N U T R I T I O N & H E A L T H PPrreevveennttiivvee NNuuttrriittiioonn TThhee CCoommpprreehheennssiivvee GGuuiiddee ffoorr HHeeaalltthh PPrrooffeessssiioonnaallss TT EE HHIIRRDD DDIITTIIOONN EEddiitteedd bbyy AAddrriiaannnnee BBeennddiicchh,, PPhhDD,, FFAACCNN RRiicchhaarrdd JJ.. DDeecckkeellbbaauumm,, ,, (( )) MMDD FFRRCCPP CC P N REVENTIVE UTRITION T E HIRD DITION Bendich_FM_Final 1 1/17/05, 2:56 PM N H UTRITION ◊ AND ◊ EALTH Adrianne Bendich, Series Editor Calcium in Human Health, edited by Connie M. Weaver and Robert P. Heaney, 2005 Preventive Nutrition: The Comprehensive Guide for Health Professionals, Third Edition, edited by Adrianne Bendich and Richard J. Deckelbaum, 2005 Nutrients, Stress, and Medical Disorders, edited by Shlomo Yehuda and David I. Mostofsky, 2005 The Management of Eating Disorders and Obesity, Second Edition, edited by David J. Goldstein, 2005 Nutrition and Oral Medicine, edited by Riva Touger-Decker, David A. Sirois, and Connie C. Mobley, 2005 IGF and Nutrition in Health and Disease, edited by M. Sue Houston, Jeffrey M. P. Holly, and Eva L. Feldman, 2005 Epilepsy and the Ketogenic Diet, edited by Carl E. Stafstrom and Jong M. Rho, 2004 Handbook of Drug–Nutrient Interactions, edited by Joseph I. Boullata and Vincent T. Armenti, 2004 Nutrition and Bone Health, edited by Michael F. Holick and Bess Dawson-Hughes, 2004 Diet and Human Immune Function, edited by David A. Hughes, L. Gail Darlington, and Adrianne Bendich, 2004 Beverages in Nutrition and Health, edited by Ted Wilson and Norman J. Temple, 2004 Handbook of Clinical Nutrition and Aging, edited by Connie Watkins Bales and Christine Seel Ritchie, 2004 Fatty Acids: Physiological and Behavioral Functions, edited by David I. Mostofsky, Shlomo Yehuda, and Norman Salem, Jr., 2001 Nutrition and Health in Developing Countries, edited by Richard D. Semba and Martin W. Bloem, 2001 Preventive Nutrition: The Comprehensive Guide for Health Professionals, Second Edition, edited by Adrianne Bendich and Richard J. Deckelbaum, 2001 Nutritional Health: Strategies for Disease Prevention, edited by Ted Wilson and Norman J. Temple, 2001 Clinical Nutrition of the Essential Trace Elements and Minerals: The Guide for Health Professionals, edited by John D. Bogden and Leslie M. Klevey, 2000 Primary and Secondary Preventive Nutrition, edited by Adrianne Bendich and Richard J. Deckelbaum, 2000 The Management of Eating Disorders and Obesity, edited by David J. Goldstein, 1999 Vitamin D: Physiology, Molecular Biology, and Clinical Applications, edited by Michael F. Holick, 1999 Preventive Nutrition: The Comprehensive Guide for Health Professionals, edited by Adrianne Bendich and Richard J. Deckelbaum, 1997 Bendich_FM_Final 2 1/17/05, 2:56 PM P N REVENTIVE UTRITION T C G H P HE OMPREHENSIVE UIDE FOR EALTH ROFESSIONALS T E HIRD DITION Edited by A B , , DRIANNE ENDICH PhD FACN GlaxoSmithKline, Parsippany, NJ and R J. D , , ( ) ICHARD ECKELBAUM MD FRCP C College of Physicians and Surgeons, Columbia University, New York, NY Foreword by A S , , LFRED OMMER MD MHS Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD Bendich_FM_Final 3 1/17/05, 2:56 PM © 2005 Humana Press Inc. 999 Riverview Drive, Suite 208 Totowa, New Jersey 07512 www.humanapr.com All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permission from the Publisher. All papers, comments, opinions, conclusions, or recommendations are those of the author(s), and do not necessarily reflect the views of the publisher. Due diligence has been taken by the publishers, editors, and authors of this book to assure the accuracy of the information published and to describe generally accepted practices. The contributors herein have carefully checked to ensure that the drug selections and dosages set forth in this text are accurate and in accord with the standards accepted at the time of publication. Notwithstanding, as new research, changes in government regulations, and knowledge from clinical experience relating to drug therapy and drug reactions constantly occurs, the reader is advised to check the product information provided by the manufacturer of each drug for any change in dosages or for additional warnings and contraindications. This is of utmost importance when the recommended drug herein is a new or infrequently used drug. It is the responsibility of the treating physician to determine dosages and treatment strategies for individual patients. Further it is the responsibility of the health care provider to ascertain the Food and Drug Administration status of each drug or device used in their clinical practice. The publisher, editors, and authors are not responsible for errors or omissions or for any consequences from the application of the information presented in this book and make no warranty, express or implied, with respect to the contents in this publication. Cover design by Patricia F. Cleary Production Editor: Robin B. Weisberg For additional copies, pricing for bulk purchases, and/or information about other Humana titles, contact Humana at the above address or at any of the following numbers: Tel.: 973-256-1699; Fax: 973-256-8341; E-mail: [email protected] or visit our website at http://humanapress.com This publication is printed on acid-free paper. ∞ ANSI Z39.48-1984 (American National Standards Institute) Permanence of Paper for Printed Library Materials. Photocopy Authorization Policy: Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients is granted by Humana Press, provided that the base fee of US $30.00 per copy is paid directly to the Copyright Clearance Center (CCC), 222 Rosewood Dr., Danvers MA01923. For those organizations that have been granted a photocopy license from the CCC, a separate system of payment has been arranged and is acceptable to the Humana Press. The fee code for users of the Transactional Reporting Service is 1-58829-445- 5/05 $30.00. Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1 eISBN 1-59259-880-3 Library of Congress Cataloging-in-Publication Data Preventive nutrition : the comprehensive guide for health professionals / edited by Adrianne Bendich and Richard J. Deckelbaum ; foreword by Alfred Sommer.-- 3rd ed. p. ; cm. -- (Nutrition and health) Includes bibliographical references and index. ISBN 1-58829-445-5 (alk. paper) 1. Nutrition. 2. Medicine, Preventive. 3. Nutritionally induced diseases--Prevention. 4. Diet therapy. [DNLM: 1. Nutrition. 2. Diet. 3. Nutrition Therapy. 4. Nutritional Status. 5. Primary Prevention. QU 145 P944 2005] I. Bendich, Adrianne. II. Deckelbaum, Richard J. III. Series: Nutrition and health (Totowa, N.J.) RM216.P778 2005 615.8'54--dc22 2004021931 Bendich_FM_Final 4 1/17/05, 2:56 PM Dedication AB dedicates this volume to her husband, David Kafkewitz, PhD, wth deepest gratitude for his unconditional support and understanding. Richard J. Deckelbaum dedicates this volume to William and Katya, and the rest of our family and friends. v Bendich_FM_Final 5 1/17/05, 2:56 PM Bendich_FM_Final 6 1/17/05, 2:56 PM Series Editor’s Introduction The Nutrition and Health Series of books has had great success because each volume has the consistent overriding mission of providing health professionals with texts that are essential since each includes (1) a synthesis of the state of the science; (2) timely, in-depth reviews by the leading researchers in their respective fields; (3) extensive, up-to-date, fully annotated reference lists; (4) a detailed index; (5) relevant tables and figures; (6) identification of paradigm shifts and their consequences; (7) virtually no overlap of information between chapters, but targeted, interchapter referrals; (8) suggestions of areas for future research; and (9) balanced, data-driven answers to patient as well as health professionals’ questions that are based on the totality of evidence rather than the findings of any single study. The series volumes are not the outcome of a symposium. Rather, each editor has the potential to examine a chosen area with a broad perspective, both in subject matter as well as in the choice of chapter authors. The editors, whose trainings are both research- and practice-oriented, have the opportunity to develop a primary objective for each book, define its scope and focus, and then invite the leading authorities to be part of their initiative. The authors are encouraged to provide an overview of the field, discuss their own research and relate the research findings to potential human health consequences. Because each book is developed de novo, the chapters are coordinated so that the resulting volume imparts greater knowledge than the sum of the information contained in the individual chapters. Many of the books in the series come with a complementary copy of the book on a CD; recently published books are available as e-books and individual chapters of the e-books are also now available from Humana Press’ website, Humanapress.com Preventive Nutrition: The Comprehensive Guide to Health Professionals, Third Edition, edited by me and Richard Deckelbaum remains the flagship volume of the series and continues to improve with each edition. The first edition, published in 1997, was widely acclaimed for its emphasis on data-driven recommendations based on the totality of the evidence that included the newest scientific discoveries and clinical applications in the key areas of preventive nutrition: cancer, cardiovascular disease, osteoporosis, age-related eye diseases, immune function, birth outcomes, and an international perspective on preventive nutrition strategies. The second edition, published in 2001, provided critical updates and also included new information on nutrition-related disease prevention strategies. In the same year, Richard and I also published a volume, Primary and Secondary Preventive Nutrition, that reviewed several other clinical areas including obesity and diabetes. In response to our readers and reviewers, we have combined the most relevant and timely chapters from these two volumes into the third edition of Preventive Nutrition. Preventive Nutrition, Third Edition, which is now more than 900 pages of text, contains 37 chapters that help to define the areas where health professionals can improve health and reduce the risk of disease with dietary modifications. We have enhanced the vii Bendich_FM_Final 7 1/17/05, 2:56 PM viii Series Editor’s Introduction contents of the first two editions even further with the addition of 16 new chapters as well as comprehensive updates of all of the chapters that are included in this edition. Chapter authors are the most authoritative leaders in their various fields of expertise. The volume contains cutting-edge chapters from 79 authors who provide a truly global perspective to preventive nutrition opportunities. In addition, Dr. Alfred Sommer, whose international research has been honored with the prestigious Lasker Award, has provided a thoughtful Foreword for our book. Thus, Richard and I have worked diligently to develop a third edition that is destined to be the benchmark in the field because of its extensive, in-depth chapters covering the most important aspects of preventive nutrition with emphasis on normal human physiology and nutritional needs, analyses of epidemiological findings, in-depth and balanced discussions of clinical findings including the role of nutrients in disease treatment as well as primary and secondary disease prevention. The book chapters are logically organized in nine sections to provide the reader with a basic understanding of the role of preventive nutrition strategies: I. Preventive Nutrition Overview, II. Cancer Prevention, III. Cardiovascular Disease Prevention, IV. Diabetes and Obesity, V. Bone Diseases, VI. Prevention of Major Disabilities: Improvement in Health Outcomes, VII. Optimal Pregnancy/Infancy Outcomes, VIII. Preventive Nutri- tion: Global Perspectives, and finally, IX. Critical Issues for the 21st Century. This logical sequence of chapters provides the latest information on the current standards of practice for clinicians, related health professionals including the dietitian, nurse, pharma- cist, physical therapist, behaviorist, psychologist, and others involved in the team effort required for successful treatments. This comprehensive volume also has great value for academicians involved in the education of graduate students and postdoctoral fellows, medical students and allied health professionals who plan to interact with patients on questions concerning the science behind the latest “study” presented on the evening news because the chapters present a synthesis of the totality of the evidence, not a conclusion based on a single study. In-depth, balanced reviews of the current science behind questions related to topics such as soy; vitamin supplements; fat substitutes; DHA; trans-fatty acids; carotenoids, such as lycopene and lutein; and numerous other dietary components, provide health care professionals and students with excellent, well-referenced answers. Medically related professionals will certainly find the chapters dealing with obesity across the age span, and including the genetic components of related diseases, of particular importance to their practice. Additional chapters provide in-depth reviews of the functions of vitamins and minerals and other dietary factors in the endocrine, cardiovascular, respiratory, gastrointestinal, immune, skeletal, and ocular systems of the body. Obesity is a critical concern for virtually every health professional. The third edition has an expanded section on obesity and diabetes that includes important aspects of childhood obesity. There is a clear, data-driven message throughout the obesity section of the volume that obesity is a chronic disease. The volume is of particular importance because it includes understand- able chapters in highly technical areas written by the leading authorities who are actually working in the areas of research discussed in their chapters. Of added value to health care professionals who are interested in public health is the exceptional introductory chapter that places preventive nutrition in its historic perspec- tive and goes on to project the enormous potential for preventive strategies to reduce Bendich_FM_Final 8 1/17/05, 2:57 PM Series Editor’s Introduction ix human suffering. This chapter is balanced with the final book chapter that provides a practical approach to determining the economic value of adopting a number of the pre- ventive nutrition strategies discussed throughout the volume. An often-overlooked dietary component, alcohol, is critically examined in a separate chapter, as it can well be a double-edged sword and can impact diseases and conditions that would otherwise be beneficially affected by implementing preventive nutrition strategies. Other unique chap- ters examine the national differences in the consumer messages that are permitted for dietary factors and the current status of nutrition education in medical schools. Of great importance, the authors have provided chapters that balance the most technical informa- tion with discussions of its importance for clients and patients as well as graduate and medical students, health professionals, and academicians. The third edition of Preventive Nutrition continues to serve as a major resource on international nutrition because the volume includes important chapters about implemen- tation strategies from leading experts about national interventions in Europe, Asia, and Africa. Prior editions were so well accepted by those interested in the impact of nutrition on world health, in part because of this unique section on global perspectives. In the current edition, this section examines the successes and consequent public health impli- cations of national preventive nutrition strategies, not only in the United States and Europe, but also in “Westernizing” nations and developing countries. Updates from Norway and Chile that were first provided in the 1997 edition are now included in the third edition. Also updated is the chapter that examines the potential health benefits to the United States with adoption of preventive nutrition strategies. There are two insightful chapters on the growing presence of obesity in Latin America and Japan and how the Westernization of eating habits has negatively impacted the health of these nations. Hallmarks of all chapters include bulleted key points at the beginning of each chapter as well as a detailed table of contents; complete definitions of terms with the abbrevia- tions fully defined for the reader, and consistent use of terms between chapters. There are numerous relevant tables, graphs, and figures as well as up-to-date references; all chap- ters include a conclusion section that provides the highlights of major findings. Each chapter ends with a recommendations section that helps to guide the reader to data- driven, balanced advice for their students, clients, and/or patients. The volume contains a highly annotated index and within chapters, readers are referred to relevant information in other chapters. In conclusion, Preventive Nutrition: The Comprehensive Guide for Health Professionals, Third Edition provides health professionals in many areas of research and practice with the most up-to-date, well-referenced and easy-to-comprehend volume on the importance of understanding the current strategies for enhancing health and preventing disease through the implementation of well-accepted and highly recommended preventive nutri- tion options. This volume will serve the reader as the benchmark in the nutrition field, as it stands as the most authoritative resource to date on prevention, and is a very welcome addition to the Nutrition and Health Series. Adrianne Bendich, PhD, FACN Series Editor Bendich_FM_Final 9 1/17/05, 2:57 PM
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