Abc de la nutricion

ABC NUTRITION
OF
FOURTH EDITION

Written by A Stewart Truswell

ABC OF NUTRITION
Fourth Edition

ABC OF NUTRITION
Fourth Edition

A STEWART TRUSWELL
Emeritus Professor of Human Nutrition, University of Sydney, Australia

with contributions from PATRICK G WALL CIARA E O’REILLY the late CHRISTOPHER R PENNINGTON NIGEL REYNOLDS

© BMJ Publishing Group 1986, 1992, 1999, 2003All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording and/or otherwise, without the prior written permission of the publishers. First published in 1986 by BMJ Books, BMA House, Tavistock Square, London WC1H 9JR www.bmjbooks.com First edition 1986 Second edition1992 Third edition 1999 Fourth edition 2003 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 0 7279 1664 5 Typeset by Newgen Imaging Systems (P) Ltd., Chennai, India Printed and bound in Spain by Graphycems, Navarra Cover shows halved apple, with permission from Gusto productions/Science Photo Library

ContentsContributors Preface 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Reducing the risk of coronary heart disease Diet and blood pressure Nutritional advice for some other chronic diseases Nutrition for pregnancy Infant feeding Children and adolescents Adults young and old Malnutrition in developing countries Other nutritional deficiencies in affluent communities Vitamins and some minerals Overweight and obesity Measuringnutrition Therapeutic diets Food poisoning Patrick G Wall, Ciara E O’Reilly Food sensitivity Processing food Nutritional support Nigel Reynolds, Christopher R Pennington Some principles Index vi vii 1 10 15 20 24 32 37 43 52 59 69 78 87 94

15 16 17

108 113 120

18

125 133

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Contributors
Ciara E O’Reilly PhD Technical Executive, Food Safety Authority of Ireland, Dublin, IrelandChristopher R Pennington MD, FRCPEd Late Professor of Gastroenterology, Ninewells Hospital and Medical School, Dundee, Scotland Nigel Reynolds MB, ChB, MRCP Medicine and Cardiovascular Group, Department of Digestive Diseases and Clinical Nutrition, Ninewells Hospital and Medical School, Dundee, Scotland A Stewart Truswell AO, MD, DSc, FRCP, FRACP Emeritus Professor of Human Nutrition, University ofSydney, Australia Patrick G Wall MB, BCh, BAO, MRCVS, MFPMM Chief Executive, Food Safety Authority of Ireland, Dublin, Ireland

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Preface
Preface to 3rd edition
Nutrition is one of those subjects which comes up every day in general practice—or should do—yet in most undergraduate medical schools it is crowded out by the big clinical specialities and high technology procedures. It is forsubjects like nutrition that the British Medical Journal’s ABC series is extremely useful. This book was started when Dr Stephen Lock, previous editor of the BMJ asked me to write a series of weekly articles for an imagined general practitioner, in an unfashionable provincial town who had been taught almost no nutrition at medical school. They now felt the need to use nutrition in the practice, butcould spare only 15 to 20 minutes a week to read about it. The brief was that the writing must be practical and relevant; about half the page was to be for tables, figures, photographs or boxes (that is, not text) and these have to tell part of the story. The writing was to “come down off the fence”, to make up its mind on the balance of evidence and state it plainly. The first edition had noreferences but some reviewers asked for them and now in the era of evidence-based medicine some well chosen references seem indispensable when writing about nutrition. Nutritional concepts, of course, are not as tightly evidence-based as information about drugs because randomised controlled trials, so routine for drug therapy, are rare for nutrition. This book does not deal with all aspects of human...