Understanding Nutrition

800 Pages·2021·116.856 MB·English

by  Ellie Whitney, Sharon Rady Rolfes

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SIXTEENTH EDITION
SE/Whitney/Rolfes, Understanding Nutrition 16e ISBN-13: 978-0-357-44751-2 ©2022 Designer: Lizz Anderson
Printer: Quad Graphics—Versailles Binding: Casebound Trim: 9" x 10.875" CMYK
Understanding
Nutrition
SIXTEENTH EDITION
Ellie Whitney
Sharon Rady Rolfes
Australia • Brazil • Canada • Mexico • Singapore • United Kingdom • United States
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Understanding Nutrition, Sixteenth Edition © 2022, 2019, 2016 Cengage Learning, Inc.
Ellie Whitney, Sharon Rady Rolfes
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Print Number: 01 Print Year: 2020
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About the Authors
Ellie Whitney grew up in New York City and received her Sharon Rady Rolfes received her MS in nutrition and food
BA and PhD degrees in English and Biology at Harvard and science from Florida State University. She is a founding member
Washington Universities, respectively. She taught at both Florida of Nutrition and Health Associates, an information resource
State University and Florida A&M University, wrote newspaper center that maintains a research database on more than
columns on environmental matters for the Tallahassee Democrat, 1000 nutrition-related topics. She has taught at Florida State
and coauthored almost a dozen college textbooks on nutrition, University and coauthored several other college textbooks,
health, and related topics, many of which repeatedly re- including Understanding Normal and Clinical Nutrition. In addi-
appear as new editions. She spent three decades exploring tion to writing, she serves as a consultant for various educa-
outdoor Florida and studying its ecology, and then cowrote tional projects. She maintains her registration as a dietitian
Priceless Florida: Natural Ecosystems and Native Species nutritionist and membership in the Academy of Nutrition and
(Pineapple Press, 2004). Now retired, and more concerned Dietetics.
about climate change than any other issue, she volunteers
full-time for the nonpartisan national nonprofit Citizens
Climate Lobby.
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Brief Contents
CHAPTER 1 An Overview of Nutrition 2
Highlight 1 > Nutrition Information and Misinformation 28
CHAPTER 2 Planning a Healthy Diet 34
Highlight 2 > Plant-Based Diets 60
CHAPTER 3 Digestion, Absorption, and Transport 66
Highlight 3 > Common Digestive Problems 85
CHAPTER 4 The Carbohydrates: Sugars, Starches, and Fibers 92
Highlight 4 > Carbs, kCalories, and Controversies 122
CHAPTER 5 The Lipids: Triglycerides, Phospholipids, and Sterols 126
Highlight 5 > High-Fat Foods—Friend or Foe? 158
CHAPTER 6 Protein: Amino Acids 166
Highlight 6 > Nutritional Genomics 188
CHAPTER 7 Energy Metabolism 194
Highlight 7 > Alcohol in the Body 218
CHAPTER 8 Energy Balance and Body Composition 228
Highlight 8 > Eating Disorders 248
CHAPTER 9 Weight Management: Overweight, Obesity, and Underweight 256
Highlight 9 > The Latest and Greatest Weight-Loss Diet—Again 284
CHAPTER 10 The Water-Soluble Vitamins: B Vitamins and Vitamin C 288
Highlight 10 > Vitamin and Mineral Supplements 321
CHAPTER 11 The Fat-Soluble Vitamins: A, D, E, and K 328
Highlight 11 > Antioxidant Nutrients in Disease Prevention 348
CHAPTER 12 Water and the Major Minerals 352
Highlight 12 > Osteoporosis and Calcium 380
CHAPTER 13 The Trace Minerals 386
Highlight 13 > Phytochemicals and Functional Foods 410
CHAPTER 14 Fitness: Physical Activity, Nutrients, and Body Adaptations 416
Highlight 14 > Supplements as Ergogenic Aids 443
CHAPTER 15 Life Cycle Nutrition: Pregnancy and Lactation 448
Highlight 15 > Fetal Alcohol Syndrome 479
CHAPTER 16 Life Cycle Nutrition: Infancy, Childhood, and Adolescence 482
Highlight 16 > Childhood Obesity and the Early Development of Chronic Diseases 521
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CHAPTER 17 Life Cycle Nutrition: Adulthood and the Later Years 526
Highlight 17 > Nutrient-Drug Interactions 550
CHAPTER 18 Disease Prevention 554
Highlight 18 > Complementary and Alternative Medicine 586
CHAPTER 19 Consumer Concerns about Foods and Water 594
Highlight 19 > Food Biotechnology 624
CHAPTER 20 Hunger and the Environment 630
Highlight 20 > Environmentally Friendly Food Choices 646
APPENDIX A Cells, Hormones, and Nerves
APPENDIX B Basic Chemistry Concepts
APPENDIX C Biochemical Structures and Pathways
APPENDIX D Measures of Protein Quality
APPENDIX E Nutrition Assessment
APPENDIX F Estimated Energy Needs
APPENDIX G Choose Your Foods: Food Lists for Diabetes and Weight Management
APPENDIX H Aids to Calculation
APPENDIX I WHO Nutrition Recommendations
Glossary GL-1
Index IN-1
INSIDE COVERS
Dietary Reference Intakes (DRI) A
Daily Values (DV) for Food Labels Y
Body Mass Index (BMI) Z
vi Brief Contents
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Table of Contents
Preface xiii 2.2 Diet-Planning Guides 40
Acknowledgments xvii USDA Food Patterns 40
Reviewers of Recent Editions xviii Food Lists 47
Putting the Plan into Action 47
CHAPTER 1 From Guidelines to Groceries 49
An Overview of Nutrition 2 2.3 Food Labels 53
The Ingredient List 53
1.1 Food Choices 3
Nutrition Facts Panel 54
1.2 The Nutrients 6
Claims on Labels 56
Nutrients in Foods and in the Body 6
Consumer Education 58
The Energy-Yielding Nutrients: Carbohydrate, Fat, and
Highlight 2 > Plant-Based Diets 60
Protein 7
The Vitamins 7
CHAPTER 3
The Minerals 11
Digestion, Absorption, and Transport 66
Water 11
1.3 The Science of Nutrition 12 3.1 Digestion 67
Conducting Research 12 Anatomy of the Digestive Tract 68
Analyzing Research Findings 14 The Muscular Action of Digestion 70
Publishing Research 16 The Secretions of Digestion 71
1.4 Dietary Reference Intakes (DRI) 17 The Final Stage 72
Establishing Nutrient Recommendations 17 3.2 Absorption 74
Establishing Energy Recommendations 20 Anatomy of the Absorptive System 75
Using Nutrient Recommendations 21 A Closer Look at the Intestinal Cells 75
Comparing Nutrient Recommendations 21 3.3 The Circulatory Systems 77
1.5 Nutrition Assessment 22 The Vascular System 77
Nutrition Assessment of Individuals 22 The Lymphatic System 79
Nutrition Assessment of Populations 24 3.4 The Health and Regulation of the GI Tract 80
1.6 Diet and Health 25 Gastrointestinal Microbes 80
Chronic Diseases 25 Gastrointestinal Hormones and Nerve Pathways 80
Risk Factors for Chronic Diseases 26 The System at Its Best 83
Highlight 1 > Nutrition Information and Misinformation 28 Highlight 3 > Common Digestive Problems 85
CHAPTER 2 CHAPTER 4
Planning a Healthy Diet 34 The Carbohydrates: Sugars, Starches,
and Fibers 92
2.1 Principles and Guidelines 35
Diet-Planning Principles 35 4.1 The Chemist’s View of Carbohydrates 93
Dietary Guidelines for Americans 38 Monosaccharides 94
Disaccharides 95
mages Polysaccharides 96
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4.3 Glucose in the Body 103
A Preview of Carbohydrate Metabolism 103
The Constancy of Blood Glucose 104
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4.4 Health Effects and Recommended Intakes of Sugars 107 Roles of Proteins 175
Health Effects of Sugars 108 A Preview of Protein Metabolism 178
Recommended Intakes of Sugars 111 6.4 Protein in Foods 180
Alternative Sweeteners 112 Protein Quality 181
4.5 Health Effects and Recommended Intakes of Starch and Complementary Proteins 181
Fibers 114 6.5 Health Effects and Recommended Intakes of Protein 182
Health Effects of Starch and Fibers 114 Health Effects of Protein 182
Recommended Intakes of Starch and Fibers 117 Recommended Intakes of Protein 183
From Guidelines to Groceries 118 From Guidelines to Groceries 184
Highlight 4 > Carbs, kCalories, and Controversies 122 Read Food Labels 185
Protein and Amino Acid Supplements 185
CHAPTER 5 Highlight 6 > Nutritional Genomics 188
The Lipids: Triglycerides, Phospholipids,
and Sterols 126 CHAPTER 7
Energy Metabolism 194
5.1 The Chemist’s View of Fatty Acids and Triglycerides 127
Fatty Acids 128 7.1 Chemical Reactions in the Body 195
Triglycerides 130 7.2 Breaking Down Nutrients for Energy 198
Characteristics of Solid Fats and Oils 131
Glucose 200
5.2 The Chemist’s View of Phospholipids and Sterols 134 Glycerol and Fatty Acids 203
Phospholipids 134 Amino Acids 205
Sterols 135 The Final Steps of Energy Metabolism 206
5.3 Digestion, Absorption, and Transport of Lipids 136 7.3 Feasting and Fasting 211
Lipid Digestion 136 Feasting—Excess Energy 211
Lipid Absorption 139 The Transition from Feasting to Fasting 212
Lipid Transport 139 Fasting—Inadequate Energy 212
5.4 Lipids in the Body 142 Low-Carbohydrate Diets 215
Roles of Triglycerides 142 Highlight 7 > Alcohol in the Body 218
Essential Fatty Acids 143
A Preview of Lipid Metabolism 144 CHAPTER 8
5.5 Health Effects and Recommended Intakes of Saturated Energy Balance and Body Composition 228
Fats, Trans Fats, and Cholesterol 145
8.1 Energy Balance 229
Health Effects of Saturated Fats, Trans Fats, and Cholesterol 146
8.2 Energy In: The kCalories Foods Provide 230
Recommended Intakes of Saturated Fat, Trans Fat, and
Food Composition 230
Cholesterol 147
Food Intake 231
5.6 Health Effects and Recommended Intakes of
8.3 Energy Out: The kCalories the Body Expends 233
Monounsaturated and Polyunsaturated Fats 147
Components of Energy Expenditure 233
Health Effects of Monounsaturated and Polyunsaturated
Estimating Energy Requirements 236
Fats 148
Recommended Intakes of Monounsaturated and 8.4 Body Weight and Body Composition 238
Polyunsaturated Fats 149 Defining Healthy Body Weight 238
From Guidelines to Groceries 150 Body Fat and Its Distribution 240
Highlight 5 > High-Fat Foods—Friend or Foe? 158 8.5 Health Risks Associated with Body Weight and Body Fat 243
Health Risks of Underweight 243
CHAPTER 6 Health Risks of Overweight and Obesity 243
Protein: Amino Acids 166 Other Considerations 245
Highlight 8 > Eating Disorders 248
6.1 The Chemist’s View of Proteins 167
Amino Acids 167
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Vitamin B 301
6
Folate 303
Vitamin B 307
12
m Choline 309
Mainka/Shutterstock.co 10.3 VNIVniiotttaeanrmmvaiicitnnta iC moC ni Rns3 osa1 lm3es3o 0n9g3 1t4he B Vitamins 309
Markus Vitamin C Recommendations 315
Vitamin C Deficiency 316
Vitamin C Toxicity 316
CHAPTER 9
Vitamin C Food Sources 317
Weight Management: Overweight, Obesity,
Highlight 10 > Vitamin and Mineral Supplements 321
and Underweight 256
CHAPTER 11
9.1 Overweight and Obesity 257
The Fat-Soluble Vitamins: A, D, E, and K 328
Fat Cell Development 257
Fat Cell Metabolism 258 11.1 Vitamin A and Beta-Carotene 329
Set-Point Theory 259
Vitamin A Roles 330
9.2 Causes of Overweight and Obesity 259 Vitamin A Deficiency 332
Genetics and Epigenetics 259 Vitamin A Toxicity 333
Environment 262 Vitamin A Recommendations 334
9.3 Problems of Overweight and Obesity 264 Vitamin A Food Sources 334
Health Risks 264 11.2 Vitamin D 336
Perceptions and Prejudices 264 Vitamin D Roles 337
Dangerous Interventions 265 Vitamin D Deficiency 338
9.4 Aggressive Treatments for Obesity 266 Vitamin D Toxicity 339
Drugs 266 Vitamin D Recommendations and Sources 339
Surgery 266 11.3 Vitamin E 341
Other Medical Procedures 267 Vitamin E Roles 342
9.5 Lifestyle Strategies 268 Vitamin E Deficiency 342
Changes, Losses, and Goals 268 Vitamin E Toxicity 342
Eating Patterns 268 Vitamin E Recommendations 342
Physical Activity 271 Vitamin E Food Sources 342
Environmental Influences 273 11.4 Vitamin K 343
Behavior and Attitude 274 Vitamin K Roles 343
Weight Maintenance 276 Vitamin K Deficiency 343
Prevention 277 Vitamin K Toxicity 344
Community Programs 277 Vitamin K Recommendations and Sources 344
9.6 Underweight 278 Highlight 11 > Antioxidant Nutrients in Disease Prevention 348
Problems of Underweight 278
Weight-Gain Strategies 278 CHAPTER 12
Highlight 9 > The Latest and Greatest Weight-Loss Water and the Major Minerals 352
Diet—Again 284
12.1 Water and the Body Fluids 353
Distribution and Movement of Body Fluids 354
CHAPTER 10
Regulation of Fluid Balance 356
The Water-Soluble Vitamins: B Vitamins
Fluid and Electrolyte Imbalance 357
and Vitamin C 288
Acid–Base Balance 358
Water Balance and Recommended Intakes 360
10.1 The Vitamins—An Overview 289
12.2 The Minerals—An Overview 363
10.2 The B Vitamins 292
Thiamin 293 12.3 The Major Minerals 364
Riboflavin 296 Sodium 364
Niacin 298 Chloride 367
Biotin 300 Potassium 368
Pantothenic Acid 300 Calcium 370
Table of Contents ix
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Phosphorus 374 Placental Development 450
Magnesium 376 Fetal Growth and Development 450
Sulfur 377 Critical Periods 452
Highlight 12 > Osteoporosis and Calcium 380 15.3 Maternal Weight 455
Weight prior to Conception 455
CHAPTER 13 Weight Gain during Pregnancy 455
The Trace Minerals 386 Exercise during Pregnancy 457
15.4 Nutrition during Pregnancy 458
13.1 The Trace Minerals—An Overview 387
Energy and Nutrient Needs during Pregnancy 459
13.2 The Trace Minerals 389
Common Nutrition-Related Concerns of Pregnancy 462
Iron 389
15.5 High-Risk Pregnancies 463
Zinc 398
The Infant’s Birthweight 464
Copper 401
Malnutrition and Pregnancy 464
Manganese 402
Food Assistance Programs 465
Iodine 403
Maternal Health 465
Selenium 404
The Mother’s Age 466
Fluoride 405
Practices Incompatible with Pregnancy 468
Chromium 406
Molybdenum 406 15.6 Nutrition during Lactation 470
Lactation: A Physiological Process 471
13.3 Contaminant Minerals 407
Breastfeeding: A Learned Behavior 471
Highlight 13 > Phytochemicals and Functional Foods 410
Maternal Energy and Nutrient Needs
during Lactation 472
CHAPTER 14
Maternal Health 474
Fitness: Physical Activity, Nutrients, and Body
Practices Incompatible with Lactation 475
Adaptations 416
Highlight 15 > Fetal Alcohol Syndrome 479
14.1 Fitness 417
CHAPTER 16
Benefits of Fitness 417
Developing Fitness 420 Life Cycle Nutrition: Infancy, Childhood,
The Components of Fitness 421 and Adolescence 482
Cardiorespiratory Endurance 421
16.1 Nutrition during Infancy 483
Muscle Strength and Endurance 422
Energy and Nutrient Needs 483
14.2 Energy Systems and Fuels to Support Activity 423
Breast Milk 485
The Energy Systems of Physical Activity 423
Infant Formula 488
Glucose Use during Physical Activity 425
Special Needs of Preterm Infants 490
Fat Use during Physical Activity 428
Introducing Cow’s Milk 490
Protein Use during Physical Activity—and between
Complementary Foods 491
Times 428
Mealtimes with Toddlers 494
14.3 Vitamins and Minerals to Support Activity 431
16.2 Nutrition during Childhood 495
Dietary Supplements 431
Energy and Nutrient Needs 495
Iron—A Mineral of Concern 431
Hunger and Malnutrition in Children 497
14.4 Fluids and Electrolytes to Support Activity 432 The Malnutrition-Lead Connection 498
Temperature Regulation 433 Hyperactivity and “Hyper” Behavior 499
Sports Drinks 435 Food Allergy and Intolerance 500
Poor Beverage Choices: Caffeine and Alcohol 437 Childhood Obesity 502
14.5 Diets for Physically Active People 437
Choosing a Diet to Support Fitness 437
Meals before and after Competition 439 m
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Life Cycle Nutrition: Pregnancy and Lactation 448 ATIST
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15.1 Nutrition prior to Pregnancy 449
15.2 Growth and Development during Pregnancy 450
x Table of Contents
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