Nutrition Guide for Physicians and Related Healthcare

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To Zac, my adorable grandson
—Norman
This book is dedicated to my beloved Jack, Dirk, Karen,
and Moki, as well as the physicians and veterinarians
whose help keep us healthy and happy.
—Ted
To my wife Mitzi with whom I have shared so many
wonderful meals.
—George
Preface

It has often been pointed out that there is a near absence of nutrition education during medical school.
If this deficiency is corrected during postgraduate medical training, it often owes more to accident
than design, or the personal interests of individual physicians. As a result most physicians presently
in practice have gaping holes in their knowledge of nutrition [1, 2]. This book is intended to help cor-
rect this deficiency.
Many advances took place in our understanding of basic nutrition during the twentieth century. In
the first half of the century the focus was largely on vitamins and minerals. Since the 1970s there has
been a flood of research studies on the role of diet in such chronic diseases as heart disease and cancer.
Today, we have a vastly greater understanding of the role of diet in causing various chronic diseases of
lifestyle. This evidence convincingly demonstrates that nutrition serves as an essential weapon for
physicians in the battle against disease and for the enhancement of human health. We know, for exam-
ple, that the risk of developing cancer, heart disease, obesity, and type 2 diabetes is affected by such
foods as whole grain cereals, fruits, and vegetables.
We can point to a great many examples of how dietary change can have a profound effect on health,
especially for the risk of chronic diseases. Here is one example. Poland went through a severe eco-
nomic and political crisis during the 1980s and into the 1990s. One of the results of this was a sharp
decrease in availability of meat and other foods of animal origin. At the same time there was an
increase in consumption of fruits and vegetables and a decrease in smoking. This was followed by a
40% drop in mortality from coronary disease during the period 1990–2002 [3]. Nevertheless, there are
still many gaps in our knowledge. For example, we cannot properly explain why taking a vitamin
supplement pill seldom delivers any health benefits.
To paraphrase Churchill, advances in the field of nutrition science in recent years represent “not the
beginning of the end but, perhaps, the end of the beginning.” In the opinion of the editors we are ready
to help physicians move their patients from the hors d’oeuvres to the main course.
Cultural change at a global, national, and regional level means that our nutrition habits and our
interpretation of them will change as time marches on. As George Bernard Shaw said…“Everything
I eat has been proved by some doctor or other to be a deadly poison, and everything I don’t eat has
been proved to be indispensable for life. But I go marching on.” His comments are a reflection of the
continued confusion in the public and among health professionals about what to eat and how much to
eat. A simple walk through the self-help section of a book store will confirm the existence of many
differing opinions of what “preventative nutrition” is all about, some verging on quackery and others
built upon solid facts. Physicians and other healthcare professionals need the best possible interpreta-
tion of nutrition so that they are empowered to provide accurate advice to their clients.
In the words of Confucius: “The essence of knowledge is that, having acquired it, one must apply
it.” But, ironically, despite overwhelming evidence that nutrition has such enormous potential to
improve human well-­being—at modest cost—there is still a chasm between nutrition knowledge and
its full exploitation for human betterment. There is also an important chasm between evaluating the

vii
viii Preface

strength of the supporting science and understanding its true meaning. Once the true meaning of nutri-
tion is understood, the next hurdle is to bring dietary change to the public and the healthcare profes-
sionals who provide healthcare to the public.
As gatekeepers to the nutritional health of their patients, it is important that healthcare profession-
als have access to up-to-date nutrition resources—such as this handbook—as well as the nutrition
expertise of a registered dietitian. Nutrition Guide for Physicians and Related Healthcare Professionals
endeavors to address the needs of those who would most benefit from up-to-­date information on
recent advances in the field of nutrition. Accordingly, our book contains chapters by experts in a
diverse range of nutritional areas. Our aim is to present a succinct overview of recent thinking and
discoveries that have the greatest capacity to aid physicians and other healthcare professionals in
improving the nutritional health of their clients.
The opening six chapters (Part 1) address the nutrient requirements and special nutrition-related
issues for people across all stages of the lifespan—from pregnancy and infancy through the adolescent
years to the older adult years. Chapters 7–19 (Part 2) summarize the role of nutrition in the prevention
and management of chronic conditions frequently seen in clinical practice, including obesity, diabe-
tes, coronary heart disease, hypertension, cancer, gastrointestinal disorders, liver and pancreatic dis-
ease, chronic kidney disease, osteoporosis, eating disorders, inherited metabolic disorders, and food
allergies and intolerances. This is followed by Chaps. 20–27 (Part 3) that look at different aspects of
the diet, including vitamins, minerals, and dietary fiber, and recommendations for vegetarian diets,
organic food, and alcoholic and nonalcoholic beverages. Chapter 28 (Part 4) then summarizes our
current knowledge regarding the relationship between diet and health. That chapter concludes with an
overview of various food guides. This theme continues in Chaps. 29–31 (Part 5) that explore diverse
sources of information including Dietary Reference Intakes, food labels, and useful approaches for
persuading patients to make healthful behavior changes. The final five chapters cover several diverse
topics (Part 6). Chapter 32 examines issues related to dietary supplements, especially the problem of
dishonest marketing. Chapter 33 then looks at the widespread problem of misleading information in
the area of nutrition. Finally, Chaps. 34–36 consider three other topics: drug interactions with foods,
methods for assessing nutritional status, and bariatric surgery.
Some readers may disagree with particular opinions presented by the authors, but in nutrition, dif-
ferences of opinion are often unavoidable because nutrition is an ever-changing science that lives and
breathes debate and controversy. Readers are also reminded that nutrition is a fast evolving science.
Many ideas regarding nutrition that are widely accepted today may be discredited in coming years.
The following three quotes illustrate our changing understanding of what constitutes nutritional and
medical wisdom.
Herman Boerhaave (1668–1738) was a great Dutch physician. One story is that he left a book in
which he had set out all the secrets of medicine. After he died it was opened and all the pages were
blank except one on which was written: “Keep the head cool, the feet warm and the bowels open.”
It was not so long ago that vegetarians were seen as cranks. Here is what George Orwell had to say
on this in The Road to Wigan Pier, written in 1936:
I have here a prospectus [from a socialist summer school] which… asks me to say ‘whether my diet is ordinary
or vegetarian’. They take it for granted, you see, that it is necessary to ask this question. This kind of thing is by
itself sufficient to alienate plenty of decent people. And their instinct is perfectly sound, for the food-crank is by
definition a person willing to cut himself off from human society in hopes of adding five years on to the life of
his carcase; this is, a person out of touch with the common humanity.

Drummond and Wilbraham published a seminal book entitled The Englishman’s Food in 1939.
Jack Drummond was a major nutrition authority in the 1920s and 1930s. It would be foolhardy to
believe that we can be any more accurate today in our predictions than they were over 70 years ago.
Preface ix

So much precise research has been done in the laboratory and so many precise surveys have been made that we
know all we need to know about the food requirements of the people….The position is perfectly clear-cut [with
respect to Britain].

Athabasca, AB, Canada Norman J. Temple

Winona, MN, USA Ted Wilson
Baton Rouge, LA, USA George A. Bray

References

1. Temple NJ. Survey of nutrition knowledge of Canadian physicians. J Am College Nutr. 1999;18:26–9.
2. Vetter ML, Herring SJ, Sood M, Shah NR, Kalet AL. What do resident physicians know about nutrition? An evalu-
ation of attitudes, self-­perceived proficiency and knowledge. J Am Coll Nutr. 2008;27:287–98.
3. Zatonski WA, Willett W. Changes in dietary fat and declining coronary heart disease in Poland: population based
study. BMJ. 2005;331:187–8.
Series Editor Page

The great success of the Nutrition and Health Series is the result of the consistent overriding mission
of providing health professionals with texts that are essential because each includes (1) a synthesis of
the state of the science; (2) timely, in-depth reviews by the leading researchers and clinicians 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 the 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 patients’ as well as health professionals’
questions which are based upon 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 and in the choice of chapter
authors. The international perspective, especially with regard to public health initiatives, is empha-
sized where appropriate. The editors, whose trainings are both research and practice oriented, have the
opportunity to develop a primary objective for their book, define the scope and focus, and then invite
the leading authorities from around the world 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 coor-
dinated so that the resulting volume imparts greater knowledge than the sum of the information con-
tained in the individual chapters.
“Nutrition Guide for Physicians and Related Healthcare Professionals, Second Edition,”
edited by Norman J. Temple, Ted Wilson, and George A. Bray is a very welcome addition to the
Nutrition and Health Series and fully exemplifies the Series’ goals. This volume represents a critical
updating of the chapters that were so well received when the first edition was published in 2010. The
volume is designed as an important resource for physicians in many clinical fields who see patients of
all ages, nutritionists and dietitians, research and public health scientists, and related health profession-
als who interact with clients, patients, and/or family members. The volume provides timely objective,
relevant information for professors and lecturers, advanced undergraduates and graduates, researchers
and clinical investigators who require extensive, up-to-date literature reviews, instructive tables and
figures, and excellent references on all aspects of the role of nutrition in human health and disease. This
volume is especially relevant as the number of research papers and meta-analyses in the clinical nutri-
tion arena increases every year and clients and patients are very much interested in dietary components
for disease prevention. Certainly, the obesity epidemic remains a major concern especially as the
comorbidities, such as the metabolic syndrome, type 2 diabetes, hypertension, and hyperlipidemia, are
seen even in young children. The editors have made great efforts to provide health professionals with
the most up-to-date and comprehensive volume that highlights the key, well-­accepted nutrition infor-
mation available to date. The editors have combined their broad backgrounds in research as well as
clinical practice to help the reader better understand the relevant science without the details of complex
discussions of in vitro and laboratory animal studies. Clear definitions and distinctions are made con-
cerning commonly asked patient questions such as what are the differences between the different types

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of fats and their negative and positive health aspects. An excellent explanation concerning the possible
reason for disparity between study findings is provided in the positing of insightful questions such as:
Were all serum measurements made within hours or weeks following dietary changes? Definitions are
provided for the numerous types of vegetable-based diets that are often discussed with health
professionals.
Unique to this volume are the in-depth chapters that explain the development of the dietary rec-
ommendations and how these are translated into information on food labels. Chapters concerning the
growing interest in organic foods and food safety are included. There is an extensive analysis of the
recommendations by nations on the contents of a healthy diet and suggestions for physicians and
other health professionals in helping patients reach the goal of understanding the value of consuming
a healthy diet. A separate chapter reviews the importance of certain dietary supplements as well as
two chapters that review the essential vitamins and essential minerals. This volume includes 36
review chapters that contain Key Points and Key Words as well as over 900 targeted references, 65
useful tables and figures, and a listing of recommended readings. In addition the volume contains an
extensive index and helpful Appendices. The volume chapters are organized in six parts that enhance
the reader’s ability to identify the areas most relevant for their needs. All chapters are available
online and are downloadable as is the entire volume.
The editors of this volume are experts in their respective fields and represent the medical profes-
sion as well as the academic research community. Norman J. Temple, Ph.D., is a member of the fac-
ulty of Centre for Science at Athabasca University, Athabasca, Alberta, and serves as Professor of
Nutrition. Dr. Temple has more than 100 peer-reviewed publications and book chapters. Since 2001,
he has coedited six volumes in the Nutrition and Health Series including “Nutritional Health:
Strategies for Disease Prevention” edited by Ted Wilson and Norman J. Temple; “Beverage
Impacts on Health and Nutrition” edited by Ted Wilson and Norman J. Temple and published in
2003; “Nutritional Health: Strategies for Disease Prevention, Second edition,” edited by Norman
J. Temple, Ted Wilson, and David R. Jacobs and published in 2006; “Nutrition Guide for Physicians”
edited by Ted Wilson, Norman J. Temple, George A. Bray, and Marie Boyle Struble and published in
2010; “Nutritional Health: Strategies for Disease Prevention, Third edition,” edited by Norman
J. Temple, Ted Wilson, and David R. Jacobs and published in 2012; and “Beverage Impacts on
Health and Nutrition, Second Edition,” edited by Ted Wilson and Norman J. Temple and published
in 2016.
Dr. Ted Wilson, Ph.D., is Professor of Biology at Winona State University in Winona, Minnesota.
His research examines how diet affects human nutritional physiology and whether food/dietary sup-
plement health claims can be supported by measurable physiological changes. He has studied many
foods and dietary supplements including pistachios, low-carbohydrate diets, cranberries, cranberry
juice, apple juice, grape juice, wine, resveratrol, creatine phosphate, soy phytoestrogens, eggplant,
coffee, tea, and energy drinks. He has examined the associations between these dietary factors and the
development of heart failure, diabetes, and obesity. Diet-induced changes that have been studied
include physiological evaluations of plasma lipid profiles, antioxidants, vasodilation, nitric oxide,
platelet aggregation, and glycemic and insulinemic responses using in vivo and in vitro models. Dr.
Wilson is a member of the American Physiological Society, American Society for Nutrition, and
Institute of Food Technologists and serves on the editorial board of the Journal of Food Processing.
As mentioned above, Dr. Wilson has coedited the first and second edition of “Beverages in Nutrition
and Health,” the three editions of “Nutritional Health: Strategies for Disease Prevention,” and
“Nutrition Guide for Physicians.” He also enjoys teaching courses entitled Nutrition, Cardiovascular
Physiology, Cell Signal Transduction, and Cell Biology.
Dr. George C. Bray is a world-recognized expert in obesity research. He became the first Executive
Director of the Pennington Biomedical Research Center in Baton Rouge, Louisiana, in 1989 and
oversaw the growth of the facility from 25 employees and a million dollar budget to a flourishing
Series Editor Page xiii

research center with over 70 scientists, 350 employees, and an annual budget of nearly $20 million.
Dr. Bray is University Professor emeritus at Louisiana State University and the Boyd Professor at the
Pennington Biomedical Research Center of Louisiana State University in Baton Rouge, Louisiana. He
is Principal Investigator for the Diabetes Prevention Program Outcomes Study and the Look AHEAD
study, two multicenter NIH-funded clinical trials. He is a Master in the American College of Physicians
and a Master of the American College of Endocrinology. He is a member of numerous professional
societies including the Obesity Society, the Endocrine Society, the American Diabetes Association,
the American Association of Clinical Endocrinologists, and the American Physiological Society. In
1982 he founded the North American Association for the Study of Obesity (NAASO, now the Obesity
Society), and he was the founding editor of Obesity Research, as well as co-founder of the International
Journal of Obesity and the founding editor of Endocrine Practice. In recognition of his critically
important contributions to the fields of obesity and human metabolism research, Dr. Bray received the
Goldberger Award from the American Medical Association, was elected to the Society of Scholars at
Johns Hopkins University, and received the Osborne–Mendel Award from the American Society for
Nutrition, the McCollum Award from the American Society of Clinical Nutrition, the Mead-Johnson
Award, the Tops Award, Stunkard Award, and the Presidential Medal from the Obesity Society. Dr.
Bray was also a coeditor of the first edition of “Nutrition Guide for Physicians.”

Part 1: Nutrition Across the Lifespan

The six introductory chapters in the first part provide readers with the basics of nutritional require-
ments during pregnancy, lactation and weaning, childhood nutrition, adolescent nutrition, unique
needs of the menstruating female, and healthy aging. The chapters describe investigations into the
mechanisms and factors affecting nutrient metabolism and the changes that occur at each life stage.
Descriptions of the nutritional and immunological value of breast milk are included as is a discussion
of the importance of protein, essential micronutrients, and balanced consumption of the other macro-
and micronutrients during childhood growth and during pregnancy. The introductory chapters also
provide reviews of the major clinical studies and national guidelines for each age and life stage. The
chapter on adolescence and young adults examines the development of eating disorders including
obesity, anorexia, bulimia, and binge eating. Healthy aging is particularly relevant as the population
is growing older. By 2030 one out of every five people in the USA will be 65 years of age or older.
Lifestyle changes and changes in body functions (sight, hearing, taste, digestion, bone, muscle, etc.)
can affect food choices and vice versa. This sensitive chapter provides a wealth of important advice to
health professionals.

Part 2: Nutrition in the Prevention and Management of Chronic Conditions

Part 2 contains 13 chapters that examine, in the first 4 chapters, the critical issues of weight manage-
ment and consequences including eating disorders, obesity and diabetes. Chapters examine the effects
of obesity and its comorbidities including insulin resistance, cardiovascular complications, lipid dis-
orders, hypertension, and hormonal imbalances. Separate chapters review the pathophysiology of the
metabolic syndrome, type 1 and type 2 diabetes, hypertension, and hyperlipidemia, and relate these to
the mechanisms behind the alterations in metabolism that increase chronic disease risk. Practice
guidelines and tools for obesity management including up-to-date information on medical nutrition
therapy and surgical obesity treatments and their implications for improving human health and
xiv Series Editor Page

reducing obesity-related diseases are tabulated for the reader. Two chapters examine the importance
of dietary intake in the prevention and treatment of cardiovascular disease and hypertension. The
chapters on coronary heart disease and blood pressure contain valuable information about salt intake,
plant stanols and sterols, homocysteine, and antioxidants and review the major clinical trials that
showed the power of diet to beneficially affect cardiovascular outcomes: the DASH study and the
Trial of Hypertension Prevention are but two examples.
There are separate chapters dealing with the gastrointestinal tract and the liver and pancreas. Topics
include malabsorption diseases, GERD, ulcers, constipation, diarrhea, diverticulosis, food allergies,
cirrhosis, nonalcoholic fatty liver disease, and acute as well as chronic diseases including cancers of
these organ systems. Renal function and its critical role in fluid balance as well as the value of a medi-
cal nutrition practice for patients with kidney diseases are discussed in Chap. 15. An important, clini-
cally related chapter examines the nutritional requirements of individuals who have the most common
forms of inherited metabolic disorders. The next chapter provides an in-depth look at the differences
between food allergies and food intolerance and the resultant differences in treatments. Bone health is
discussed with regard to age appropriate requirements for specific nutrients. The importance of cal-
cium, phosphorus, vitamin D, and parathyroid hormone to both kidney and bone health becomes
apparent after reading these chapters. The final chapter in this part deals with cancer and the nutri-
tional as well as physical activity needs for prevention as well as during treatment. The comprehensive
chapters are practice oriented and detailed and include a number of relevant tables and figures.

Part 3: Food, the Substances in Food, and Their Effects on Health

The eight chapters included in the third part review the major food categories of fat, fiber, vitamins
and minerals, alcoholic and nonalcoholic beverages and also examine the benefits and risks associated
with vegetarian as well as vegan diets. The last chapter in this part looks at the questions of food safety
and quality and emphasizes the importance of understanding the meaning of organic when used to
describe different types of foods. There are several comprehensive tables found in these chapters
including the in-depth tables concerning vitamins and minerals.

Part 4: Diet and Health: A Summary

The summary chapter by Dr. Temple encompasses the key information in the preceding chapters and
provides helpful information for health providers who are treating patients and/or clients who have
nutrition-related questions.

Part 5: Sources of Nutritional Information

Of importance to physicians and other health professionals who provide advice concerning diet,
foods, nutrition, and clinical management of nutritionally related conditions and/or diseases is identi-
fication of reputable sources of nutrition information. Part 5 provides chapters that review these rele-
vant resources. The first chapter examines the national food guides that review the components of a
healthy diet. These recommendations differ across nations and both the US and Canadian guidelines
are examined. In the USA, there are several national departments that oversee dietary guidelines
Series Editor Page xv

including the US Department of Agriculture (USDA) and the Food and Drug Administration (FDA);
the government-independent National Academy of Sciences publishes the Dietary Reference Intakes
for essential nutrients. Thus, there are several sources of professionally generated recommendations
for health professionals as well as consumers. Moreover, many university nutrition departments have
posted their own evaluations on the Internet. Adding to the confusion, food labels and other informa-
tion on the label, such as claims statements, are reviewed by the FDA as well as the Federal Trade
Commission (FTC) in the USA. The three chapters in this section provide important guidance to
physicians and others who provide advice to patients and consumers.

Part 6: Other Selected Topics

The last six chapters in this comprehensive volume examine patient-related topics including chapters
that review the potential for physicians to alter patient dietary habits and a review of the many types
of dietary supplements, their contents and potential for containing unacceptable components espe-
cially in weight reduction and body-building products. Patients and consumers are concerned about
many claims that are made for common foods, such as juice drinks, soy products, novel fruits, genetic
modification of foods, and other areas of interest. Chapter 33 examines these and other provocative
areas of diet information. The final three chapters provide clinically relevant information on drug-
nutrient interactions, assessment methods of nutritional status, and nutritional effects of bariatric sur-
gery. These three chapters provide a wealth of timely information for any health professional.

Appendices

The volume includes three helpful appendices that include a table of aids for calculating nutritionally
related concentrations, and a list of books and websites that contain reliable nutrition and diet infor-
mation and a tabulation of the current Dietary Reference Intakes.

Conclusions

Drs. Temple, Wilson, and Bray are internationally recognized leaders in the fields of human nutrition
including obesity research and clinical outcomes. These editors are proven excellent communicators
and they have worked tirelessly to develop this volume that is destined to be the benchmark in the field
because of its extensive covering of the most important aspects of clinical nutrition including complex
interactions between diet, health, and disease. The editors have chosen 57 of the most well-recognized
and respected authors from around the world to contribute the 36 informative chapters in the volume.
Hallmarks of all of the chapters include complete definitions of terms with the abbreviations fully
defined for the reader and consistent use of terms between chapters. Key features of this comprehen-
sive volume include the informative Key Points and Key Words that are at the beginning of each
chapter and suggested readings as well as bibliography at the end of each chapter. The editors have
added three useful appendices including a detailed table of major conversions used in nutrient calcula-
tions, suggested sources of reliable nutrition information on the web, and a copy of the dietary refer-
ence intake tables from the US Institute of Medicine. The volume also contains more than 50 detailed
tables and figures, an extensive, detailed index, and more than 900 up-to-date references that provide
xvi Series Editor Page

the reader with excellent sources of worthwhile information about the role of diet, nutrition and exer-
cise, food intake, nutritional value of foods, human physiology, and pathophysiology of the diet-
related morbidities and comorbidities.
In conclusion, “Nutrition Guide for Physicians and Related Healthcare Professionals, Second
Edition,” edited by Norman J. Temple, Ph.D., Ted Wilson, Ph.D., and George A. Bray, M.D., pro-
vides health professionals in many areas of research and practice with the most up-to-date, organized
volume on well-accepted, data-driven nutrition topics that are often discussed by patients with their
healthcare provider. This volume serves the reader as the benchmark in this complex area of interre-
lationships between food and body weight, diet and health, and the role of national organizations in
setting recommendations on dietary intakes. Moreover, the interactions between obesity, genetic fac-
tors, and the numerous comorbidities are clearly delineated so that practitioners can better understand
the complexities of these interactions. The editors are applauded for their efforts to develop this vol-
ume with their firm conviction that “nutrition serves as an essential weapon for all doctors in the battle
against disease and for the enhancement of human health.” This excellent text is a very welcome
addition to the Nutrition and Health series.

 Adrianne Bendich, Ph.D., FACN, FASN

About the Series Editors

Adrianne Bendich, Ph.D., F.A.S.N., F.A.C.N. has served as the

“Nutrition and Health” Series Editor for 20 years and has provided lead-
ership and guidance to more than 200 editors that have developed the 70+
well-respected and highly recommended volumes in the series.
In addition to “Nutrition Guide for Physicians and Related
Healthcare Professionals,” Second Edition, edited by Norman
J. Temple, Ted Wilson, and George A. Bray, major new editions
published in 2012–2016 and expected to be published shortly
include:
1. A
 rginine in Clinical Nutrition, edited by Rajkumar Rajendram,
Vinood Patel, and Victor Preedy, 2016
2. Preventive Nutrition: The Comprehensive Guide For Health Professionals, Fifth Edition, edited
by Adrianne Bendich, Ph.D., and Richard J. Deckelbaum, M.D., 2015
3. Beverage Impacts on Health and Nutrition, Second Edition, edited by Ted Wilson, Ph.D., and
Norman J. Temple, Ph.D., 2015
4. Nutrition in Cystic Fibrosis: A Guide for Clinicians, edited by Elizabeth H. Yen, M.D., and
Amanda R. Leonard, MPH, RD, CDE, 2015
5. Glutamine in Clinical Nutrition, edited by Rajkumar Rajendram, Victor R. Preedy, and Vinood
B. Patel, 2015
6. Nutrition and Bone Health, Second Edition, edited by Michael F. Holick and Jeri W. Nieves, 2015
7. Branched Chain Amino Acids in Clinical Nutrition, Volume 2, edited by Rajkumar Rajendram,
Victor R. Preedy, and Vinood B. Patel, 2015
8. Branched Chain Amino Acids in Clinical Nutrition, Volume 1, edited by Rajkumar Rajendram,
Victor R. Preedy, and Vinood B. Patel, 2015
9. Fructose, High Fructose Corn Syrup, Sucrose and Health, edited by James M. Rippe, 2014
10. Handbook of Clinical Nutrition and Aging, Third Edition, edited by Connie Watkins Bales, Julie
L. Locher, and Edward Saltzman, 2014
11. Nutrition and Pediatric Pulmonary Disease, edited by Dr. Youngran Chung and Dr. Robert
Dumont, 2014
12. Integrative Weight Management, edited by Dr. Gerald E. Mullin, Dr. Lawrence J. Cheskin, and
Dr. Laura E. Matarese, 2014
13. Nutrition in Kidney Disease, Second Edition, edited by Dr. Laura D. Byham-Gray, Dr. Jerrilynn
D. Burrowes, and Dr. Glenn M. Chertow, 2014
14. Handbook of Food Fortification and Health, Volume I, edited by Dr. Victor R. Preedy, Dr. Rajaventhan
Srirajaskanthan, and Dr. Vinood B. Patel, 2013
15. Handbook of Food Fortification and Health, Volume II, edited by Dr. Victor R. Preedy, Dr.
Rajaventhan Srirajaskanthan, and Dr. Vinood B. Patel, 2013

xvii
xviii About the Series Editors

16. Diet Quality: An Evidence-Based Approach, Volume I, edited by Dr. Victor R. Preedy, Dr. Lan-
Ahn Hunter, and Dr. Vinood B. Patel, 2013
17. Diet Quality: An Evidence-Based Approach, Volume II, edited by Dr. Victor R. Preedy, Dr. Lan-
Ahn Hunter, and Dr. Vinood B. Patel, 2013
18. The Handbook of Clinical Nutrition and Stroke, edited by Mandy L. Corrigan, MPH, RD, Arlene
A. Escuro, MS, RD, and Donald F. Kirby, MD, FACP, FACN, FACG, 2013
19. Nutrition in Infancy, Volume I, edited by Dr. Ronald Ross Watson, Dr. George Grimble, Dr.
Victor Preedy, and Dr. Sherma Zibadi, 2013
20. Nutrition in Infancy, Volume II, edited by Dr. Ronald Ross Watson, Dr. George Grimble, Dr.
Victor Preedy, and Dr. Sherma Zibadi, 2013
21. Carotenoids and Human Health, edited by Dr. Sherry A. Tanumihardjo, 2013
22. Bioactive Dietary Factors and Plant Extracts in Dermatology, edited by Dr. Ronald Ross Watson
and Dr. Sherma Zibadi, 2013
23. Omega 6/3 Fatty Acids, edited by Dr. Fabien De Meester, Dr. Ronald Ross Watson, and Dr.
Sherma Zibadi, 2013
24. Nutrition in Pediatric Pulmonary Disease, edited by Dr. Robert Dumont and Dr. Youngran Chung,
2013
25. Magnesium and Health, edited by Dr. Ronald Ross Watson and Dr. Victor R. Preedy, 2012.
26. Alcohol, Nutrition and Health Consequences, edited by Dr. Ronald Ross Watson, Dr. Victor
R. Preedy, and Dr. Sherma Zibadi, 2012
27. Nutritional Health, Strategies for Disease Prevention, Third Edition, edited by Norman J. Temple,
Ted Wilson, and David R. Jacobs, Jr., 2012
28. Chocolate in Health and Nutrition, edited by Dr. Ronald Ross Watson, Dr. Victor R. Preedy, and
Dr. Sherma Zibadi, 2012
29. Iron Physiology and Pathophysiology in Humans, edited by Dr. Gregory J. Anderson and Dr.
Gordon D. McLaren, 2012
Earlier books included Vitamin D, Second Edition, edited by Dr. Michael Holick; Dietary Components
and Immune Function, edited by Dr. Ronald Ross Watson, Dr. Sherma Zibadi, and Dr. Victor R. Preedy;
Bioactive Compounds and Cancer, edited by Dr. John A. Milner and Dr. Donato F. Romagnolo; Modern
Dietary Fat Intakes in Disease Promotion, edited by Dr. Fabien De Meester, Dr. Sherma Zibadi, and Dr.
Ronald Ross Watson; Iron Deficiency and Overload, edited by Dr. Shlomo Yehuda and Dr. David
Mostofsky; Nutrition Guide for Physicians, edited by Dr. Edward Wilson, Dr. George A. Bray, Dr. Norman
Temple, and Dr. Mary Struble; Nutrition and Metabolism edited by Dr. Christos Mantzoros and Fluid and
Electrolytes in Pediatrics edited by Leonard Feld and Dr. Frederick Kaskel. Recent volumes include
Handbook of Drug-Nutrient Interactions edited by Dr. Joseph Boullata and Dr. Vincent Armenti; Probiotics
in Pediatric Medicine, edited by Dr. Sonia Michail and Dr. Philip Sherman; Handbook of Nutrition and
Pregnancy, edited by Dr. Carol Lammi-Keefe, Dr. Sarah Couch, and Dr. Elliot Philipson; Nutrition and
Rheumatic Disease, edited by Dr. Laura Coleman; Nutrition and Kidney Disease, edited by Dr. Laura
Byham-Gray, Dr. Jerrilynn Burrowes, and Dr. Glenn Chertow; Nutrition and Health in Developing
Countries, edited by Dr. Richard Semba and Dr. Martin Bloem; Calcium in Human Health edited by Dr.
Robert Heaney and Dr. Connie Weaver and Nutrition and Bone Health edited by Dr. Michael Holick and
Dr. Bess Dawson-Hughes.
Dr. Bendich is President of Consultants in Consumer Healthcare LLC and is the editor of ten books
including Preventive Nutrition: The Comprehensive Guide for Health Professionals, Fifth Edition,
coedited with Dr. Richard Deckelbaum (www.springer.com/series/7659). Dr. Bendich serves on the
Editorial Boards of the Journal of Nutrition in Gerontology and Geriatrics and Antioxidants and has
served as Associate Editor for Nutrition, the International Journal; served on the Editorial Board of
the Journal of Women’s Health and Gender-based Medicine, and served on the Board of Directors of
the American College of Nutrition.
About the Series Editors xix

Dr. Bendich was Director of Medical Affairs at GlaxoSmithKline (GSK) Consumer Healthcare
and provided medical leadership for many well-known brands including TUMS and Os-Cal. Dr.
Bendich had primary responsibility for GSK’s support for the Women’s Health Initiative (WHI) inter-
vention study. Prior to joining GSK, Dr. Bendich was at Roche Vitamins Inc. and was involved with
the groundbreaking clinical studies showing that folic acid-­containing multivitamins significantly
reduced major classes of birth defects. Dr. Bendich has coauthored over 100 major clinical research
studies in the area of preventive nutrition. She is recognized as a leading authority on antioxidants,
nutrition and immunity and pregnancy outcomes, vitamin safety, and the cost-effectiveness of vita-
min/mineral supplementation.
Dr. Bendich received the Roche Research Award, is a Tribute to Women and Industry Awardee, and
was a recipient of the Burroughs Wellcome Visiting Professorship in Basic Medical Sciences. Dr.
Bendich was given the Council for Responsible Nutrition (CRN) Apple Award in recognition of her
many contributions to the scientific understanding of dietary supplements. In 2012, she was recog-
nized for her contributions to the field of clinical nutrition by the American Society for Nutrition and
was elected a Fellow of ASN. Dr. Bendich is Adjunct Professor at Rutgers University. She is listed in
Who’s Who in American Women.

Connie W. Bales, Ph.D., R.D. is a Professor of Medicine in the

Division of Geriatrics, Department of Medicine, at the Duke School
of Medicine and Senior Fellow in the Center for the Study of Aging
and Human Development at Duke University Medical Center. She is
also Associate Director for Education/Evaluation of the Geriatrics
Research, Education, and Clinical Center at the Durham VA Medical
Center. Dr. Bales is a well-recognized expert in the field of nutrition,
chronic disease, function, and aging. Over the past two decades her
laboratory at Duke has explored many different aspects of diet and
activity as determinants of health during the latter half of the adult
life course. Her current research focuses primarily on the impact of protein enhanced meals on muscle
quality, function, and other health indicators during obesity reduction in older adults with functional
limitations. Dr. Bales has served on NIH and USDA grant review panels and is a member of the
American Society for Nutrition’s Medical Nutrition Council. Dr. Bales has edited three editions of the
Handbook of Clinical Nutrition in Aging and is Editor-in-Chief of the Journal of Nutrition in
Gerontology and Geriatrics.
About the Volume Editors

Norman J. Temple, Ph.D. is professor of nutrition at Athabasca

University in Alberta, Canada. He has published 85 papers, mainly in
the area of nutrition in relation to health. He has also published 14
books. Together with Denis Burkitt he coedited Western Diseases:
Their Dietary Prevention and Reversibility (1994). This continued
and extended Burkitt’s pioneering work on the role of dietary fiber in
chronic diseases of lifestyle. He coedited Nutritional Health:
Strategies for Disease Prevention (2012; third edition), Beverage
Impacts on Health and Nutrition (2016; second edition), Community
Nutrition for Developing Countries (2016), and Excessive Medical
Spending: Facing the Challenge (2007). He conducts collaborative research in Cape Town on the
role of the changing diet in South Africa on the pattern of diseases in that country, such as obesity,
diabetes, and heart disease.

Ted Wilson, Ph.D. is a Professor of Biology at Winona State

University in Winona, Minnesota. His research examines how diet
affects human nutritional physiology and whether food/dietary supple-
ment health claims can be supported by measurable physiological
changes. He has studied many foods, dietary supplements, and disease
conditions including pistachios, low-carbohydrate diets, cranberries,
cranberry juice, apple juice, grape juice, wine, resveratrol, creatine
phosphate, soy phytoestrogens, eggplants, coffee, tea, energy drinks,
heart failure prognosis, diabetes, and obesity. Diet-induced changes
have included physiological evaluations of plasma lipid profile, anti-
oxidants, vasodilation, nitric oxide, platelet aggregation, and glycemic
and insulinemic responses using in vivo and in vitro models. With Dr. N. Temple he edited the first and
second edition of Beverages in Nutrition and Health (Humana Press, 2004 and 2016), Nutritional
Health: Strategies for Disease Prevention (Humana Press, 2001 first, 2006 second, and 2012 third
editions), and Nutrition Guide for Physicians (Humana/Springer Press Inc, 2010). He also enjoys
teaching courses in Nutrition, Cardiovascular Physiology, Cell Signal Transduction, and Cell Biology.
When not in the laboratory he enjoys family time, the outdoors, and farming.

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