonnutritive Sweeteners
Evidence-Based Practice Box
Do Nonnutritive Sweeteners Help You Lose Weight?
Bibliography
Carbohydrates and oral health
Imbalances in carbohydrate intake
High-Carbohydrate Diets
FIGURE 3-2 Dental caries can result from poor dental hygiene and continuous snacking and drinking of items high in added sugar or other refined carbohydrates.
Low-Carbohydrate Diets
Fiber—the nondigestible carbohydrate
Dietary Fiber
BOX 3-5 Sources of Dietary Fiber
Pectin, β-Glucans, Gums
Cellulose, Hemicellulose, Lignin
Functional Fiber
TABLE 3-5 Dietary Fiber and Energy Content of Selected Foods
Health promotion
Health Benefits of Fiber
Recommended Fiber Intake
Functional foods—special carbohydrate foods
TABLE 3-6 Selected Functional Foods and Their Proposed Health Benefits
Digestion-absorption-metabolism review
Digestion
Absorption and Metabolism
To sum up
Questions for review
References
Further readings and resources
Readings
Websites of Interest
CHAPTER 4 Lipids
Key terms
Lipids in nutrition and health
Health Issues and Lipids
Amount of Fat
Type of Fat
Functions of Lipids
Food Lipids
Body Lipids
Physical and chemical nature of lipids
Physical Characteristics
Chemical Characteristics
Fatty acids and triglycerides
Characteristics of Fatty Acids: Saturation
Characteristics of Fatty Acids: Chain Length
BOX 4-1 Degrees of Saturation of Food Fats
Highly Saturated Fat (solid at room temperature)
Less-Saturated Fat (very soft at room temperature)
Unsaturated Fat (liquid at room temperature)
BOX 4-2 Chain Length of Fatty Acids
Essential Fatty Acids
FIGURE 4-1 Various fatty acids and prostaglandins are made from each of the two essential fatty acids. Prostaglandins help regulate many important body functions.
Dietary Reference Intakes
Special Needs of Infants
Food Sources
BOX 4-3 Food Sources of Fatty Acids Important to Health
Linoleic Acid: n-6 Fatty Acid (essential)
α-Linolenic Acid: n-3 Fatty Acid (essential)
Fatty Acids from Fish: n-3 Fatty Acids (can be synthesized by the body)
Use of Fish Oil Supplements
Triglycerides
Structure
Food lipids and health
Degree of Saturation
FIGURE 4-2 Spectrum of food fats according to degree of saturation. Note that the two food fats with the highest degree of saturation are plant fats, followed by various animal fats in decreasing order of saturation. In general, plant fats are less saturated.
FIGURE 4-3 The cis and trans forms of a fatty acid.
TABLE 4-1 Effects of Fatty Acid Saturation on Blood Lipids
Cis versus Trans Fats
BOX 4-4 Visible and Hidden Fats in Food
Visible Fats
Hidden Fats
Visible and Hidden Fat
Acceptable Macronutrient Distribution Range
Focus on Culture
Developing a Food Frequency Questionnaire for Culturally Diverse Groups
Using a Food Frequency Questionnaire
Developing a Food Frequency Questionnaire
Step 1
Step 2
Step 3
Step 4
Special Problems with Fats
References
Appropriate Intakes of Fat and Carbohydrate
Perspectives in Practice
Lowering Your Fat Intake
Health promotion
Lowering Fat Intake
Fat Replacers
TABLE 4-2 Fat Replacers Approved for Use in Processed Foods
Lipid-related compounds
Cholesterol
Structure
Functions
Food Sources
Suggested Cholesterol Intake
Lipoproteins
Function
Lipid Transport
Evidence-Based Practice
Plant Sterols
New Weapon for Lowering Blood Cholesterol Levels
References
Classes of Lipoproteins
Cholesterol, Lipoproteins, and Cardiovascular Risk
Digestion-absorption-metabolism review
Digestion
TABLE 4-3 Summary of Lipid Digestion
Mouth
Stomach
Small Intestine
FIGURE 4-4 Micellar complex of fats and bile salts for transport into the intestinal wall. The fatty acid in the 2 position of the triglyceride is the most difficult to remove, and some fat is absorbed in the monoglyceride form.
FIGURE 4-5 Absorption of fat, cholesterol, and phospholipids.
Absorption
Stage I: Initial Lipid Absorption
Stage II: Absorption Within the Intestinal Wall
Stage III: Final Absorption and Transport
Metabolism
To sum up
Questions for review
References
Further readings and resources
Readings
Websites of Interest
CHAPTER 5 Proteins
Key terms
Physical and chemical nature of proteins
General Definition
Chemical Nature
General Pattern and Structure
FIGURE 5-1 Basic structure of an amino acid.
FIGURE 5-2 Structure of glycine and alanine.
BOX 5-1 Categories of Amino Acids
Indispensable (Essential)
Dispensable (Nonessential)
Conditionally Indispensable (Essential)
Essential Amino Acids
The building of proteins
Protein Structure
Peptide Bond
Large-Complex Proteins
FIGURE 5-3 Structure of arginine.
Types of Proteins
Myosin
Collagen
Hemoglobin
FIGURE 5-4 Myosin is a globular protein in muscle that combines with actin to form actomyosin, the fundamental contractile unit of muscle.
Albumin
FIGURE 5-5 Tissues that contain collagen, a structural protein forming connective tissue.
FIGURE 5-6 Hemoglobin is the iron-containing protein in red blood cells that carries oxygen to body cells and tissues.
Proteins with Special Roles
Functions of protein
Growth, Tissue Building, and Maintenance
Physiologic Roles
Role in Critical Care
Energy Source
Protein and nitrogen balance
Concept of Balance
Protein Reserves
Protein Balance
FIGURE 5-7 Flow between protein compartments and the amino acid pool. Amino acids are constantly entering and leaving the body’s amino acid pool to form new proteins or other nitrogen-containing compounds, to be converted to carbohydrate and used for energy, or to be converted to fat for storage.
Nitrogen Balance
Protein quality
Evaluating Food Proteins
BOX 5-2 Complete Proteins
Comparing Food Proteins
Amino Acid Content of Plant and Animal Foods
FIGURE 5-8 Complementary vegetable proteins. Examples of common plant foods that when eaten together supply the amounts of essential amino acids required for protein synthesis.
TABLE 5-1 Comparative Protein Quality of Selected Foods According to Amino Acid Score and Digestibility
BOX 5-3 Incomplete Proteins
Protein requirements
Factors Influencing Protein Requirements
Protein Quality
Protein Digestibility
Tissue Growth
Energy Content of the Diet
Health Status
Focus on Culture
Soy
A Protein Source for Thousands of Years
Bibliography
Dietary Reference Intakes
Protein
Amino Acids
Acceptable Macronutrient Distribution Range
Protein intake
Protein-Energy Malnutrition
Amounts and Types of Protein
FIGURE 5-9 Protein-energy malnutrition (PEM). A, Marasmus results from starvation. B, Kwashiorkor results from a diet that may be sufficient in kcalories but is deficient in protein. Note the abdominal bloating typical of kwashiorkor.
Clinical Applications: Low and High Protein Intakes
Low-Protein Diets
High-Protein Diets
Health promotion
Health Benefits of Plant Protein Foods
Nutritional Contributions of Animal Protein Foods
Mixing Animal and Plant Proteins
Evidence-Based Practice
Effect of Soy on Cardiovascular Risk
Bibliography
Vegetarian diets
BOX 5-4 Reasons for Following A Plant-Based Diet
Nutritional Implications of Vegetarian Diets
Planning Vegetarian Diets
Vegetarian Diets and Chronic Disease
Digestion-absorption-metabolism review
Digestion
Mouth
FIGURE 5-10 Vegetarian food guide rainbow. Notice the slice of the rainbow calling attention to the foods in each group that are good sources of calcium.
BOX 5-5 Plant Sources of Protein
BOX 5-6 Suggestions for Planning Vegetarian Meals
Perspectives in Practice
Increase Your Variety
Exploring Complementary Proteins
Bibliography
Stomach
Small Intestine
Absorption
Metabolism
To sum up
Questions for review
References
Further readings and resources
Readings
Websites of Interest
CHAPTER 6 Vitamins
Key terms
Vitamins: essential nutrients
General Nature and Classification
What Is a Vitamin?
Basic Principles
Classification
Fat-Soluble Vitamins
BOX 6-1 Classification of Vitamins
Fat-Soluble Vitamins
Water-Soluble Vitamins
Water-Soluble Vitamins
Current Knowledge and Key Questions
Fat-soluble vitamins
Vitamin A
Chemical and Physical Nature
BOX 6-2 Sources of Preformed And Provitamin A
Preformed Vitamin A
Provitamin A
Forms
Absorption, Transport, and Storage
Substances Needed for Absorption
TABLE 6-1 Conversion of Carotenoids to Vitamin A
Conversion of β-Carotene
Transport and Storage
FIGURE 6-1 Structure of the eye as viewed from the side.
Functions of Vitamin A
Vitamin A Deficiency and Clinical Applications
Vision
Cell Differentiation
FIGURE 6-2 The vision cycle: light-dark adaptation role of vitamin A.
FIGURE 6-3 Xerophthalmia.
Growth
FIGURE 6-4 Follicular hyperkeratosis caused by vitamin A deficiency.
Reproduction
Immunity
Vitamin A Requirement
Influencing Factors
Causes of Vitamin A Deficiency
BOX 6-3 Signs of Vitamin A Toxicity
Dietary Reference Intake
Vitamin A Toxicity
Hypervitaminosis A
Food Sources of Vitamin A
BOX 6-4 Food Sources of Vitamin A
Vitamin D
Chemical and Physical Nature
Focus on Culture
Acculturation
Effect on Food Patterns
References
Forms
Absorption, Transport, and Storage
Absorption
Active Hormone Synthesis
FIGURE 6-5 Formation of the active vitamin D hormone. Vitamin D undergoes a conversion in the liver and then a second conversion in the kidneys to form the vitamin D hormone calcitriol. Notice that vitamin D is handled in the same way whether it was synthesized in the skin or obtained from dietary sources.
Functions of Vitamin D
Control of Calcium and Phosphorus Levels in Bone and Blood
New Roles for Vitamin D
Vitamin D Deficiency and Clinical Applications
Bone Disease
FIGURE 6-6 Bowlegs in rickets.
Vitamin D Requirement
Influencing Factors
Dietary Reference Intake
Vitamin D Toxicity
Health promotion
Implications of Vitamin D Deficiency
Food Sources of Vitamin D
Vitamin E
Chemical and Physical Nature
Forms
BOX 6-5 Food Sources of Vitamin D
Vitamin D occurs naturally in eggs and fish. Fortified dairy foods, soy milk, juices, and cereals are other good sources for persons with limited exposure to sunlight.
Absorption, Transport, and Storage
Functions of Vitamin E
Antioxidant Activity
Partnership with Selenium
New Roles for Vitamin E
Vitamin E Deficiency and Clinical Applications
Premature Infants
Children and Adults
Vitamin E Requirement
Dietary Reference Intake
Vitamin E Toxicity
Evidence-Based Practice
Food or Supplements
Do They Both Produce the Same Results?
Bibliography
Food Sources of Vitamin E
BOX 6-6 Food Sources of Vitamin E
Vitamin K
Chemical and Physical Nature
Chemical Nature
Absorption, Transport, and Storage
Functional Roles of Vitamin K
Blood Clotting
Bone Metabolism
Complementary And Alternative Medicine
Vitamin K, Vitamin E, and Anticoagulant Drugs
Vitamin K Deficiency and Clinical Applications
Neonatology
Malabsorption Problems
Drug Therapy
BOX 6-7 Food Sources of Vitamin K
Vitamin K Requirement
Dietary Reference Intake
Food Sources of Vitamin K
TABLE 6-2 Summary of Fat-Soluble Vitamins
Water-soluble vitamins
Vitamin C (ascorbic acid)
Chemical and Physical Nature
Absorption, Transport, and Storage
Functions of Vitamin C
Antioxidant Capacity
Formation of Intercellular Cement
Support of General Body Metabolism
BOX 6-8 Signs of Vitamin C Deficiency
Clinical Applications
Vitamin C Requirement
Dietary Reference Intake
BOX 6-9 Food Preparation Methods to Preserve Vitamin Content
Vitamin C Toxicity
Food Sources of Vitamin C
Focus on Food Safety
Did You Wash That Orange?
The B vitamins
Deficiency diseases and vitamin discoveries
Coenzyme role
Thiamin
Chemical and Physical Nature
BOX 6-10 Food Sources of Vitamin C
TABLE 6-3 Summary of Vitamin C (Ascorbic Acid)
Absorption, Transport, and Storage
FIGURE 6-7 Beriberi is a thiamin deficiency disease characterized by extreme weakness, paralysis, anemia, and wasting away (e.g., decreased metabolic function in the liver).
Function of Thiamin
Coenzyme Role
Thiamin Deficiency and Clinical Applications
Thiamin Requirement
Dietary Reference Intake
Clinical Applications
Food Sources of Thiamin
BOX 6-11 Food Sources of Thiamin
Riboflavin
Discovery
Chemical and Physical Nature
Absorption, Transport, and Storage
BOX 6-12 Signs of Riboflavin Deficiency
FIGURE 6-8 Glossitis resulting from riboflavin deficiency.
Functions of Riboflavin
Coenzyme Role
Riboflavin Deficiency and Clinical Applications
Riboflavin Requirement
Dietary Reference Intake
Populations at Risk
Food Sources of Riboflavin
Niacin
Chemical and Physical Nature
BOX 6-13 Food Sources of Riboflavin
FIGURE 6-9 Pellagra is caused by niacin deficiency.
Functions of Niacin
Coenzyme Role
Use as a Drug
Niacin Deficiency and Clinical Applications
Niacin Requirement
Dietary Reference Intake
Food Sources of Niacin
Pantothenic acid
Discovery
Chemical and Physical Nature
Functions of Pantothenic Acid
Pantothenic Acid Requirements
Food Sources of Pantothenic Acid
Biotin
General Nature of Biotin
BOX 6-14 Food Sources of Niacin
Functions of Biotin
Biotin Requirement
Food Sources of Biotin
Vitamin B6 (Pyridoxine)
Chemical and Physical Nature
Forms
Absorption, Transport, and Storage
Functions of Vitamin B6
Coenzyme in Protein Metabolism
Coenzyme in Fat Metabolism
Vitamin B6 Deficiency and Clinical Applications
Vitamin B6 Requirement
Dietary Reference Intake
Vitamin B6 Toxicity
Food Sources of Vitamin B6
Folate
Discovery
Chemical and Physical Nature
BOX 6-15 Food Sources of Vitamin B6 (Pyridoxine)
Absorption, Transport, and Storage
Functions of Folate
Coenzyme Role
BOX 6-16 Calculating Dietary Folate Equivalents
Folate Deficiency and Clinical Applications
Anemia
Presence of Gastric Acid
Medications
Folate and Birth Defects
FIGURE 6-10 Neural tube defects (NTDs) include spina bifida and anencephaly. They result from a lack of folate needed to close the neural tube that becomes the spinal cord in the developing fetus.
Folate and Chronic Disease
Folate Requirement
Dietary Reference Intake
Folate Toxicity
BOX 6-17 Food Sources of Folate
Food Sources of Folate
Vitamin B12 (Cobalamin)
Discovery
Chemical and Physical Nature
Absorption, Transport, and Storage
Functions of Vitamin B12
Basic Coenzyme Role
Vitamin B12 Deficiency and Clinical Applications
Vitamin B12 Requirement
Food Sources of Vitamin B12
BOX 6-18 Food Sources of Vitamin B12 (Cobalamin)
Naturally Occurring Sources of Vitamin B12
Examples of Non-Animal Foods Sometimes Fortified with Vitamin B12
TABLE 6-4 Summary Of B-Complex Vitamins
Perspectives in Practice
Do I Need a Vitamin-Mineral Supplement?
References
To sum up
Questions for review
References
Further readings and resources
Readings
Websites of Interest
CHAPTER 7 Minerals
Key terms
Minerals in human nutrition
Comparison of Vitamins and Minerals
Cycle of Minerals
TABLE 7-1 Mineral and Vitamin Comparison
Metabolic Roles
Differing Functions
Differing Amounts
Concept of Bioavailability
Classification
Major Minerals
Trace Elements
BOX 7-1 Essential Major Minerals and Trace Elements
Major minerals
Calcium
Intake-Absorption-Excretion Balance
Calcium Intake
Calcium Absorption
Factors Increasing Calcium Absorption
Factors Decreasing Calcium Absorption
FIGURE 7-1 Bone and cartilage development.
Calcium Excretion
Bone-Blood Balance
Calcium in the Bones
Calcium in the Blood
Calcium-Phosphorus Serum Balance
FIGURE 7-2 Calcium metabolism. Note the relative distribution of calcium in the body.
Physiologic Functions of Calcium
Bone Formation
Tooth Formation
General Metabolic Functions
Clinical Applications
Tetany
Rickets and Osteomalacia
Resorptive Hypercalciuria and Renal Calculi
Calcium and Health
Bone Disease
FIGURE 7-3 Comparison of normal and osteoporotic spongy bone. Scanning electron micrograph (SEM) of A, normal bone, and B, bone with osteoporosis. Note the loss of trabeculae and appearance of enlarged pores in the osteoporotic bone.
Metabolic Disease
Calcium Requirement
Dietary Reference Intake
Food Sources of Calcium
BOX 7-2 Comparison of Calcium Food Sources
BOX 7-3 Food Sources of Calcium
TABLE 7-2 Choosing a Calcium Supplement
Calcium Supplements
Phosphorus
Absorption-Excretion Balance
Absorption
Excretion
Bone-Blood-Cell Balance
Bone
Blood
Evidence-Based Practice
Restoring Lost Bone: Are Drugs Always Needed?
Bibliography
Cells
Hormonal Controls
Physiologic Functions
Bone and Tooth Formation
General Metabolic Activities
Clinical Applications
Phosphorus Requirement
Dietary Reference Intake
Food Sources of Phosphorus
Sodium
Absorption-Excretion Balance
Absorption
Excretion
Physiologic Functions of Sodium
Water Balance
Acid-Base Balance
Cell Permeability
Muscle Action
Sodium Requirement
Dietary Reference Intake
Health promotion
Sodium and Blood Pressure
Focus on Culture
Low Mineral Intake: Does It Have an Effect on Blood Pressure Among African Americans?
References
Sodium Intake
Controlling Sodium Intake
FIGURE 7-4 Sources of dietary sodium. Most of our dietary sodium comes from processed food.
Potassium
TABLE 7-3 Sodium-Containing Additives Commonly Used in Food Processing
Absorption-Excretion Balance
Absorption
Excretion
Physiologic Functions of Potassium
Water Balance
Muscle Activity
Carbohydrate Metabolism
Protein Synthesis
Control of Blood Pressure
Acid-Base Balance
BOX 7-4 Sodium Content of Processed Versus Unprocessed Foods*
Potassium Requirement
Dietary Reference Intake
Perspectives in Practice
Potassium—The Other Side of the Blood Pressure Equation
Clinical Implications of Excessive Intake
Food Sources of Potassium
BOX 7-5 Food Sources of Potassium
Magnesium
Magnesium Requirement
Food Sources
Chloride
Sulfur
BOX 7-6 Food Sources of Magnesium
Essential trace elements
Trace elements: the concept of essentiality
TABLE 7-4 Summary of Major Minerals
Iron
Forms of Iron in the Body
Absorption-Transport-Storage-Excretion Balance
Absorption
TABLE 7-5 Characteristics of Heme and Nonheme Dietary Iron
Transport
Storage
Excretion
Physiologic Functions of Iron
Oxygen Transport
Cellular Oxidation
Immune Function
Growth Needs
Brain and Cognitive Function
Clinical Applications
FIGURE 7-5 Summary of iron metabolism, showing its absorption, transport, use in hemoglobin formation, and storage forms (ferritin and hemosiderin).
Iron Deficiency Anemia
BOX 7-7 Signs of Iron Deficiency
Worldwide Problem of Iron Deficiency Anemia
Iron Requirement
Dietary Reference Intake
Special Considerations for Vegetarians
Iron Toxicity
Hemochromatosis
Tolerable Upper Intake Level
Food Sources of Iron
Iodine
BOX 7-8 Food Sources of Iron
Absorption-Excretion Balance
Absorption
Excretion
Hormonal Control
FIGURE 7-6 Goiter. The extreme enlargement shown here reflects an extended duration of iodine deficiency.
Physiologic Function of Iodine
Thyroid Hormone Synthesis
Plasma Thyroxine
Clinical Applications
Iodine Deficiency Disorder: Goiter
Iodine Deficiency Disorder: Cretinism
Iodine Overload
Iodine Requirement
Dietary Reference Intake
Food Sources of Iodine
Zinc
Clinical Applications
Zinc Requirement
Dietary Reference Intake
Food Sources of Zinc
BOX 7-9 Food Sources of Zinc
Copper
Manganese
Chromium
Focus on Food Safety
Minerals from Cooking Utensils
What Is Safe and What Is Harmful?
Cobalt
Selenium
Molybdenum
Fluoride
Other trace elements
Water-electrolyte balance
Body water distribution
Functions of water
Overall water balance: input and output
TABLE 7-6 Summary of Trace Elements
TABLE 7-7 Approximate Daily Adult Water Intake and Output
BOX 7-10 Functions of Body Water
Water requirements
Dietary Reference Intake
TABLE 7-8 Water Content of Selected Foods and Beverages
TABLE 7-9 Adequate Intakes of Fluid*
Special Clinical Applications
Water Compartments
Forces controlling water distribution
Solutes
Electrolytes
Plasma Proteins
Organic Compounds of Small Molecular Size
FIGURE 7-7 Body fluid compartments. Note the relative amounts of water in the intracellular compartment and extracellular compartment.
Membranes
Influence of electrolytes on water balance
Measurement of Electrolytes
Electrolyte Balance
Electrolyte Control of Body Hydration
Influence of plasma proteins on water balance
Capillary Fluid Shift Mechanism
Cell Fluid Control
Hormones controlling water balance
Antidiuretic Hormone
Aldosterone
To sum up
Questions for review
References
Further readings and resources
Readings
Websites of Interest
CHAPTER 8 Energy Balance
Key terms
The human energy system
Energy Cycles and Energy Transformation
Forms of Human Energy
Transformation of Energy
FIGURE 8-1 Transformation of energy from its primary source (the sun) to the forms needed for biologic work by means of metabolic processes (“transformers”).
Energy Balance: Input and Output
Energy Control in Human Metabolism
Chemical Bonding
FIGURE 8-2 Lock-and-key concept of the actions of enzyme, coenzyme, and substrate to produce a new reaction product.
Controlled Reaction Rates
Types of Metabolic Reactions
Sources of Stored Energy
Measurement of Energy Balance
Kilocalorie
Joule
Food Energy Measurement
Calorimetry
Approximate Composition
Total energy requirement
Basal Metabolic Needs
Basal Metabolic Rate
TABLE 8-1 Fuel Factors
Measuring Basal Metabolic Rate
BOX 8-1 Required Conditions for Measuring Basal Metabolic Rate
Factors Influencing Basal Metabolic Rate
Food Intake Effect (Thermic Effect of Food)
Physical Activity Needs
TABLE 8-2 Energy Expended in Selected Physical Activities
FIGURE 8-3 Effect of body weight on energy expended walking at different speeds. Body weight and walking speed influence the kcalories burned. Persons with a higher body weight use more kcalories in weight-bearing activities than persons with a lower body weight; the faster you walk the more kcalories you will use.
Estimating Energy Requirements
TABLE 8-3 Estimated Energy Requirements Based on Age and Activity Level*
Body composition: fatness and leanness
Body Weight and Body Fat
Overweight Versus Overfat
FIGURE 8-4 Body types: the ectomorph, the mesomorph, and the endomorph.
Body Compartments
FIGURE 8-5 A pod for measuring body composition. The BOD POD uses air displacement technology to measure body composition.
Importance of Body Fat
Measuring Body Compartments
Specialized Methods
Reference Height-Weight Tables
Focus on Culture
Evaluating Body Compartments: One Size Really Doesn’t Fit All
Bibliography
Reference Tables From Government Agencies
Body Mass Index
TABLE 8-4 Adult Body Mass Index Chart
TABLE 8-5 Classification of Body Weight According to Body Mass Index
Waist-to-Hip Ratio
Health promotion
Finding a Healthy Weight
FIGURE 8-6 The pear shape versus the apple shape. Those with an apple shape and more abdominal fat have a greater risk of chronic disease than those with a pear shape and less abdominal fat. In women the waist-to-hip ratio should not exceed 0.8; in men it should not exceed 0.9.
Developing a Healthy Lifestyle
Perspectives in Practice
Assessing Energy Expenditure and Body Weight
A Calculate Your Total Energy Output per Day
1 Resting Metabolic Rate
2 Thermic Effect of Food
3 Physical Activity
Calculating Your Physical Activity Kcalories Using an Activity Record
Approximating Your Physical Activity Kcalories Using Your RMR
4 Calculate Your Total Energy Expenditure
B Evaluate Your Body Weight Using the Body Mass Index
1 Calculate Your Body Mass Index
C Evaluate Your Health Status Using Waist Circumference
References
Evidence-Based Practice
Is There a Role for Walking in Weight Management?
Current Recommendations
Walking and Weight Management
Bibliography
Fatness, thinness, and health
Rise in Obesity
Focus on Food Safety
Safe Snacking
Obesity and Health
Obsession with Thinness
Eating Disorders: A High Price for Thinness
Causes of Eating Disorders
Types of Eating Disorders
Prevention and Treatment
BOX 8-2 Signs Associated with Development of Eating Disorders in Adolescents
Behavioral Signs
Clinical Signs (Anorexia Nervosa)
Clinical Signs (Bulimia Nervosa)
The Problem of Underweight
Definition
General Causes
BOX 8-3 Causes of Underweight
Nutritional Care
To sum up
Questions for review
References
Further readings and resources
Readings
Websites of Interest
PART 2 Community Nutrition and the Life Cycle
CHAPTER 9 The Food Environment and Food Safety
Key terms
Personal food selection
Cultural Influences
Cultural Identity
Food in a Culture
Focus on Culture
Family Meals: Where Food and Culture Meet
Bibliography
Social Influences
Internal Factors
External Factors
Psychologic Influences
FIGURE 9-1 A family sharing food. Sharing food with visitors to your home is an established custom among many cultural and ethnic groups.
BOX 9-1 Factors Influencing Food Choices
Environmental Factors
Social Factors
Physiologic Factors
Trends in food selection
Defining a Food Pattern
Changing American Food Patterns
BOX 9-2 Current Food Trends
Convenience Meals
Perspectives in Practice
Returning to Hands-On Food
References
Grazers
Family Meals
Health Concerns
Ethnic and Specialty Dining
The problem of food misinformation
Types of False Food Claims
Groups Vulnerable to Food Misinformation
Combating Food Misinformation
BOX 9-3 Checklist for Spotting a Health Scam
Biotechnology and food: promise and controversy
Bovine Growth Hormone
Genetically Modified Plants
Goals for Genetic Modification
Safety of Genetically Modified Crops
Biotechnology and Animal Foods
Ensuring a safe and wholesome food supply
Government Agencies Responsible for Food Safety
A Shared Regulatory System: USDA and FDA
BOX 9-4 Food-Related Activities of the u.s. Food and Drug Administration
Food and Drug Administration
Food Safety Laws
Approval Process for Drugs
Regulation of Food Ingredients and Food Additives
Perspectives in Practice
The Threat of Bioterrorism to the Food Supply: Risk Assessment and Response
Bibliography
Dietary Supplements
Agricultural Chemicals
Water Contamination
FIGURE 9-2 Seal of the National Organic Program. The U.S. Department of Agriculture (USDA) has developed a certification program to help organic farmers label their produce as organically grown.
BOX 9-5 Mercury Content of Fish
Fish Lower in Mercury
Fish Higher in Mercury
Food Labels
FIGURE 9-3 Example of a food label. Notice that this label also informs the consumer that the product contains wheat—one of eight food allergens that must be clearly stated on the food label to protect individuals having this allergy.
Early Efforts at Food Labeling
Current Food Labeling Regulations
Health promotion
Using the Nutrition Label
FIGURE 9-4 A nutrition label. The nutrition label helps consumers evaluate the nutrient content of processed foods.
TABLE 9-1 Health Claims Approved by the Fda for Nutrition Labels
Food and Botanicals
Food safety and food processing
Foodborne Illness
Prevalence and Causes of Foodborne Illness
Forms of Foodborne Illness
Bacterial Food Infection
Focus on Food Safety
Do I Really Need to Wash That Melon?
Bacterial Food Poisoning
Viruses
TABLE 9-2 Selected Examples of Bacterial Foodborne Disease
Costs of Foodborne Illness
Prevention of Foodborne Illness
Sanitation Procedures
FIGURE 9-5 Chart of food temperatures. It is important to keep hot foods hot and cold foods cold. Foods should be held at temperatures less than 45° F or greater than 140° F to prevent microbial growth. Microorganisms grow rapidly between 45° F and 140° F. Meat and poultry products should be cooked to the internal temperature indicated on the chart.
Case Study
Planning the Family Dinner
Questions for Analysis
FIGURE 9-6 Seven-step process for proper hand washing. Failure to wash hands thoroughly before and after food preparation and before eating is a common cause of foodborne illness.
Food Irradiation
Food Safety Education
Evidence-Based Practice
Developing Food Safety Education Programs: Assessing Learner Needs
References
FIGURE 9-7 Fight BAC!, a program initiative of the Partnership for Food Safety Education, emphasizes four steps in food handling to prevent foodborne illness: (1) clean, (2) separate, (3) cook, and (4) chill.
Food Preservation and Processing
Preservation Methods
TABLE 9-3 Examples of Food Additives
Chemical Additives
Nutritional Aspects of Food Processing
To sum up
Questions for review
References
Further readings and resources
Further Readings
Websites of Interest
CHAPTER 10 Community Nutrition: Promoting Healthy Eating
Key terms
Implementing nutrition education
Framework for Wellness
Framework for Nutrition Education
Person-Centered Goals
Model for Nutrition Counseling
Getting Started
FIGURE 10-1 Model for dietary counseling. The goal of dietary counseling is to bring about a change in food and lifestyle behaviors that will lower the risk of chronic disease.
FIGURE 10-2 Sitting at a table with your client in a quiet place provides a supportive environment for communication. Online nutrition education materials can be helpful in nutrition counseling.
Counseling as a Process
Evidence-Based Practice
New Communication Methods
Are They Effective in Nutrition Education?
Personalized Telephone Counseling
Automated Telephone Messages
Short-Message Service (Text Messaging)
Bibliography
Communication as a Process
TABLE 10-1 Levels of Personal Responsibility and Intervention Methods: a Diabetes Example
Focus on Culture
Counseling and Culture
Respecting Cultural Differences
Individual or Group Orientation
Locus of Control
Patterns of Communication
Bibliography
Theories for Behavior Change

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