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ContentsPreface Acknowledgments About the Authors

CHAPTER 1 The Food on Your Plate 1How Nutrition Has Evolved 3

How Do We Define Nutrition? 3 Classifying Nutrients 4 What’s Hot: Superfoods 10

Why Do We Make the Food Choices We Do? 11Taste 11Environment 12Culture and Tradition 12 Culture and Ethnic Foods: What does religion have to do with diets? 13Family 13Finances 14Convenience 14 The Media 14Age 15Health Issues 15

How Do the Food Choices We Make Influence Our Health? 16Nutrition and Disease: How common is the connection between diet and disease? 17The Role of Nutrition in the Treatment of Disease 19The Role of Government in Nutrition 20

World Nutrition Problems 23Undernutrition in the World 25Societal Causes of Undernutrition 27

The Science of Nutrition 28Whom Are We to Believe About Diet Advice? 29

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How Can You Identify Reputable Sources of Nutrition Information? 30How Nutrition Recommendations Are Developed 31

Chapter Summary 34Key Terms 34Chapter Quiz 36

CHAPTER 2 Think Before You Eat: Developing a Nutrition Plan for Health 39

Defining a Healthy Diet 42Dietary Guidelines 43

Healthy People 2020 45Recommendations for Specific Nutrients 46

The Dietary Reference Intakes (DRIs) 47Energy and Macronutrient Requirements 49MyPlate 51Solid Fats and Added Sugars 56

MyPyramid Versus MyPlate: Why the change? 57The Nutrition Facts Label 59

You Decide: Food additives—do we need them and are they safe? 60Serving Size 62Calories 63Nutrients 63Daily Value 64Sustainable Nutrition: Cage-free or free-range—what do they really mean? 66Claims on Labels 67

Putting It All Together 70Chapter Summary 73Key Terms 74References 75Chapter Quiz 75Cooking 101: Quick, Easy, Healthy Meal Planning and Preparation 77

CHAPTER 3 Carbohydrates: From Sugar to Fiber and All That’s in Between 93

Carbohydrates: A Diverse Class of Nutrients 95Global Nutrition: Sorghum—the Forgotten Grain 98

How Do We Define a Carbohydrate? 98Types of Carbohydrates 99Flavoring and Sweetening Foods 100Myths and Legends: Is honey healthier for you than table sugar? 101Complex Carbohydrates 103

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What Are the Primary Sources of Carbohydrates? 104Myths and Legends: Is there a problem with wheat? 107

The Dietary Role of Carbohydrates 109Dietary Energy 109Protein Sparing 110Preventing Ketosis 110Regulating Blood Glucose Levels 110Glycemic Response 112

Diabetes Mellitus 114Forms of Diabetes 115

Health Benefits of Dietary Fiber 118Resistant Starches 121Make It a Practice: What’s the best way to add fiber to your diet? 122Can You Consume Too Much Fiber? 123To Supplement or Not? Is supplemental fiber in pill or powder form the same as fiber found in food? 123

Your Health and Carbohydrates 126Empty Calories 126Nutrition and Lifestages: What’s so bad about soda in schools? 126Sugar Intake and Dental Decay 127Carbohydrate Intake and Obesity 128Low-Carbohydrate Diets and Weight Loss 128Myths and Legends: Does eating sugar really cause obesity? 129

Cancer and Heart Disease 130Lactose Intolerance 130Chapter Summary 133Key Terms 133Reference 134Chapter Quiz 135

CHAPTER 4 Fats or Lipids: From Plate to Waist 137The Lipids in Our Food and Our Bodies 139

Fatty Acids 140What’s Hot? Something fishy—omega-3 fatty acids 144Myths and Legends: Healthwise, which is better—butter or margarine? 148Triglycerides 148Phospholipids 149Sterols/Cholesterol 150

Lipid Functions 151Storage Form of Energy 151Supply of Essential Fatty Acids 152Absorption and Transport of Fat-Soluble Vitamins 152

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Organ Insulation and Protection 152Cell Membrane Structure 153Precursor to Steroid Hormones 153Flavor and Satiety of Food 153

Fat Content of Foods 154Label Definitions 156Identifying Fats on the Label 157Trans-Fatty Acids 157Fat Substitutes 157

Lipids and Health 159Recommendations for Dietary Intake of Fats 160Make It a Practice: Choosing the right fats for your diet 162Obesity 164Heart Disease 165What’s Hot?: Is Coconut Oil Bad for you or not? 171Cancer 171Nutrition and Disease: Who’s more susceptible to heart disease, men or women? 172Nutrition and Culture: Why is the Mediterranean diet so widely recommended? 173


CHAPTER 5 Proteins: More Than Just Meat and Muscle 181

Protein Structure, Function, and Turnover 184Amino Acids 184Protein Structure 186Protein Function 189

Food Sources of Protein 195Protein Quality 195Nutrition and Disease: Are soybeans a miracle food? 197Supplemental Protein 198Recommendations for Protein Intake 199Myths and Legends: More protein = more muscle—do athletes really need more protein? 200

Vegetarianism 201Different Types of Vegetarian Diets 201Why Do People Choose to Become Vegetarians? 203Health Benefits of a Vegetarian Diet 204Challenges for Vegetarians 205What’s Hot: Protein for Weight Loss 206

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Protein Imbalance 209Too Little Protein 209Too Much Protein 211

Chapter Summary 215Key Terms 216Chapter Quiz 218References 220

CHAPTER 6 Digestion, Absorption, and Metabolism: The Link Between Food and Energy 221

The Organs and the Functions of Digestion 224Myths and Legends: If you swallow chewing gum, will it stay in your stomach for seven years? 225Absorption 227The Sum of the Parts 228Nutrition and Disease: Stomach ulcers 231What’s Hot: Colon cleansing: beware of parasites 236To Supplement or Not: Probiotics and prebiotics 237

Digestion and Absorption: From Tongue to Blood 239Carbohydrates 239Fats 241Protein 242Alcohol 242Vitamins and Minerals 244Water 245Myths and Legends: When you mix it up—combining foods 246

Energy and Nutrient Metabolism 249A Usable Form of Energy 249Building and Storing 253

Chapter Summary 256Key Terms 257References 258Chapter Quiz 258

CHAPTER 7 Energy Balance and Obesity 261Calories In Versus Calories Out 264

Calories In: The Food We Eat 264You Decide: Is the food industry to blame for increasing portion sizes? 266Make It a Practice: Achieving a healthy weight starts here: portion sizes 267Calories Out: Energy Expenditure 269

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Self-Assessment: Estimating your REE 275Out of Balance: Overweight, Obesity, and Underweight 276

Body Mass Index (BMI) 277Body Composition 281Body Fat Distribution 283

Obesity: An Alarming Trend 284Nutrition and Lifestages: “The Freshman Fifteen”—fact or fiction? 287Global Nutrition: Obesity as a global issue 289

Obesity: Choice or Destiny? 290Causes of Obesity 290Genetics 292What’s Hot: Food addiction 293

Weight Management: A Balancing Act 294Hunger, Appetite, and Satiety 294Weight Loss: What Doesn’t Work 297Fasting and Skipping Meals 300What Does Work 301You Decide: Is obesity a political issue? 306Self-Assessment: What do I need to change to be healthier? 310Seeking Balance 311


CHAPTER 8 Water and Electrolytes: Striking a Balance 319

Water and Water Balance 322Myths and Legends: Is bottled water safer and better for you? 324Water Balance 325Sources of Water Loss in the Body 326Make It a Practice: Staying hydrated during exercise 328Nutrition and Lifestages: Dehydration in infancy 331

Electrolytes: Sodium, Potassium, and Chloride 334Dietary Sodium 335Dietary Chloride 336Dietary Potassium 336 Make It a Practice: Minimizing salt in your diet 337Hypertension and Sodium 339Culture and Ethnic Foods: Salt intake and high blood pressure around the world 340

Absorption and Functions of Electrolytes 344Absorption 344

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Physiological Functions 345Deficiencies 346What’s Hot: Should you use sports drinks when you exercise? 348


CHAPTER 9 Vitamins 355 Vitamins: A Little Goes a Long Way 358Origins of the Term “Vitamin” 358

Fat-Soluble Vitamins 360Vitamin A 360You Decide: Should I take beta-carotene as a supplement? 364

Vitamin D 365To Supplement or Not 369

Vitamin E 370Vitamin K 372What’s Hot? Soda for breakfast? 374

Water-Soluble Vitamins 376Vitamin C 376Make It a Practice: How to cook your vegetables 379B Vitamins 379Thiamin (B1) 381 Riboflavin (B2) 382Niacin (B3) 382Vitamin B6 384Recommended Intakes and Food Sources 384Nutrition and Lifestages: Food for thought for all ages 385Folate (B9) 386 Vitamin B12 389Nutrition and Disease: The impact of folic acid and vitamin B12 on blood homocysteine levels and heart disease 390Biotin (B7) 391Pantothenic Acid (B5) 392

Enrichment, Fortification, and Supplementation 393Enrichment 393Fortification 394To Supplement or Not: Vitamin supplements—who needs them? 394


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CHAPTER 10 Minerals 409 Mineral Refers to Mining 411

The Macrominerals 413Calcium 413Nutrition and Disease: Calcium and vitamin D in bone health 414Phosphorus 422Magnesium 424

Sulfur 427The Microminerals 429

Iron 429Zinc 433Nutrition and Lifestages: Zinc in teenage males 435Copper 436You Decide: Can a lack of dietary copper lead to heart disease? 438Selenium 439Fluoride 443Chromium 444Myths and Legends: Can chromium picolinate supplements increase lean tissue in your body? 444


CHAPTER 11 Supplements 455 History of Dietary Supplements 458

Supplement Regulation 459Make It a Practice: Buyer beware 460Myths and Legends: Ephedra—a matter of life and death for some! 461Partially True Claims 462Nutrition and Lifestages: The fountain of youth in a bottle? 463

Who Takes Supplements and Why 464Who’s Buying Them? 464What’s Hot? Energy drinks—do they give you wings or leave you hangin’? 466Why Are They Buying Them? 467Make It a Practice: Always do your homework! 470

Types of Supplements 472Vitamins and Minerals 472Individual Supplements 473Coenzyme Q10 475Glucosamine Chondroitin 475

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Protein and Amino Acid Supplements 478 Myths and Legends: Weight-loss supplements—trading on the hopes and desperation of an overweight nation 481

Supplements for Performance 483Caffeine 483Carnitine 484Creatine 483Beta-Hydroxy Beta-Methylbutyrate or HMBTo Supplement or Not: Will dietary supplements help me or harm me? 486

Herbs and Botanicals 487Are Natural Supplements More Effective? 487


CHAPTER 12 Pregnancy, Breastfeeding, and Infant Feeding 501

Nutrition during Preconception 505 Women 505 Men 505

Stages of Pregnancy 506 First Trimester (Weeks 1–13) 506 Second Trimester (Weeks 14–27) 508Third Trimester (Week 28 to Birth) 508Low-Birthweight Newborns 508

Nutritional Needs During Pregnancy 509Weight Gain 509Meeting Increased Nutrient Needs 510 Prenatal Vitamin and Mineral Supplements 514To Supplement or Not: Should pregnant women take herbal and botanical supplements? 515Hydration 516

Factors That Can Affect Nutritional Intake and Pregnancy Outcome 517Exercise and Pregnancy 517Morning Sickness 518Food Cravings 519Gastrointestinal Issues 520Health Conditions 520Nutrition and Disease: Gestational diabetes 521Health Precautions During Pregnancy 522

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Breast-Feeding 525Benefits of Breast-Feeding 526What’s Hot? Are breast-fed infants less likely to become overweight? 527Global Nutrition: Breast-feeding— a cultural thing 529Recommendations by Government Organizations 530Breast-Feeding in the First Days Following Birth 531Breast-Feeding After Six Months 531Nutritional Needs of the Breast-Feeding Mother 532Foods to Avoid 533Barriers to Breastfeeding 534What Are the Alternatives to Breast-Feeding? 534

The Nutritional Needs of Infants Beyond Milk 537Hydration 537Vitamins and Minerals 540Starting Solid Foods 541The Importance of Nutrient-Dense Foods 543Vegetarianism: Are vegan and vegetarian diets safe for infants? 544Sequencing Solid Foods 545Bottle-Mouth Syndrome 547


CHAPTER 13 Nutrition for Children, Adolescents, and Older Adults 555

Nutrition During Childhood 558Rapid Development Change in Childhood 558The Nutritional Needs and Eating Habits of Children 558What Children Like to Eat and Why 561Snacking 563Health Concerns of Childhood 564What’s Hot: Fast food—excess calories for children 568Food and Behavior in Children 571Nutrition and Lifestages: Does breakfast for children improve brain function? 572

Nutrition During the Adolescent Years 573 Rapid Growth 574Puberty 574Nutrient Needs of Adolescents 574To Supplement or Not: Should teenage girls take a calcium supplement? 576

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Food Habits of Adolescents 577What Are Some of the Major Health Concerns of Adolescents? 578Nutrition and Disease: Are Adolescents at Risk for Diabetes? 580Myths and Legends: Do certain foods cause or contribute to acne? 582

Nutrition for Older Adults 583Social and Psychological Aspects of Aging 584Make It a Practice: Community food programs 586Physical and Physiological Factors 587Nutrition and Disease: Is aging really a disease? 591Nutrient Requirements of Older Adults 592Factors Affecting Nutrient Use 593

Major Nutrition-Related Issues and Older Adults 593The Most Common Issues 593Make it a practice: A diet for successful aging 599 You Decide: Should older adults use vitamin and mineral supplements? 600

Chapter Summary 602 Key Terms 603References 603Chapter Quiz 604

CHAPTER 14 Sport and Exercise Nutrition 607Exercise Basics 611

The Benefits of Exercise 611Self-Assessment: How do you choose the right exercise? 612The Role of Exercise in Weight Management and Strength Training 614Nutrition and Lifestages: It’s never too late—exercise and sports nutrition for the older adult 614Recommendations: How Much Exercise Is Enough? 615Myths and Legends: What not to believe! 616Strength Training 617

Fueling Exercise 619 The Immediate Energy System 620Glycolysis 620Continual Use of Energy Pathways 622

Fuel for Exercise 623Calorie Needs 623Make It a Practice: Gaining muscle mass the healthy way 624Carbohydrates as a Fuel 626The Importance of Maintaining Carbohydrate Reserves 627Fat as a Fuel 628

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Protein as a Fuel 629Vegetarianism: Does being a vegetarian impair performance? 630Vitamin and Mineral Needs for Exercise 631Ergogenic Aids 631Pre-Exercise Meals 632Make It a Practice: Carbohydrate loading 633Nutrition during Exercise 636Make It a Practice: Eating and drinking when you’re literally “ on the run” 637Post-Exercise Recovery 638What’s Hot?: Energy bars—do you really need them? 639

Maintaining Fluid Balance during Exercise 641Drink Early, Drink Often 642Adjustments in Cold Weather 642Monitoring Hydration Status 642Electrolytes 643Wrapping It All Up 644


CHAPTER 15 Eating Disorders: Do Not Discriminate 653How Do We Define Eating Disorders? 656

Anorexia Nervosa 658Bulimia Nervosa 658Binge Eating Disorder 659Nutrition and Culture: Men and eating disorders 659Other Specified Feeding or Eating Disorders (OSFED) 661Eating Disorders Affect People of All Ages and Ethnicities 661Make It a Practice: Does someone you care about potentially have an eating disorder 663

Risk Factors 666Dieting 666Cultural Pressure 668Body Dissatisfaction 669To Supplement or Not: Anabolic steroids— a vicious cycle 670Teasing 672Self-Esteem 673Self-Assessment: How do you feel about your own body? 674Puberty 674Family 675 Athletes 676

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Medical Complications, Treatment, and Prevention of Eating Disorders 678

Medical Complications 678Treatment 680


CHAPTER 16 Alcohol and Your Health 691Alcohol Production 694

How Alcoholic Beverages Are Made 694Proof and Percentage of Alcohol 695Alcohol Consumption and Its Influence on Blood Alcohol Concentration (BAC) 696Myths and Legends: Will drinking coffee make you sober? 699 Levels of Consumption 699To Supplement or Not: Will supplements prevent or cure a hangover? 700

Digestion and Metabolism 701Alcohol, Absorption, and the Liver 701Nutrition and Disease: Alcohol and liver disease 702Alcohol and the Brain 703What’s Hot: Binge drinking on college campuses 704

Health and Alcohol Consumption 705Health Risks 706Nutrition and Lifestages: Alcohol and pregnancy 707You Decide: Alcohol intake and advertisement in youth: Should alcohol advertisement be banned? 708 Self-Assessment: Do you have a problem with alcohol? 711Health Benefits 713Nutrition and Culture: Alcohol intake in the United States 717


CHAPTER 17 Assuring a Safe Food Supply 723Myths and Legends: The “five-second rule” 726

The Food Supply Chain 727What’s Hot: The “American food supply”: a return to a local approach 727Causes of Food-Borne Illness 728

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Food-Borne Illnesses Remain a Significant Public Health Problem 734

Food Processing and Safety: From Farm to Table 738The Hazard Analysis Critical Control Point System 738Food Safety at the Farm 738Sustainability of the Food Supply 739Contaminants in the Fish Supply 740What’s Hot: Are organic foods better for you? 740Food Safety and Common Food-Processing Techniques 741Myths and Legends: Is raw milk better for children? 743You Decide: Is the use of hormones and antibiotics in the production of meat and dairy products harmful? 746What’s Hot: Genetically engineered foods—are they a change for the better? 749

Consumers: The Last Line of Defense 750Food Safety Practices You Can Use 750Tips for Grocery Shopping 753Storing Food 756Preparing Food 758Putting It All Together 762


INDEX

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