Table Of ContentEssentials of
Human Nutrition
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Essentials of
Human Nutrition
Fourth Edition
Edited By
Jim Mann
Professor of Human Nutrition and Medicine, University of Otago, 
New Zealand
A. Stewart Truswell
Emeritus Professor of Human Nutrition, University of Sydney, Australia
1
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1
Great Clarendon Street, Oxford ox2 6dp
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Crown Copyright material reproduced with the permission of the 
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First edition published 1998
Second edition published 2002
Th ird edition published 2007
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Printed in Great Britain
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Ashford Colour Press Ltd, Gosport, Hampshire
ISBN 978-0-19-956634-1
10 9 8 7 6 5 4 3 2 1
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Preface
Several excellent textbooks of human nutrition are available. We have attempted 
to produce a book that diff ers from most of them by asking our contributors to 
describe what they regard as those aspects of their topics that are essential to the 
understanding and practice of human nutrition. Most of the authors are interna-
tional authorities on the subjects on which they have written and all are very 
experienced teachers.
We were initially reluctant to accept the off er of the publishers to produce yet 
another textbook of human nutrition. We were persuaded to do so because we felt 
there was a need for a book that described the essential information required by 
students embarking on a University course in human nutrition, and by those in 
training in the health and food science professions, where the importance of 
nutrition is being increasingly recognized. Many of our clinical colleagues in 
medicine, dentistry, nursing and physiotherapy, and school teachers, provided 
strong encouragement for this project, since they too required a simple reference 
volume, having themselves received little formal training in nutrition. An increas-
ingly informed public expects its health providers to have knowledge of one of the 
most important determinants of individual and public health. Health profession-
als and food scientists need to be able to disentangle scientifi cally established 
nutrition principles from the morass of misinformation available in the public 
domain. Th  e book may also be of value to those in the fi tness industry, and, last 
but not least, individual members of the public who have suffi  cient knowledge of 
biology and chemistry and who wish to be informed of the essentials of human 
nutrition. Th  e book is not intended to be a detailed reference volume and each 
chapter contains further reading for those wishing to extend the information 
 provided in the text.
We have tried to emphasize that nutritional science encompasses a spectrum of 
disciplines and involves the use of many methodologies. In the past, the major 
advances in nutrition were made at the level of organs and organisms, many from 
studies of experimental animals. Most present advances have been at the popula-
tion level and, even more recently, at the molecular level. Th  e discovery that die-
tary alteration can modify gene expression suggests that what we eat has even 
more profound implications than had previously been believed. Th  ese disciplines 
now need to be integrated at the human level to promote the practical application 
of nutritional science in metabolic, clinical, and public health nutrition.
Th  is medium-sized textbook has become popular, especially in universities in 
Europe and the Southern Hemisphere. Human nutrition science continues to 
evolve since our third edition in 2007 and thus Oxford University Press asked us to 
prepare this fourth edition.
Seventeen new writers have joined the authorship of the book. Most are very 
well-known nutritional scientists. Six of the 42 chapters are completely rewritten 
and all the others have been revised and updated. Professor John Milner and 
Dr Young Kim, have written a new chapter on ‘Genes, nutrition, and disease risk,’ 
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vi
Professor Tim Lang and Dr Helen Crawley have written a new chapter entitled 
‘Nutrition, the environment, and sustainable diets,’ and case studies have been 
e
ac included in four of the chapters. In a few chapters, potentially controversial views 
f
e regarding the implementation of nutrition interventions have been expressed. 
r
P
Th  ese are not necessarily the views of the editors.
We are very grateful to our chapter writers for their expert and well-described 
 material—and also for their tolerance of our editing of what they wrote. We have 
been somewhat interventionist in our attempt to keep the writing simple and 
readable and the diff erent chapters fairly consistent. We thought it important not 
to let ‘essentials’ get wordy, long, heavy, and costly.
Although we two editors live and work in separate countries, it has been 
an enjoyable and creative task to work together, with the help of many e-mails 
and teleconferences.
We hope that readers will fi nd our book useful in their study of human nutri-
tion. For those who would like more detail, each chapter has a list of suggestions 
for further reading. Th  ese references are not comprehensive but selected, and 
most of them should be accessible.
We have arranged to participate in an Editors’ Forum via OUP’s Online 
Resource Centre. Twice a year we will send notes on new developments in the 
whole area of human nutrition. In addition, we would welcome comments from 
students, lecturers, or general readers.
Prof. Jim Mann, [email protected]
Prof. Stewart Truswell, [email protected]
New to this edition
• Six chapters entirely rewritten, all others revised and updated.
• New chapters: ‘Genes, nutrition, and disease risk’ and ‘Nutrition, the environ-
ment, and sustainable diets’.
• Enhanced coverage of the B vitamins and obesity.
• Several new case studies.
To see topical and scientifi cally robust updates on nutrition associated 
with this textbook and web links to many of the journal articles in the 
 Further Reading sections, please see the dedicated Online Resource  Centre 
at www.oxfordtextbooks.co.uk/orc/mann4e/.
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Acknowledgements
Th  e editors are very pleased that so many leading nutrition scientists have been 
prepared to contribute and have tolerated our editing. Our knowledge of nutri-
tion has been moulded by many discussions with many colleagues over several 
years. Lesley Day has been the main editorial assistant for the book in Otago. She 
assisted with the revision of many of the chapters following the editorial process 
and ensured the standardized format required by the publishers. She has also 
been responsible for obtaining permissions to reproduce original material from 
other sources. We are grateful to her for playing a crucial role in the production 
of the book.
Marianne Alexander was Professor Truswell’s secretary in Sydney for the fi rst 
three  editions and since early 2010, he has been assisted by Th  eodora Sideratou. 
Elizabeth Gray, editorial assistant for the fi rst two editions, provided support for 
the third and fourth  editions. For this edition, Gordon Hargreaves carried out the 
drawing and preparation of fi gures as required.
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Contents
Abbreviations...........................................................................................................................................xiii
Contributors ............................................................................................................................................xvii
1  Introduction .........................................................................................................................1
  Stewart Truswell and Jim Mann
2  Genes, nutrition, and disease risk .......................................................................................8
  Young Sook Kim and John A. Milner
Part 1 Energy and macronutrients
3  Carbohydrates ...................................................................................................................21
  John Cummings and Jim Mann
4  Lipids..................................................................................................................................49
  C. Murray Skeaff  and Jim Mann
5  Protein ...............................................................................................................................70
  Alan A. Jackson and Stewart Truswell
6  Energy ................................................................................................................................92
  Andrew M. Prentice
7  Alcohol .............................................................................................................................109
  Stewart Truswell
Part 2 Organic and inorganic essential nutrients
8  Water, electrolytes, and acid–base balance ...................................................................125
  Zoltán H. Endre and James Robinson*
9  Major minerals: calcium and magnesium ........................................................................139
9.1 Calcium  Susan A. Lanham-New, Ohood Hakim, and Ailsa Goulding ........................................139
9.2  Magnesium  Susan A. Lanham-New, Ohood Hakim, and Andrea Grant ..................................153
10 Iron ...................................................................................................................................157
  A. Patrick MacPhail
*deceased
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Description:Nutrition is one of the most important determinants of individual and public health. An increasingly informed public expects its health and food professionals to be able to offer clear, evidence-based advice on diet and associated health implications, but how can established nutrition principles be