Food and Nutrients in Disease Management

With contributions from highly regarded experts who work on the frontlines of disease management, Food and Nutrients in Disease.
Table of contents

Ravinder Reddy, Peter B.

Food and Nutrients in Disease Management

Clinical Nutrition Series The last decades have illuminated the important role of nutrition in the prevention and management of diseases. Despite the elaborated knowledge and discussions on the scientific podium, the role of nutrition is often overlooked in clinical practice. Unfortunately, medical nutrition is in most cases not incorporated in the curriculum at medical schools, which might lead to negative attitudes or even total neglect of the nutritional needs of hospitalized patients.

Nutrition is a basic requirement for life and plays an important role in health and in diseaseprevention, but malnutrition is a common event and a cause of increased morbidity andmortality, particularly in patients with disease-related malnutrition showing inflammationand a catabolic state.

2nd Edition

Malnutrition is often overlooked, and deterioration in the nutritionalstatus following admission to hospital is common. It should be actively pursued by aubiquitous system of nutrition screening, and full nutritional assessment is required forthose found to be at risk.

There are simple screening tools which can be used by all healthcare professionals. Assessment considers body composition, inflammatory status and otheraspects of underlying diseases and their functional consequences; it is a more specialistprocess. It is important to determine the energy and protein needs of each individualpatient. Appropriate nutritional intervention can often be offered by the oral route, usingfood with or without special supplements. When this is insufficient, enteral tube feedingwill normally be sufficient, but there is an important subgroup of patients in whom enteralfeeding is contraindicated or unsuccessful, and in these patients parenteral nutrition either total or supplemental is required.

A number of immunonutrients and other specialsubstrates have been shown to be helpful in specific circumstances, but their use is notwithout potential hazards, and therefore adherence to international guidelines is recommended. In starvation and to a lesser extent in stress starvation, the loss of protein mass is sparedas much as possible.

This metabolic arrangement must have developed under the influenceof evolutionary pressure in view of the importance of protein mass for function andlongevity. Peripheral adipose tissue mass is only limiting when its mass is extremely small. Protein is the predominant precursor of glucose in stress starvation and glucose is anessential substrate for the synthesis and maintenance of cells and matrix and for the controlof the redox state.

To spare protein, glucose should be used efficiently only for thosepurposes that cannot be achieved by fat.

Advancing Medicine with Food and Nutrients - CRC Press Book

It is suggested that this is achieved by limitingfull glucose oxidation and increasing fatty acid and ketone body oxidation, which mostlikely can also largely cover energy needs of the central nervous system. In stress states,net negative nitrogen balance catabolism largely results from net losses of peripheralprotein mass, predominantly muscles, whereas central organs e.

A number of factors are responsible for a netnegative nitrogen balance which may ultimately lead to death if stress persists. In stress,the amino acid mix derived from peripheral predominantly muscle tissues is modified ininterplay with the liver and to a minor extent the kidney. This mix is different in nonstressedconditions, containing substantially increased amounts of the nonessential aminoacids glutamine, alanine, glycine and hydroxy proline.

Part of the amino acid skeletonsreleased by muscles are substrates to produce glucose in the liver and kidney. Glucoseand the amino acids produced especially serve as substrates for cell proliferation and matrixdeposition.

The catabolic processes in peripheral tissues cannot be countered completelyby adequate nutritional support as long as stress persists. This metabolic arrangementdictates a nutritional mix containing liberal amounts of protein and carbohydratesand addition of lipids to cover energy requirements. Noncaloric benefits of carbohydrates are due to the presence of dietary fibers, which area heterogeneous group of natural food sources and form an important component of ahealthy diet.

They differ in physiochemical properties such as solubility, fermentability andviscosity. They have a wide range of physiological effects resulting in gastrointestinal andsystemic benefits. These include appetite, satiety, bowel transit time and function, productionof short-chain fatty acids and certain vitamins, and effects on gut microbiota, immunityand inflammation, as well as mineral absorption. They also help to control theglycemic status and serum lipid levels, resulting in reduced incidence rates of atherosclerosis,hypertension, stroke and cardiovascular diseases.

The biological value of a protein extends beyond its amino-acid composition and digestibility,and can be influenced by additional factors in a tissue-specific manner. In healthyindividuals, the slow appearance of dietary amino acids in the portal vein and subsequentlyin the systemic circulation in response to bolus protein ingestion improves nitrogen retentionand decreases urea production. This is promoted by slow absorption when onlyprotein is ingested e. When a full meal is ingested, whey achieves slightly betternitrogen retention than soy or casein, which is very likely achieved by its high content ofessential amino acids especially leucine.

It should certainly be a well-read addition to the library of every health care provider who wants to use an evidence-based approach to treating and caring for their patients. Kohlstadt has pulled together a wonderful array of scientists and clinicians who have brought the science and practice of medicine into one compendium. Advancing Medicine with Food and Nutrients is a wealthy string of clinical pearls, this book maximizes the subtle and significant effects of food and nutritional supplements.

It represents a unique collaborative, written by leaders in naturopathic and allopathic medicine. This work should empower practitioners to better follow Hippocrates admonition to "Let foodbe thy medicine and medicine be thy food". Kohlstadt has edited an up-to-date, comprehensive, massive yet easy-to-navigate guide for using nutrition to improve health …Well laid-out and very helpful treatment-oriented nutritional guidance.

The breadth and scope of this new book by Dr.

Kohlstadt is truly immense. Down-home, real-life, scientific rationale for incorporating nutrition into practice.

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This is not just a second edition, this is volume II - filled with new chapters, topics, updates, authors. Together they provide valuable information and indispensable source of reference for medical practitioners and especially any busy Integrative Medicine Clinic like ours. The consistent and practice friendly format give the book a uniform, accessible feel, all to the credit of a strong editor, Dr. We live in a time a great transition.

Millions more people are suffering from diseases associated with too few calories, protein, or vital nutrients each year, while even a greater number are still suffering from overnutrition. Evidence continues to mount that nutrition, along with exercise, other key lifestyle factors, and decisions regarding environmental exposure are fundamental to health, well-being, and compression of morbidity in association with medicine and genetics.

This book, Advancing Food and Nutrition, is, perhaps, the most important compendium of articles by physicians and other health scientists describing the role of the intelligent use of food and nutrients in medicine.

It lays a foundation for a knowledge base critical to the medical management of health and disease, not only as a supplement to other modalities of therapy, but in the case of literally millions of Americans, the scientific application of food and nutritional knowledge is primary to their health and disease conditions.

Food and Nutrients in Disease Management, Second Edition, is an extraordinary evidence-based information source for the treatment and prevention of disease. An interesting and practical addition to the regular medical textbooks. Food and Nutrients in Disease Management provides a wealth of information on the relationships between food, nutrients, and management of disease. All of the chapters are well referenced. The book is an up-to-date reference text that physicians, particularly family practice physicians, should have on their bookshelves.

The text should be of interest to nutritionists, dieticians, pharmacists, and other health professionals. Every physician who treats patients should devour this book. Food and Nutrients in Disease Management is a text that is long overdue. Written by pioneering experts in the field of nutrition and health, this text pulls together in one convenient place material that has been difficult to find in mainstream medicine.

Every physician in the world should read, refer to, and apply the information in these pages. Kohlstadt has established a benchmark of nutrition and nutrient effects on health and disease that meets the educational needs of a growing group of doctors, who are poised to use the best foods and nutrients available to promote health and treat disease. As an educator in an integrative medicine academic practice, I would have this text available and required reading for all of the students, residents, and fellows that rotate through our program.

The recommendations for use of nutrition and nutritional supplements during healthcare are made with the latest evidence at hand, coupled with great clinical insight. Ingrid Kohlstadt has skillfully edited the contributions of 64 distinguished contributors to create a comprehensive resource on the importance of good nutrition in the promotion of health and in healing disease. Chapter 25 Attention Deficit Hyperactivity Disorder.

Chapter 26 Migraine Headaches. Chapter 27 Alzheimers Disease. Chapter 28 Parkinsons Disease. Chapter 30 Sleep Disturbance. Chapter 9 Chronic Obstructive Pulmonary Disease. Chapter 10 Gastroesophageal Refl ux Disease. Chapter 11 Peptic Ulcer Disease and Helicobacter pylori. Chapter 13 Irritable Bowel Syndrome. Chapter 14 Inflammatory Bowel Disease. Chapter 15 Food Reactivities. Section V Renal Diseases. Chapter 21 Renal Calculi.