Primary care nutrition writing the nutrition prescription 1st edition by David Heber, Zhaoping Li ISBN 0367273170 9780367273170

Chapter 1 Incorporating Nutrition into the Primary Care Practice

1.1 Introduction

1.2 Survey Your Practice Population’s Nutrition Status and Lifestyle

1.2.1 The Global Nutrition Transition and Your Practice

1.2.2 Food Insecurity and Low Socioeconomic Status

1.2.3 Relative Food Costs and Calories per Bite

1.3 Identifying Medical, Nutritional, Behavioral, and Exercise Resources Available

1.4 Obtaining the Equipment Needed for Primary Care Nutrition Practice

1.5 Outfitting Your Office to Accommodate Obese Patients

1.6 Training Your Staff to be Empathetic and Have Supportive Interactions

1.7 Modifying Routines to Maintain Efficient Patient Flow

1.8 Providing Internet Resources for Self-Monitoring and Reporting Progress to Your Practice

1.9 Establish Methods to Obtain Reimbursement for Your Services

1.10 Primary Care Algorithm

References

Chapter 2 Personalization of Nutrition Advice

2.1 Introduction

2.2 Understanding the Dietary Guidelines and Government Advice

2.2.1 Personalization of Dietary Guidelines

2.2.2 Recommended Dietary Allowances: A Brief History

2.2.3 Dietary Reference Intakes

2.2.4 The 2015–2020 Dietary Guidelines

2.2.5 Dietary Patterns Recommended by the 2015–2020 U.S. Dietary Guidelines

2.2.6 Physical Activity Guidelines

2.2.7 Daily Values and Label Reading

2.3 Body Composition and Personalization of the Nutrition Prescription

2.3.1 Rationale for a Balanced Diet Based on Supplemented Personalized Protein

2.3.2 Protein Quantity and Quality

2.3.3 Carbohydrates and Fibers

2.3.4 Simple Sugars and Complex Carbohydrates

2.3.5 Glycemic Index, Glycemic Load, and Calories

2.3.6 Fats and Oils

2.3.7 Dietary Pattern That Prevents Weight Gain

2.4 Optimizing Vitamin, Mineral, and Micronutrient Intake from Foods and Supplements

2.4.1 Fat-Soluble Vitamins: A, D, E, and K

2.4.1.1 Vitamin A

2.4.1.2 Vitamin D

2.4.1.3 Vitamin E

2.4.1.4 Vitamin K

2.4.2 Water-Soluble Vitamins

2.4.2.1 Vitamin B1 (Thiamin)

2.4.2.2 Vitamin B2 (Riboflavin)

2.4.2.3 Vitamin B6 (Pyridoxine)

2.4.2.4 Niacin

2.4.2.5 Folic Acid

2.4.2.6 Vitamin B12

2.4.2.7 Choline

2.4.2.8 Pantothenic Acid and Coenzyme A

2.4.2.9 Biotin

2.5 Writing the Exercise Prescription and Evaluating Fitness

2.6 Leveraging Dietetic and Nursing Support

2.7 Issues Around Botanical Dietary Supplements

2.8 Enabling Patient Choice in Nutrition for Diets and Supplements

References

Chapter 3 Nutrition and the Immune System

3.1 Introduction

3.2 The Fat Cell as an Endocrine and Immune Cell

3.3 Malnutrition and Immune Function

3.4 Immune Function in Obesity

3.5 Immune Function and Vitamin and Mineral Balance

3.6 Interaction of Omega-3 Fatty Acids and Macrophage

3.7 Caloric Restriction without Malnutrition and Immune Function

3.8 Gut Microbiota and Immune Function

3.9 Practical Considerations for Modulating Immune Function

References

Chapter 4 Nutrition and Gastrointestinal Disorders

4.1 Introduction

4.2 Food Addiction or Simply Craving?

4.3 Eating Disorders: from Bulimia to Anorexia Nervosa

4.4 Treatment of Eating Disorders

4.5 Food Intolerance and Food Allergy

4.6 Irritable Bowel Syndrome

4.7 Gluten Enteropathy and Gluten Sensitivity

4.8 Inflammatory Bowel Diseases

4.8.1 Malnutrition

4.8.2 Enteral and Parenteral Nutrition

4.8.3 Breastfeeding

4.8.4 Specific Carbohydrate Diet

4.8.5 FODMAP Diet

4.8.6 Western Diet and Obesity

4.8.7 Omega-3 Polyunsaturated Fatty Acids

4.8.8 Vitamin D

4.9 Summary

References

Chapter 5 Approach to the Overweight and Obese PatientThe Elephant in the Room

5.1 Introduction

5.2 Pathophysiology of Obesity

5.2.1 Genetic and Environmental Interactions in Obesity

5.2.2 Biological Signals Regulating Food Intake

5.2.3 Protein Is the Most Satiating Macronutrient

5.2.4 Drugs for Obesity

5.2.5 Surgical Approaches to Obesity

5.3 Impact of Excess Body Fat on Health

5.3.1 Type 2 Diabetes Mellitus

5.3.2 Hypertension and Renal Disease

5.3.3 Cardiovascular Diseases: Coronary Artery Disease and Stroke

5.3.4 Obesity and Cancer

5.3.5 Obesity and Depression

5.3.6 Obesity and Infertility

5.3.7 Obesity and Pulmonary Diseases: Sleep Apnea and Asthma

5.3.8 Obesity in Aging and Brain Health

5.3.9 Obesity and Musculoskeletal Disorders

5.3.10 Obesity and Fatty Liver Disease

5.3.11 Gallstones and Gout

5.3.12 Bottom Line on Obesity and Health

5.4 Determining the Obesity Phenotype

5.5 Estimating Energy Expenditure and Protein Requirements

5.6 Providing Structured Diet Programs that Include Choice

5.7 Leisure Time Physical Activity and Exercise

5.8 Behavioral Strategies that Work

5.8.1 Widely Accepted Behavioral Strategies

5.9 Follow-Up and Social Support

References

Chapter 6 Evolution of Type 2 Diabetes Mellitus

6.1 Introduction

6.2 Social and Economic Determinants of Risk

6.3 Minority Health Disparities and Risk Factors in the United States

6.4 Adaptation to Starvation Sets the Stage for T2DM

6.5 Pancreatic ß-Cell Exhaustion and the Development of T2DM

6.6 Genetics of T2DM Linked to Multiple Risk Factors

6.6.1 Gestational Diabetes Mellitus

6.6.2 Gene–Environment Interaction and Risk for T2DM

6.6.3 Prediabetes

6.7 Conclusion

References

Chapter 7 Managing Diabetes without Weight Gain

7.1 Introduction

7.2 Diagnosis of T2DM

7.3 Pharmacological Treatment of Diabetes: A Brief History

7.4 Diabetes and Obesity

7.5 Nutrition and Diabetes Management

7.5.1 Weight Management and Weight Reduction in T2DM

7.5.2 Typical Modern Management of T2DM

7.5.3 Use of Metformin in T2DM

7.5.4 Meal Replacements as a Tool for Planning Weight Management Diets

7.5.5 Physical Activity, Including Resistance Exercise, to Increase Muscle Mass

7.5.6 Low-GI Foods, Fiber, and Resistant Starches in T1DM and T2DM

7.5.7 Monounsaturated Fats

7.5.8 Omega-3 Fatty Acids

7.5.9 Spices and Glucose Control

7.5.10 Micronutrients

7.6 Conclusion

References

Chapter 8 Fatty Liver Disease

8.1 Introduction

8.2 Pathophysiology of NAFLD

8.3 NAFLD and Metabolic Syndrome

8.4 NAFLD and Cirrhosis

8.5 NAFLD and Hepatocellular Cancer

8.6 Fatty Liver Interactions with Alcoholic And Viral Hepatitis

8.7 Diagnostic Dilemmas

8.8 Clinical Presentation of Significant Liver Damage

8.9 Nutritional Approaches to Liver Disease

8.9.1 Fructose and Fatty Liver

8.9.2 Vitamin E, Fish Oils, Phytonutrients, and Overall Nutrition for Liver Disease

8.9.3 Management of Protein Malnutrition in Advanced Liver Disease

8.10 Conclusion

References

Chapter 9 Lipid Disorders and Management

9.1 Introduction

9.2 Lipoproteins and Lipid Metabolism

9.3 Disorders of Cholesterol Metabolism and Transport

9.4 Differentiating Common and Rare Lipid Disorders

9.4.1 Familial Hypertriglyceridemia and Secondary Hypertriglyceridemia

9.4.2 Hypercholesterolemia and Familial Hypercholesterolemia

9.5 Hypertriglyceridemia and the Unrecognized Impact of Visceral Fat

9.6 Control of LDL Cholesterol for Prevention of Atherosclerotic Cardiovascular Diseases

9.7 Impact of Nutrition on Lipid Disorders

References

Chapter 10 Nutrition and Coronary Artery Disease

10.1 Introduction

10.2 Coronary Artery Disease, Unstable Plaques, and Myocardial Infarction

10.2.1 Cellular Basis of Atherosclerosis and Inflammation

10.2.2 Endothelial Dysfunction and Nitric Oxide in CAD

10.2.3 Coronary Artery Calcification

10.3 Type 2 Diabetes and CAD

10.4 Effects of Statin Drugs in CAD Beyond Lipid Lowering

10.5 Dietary Recommendations for Patients with Coronary Artery Disease

10.6 Weight Management through Nutrition and Exercise to Reduce Visceral Fat

10.6.1 Dietary Pattern and CAD

10.6.2 Nitrate-Rich Foods Defend Endothelial Health under Hypoxic Conditions

10.6.3 Refined Carbohydrates and Sugar versus Fruits and Vegetables in Low-Glycemic-Index Diets

10.6.4 Phytonutrients, Potential Role in Stabilizing Atherosclerotic Plaques

10.7 Conclusion

References

Chapter 11 Hypertension and Obesity

11.1 Introduction

11.2 Epidemiology of Obesity and Hypertension

11.3 Diet in Obesity and Hypertension

11.4 Mechanisms Mediating Obesity-Related Hypertension

11.5 Nutrition Approaches to Obesity-Associated Hypertension and the Metabolic Syndrome

11.5.1 Sodium Restriction in Therapy of Hypertension and Obesity

11.5.2 Pharmacological Adjunctive Treatment May Be Necessary

11.6 Summary and Overall Treatment Recommendations

References

Chapter 12 Nutrition, Chronic Kidney Disease, and Kidney Failure

12.1 Introduction

12.2 Obesity, Fatty Kidney, and Chronic Kidney Disease

12.3 Renal Insufficiency and Chronic Kidney Disease

12.4 Nutrition and Prevention of Chronic Kidney Disease

12.5 Nutrition in Chronic Kidney Disease and End-Stage Renal Disease

12.6 Summary

References

Chapter 13 Nutrition and Heart Failure

13.1 Introduction

13.2 Etiology and Clinical Classification of Heart Failure

13.3 Diagnosis and Medical Treatment of Heart Failure

13.3.1 Heart Failure with Preserved Ejection Fraction

13.3.2 Pharmacotherapy of Heart Failure with Reduced Ejection Fraction

13.3.3 Sodium Restriction in Low-Output Heart Failure

13.3.4 Heart Failure Treatment: Medical Therapy

13.3.4.1 ACE Inhibitors and Angiotensin Receptor Blockers

13.3.4.2 ß-Blockers

13.3.4.3 Aldosterone Antagonists

13.3.4.4 Digoxin

13.3.4.5 Diuretics

13.3.4.6 ADH Antagonists

13.3.4.7 Nesiritide

13.3.4.8 Hydralazine and Nitrates

13.3.5 Heart Failure Treatment: Mechanical, Revascularization, and Heart Transplant

13.4 BMI Paradox in Heart Failure

13.5 Macronutrients

13.5.1 Protein in Sarcopenia and Cardiac Cachexia

13.5.2 Balancing Omega-3 and Omega-6 Fats in the Diet

13.6 Micronutrients

13.6.1 Coenzyme Q10 Supplementation

13.6.2 Thiamine

13.7 Conclusion

References

Chapter 14 Pulmonary Function, Asthma, and Obesity

14.1 Introduction

14.2 Pulmonary Function in Obesity

14.3 Asthma and Obesity

14.4 Obstructive Sleep Apnea and Hypoventilation Syndrome

14.5 Effects of Poor-Quality Sleep in Obesity

14.6 Primary Care Sleep Hygiene Recommendations

14.7 Summary

References

Chapter 15 Frailty, Nutrition, and the Elderly

15.1 Introduction

15.2 Nature of Aging

15.3 Epidemiology of Frailty

15.4 Sarcopenia

15.5 Muscle Protein Synthesis

15.6 Protein Requirements

15.7 Smell and Taste Changes with Aging

15.8 Prevention and Treatment of Frailty

15.9 Summary

References

Chapter 16 Nutrition in Neurodegenerative Disorders and Cognitive Impairment

16.1 Introduction

16.2 Epidemiology

16.3 Diagnosis of Dementia

16.4 Age-Related Changes in the Brain

16.5 Inflammation, Oxidative Stress, and the Brain

16.6 Healthy Lifestyle and the Brain

16.6.1 Exercise and Brain Health

16.6.2 Omega-3 Fatty Acids and Fish Oils

16.6.3 Antioxidant-Rich Foods

16.6.4 Coffee, Caffeine, and the Brain

16.6.5 Alcohol and the Brain

16.6.6 Dietary Supplements and the Brain

16.7 Diabetes, Visceral Fat, Inflammation, and Alzheimer’s Disease

16.8 Primary Care Physician and Case Manager Collaboration in Dementia Patients

16.9 Summary

References

Chapter 17 Gene–Nutrient Interaction

17.1 Introduction

17.2 Human Nutrition and Gene–Nutrient Interaction

17.3 Nutrigenetics

17.4 Nutrigenomics: Effects of Nutrients on Gene Expression

17.5 Epigenetics and Diet

17.6 Gene–Nutrient Interactions in Cancer and Aging

17.7 Genome-Wide Scanning and Disease Risk

17.8 The Microbiome and the Metagenome

17.9 Case Study of Clinical Application in Primary Care of Gene–Nutrient Interactions

17.10 Summary

References

Chapter 18 Nutrition and the Risk of Common Forms of Cancer

18.1 Introduction

18.2 Nutrition and Physical Activity as Risk Factors

18.3 Risk Factors Versus Statistical Bad Luck and Cancer Risk

18.3.1 Obesity and Cancer

18.3.2 Alcohol

18.4 Phytonutrients from Fruits, Vegetables, and Spices

18.5 Antioxidant Supplements

18.5.1 Folic Acid

18.5.2 Lycopene

18.5.3 Glucosinolates from Cruciferous Vegetables

18.5.4 Green Tea Polyphenols

18.6 Spices

18.7 Microbiota Metabolism of Phytonutrients and Immune Function

18.8 Summary

References

Chapter 19 Nutrition and the Cancer Patient

19.1 Introduction

19.2 Primary Care Oncology

19.3 Changing Face of Cancer

19.4 Cancer Survivors in Primary Care

19.5 Malnutrition and Cancer

19.5.1 Protein–Energy Malnutrition

19.5.2 Carbohydrate Metabolism

19.5.3 Host–Tumor Interactions and Metabolic Abnormalities in the Cancer Patient

19.6 Nutrition Screening

19.7 Selecting Appropriate Methods of Nutrition Care

19.7.1 Oral Nutrition Support

19.7.2 Enteral Nutrition

19.7.3 Parenteral Nutrition

19.8 Diet and Cancer Prevention: The Role of Colorful Fruits and Vegetables

19.9 Complementary and Alternative Medicines

References

Chapter 20 Writing the Nutrition Prescription

20.1 Introduction

20.2 Nutrition Prescriptions by Chapter

20.3 Engaging with Patients Using Wearable Devices and Social Media

20.3.1 Wearable Devices

20.3.2 Social Media

20.4 Managing Information Overload to Keep Up with Nutrition Research

20.5 Information Management Strategies

20.6 Continuing Education and Certification

20.6.1 American Board of Nutrition Physician Specialists

20.6.2 American Board of Obesity Medicine

20.6.3 Specialist Certification of Obesity Professional Education

Reference

Index