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P1:SFK/UKS P2:SFK Color:1C FM BLBK278-Katsilambros May3,2010 21:29 Trim:244mmX172mm ii P1:SFK/UKS P2:SFK Color:1C FM BLBK278-Katsilambros May3,2010 21:29 Trim:244mmX172mm Clinical Nutrition in Practice i P1:SFK/UKS P2:SFK Color:1C FM BLBK278-Katsilambros May3,2010 21:29 Trim:244mmX172mm ii P1:SFK/UKS P2:SFK Color:1C FM BLBK278-Katsilambros May3,2010 21:29 Trim:244mmX172mm Clinical Nutrition in Practice Nikolaos Katsilambros, MD Charilaos Dimosthenopoulos, MMedSci, SRD Meropi Kontogianni, PhD Evangelia Manglara, SRD Kalliopi-Anna Poulia, MMedSci, AssocNutr AthensUniversitySchoolofMedicine LaikoUniversityHospital Athens Greece & DepartmentofNutritionandDietetics HarokopioUniversity Athens Greece A John Wiley & Sons, Ltd., Publication iii P1:SFK/UKS P2:SFK Color:1C FM BLBK278-Katsilambros May3,2010 21:29 Trim:244mmX172mm Thiseditionfirstpublished2010 (cid:1)C 2010BlackwellPublishingLtd BlackwellPublishingwasacquiredbyJohnWiley&SonsinFebruary2007.Blackwell’spublishing programmehasbeenmergedwithWiley’sglobalScientific,Technical,andMedicalbusinesstoform Wiley-Blackwell. Registeredoffice JohnWiley&SonsLtd,TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UnitedKingdom Editorialoffices 9600GarsingtonRoad,Oxford,OX42DQ,UnitedKingdom 2121StateAvenue,Ames,Iowa50014-8300,USA Fordetailsofourglobaleditorialoffices,forcustomerservicesandforinformationabouthowtoapplyfor permissiontoreusethecopyrightmaterialinthisbookpleaseseeourwebsiteat www.wiley.com/wiley-blackwell. Therightoftheauthortobeidentifiedastheauthorofthisworkhasbeenassertedinaccordancewiththe UKCopyright,DesignsandPatentsAct1988. Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,or transmitted,inanyformorbyanymeans,electronic,mechanical,photocopying,recordingorotherwise, exceptaspermittedbytheUKCopyright,DesignsandPatentsAct1988,withoutthepriorpermissionof thepublisher. Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappearsinprintmaynot beavailableinelectronicbooks. Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedastrademarks.Allbrand namesandproductnamesusedinthisbookaretradenames,servicemarks,trademarksorregistered trademarksoftheirrespectiveowners.Thepublisherisnotassociatedwithanyproductorvendor mentionedinthisbook.Thispublicationisdesignedtoprovideaccurateandauthoritativeinformationin regardtothesubjectmattercovered.Itissoldontheunderstandingthatthepublisherisnotengagedin renderingprofessionalservices.Ifprofessionaladviceorotherexpertassistanceisrequired,theservicesof acompetentprofessionalshouldbesought. LibraryofCongressCataloging-in-PublicationData Clinicalnutritioninpractice/NikolaosKatsilambros...[etal.]. p.;cm. Includesbibliographicalreferencesandindex. ISBN978-1-4051-8084-9(pbk.:alk.paper) 1.Dietetics–Miscellanea. 2.Diettherapy–Miscellanea. I.Katsilambros,Nicholas. [DNLM:1.NutritionDisorders–Handbooks. 2.NutritionTherapy–Handbooks. 3.Nutritional PhysiologicalPhenomena–Handbooks.WD101C6412010] RM217.C652010 615.8(cid:2)54–dc22 2010007725 AcataloguerecordforthisbookisavailablefromtheBritishLibrary. Setin10/12ptAvenirbyAptaraInc.,NewDelhi,India PrintedinMalaysia 1 2010 iv P1:SFK/UKS P2:SFK Color:1C FM BLBK278-Katsilambros May3,2010 21:29 Trim:244mmX172mm Contents Preface vii 1 PrinciplesofHealthyNutrition 1 CharilaosDimosthenopoulos,MeropiKontogianniand EvangeliaManglara 2 NutritionalAssessment 27 CharilaosDimosthenopoulos 3 Malnutrition 37 CharilaosDimosthenopoulos 4 WeightManagementandEatingDisorders 45 NikolaosKatsilambrosandCharilaosDimosthenopoulos 5 Diabetes 61 NikolaosKatsilambrosandCharilaosDimosthenopoulos 6 HypertensionandCardiovascularDiseases 79 MeropiKontogianni 7 GastrointestinalDiseases 93 MeropiKontogianni 8 RenalDisease 127 Kalliopi-AnnaPoulia 9 PulmonaryDiseases 139 CharilaosDimosthenopoulos,MeropiKontogianniand Kalliopi-AnnaPoulia 10 LifeExpectancy 143 EvangeliaManglara 11 HIV/AIDS 147 Kalliopi-AnnaPoulia v P1:SFK/UKS P2:SFK Color:1C FM BLBK278-Katsilambros May3,2010 21:29 Trim:244mmX172mm vi Contents 12 MetabolicStress 155 CharilaosDimosthenopoulos 13 NeoplasticDiseases 163 MeropiKontogianni 14 RheumaticDiseases 171 MeropiKontogianni 15 NutritionandAnaemias 181 Kalliopi-AnnaPoulia 16 NeurologicalandMentalDisorders 187 Kalliopi-AnnaPoulia 17 EnteralNutrition 197 Kalliopi-AnnaPoulia 18 ParenteralNutrition 205 Kalliopi-AnnaPoulia 19 FoodAllergy 213 MeropiKontogianni Index 217 P1:SFK/UKS P2:SFK Color:1C FM BLBK278-Katsilambros May3,2010 21:29 Trim:244mmX172mm Preface Nutrition is of central importance to the treatment of various diseases and health conditions, just as malnourishment is largely responsible for their prevalence. In recent decades, great emphasis has been placed on the im- portanceofnutritionandahealthydiet,especiallyinhospitalsettings,since malnutrition is a widely presented problem and an appropriate dietary plan canshortenthetreatmentperiodandhencethedurationofapatient’shos- pitalisation. ClinicalNutritioninPracticeis aimed at health professionals who are in- volvedinthegeneralmedicaltreatmentofpatients.Thebookisintheform ofquestionsandanswers,inordertobemoreinterestingandpracticalforthe reader.Itcontainsshortanswersontopicsrelatedtodifferentscientificfields of nutrition, based on the recent literature, and can be used as a scientific toolforallprofessionalsindailypractice. Iwouldliketothankalltheauthorsofthebook,whoareclinicaldietitians andnutritionistswithgreatexperienceintheclinicalfield,withwhomIcollab- orated on a daily basis, in ‘Laiko’ General Hospital, Athens, Greece. I would likeespeciallytothankCharilaosDimosthenopoulos(RD)forhiscooperation inthegeneralorganisationofthebook. I would also like to thank Wiley-Blackwell for publishing this book. It has been a great honour to work with them on it, and I hope that it will extend and deepen health professionals’ knowledge and understanding of clinical nutrition. ProfessorNikolaosKatsilambros MD,PhD(AthensUniversity),FACP vii P1:SFK/UKS P2:SFK Color:1C FM BLBK278-Katsilambros May3,2010 21:29 Trim:244mmX172mm viii