Meat Consumption.
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brief contents
10 Achieving and Maintaining a Healthful Body Weight 342
in depth 10.5 Obesity 372
11 Nutrition and Physical Fitness: Keys to good health 380
in depth 11.5 Disorders Related to Body Image, Eating, and Exercise†413
12 Food Safety and Technology: Protecting our food 424
in depth 12.5†Theâ€Safetyâ€andâ€Effectivenessâ€of†Dietaryâ€Supplements†454
13 Food Equity, Sustainability, and Quality: The challenge of “good food” 460
in depth 13.5†Malnutrition†480
14 Nutrition Through the Life Cycle: Pregnancy and the first year of life 486
in depth 14.5†Theâ€Fetalâ€Environment†524
15 Nutrition Through the Life Cycle: Childhood to late adulthood 528
in depth 15.5†Searchingâ€forâ€theâ€Fountain†of Youth†562
Appendices A-1 References R-1 Answers AN-1 Glossary GL-1 Index IN-1 Credits CR-1
1 Nutrition: Linking food and health 2
in depth 1.5 New Frontiers in Nutrition and Health 29
2 Designing a Healthful Diet 36 in depth 2.5†Healthfulâ€Eatingâ€Patterns†59
3 The Human Body: Are we really what we eat? 64
in depth 3.5 Disorders Related to Specific Foods†93
4 Carbohydrates: Plant-derived energy nutrients 98
in depth 4.5â€â€ Diabetes†130
5 Fats: Essential energy-supplying nutrients 138
in depth 5.5†Cardiovascularâ€Disease†167
6 Proteins: Crucial components of all body tissues 178
in depth 6.5 Vitamins and Minerals: Micronutrientsâ€with†Macro Powers†211
7 Nutrients Essential to Fluid and Electrolyte Balance 222
in depth 7.5†Alcohol†249
8 Nutrients Essential to Key Body Functions 260
in depth 8.5†Cancer†292
9 Nutrients Essential to Healthy Tissues 300
in depth 9.5†Osteoporosis†334
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Helping Students See Nutrition Concepts Come Alive in Their Daily Lives
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Nutrition Concepts Applied to Students’ Daily Lives
NEW! In Depth Chapters Obesity, Malnutrition, and Healthful Eating Patterns are three new mini-chapters that focus on topics such as the health and societal problems surrounding undernourishment; the effectiveness of lifestyle changes, medications, dietary supplements, and surgery in obesity treatment; and the components and principles of a healthful eating pattern.
NEW! Chapter 13: Food Equity, Sustainability, and Quality: The Challenge of “Good” Food Focuses on current issues of food quality and availability that directly affect today’s students. Topics include the disparities in availability of high-quality, nourishing food thought to contribute to the poverty-obesity paradox, unsafe working conditions in many U.S. farms and factories, and more.
NEW! Focus Figures 6 new Focus Figures on topics such as nutrition and human disease, the scientific method, the new nutrition facts panel, and more; and 8 new Meal Focus Figures have been added that graphically depict the differences in sets of meals, such as a comparison of nutrient density or a comparison of two high- carbohydrate meals, to engage students with relevant and practical information, and much more.
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Help Students Master Tough Concepts of the Course
NEW! Learning Outcomes Approach New approach creates a clear learning path for students with numbered learning outcomes at the beginning of each chapter that are then tied to each major chapter section, helping students navigate each chapter and measure their progress against specific learning goals; this approach also helps instructors assess the key information and skills students are meant to take away from each chapter.
NEW! Study Plans Study Plans conclude each chapter, tying the chapter learning outcomes to the review questions and math review questions, and also includes the test yourself t/f answers and web links.
NEW! Table of Contents Organization To better streamline the coverage of the micronutrients, four former chapters (7-10 in the 4e) now become three (7-9 in the 5e) to help students better comprehend the role of vitamins and minerals in fluid and electrolyte balance (Ch. 7); key body functions (energy metabolism, antioxidant functions, and vision) (Ch. 8); and healthy body tissues (collagen, blood, and bone) (Ch. 9).
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BEFOrE CLASS Mobile Media and Reading Assignments Ensure Students Come to Class Prepared
Continuous Learning Before, During, and After Class
Pre-Lecture Reading Quizzes are easy to customize and assign
NEW! Interactive eText 2.0 gives students access to the text whenever they can access the internet. eText features include:
• Now available on smartphones and tablets
• Seamlessly integrated videos and other rich media
• Accessible (screen-reader ready) • Configurable reading settings, including
resizable type and night reading mode • Instructor and student note-taking,
highlighting, bookmarking, and search • Also available for offline use via Pearson’s
eText 2.0 app
NEW! Reading Questions ensure that students complete the assigned reading before class and stay on track with reading assignments. Reading Questions are 100% mobile ready and can be completed by students on mobile devices.
UPDATED! Dynamic Study Modules help students study effectively by continuously assessing student performance and providing practice in areas where students struggle the most. Each Dynamic Study Module, accessed by computer, smartphone or tablet, promotes fast learning and long-term retention.
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AFTEr CLASS MasteringNutrition Delivers Automatically Graded Nutrition Activities
Learning Catalytics, a “bring your own device” student engagement, assessment, and classroom intelligence system, allows students to use their smartphone, tablet, or laptop to respond to questions in class.
DUrING CLASS Engage students with Learning Catalytics
with MasteringNutrition™
UPDATED! Nutrition Animations explain big picture concepts that help students learn the hardest topics in nutrition. These animations, complete with a new design and compatible with Mastering and mobile devices, help students master tough topics and address students’ common misconceptions, using assessment and wrong-answer feedback.
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AFTEr CLASS Easy-to-Assign, Customize, Media-Rich, and Automatically Graded Assignments.
Continuous Learning Before, During, and After Class
NEW! Study Plan items tie all end-of- chapter material to specific numbered Learning Outcomes and Mastering assets. Assignable study plan items contain at least one multiple choice question per Learning Outcome and wrong-answer feedback.
NEW! ABC News Videos bring nutrition to life and spark discussion with up-to-date hot topics from 2012 to 2016 that occur in the nutrition field. Multiple-choice questions provide wrong-answer feedback to redirect students to the correct answer.
ExPANDED! Focus Figure Coaching Activities better guide students through key nutrition concepts with interactive mini-lessons.
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with MasteringNutrition™
Math Coaching Activities provide hands-on practice of important nutrition- related calculations to help students understand and apply the material. Questions include wrong-answer feedback.
UPDATED! Nutritools Build-A-Meal Coaching Activities have been updated and allow students to combine and experiment with different food options and learn firsthand how to build healthier meals. The Build a Meal, Build a Pizza, Build A Salad, and Build A Sandwich tools have been carefully rethought to improve the user experience, making them easier to use and are now HTML5 compatible for mobile devices.
Single sign-on to MyDietAnalysis allows students to complete a diet assignment. Students keep track of their food intake and exercise and enter the information to create a variety of reports. A mobile version gives students 24/7 access via their smartphones to easily track food, drink, and activity on the go. MyDietAnalysis Case Study Activities with quizzing provide students with hands-on diet analysis practice that can also be automatically graded.
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Teaching Resources â– â– Instructor Resource and Support Manual in
Microsoft Word and PDF formats â– â– Teaching with Student Learning Outcomes â– â– Teaching with Web 2.0 â– â– Learning Catalytics: Getting Started â– â– Getting Started with MasteringNutrition
Student Supplements â– â– Eat Right! â– â– Live Right! â– â– Food Composition Table
resources for YOU, the Instructor
MasteringNutrition™ provides you with everything you need to prep for your course and deliver a dynamic lecture, in one convenient place. Resources include:
Media Assets for Each Chapter â– â– ABC News Lecture Launcher videos â– â– Nutrition Animations â– â– PowerPoint Lecture Outlines â– â– PowerPoint clicker questions and Jeopardy-style
quiz show questions â– â– Files for all illustrations and tables and selected
photos from the text
Test Bank â– â– Test Bank in Microsoft, Word, PDF, and RTF
formats â– â– Computerized Test Bank, which includes all
the questions from the printed test bank in a format that allows you to easily and intuitively build exams and quizzes.
Measuring Student Learning Outcomes? All of the MasteringNutrition assignable content is tagged to book content and to Bloom’s Taxonomy. You also have the ability to add your own learning outcomes, helping you track student performance against your learning outcomes. You can view class performance against the specified learning outcomes and share those results quickly and easily by exporting to a spreadsheet.
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Janice Thompson, PhD, FACSM University of Birmingham
Melinda Manore, PhD, RD, CSSD, FACSM Oregon State University
Nutrition An Applied Approach F I F T H E D I T I O N
330 Hudson Street, NY NY 10013
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Courseware Portfolio Manager: Michelle Yglecias Content Producer: Deepti Agarwal Managing Producer: Nancy Tabor Courseware Director, Content Development: Barbara Yien Development Editor: Laura Bonazzoli Art Development Editor: Jay McElroy Courseware Editorial Assistant: Nicole Constantine Rich Media Content Producer: Timothy Hainley, Lucinda Bingham Mastering Content Developer, Science: Lorna Perkins Full-Service Vendor: SPi Global Copyeditor: Alyson Platt Art Coordinator: Rebecca Marshall, Lachina Publishing Services Design Manager: Mark Ong Interior Designer: Preston Thomas Cover Designer: Preston Thomas Photographer: Renn Valo, CDV LLC Rights & Permissions Project Manager: Matt Perry, Cenveo Publishing Services Rights & Permissions Management: Ben Ferrini Photo Researcher: Danny Meldung, Photo Affairs, Inc. Manufacturing Buyer: Stacey Weinberger, LSC Communications Executive Product Marketing Manager: Neena Bali Senior Field Marketing Manager: Mary Salzman
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Copyright © 2018, 2015, 2012 Pearson Education, Inc. All Rights Reserved. Printed in the United States of America. This publication is protected by copyright, and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise. For information regarding permissions, request forms and the appropriate contacts within the Pearson Education Global Rights & Permissions department, please visit www.pearsoned.com/permissions/.
Acknowledgements of third party content appear on pages CR-1 to CR-3, which constitutes an extension of this copyright page.
PEARSON, ALWAYS LEARNING and MasteringHealth are exclusive trademarks in the U.S. and/or other countries owned by Pearson Education, Inc. or its affiliates.
Unless otherwise indicated herein, any third-party trademarks that may appear in this work are the property of their respective owners and any references to third-party trademarks, logos or other trade dress are for demonstrative or descriptive purposes only. Such references are not intended to imply any sponsorship, endorsement, authorization, or promotion of Pearson’s products by the owners of such marks, or any relationship between the owner and Pearson Education, Inc. or its affiliates, authors, licensees or distributors.
Library of Congress Cataloging-in-Publication Data Names: Thompson, Janice, author. | Manore, Melinda, author. Title: An applied approach / Janice Thompson, Ph.D., FACSM, University of Birmingham, Melinda Manore, Ph.D., RD, CSSD, FACSM, Oregon State University. Description: Fifth edition. | New York, NY : Pearson, 2017. Identifiers: LCCN 2016037778 | ISBN 0134516230 Subjects: LCSH: Nutrition. Classification: LCC QP141 .T467 2017 | DDC 612.3–dc23 LC record available at https://lccn.loc.gov/2016037778
1 16
ISBN 10: 0-13-451623-0; ISBN 13: 978-0-13-451623-3 (Student edition) ISBN 10: 0-13-460828-3; ISBN 13: 978-0-13-460828-0 (Instructor’s Review Copy)www.pearsonhighered.com
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This book is dedicated to my family, friends, and colleagues—you provide constant support, encouragement, and unconditional love. It is also dedicated to my students and the communities with which I work—you continue to inspire me, challenge me, and teach me.
This book is dedicated to my parents, for their consistent love, prayers, support, and encouragement. You helped me believe in myself.
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Janice Thompson, PhD, FACSM University of Birmingham, UK
Janice Thompson earned a doctorate in exercise physiology and nutrition at Arizona State University. She is currently professor of public health nutrition and exercise at the University of Birmingham, UK, in the School of Sport and Exercise Sciences. Her research focuses on designing and assessing the impact of nutrition and physi- cal activity interventions to reduce the risks for obesity, cardiovascular disease, and type 2 diabetes in high-risk populations. She also teaches nutrition and research methods courses and mentors graduate research students. Janice is a Fellow of the American College of Sports Medicine (ACSM), a member of the Scientific Committee of the European College of Sports Science, and a member of the American Society for Nutrition (ASN), the British Association of Sport and Exercise Science (BASES), and the Nutrition Society. Janice won an undergraduate teaching award while at the University of North Carolina, Charlotte, a Community Engagement Award while at the University of Bristol, and the ACSM Citation Award for her contributions to research, education, and service to the exercise sciences. In addition to The Science of Nutrition, Janice coauthored the Pearson textbooks Nutrition: An Applied Approach and Nutri- tion for Life with Melinda Manore. Janice loves hiking, yoga, traveling, and cooking and eating delicious food. She likes almost every vegetable except fennel and believes chocolate should be listed as a food group.
Melinda Manore, PhD, RD, CSSD, FACSM Oregon State University
Melinda Manore earned a doctorate in human nutrition with minors in exercise physi- ology and health at Oregon State University (OSU). She is the past chair of the OSU Department of Nutrition and Food Management and is currently a professor of nutri- tion. Prior to OSU, she was a professor at Arizona State University. Melinda’s area of expertise is nutrition and exercise, particularly the role of diet and exercise in health and prevention of chronic disease, exercise performance, and energy balance. She has a special focus on the energy and nutritional needs of active women and girls across the life cycle. Melinda is an active member of the Academy of Nutrition and Dietetics (AND) and the American College of Sports Medicine (ACSM). She is the past chair of the AND Research Dietetic Practice Group; served on the AND Obesity Steering Com- mittee; and is an active member of the Sports, Cardiovascular, and Wellness Nutri- tion Practice Group. She is a fellow of ACSM, has served as vice president and on the Board of Trustees, and received the ACSM Citation Award for her contributions to research, education, and service to the exercise sciences. Melinda is also a member of the American Society of Nutrition (ASN) and the Obesity Society. She is the past chair of the U.S. Department of Agriculture (USDA) Nutrition and Health Committee for Pro- gram Guidance and Planning and currently is chair of the USDA, ACSM, AND Expert Panel Meeting, Energy Balance at the Crossroads: Translating Science into Action. She serves on the editorial board of numerous research journals and has won awards for excellence in research and teaching. Melinda also coauthored the Pearson textbooks Nutrition: An Applied Approach and Nutrition for Life with Janice Thompson. Melinda is an avid walker, hiker, and former runner who loves to garden, cook, and eat great food. She is also an amateur birder.
about the authors
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Why We Wrote This Book Nutrition gets a lot of press. Go online or pick up a magazine and you’ll read the lat- est debate over which weight-loss diet is best; turn on the TV or stream a video and you’ll hear a celebrity describe how she lost 50 pounds without exercising; scan the headlines or read some blogs and you’ll come upon the latest “super foods” and the politics surrounding the creation of new, enhanced “designer” foods. How can you evaluate these sources of nutrition information and find out whether the advice they provide is reliable? How do you navigate through seemingly endless recommenda- tions and arrive at a way of eating that’s right for you—one that supports your physi- cal activity, allows you to maintain a healthful weight, and helps you avoid chronic diseases?
Nutrition: An Applied Approach began with our conviction that students and instructors would both benefit from an accurate and clear textbook that links nutri- ents to their functional benefits. As authors and instructors, we know that students have a natural interest in their bodies, their health, their weight, and their success in sports and other activities. By demonstrating how nutrition relates to these interests, this text empowers students to reach their personal health and fitness goals. Through- out the text, material is presented in a lively narrative that continually links the facts to students’ circumstances, lifestyles, and goals. Information on current events and research keeps the inquisitive spark alive, illustrating that nutrition is truly a “living” science, and a source of considerable debate. The content of Nutrition: An Applied Approach is appropriate for non-nutrition majors, but also includes information that will challenge students who have a more advanced understanding of chemistry and math. We present the “science side” in a contemporary narrative style that’s easy to read and understand, with engaging features that reduce students’ apprehensions and encourage them to apply the material to their lives. Also, because this book is not a derivative of a major text, the writing and the figures are cohesive and always level appropriate.
As teachers, we are familiar with the myriad challenges of presenting nutrition information in the classroom, and we have included the most comprehensive ancil- lary package available to assist instructors in successfully meeting these challenges. We hope to contribute to the excitement of teaching and learning about nutrition—a subject that affects all of us, and a subject so important and relevant that correct and timely information can make the difference between health and disease.
New to the Fifth Edition Retaining its hallmark applied approach, the new fifth edition takes personal nutrition concepts a step further with dynamic new features that help students realize that they think about their nutrition daily. The most noteworthy changes include:
NEW! Focus Figures (two new) in Chapter 1, one focusing on nutrition and human disease, the other on the six groups of nutrients found in food. NEW! Meal Focus Figures (four new) graphically depict the differences in sets of meals, such as a comparison of nutrient density or a comparison of two high- carbohydrate meals, to engage students with useful information. UPDATED! Nutrition Facts Panel and Dietary Guidelines for Americans offer the latest nutritional guidelines (Chapter 2). NEW! Chapter 13: Food Equity, Sustainability, and Quality: The Challenge of “Good” Food focuses on current issues of food quality and availability that directly affect today’s students. Topics include the disparities in availability of high-quality,
Welcome to Nutrition: An Applied Approach, Fifth Edition!
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viii | New to the Fifth Edition
nourishing food thought to contribute to the poverty-obesity paradox, unsafe working conditions in many U.S. farms and factories, and more. NEW! In Depth Chapters: Obesity, Malnutrition, and Healthful Eating Patterns, these three new mini-chapters focus on topics such as the health and societal problems surrounding undernourishment; the effectiveness of lifestyle changes, medications, dietary supplements, and surgery in obesity treatment; and the com- ponents and principles of a healthful eating pattern. NEW! ABC News Videos bring nutrition to life and spark discussion with up-to- date hot topics from 2012 to 2016. MasteringNutrition activities tied to the videos include multiple-choice questions that provide wrong-answer feedback to redirect students to the correct answer.
To help students master tough concepts of the course, updates include:
NEW! Table of Contents organization to better streamline the coverage of the micronutrients where four former chapters [7 to 10 in the 4th edition] now become three [7 to 9 in the 5th edition] to reduce duplicate coverage and help students better comprehend the role of vitamins and minerals in fluid and elec- trolyte balance (Chapter 7); key body functions (energy metabolism, antioxidant functions, and vision) (Chapter 8); and healthy body tissues (collagen, blood, and bone) (Chapter 9). NEW! Learning Outcomes approach creates a clear learning path for students with numbered learning outcomes at the beginning of each chapter that are then tied to each major chapter section, helping students navigate each chapter and measure their progress against specific learning goals, and helping instructors assess the key information and skills students are meant to take away from each chapter. NEW! Study Plans conclude each chapter, tying the chapter learning outcomes to the review questions and math review questions, and also includes the Test Your- self true/false answers and Web Links. NEW! Offline access to the eText anytime with eText 2.0. Complete with embed- ded ABC News videos and animation, eText 2.0 is mobile friendly and ADA accessible.
Now available on smartphones and tablets. Seamlessly integrated videos. Accessible (screen-reader ready). Configurable reading settings, including sizable type and night reading mode. Instructor and student note taking, highlighting, bookmarking, and search.
This fifth edition of Nutrition: An Applied Approach also features the Mastering- Nutrition™ online homework, tutorial, and assessment system, which delivers self- paced tutorials and activities that provide individualized coaching, a focus on course objectives, and tools enabling instructors to respond individually to each student’s progress. The proven Mastering system provides instructors with customizable, easy- to-assign, automatically graded assessments that motivate students to learn outside of class and arrive prepared for lecture.
The Visual Walkthrough located at the front of this text provides an overview of these and other important features in the fifth edition. For specific changes to each chapter, see the following.
Chapter 1 Nutrition: Linking Food and Health Restructured headings throughout the chapter to improve organization and flow of the chapter. Expanded narrative text on wellness and the role that a healthy diet plays in pro- moting wellness. Revised Figure 1.1 (previously titled “Components of Wellness”) to figure illustrat- ing how a nutritious diet contributes to wellness in numerous ways. Deleted the Nutrition Myth or Fact and incorporated discussion of pellagra into the narrative text. Deleted the Hot Topic on spam and incorporated it into the narrative text.
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New to the Fifth Edition | ix
New Focus Figure 1.2 on the relationship between nutrition and human disease, which consolidated the previous Figures 1.2 to 1.4. New Focus Figure 1.3 on the six groups of nutrients found in foods, which consoli- dated the previous Figures 1.6 to 1.8, and added in new information and graphics on vitamins and minerals. Deleted previous Table 1.4 on AMDRs, as this information is provided in Focus Figure 1.4. New Focus Figure 1.5 on the scientific method—improves upon previous figure. Added new narrative text for epidemiological studies, prevalence, and incidence. New Figure 1.6 on types of research studies—combines narrative and decorative photos. New end-of-chapter Nutrition Debate on “Conflict of Interest”; included a new Critical Thinking Question that requires students to conduct research into the topic.
In Depth 1.5 New Frontiers in Nutrition and Health Slightly expanded the discussion of epigenetics and added a new figure illustrating the effect of epigenetic factors on gene expression. Deleted the Hot Topic on PB&J.
Chapter 2 Designing a Healthful Diet Restructured chapter headings and subheadings to improve organization, flow, and readability. Revised the chapter opener Test Yourself questions. Included new Meals Focus Figure (now Figure 2.1) illustrating the concept of nutrient density, which is now discussed as one of the characteristics of a health- ful diet. Expanded narrative on nutrient density to include an example of the NuVal system in supermarkets. Complete rewrite of section on “What’s Behind Our Food Choices?” which moved here from the former In Depth 2.5. Updated section on food labels, and included updated and enhanced figures on food labels (now Figure 2.3) and the Nutrition Facts panel (now Focus Figure 2.4). Deleted the previous Figure 2.3 (Health Claims Report Card) as it was repetitive and not particularly helpful. Updated section on Dietary Guidelines for Americans to include the latest 2015– 2020 DGAs. Deleted previous Table 2.3 (Ways to Incorporate the Dietary Guide- lines for Americans into your Daily Life) as it was outdated and inconsistent with the new DGAs. Moved the discussion and figure of the Mediterranean-style eating pattern and the Exchange System to the new In Depth on Healthful Eating Patterns, and tightened up the section on “Ethnic Variations and Other Eating Plans.” Added in a new section on “Get Some High-Tech Help” in designing a healthful diet. Expanded the section “Can Eating Out Be Part of a Healthful Diet?” to include recent evidence related to nutrition labeling on menus, and whether this has changed the menu choices of Americans when eating out. Deleted the Nutrition Label Activity on “How Realistic Are the Serving Sizes Listed on Food Labels?” as it was repetitive and did not add any additional information to what is already included in the narrative and figures. Revised the Nutrition Debate on “Nutrition Advice from the U.S. Government: Is Anyone Listening?”
In Depth 2.5 Healthful Eating Patterns This is an entirely new In Depth, teaching students the components and principles of a healthful eating pattern as recommended by the 2015–2020 Dietary Guidelines for Americans, and providing some examples, such as the Mediterranean diet.
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x | New to the Fifth Edition
Chapter 3 The Human Body: Are We Really What We Eat?
Reorganized opening section to improve text-art integration. Split discussion of gastrointestinal anatomy and physiology so that the journey of food through the GI tract is discussed in its own A-section, followed by an A- section covering the accessory organs and special features. Deleted the Hot Topic on GI simulators. Added discussion and a figure of the four mechanisms by which nutrients are absorbed across enterocytes. Expanded discussion and added figure of peristalsis and segmentation.
In Depth 3.5 Disorders Related to Specific Foods Tightened narrative on food allergies. Added discussion of non-celiac gluten sensitivity.
Chapter 4 Carbohydrates: Plant-Derived Energy Nutrients Incorporated the information on health properties of various forms of sugars into the chapter narrative (previously in Nutrition Myth or Fact box). Expanded information on types of soluble fibers. Added more detail on how fructose is metabolized differently from glucose, and the impact of these differences on insulin release, satiety, and associations with obesity. Incorporated information on hypoglycemia into the narrative (previously included in a Hot Topic). Updated the recommendations on added sugars based on the new 2015–2020 Dietary Guidelines for Americans in the narrative and Table 4.1. Added information on Advantame, a new artificial sweetener. Fully revised the section on the role artificial sweeteners play in weight management. Updated the end-of-chapter Nutrition Debate on whether added sugars are the cause of the obesity epidemic. Revised Figure 4.1 to more clearly show the results that occur from the chemical reactions that take place in photosynthesis. Enhanced Figure 4.11 on the glycemic index to include a graph showing the surge in blood glucose with high versus low glycemic index foods, along with the glyce- mic index values for specific foods. Added new Meals Focus Figure 4.16 comparing the food and fiber content of two diets, one high in fiber-rich carbohydrates and one high in refined carbohydrates.
In Depth 4.5 Diabetes Added historical information on the discovery of the role of insulin in diabetes. Added a figure identifying and allowing comparison of lab values for normal blood glucose, prediabetes, and diabetes for the FPG, OGT, and A1C tests. Expanded the information on lifestyle changes (including dietary strategies and smoking cessation) to reduce the risk for type 2 diabetes.
Chapter 5 Fats: Essential Energy-Supplying Nutrients Reorganized opening pages of the chapter: The first main section now provides an overview of the three main types of lipids. The second main section discusses triglycerides in detail. Updated the discussion of trans fatty acids to cover the recent FDA ruling to elimi- nate partially hydrogenated oils (PHOs) from the food supply by 2018. Updated all content to reflect the 2015–2020 Dietary Guidelines. Updated Figure 5.11 on micelle transport.
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New to the Fifth Edition | xi
Added a new Meals Focus Figure comparing a day’s meals high and low in satu- rated fat. Deleted Table 5.2. Expanded recommendations for consuming beneficial fats. Emphasized the role of a diet high in added sugars in cardiovascular disease. Replaced the Nutrition Debate on fat blockers with a new debate on the contro- versy about the role of saturated fats in cardiovascular disease.
In Depth 5.5 Cardiovascular Disease Updated throughout, including and especially on role of different types of dietary fats and blood lipids in CVD. Replaced calculation matrix (former Figure 4) with a link to a web-based risk assessment, replacing the lab data on blood lipids with a table from the NHLBI. Modestly expanded the information on medications for CVD.
Chapter 6 Proteins: Crucial Components of All Body Tissues
Revised chapter introduction to make it more pertinent to the target audience. Revised Figure 6.6 to include exclusively red blood cells. Expanded section on nitrogen balance to include a discussion of the limitations of the method. Deleted previous Table 6.2 (protein needs) to reflect most up-to-date evidence that is now discussed in the text. Updated section on protein needs, including new evidence that protein needs of many groups may be higher than the RDA. Streamlined and updated the section on potential harmful effects of high protein intakes. Added a Nutrition Label Activity on assessing your protein intake. Expanded the information on vegan diets, including more information on health benefits as compared to vegetarian diets. Included a new Meal Focus Figure comparing a day’s meals that are comprised of nutrient-dense protein sources to meals that are less nutrient dense (Figure 6.13). Included a new figure comparing the protein content of a vegan meal with a meat- based meal (Figure 6.15). Deleted section on “Disorders Related to Genetic Abnormalities.” Replaced the Nutrition Debate with a more current topic, “Are Current Protein Recommendations High Enough?”
In Depth 6.5 Vitamins and Minerals: Micronutrients with Macro Powers
Added information on ultra-trace minerals. Added QuickTips on retaining vitamins in foods.
Chapter 7 Nutrients Essential to Fluid and Electrolyte Balance
Added a new figure on fluid balance. Expanded the description of the regulation of fluid balance. Updated information on the dangers of energy drinks. Changed feature box on bottled water to a Nutrition Label Activity. Added a Nutrition Debate on controversy related to current sodium intake guidelines.
In Depth 7.5 Alcohol Added a new figure showing caloric content of popular alcoholic drinks. Added a new figure describing levels of impairment related to blood alcohol concentration.
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xii | New to the Fifth Edition
Chapter 8 Nutrients Essential to Key Body Functions This chapter combines the content from Chapters 8 and 10 of the fourth edition that focuses on the role of micronutrients in supporting three key body functions, namely, energy metabolism, antioxidant function, and vision. The micronutrients covered here are: for energy metabolism, the B-vitamins, choline, iodine, chro- mium, manganese, and sulphur; for antioxidant function, vitamin E, vitamin C’s antioxidant role, selenium, and the antioxidant functions of the carotenoids; and for vision, vitamin A. To maintain a chapter of reasonable length, content has been condensed modestly throughout. The chapter includes a Focus Figure on vision, two QuickTips features, a Nutri- Case, several Nutrition Online links, and a Nutrition Debate on the importance of deriving antioxidants from foods and not supplements.
In Depth 8.5 Cancer Expanded the description of cancer progression (Initiation, Promotion, and Progression). Updated the discussion and debate around the potential contribution of “bad luck” to causing cancer. Added in information on how exercise can reduce risks for various forms of cancer. Updated information on the role of tanning beds in increasing the risk for skin cancer. Updated information on the role of phytochemicals in cancer prevention.
Chapter 9 Nutrients Essential to Healthy Tissues This chapter combines the content from Chapters 8, 9, and 10 of the fourth edi- tion that focuses on the role of micronutrients in supporting connective tissues; namely, blood, the collagen component of connective tissues, and bone. The micronutrients covered here are: for blood, the trace minerals iron, zinc, and cop- per, and vitamins B6, folate, B12, and K; for collagen synthesis, vitamin C; and for bone, calcium, phosphorus, magnesium, fluoride, and vitamins D and K. To maintain a chapter of reasonable length, content has been condensed modestly throughout. The chapter includes a new figure on the role of vitamin C in collagen synthesis; a new Focus Figure on regulation of blood calcium; a You Do the Math on calculat- ing iron intake; three QuickTips features, a Nutri-Case, several Nutrition Online links, and a Nutrition Debate on the surge in vitamin D deficiency.
In Depth 9.5 Osteoporosis Updated opening story on bone health to discuss mother-daughter with osteoporo- sis and osteopenia. Expanded information on the role of calcium and vitamin D supplements in pro- moting bone health. Included a more age-appropriate figure for kyphosis (now Figure 3). Added a new figure on the reduction in bone density with age (now Figure 4). Updated research on the impact of caffeine on risk for fractures. Tightened up section on nutritional influences on osteoporosis risk, and updated information on the role of protein in promoting bone health. Updated the research into whether calcium and vitamin D supplementation can prevent osteoporosis. Included new information addressing the latest controversy on whether exercise can strengthen bone and reduce risk for fractures. Added new information on pharmaceutical treatments for osteoporosis. Discussed the controversy on whether taking calcium supplements increases the risk for myocardial infarction.
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Chapter 10 Achieving and Maintaining a Healthful Body Weight
Reorganized chapter headings and content to improve flow and clarity. Deleted three figures to update and reduce clutter: (a) variations in lean body mass (previously Figure 11.7); (b) the goal-setting card (previously 11.9); and (c) graph of childhood obesity rates (previously 11.11). Replaced the previous Figure 11.8 with a new Meal Focus Figure (now Figure 10.7). Incorporated updated information on whether being overweight is associated with decreased risks for premature mortality and various chronic diseases. Added two new sections on the factors that influence body weight: (a) the protein leverage hypothesis; and (b) the drifty gene hypothesis. Integrated the information on sociocultural factors affecting food choice and body weight to reduce repetition. Expanded information on non-exercise activity thermogenesis (NEAT), and added as a boldface term and margin definition. Moved all information on obesity (why it is harmful, why it occurs, and how it is treated) into In Depth 11.5. Condensed the narrative on the effect of macronutrient composition of the diet on weight loss to reduce repetition. Included a discussion of mindful eating in the section on behavioral modification. Updated the Nutrition Debate on high-carbohydrate, moderate-fat diets, and included a discussion of the effects of the Paleo diet on weight loss.
In Depth 10.5 Obesity Extracted, updated, and expanded information that had been in the weight chap- ter in the fourth edition. Included new information on the pro-inflammatory role of adipokines and the relationship between abdominal obesity, metabolic syndrome, and cardiometabolic risk. To support this discussion, we altered Figure 1, which depicts abdominal obesity and its inflammatory effects. Added a new Focus Figure 2 and accompanying discussion on the more than 100 variables that directly or indirectly influence energy balance and body weight. Expanded the discussion of how people in the National Weight Control Registry succeed in losing weight and keeping it off. Added more information on prescription weight-loss medications, on weight-loss dietary supplements, and on the risks and benefits of bariatric surgery.
Chapter 11 Nutrition and Physical Fitness: Keys to Good Health
Incorporated the discussion of the inactivity levels of Americans into the section on “How Can You Improve Your Fitness?” Added in a link to the President’s Challenge Adult Fitness Test to the end-of- chapter Web Links. Incorporated the latest information on the roles of lactic acid as a key fuel source into the section, “The Breakdown of Carbohydrates Provides Energy for Both Brief and Long-Term Exercise.” Revised Figure 11.9 (illustration of use of carbohydrate and fat across levels of exercise intensity) to include an additional bar graph illustrating the absolute amount of kcal from fat and carbohydrate that are expended during exercise of low and moderate intensity. Added in new information and references related to intrinsic and extrinsic motiva- tion to be active and high intensity interval training (HIIT). Incorporated the latest sports nutrition guidance for macronutrient, micronutri- ent, and fluid replacement that was recently published in the 2016 ACSM Position Stand on Nutrition and Exercise Performance. Included a new Meal Focus Figure (Figure 11.10) illustrating examples of one day of high-carbohydrate meals differing in total energy content.
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Incorporated updated section on ergogenic aids into the chapter narrative. Updated the Nutrition Debate on “How Much Physical Activity Is Enough?”
In Depth 11.5 Disorders Related to Body Image, Eating, and Exercise
Expanded the information on body image, explaining how it can affect eating and exercise patterns, as well as physical and mental health. Included a discrete discussion of excessive exercise (also called exercise addiction or exercise dependence). Included a discrete narrative discussion of body dysmorphic disorder and the sub- type called muscle dysmorphia. Included information about relative energy deficiency in sports (RED-S), which encompasses numerous health problems associated with inadequate energy con- sumption to meet the energy needs of active men and women. The female athlete triad is one form of RED-S. Removed discussion of talking to a friend about disordered eating.
Chapter 12 Food Safety and Technology: Protecting Our Food
Replaced Fight Bac! Logo with the food safety logo from the USDA’s Foodsafety.gov. Added information on the Hazard Analysis Critical Control Point (HACCP) system. Identified percentages of foodborne illness outbreaks by setting (restaurants, homes, etc.). Added a QuickTips for food safety for packed lunches. Expanded narrative on benefits and concerns of GM foods, placing the entire dis- cussion in the narrative section instead of covering part in narrative and part in the Nutrition Debate. Expanded the discussion of persistent organic pollutants, including types and health concerns. Briefly explained how food animals become reservoirs for antibiotic-resistant pathogens. Changed the Nutrition Debate topic to question organic foods: are they worth the cost?
In Depth 12.5 The Safety and Effectiveness of Dietary Supplements
Throughout, emphasized safety concerns with dietary supplements. Tightened the structure of the chapter to eliminate repetition. Completely rewrote the table on herbal supplements.
Chapter 13 Food Equity, Sustainability, and Quality: The Challenge of “Good Food” This is an entirely new chapter for the fifth edition. It covers global and domestic food insecurity, inequities in farm, food service, and food retail labor, the role of the food industry in limiting food diversity and influencing our food choices, sustainability (use of natural resources and emission of greenhouse gases and other forms of pollu- tion) and aspects of the food movement such as local food, fair trade, and others.
In Depth 13.5 Malnutrition This is a new In Depth. It covers severe acute malnutrition (SAM), micronutrient deficiencies, the nutrition paradox in countries transitioning out of poverty, and the poverty– obesity paradox, emphasizing hypotheses attempting to explain why it occurs.
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Chapter 14 Nutrition Through the Life Cycle: Pregnancy and the First Year of Life
Expanded the discussion of the roles of mothers’ and fathers’ preconception health and pregnancy outcomes. Updated guidelines to reflect 2015–2020 Dietary Guidelines for Americans. New figure on foods at risk for bacterial contamination. Added discussion on ”older” mothers. Added Meal Focus Figure comparing nonpregnant and lactating diets. Added discussion of Cronobacter contamination of infant formula. New Nutrition Debate on new approaches to preventing pediatric food allergies.
In Depth 14.5 The Fetal Environment Updated research throughout, especially on the effects of maternal obesity on offspring.
Chapter 15 Nutrition Through the Life Cycle: Childhood to Late Adulthood
Expanded information on the federal School Breakfast and School Lunch Pro- grams, as well as in-class breakfasts, replacing the former Nutrition Myth or Fact box on breakfast. Added discussion of Class 2 and Class 3 obesity in pediatric populations, and of the health effects of pediatric obesity. Expanded the discussion on the family’s role in the prevention and management of pediatric obesity. Replaced the Tufts University plate for older adults with a plate based on the USDA MyPlate. Expanded the discussion on nutrition/medication interactions for older adults. Updated information on federal food programs for older adults.
In Depth 15.5 Searching for the Fountain of Youth Updated all research throughout, especially in the discussion on Calorie restriction and other dietary approaches, “anti-aging” supplements, and the CDC’s guidelines for healthy lifestyle and chronic disease prevention.
Teaching and Learning Package Available with Nutrition: An Applied Approach, Fifth Edition, is a comprehensive set of ancillary materials designed to enhance learning and to facilitate teaching.
Instructor Supplements MasteringNutrition with Pearson eText 2.0 and MyDietAnalysis MasteringNutrition is an online homework, tutorial, and assessment product designed to improve results by helping students quickly master concepts. Stu- dents will benefit from self-paced tutorials that feature immediate wrong answer feedback and hints that emulate the office-hour experience to help keep them on track. With a wide range of interactive, engaging, and assignable activities, stu- dents will be encouraged to actively learn and retain tough course concepts:
Before class, assign adaptive Dynamic Study Modules and reading assignments from the eText with Reading Quizzes to ensure that students come prepared to class, having done the reading.
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During class, Learning Catalytics, a “bring your own device” student engagement, assessment and classroom intelligence system, allows students to use their smartphone, tablet, or laptop to respond to questions in class. With Learning Catalytics, you can assess students in real time using open- ended question formats to uncover student misconceptions and adjust lectures accordingly. After class assign, an array of assignments such as Focus Figure Coaching Activities, ABC News Videos, Nutrition Animations, Nutri-Tool Activities, and much more. Students receive wrong-answer feedback personalized to their answers, which will help them get back on track. MyDietAnalysis is available as a single sign-on to MasteringNutrition. Devel- oped by the nutrition database experts at ESHA Research, Inc., and tailored for use in college nutrition courses, MyDietAnalysis provides an accurate, reliable, and easy-to-use program for students’ diet analysis needs. Featured is a data- base of nearly 20,000 foods and multiple reports.
For more information on MasteringNutrition, please visit www.masteringhealthand nutrition.com
ABC News Nutrition and Wellness Lecture Launcher Videos. Twenty-seven brand-new brief videos help instructors stimulate critical discussion in the class- room. Videos are provided already linked within PowerPoint lectures and are available separately in large-screen format with optional closed captioning through MasteringNutrition. Instructor Resource and Support Manual. Easier to use than a typical instructor’s manual, this key guide provides a step-by-step visual walk-through of all the resources available to you for preparing your lectures. Also included are tips and strategies for new instructors, sample syllabi, and suggestions for integrating MasteringNutrition into your classroom activities and homework assignments. Test Bank. The Test Bank incorporates Bloom’s Taxonomy, or the Higher Order of Learning, to help instructors create exams that encourage students to think analytically and critically, rather than simply to regurgitate information. Great Ideas! Active Ways to Teach Nutrition. This manual provides ideas for classroom activities related to specific nutrition topics, as well as suggestions for activities that can be adapted to various topics and class sizes.
Student Supplements MasteringNutrition Student Study Area also provides students with self-study material like access to the eText 2.0, practice quizzes, flashcards, videos, MP3s, and much more to help them get the best grade in your course at their own pace. Dynamic Study Modules in MasteringNutrition assess students’ performance and activity in real time. They use data and analytics that personalize content to target students’ particular strengths and weaknesses. And, because we know students are always on the go, Dynamic Study Modules can be accessed from any computer, tablet, or smartphone. MyDietAnalysis (www.mydietanalysis.com). Powered by ESHA Research, Inc., MyDietAnalysis features a database of nearly 20,000 foods and multiple reports. It allows students to track their diet and activity using up to three profiles and to generate and submit reports electronically. Eat Right! Healthy Eating in College and Beyond. This handy, full-color booklet provides students with practical guidelines, tips, shopper’s guides, and recipes that turn healthy eating principles into blueprints for action. Topics include healthy eating in the cafeteria, dorm room, and fast-food restaurants; planning meals on a budget; weight management; vegetarian alternatives; and how alcohol affects health. Food Composition Table available via PDF and posted in the MasteringNutrition Study Area for students to access easily.
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Nutri-case: You Play the Expert! | xvii
nutri-case | YOU PlaY THE ExPErT! Our Nutri-Case scenarios enable students to evaluate the nutrition-related beliefs and behaviors of five people representing a range of backgrounds and nutritional chal- lenges. Take a moment to get acquainted with our Nutri-Case characters here.
THEO Hi, I’m Theo. let’s see, I’m 21, and my parents moved to the Midwest from Nigeria 11 years ago. I’m 6’8” tall and weigh in at 200 lbs. The first time I ever
played basketball, in middle school, I was hooked. I won lots of awards in high school and then got a full scholarship to the state univer-
sity, where I’m a junior studying political science. I decided to take a nutrition course because, last year, I had a hard time making it through the playing season, plus keeping up with my classes and homework. I want to have more energy, so I thought maybe I’m not eating right. anyway, I want to
figure out this food thing before basketball season starts again.
HaNNaH Hi, I’m Hannah. I’m 18 years old and in my first year at Valley Community College. I’m 5’6” and right now I weigh 171 lbs. I haven’t made up my mind yet about my
major. all I know for sure is that I don’t want to work in a hospital like my mom! I got good grades in high school, but I’m a little freaked out by college so far. There’s so much homework, plus one of my courses has a lab, plus I have to work part time because my mom doesn’t have the money to put me through school. . . . Sometimes I feel like I just can’t handle it all. and when I get stressed out, I eat. I’ve already gained 10 pounds and I haven’t even finished my first semester!
lIZ I’m liz, I’m 20, and I’m a dance major at the School for Performing arts. I’m 5’4” and currently weigh about 103 lbs. last year, two other dancers from my class
and I won a state championship and got to dance in the New Year’s Eve celebration at the governor’s mansion. This spring, I’m going to audition for the City Ballet, so I have to be in top condition. I wish I had time to take a nutrition course, but I’m too busy with dance classes, rehearsals, and teaching a dance class for kids. But it’s okay, because I get lots of tips from other dancers and from the Internet. like last week, I found a website especially for dancers that explained how to get rid of bloating
before an audition. I’m going to try it for my audition with the City Ballet!
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xviii | Nutri-case: You Play the Expert!
GUSTaVO Hello. My name is Gustavo. I’m 69 years young at the moment, but when I was
13 years old I came to the United States from Mexico with my parents and three sisters to pick crops in California. Now I manage a large vineyard. They ask me when I’m going to retire, but I can still work as hard as a man half my age. Health problems? None. Well, maybe my doctor tells
me my blood pressure is high, but that’s normal for my age! I guess what keeps me going is thinking about how my father died 6 months after he retired. He had colon cancer, but he never knew it until it was too late. anyway, I watch the nightly news and read the papers, so I keep up on what’s good for me, “Eat less salt” and all that stuff. I’m doing great! I’m 5’5” tall and weigh 166 lbs.
JUDY I’m Judy, Hannah’s mother. I’m 38 years old and a nurse’s aide at Valley Hospital. I’m 5’5” and weigh 200 lbs. Back when Hannah was a baby, I dreamed of going to college so I could be a registered nurse. But then my ex and I split up, and
Hannah and me, we’ve been in survival mode ever since. I’m proud to have raised my daughter without any handouts, and I do good work, but the pay never goes far enough and it’s exhausting. I
guess that’s partly because I’m out of shape, and my blood sugar is high. Most nights I’m so tired at the end of my shift that I just pick up some fast food for supper. I know I should be making home-cooked meals, but like I said, I’m in survival mode.
Throughout this text, students will follow these five characters as they grapple with various nutrition-related challenges. As they do, the characters might remind students of themselves, or of people they may know. Our hope is that by applying the information learned in this course to their own circumstances, students will deepen their understanding of the importance of nutrition in achieving a healthful life.
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It is always eye-opening to author a textbook and to realize that the work of so many people contributes to the final product. There are numerous people to thank, and we’d like to begin by extending our gratitude to our contributors. Our deepest gratitude and appreciation goes to Dr. Linda Vaughan of Arizona State University. Linda revised and updated the fluid and electrolyte balance chapter and the life cycle chapters. She also revised the In Depth features on alcohol, the fetal environment, and strategies to promote healthy aging. Our enduring thanks as well goes to the many contributors and colleagues who made important and lasting contributions to earlier editions of this text. We also extend our sincere thanks to the able reviewers who provided much important feedback and guidance for this revision. These reviewers help to ensure our content is up-to-date and that the presentation of this information meets the needs of instructors and students.
We would like to thank the fabulous staff at Pearson for their incredible sup- port and dedication to this book. Our Acquisitions Editor, Michelle Yglecias, has provided unwavering support and guidance throughout the entire process of writing and publishing this book. We could never have written this text without the exceptional skills of our Developmental Editor, Laura Bonazzoli, whom we have been fortunate enough to have had on board for multiple editions. In addi- tion to providing content guidance, Laura revised and updated the chapters on the human body, food safety, and food security, as well as the In Depth features on new frontiers in nutrition, disorders related to specific foods, dietary supple- ments, and malnutrition. Laura’s energy, enthusiasm, and creativity significantly enhanced the quality of this textbook. Deepti Agarwal, our Project Editor, kept us on course and sane with her humor, organizational skills, and excellent edi- torial instincts, and made revising this book a pleasure rather than a chore. We are also deeply indebted to Art Development Editor Jay McElroy for his work on the Focus Figures in this edition. Nicole Constantine, Editorial Assistant, pro- vided invaluable editorial and administrative support that we would have been lost without. Multiple talented players helped build this book in the production and design processes as well. Rebecca Marshall supervised the photo program, assisted by Matt Perry, who researched the important photo permissions. Pres- ton Thomas created both the beautiful interior design and our glorious cover, under the expert guidance of Mark Ong. We would also like to thank the pro- fessionals at SPi Global, especially our Project Manager Karen Berry, for their important contributions to this text. Our thanks as well to Laura Bonazzoli for her excellent work on developing and updating the comprehensive Test Bank.
We also can’t go without thanking the marketing and sales teams, espe- cially Neena Bali, Executive Marketing Manager, and Mary Salzman, Field Marketing Manager, who ensured that we directed our writing efforts to meet the needs of students and instructors. The team at Pearson is second to none, and their hard work and targeted efforts ensure that this book will get out to those who will benefit most from it.
We would also like to thank the many colleagues, friends, and family mem- bers who helped us along the way. Janice would like to thank her coauthor Melinda Manore, who has provided unwavering support and guidance through- out her career and is a wonderful life-long friend and colleague. She would also like to thank her family and friends, who have been so incredibly supportive throughout her career. They are always there to offer a sympathetic ear and
acknowledgments
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xx | Acknowledgments
endless encouragement, and lovingly tolerate the demands of juggling a full- time job and authoring multiple textbooks. She would also like to thank her students because they are the reason she loves her job so much. They provide critical feedback on her teaching approaches, and help her to understand the issues and challenges they face related to learning and application of knowledge.
Melinda would specifically like to thank her husband, Steve Carroll, for the patience and understanding he has shown through this process—once again. He has learned that there is always another chapter due! Melinda would also like to thank her family, friends, graduate students, and profes- sional colleagues for their support and listening ear throughout this whole process. They all helped make life a little easier during this incredibly busy time. Finally, she would like to thank Janice, a great friend and colleague, who makes working on the book fun and rewarding.
Janice Thompson
Melinda Manore
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Ann Marie Afflerbach University of North Texas
April Graveman Marshalltown Community College
Christina Minges Miami University of Ohio
George Delahunty Goucher College
reviewers
Irving Smith Coppin State University
Lisa Murray Pierce College
Mallory Brown Eastern Kentucky University
Monica Esquivel University of Hawaii—Manoa
Theresa Martin College of San Mateo
Zhenhua Liu University of Massachusetts— Amherst
focus group participants
Priscilla Connors University of North Texas
Emily Shupe Western Illinois University
Donna Louie University of Colorado, Boulder
Elizabeth Sussman California State University, Northridge
Lisa Kenyon Wright State University
Joanne Tippin Shasta College
Pei-Yang Liu University of Akron
Elisabeth De Jonge George Mason University
Sherry Stewart Navarro College
Linda Friend Wake Technical Community College
Joann Burnett Indiana University, Purdue
Julia Rieck Indiana University, Purdue
Heidi Wengreen Utah State University
Serah Theuri University of Southern Indiana
Sherry Fletcher Palm Beach Community College
Lisa Herzig California State University, Fresno
Nancy Hunt Lipscomb University
Betty Joynes Camden County Community College
Erika Ireland California State University, Fresno
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10 Achieving and Maintaining a Healthful Body Weight 342
in depth 10.5 Obesity 372
11 Nutrition and Physical Fitness: Keys to good health 380
in depth 11.5 Disorders related to Body Image, Eating, and Exercise†413
12 Food Safety and Technology: Protecting our food 424
in depth 12.5 The Safety and Effectiveness of Dietary Supplements 454
13 Food Equity, Sustainability, and Quality: The challenge of “good food” 460
in depth 13.5 Malnutrition 480
14 Nutrition Through the Life Cycle: Pregnancy and the first year of life 486
in depth 14.5 The Fetal Environment 524
15 Nutrition Through the Life Cycle: Childhood to late adulthood 528
in depth 15.5 Searching for the Fountain of Youth†562
Appendices A-1 References R-1 Answers AN-1 Glossary GL-1 Index IN-1 Credits CR-1
1 Nutrition: Linking food and health 2
in depth 1.5 New Frontiers in Nutrition and Health 29
2 Designing a Healthful Diet 36 in depth 2.5 Healthful Eating Patterns 59
3 The Human Body: Are we really what we eat? 64
in depth 3.5 Disorders related to Specific Foods†93
4 Carbohydrates: Plant-derived energy nutrients 98
in depth 4.5 Diabetes 130
5 Fats: Essential energy-supplying nutrients 138
in depth 5.5 Cardiovascular Disease 167
6 Proteins: Crucial components of all body tissues 178
in depth 6.5 Vitamins and Minerals: Micronutrients with Macro Powers†211
7 Nutrients Essential to Fluid and Electrolyte Balance 222
in depth 7.5 alcohol 249
8 Nutrients Essential to Key Body Functions 260
in depth 8.5 Cancer 292
9 Nutrients Essential to Healthy Tissues 300
in depth 9.5 Osteoporosis 334
brief contents
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1 Nutrition: Linking food and health 2 What is nutrition? 4 How does nutrition support health? 5
a Nutritious Diet Contributes to Wellness 5
a Nutritious Diet reduces the risk for Disease 5
What are nutrients? 8 Macronutrients Provide Energy 8
you do the math Calculating the Energy Contribution of Carbohydrates, Fats, and Proteins 10
Micronutrients assist in the regulation of Body Functions 11
Water Supports all Body Functions 12
How much of each nutrient do most people need? 12 How do nutrition scientists evaluate claims? 15
The Scientific Method Enables researchers to Test a Hypothesis 15
repetition of research Is required to Develop Theories 17
Why do nutrition scientists use different types of research? 18
animal Studies Can Inform Human Studies 18
Epidemiological Studies Explore Patterns Within Populations 18
Clinical Trials Examine Cause and Effect 19
How can you use your knowledge of research to evaluate nutrition claims? 20
Watch for Conflict of Interest and Bias 21
Evaluate a Website’s Credibility 22
nutri-case LIZ 23
Which sources of nutrition advice are trustworthy? 23
Trustworthy Experts are Educated and Credentialed 23
Government agencies are Usually Trustworthy 24
Professional Organizations Provide reliable Nutrition Information 25
nutrition debate Conflict of Interest: Should Scientists and Industry Collaborate in Research? 26
contents
xxiii
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1.5 New Frontiers in Nutrition and Health 29 How does our diet affect our genes? 30
The Foods We Eat Can Influence Gene Expression 30
Nutrigenomics Studies Food-Gene Interactions 31
Nutrigenomics Could lead to Personalized Nutrition 31
How does our diet affect our microbiome? 32 a Healthy Microbiome Promotes a Healthy Body 32
Probiotics and Prebiotics Nourish the Microbiome 32
How do phytochemicals enhance our health? 33
nutri-case HANNAH 33
2 Designing a Healthful Diet 36 What is a healthful diet? 38
a Healthful Diet Is adequate 38
a Healthful Diet Is Moderate 38
a Healthful Diet Is Nutrient-Dense 38
a Healthful Diet Is Balanced 38
a Healthful Diet Is Varied 40
What’s behind our food choices? 40 Sensory Data Influence Food Choices 40
Sociocultural Cues and Emotions Influence Food Choices 41
learning Influences Food Choices 41
How can reading food labels help you improve your diet? 42
Five Components Must Be Included on Food labels 42
Use the Nutrition Facts Panel to Evaluate and Compare Foods 43
Food labels Can Display a Variety of Claims 43
nutri-case GUSTAVO 47
How do the Dietary Guidelines for Americans promote a healthful diet? 47 How can the USDA Food Patterns help you design a healthful diet? 48
log Onto MyPlate 48
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limit Empty Calories 49
Watch Your Serving Sizes 50
Consider Ethnic Variations and Other Eating Plans 50
Get Some High-Tech Help 51 you do the math How Much Exercise Is Needed to Combat Increasing Food
Portion Sizes? 52
Can eating out be part of a healthful diet? 53 avoid large Portions 53
Use Nutrition Information 54 nutrition debate Nutrition Advice from the U.S. Government:
Is Anyone Listening? 56
2.5 Healthful Eating Patterns 59 What is a healthful eating pattern? 60
nutri-case JUDY 60
What are some healthful eating patterns? 61 a Mediterranean-Style Eating Pattern Is Healthful 61
The Exchange System Can Help You Follow a Healthful Eating Pattern 62
The Healthy Eating Plate and Power Plate are also Healthful Eating Patterns 62
Include regular Physical activity 63
3 The Human Body: Are we really what we eat? 64 How do food molecules build body structure? 66
atoms Bond to Form Molecules 66
Molecules Join to Form Cells 66
Why do we feel the urge to eat? 68 The Hypothalamus regulates Hunger 68
Nerve Cells in the Gastrointestinal System Signal the Hypothalamus 69
Hormones Send Chemical Messages to the Hypothalamus 69
The amount and Type of Food Play a role 70
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How does food travel through the gastrointestinal tract? 70
Digestion Begins in the Mouth 72
The Esophagus Transports Food from the Pharynx into the Stomach 73
The Stomach Mixes, Digests, and Stores Food 74 you do the math Negative Logarithms and the pH Scale 76
Most Digestion and absorption Occur in the Small Intestine 77
The large Intestine Stores Food Waste Until It Is Excreted 77
What else contributes to gastrointestinal function? 79 The Gallbladder and Pancreas aid in Digestion 79
a Specialized lining Boosts absorption in the Small Intestine 80
Four Types of absorption Occur in the Small Intestine 80
Blood and lymph Transport Nutrients 80
The liver regulates Blood Nutrients 82
The GI Flora Perform Several Beneficial Functions 83
The Neuromuscular System regulates the activities of the GI Tract 83
What disorders are related to digestion, absorption, and elimination? 85
Heartburn and Gastroesophageal reflux Disease (GErD) are Caused by reflux of Gastric Juice 85
an Ulcer Is an area of Erosion in the GI Tract 86
Some Disorders affect Intestinal Function 87
nutri-case THEO 88
Cancer Can Develop in any Gastrointestinal Organ 89 nutrition debate H. pylori: Could the Same Germ Make Us Sick
and Keep Us Well? 90
3.5 Disorders Related to Specific Foods 93 What are food intolerances? 94 What are food allergies? 94 nutrition label activity Recognizing Common Allergens in Foods 95
Is celiac disease the same as gluten sensitivity? 96 Celiac Disease Is an Inherited Immune Disease 96
nutri-case LIZ 96
Nonceliac Gluten Sensitivity Is the Subject of research 97
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4 Carbohydrates: Plant-derived energy nutrients 98 What are carbohydrates? 100
Simple Carbohydrates Include Monosaccharides and Disaccharides 100
Polysaccharides are Complex Carbohydrates 102
Why do we need carbohydrates? 104 Carbohydrates Provide Energy for Daily activities and Exercise 104
Carbohydrates Spare Protein and Prevent Ketoacidosis 105
Fiber Helps Us Stay Healthy 105
How does the body process carbohydrates? 107 Digestion Breaks Down Most Carbohydrates into Monosaccharides 107
The liver Converts Most Nonglucose Monosaccharides into Glucose 107
Fiber Is Excreted from the large Intestine 109
How does the body regulate blood glucose levels? 110 Insulin and Glucagon regulate Blood Glucose levels 110
Fructose Does Not Stimulate Insulin release 110
Other Hormones Increase Blood Glucose levels 112
The Glycemic Index Shows How Foods affect Our Blood Glucose level 112
How much total carbohydrate and added sugar should you eat? 114
The recommended Dietary allowance for Total Carbohydrate reflects Glucose Use by the Brain 114
Most americans Eat Too Much added Sugar 114
Sugars are Blamed for Many Health Problems 115
How much fiber do you need, and what are the best sources? 118
Whole Grains are Excellent Sources of Fiber 118
Other Good Sources of Fiber are Vegetables, Fruits, Nuts, and Seeds 119
nutrition label activity Recognizing Carbohydrates on the Label 120
What’s the story on alternative sweeteners? 123 limited Use of alternative Sweeteners Is Not Harmful 124
The Effect of alternative Sweeteners on Body Weight Is Unclear 125
nutri-case HANNAH 126
nutrition debate Are Added Sugars the Cause of the Obesity Epidemic? 127
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4.5 Diabetes 130 What is diabetes? 131 How is diabetes classified? 132
In Type 1 Diabetes, the Body Does Not Produce Enough Insulin 132
In Type 2 Diabetes, Cells Become less responsive to Insulin 132
Three Blood Tests are Used to Diagnose Diabetes 134
How can you reduce your risk for type 2 diabetes? 134 Some Diabetes risk Factors are Modifiable 135
lifestyle Changes Can reduce Your risk 135
Dietary Counseling Can Help People living with Diabetes 136
nutri-case JUDY 136
Prescription Medications or Surgery May Be advised 136
5 Fats: Essential energy-supplying nutrients 138 What are fats? 140
Triglycerides are the Most Common Food-Based Fat 140
Phospholipids Combine lipids with Phosphate 141
Sterols Have a ring Structure 141
Why are some triglycerides better than others? 142 Fatty acid Chain length affects Digestion and absorption 142
level of Hydrogen Saturation Influences Health Effects 142
Carbon Bonding Influences Shape 143
Trans Fatty acids are Especially Harmful 144
Essential Fatty acids Have Unique Health Benefits 145
Why do we need fats? 147 Fats Provide Energy 147
Fats Enable the Transport of Fat-Soluble Vitamins 149
Fats Help Maintain Cell Function 149
Body Fat Provides Protection 149
Dietary Fats Contribute to the Flavor, Texture, and Satiety of Foods 149
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How does the body process fats? 150 The Gallbladder, liver, and Pancreas assist in Fat Digestion 150
absorption of Fat Occurs Primarily in the Small Intestine 150
Fat Is Stored in adipose Tissues for later Use 153
How much fat should you eat? 154 recognize the Fat in Foods 154
Decipher label Claims 154 nutrition label activity How Much Fat Is in This Food? 155
nutri-case LIZ 156
Keep Your Fat Intake Within the aMDr 156
aim for a Balance of the Essential Fatty acids 156
reduce Your Intake of Saturated Fats 157
avoid Trans Fatty acids 158
What about Dietary Cholesterol? 158
Select Beneficial Fats 160
Watch Out When You’re Eating Out 162
Be aware of Fat replacers 163
Fat Blockers Contribute Minimally to Weight loss 163 nutrition debate Are Saturated Fats Bad or Benign? 164
5.5 Cardiovascular Disease 167 What is cardiovascular disease? 168
atherosclerosis Is Narrowing of arteries 168
Hypertension Increases the risk for Heart attack and Stroke 170
What factors influence the risk for cardiovascular disease? 170
Many CVD risk Factors are Within Your Control 170
Blood lipids Play a Significant role in Cardiovascular Disease 171
You Can Estimate Your risk for Cardiovascular Disease 174
How can you reduce your risk for cardiovascular disease? 174
Take Steps to Improve Your Blood lipid levels 174
Take Steps to Manage Your Blood Pressure 175
nutri-case GUSTAVO 177
Prescription Medications Can Improve Blood lipids and Blood Pressure 177
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6 Proteins: Crucial Components of All Body Tissues 178 What are proteins? 180
The Building Blocks of Proteins are amino acids 180
Nine amino acids are Essential 180
How are proteins made? 181 amino acids Bond to Form a Variety of Peptides 182
Genes regulate amino acid Binding 182
Protein Turnover Involves Synthesis and Degradation 184
Protein Organization Determines Function 184
Protein Denaturation affects Shape and Function 185
Protein Synthesis Can Be limited by Missing amino acids 186
Protein Synthesis Can Be Enhanced by Mutual Supplementation 186
Why do we need proteins? 187 Proteins Contribute to Cell Growth, repair,
and Maintenance 187
Proteins act as Enzymes and Hormones 188
Proteins Help Maintain Fluid and Electrolyte Balance 188
Proteins Help Maintain acid–Base Balance 188
Proteins Help Maintain a Strong Immune System 189
Proteins Serve as an Energy Source 190
Proteins assist in the Transport and Storage of Nutrients 190
Proteins are Critical to Nerve Function, Blood Clotting, and Wound Healing 191
How does the body process proteins? 191 Stomach acids and Enzymes Break Proteins into Short
Polypeptides 191
Enzymes in the Small Intestine Break Polypeptides into Single amino acids 191
Protein Digestibility affects Protein Quality 193
How much protein should you eat? 193 Nitrogen Balance Is a Method Used to Determine
Protein Needs 193 you do the math Calculating Your Protein Needs 195
recommended Dietary allowance for Protein 195
Most americans Meet or Exceed the rDa for Protein 196
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Protein Sources Include Much More Than Meat! 196 nutrition label activity How Much Protein Do You Eat? 199
The Health Effects of High Protein Intake are Unclear 199
Protein Deficiency Can result in Severe Illness and Death 201
Can a vegetarian diet provide adequate protein? 203 There are Many Types of Vegetarian Diets 203
People Choose Vegetarianism for Many Different reasons 204
a Vegetarian Diet Can Present Some Challenges 206
MyPlate Can Help You Plan a Vegetarian Diet 207
nutri-case THEO 207
nutrition debate Are Current Protein Recommendations High Enough? 208
6.5 Vitamins and Minerals: Micronutrients with Macro Powers 211 How were the micronutrients discovered? 212 How are vitamins classified? 212
Fat-Soluble Vitamins 212
Water-Soluble Vitamins 212
Same Vitamin, Different Names and Forms 213
How are minerals classified? 214 Major Minerals 214
Trace and Ultra-Trace Minerals 216
Same Mineral, Different Forms 218
How do our bodies use micronutrients? 218 What We Eat Differs from What We absorb 218
What We Eat Differs from What Our Cells Use 218
What are some controversies in micronutrient research? 218
are Supplements Healthful Sources of Micronutrients? 220
Can Micronutrients Prevent or Treat Chronic Disease? 220
nutri-case LIZ 220
Do More Essential Micronutrients Exist? 221
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7 Nutrients Essential to Fluid and Electrolyte Balance 222 What is body fluid? 224
Body Fluid Is the liquid Portion of Our Cells and Tissues 224
Body Fluid Is Composed of Water and Electrolytes 225
Why do we need water and electrolytes? 226 Water Performs Functions Critical to life 226
Electrolytes Support Many Body Functions 227
How does the body maintain fluid balance? 230 The Hypothalamus regulates Thirst 230
We Gain Fluids Through Intake and Metabolism 231
We lose Fluids Through Urine, Sweat, Evaporation, Exhalation, and Feces 232
How much water should you drink? 233 Our requirements for Water are Individualized 233
Tap Water Is as Healthful as Bottled Water 233
all Beverages are Not Created Equal 234 nutrition label activity Is Bottled Water Better Than Tap? 235
How do four major minerals contribute to fluid balance? 237
Sodium Is a Positively Charged Extracellular Electrolyte 238
Potassium Is a Positively Charged Intracellular Electrolyte 240
Chloride Is a Negatively Charged Extracellular Electrolyte 242
Phosphorus Is a Negatively Charged Intracellular Electrolyte 242
What disorders are related to fluid and electrolyte balance? 243
Dehydration Develops as Fluid loss Exceeds Fluid Intake 243
Water Intoxication Can Be Fatal 244
Heat Illnesses are linked to Dehydration 244
nutri-case GUSTAVO 245
nutrition debate Low Sodium Diets: Fit for All or Just a Few? 246
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7.5 Alcohol 249 What happens to alcohol in the body? 250 What do we know about moderate drinking? 251
Moderate Drinking Has Certain Health Benefits 251
Moderate Drinking Is associated with Certain risks 251
What do we know about alcohol use disorders? 252 alcohol Use Disorders Include abuse and Dependence 252
alcohol Use Disorders Have Toxic Effects 253
nutri-case THEO 254
Should you be concerned about your alcohol intake? 257 How can you talk to someone about an alcohol use disorder? 258
8 Nutrients Essential to Key Body Functions 260 How does the body regulate energy metabolism? 262 How do the B-vitamins function in energy metabolism? 264
Thiamin Supports Carbohydrate and amino acid Metabolism 264
riboflavin Supports the Metabolism of Carbohydrates and Fats 265
Niacin Supports Metabolism, DNa replication, and Cell Differentiation 266
Vitamin B6 Is a Coenzyme for Over 100 Enzymes 267
The Most Basic Cellular Functions require Folate 269
Vitamin B12 Participates in amino acid and Homocysteine Metabolism 270
Pantothenic acid and Biotin are required for all Energy Pathways 272
nutri-case JUDY 273
How do choline and four minerals function in energy metabolism? 273
Choline Is a Vitamin-like Nutrient 273
Iodine Is required for the Synthesis of Thyroid Hormones 273
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Chromium Is Important in Carbohydrate Metabolism 274
Manganese assists in Energy Metabolism and Bone Health 274
Sulfur Is a Component of Thiamin, Biotin, and Two amino acids 275
What are antioxidants, and how do they protect our cells? 275
Oxidation Is a Chemical reaction in Which atoms lose Electrons 275
Oxidation Sometimes results in the Formation of Free radicals 276
Free radicals Can Destabilize Other Molecules and Damage Our Cells 276
antioxidants Work by Stabilizing Free radicals or Opposing Oxidation 277
What nutrients and phytochemicals function as antioxidants? 278
Vitamin E Is a Key antioxidant 278
Vitamin C Is a Water-Soluble antioxidant 280
Selenium Is a Key antioxidant Mineral 280
Manganese, Copper, Iron, and Zinc assist in antioxidant Function 281
Carotenoids like Beta-Carotene Have antioxidant Properties 281
What is the role of vitamin A in vision and other functions? 283
There are Several Forms of Vitamin a 284
Vitamin a Is Essential to Sight 284
Vitamin a Supports Cell Differentiation, reproduction, and Bone Growth 284
avoid Excessive Intake of Vitamin a 286
Vitamin a Derivatives are Effective in Treating acne 287 nutrition debate Antioxidants: From Foods or Supplements? 289
8.5 Cancer 292 What is cancer and how does it arise? 293 What factors influence cancer risk? 293
Nonmodifiable Factors Play a role 293
Many risk Factors are Modifiable 295
How is cancer diagnosed and treated? 296 Can cancer be prevented? 297
Check 297
Quit 297
Move 297
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Nourish 298
antioxidants Play a role in Preventing Cancer 298
nutri-case GUSTAVO 299
9 Nutrients Essential to Healthy Tissues 300 How do three trace minerals help maintain healthy blood? 302
Iron Is a Component of the Oxygen-Carrying Proteins in Blood and Muscle 303
you do the math Calculating Daily Iron Intake 305
Zinc Contributes to Hemoglobin 307
Copper Is Critical for Iron Transport 308
How do four vitamins promote healthy blood? 310 Vitamin B6, Folate, and Vitamin B12 are required for the Healthy
Development of red Blood Cells 310
Vitamin K Supports Blood Clotting 311
How does vitamin C help maintain healthy collagen? 312
Vitamin C Is required for the Synthesis of Collagen 312
Vitamin C Has Many Other roles in the Body 313
The rDa for Vitamin C Is Easily Obtained 313
What are the components and activities of healthy bone? 315
The Composition of Bone Provides Strength and Flexibility 315
The Constant activity of Bone Tissue Promotes Bone Health 316
Bone Density Is assessed with a Dxa Test 317
How do four minerals help maintain healthy bone? 318
Calcium Is the Major Mineral Component of Bone 318
Phosphorus Combines with Calcium in Hydroxyapatite Crystals 323
Magnesium Is a Component of Bone and Helps regulate Bone Status 323
Fluoride Is Found in Teeth and Bones 324
How do two fat-soluble vitamins support healthy bone? 326
Vitamin D regulates Calcium 326
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nutri-case THEO 330
Vitamin K assists in remodeling of Bone 330 nutrition debate Vitamin D Deficiency: Why the Surge, and What Can
Be Done? 331
9.5 Osteoporosis 334 What is osteoporosis? 335 What influences osteoporosis risk? 335
aging Increases Osteoporosis risk 336
Gender and Genetics affect Osteoporosis risk 336
Tobacco, alcohol, and Caffeine Influence Osteoporosis risk 337
Nutritional Factors Influence Osteoporosis risk 338
regular Physical activity reduces Osteoporosis risk 338
How is osteoporosis treated? 339 Can osteoporosis be prevented? 340
Some People Might Benefit from Supplements 340
nutri-case GUSTAVO 340
Physical activity and Other lifestyle Choices Can Help 341
10 Achieving and Maintaining a Healthful Body Weight 342 What is a healthful body weight? 344 How can you evaluate your body weight? 344
Determine Your Body Mass Index 344 you do the math Calculating Your Body Mass Index 346
Measure Your Body Composition 347
assess Your Fat Distribution Patterns 347
How does energy balance influence body weight? 349 Energy Intake Is the Kilocalories We Consume Each Day 351
Energy Expenditure Includes More Than Just Physical activity 351
you do the math Calculating BMR and Total Daily Energy Needs 354
research Suggests limitations of the Energy Balance Equation 355
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What factors influence body weight? 355 Genes May Influence Body Weight in Different Ways 355
Metabolic Factors Influence Weight loss and Gain 357
Physiologic Factors Influence Body Weight 357
Sociocultural Factors affect Food Choices and Body Weight 358
How can you lose weight safely and keep it off? 360
nutri-case HANNAH 361
avoid Fad Diets 361
Many Diets Focus on Macronutrient Composition 362
If You Design Your Own Diet Plan, Include the Three Strategies 362
What if you need to gain weight? 367 For Safe and Effective Weight Gain, Choose Nutrient-Dense Foods 367
amino acid and Protein Supplements Do Not Increase Muscle Mass 368 nutrition debate High-Carbohydrate, Moderate-Fat Diets—Have They
Been Oversold? 369
10.5 Obesity 372 Why is obesity harmful? 373 Why does obesity occur? 374 How is obesity treated? 376
Obesity Does respond to Diet and Exercise 376
Weight loss Can Be Enhanced with Prescription Medications 376
Many Supplements Used for Weight loss Contain Stimulants 377
Surgery Can Be Used to Treat Morbid Obesity 377
11 Nutrition and Physical Fitness: Keys to good health 380 What are the benefits of physical activity? 382
Physical activity Increases Our Fitness 382
Physical activity reduces Our risk for Chronic Diseases 383
How can you improve your fitness? 384 assess Your Current level of Fitness 384
Identify Your Personal Fitness Goals 384
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Make Your Program Varied, Consistent, and Fun! 385
appropriately Overload Your Body 386
Include a Warm-Up and a Cool-Down Period 388 you do the math Calculating Your Maximal and Training Heart
Rate Range 389
Keep It Simple, Take It Slow 389
What fuels our activities? 391 The aTP-CP Energy System Uses Creatine Phosphate
to regenerate aTP 391
The Breakdown of Carbohydrates Provides Energy for Both Brief and long-Term Exercise 391
aerobic Breakdown of Fats Supports Exercise of low Intensity and long Duration 394
amino acids are Not Major Sources of Fuel During Exercise 396
How does physical activity affect energy and macronutrient needs? 396
Vigorous Exercise Increases Energy Needs 397
Carbohydrate Needs Increase for Many active People 399
nutri-case JUDY 400
Moderate Fat Consumption Is Enough to Support Most activities 402
Many athletes Have Increased Protein Needs 403
How does physical activity affect fluid and micronutrient needs? 403
Dehydration and Heat-related Illnesses 403
Guidelines for Proper Fluid replacement 404
Inadequate Micronutrient Intake Can Diminish Health and Performance 405
Are ergogenic aids necessary for active people? 407 Many Ergogenic aids are Said to Build Muscle Mass and Strength 407
Some Ergogenic aids are Said to Optimize Fuel Use 408 nutrition debate How Much Physical Activity Is Enough? 410
11.5 Disorders Related to Body Image, Eating, and Exercise 413 What is body image, and how does it influence health? 414
Body Image Influences Eating Behaviors 414
Body Image Influences Exercise Behaviors 414
Body Dysmorphic Disorder Is a Psychiatric Diagnosis 415
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What factors contribute to disorders related to body image, eating, and exercise? 416
Influence of Genetic Factors 416
Influence of Family 416
Influence of Media 416
Influence of Social and Cultural Values 417
Comorbidity with Other Psychological Disorders 417
What psychiatric eating disorders are recognized? 417
anorexia Nervosa 417
Bulimia Nervosa 418
Binge-Eating Disorder 420
What syndromes of disordered eating are recognized? 420
Night-Eating Syndrome 420
The Female athlete Triad 421
nutri-case LIZ 422
How are eating disorders treated? 422
12 Food Safety and Technology: Protecting our food 424 What is foodborne illness and why is it a critical concern? 426
Ingestion of Contaminants Prompts acute Illness 426
reducing Foodborne Illness Is a Challenge 426
What causes most foodborne illness? 429 Several Types of Microorganisms Contaminate Foods 429
Some Foodborne Illness Is Due to Toxins 431
Certain Conditions Help Microorganisms Multiply in Foods 433
nutri-case THEO 433
How can you prevent foodborne illness? 434 Clean: Wash Your Hands and Kitchen Surfaces Often 434
Separate: Don’t Cross-Contaminate 434
Chill: Store Foods in the refrigerator or Freezer 435
Cook: Heat Foods Thoroughly 437
Protect Yourself from Toxins in Foods 437
Be Choosy When Eating Out—Close to Home or Far away 438
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How is food spoilage prevented? 440 What are food additives, and are they safe? 441
Food additives Include Nutrients and Preservatives 441
Other Food additives Include Flavorings, Colorings, and Texturizers 442
are Food additives Safe? 442
How is genetic modification used in food production, and is it safe? 443
Genetic Modification Includes Selective Breeding and recombinant DNa Technology 443
Genetic Modification Has Many Benefits 444
Genetic Modification Poses Certain risks 444
Should GM Foods Be labeled? 445
How do residues harm our food supply? 446 Persistent Organic Pollutants Can Cause Illness 446
Pesticides Protect against Crop losses—But at a Cost 448
Growth Hormones and antibiotics are Used in animals 449
Organic Farming Promotes Ecological Balance 449 nutrition debate Organic Foods: Are They Worth the Cost? 451
12.5 The Safety and Effectiveness of Dietary Supplements 454 How are dietary supplements regulated? 455 Are there special precautions for herbs? 456 Should you take a dietary supplement? 457
nutri-case THEO 459
13 Food Equity, Sustainability, and Quality: The challenge of “good food” 460 How prevalent is food insecurity? 462
about 795 Million People Worldwide are Hungry 462
Over 17 Million american Households are Food Insecure 463
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Why don’t all people have access to nourishing food? 463
nutri-case JUDY 464
acute Food Shortages are Often Caused by Weather Events and Wars 464
The Major Cause of Chronic Hunger Is Unequal Distribution of Food 464
Overpopulation Contributes to Chronic Food Shortages 465
local Conditions Can Contribute to Chronic Hunger 465
Climate Change Threatens Global Food Security 466
Is our food equitably produced and sold? 467 Farm labor Is Dangerous and Poorly Paid 467
Food retail and Service Work Maintains the “Working Poor” 467
How does industrial agriculture affect the security, sustainability, and diversity of our food supply? 468
Industrial agriculture Has Increased Food Security but Threatens Our Environment 468
Monopolization of agriculture reduces Food Diversity 469
The Food Industry Influences america’s Diet 470
What initiatives are addressing the challenges of “good” food? 471
Many International Initiatives Increase access to Nourishing Food 471
National and local Programs Help Nourish americans 471
Sustainable agriculture reduces Environmental Impact and Increases Food Diversity 472
Corporate and Philanthropic Initiatives are Promoting “Good” Food 473
How can you promote “good” food? 474 Support Food Security 474
Purchase Fair Trade Goods 474
Choose Foods That are Healthful for You and the Environment 475 nutrition debate Meat Consumption and Climate Change: Tofu to the
Rescue? 477
13.5 Malnutrition 480 What problems are linked to undernourishment? 481
low Energy Intake Promotes Wasting, Stunting, and Mortality 481
Micronutrient Deficiencies lead to Preventable Diseases 481
Undernourishment Promotes Socioeconomic Problems 482
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nutri-case LIZ 483
How could limited access to good food promote obesity? 483
a Nutrition Paradox Is Evident in Transitioning Populations 483
Physical and Socioeconomic Factors May Promote Obesity among the Poor 484
14 Nutrition Through the Life Cycle: Pregnancy and the first year of life 486 How does a healthful diet support conception and gestation? 488
a Healthful Diet Is Critical Before Conception 488
a Healthful Diet Supports Embryonic and Fetal Development 488
appropriate Maternal Weight Gain Supports a Healthy Birth Weight 492
What are a pregnant woman’s nutrient needs? 494 Macronutrients Provide Energy and Build Tissues 494
Micronutrients Support Increased Energy Needs and Tissue Growth 495
Fluid Needs of Pregnant Women Increase 498
What are some common nutrition-related concerns of pregnancy? 499
Morning Sickness, Cravings, and GI Discomfort are Common 499
Serious Disorders Include Diabetes, Hypertension, and Foodborne Illness 500
nutri-case JUDY 501
Maternal age Can affect Pregnancy 502
a Careful Vegetarian Diet and regular Exercise are Safe During Pregnancy 502
Many Substances Can Harm the Embryo or Fetus 504
How does nutrition support lactation? 505 lactation Is Maintained by Hormones and Infant Suckling 505
Breastfeeding Woman Have High Nutrient Needs 506
What are some advantages and challenges of breastfeeding? 509
Breast Milk Is Nutritionally Superior to Infant Formula 509
Breastfeeding Has Many Other Benefits for the Infant and Mother 510
Physical and Social Concerns Can Make Breastfeeding Challenging 511
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What are an infant’s nutrient needs? 513 Nutrition Fuels Infant Growth and activity 513
Infants Have Unique Nutrient Needs 514
Infant Formula Is a Nutritious alternative to Breast Milk 516 nutrition label activity Reading Infant Food Labels 517
What are some common nutrition-related concerns of infancy? 518
Infants Begin to Need Solid Foods at about 6 Months of age 518
Some Foods and Beverages are Not Safe for Infants 519
Several Nutrition-related Disorders are Concerns for Infants 519 nutrition debate Preventing Food Allergies in Infants: Allergen Avoidance,
or Introduction? 521
14.5 The Fetal Environment 524 How does fetal adaptation to famine affect adult health? 525 How do other nutritional imbalances in utero affect adult health? 525
nutri-case HANNAH 526
15 Nutrition Through the Life Cycle: Childhood to late adulthood 528 What are the nutritional needs and concerns of toddlerhood? 530
Body Size and activity Increase Toddlers’ Nutrient Needs 530 you do the math Is This Menu Good for a Toddler? 532
Encourage Nutritious Food Choices with Toddlers 533
Vegan Diets May Not Be Healthful for Toddlers 534
What are the nutritional needs and concerns of childhood? 535
Growth and Development Increase Children’s Nutrient Needs 535
Encourage Nutritious Food Choices with Children 538
School attendance Influences Children’s Nutrition 538
Childhood Brings Unique Nutrition-related Concerns 539
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What are the nutritional needs and concerns of adolescence? 541
Puberty Triggers Dramatic Growth and Maturation 541
rapid Growth Increases an adolescent’s Nutrient Needs 541
Encourage Nutritious Food Choices with adolescents 543
appearance and Substance Use are Key Concerns of adolescence 543
nutri-case LIZ 546
Why is pediatric obesity harmful, and what can be done? 546
Obesity Impairs Children’s Health 546
Encourage Healthful Eating Patterns 547
Encourage Physical activity 548
What characterizes aging? 549 americans are Getting Older 549
Characteristic Physiologic Changes accompany aging 550
What are the nutritional needs and concerns of older adults? 551
Some Nutrient recommendations Increase or Decrease with aging 551
Older adults Have Many Unique Nutrition-related Concerns 555 nutrition debate Physical Activity in Older Adulthood: What Amounts, Types,
and Intensities Are Appropriate? 559
15.5 Searching for the Fountain of Youth 562 Does calorie restriction increase life span? 563
Calorie restriction May reduce Production of Free radicals 563
Calorie restriction Presents Significant Challenges 564
alternatives to Calorie restriction Show Similar Benefits 564
Can supplements slow aging? 565
nutri-case GUSTAVO 565
Are your actions today promoting a longer, healthier life? 566
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Contents | xlv
Appendices A 2015–2020 Dietary Guidelines, Dietary Reference Intakes, and Dietary
Guidelines Recommendations A-3 B Calculations and Conversions B-1 C Foods Containing Caffeine C-1 D U.S. Exchange Lists for Meal Planning D-1 E Stature-for-Age Charts E-1 F The USDA Food Guide Evolution F-1
References R-1 Answers AN-1 Glossary GL-1 Index IN-1 Credits CR-1
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2
test yourself 1. T F A Calorie is a measure of the amount of
fat in a food.
2. T F Proteins are not the primary source of energy for our body.
3. T F The Recommended Dietary Allowance is the maximum amount of a vitamin or other food component that people should consume to support normal body functions.
Test Yourself answers are located in the Study Plan at the end of this chapter.
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Go online for chapter quizzes, pre-tests, interactive activities, and more!
1 Nutrition Linking food and health Miguel hadn’t expected college life to make him feel so tired. After classes, he just wanted to go back to his dorm and sleep. Scott, his roommate, had little sympathy. “It’s all that junk food you eat!” he insisted. “Let’s go down to the organic market for some real food.” Miguel dragged himself to the market with Scott. They bought fresh vegetables and fish, and were heading to the checkout when they noticed a woman in a white lab coat promoting a variety of “energy-boosting” supplements. Miguel was intrigued and told her that he had been feeling tired lately. She nodded sympathetically. “You look pale. I’d recommend taking an iron supplement.” She handed him a bottle of tablets. “This one is easy to absorb, and it’s on special this week.” Miguel bought the supplement and began taking it that night. A week later, he didn’t feel any better, so he visited the campus health clinic. The physician there ran some tests and told him that his thyroid gland wasn’t function- ing properly. She prescribed a medication and congratulated Miguel for catching the problem early. “If you had waited,” she said, “you could have become seriously ill.” Miguel asked if he should continue taking his iron supplement. The doctor looked puzzled. “Where did you get the idea that you needed an iron supplement?”
Like Miguel, you’ve probably been offered nutrition-related advice from well-meaning friends and self-professed “experts.” Perhaps you found the advice helpful, or maybe, as in Miguel’s case, it turned out to be all wrong. Where can you go for reli- able advice about nutrition? What exactly is nutrition, and how does what we eat influence our health? In this chapter, we’ll begin to answer these questions.
learning outcomes After studying this chapter you should be able to:
1 Define the term nutrition and describe its evolution as a science, p. 4.
2 Explain how nutrition supports health, pp. 5–6.
3 Identify the six classes of nutrients essential for health, pp. 8–12.
4 Distinguish among six groups of Dietary Reference Intakes for nutrients, pp. 12–15.
5 Describe the steps of the scientific method, pp. 15–18.
6 Discuss the design and primary goals of three basic types of nutrition research, pp. 18–20.
7 Explain how to discern the truth or fallacy of nutrition- related claims, pp. 20–23.
8 List several professionals, government agencies, and organizations that are trustworthy sources of nutrition information, pp. 23–25.
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4 | Chapter 1 Nutrition: Linking food and health
What is nutrition? Although many people think that food and nutrition mean the same thing, they don’t. Food refers to the plants and animals we consume. It provides the chemicals our body need to maintain life and support growth and health. Nutrition, in contrast, is the sci- ence that studies food and how food nourishes our body and influences our health. It encompasses how we consume, digest, absorb, and store the chemicals in food, and how these chemicals affect our body. Nutrition also involves studying the factors that influence our eating patterns, making recommendations about the amount we should eat of each type of food, attempting to maintain food safety, and addressing issues related to the global food supply. You can think of nutrition, then, as the science that encompasses everything about food.
When compared with other scientific disciplines such as chemistry, biology, and physics, nutrition is a relative newcomer. Although food production has played a defining role in the evolution of the human species, an appreciation of the importance of nutrition to our health has developed only within the past 400 years. Early research in nutrition focused on making the link between dietary deficiencies and illness. For instance, in the mid-1700s, it was discovered that regular consumption of citrus fruits could prevent a potentially fatal disease called scurvy. But two centuries would pass before a deficiency of vitamin C was identified as the precise culprit. Another early discovery in nutrition is related to pellagra, a disease characterized by a skin rash, diarrhea, and mental impairment. In the early 20th century it afflicted more than 50,000 people each year, and in about 10% of the cases it resulted in death. Originally thought to be an infectious disease, experiments conducted by Dr. Joseph Goldberger and colleagues found that pellagra could be effectively treated by changing the diet of those affected from one that was predominantly corn-based to one that included a variety of nutritious foods. Although Goldberger could not identify the precise com- ponent in the new diet that cured pellagra, he eventually found an inexpensive and widely available substance, brewer’s yeast, that when added to the diet prevented or reversed the disease. Shortly after Goldberger’s death in 1937, scientists identified the component that is deficient in the diet of pellagra patients: a vitamin called niacin, which is plentiful in brewer’s yeast.
Nutrition research continued to focus on identifying and preventing deficiency diseases through the first half of the 20th century. Then, as the higher standard of living after World War II led to an improvement in the American diet, nutrition research began pursuing a new objective: supporting health and preventing and treating chronic diseases—that is, diseases that come on slowly and can persist for years, often despite treatment. Chronic diseases of particular interest to nutrition researchers include obesity, cardiovascular disease, type 2 diabetes, and various cancers. This new research has raised as many questions as it has answered, and we still have a great deal to learn about the relationship between nutrition and chronic disease.
In recent decades, advances in technology have contributed to the emergence of several exciting new areas of nutrition research. For example, reflecting our growing understanding of genetics, nutrigenomics seeks to uncover links between our genes, our environment, and our diet. The In Depth following this chapter describes this and other new frontiers in nutrition research and health.
food The plants and animals we consume. nutrition The science that studies food and how food nourishes our body and influences our health. chronic diseases Diseases that come on slowly and can persist for years, often despite treatment.
↑  Nutrition is the science that studies all aspects of food and its influence on our body and health.
LO 1 Define the term nutrition and describe its evolution as a science.
recap Food refers to the plants and animals we consume, whereas nutrition is the scientific study of food and how food affects our body and our health. An appreciation of the importance of nutrition to our health has developed only within the past 400 years. Early research in nutrition focused on making the link between dietary deficiencies and illness. Contemporary nutrition research typi- cally studies the influence of nutrition on chronic disease.
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How does nutrition support health? | 5
How does nutrition support health? Think about it: If you eat three meals a day, by this time next year, you’ll have had more than a thousand chances to influence your body’s makeup! As you’ll learn in this text, you really are what you eat: the substances you take into your body are broken down and reassembled into your brain cells, bones, muscles—all of your tis- sues and organs. The foods you eat also provide your body with the energy it needs to function properly. These are just two of the ways that proper nutrition supports your health. Let’s look at two more.
A Nutritious Diet Contributes to Wellness Wellness can be defined in many ways. Traditionally defined as simply the absence of disease, wellness is now considered an active process we work on every day. Consuming a nutritious diet contributes to wellness in a variety of ways, including by providing the energy and functional chemicals that help us to perform activi- ties of daily living, support our ability to concentrate and perform mental tasks, and boost our ability to ward off infections (FIguRE 1.1).
In this book, we focus on two critical aspects of physical health: nutrition and physical activity. The two are so closely related that you can think of them as two sides of the same coin: our overall state of nutrition is influenced by how much energy we expend doing daily activities, and our level of physical activity has a major impact on how we use the food we eat. We can perform more strenuous activities for longer periods when we eat a nutritious diet, whereas an inadequate or excessive food intake can make us lethargic. A poor diet, inadequate or excessive physical activity, or a combination of these also can lead to serious health problems. Finally, several studies have suggested that healthful nutrition and regular physical activity can increase feelings of well-being and reduce feelings of anxiety and depression. In other words, whole- some food and physical activity just plain feel good!
Because of its importance to the wellness of all Americans, nutri- tion has been included in the national health promotion and disease prevention plan of the United States. Called Healthy People, the plan is revised every decade. Healthy People 2020, launched in January 2010, identifies a set of goals and objectives (as an agenda) that we hope to reach as a nation by the year 2020.1 This agenda was devel- oped by a team of experts from a variety of federal agencies under the direction of the Department of Health and Human Services.
The four overarching goals of Healthy People are to “1) attain high-quality, longer lives free of preventable disease, disability, injury, and premature death; 2) achieve health equity, eliminate disparities, and improve the health of all groups; 3) create social and physical environments that promote good health for all; and 4) promote quality of life, healthy development, and healthy behaviors across all life stages.” These overarching goals are supported by hundreds of specific goals, including many related to nutrition. Others address physical activity and the problems of overweight and obesity, which are, of course, influenced by nutrition. TAbLE 1.1 identifies some objectives related to weight, nutrition, and physical activity from Healthy People 2020.
A Nutritious Diet Reduces the Risk for Disease Nutrition appears to play a role—from a direct cause to a mild influence—in the development of many diseases (FOCus FIguRE 1.2). As we noted, poor nutrition is a direct cause of deficiency diseases, such as scurvy and pellagra. Early nutrition
LO 2 Explain how nutrition supports health.
wellness A multidimensional, active process by which people make choices that enhance their lives.
↑  FIguRE 1.1 Consuming a nutritious diet contrib- utes to our wellness in numerous ways.
Supports our ability to perform activities of daily living
Enhances our ability to concentrate and perform mental tasks
Strengthens our ability to fight infections by maintaining our immune system
Provides opportunities for social interactions through shared cooking and eating experiences
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6 | Chapter 1 Nutrition: Linking food and health
research focused on identifying the missing vitamin or other food substance behind such diseases and on developing guidelines for intake levels that are high enough to prevent them. Over the years, nutrition scientists successfully lobbied for the fortifi- cation of foods with the substances of greatest concern. These measures, along with a more abundant and reliable food supply, have almost completely wiped out the majority of nutritional deficiency diseases in developed countries. However, they are still major problems in many developing nations.
In addition to causing disease directly, poor nutrition can have a subtle influ- ence on our health. For instance, it can contribute to the development of brittle bones (a disease called osteoporosis) as well as to the progression of some forms of cancer. These associations are considered mild; however, poor nutri- tion is also strongly associated with three chronic diseases—heart disease, stroke, and diabetes—which are among the top 10 causes of death in the United States (see Focus Figure 1.2).
It probably won’t surprise you to learn that the primary link between poor nutri- tion and early death is obesity. Fundamentally, obesity is a consequence of eating more Calories than are expended. At the same time, obesity is a well-established risk factor for heart disease, stroke, and the most common form of diabetes. Unfor- tunately, the prevalence of obesity has dramatically increased throughout the United States during the past 30 years (see Focus Figure 1.2). Throughout this text, we will discuss in detail how nutrition and physical activity affect the development of obesity.
recap Nutrition is an important component of wellness and is strongly associated with physical activity and body weight. Healthy People 2020 is a health promotion and disease prevention plan for the United States. One goal of a healthful diet is to prevent deficiency diseases, such as scurvy and pella- gra; a second goal is to lower the risk for chronic diseases, including heart disease, stroke, and the most common form of diabetes, all of which are linked to obesity.
TAbLE 1.1 Weight, Nutrition, and Physical Activity Objectives from Healthy People 2020
Topic Objective Number and Description
Weight status NWS-8. Increase the proportion of adults who are at a healthy weight from 30.8% to 33.9%. NWS-9. Reduce the proportion of adults who are obese from 34.0% to 30.6%. NWS-10.2. Reduce the proportion of children aged 6 to 11Â years who are considered obese from 17.4% to 15.7%.
Food and nutrient composition
NWS-14. Increase the contribution of fruits to the diets of the population aged 2 years and older. NWS-15. Increase the variety and contribution of vegetables to the diets of the population aged 2 years and older.
Physical activity PA–1. Reduce the proportion of adults who engage in no leisure-time physical activity from 36.2% to 32.6%. PA–2.1. Increase the proportion of adults who engage in aerobic physical activity of at least moderate intensity for at least 150 minutes per week, or 75 minutes per week of vigorous intensity, or an equivalent combination from 43.5% to 47.9%. PA–2.3. Increase the proportion of adults who perform muscle-strengthening activities on 2 or more days of the week from 21.9% to 24.1%.
Data adapted from: Healthy People 2020 (U.S. Department of Health and Human Services).
Want to see how the prevalence of obesity differs across various ethnic groups
in the United States? Go to www .cdc.gov and enter “obesity data trend maps” into the search bar.
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focus figure 1.2 The Relationship between Nutrition and Human Disease
Diseases of the heart
Cancer
Chronic respiratory disease
Unintentional injuries
Stroke
Alzheimer’s disease
Diabetes mellitus
Influenza and pneumonia
Inflammatory kidney disease
Suicide
0 100 200 300 400 500 600
Number of deaths (in thousands)
700
20101994
No Data <10% 10%–14% 15%–19%
20%–24% ≥30%25%–29%
15%–20% 20%–25%
25%–30% 30%–35% ≥35%
Obesity, which increases the risk for diseases of the heart, stroke, and diabetes, surged between 1994 and 2010, the last year during which there was a significant increase in rates.
Graphics and data from: “Prevalence of Self-Reported Obesity among U.S. Adults” and “Percent of Obese (BMI=30) in U.S. Adults: 1994” (Centers for Disease Control and Prevention).
Source: Graphics from Centers for Disease Control and Prevention, Obesity Prevalence Maps 1985 to 2010.
Nutrition also plays a minor role in some diseases, such as certain types of cancer, some joint diseases such as osteoarthritis, and a disease called osteoporosis, which can cause loss of bone mass, as shown here.
Some diseases are the direct result of a nutritional deficiency or toxicity. The disease shown here, pellagra, is caused by a deficiency of a vitamin called niacin.
Some diseases have a strong nutritional component. These include diseases of the heart, stroke, and diabetes, all of which are among the top causes of death in the United States, as shown in this graph. Data from: “Deaths: Preliminary Data for 2011” (U.S. Department of Health and Human Services).
611
585
131
149
129
76
85
57
47
41
Bone loss from osteoporosis
Normal bone
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8 | Chapter 1 Nutrition: Linking food and health
What are nutrients? We enjoy eating food because of its taste, its smell, and the pleasure and comfort it gives us. However, we rarely stop to think about what our food actually contains. Foods are composed of many chemical substances, some of which are not useful to the body and others of which are critical to our growth and function. These latter chemicals are referred to as nutrients. The six groups of nutrients found in foods are (FOCus FIguRE 1.3):
carbohydrates fats and oils (two types of lipids) proteins vitamins minerals water
The term organic is commonly used to describe foods that are grown with little or no use of synthetic chemicals. But when scientists describe individual nutrients as organic, they mean that these nutrients contain both carbon and hydrogen, funda- mental units of matter that are common to all living organisms. Carbohydrates, lipids, proteins, and vitamins are organic. Minerals and water are inorganic. Organic and inorganic nutrients are equally important for sustaining life but differ in their struc- tures, functions, and basic chemistry. You will learn more about these nutrients in subsequent chapters; a brief review is provided here.
Macronutrients Provide Energy Carbohydrates, fats, and proteins are the only nutrients that provide energy. By this we mean that our body breaks down these nutrients and reassembles their compo- nents into a fuel that supports physical activity and basic functioning. Although tak- ing a multivitamin might be beneficial in other ways, it will not provide you with the energy for a 20-minute session on the stair-climber! The energy-yielding nutrients are also referred to as macronutrients. Macro means “large,” and our body need relatively large amounts of these nutrients to support normal function and health.
Energy Is Measured in Kilocalories The energy in foods is measured in units called kilocalories (kcal). A kilocalorie is the amount of heat required to raise the temperature of 1 kilogram (about 2.2 pounds) of
water by 1 degree Celsius. We can say that the energy found in 1 gram of carbohydrate is equal to 4 kcal.
Kilo- is a prefix used in the metric system to indicate 1,000 (think of kilometer). Technically, 1 kilocalorie is equal to 1,000 calories. A kilocalo- rie is also sometimes referred to as a large calorie or as a Calorie, written with a capital C. Because they’re designed for the public, nutrition labels typically use the term calories to indicate kilocalories. Thus, if the wrapper on an ice cream bar states that it contains 150 calories, it actually contains 150 kilocalories.
In this textbook, we use the term energy when referring to the gen- eral concept of energy intake or energy expenditure. We use the term kilocalories (kcal) when discussing units of energy. We use the term Calories with a capital “C” when presenting information about foods and food labels.
Both carbohydrates and proteins provide 4 kcal per gram, alcohol provides 7 kcal per gram, and fats provide 9 kcal per gram. Thus, for every gram of fat we consume, we obtain more than twice the energy derived from a gram of carbohydrate or protein. Refer to the You Do the Math box on page 10 to learn how to calculate the energy contribution of carbohydrates, fats, and proteins in a given food.
LO 3 Identify the six classes of nutrients essential for health.
nutrients Chemicals found in foods that are critical to human growth and function.
organic A substance or nutrient that contains the elements carbon and hydrogen.
inorganic A substance or nutrient that does not contain carbon and hydrogen.
macronutrients Nutrients that our body need in relatively large amounts to support normal function and health. Carbohydrates, fats, and proteins are energy-yielding macronutrients.
↑  Carbohydrates are the primary source of fuel for our body, particularly for our brain.
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9
focus figure 1.3 The six groups of Nutrients Found in Foods
Vitamins
Carbohydrates
Proteins
Minerals
Functions: Primary energy source for the body Composed of: Chains of carbon, hydrogen, and oxygen Best Food Sources: Whole grains, vegetables, fruits
Functions: Support tissue growth, repair, and maintenance Composed of: Amino acids made up of carbon, hydrogen, oxygen, and nitrogen Best Food Sources: Meats, dairy products, seeds, nuts, legumes
Functions: Assist with release of macronutrients; critical to building and maintaining bone, muscle, and blood; support immune function and vision Composed of: Fat-soluble and water-soluble compounds Best Food Sources: Fruits, vegetables, dairy products, meats
Functions: Assist with fluid regulation and energy production; maintain health of blood and bones; rid body of harmful by-products of metabolism Composed of: Single elements such as sodium, potassium, calcium, or iron Best Food Sources: Fruits, vegetables, dairy products, meats
Functions: Ensures proper fluid balance; assists in regulation of nerve impulses, body temperature, and muscle contractions Composed of: Hydrogen and oxygen Best Food Sources: Water, juices, soups, fruits, vegetables
Functions: Important source of energy at rest and during low- intensity exercise Composed of: Carbon, hydrogen, and oxygen Best Food Sources: Vegetable oils, butter, and dairy products
Fats and oils
Water
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10 | Chapter 1 Nutrition: Linking food and health
The energy in food is used for everything from maintaining normal body functions—such as breathing, digesting food, and repairing damaged tissues and organs—to enabling you to perform physical activity and even to read this text. So how much energy is produced from the foods you eat?
To answer this question, you need to know the follow- ing information:
Carbohydrates should make up the largest percentage of your nutrient intake, about 45–65%; they provide 4 kcal of energy per gram of carbohydrate consumed.
Proteins also provide 4 kcal of energy per gram; they should be limited to 10–35% of your daily energy intake.
Fats provide the most energy, 9 kcal per gram; they should make up 20–35% of your total energy intake.
In order to figure out whether you’re taking in the appropriate percentages of carbohydrates, fats, and pro- teins, you will need to use a little math.
1. Let’s say you have completed a personal diet analysis, and you consume 2,500 kcal per day. You consume 300 g of carbohydrates, 90 g of fat, and 123 g of protein.
2. To calculate your percentage of total energy that comes from carbohydrate, you must do two things:
a. Multiply your total grams of carbohydrate by the energy value for carbohydrate.
300 g of carbohydrate * 4 kcal/g = 1,200 kcal of carbohydrate consumed
b. Take the kcal of carbohydrate consumed, divide this by the total kcal consumed, and multiply by 100. This will give you the percentage of the total energy you consume that comes from carbohydrate.
(1,200 kcal/2,500 kcal) * 100 = 48% of total energy comes from carbohydrate
3. To calculate your percentage of total energy that comes from fat, you follow the same steps but incor- porate the energy value for fat:
a. 90 g of fat * 9 kcal/g = 810 kcal of fat b. (810 kcal/2,500 kcal) * 100 = 32.4% of total
energy comes from fat
Now try these steps to calculate the percentage of the total energy you consume that comes from protein.
Also, have you ever heard that alcohol provides “empty Calories”? Alcohol contributes 7 kcal per gram. You can calculate the percentage of kcal from alcohol in your daily diet, but remember that it is not considered an energy nutrient.
These calculations will be very useful throughout this course as you learn more about how to design a health- ful diet and how to read labels to help you meet your nutritional goals. Later in this book you will learn how to estimate your unique energy needs.
Carbohydrates Are a Primary Fuel source Carbohydrates are the primary source of fuel for our body, particularly for our brain and during physical exercise (see Focus Figure 1.3). Carbo- refers to carbon, and hydrate refers to water. You may remember that water is made up of hydrogen and oxygen. Thus, carbohydrates are composed of chains of carbon, hydrogen, and oxygen.
Carbohydrates are found in a wide variety of foods, including rice, wheat, and other grains, as well as vegetables and fruits. Carbohydrates are also found in legumes (foods that include lentils, beans, and peas), seeds, nuts, and milk and other dairy products. (Carbohydrates and their role in health are the subject of Chapter 4.)
Fats Provide Energy and Other Essential Nutrients Fats are another important source of energy for our body (see Focus Figure 1.3). They are a type of lipids, a diverse group of organic substances that are insoluble in water. Like carbohydrates, fats are composed of carbon, hydrogen, and oxygen; however, they contain proportionally much less oxygen and water than carbohydrates do. This quality allows them to pack together tightly, which explains why they yield more energy per gram than either carbohydrates or proteins.
carbohydrates The primary fuel source for our body, particularly for our brain and for physical exercise.
Meat Consumption
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