Nutrition: Metabolic and Clinical Applications PDF
Preview Nutrition: Metabolic and Clinical Applications
Nutrition Metabolic and Clinical Applications Human Nutrition A COMPREHENSIVE TREATISE General Editors: Roslyn B. Alfin-Slater, University of California, Los Angeles David Kritchevsky, The Wistar Institute, Philadelphia Volume 1 Nutrition: Pre- and Postnatal Development Edited by Myron Winick Volume 2 Nutrition and Growth Edited by Derrick B. Jelliffe and E. F. Patrice Jelliffe Volume 3A Nutrition and the Adult: Macronutrients Edited by Roslyn B. AlfinSlater and David Kritchevsky Volume 3B Nutrition and the Adult: Micronutrients Edited by Roslyn B. Alfin-Slater and David Kritchevsky Volume 4 Nutrition: Metabolic and Clinical Applications Edited by Robert E. Hodges Nutrition Metabolic and Clinical Applications Edited by Robert E. Hodges • University of California Davis, California PLENUM PRESS . NEW YORK AND LONDON library of Congress Cataloging in Publication Data Main entry under title: Nutrition, metabolic and clinical applications. (Human nutrition; v. 4) Includes bibliographical references and index. 1. Nutrition disorders. 2. Deficiency diseases. 3. Metabolism, Disorders of. 4. Infec- tion-Nutritional aspects. I. Hodges, Robert Edgar, 1922- II. Series. [DNLM: 1. Nutrition disorders. 2. Metabolic diseases. QU145.3 H9183 v.4] QP141.H78 vol. 4 [RC620] 612'.3'08s [616.3'9] 78-27208 ISBN-13: 978-1-4615-7215-2 e-ISBN-13: 978-1-4615-7213-8 001: 10.1007/978-1-4615-7213-8 ©1979 Plenum Press, New York Softcover reprint of the hardcover 1st edition 1979 A Division of Plenum Publishing Corporation 227 West 17th Street, New York, N.Y. 10011 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, microftlming, recording, or otherwise, without written permission from the publisher This volume is dedicated to all the scientists whose work has advanced our understanding of how to apply knowledge to benefit human nutrition. Contributors Roslyn B. Aljin-SloJer • School of Public Health, University of California, Los Angeles, California WiUiam R. Beisel. U.S. Army Medical Research Institute of Infectious Di seases, Fort Detrick, Frederick, Maryland Rene Bine, Jr. • Mount Zion Hospital and Medical Center, San Francisco, California Pie"e M. Dreyfus. Department of Neurology, School of Medicine, Univer sity of California, Davis, California Clifford F. Gastineau • Mayo Medical School, Rochester, Minnesota /lobert H. Herman. Department of Medicine, Letterman Army Institute of Research, Presidio of San Francisco, San Francisco, California Thomas H. Jukes. Division of Medical Physics, University of California, Berkeley, California Bryna Kane-Nussen • Department of Nutrition and School of Medicine, Uni versity of California, Davis, California Joel D. Kopple • Department of Medicine, University of California at Los Angeles, and Veterans Administration Wadsworth Medical Center, Los Angeles, California Charles S. Lieber. Section of Liver Disease and Nutrition and Alcoholism Research and Treatment Center, Veterans Administration Hospital, Bronx, New York, and Mount Sinai School of Medicine of the City University of New York, New York, New York John Lindenbaum. Department of Medicine, Harlem Hospital Center, and Department of Medicine, Columbia University, College of Physicians and Surgeons, New York, New York Esteban Mezey. Department of Medicine, Baltimore City Hospitals, and The Johns Hopkins University School of Medicine, Baltimore, Maryland Spencer Shaw • Section of Liver Disease and Nutrition and Alcoholism Re search and Treatment Center, Veterans Administration Hospital, Bronx, N ew York, and Mount Sinai School of Medicine of the City University of New York, New York, New York .ii IIiii Contributors Judith S. Stern • Department of Nutrition and School of Medicine, University of California, Davis, California Joseph J. Vitale • Section of Nutrition, Department of Pathology, Boston University School of Medicine, and Nutrition Pathology Unit, Mallory Institute of Pathology, Boston City Hospital, Boston, Massachusetts Donald M. Watkin • Lipid Research Clinic, The George Washington Univer sity Medical Center, Washington, D.C. Penelope Wells • Cutter Laboratories, Inc., Berkeley, California Foreword The science of nutrition has advanced beyond expectation since Antoine La voisier as early as the 18th century showed that oxygen was necessary to change nutrients in foods to compounds which would become a part of the human body. He was also the first to measure metabolism and to show that oxidation within the body produces heat and energy. In the two hundred years that have elapsed, the essentiality of nitrogen-containing nutrients and of proteins for growth and maintenance of tissue has been established; the ne cessity for carbohydrates and certain types of fat for health has been docu mented; vitamins necessary to prevent deficiency diseases have been identified and isolated; and the requirement of many mineral elements for health has been demonstrated. Further investigations have defined the role of these nutrients in metabolic processes and quantitated their requirements at various stages of development. Additional studies have involved their use in the possible prevention of, and therapy for, disease conditions. This series of books was designed for the researcher or advanced student of nutritional science. The first volume is concerned with prenatal and post natal nutrient requirements; the second volume with nutrient requirements for growth and development; the third with nutritional requirements of the adult; and the fourth with the role of nutrition in disease states. Our objectives were to review and evaluate that which is known and to point out those areas in which uncertainties and/or a lack of knowledge still exists with the hope of encouraging further research into the intricacies of human nutrition. Roslyn B. Alfin-Slater David Kritchevsky ix Preface Nutrition, which once was the Cinderella of biochemical research and later fell into disrepute, is now enjoying a robust reawakening of interest. Much credit must be given to those steady workers in the field of public health who demonstrated clearly that the inhabitants of the industrialized nations have had, since the end of World War II, not only sufficient food to meet their nutritional needs but a surplus that encouraged dietary excess. No longer were deficiency syndromes (with the possible exception of iron) common, but obes ity with its accompanying problems became ever more common. In the current era the prevalence of various diseases is carefully tabulated and the causes of death are published regularly. It has become obvious that while life expectancy (from birth to death) has risen to approximately the biblical "three-score years and ten," the outlook for an adult who has reached 50 years of age is essentially unchanged from that of his or her grandparents. The major improvement results from a marked increase in the survival of infants and children up to the age of two years. No longer do large numbers of children die from tuberculosis, pneumonia, or whooping cough. And few die of typhoid, dysentery, or nonspecific diarrhea. The era of modem plumbing and sanitation buttressed by immunizations, antibiotics, and modem medical care has been largely responsible for this sharp reduction in the death rate of young children. Undoubtedly, better nutrition has played a minor role also. But for the middle-aged or elderly citizens the outlook for survival has changed scarcely at all. The causes of death may be different, with heart disease, cancer, and stroke being most common now, but the age of death has remained substantially unchanged since the early decades of this century. One might argue that the quality of life for the mature or elderly person has improved, but has it? People today have, on the average, a lower levei of physical activity and a greater prevalence of obesity than they did two gen erations before. It seems doubtful that a sedentary life free from useful or necessary chores is more enjoyable than that of our forefathers who were required to be more active. Another phenomenon has become quite apparent in recent years. People in all walks of life are more interested in and concerned with nutrition. Many tum to their physicians who, in some instances, are hard-pressed to give xi xii Preface satisfactory answers, for until recently most medical schools taught little or nothing about nutrition. It is understandable that large numbers of people have turned to the self-professed "nutrition experts" who make extravagant claims and exhibit their paper-bound pUblications in supermarkets, drug stores, and "health-food" stores. The general public, as well as the medical profession and many paramed ical scientists, now recognize a need for accuracy and reasonable detail, cur rent applicability, and up-to-date references, for patterns of interest are chang ing constantly. This book represents an attempt to fill part of that need. The authors, who are highly regarded members of their profession, have written in a timely fashion about topics of interest to lay persons, medical personnel, and physicians alike. An effort has been made to avoid writing an encyclopedia, for such books, however useful, generally make dull reading. Topics which have been covered in depth by virtually every author of books dealing with nutrition have been given brief treatment in this volume. In every chapter, major emphasis has been placed on expert opinion and factual interpretation. As a result, the reader will be given a concept that represents the best judgment of an author who is well-informed and mature. The obvious roles of nutrients in both health and disease are clearly demon strated in the following chapters. Robert E. Hodges Davis, California
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