Metabolic Issues Of Clinical Nutrition

As widely spread health problems related to over-and undernutrition have grown nowadays to an epidemic extent and even prevail over infectious diseases, a better knowledge of the metabolic basis of clinical nutrition has become essential. The extremes of the nutritional spectrum, undernutrition and obesity, are no longer considered as isolated opposites with different effects on separate risk groups, but paradoxically prove to be interacting in a setting of rapidly changing lifestyles, as is presently the case worldwide. Recurring issues such as insulin resistance, changes in intermediary metabolism, fluid and electrolyte physiology, genetic and non-genetic inheritance are highlighted, as well as the biological linkage between maternal undernutrition and the development of obesity, diabetes and cardiovascular disease in later life. The problems at stake present a new and enormous challenge for future healthcare policies and, therefore, are better tackled today. This book will be an interesting source of knowledge for internists, family physicians, pediatricians, dieticians, endocrinologists, gastroenterologists, and public health officers.

The field of clinical nutrition as a whole seeks to consider the nutrition of patients within the healthcare system, paying attention to the interactions between diet, nutrition, and disease. To that end, this book discusses nutrition as both a contributing and managing factor in relation to diseases such as obesity and diabetes. It also presents malnutrition as a contributing factor to such diseases and considers the efficacy of micronutrient supplementation. It ends by looking at some of the recent developments and future trends in the field of clinical nutrition.

As widely spread health problems related to over- and undernutrition have grown nowadays to an epidemic extent and even prevail over infectious diseases, a better knowledge of the metabolic basis of clinical nutrition has become essential. The extremes of the nutritional spectrum, undernutrition and obesity, are no longer considered as isolated opposites with different effects on separate risk groups, but paradoxically prove to be interacting in a setting of rapidly changing lifestyles, as is presently the case worldwide. Recurring issues such as insulin resistance, changes in intermediary metabolism, fluid and electrolyte physiology, genetic and non-genetic inheritance are highlighted, as well as the biological linkage between maternal undernutrition and the development of obesity, diabetes and cardiovascular disease in later life. The problems at stake present a new and enormous challenge for future healthcare policies and, therefore, are better tackled today. This book will be an interesting source of knowledge for internists, family physicians, pediatricians, dieticians, endocrinologists, gastroenterologists, and public health officers.

This text presents a compilation of topics that have been taught at Metabolic University (MU), an interactive, didactic educational program that has trained over 600 metabolic dietitians/nutritionists, physicians, nurses and genetic counselors. This book was created in 2014 for the metabolic community. The 1st edition contains only subject matter covered at Metabolic University; therefore, it is not a comprehensive treatise on Inherited Metabolic Disorders (IMD) but rather a text on the most frequently encountered challenges in IMD nutrition. Each chapter in the book highlights principles of nutrition management, how to initiate a diet, and biomarkers to monitor the diet. Recognizing that there are variations in practice, this book addresses that the key to management lies in the understanding how the inactivity of an enzyme in a metabolic pathway determines which components of the diet must be restricted and which must be supplemented as well as the monitoring of appropriate biomarkers to make diet adjustments and ensure the goals of therapy are met The 2nd edition is an updated and more extensive version covering the nutrition management of IMD, and covers a wide range of these disorders, including phenylketonuria and other aminoacidopathies, organic acidemias, urea cycle disorders, fatty acid oxidation disorders, galactosemia and glycogen storage diseases. Guidance is also provided on laboratory evaluations and biochemical testing and monitoring. Topics such as newborn screening for IMD, as well as nutrition management during pregnancy and transplantation, are also addressed. In addition, current medical management therapies is included.

Nutrition and Metabolism: Underlying Mechanisms and Clinical Consequences brings together internationally recognized experts to comprehensively review our current understanding of how nutrition interacts with the genetic substrate as well as environmental-exogenous factors, including physical activity or the lack thereof, to result in insulin resistance and the metabolic syndrome. After presenting the scope of the problem, the first major part of the book is devoted to genetics and pathophysiology, the second part of the book presents the public health perspective of the most prevalent problems associated with nutrition and the metabolic syndrome, whereas the third major part of the book focuses on clinical assessment and management of the main disease states associated with inappropriate nutrition and the metabolic syndrome. Finally, general information useful for both clinicians and researchers alike is presented in the Appendix. Nutrition and Metabolism: Underlying Mechanisms and Clinical Consequences offers the reader an up-to-date and authoritative review of the major scientific and clinical aspects of the overlapping areas between nutrition and metabolism.

5 Stars! Doody's Book Review Written by the foremost nutritionists in the United States, each of whom has more than 15 years of clinical experience providing nutrition management of patients with an inherited metabolic disorder (IMD), Nutrition Management of Patients with Inherited Metabolic Disorders supplies information to enhance the knowledge and skills needed by nutritionists/dietitians and other health care professionals who provide services to patients with IMDs. Many disorders that are disastrous to patients have been diagnosed and managed by diet, improving neurological and physical outcomes. However, nutrition problems still occur, whether due to the quality of the medical foods, inadequate prescription by health care providers or poor diet adherence by the patient. This book describes these problems and helps medical food manufacturers, medical geneticists, nutritionists/dietitians, and other health care providers find alternative forms of nutrients that would provide optimal nutrition and health for the patients.

The prevalence of metabolic syndrome (MS) is rising in developing countries and developed countries at such high rates that it is now considered a worldwide public health problem of pandemic proportions. Yet its spread can usually be mitigated by diet and lifestyle behavior. Nutritional Intervention in Metabolic Syndrome brings together coverage of dietary patterns and dietary components to create a complete understanding of the mechanisms by which these diets and components may improve metabolic syndrome. It then presents information on how to treat MS through lifestyle change and nutritional intervention. Witten by experts, the book focuses on diet therapy, nutritional intervention, and oxidative stress in metabolic syndrome. It presents information on dietary patterns in metabolic syndrome, including Mediterranean style diets, DASH, and low calorie diets. The text then provides an understanding of the physiopathology mechanisms in metabolic syndrome and strategies to treat these conditions through nutritional intervention. Chapters cover prevalence of MS, pathophysiology, MS in systemic lupus erythematosus and rheumatoid arthritis, gene-nutrient interactions, MS in adolescents and children, lifestyle change and physical activity, and various effects of dietary components in MS. Research studies examining food groups are important, and there is a trend in the literature to verify the relationship between dietary patterns and cardiovascular risk factors. However, studies examining dietary components, such as olive oil, soy-based products, n-3 polyunsaturated fatty acids, berries, whole grains, nuts, dairy foods, tea, coffee, and alcoholic beverages are also important. The coverage of both in this book gives you an understanding of the pathophysiology underlying MS that you can use to develop strategies to prevent and treat these conditions through nutritional intervention.

This book is a guide for clinicians seeking to use metabolic approaches in the care of hospitalized patients. Since a nutritional component exists for practically any disease process managed, it is important to properly address the macro- and micronutrient issues that can help facilitate a favourable clinical outcome. Metabolic medicine is a newly recognized speciality that applies proven nutritional approaches to support hospitalized patients within existing standards of care. Optimizing Metabolic Status for the Hospitalized Patient: The Role of Macro- and Micronutrition on Disease Management addresses the gap of nutrition knowledge among physicians who generally care for patients without addressing the nutritional and metabolic perspective. Features: State-of-the-art guidelines for practicing metabolic medicine in the hospital setting “Hands on” guide for day-to-day metabolic management of hospitalized patients Personal insights from one of the field’s leading practitioners, drawing upon decades of experience Historical reviews of key scientific developments This book is written by Dr Michael M. Rothkopf, Clinical Professor of Medicine at Rutgers/New Jersey Medical School. Dr Rothkopf founded the Metabolic Medicine Center at Morristown Medical Center and is the current Metabolic Medicine Consultant for the Heart Transplant, Lung Transplant, Cardiac Surgery and Wound Care Programs at RWJBH/Newark Beth Israel Medical Center. This book is directed at the physician level of hospital care. It provides value to a broad range of physicians regardless of their medical specialty or subspecialty. It will also be useful for medical students and resident physicians in training as well as nurse practitioners and physician assistants working in hospital settings.