Table Of Content6814_FM_i-x 30/07/18 3:50 PM Page i
Lutz’s
Nutrition
and
Diet Therapy
SEVENTH EDITION
Erin E. Mazur, MSN, RN, FNP-BC
Associate Professor of Nursing
Jackson College
Jackson, Michigan
Nancy A. Litch, MS, RDN
Dietitian, Retired
East Lansing, Michigan
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F. A. Davis Company
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Copyright © 2019 by F. A. Davis Company
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As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes.
The author(s) and publisher have done everything possible to make this book accurate, up-to-date, and in accord with accepted standards at the
time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the
book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied
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before administering any drug. Caution is especially urged when using new or infrequently ordered drugs.
Library of Congress Cataloging-in-Publication Data
Library of Congress Cataloging-in-Publication Data
Names: Mazur, Erin E., author. | Litch, Nancy A., author. | Preceded by
(work): Lutz, Carroll A. Nutrition and diet therapy.
Title: Lutz’s nutrition and diet therapy / Erin E. Mazur, Nancy A. Litch.
Other titles: Nutrition and diet therapy
Description: Seventh edition. | Philadelphia, PA : F. A. Davis Company,
[2019] | Preceded by Nutrition and diet therapy / Carroll A. Lutz, Erin E.
Mazur, Nancy A. Litch. 2015. | Includes bibliographical references and
index.
Identifiers: LCCN 2018021835 (print) | LCCN 2018022914 (ebook) | ISBN
9780803689985 () | ISBN 9780803668140 (pbk.)
Subjects: | MESH: Nutritional Physiological Phenomena | Nutrition Therapy
Classification: LCC RM216 (ebook) | LCC RM216 (print) | NLM QU 145 | DDC
613.2—dc23
LC record available at https://lccn.loc.gov/2018021835
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system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: 978-0-8036-6814-0/18 + $.25.
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Dedications
Carroll Lutz, thank you for all your years of dedication and
hard work to provide six editions of this textbook. Your
commitment to providing students with current information
regarding nutrition is to be commended. Without your vision
and perseverance, this textbook would not be possible.
— Erin E. Mazur and Nancy A. Litch
To my family and friends for the constant support during the
writing process, especially Jeff, Spencer, Carter, Mom, and
Jen; I’m forever grateful.
— Erin E. Mazur
This is for all the students interested in the facts regarding
nutrition and health; never stop seeking knowledge. To my
family and friends who have supported me in this process,
especially Paul, Evan, and Mom, much love and thanks.
— Nancy A. Litch
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Preface
The seventh edition of Lutz’s Nutrition and Diet Therapy is Unit 1, The Role of Nutrients in the Human Body,cov-
designed to provide the beginning student with knowledge ers basic information on nutrition as a science and how this
of the fundamentals of nutrition related to the promotion information is applied to nutritional care. All the essential
and maintenance of optimal health. Practical applications nutrients are covered, including definitions and descriptions
and treatment of pathologies with nutritional components of functions, effects of excesses and deficiencies, and food
are stressed. In addition, basic scientific information is in- sources. Nutritional standards, including the Dietary Refer-
troduced to enable students to begin to understand nutri- ence Intakes, are explained and incorporated into discus-
tional issues reported in the mass media. The sequential sions of nutrients. Information on the use of food in the
introduction of material continues to be a unique feature body and how the body maintains energy balance com-
of this text. The authors resist the temptation to introduce pletes the unit.
concepts and examples of applications before the underly- Unit 2, Family and Community Nutrition,provides an
ing basic science and vocabulary have been covered. The overview of topics such as nutrition throughout the life
seventh edition has been extensively streamlined and up- cycle, covering pregnancy, lactation, infancy, childhood,
dated with new information (e.g., the new food label), in- adolescence, and adulthood. Lastly, issues in food manage-
corporating updated illustrations and tables. Within the ment are addressed.
boundaries of a beginning course, specific information is Unit 3, Clinical Nutrition, focuses on the care of
included to enhance understanding of the “why” of nutri- clients with pathologies caused by or causing nutritional
tional care, not only the “what.” impairments. General topics include nutrient delivery via
This book was written to meet the educational needs of oral, enteral, and parenteral routes, and interactions
nursing students, dietetic assistants, diet technicians, and among foods, nutrients, medications, and supplements.
others. Support materials for the student include case stud- Pathological conditions include diabetes mellitus and hy-
ies with examples of care plans, including referrals to other poglycemia, cardiovascular disease, renal disease, diges-
members of the health-care team, followed by Critical tive diseases, and cancer. Other pertinent topics include
Thinking Questions designed to provoke imaginative weight control, nutrition in critical care and during stress,
thought and to foster discussion. Each chapter has review diet affecting inflammation and infections, and care of
questions and clinical analysis study questions. the client with a terminal illness.
As researchers discover new and more effective treat- Special features are used throughout the text to facilitate
ments for nutrition-related disorders and health mainte- the teaching and learning process. Chapters include the
nance, the ability to think critically becomes increasingly following:
important for professional growth and development. Stu- Boxes and Tables contain summaries, assessment tools,
dents need not only to grasp the facts but also to apply the commonly prescribed diets used in medical nutrition ther-
information in a clinical environment. This text has been apy, and research findings.
developed to facilitate acquiring these skills. Clinical Applications stimulate the interest of the begin-
The text can be used to teach a complete course in nutri- ning student by showing how the information is pertinent
tion or as a desk reference for practitioners. The student using to providing health care.
this book needs no previous grounding in anatomy, physiol- Clinical Calculations isolate and explain many of the
ogy, or medical terminology. Subjects are fully supported by mathematical calculations that are used in nutritional science.
diagrams, illustrations, figures, and tables. Depending on the Dollars & Sense items focus on costs associated with
curriculum, chapters may be omitted or presented in a dif- commonly used foods and supplements. Occasionally,
ferent sequence. We recognize that this text contains an budget-sparing recipes are given to exemplify principles in
immense amount of data and information. It is our hope that the chapters.
this rich store of information permits instructors to adapt the Genomic Gemshighlight links between a person’s genetic
text to the objectives of their courses while serving as a refer- makeup and utilization of nutrients and dietary substances.
ence and directory for students, satisfying their curiosities or Illustrations reinforce important points in the text or
completing solo or group projects whether in preclinical or graph statistical data for clarity.
in clinical courses. Flowcharts of physiological and pathological processes
The content of Lutz’s Nutrition and Diet Therapy,seventh lead the student to an understanding of the relationship be-
edition, is organized into three units. tween nutrition and health.
iv
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PREFACE v
A Case Studywith a proposed Care Planallows the stu- The Bibliography supports the text with data sources
dent to see how the nutrition principles described in the and introduces the student to the scientific literature and is
chapter are applied in a specific clinical situation. The case on DavisPlus.
studies were written to incorporate elements that are likely Accompanying the text for instructors who adopt it for
to occur in practice. their classes are:
Teamwork following the care plan illustrates continuing An Active ClassroomInstructors’ Guidewith suggestions
care of a client by various members of the health-care team. for lectures, classroom activities, and student assignments.
Chapter Review Questions andClinical Analysis Ques- PowerPoint Presentations for all the chapters of the
tions help the student to focus on essential concepts. An- book. These presentations provide a ready source of mate-
swers to these questions are on DavisPlus. rial to select for classroom use.
Critical Thinking Questionsinvite the student to think A Test Bankcontaining over 450 questions, arranged by
holistically with compassion and creativity. They can be chapter.
used as a basis for class discussion. We believe that Lutz’s Nutrition and Diet Therapy,seventh
Appendices of Dietary Reference Intakes (Appendix A) edition, provides the clinical information necessary for a
serve as a readily available source of information for stu- fuller understanding of the relationship between the knowl-
dents in class discussions or group assignments. edge about nutrition and diet and its clinical application.
A Glossary(Appendix B) of more than 1,000 entries as- This text balances direct explanations of the underlying sci-
sists the reader to recall definitions of terms boldfaced in ence with an introduction to the clinical responsibilities of
the text. the health-care professional.
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Reviewers
Robin Adams-Weber, DNP, RN, WHNP-BC Teresa W. Johnson, DCN, RD
Associate Professor of Nursing Professor
Malone University Troy University
Canton, Ohio Troy, Alabama
Debora Boone, MSN, RN Marina Martinez-Kratz, MS, RN, CNE
Associate Professor/Health Science ADN Program Professor of Nursing
Maysville Community and Technical College Jackson College
Maysville, Kentucky Jackson, Michigan
Stephanie Bruce, MS, RN, ACNS-BC Joseph Molinatti, EdD, RN
Assistant Professor Associate Professor
Alverno College College of Mount Saint Vincent
Milwaukee, Wisconsin Riverdale, New York
Claire Cyriax, DNP, RN, LNC, CAPA Rhonda Y. Sims, RN, DNP, MSN, MS, LNC, SANE-A
Professor Professor of Nursing
Bergen Community College Maysville Community & Technical College
Paramus, New Jersey Maysville, Kentucky
Carol Della Ratta, PhD, RN, CCRN Shantelle L. Wade, MS, RN
Chair and Clinical Associate Professor Nursing Faculty/Clinical Coordinator
Stony Brook University Presentation College
Stony Brook, New York Aberdeen, South Dakota
vi
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Acknowledgments
Writing a book, even a seventh edition, is a huge task, editions. Our editorial and production staff at F.A. Davis
requiring the assistance of many people. All of our colleagues Company, including Megan Klim, Christine Abshire, Daniel
and family members contributed to this project, sometimes Domzalski, and Bob Butler, shared their knowledge and
with information and critiques, sometimes by being sup- expertise throughout the project. To all of them and the
portive, and sometimes just by leaving us alone to work. countless others who did not have to deal with us directly go
We thank all the organizations and publishers that gave our heartfelt thanks.
permission for the use of their materials for this and previous
vii
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Contents
Preface, iv
Reviewers, vi
Acknowledgments, vii
UNIT I The Role of Nutrients in the Human Body, 1
1 Nutrition in Human Health, 3
2 Carbohydrates, 24
3 Fats, 36
4 Protein, 49
5 Energy Balance, 60
6 Vitamins, 71
7 Minerals, 94
8 Water, 122
9 Digestion, Absorption, Metabolism, and Excretion, 141
UNIT II Family and Community Nutrition, 159
10 Life Cycle Nutrition: Pregnancy and Lactation, 161
11 Life Cycle Nutrition: Infancy, Childhood,
and Adolescence, 179
12 Life Cycle Nutrition: The Mature Adult, 207
13 Food Management, 224
UNIT III Clinical Nutrition, 237
14 Nutrient Delivery, 239
15 Interactions: Food and Nutrients Versus Medications
and Supplements, 259
16 Weight Management, 280
17 Diet in Diabetes Mellitus and Hypoglycemia, 298
18 Diet in Cardiovascular Disease, 317
19 Diet in Renal Disease, 333
20 Diet in Digestive Diseases, 350
21 Diet and Cancer, 375
viii
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CONTENTS ix
22 Nutrition in Critical Care, 389
23 Diet in HIV and AIDS, 403
24 Nutritional Care of the Terminally Ill, 414
Appendices
A Dietary Reference Intakes for Individuals, 425
B Glossary, 431
Index, 454
Available on DavisPlus
Answers to End-of-Chapter Questions
Bibliography
