Nutrición

ABC
NUTRITION
OF

FOURTH EDITION

Written by A Stewart Truswell

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, 2003

All rights reserved. No part ofthis 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 edition 1992
Third edition 1999Fourth 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

Contents
Contributors

viPreface

vii

1

Reducing the risk of coronary heart disease

1

2

Diet and blood pressure

10

3

Nutritional advice for some other chronic diseases

15

4

Nutrition for pregnancy

20

5

Infant feeding

24

6

Children and adolescents

32

7

Adults young and old

37

8

Malnutrition in developing countries

43

9

Other nutritionaldeficiencies in affluent communities

52

10

Vitamins and some minerals

59

11

Overweight and obesity

69

12

Measuring nutrition

78

13

Therapeutic diets

87

14

Food poisoning
Patrick G Wall, Ciara E O’Reilly

94

15

Food sensitivity

108

16

Processing food

113

17

Nutritional support
Nigel Reynolds, Christopher R Pennington

120

18Some principles

125

Index

133

v

450
Finland
USA

Australia
UK

Hungary
Japan

360

270

180

90

93

92

91

90

89

88

87

86

0
50
-5
4
55
-5
9
60
-6
4
65
-6
9
70
-7
4
75
-7
9
80
-8
4

For some doctors in affluent countries the first question about
prevention of coronary heart disease (CHD) nowadays is
whether to write aprescription for one of the statins
(simvastatin, pravastatin, fluvastatin, atorvastatin, etc) which
inhibit an early step of cholesterol biosynthesis in the body (see
p 7). Tables are available to show whether the 5- or 10-year risk
justifies the cost of long term statin medication, but the
relation of diet and CHD is still of primary importance for the
majority of people. What we eat isbound up with the aetiology
of CHD. Many people do not know their current plasma
cholesterol, many coronary deaths occur before medical help
and most countries cannot afford these expensive drugs.
Coronary heart disease is the largest single cause of death
in Britain and the disease that causes most premature deaths,
but it is only one-seventh as common in industrial Japan and
rare in themasses in most developing countries. Its incidence
must be environmentally determined because immigrant
groups soon take on the incidence rate of their new country
and there have been large changes in mortality over time.
Coronary heart disease was uncommon everywhere before 1925
and then increased steadily in Western countries until the
1970s, except for a dip during the Second World War.Age-standardised mortality rates from coronary heart disease in
the United States of America and Australia started to decline
from 1966 and have reduced by more than 70%. In Britain
rates are higher in Scotland and Ireland than in England, and
higher in the north of England than the south. They have been
declining since 1979 and have fallen by about 25%. Most
EU countries have shown similar...