Table Of Content

Adult BMI ready reckoner* 125 123 121 119 117 115 113 111 109 107 105 103 101 99 97 95 93 91 89 87 85 83 81 79 77 75 73 71 69 67 65 63 61 59 57 55 53 51 49 47 45 43 68 67 65 64 63 62 61 60 59 58 57 56 55 54 52 51 50 49 48 47 46 45 44 43 42 41 39 38 37 36 35 34 33 32 31 30 29 28 26 25 24 23 1.36 Height (m) 64 63 62 61 60 59 58 57 56 55 54 53 52 51 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 29 28 27 26 25 24 23 22 1.40 60 59 58 57 56 55 54 54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 29 28 27 27 26 25 24 23 22 21 1.44 57 56 55 54 53 53 52 51 50 49 48 47 46 45 44 43 42 42 41 40 39 38 37 36 35 34 33 32 32 31 30 29 28 27 26 25 24 23 22 21 21 20 1.48 54 53 52 52 51 50 49 48 47 46 45 45 44 43 42 41 40 39 39 38 37 36 35 34 33 32 32 31 30 29 28 27 26 26 25 24 23 22 21 20 19 19 1.52 51 51 50 49 48 47 46 46 45 44 43 42 42 41 40 39 38 37 37 36 35 34 33 32 32 31 30 29 28 28 27 26 25 24 23 23 22 21 20 19 18 18 1.56 49 48 47 46 46 45 44 43 43 42 41 40 39 39 38 37 36 36 35 34 33 32 32 31 30 29 29 28 27 26 25 25 24 23 22 21 21 20 19 18 18 17 1.60 46 46 45 44 44 43 42 41 41 40 39 38 38 37 36 35 35 34 33 32 32 31 30 29 29 28 27 26 26 25 24 23 23 22 21 20 20 19 18 17 17 16 1.64 44 44 43 42 41 41 40 39 39 38 37 36 36 35 34 34 33 32 32 31 30 29 29 28 27 27 26 25 24 24 23 22 22 21 20 19 19 18 17 17 16 15 1.68 42 42 41 40 40 39 38 38 37 36 35 35 34 33 33 32 31 31 30 29 29 28 27 27 26 25 25 24 23 23 22 21 21 20 19 19 18 17 17 16 15 15 1.72 40 40 39 38 38 37 36 36 35 35 34 33 33 32 31 31 30 29 29 28 27 27 26 26 25 24 24 23 22 22 21 20 20 19 18 18 17 16 16 15 15 14 1.76 39 38 37 37 36 35 35 34 34 33 32 32 31 31 30 29 29 28 27 27 26 26 25 24 24 23 23 22 21 21 20 19 19 18 18 17 16 16 15 15 14 13 1.80 37 36 36 35 35 34 33 33 32 32 31 30 30 29 28 28 27 27 26 26 25 25 24 23 23 22 22 21 20 20 19 19 18 17 17 16 16 15 14 14 13 13 1.84 35 35 34 34 33 33 32 31 31 30 30 29 29 28 27 27 26 26 25 25 24 23 23 22 22 21 21 20 20 19 18 18 17 17 16 16 15 14 14 13 13 12 1.88 34 33 33 32 32 31 31 30 30 29 28 28 27 27 26 26 25 25 24 24 23 23 22 21 21 20 20 19 19 18 18 17 17 16 15 15 14 14 13 13 12 12 1.92 33 32 31 31 30 30 29 29 28 28 27 27 26 26 25 25 24 24 23 23 22 22 21 21 20 20 19 18 18 17 17 16 16 15 15 14 14 13 13 12 12 11 1.96 31 31 30 30 29 29 28 28 27 27 26 26 25 25 24 24 23 23 22 22 21 21 20 20 19 19 18 18 17 17 16 16 15 15 14 14 13 13 12 12 11 11 2.00 BMI <18.5 – underweight BMI 18.5–24.9 – acceptable weight BMI 25–29.9 – overweight BMI 30–39.9 – obese BMI >= 40 – morbid obesity Weight (kg) * Reproduced from Simon et al, Oxford Handbook of General Practice 2e. By permission of Oxford University Press. i OXFORD MEDICAL PUBLICATIONS Oxford Handbook of Nutrition and Dietetics 1 ii Published and forthcoming Oxford Handbooks Oxford Handbook of Clinical Medicine 6/e (also available for PDAs and in a Mini Edition) Oxford Handbook of Clinical Specialties 7/e Oxford Handbook of Acute Medicine 2/e Oxford Handbook of Anaesthesia 2/e Oxford Handbook of Applied Dental Sciences Oxford Handbook of Cardiology Oxford Handbook of Clinical Dentistry 4/e Oxford Handbook of Clinical and Laboratory Investigation 2/e Oxford Handbook of Clinical Diagnosis Oxford Handbook of Clinical Haematology 2/e Oxford Handbook of Clinical Immunology and Allergy 2/e Oxford Handbook of Clinical Pharmacy Oxford Handbook of Clinical Surgery 2/e Oxford Handbook of Critical Care 2/e Oxford Handbook of Dental Patient Care 2/e Oxford Handbook of Dialysis 2/e Oxford Handbook of Emergency Medicine 3/e Oxford Handbook of Endocrinology and Diabetes Oxford Handbook of ENT and Head and Neck Surgery Oxford Handbook for the Foundation Programme Oxford Handbook of Gastroenterology and Hepatology Oxford Handbook of General Practice 2/e Oxford Handbook of Genitourinary Medicine, HIV and AIDS Oxford Handbook of Geriatric Medicine Oxford Handbook of Medical Sciences Oxford Handbook of Nephrology and Hypertension Oxford Handbook of Neurology Oxford Handbook of Obstetrics and Gynaecology Oxford Handbook of Oncology 2/e Oxford Handbook of Ophthalmology Oxford Handbook of Palliative Care Oxford Handbook of Practical Drug Therapy Oxford Handbook of Psychiatry Oxford Handbook of Public Health Practice 2/e Oxford Handbook of Rehabilitation Medicine Oxford Handbook of Respiratory Medicine Oxford Handbook of Rheumatology Oxford Handbook of Tropical Medicine 2/e Oxford Handbook of Urology 1 iii Oxford Handbook of Nutrition and Dietetics Joan Webster-Gandy Angela Madden Michelle Holdsworth 1 iv Great Clarendon Street, Oxford OX2 6DP Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide in Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries Published in the United States by Oxford University Press, Inc., New York © Oxford University Press, 2006 The moral rights of the authors have been asserted Database right Oxford University Press (maker) First published 2006 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this book in any other binding or cover and you must impose the same condition on any acquirer British Library Cataloguing in Publication Data Data available Library of Congress Cataloging in Publication Data Data available Typeset by Newgen Imaging Systems (P) Ltd., Chennai, India Printed in Italy on acid-free paper by LegoPrint S.p.A. ISBN 0–19–856725–1 978–0–19–856725–7 (flexicover) 10 9 8 7 6 5 4 3 2 1 1 v Preface When we were approached to write this handbook the original idea was to write a book for general practice. However, we all remember being student dietitians and all created our own handbook of useful information that we carried around with us and were totally lost without. On reflection of what text books are now available in nutrition or dietetics, it became clear that although there are now concise pocket books written for dietitians working predominantly in a clinical setting, there was a need for a user friendly handbook of nutrition and dietetics for a wider audience that included doctors, nurses, nutritionists and other health care professionals. The available textbooks are, by necessity, large tomes or series that are unlikely to adorn the shelves of many doctors or nurses whether in primary or secondary care. As a result, we have tried to present nutritional science, therapeutics and community public health nutrition in a concise and integrated manner. While writing the text we have tried to identify what information would be useful to different professionals in a variety of settings. For example a doctor or nurse may want information on obesity and will find a ready reckoner for the calculation of BMI, information on associated problems and treatment options. Dietitians working in the community or public health will have this information but will find the sections on the meas- urements of obesity or nutrition interventions more informative. How well we have achieved this is for the reader to decide. Nutrition is fascinating for many reasons, one of which is the fact that it is a very dynamic discipline. We have tried very hard to be contemporary but there will inevitably be changes in basic science, practice and policy as the discipline continues to evolve. Major developments and changes will be posted on the relevant page of the OUP web site. For us it has been a very enjoyable, if at times rather demanding, process and we hope that this book is useful to all health care professionals. J.W-G. A.M.M. M.H. This page intentionally left blank 1 vii Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplica- tion of material in this work. 1 viii Foreword Both health professionals and the general public now realize that good nutrition is essential for good health. Indeed, nutrition is the health topic on which the lay public receives the most advice from popular books and magazines, but often this advice is unsound. It is therefore essential that health-carers have readily available reliable information about all aspects of nutrition. This includes nutritional science, public health nutrition, and therapeutic nutrition. This handbook provides, in concise format, the information about nutrition needed by those training to be dietitians (RD), nutritionists (RNutr), public health nutritionists (RPHNutr), or doctors or nurses either in hospital or primary care. It will continue to be a valuable resource after graduation, since the scope of modern nutrition is so large that a specialist in one field (say, public health nutrition) cannot hope to have instantly accessible all the necessary information about therapeutic diets, or nutritional sciences, and vice versa. The three authors of this Handbook are all registered dietitians, each of whom has a solid research record as well as extensive experience of the nutritional problems that dietitians, hospital doctors, general practi- tioners, and specialist nurses will encounter. I am confident that readers will be thankful to have this book in their pocket to guide them to the correct immediate response to a nutritional problem, even if later they have to consult a senior dietitian or textbook for more detailed advice. John Garrow MD PhD FRCP Emeritus Professor of Human Nutrition University of London. 1 ix Acknowledgements Special thanks go to everyone who has helped and supported us during the production of this book. We are particularly grateful to: Julie Beckerson, Alison Culkin, George Grimble, Michelle Harvie, Catherine Hodgson, Catherine Humphries, Tom Humphries, Jamie Hustler, Cathy Mooney, Gail Rees, Alan Rio, Ann Van Duzer, and Liz Weekes. Finally, thanks to the medical division at OUP for all the encourage- ment and support. 1 x Dedication To Beth, Didier, Catherine, Matthew, Milo, Paula, and Will, with much love. 1 xi Contents Detailed contents xv Contributors xxvi Abbreviations xxix 1 Introduction to nutrition 2 Dietary reference values (DRVs) and food-based dietary guidelines 3 Current dietary patterns in the UK 4 Nutrition assessment 5 Nutrients 6 Food labelling, functional foods, and food supplements 7 Non-nutrient components of food 8 Drug–nutrient interactions and prescription of nutritional products 9 Diet before and during pregnancy 10 Infants and preschool children 11 School-aged children and adolescents 12 Older people 13 Nutrition in special groups 14 Nutrition intervention with individuals 15 Nutrition intervention with populations 3 17 29 33 55 167 183 199 209 221 255 267 281 305 321 1CONTENTS xii contents 16 Nutrition support 17 Obesity 18 Diabetes 19 Cardiovascular disease 20 Cancer and leukaemia 21 Nutrition in gastrointestinal diseases 22 Pancreatic disease 23 Liver disease 24 Renal disease 25 Respiratory disease and cystic fibrosis 26 Human immunodeficiency virus (HIV) infection 27 Nutrition in mental health 28 Nutrition in neurological conditions 29 Palliative care 30 Inherited metabolic disorders 31 Epilepsy and ketogenic diets 32 Food hypersensitivity 33 Rheumatology and bone health 34 Hospital catering 35 Popular diets Appendices 1 Weights and measures 2 Anthropometrics 3 Conversion factors 4 Energy expenditure prediction equations 5 Clinical chemistry reference ranges 6 Dietary reference values 7 Nutritional composition of common foods 697 689 687 685 683 661 653 649 659 637 631 627 619 615 609 599 591 585 555 543 539 489 475 449 423 405 347 CONTENTS1 xiii 8 Useful contacts 9 The National Statistics Socio-economic Classification (UK) 10 Bibliography and further reading Index 717 Adult BMI ready reckoner Inside front cover MUST screening tool Inside back cover Contents 713 711 705