6814_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 6814_FM_i-x 30/07/18 3:50 PM Page ii F. A. Davis Company 1915 Arch Street Philadelphia, PA 19103 www.fadavis.com Copyright © 2019 by F. A. Davis Company Copyright © 2019 by F. A. Davis Company. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Publisher: Megan Klim Manager of Project and eProject Management: Catherine H. Carroll Senior Content Project Manager: Christine Abshire Electronic Project Editor: Samantha Olin Illustration and Design Manager: Carolyn O’Brien 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 by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications 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 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: 978-0-8036-6814-0/18 + $.25. 6814_FM_i-x 30/07/18 3:50 PM Page iii 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 6814_FM_i-x 30/07/18 3:50 PM Page iv 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 6814_FM_i-x 30/07/18 3:50 PM Page v 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. 6814_FM_i-x 30/07/18 3:50 PM Page vi 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 6814_FM_i-x 30/07/18 3:50 PM Page vii 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 6814_FM_i-x 30/07/18 3:50 PM Page viii 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 6814_FM_i-x 30/07/18 3:50 PM Page ix 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