Clinical Nutrition For Dummies E-Book

Michael J. Rovito

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 543

Veröffentlichungsjahr: 2014

Beschreibung

Get up to date on clinical nutrition for school, work, or your own health From the proper function of the major organs and the role that proper nutrition plays in their functioning, to a breakdown of carbs, proteins, fats, vitamins, and minerals, Clinical Nutrition For Dummies provides you with the easy-to-read guide you need to immerse yourself in the subject! Written in the fun style that the For Dummies series has become known for, the book is perfect for students in the wide variety of fields that require an in-depth understanding of clinical nutrition, or for those who want to improve their own lives through better nutrition. Dive right into the book for an exploration of the chemical and functional components of food, how to properly assess your nutritional intake, the changing face of nutrition throughout the human lifespan, and so much more! This handy resource offers a wealth of information, and specifically addresses the growing obesity and diabetes epidemics that promise to make the study of clinical nutrition more important than ever. Includes a complete breakdown of the relationship between nutrition and chronic diseases. * Explores the nutritional requirements at various life stages, from pediatric through geriatric * Features information on the importance of proper nutrition during pregnancy * Shares tips for modifying dietary intake and health behavior theory, along with properly communicating health information Clinical Nutrition For Dummies is your complete, fun guide to the topic of nutrition--dive in today to get started on the pathway to mastering this increasingly important subject.

Leseprobe

Clinical Nutrition For Dummies®

Published by:John Wiley & Sons, Inc.111 River StreetHoboken, NJ 07030-5774www.wiley.com

Copyright © 2014 by John Wiley & Sons, Inc., Hoboken, New Jersey

Published by John Wiley & Sons, Inc., Hoboken, New Jersey

Published simultaneously in Canada

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Library of Congress Control Number is available upon request

ISBN 978-1-118-66546-6 (pbk); ISBN 978-1-118-66576-3 (ebk); ISBN 978-1-118-66581-7 (ebk); ISBN 978-1-118-66588-6 (ebk)

Manufactured in the United States of America

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Clinical Nutrition For Dummies®

Visit http://www.dummies.com/how-to/content/clinical-nutrition-for-dummies-cheat-sheet.html to view this book's cheat sheet.

Table of Contents

Introduction

About This Book

Conventions Used in This Book

Foolish Assumptions

Icons Used in This Book

Beyond the Book

Where to Go from Here

Part I: Getting Started with Clinical Nutrition

Chapter 1: Getting Started with Clinical Nutrition

Pillars of the Practice: Recognizing theLinks between Nutrition and Health

Revisiting traditional views of food and health

Introducing the key tenets of clinical nutrition

Taking a New(-ish) Approach toMedical Care and Public Health

Preventing disease

Devising therapeutic measures to treat disease

Addressing nutritional needs throughout your lifespan

Increasing Visibility (and Abbreviations) through Key Organizations

Walking the hallowed halls: Clinical nutrition in academia

Getting better: Clinical nutrition in healthcare settings

Selling wellness: Clinical nutrition as a business

Affecting public policy: Governmental organizations

Chapter 2: Nutrition 101

The ABCMVs of Eating

Introducing a common-sense diet

Determining whether your diet is adequate

Balancing your diet

Keeping caloric intake in check

Following the “everything in moderation” rule

Spicing up your life with variety

Knowing Your Nutrients

Energizing nutrients: Proteins, carbs, and fats

Aiding in body function: Vitamins and minerals

Water: The most important nutrient

Examining the essentials — essential nutrients, that is

Exploring Nutrient Mobility and Use

Chapter 3: Determining Whether You're Eating Correctly

The Dietary Reference Intakes: An Alphabet Soup of Recommendations

The RDA: Setting recommended intake values

Estimated energy requirements (EERs): Monitoring your energy intake

Upper intake levels (ULs): Determining nutritional safety

Acceptable macronutrient distribution ranges (AMDR): Preventing disease

Beyond the U.S.: Standards from around the World

The European Food Safety Authority

Australia's Food for Health

The UN's World Health Organization

Vetting Nutrition Information

Going to expert sources

Judging the quality of online information

Evaluating the usefulness of the study findings

Assessing Your Lifestyle Choices

Keeping track of your habits

Giving yourself a bit of leeway

Reading food labels

Chapter 4: The Grim Reality of Worldwide Wellness

From Infectious to Chronic Diseases: A Global Transformation

Making the epidemiological transition

Getting familiar with chronic disease: Public Enemy Number1

Garbage In, Garbage Out: Why What You're Eating Is Killing You

Making a link between diet and disease

Taking its toll on your mental and cognitive health

Tackling Nutrition Head On: Common Strategies

Is there a pill for that? Taking supplements

Dieting: What is it and who should be doing it?

Accepting that the solution is long term

Part II: You Are What You Eat

Chapter 5: Observing Obesity

Gaining Basic Info about Obesity and Being Overweight

Balancing energy intake and output

Determining how much energy intake you need

Measuring Weight and Body Fat

Calculating Body Mass Index (BMI)

Using anthropometric body fat tests

Comorbidities: Encountering Obesity and the Diseases That Go with It

Introducing obesity-related diseases

Bellying up to bar: Central adiposity

Underlying mental health complications of being obese

Achieving and Maintaining a Healthy Body Weight

Consulting a dietary health professional about losing weight

Implementing medical therapy

Rising Global Morbidity Rates

Doing a survey of the people and regions affected

Understanding the spread of obesity around the world

Chapter 6: Concerning Yourself and Cancer

Grasping Cancer Basics

Understanding global cancer epidemiology

Discovering how cancer develops: Free radicals and carcinogens

Seeing how cancer progresses

Noting Nutritional Risks

Eating a high-energy diet with a side of sedentary lifestyle

Consuming a lot of red meat

Drinking too much alcohol

Taking Charge of Your Nutrition to Ward Off a Cancer Diagnosis

Promoting healthy lifestyles through a multifaceted approach

Adapting behaviors to reduce cancer risk

Making healthy changes to your diet

Chapter 7: Cracking the Cardiovascular Case

Clarifying Confusing Terminology about Cardiovascular Disease

Attacking Atherosclerosis

Watching how atherosclerosis develops

Plucking away at your heart strains

Clotting up a storm

Figuring Out the Risk Factors of CVD

Eating Your Way to a Healthy Heart

Controlling cholesterol

Taking care of fats

DASH-ing your diet for good health

Putting Together Your Action Plan

Chapter 8: Discussing Diabetes

Outlining the Physiology of the Disease

Gaining insight on blood glucose

Understanding the purpose of insulin

Defining Diabetes

Distinguishing between type 1 and type 2 diabetes

Toxic effects of diabetes

Paying attention to warning signs

Clarifying the risk factors

Preventing and Treating Diabetes through Diet and Lifestyle

Controlling blood glucose levels

Reducing your carbs

Determining how stringent your diet must be

Timing your meals

Chapter 9: Caring about Kidney Disease

Getting Comfortable with Your Kidneys

Understanding Kidney Disease

Moving through the stages

Calculating the global rate of chronic kidney disease

Dieting to Prevent Kidney Disease

Knowing which foods to restrict or avoid

Deciding which foods to eat

Dieting to Treat Kidney Disease

Focusing on food and fluid restrictions

Leaving the diet planning to professionals

Casting No Kidney Stones

Materials that make up kidney stones

Limiting oxalates

Avoiding foods high in purines

Chapter 10: All about Food Safety

Assessing Food Adulteration

Understanding the motivation behind adulteration

Identifying common types of adulteration

Looking for signs of adulteration in food

Controlling Food Contamination

Discovering the prevalence of contamination

Recognizing the risks contaminants pose to your health

Taking steps to prevent contamination

Discussing Foodborne Disease

Passing on the poison: Foods that are naturally toxic

Minding your microbes: Foodborne illness caused by contamination

Being safe with food choice

Part III: Major Organ Systems and Nutrition

Chapter 11: Gaining Insight on the Gastrointestinal System

Making Up the Gastrointestinal System

Mentioning your mouth

Explaining your esophagus

Understanding your stomach's role

Your wondrous small intestine

Concerning the colon (large intestine)

Reviewing the rectum and anus

Discussing Some Functional Disorders of the GI Tract

Discussing constipation

Acid reflux

Barrett's esophagus

Peptic ulcers

Inflammatory bowel disease (IBD)

Discussing diverticular disease

Colon polyps and cancer

Eating Your Way to Healthy Guts

Figuring out what foods to avoid

Figuring out which foods to eat

Chapter 12: Caring for the Cardiovascular System

Making Up the Cardiovascular System

Keeping the beat: Your heart

Transporting oxygen and removing waste

Getting in on the bloody basics

Hurting the heart: Cardiovascular disease

Eating Your Way to a Healthy Cardiovascular System

Keeping away from bad fats

Staying away from sodium

Focusing on fish and flaxseed

Going nuts for nuts

Eating your fruits and vegetables

Hopping on the whole grain bandwagon

Enjoying wine and dark chocolate

Chapter 13: Exploring the Endocrine System

Outlining the Basics of the Endocrine System

Glancing at different types of glands

Shhh . . . It's a secrete! Discovering how endocrine glands work

Taking Care of Your Endocrine Health

It's number 1 (unfortunately)! Diabetes

Getting gout

Polycystic ovary syndrome

Combating osteomalacia (rickets)

Osteoporosis

Noting health problems related to thyroid function

Interacting with the digestive system: The pancreas

Eating your way to a healthy endocrine system

Chapter 14: The Ins and Outs of the Excretory System

Taking a Trip through the Excretory System

Identifying the system's key components

Watching the system in action

Going beyond Urination: What This System Actually Does

Balancing water levels in the blood

Protecting your body from toxins

Regulating blood sodium levels

Maintaining a Healthy Excretory System

Making good food choices

Eliminating additives

Following other dietary recommendations

Exercising for the sweat

Dealing with Urinary Tract Infections

Enjoying foods that prevent or reduce the effects of UTIs

Taking other steps to avoid a UTI

Part IV: Nutrition through the Lifespan

Chapter 15: Having a Baby? Pre- and Post-Natal Nutrition

Adopting Healthy Lifestyles during the Conception Period: The Basics

Teaming up: Steps both moms- and dads-to-be can take

Chatting with your doc: A checklist

Identifying What Dad Can Do to Boost Fertility

Paying attention to diet

Taking other steps to improve fertility

What Mom Can Do: Preparing Her Body to Sustain a Healthy Pregnancy

Regulating your weight

Prepping your placenta for pregnancy

You're Pregnant — Now What?

Understanding the process of trimester development

Eating while pregnant: A trimester guide

Managing calories and weight gain during pregnancy

Chapter 16: Caring for Kids, from Infancy through the Teen Years

The Building Blocks of a Healthy Diet for Children

Being aware of the changing dietary needs as children grow

Facing common challenges when making the transition to solid foods

Identifying good sources of nutrients for infant and toddler diets

Getting the proper amounts and right kinds of energy

Getting your vitamins and minerals

Taking care with iron and lead

A word about supplements

Fitting in healthy snacks

Patrolling What Your Children Eat

Providing an inviting environment

Avoiding choking hazards

Beyond pickiness: Identifying food intolerances, aversions, and allergies

Deciding on school lunches

Understanding the Effects of Diet on Your Child's Health

Eating breakfast: The most important meal of the day for children

Gimme some sugar: Addressing the causes of hyperactivity

Popping those pimples

Caring for those cavities

Chapter 17: Making Sense of Middle Age

Coming to Grips with Your Changing Body

Paying attention to changes in body shape

Noting how body movement changes

Paying attention to changes in body function

Taking action to offset the effects of aging

Paying Extra Attention to Your Diet

Minding your vitamins and minerals

Getting enough of the energy nutrients

Racing to Save Your Exercise Habits

Recognizing the challenges to maintaining an exercise routine

Incorporating exercise into a busy schedule

Some Final Tips for Mastering Middle Age

Chapter 18: Retiring into the Golden Years

Accepting the Changes That Age Brings

Losing muscle mass and bone density

Disappearing digestive ability

Managing menopause

Paying attention to your mental health

Addressing the Nutritional Needs of the Elderly

Curbing your energy intake

Planning for protein

Fitting fats into your diet

Concerning carbohydrates

Vitamins, minerals, and water

Fighting Common Diseases of the Elderly with Diet

Protecting yourself from prostate cancer

Protecting yourself from breast cancer

Protecting yourself from Alzheimer's disease and dementia

Keeping It Simple and Structured

Part V: Theoretical Foundations of Health Behavior

Chapter 19: Modifying Health Behaviors

Grasping the Theoretical Foundations of Health Behaviors

Reaching through people's differing opinions, ideas, and notions

Getting familiar with the terminology

Examining the Influence of Personality

Myers-Briggs personality assessment

Looking at the Locus of Control model

Examining Environmental Influences

Understanding the three different environments

Putting these environments together: Reciprocal Determinism

Intending to Perform Behaviors: The Key to Action

Modeling Behaviors with Behavior Models

The Health Belief model

The Theory of Planned Behavior

The Transtheoretical model

Chapter 20: Communicating Health Information

Communicating Health Information: The Basics

Defining health communication

Introducing informed decision-making

Trying your hand with an example scenario

Grasping the Art and Science of Communicating

Getting the nuts and bolts right: The content

Being content with your message's language

Knowing your audience: The receiver

Engaging your audience

Working through an example

Taking Your Communication to the Next Level

Exploring intrapersonal influences

Understanding community complexities

Assessing the political effect on communication

Part VI: The Part of Tens

Chapter 21: Ten of the Greatest Superfoods

Beans

Blueberries

Broccoli

Garlic

Honey

Salmon

Soybeans and Other Soy Products

Vinegar

Walnuts and Almonds

Yogurt

Chapter 22: Ten Things to Know about Eating Disorders

Three Main Types of Eating Disorders Exist

Disordered Eating Is Different from Eating Disorders

The Rate of Eating Disorders Is Increasing

Men Suffer from Eating Disorders, Too

Binge Eating Is Commonly Diagnosed among Adults

You Can Be Overweight or Obese and Have Bulimia

One Symptom Does Not an Eating Disorder Make

Anorexia Nervosa Is the Most Deadly Eating Disorder

Mental Health Treatment Is a Large Component of the Cure

You Need to Be on the Lookout for Warning Signs

Chapter 23: Ten International Resources You Don't Want to Miss

The Academy of Nutrition and Dietetics Foundation (ANDF)

Australasian Society for Parenteral and Enteral Nutrition (AuSPEN)

The British Association for Parenteral and Enteral Nutrition (BAPEN)

Irish Society for Clinical Nutritional and Metabolism (IrSPEN)

The Nevin Scrimshaw International Nutrition Foundation (INF)

The Nutritional Barometer

Nutrition Education and Consumer Awareness Group

UNICEF

Vitamin and Mineral Nutrition Information System (VMNIS)

World Public Health Nutrition Association (WPHNA)

About the Author

Cheat Sheet

More Dummies Products

Guide

Table of Contents

Begin Reading

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Introduction

The notion that you can eat your way to a healthier, longer life is an awesome concept. Think about it: Within your power is the opportunity to control one of the biggest factors impacting your health: your diet. Through diet, you can prevent, treat, and even cure diseases. Even more amazing is that the diet that promotes good health isn't difficult to follow. It's quite simple, actually: You simply eat high-fiber, low-fat foods, choose lean proteins, limit junk food, and watch portion sizes.

Still, changing lifestyle behaviors can be very difficult psychologically. Even though some will tell you that losing weight is a simple matter of math — eat fewer calories than you burn — the reality is much different. Eating isn't merely a way to fuel your body; how people react to foods also has emotional and social components as well. On top of that, you have to factor in food addictions, dietary allergies, and the thousands of other factors that influence how and what a person eats. Well, you can see how a simple concept — that you can improve your health by improving your diet — gets a bit more complicated. Eating right for your health is more than a physical challenge; it's a mental challenge as well.

Clinical nutrition is both an art and a science, and the primary goal of clinical nutritionists is to help people make healthy dietary choices. To do so requires doing the following:

Understanding the connection between food and health and incorporating that information into an action plan for patientsDeveloping effective ways of explaining that connection to people to inspire them to make changes that can improve their health

This method — mastering the data and finding compelling ways to communicate that data to patients — helps people get healthy. This is clinical nutrition.

About This Book

This book is a compilation of concepts and information that are thousands of years old. As far back as recorded history, people have been extolling the virtues of eating right and exercising. What we have on our side today is lots of hard data and scientific research that lets us know why, for example, oranges and other citrus fruits prevent scurvy, or that uncovers connections between certain kinds of food and cancer prevention. But the general ideas are the same.

This book shares the hard data with you and gives you the tools you need to communicate this information to others in an effective and persuasive manner. My hope is that the content here not only empowers you to eat right for a great cause — living a long, healthy life — but also inspires you to find out more about clinical nutrition or become a clinical nutritionist yourself.

Sometimes people don't realize that the power to change health for the better lies within, not without. And clinical nutrition gives you a way to improve health and prolong life that doesn't rely on medications. Eating for health is one way you can claim ownership over your life. Eat on, I say!

Conventions Used in This Book

This book is designed so that you can easily find the information you need. Here are some conventions I've used throughout the book:

The illustrations and tables are included to help you understand the general concepts being explained. In other words, I didn't include pictures just because I thought they were pretty; every one can help you more easily grasp the material.The units of measurements for food material are in grams (g) and milligrams (mg), which is the industry norm.The word serving refers to the United States Food and Drug Administration serving size regulations. Most other Western nations have similar, if not identical, serving size rules.I've made nonessential information easy to recognize. Look for the Technical Stuff icon and the shaded boxes of information. This isn't vital to your understanding of clinical nutrition, but those who like the nitty-gritty details will definitely find these bits worthy of note.

In addition, you may note that some web addresses break across two lines of text. If you're reading this book in print and want to visit one of these web pages, simply key in the web address exactly as it's noted in the text, pretending as though the line break doesn't exist. If you're reading this as an e-book, you've got it easy — just click the web address to be taken directly to the web page.

Foolish Assumptions

Maybe you're a college student looking for some extra help in an introductory course to clinical nutrition. Maybe you're a retiree who is just interested on how to make sure you're eating right to increase your chances of living a healthier, longer life. Maybe you just picked this book up randomly at a bookstore because you wanted some quick tips on eating responsibly for better health. Whoever you are, I've made some assumptions about the kind of information you want:

You're interested in nutrition, either personally or because you're considering it as a career choice.You want to know how diet can help prevent, treat, and maybe cure certain diseases.You don't want overly technical or jargon-laden explanations.You're busy and want information that you can reference easily.

If this list describes you, you've picked up the right book. That said, here's one more thing I am assume about you: You are a responsible person who, after reading this material but before changing your diet based on this information, will consult a physician.

Icons Used in This Book

I use several icons in this book to help you identify certain kinds of information so that you can easily find the information you seek. They're all worth reading (even the Technical Stuff, which I included specifically for nutrition geeks — people who, like me, really like the details of what's going on behind the scenes). Here's what the different icons mean:

 This icon highlights information that can help you make responsible choices in your life to improve your health. I also use this icon when I share shortcuts, timesavers, or tricks that can help you grasp a concept.

 Certain information is absolutely vital for anyone interested in nutrition. When you see this icon, you know you've come across one of these nuggets. Keep these very important facts in your head.

Clinical nutrition is all about using diet to produce beneficial health outcomes. But some behaviors — like over- or under-consuming certain vitamins, minerals, fats, carbs, and so on — put you at risk for negative health consequences, some even severe enough to kill you. Pay special attention when you see this icon because it alerts you to these dangers.

 As I mention earlier, this icon highlights the info you don't have to read. Skipping these tidbits won't impair your understanding of clinical nutrition. But I recommend you read them, of course. Some are fun facts, some are esoteric details, some are behind-the-scenes looks, but all are interesting.

Beyond the Book

In addition to the material in the print or e-book you're reading right now, this product also comes with some access-anywhere information on the web. How convenient! Clinical nutrition can be complicated, and you may need to access resources when you're away from your text, and that's what this online content provides: super convenient, super quick access to interesting info. For additional content related to clinical nutrition, be sure to check out the free Cheat Sheet at http://www.dummies.com/how-to/content/clinical-nutrition-for-dummies-cheat-sheet.html. I've also provided lots of bonus material at www.dummies.com/extras/clinicalnutrition that goes beyond the content in both the print and e-books.

Where to Go from Here

This book is modular, meaning that you can start anywhere you want to find the information you need. You don't have to read from beginning to end because I've written each chapter as a stand-alone element, and if a discussion somewhere else would be helpful, I add a cross-reference to tell you where to go to find the information.

Still, if you're new to clinical nutrition, I recommend that you begin reading through Part I, which lays the foundation for the discussions in the rest of the book. Beyond that, head to the table of contents or the index to find a topic that interests you, or thumb through the pages until something catches your eye. Wherever you land, you'll find information you can use.

Part I

Getting Started with Clinical Nutrition

 Visit www.dummies.com for great Dummies content online.

In this part. . .

Discover the basic concepts of nutrition and how new approaches seek to address both individual and global healthcare issuesRecognize the components of a career in clinical nutrition and identify which area interests you mostUnderstand how nutrition is increasingly being integrated into educational and clinical applications to promote wellness of groups and individualsBecome familiar with the different nutrients, the recommended intake levels, and how diet promotes or hinders optimum heathDiscover strategies that help you change behaviors to make your life, or your patients’ lives, longer and healthier

Chapter 1

Getting Clinical about Nutrition

In This Chapter

Conceptualizing clinical nutrition

Understanding the fundamentals of clinical nutrition

Becoming aware of the growing international focus on proper nutrition

The fact that you are reading this book means that you are at least partially tuned into the connection between what you eat and how it affects your health. Congratulations! Either through a course you are taking or through your own personal curiosity, you are choosing to get better acquainted with the study of diet and how it influences your overall status of health and wellness.

The relationship between what you eat and how healthy you are can be complex, but it's not impossible to understand. In fact, this text focuses on a few simple guidelines:

You must eat fruits, vegetables, and whole grains.You must moderate your fat, salt, and sugar intakes.You must exercise.

If you follow all these guidelines, you'll find yourself more healthy than not and will realize the truth behind the adage that you are what you eat.

This chapter takes you on a quick tour of the fundamental principles related to the study of clinical nutrition. Retaining a basic understanding of the concepts I introduce you to here is a great foundation for all the chapters that follow.

Pillars of the Practice: Recognizing theLinks between Nutrition and Health

To state the obvious, food is essential for human survival. Since humans — or some form thereof — first started to walk the earth, the human body has evolved to benefit from the foods available in a given environment.

Generations of trial and error, in which we sampled literally tens of thousands of different species of potential food, enabled us to obtain from nature the nutrients needed for life. Our bodies adapted over thousands of years to both the bounty and the scarcity of what existed in the environment — what we were able to gather, hunt, and farm.

Recently, however, that relationship has been altered, and along with that change is a realization that modern eating habits aren't necessarily better. From that realization have sprung efforts to return to a healthier way of eating.

Revisiting traditional views of food and health

Just up until the middle of the last century, people ate a variety of foods that were in balance with the major food groups. Through the process of evolution, humans naturally gravitated toward a diet that was relatively in tune with what the body needed to survive. The availability of — and our preferences for — food were naturally balanced in a way that provided a healthy diet. Whether the available diet and the human body's needs evolved together is uncertain, but one thing we do know for sure is that, back then, humans didn't overeat as much.

A snapshot of the past

Before industrialization, globalization, and modern farming and transportation techniques, food was scarcer than today. You ate what you needed — not what you wanted — and what was available.

Convenience stores selling all kinds of processed foods didn't dot every city corner. Nor were there gigantic supermarkets holding thousands of items to choose from. If you wanted a grape grown in Chile or an apple grown in New Zealand, you needed to live in (or pretty darn close to) those countries, because systems for transporting fresh food around the globe didn't exist.

Basically, you had yourself to rely on: You had to grow and harvest your own food, and prepare it yourself — all tasks that involve lots of manual labor. Of course, hunger was an issue (as it still is for too many people today), but the overabundance of food that's common today simply did not exist back then.

Fast forward to today

Today, the food landscape is very different. You can walk into a supermarket and buy almost any fresh product from any corner of the world. You can swing by a convenience store for a quick snack and a mega-gulp. You can go to a fast-food restaurant and buy a meal packed full of a day's worth of calories and gobble it down within 15 minutes of walking in the door. You have the world at your culinary disposal.

Ample quantities of food are available, and you don't have to exert much physical labor to procure it. Before, if you wanted a special type of walnut from some distant land, you'd probably have to go there yourself, or order it and wait four months for it to arrive at the dock. You wouldn't be able to find it prepackaged in plastic in aisle 10 of your local megamart.

Never has such a scenario existed in the course of human history. Consider yourself lucky — and then recognize the health trade-off that's occurred due to the abundance of unhealthy, highly processed foods.

 Diets that are high in fat, salt, and sugar have become more commonplace. Public health and nutrition researchers theorize that this phenomenon has promoted epidemic levels, perhaps even pandemic (worldwide) levels, of adverse health effects. Whereas the rates of obesity, heart disease, and diabetes (and even some type of cancers) occurred at drastically lower levels before the mid-20th century, today those conditions occur at an alarming rate.

With the discovery of the direct relationship between the foods we eat and these (and other) health conditions, people are beginning to return to a more simplistic, healthier, and, dare I say, natural way of eating food. (For details on the relationship between diet, nutrition, and a variety of conditions and diseases, head to Part II.)

Introducing the key tenets of clinical nutrition

Clinical nutrition is the study of the connection between your body's overall state of wellness and the foods you eat each day. What's so interesting about this field is that, if you go beyond the details (how particular nutrients do particular things or what proportion of what kinds of foods produces optimal results, for example), you realize that it really matters: Because of this awareness, clinical nutrition, in a sense, seeks to re-establish the connection people used to have with food, in which their diets provide the nutrients necessary to ensure adequate nourishment and to build and maintain healthy, strong, and resilient bodies.

If you took all the tips and tricks mothers, fathers, grandparents, and others have passed down about what to eat to maintain healthiness or to prevent disease, and distilled those nuggets into a science, you would end with many of the key tenets of clinical nutrition. Here are some things that Grandma may have said and what modern science shows (I delve into these tenets in more detail throughout this book):

You are what you eat: If you eat too much fat and calories without being active, you'll put on weight. If you eat healthy foods, you'll be healthy. If you eat lots of carrots, you'll be . . . okay, well this one doesn't quite work, but interestingly you can get beta-carotene poisoning, which makes your skin turn orange . . . like a carrot! Silly example aside, the point is still a good one: What you put into your body has a direct affect on your body and your health.An apple a day keeps the doctor away: The quality of the food you eat has a direct impact on your health. (I cover the role of diet in a variety of diseases in the chapters in Part II).

Ask yourself this question: Would you put sand into the fuel tank to make the vehicle run? Of course not. Not unless you want to irreparably damage the inner workings of your car. A car needs gasoline, not sand, just as your body needs healthy, whole foods for better health outcomes. Both need the best sources of fuel to optimally perform.

Don't eat anything you don't recognize as food: Your body evolved to digest food, not food products, to maintain health. You want to eat as many simple, whole foods as possible. Eating oranges is better than drinking orange juice, and drinking orange juice is better than eating orange popsicles.

 Here's a tip to help you avoid foods that are overly processed: Avoid or find alternatives for food that

Has more than five ingredientsHas ingredients you cannot pronounceContains high-fructose corn syrup or hydrogenated oils

If a food falls into two of these three categories, it may be processed and not one your ancestors would have recognized. Steer clear as much as possible from these products.

To lengthen your life, shorten your meals: One key to a healthy life is to eat in moderation. Research suggests that, on average, the more energy (calories) you consume, the worse health outcomes you have compared to people who eat a moderate amount of food. I delve more deeply into this concept in Chapter 2.A little dirt never hurt anybody: Did you ever hear your mother or father say, “Germ him up!” Maybe not, but my father said it numerous times about me to my mother. They knew that children, and adults, benefit from certain bacteria in dirt and other external sources. Being exposed helps train your body to become resistant to these microbes in the future. In other words, food doesn't have to be sterile to be good for you.

Now, don't take this advice too far and eat random, dirty objects. That is not the best thing to do. You will get sick. (Head to Chapter 10 for information on food contaminants you need to protect yourself from.) Still, as the phrase suggests, a little dirt will never hurt. Many beneficial microbes vital to the human body are ones that you can only get through external sources — your food and things on your food. Be sure to check out Part III for more information on specific diets and how they benefit specific systems of the body.

 Although clinical nutrition is a comprehensive, advanced science, a simplified version of the tenets of clinical nutrition can be learned from talking to older members (grandparents or even great-grandparents) of your family. Ask them how or what they used to eat, their exercise habits when they were younger, and how they eat now. You'll be surprised at the similarities between what your older family members used to eat (or maybe still do) and what the most advanced clinical nutrition research suggests for a healthier life. The terms may be more complicated on the clinical nutrition side, but the premises are very similar.

Taking a New(-ish) Approach toMedical Care and Public Health

Clinical nutrition is mainly concerned with two overarching goals — disease prevention and therapies used to treat particular diseases — which it seeks to achieve by focusing on the following areas:

Dietetics: Dietetics is the study of food and its regulation, and proper nutrition, and how these factors influence health outcomes in both behavioral settings (public health, community-wide applications) and clinical settings (laboratory or hospital-based applications).Nutritional genomics: Nutritional genomics is an expanding field in clinical nutrition. Professionals are placing more and more emphasis not only on the immediate effects of a poor diet on the body but also on the long-term effects, including those passed through generations. Nutritional genomics studies how your diet affects your genes and how possible differences in genetic components of the human body can affect your health. Essentially, nutritional genomics is the study of how your ancestors ate and how their diets possibly affect your health outcomes. It is interesting — maybe even alarming — to think that what you're eating now could have an impact upon your great-great-grandchildren's health!

In this section, you get a general look at how the field of clinical nutrition helps prevent disease and can be used to improve treatment therapies. For detailed information on the connection between diet and disease, head to Part II; Part III explores the role nutrition plays on the organ systems in the body.

Preventing disease

Most dietary recommendations from the majority, if not all, governing health bodies aim to prevent the following three major conditions and the diseases associated with them:

Obesity: Obesity is caused by eating more calories than the body burns, a situation that leads to increases in body fat. Research suggests that weight gain is at the root of many of the risk factors leading to a variety of different diseases, including heart disease, diabetes, sleep apnea, arthritis, hypertension (high blood pressure), gout, and certain types of cancers, to name just a few.

People who are obese tend to have other diseases associated with obesity, a situation referred to as being comorbid. Clinical nutritionists are working with public health officials to alter public dietary behaviors by providing individual counseling, promoting policy changes (such as banning, or limiting, trans-fats in foods), and modifying school lunch programs to offer more fruit and vegetable choices in place of processed carbohydrate-dominated foods (like pizza and french fries), to name a few.

Heart disease: Heart disease is the number one cause of death worldwide, and it is largely the result of poor dietary choices and physical inactivity. Research suggests that people who live sedentary lives and eat high-fat, low-fiber foods have a higher risk for developing heart disease than those who are active and eat a low-fat, high-fiber diet. Clinical nutritionists work with individual patients and public health officials to help promote heart-healthy behaviors, like exercising regularly and eating low-fat diets.Malnutrition: The World Health Organization (WHO) currently emphasizes malnutrition as one of the most important public health concerns the world faces today. According to WHO, malnutrition consists of undernutrition (chronically not getting enough nutrition through food or supplements, or the body's inability to process certain nutrients to support normal bodily functions) and overweight/obesity — both major global health concerns. Clinical nutritionists are implementing various educational campaigns aimed at raising awareness and limiting the spread and effects of these diseases.

Devising therapeutic measures to treat disease

As I note earlier, clinical nutrition is the study of how foods you eat each day impact your body's overall state of wellness, and it's yielded all sorts of information that health professionals can use to design more effective treatment programs for those suffering from disease. Specifically, clinical nutrition has made possible a therapeutic approach for treating health conditions and their associated symptoms by using a therapeutic, or specialized, diet.

 A therapeutic diet is specifically designed to promote optimum wellness for an individual, based upon that individual's immediate dietary needs. This tailored diet is based upon the patient's entire medical history profile. Such treatments aim to reduce the risk of developing complications for conditions such as diabetes and to ameliorate the effects of conditions like high cholesterol.

Many of these modern-day recommendations stem from knowledge our ancestors had about different foods and their potential curative properties. Following are some examples of folk wisdom that research has shown to be effective:

Orange juice assists immune system response. Orange juice is high in vitamin C, an antioxidant that helps protect your body from cell damage and plays a key role in your immune system.Honey can be used as an antiseptic. Honey has antimicrobial qualities and forms a protective barrier over a wound to prevent other microbes from getting into the cut. To find out more about the medicinal and antibacterial properties of honey, check out the article “Honey: its medicinal property and antibacterial activity,” by Manisha Deb Mandal and Shyamapada Mandal at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609166/.Fiber and whole grains help gastrointestinal tract issues. Excess fat and cholesterol bind to fiber in the intestines, which then excrete the waste out of the body instead of recycling it back into the blood. Further, fiber promotes bacterial growth in the intestines to aid in digestion. For more on the ins and outs of the excretory system, head to Chapter 14.The BRAT diet (bananas, rice, applesauce, and toast) is good for diarrhea. If you are experiencing an overactive gastrointestinal tract, like diarrhea, for instance, you should eat low-fiber foods that are bland, which is what the BRAT diet proposes. In addition to keeping you feeling full, the BRAT foods provide nourishment without further upsetting your already sensitive stomach and intestines.

 These recommendations stem from more traditional sources that have been used for generations. What clinical nutritionists are doing now is perfecting the science and attempting to understand the physiologic components of the relationship between those foods and overall health. Bottom line: Our ancestors knew these treatments worked; nowadays, we want to know why.

 Some food remedies can actually cause more harm than good. Most people know to be wary of products that claim to bring about rapid weight loss, strength gain, longevity, and so on. But you must also be extremely cautious about the supplements you take. Some situations — the presence of existing health conditions, negative interactions with medications you're already taking, and more — can make taking the supplement dangerous. For example, some research suggests that taking calcium supplements may actually raise your risk for heart disease. Check out this website for more information on the topic: http://www.health.harvard.edu/blog/link-between-calcium-supplements-and-heart-disease-raises-the-question-take-them-or-toss-them-201205304813

Addressing nutritional needs throughout your lifespan

Healthy dieting and maintaining wellness is a lifelong effort, not a temporary distraction. As you work to maintain a healthy diet throughout your life, you must be aware that your diet will change. Nutritional requirements are not static. As you age, your needs shift, and your diet must change to fulfill those needs.

Clinical nutrition helps individuals transition their dietary and lifestyle behaviors throughout life. Clinical nutritionists give patients information to help them choose and eat the right foods at the right times of their lives. This field is expanding and becoming a main contributor of scientific advancements related to aging and diet.

I discuss how nutritional needs change throughout life in Part IV. Head there to find details and suggestions for ensuring that your diet matches your nutritional needs.

Increasing Visibility (and Abbreviations) through Key Organizations

The dramatic rise in chronic diseases stemming from nutritional deficiencies and/or excesses, poor quality food supply, and other diet-related issues has spurred a flurry of research and outreach from a number of levels. Governmental, nongovernmental, academic, and international agencies have all joined the fight in combatting health risks by promoting wellness and disease prevention through lifestyle change and nutritional therapy. The following sections introduce you to a few of the different kinds of organizations involved. For a list of ten specific organizations combatting diet- and nutrition-related problems around the globe, head to Chapter 23.

Walking the hallowed halls: Clinical nutrition in academia

Globally, many colleges and universities now provide training and credentialing services for clinical nutrition sciences. This attention is prompted primarily by the increasing incidence of chronic diseases around the world and the number of clinical care facilities offering dietary services. These two primary driving factors create a demand for trained professionals who can provide those services.

Currently in the United States alone, scores of institutes of higher learning provide some type of degree or certificate in clinical nutrition sciences — a figure that doesn't include the colleges and universities that offer courses on the topic but don't provide credentials of training. If those institutions were included, the number of facilities offering education in the field would be in the hundreds.

Globally, thousands of institutes of higher learning may offer some type of training in the field of clinical nutrition. Although exact numbers aren't known, one thing is clear: In recent decades, clinical nutrition is becoming a more and more popular field.

 When you choose a program, make sure you receive your training at facilities or institutions that are certified, endorsed, and/or accredited by professional organizations such as the following:

American Clinical Board of Nutrition (ACBN,www.acbn.org): This organization establishes education, examination, experience, and ethics requirements for certification in the field of nutrition.Academy of Nutrition and Dietetics (www.eatright.org): Formerly known as the American Dietetic Association, this organization is committed to improving the nation's health and advancing the profession of dietetics through research, education, and advocacy. The organization empowers its members to become national and global nutrition leaders.International & American Association of Clinical Nutritionists (IAACN,www.iaacn.org): This organization aims to enrich the curriculum offered in clinical nutrition training programs through competency and practice. The IAACN helps establish education programs for clinical nutritionists in order to ensure the highest quality standards and processes for those who practice in the field.International Nutrition Consultant Association (www.in-ca.org): This body upholds professional standards in the field for practicing clinical nutritionists.

 These governing bodies’ strict guidelines regarding the quality of clinical nutrition education offered are intended to dissuade any unqualified entities from training future practitioners in the field. Sometimes, however, facilities that are not endorsed by these organizations offer very high-quality training but are new and in the process of being accredited; others are not worth the investment. Do your homework before entering a specific program!

Getting better: Clinical nutrition in healthcare settings

More and more clinical health facilities worldwide offer services designed to reconnect diet and health for their clients and patients. These facilities, a few of which I list here, offer services ranging from dietetic therapy to nutritional counseling:

Hospitals: Hospitals employ clinical nutritionists to offer nutritional treatment for certain health issues on an in-patient basis (that is, to patients admitted to the hospital). These nutritionists use food and supplements to assist with a patient's therapy, based on the particular health concern.Health clinics: Health clinics offer access to nutritional counseling or to dietary supplements. This type of service is primarily provided on an out-patient basis.Outreach programs: These programs provide services that help clients navigate health systems for dietary treatment; they may offer free services for nutritional counseling, for example. Outreach programs also offer programs that improve access to fresh and safe sources of food for disadvantaged and needy populations.

Selling wellness: Clinical nutrition as a business

The private sector is also staking claim to the expanding interest in clinical nutrition sciences. Everywhere you look nowadays, you are likely to see advertisements selling the idea of the diet-health connection and claiming that a dream diet can help you achieve your ideal weight with minimal effort or that a dietary supplement can rid your body of toxins. You probably see ads for new medical practices that offer dietary services, as well as ads for health coaches, life coaches, and diet coaches who promise to help you become a healthier person through healthier eating. Even spas, resorts, community centers, and gyms often claim to have services that can reconnect you with the knowledge and tools to improve your health.

 Do your homework to ensure you are getting the best quality from a qualified professional. Try these suggestions:

Look for diplomas on the walls of the professionals providing advice and make sure the diplomas come from reputable universities or training facilities.Go online to find reviews written by the business's other clients or patients.

Make sure that you obtain information about nutrition and health from credible sources. Take special care with open-source information, like blogs and other sites that allow anyone with an opinion to state thoughts on any given topic without verification of facts. The easy flow of information gives you the opportunity to find information efficiently, but you must vet the information you find. Anyone can post material online, even content that is full of errors or misinformation.

Ask about the business's accreditation. Is the professional organization that accredited the business reputable? Refer to the earlier section “Walking the hallowed halls: Clinical nutrition in academia” for a list of reputable organizations.

Affecting public policy: Governmental organizations

Governments are taking a more active role in helping their citizens eat healthier, gain better access to healthy foods, and live healthier lifestyles. In this section, I provide examples of governmental organizations from around the world that seek to address the nutrition needs of their respective populations.

USDA

Working with the First Lady of the United States Michelle Obama, the United States Department of Agriculture (USDA) introduced ChooseMyPlate.gov. The goal of this program is to help Americans make better, more informed choices about what they eat.

ChooseMyPlate, shown in Figure 1-1, was unveiled to take the place of MyPyramid, the pyramid-shaped food guide that most people found more confusing than helpful. The MyPlate graphic and the persuasive and educational messaging that accompanies it (head to www.choosemyplate.gov to see) aim to demonstrate not only what to eat, but also how much to eat.

National Institute for Health and Clinical Excellence

The National Institute for Health and Clinical Excellence (NICE), part of the U.K.’s National Health Service (NHS), seeks to promote good health and prevent diseases through evidence-based medicine. NICE puts forth an array of guidelines to help combat health issues stemming from improper nutrition. These guidelines — such as promoting breastfeeding to expectant and new mothers and offering ways to prevent stroke or decrease hypertension — set the standard for high-quality healthcare services while simultaneously promoting healthy living for a longer life.

Illustration courtesy of USDA, www.choosemyplate.gov

Figure 1-1:Choose- MyPlate seeks to simplify healthy eating guidelines.

Canadian Nutrition Society/la Societe canadienne de nutrition

The Canadian Nutrition Society/la Societe canadienne de nutrition (CNS/SCN) promotes health and preventative services through clinical nutrition science and continuing education programs. One primary objective of CNS/SCN is to integrate academic, clinical, private sector, and governmental agencies involved with dietetic education and nutritional counseling. One such effort is the Canadian Malnutrition Task Force (CMTF), which aims to improve nutrition care across the country to help all Canadians achieve optimal nutrition.

National Health and Medical Research Council

The Australian National Health and Medical Research Council (NHMRC) supports health and medical research used to develop health education and awareness campaigns across the country. A primary goal of NHMRC is to provide disease prevention and therapy through the use of healthy diets and exercise. The NHMRC provides an entire library of research and policy statements on health and wellness issues. For more information on NHMRC programs, be sure to check its website: http://www.nhmrc.gov.au/about/committees-nhmrc.

Chapter 2

Nutrition 101

In This Chapter

Discovering the basics of eating well

Determining what nutrients make up the food systems

Understanding how your body utilizes nutrients

Can eating to ensure a longer life and higher quality of life be as simple as A, B, C? Pretty much, yes. Despite the abundance of confusing and often misleading or incorrect information circulating in the media, the best diet is a basic, common-sense diet.

No magic bullet can guarantee that you will live longer or healthier. The key to building a healthy lifestyle is to ensure proper dietary habits. Fortunately, doing so isn't complicated. The formula is simple and easy.

In this chapter, I provide an overview of basic nutritional concepts and body functions related to how your body digests, transports, and uses nutrients. This information is vital to your understanding of major diseases and organ systems and of how proper nutrition is essential to a healthy, vibrant lifestyle. (For detailed discussions of the impact of nutrition on major diseases and organ systems, head to Parts II and III, respectively).

The ABCMVs of Eating

Here's a fact that many people have a hard time believing: Eating more like your ancestors did (fresh, seasonal varieties of fruits and vegetables, lean meats, whole grains, and yes, even saturated fats) is actually better for your health and well-being than dining on some power smoothie chock-full of synthetic vitamins. (Apparently Mom and Grandma really did know best!)

Research and current thinking indicate that individuals need to adopt such a diet in order to produce positive health outcomes. I delve more into that topic in Part II, which is devoted to the link between diet and disease, and Part III, which covers the connection between nutrition and the function of major body systems. Here, I start with the basics.

Most of the time, the simplest food is also the healthiest. For example, are hard-boiled eggs a better source of fat and protein for you than a synthetic protein powder blend with some form of hydrogenated oil? You betcha.

Introducing a common-sense diet

 The answer to living longer and healthier is actually as simple as A, B, C, with a couple of other letters thrown in:

Adequacy: Are you getting sufficient vitamins and minerals from your food? The key here is to eat foods that are packed with nutrients rather than foods that offer nothing other than empty calories. An easy way to do this is to eat colorful fruits and vegetables, whole grains, and lean meat.Balance: Are you getting enough food from each food group? For most of your meals, you want to have more vegetables and fruits on your plate than any other type of food, such as bread, meat, or dairy.Calorie control: Are you consuming the right amount of calories — not too many or too few — per day? A great way to control calories is to limit the amount of high-sugar and high-fat foods you eat, like soft drinks, candy, cookies, and other baked goods.Moderation: Are you sure that you're not getting too much of one thing over another? When it comes to moderation, you also want to limit the amount of highly processed food you eat, like fried snack foods, fast food, and prepackaged prepared meals.Variety: Are you eating a varied diet and not the same thing over and over again? Try eating something different for breakfast, lunch, and dinner every day. Don't be hesitant to eat something you never tried before. Remember: Variety is the spice of life!

If you can answer “yes” to the preceding questions, your diet is probably one that gives you the nourishment necessary to help prevent illness and early death. That's it. Nothing spectacular. No pills. No bells. No whistles. Just plain, old-fashioned common sense.

 Be wary of any product or regimen that guarantees you can live a longer, healthier life by taking a pill or supplement alone. The key to living longer and living healthier is a healthy diet and a lifestyle that incorporates regular exercise and refrains from tobacco use, alcohol abuse, or any other risky behavior.

Well, don't I have egg on my face!