THIRD EDITION Nutrition in Pediatrics Basic Science and Clinical Applications W ALLAN WALKER, MD Division of Nutrition Harvard Medical School Boston, Massachusetts JOHN B WATKINS, MD Division of Gastroenterology and Nutrition Children’s Hospital Boston Harvard Medical School Boston, Massachusetts CHRISTOPHER DUGGAN, MD, MPH Division of Gastroenterology and Nutrition Children’s Hospital Boston Harvard Medical School Boston, Massachusetts 2003 BC Decker Inc Hamilton • London BC Decker Inc P.O Box 620, L.C.D Hamilton, Ontario L8N 3K7 Tel: 905-522-7017; 800-568-7281 Fax: 905-522-7839; 888-311-4987 E-mail: info@bcdecker.com www.bcdecker.com © 2003 W Allan Walker, MD, John B Watkins, MD, Christopher Duggan, MD, MPH Previous copyright BC Decker Inc 1996 under ISBN 1-55009-026-7 All rights reserved Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any 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Publishers’ Agency P.O Box 878 Kimberton, PA 19442 Tel: 610-827-1640 Fax: 610-827-1671 E-mail: jsco@voicenet.com Singapore, Malaysia,Thailand, Philippines, Indonesia, Vietnam, Pacific Rim, Korea Elsevier Science Asia 583 Orchard Road #09/01, Forum Singapore 238884 Tel: 65-737-3593 Fax: 65-753-2145 Australia, New Zealand Elsevier Science Australia Customer Service Department STM Division Locked Bag 16 St Peters, New South Wales, 2044 Australia Tel: 61 02 9517-8999 Fax: 61 02 9517-2249 E-mail: stmp@harcourt.com.au www.harcourt.com.au Mexico and Central America ETM SA de CV Calle de Tula 59 Colonia Condesa 06140 Mexico DF Mexico , Tel: 52-5-5553-6657 Fax: 52-5-5211-8468 E-mail: editoresdetextosmex@prodigy.net.mx Argentina CLM (Cuspide Libros Medicos) Av Córdoba 2067 - (1120) Buenos Aires, Argentina Tel: (5411) 4961-0042/(5411) 4964-0848 Fax: (5411) 4963-7988 E-mail: clm@cuspide.com Brazil Tecmedd Av Maurílio Biagi, 2850 City Ribeirão Preto – SP – CEP: 14021-000 Tel: 0800 992236 Fax: (16) 3993-9000 E-mail: tecmedd@tecmedd.com.br Notice: The authors and publisher have made every effort to ensure that the patient care recommended herein, including choice of drugs and drug dosages, is in accord with the accepted standard and practice at the time of publication However, since research and regulation constantly change clinical standards, the reader is urged to check the product information sheet included in the package of each drug, which includes recommended doses, warnings, and contraindications This is particularly important with new or infrequently used drugs Any treatment regimen, particularly one involving medication, involves inherent risk that must be weighed on a case-by-case basis against the benefits anticipated The reader is cautioned that the purpose of this book is to inform and enlighten; the information contained herein is not intended as, and should not be employed as, a substitute for individual diagnosis and treatment DEDICATIONS To the memory of Myriam Puig, MD, PhD, a contributor to the second and third editions of this textbook Dr Puig succumbed to cancer in September 2002 Her professional life was dedicated to the nutritional health of underprivileged Venezuelan children and her publications to the benefit of nutrition for children everywhere — W ALLAN WALKER To my colleagues, students, residents, and fellows, who continue to provide me with the stimulation and inspiration to learn and ask new questions, and to my daughters, Sarah Watkins and Leah Watkins Beane, and my wife, Mary Watkins, for their continued love and support — JOHN B WATKINS To Catherine and John Duggan, who nourished me from the beginning and inspired a career in medicine; to Michael, Brendan, and Emily Duggan, and the rest of the world’s children, for their optimal nutrition; and to Deborah Molrine, for constant love and support — CHRISTOPHER DUGGAN This page intentionally left blank CONTENTS Preface ix Contributors xi I GENERAL CONCEPTS Pediatric Nutrition: A Distinct Subspecialty William C MacLean Jr, MD, Alan Lucas, MD, FRCP FMed.Sci , Clinical Assessment of Nutritional Status Irene E Olsen, PhD, RD, Maria R Mascarenhas, MD, Virginia A Stallings, MD Laboratory Assessment of Nutritional Status 17 Clifford W Lo, MD, MPH, ScD, Aime O’Bryan, RD, LD, CNSD Body Composition and Growth 32 Lori J Bechard, MEd, RD, LD, Myriam Puig, MD, PhD 5.1 Macronutrient Requirements for Growth: Fat and Fatty Acids 52 Christine L Williams, MD,MPH, Richard J Deckelbuam, MD 5.2 Macronutrient Requirements for Growth: Carbohydrates 67 Jonathan E Teitelbaum, MD, Susan B Roberts, PhD 5.3 Macronutrient Requirements for Growth: Protein and Amino Acids 73 Leticia Castillo, MD Trace Elements 86 Nancy F Krebs, MD, MS, K Michael Hambidge, MD, ScD Vitamins 111 Eduardo Villamor, MD, DrPH, Roland Kupka, BS, Wafaie Fawzi, MD, DrPH The Prudent Diet: Preventive Nutrition 134 Ronald M Lauer, MD, Linda G Snetselaar, RD, LD, PhD 9.1 Community Nutrition and Its Impact on Children: Developed Countries 142 Johanna Dwyer, DSc, RD, Melanie A Stuart, MS, RD, Kristy M Hendricks, DSc, RD 9.2 Community Nutrition and its Impact on Developing Countries (The Chilean Experience) 161 Gerardo Weisstaub, MD, MSc, Magdalena Araya, MD, PhD, Ricardo Uauy, MD, PhD 10 Protein-Energy Malnutrition: Pathophysiology, Clinical Consequences, and Treatment 174 Mary E Penny, MB, ChB 11 International Nutrition 195 Benjamin Caballero, MD, PhD, Asim Maqbool, MD v vi 12 Contents Nutritional Epidemiology 205 Carine M Lenders, MD, MS, Walter Willett, MD, DrPH 13 Food Safety 219 Catherine E Woteki, PhD, RD, Brian D Kineman, MS 14 Drug Therapy and the Role of Nutrition 234 Kathleen M Gura, PharmD, BCNSP FASHP Lingtak-Neander Chan, PharmD, BCNSP , , II 15 PHYSIOLOGY AND PATHOPHYSIOLOGY Gene Expression 256 Mona Bajaj-Elliott, BSc, PhD, Ian R Sanderson, MD, MSc, MRCP 16 Humoral Regulation of Growth 277 William E Russell, MD, J Marc Rhoads, MD 17 Energy Metabolism and Requirements In Health and Disease 304 Jean-Louis Bresson, MD, Jean Rey, MD, FRCP 18 Gastrointestinal Development: Implications for Infant Feeding 323 Robert K Montgomery, PhD, Richard J Grand, MD 19 Immunophysiology and Nutrition of the Gut 341 Elizabeth E Mannick, MS, MD, Zili Zhang, MD, PhD, John N Udall Jr, MD, PhD 20 Malnutrition and Host Defenses 367 Susanna Cunningham-Rundles, PhD, David F McNeeley, MD, MPHTM 21 Brain Development 386 Maureen M Black, PhD 22 Nutrition and the Behavior of Children 397 Kathleen S Gorman, PhD, Elizabeth Metallinos-Katasaras, PhD, RD 23 Energy and Substrate Regulation in Obesity 414 Susan B Roberts, PhD, Daniel J Hoffman, PhD III 24 PERINATAL NUTRITION Maternal Nutrition and Pregnancy Outcome 429 Theresa O Scholl, PhD, MPH 25 Fetal Nutrition and Imprinting 442 Hilton Bernstein, MD, Donald Novak, MD 26 Development of the Fetus: Carbohydrate and Lipid Metabolism 449 William W Hay Jr, MD 27 Amino Acid Nutrition in Utero: Placental Function and Metabolism 471 Timothy R H Regnault, PhD, Frederick C Battaglia, MD 28 The Low Birth Weight Infant 491 Richard J Schanler, MD 29 The Term Infant 515 Ekhard E Ziegler, MD, Samuel J Fomon, MD, Susan J Carlson, MMSc, RD, CSP LD, CNSD , Contents 30 vii Weaning: Pathophysiology, Practice, and Policy 528 Kristy M Hendricks, DSc, RD 31 Human Milk: Nutritional Properties 539 Jenifer R Lightdale, MD, Jill C Fulhan, MPH, RD, LD, IBCLC, Clifford W Lo, MD, MPH, ScD 32 Protective Properties of Human Milk 551 Armond S Goldman, MD, Randall M Goldblum, MD, Frank C Schmalstieg Jr, MD, PhD 33 Approach to Breast-Feeding 562 Ruth Lawrence, MD, Robert M Lawrence, MD IV 34 NUTRITIONAL ASPECTS OF SPECIFIC DISEASE STATES Developmental Disabilities 580 Babette S Zemel, PhD, Virginia A Stallings, MD 35 Inborn Errors of Fasting Adaptation 591 Jon Oden, MD, William R Treem, MD 36 Persistent Renal Failure 609 Rita D Swinford, MD, Ewa Elenberg, MD, Julie R Ingelfinger, MD 37 Inflammatory Bowel Disease 635 Robert B Heuschkel, MBBS, MRCPCH, John Walker-Smith, MD, FRCP FRACP FRCPCH , , 38 Pediatric HIV Infection 653 Tracie L Miller, MS, MD, Colleen Hadigan, MD, MPH 39 Exocrine Pancreatic Disease Including Cystic Fibrosis 671 Kevin J Gaskin, MD, FRACP Jane Allen, PhD, DipNutrDiet , 40 Acute and Chronic Liver Disease 686 Deirdre A Kelly, MD, FRCP FRCPI, FRCPCH , 41.1 Cancer Prevention 699 Richard S Rivlin, MD, Susanna Cunningham-Rundles, PhD 41.2 Cancer Treatment 709 Sarah J Schwarzenberg, MD, Sally Weisdorf-Schindele, MD 42 Diabetes Mellitus 722 Joseph I Wolfsdorf, MB, BCh, Maryanne Quinn, MD, Roberta D Laredo, RD, LD, CDE 43 Acute Diarrhea 738 Caleb K King, MD, PhD, Christopher Duggan, MD, MPH 44 Chronic Diarrhea and Intestinal Transplantation 752 Olivier Goulet, MD, PhD 45 Short-Bowel Syndrome, Including Adaptation 771 Jon A Vanderhoof, MD 46 The Critically Ill Child 790 Patrick J Javid, MD, Tom Jaksic, MD, PhD 47 Hyperlipidemia and Cardiovascular Disease 799 Sarah D deFerranti, MD, MPH, Ellis Neufeld, MD, PhD viii 48 Contents Carbohydrate Absorption and Malabsorption 811 Martin H Ulshen, MD 49 Nutritional Anemias 830 Paul Harmatz, MD, Ellen Butensky, RN, MSN, PNP Bertram Lubin, MD , 50 Function and Nature of the Components in the Oral Cavity 848 James H Shaw, DMD, PhD, Linda P Nelson, DMD, MScD, Catherine Hayes, DMD, DMSc 51.1 Adolescence: Healthy and Disordered Eating 861 Ellen S Rome, MD, MPH, Isabel M Vazquez, MS, RD, LD, Nancy E Blazar, RD, LD 51.2 The Adolescent Athlete: Performance-Enhancing Drugs and Dietary Supplements 878 Jordan D Metzl, MD 51.3 Adolescence: Bone Disease 883 Keith J Loud, MD, CM, Catherine M Gordon, MD, MS 52 Failure to Thrive: Malnutrition in the Pediatric Outpatient Setting 897 Robert Markowitz, MD, Christopher Duggan, MD, MPH 53 Protein-Energy Malnutrition in the Hospitalized Patient 910 Susan S Baker, MD, PhD 54 Evaluation and Management of Obesity 917 Carine M Lenders, MD, MS, Alison G Hoppin, MD V 55 APPROACH TO NUTRITIONAL SUPPORT Standard and Specialized Enteral Formulas 935 Tien-Lan Chang, MD, Ronald E Kleinman, MD 56 Enteral Nutrition 945 Maria-Luisa Forchielli, MD, MPH, FACG, Julie Bines, MD, FRACP 57 Parenteral Nutrition 957 John A Kerner Jr, MD 58 Dietary Supplements (Nutraceuticals) 986 Steven H Zeisel, MD, PhD, Karen E Erickson, MPH 59 Special Diets 997 Sherri Utter, MS, RD, LD, CNSD, Sharon B Collier, MEd, RD, LD APPENDIX I Nutritional Assessment 1017 Gina Hardiman, RD, LD II Nutritional Requirements 1050 Gina Hardiman, RD, LD III Enteral Products 1060 Gina Hardiman, RD, LD PREFACE B ecause the field of nutrition is actively evolving and creating major new principles in the care of the pediatric patient, we have embarked on the third edition of this textbook The editors continue to support the premise that a comprehensive text as a reference source in pediatric nutrition is essential for the proper care of infants and children As medical care in the twenty-first century is predicated on prevention of disease, the discipline of pediatric nutrition becomes that much more important For example, we now know from the Barker hypothesis that intrauterine nutrition and weight gain during the first year of life are important predictors of chronic diseases of adulthood (cardiovascular disease, diabetes, and hypertension) In addition, as we attempt to cope with the worldwide epidemic of obesity and its concomitant “syndrome X,” we recognize that a healthful diet and attention to weight gain must begin in early childhood before “bad” eating habits are established Furthermore, as parents seek a more healthful lifestyle for themselves and their children, they are assessing conventional approaches to treatment of disease and are seeking alternative forms of treatment and prevention An example of this alternative approach is the use of probiotics to treat diarrhea, prevent daycare infections, and cope with the “hygiene hypothesis” for the development of atopic disease Therefore, an updated access to clinical research-based information on the appropriate use of nutrition as an alternative form of therapy is essential for the practicing physician As with the first edition, we commissioned a comprehensive review of the second edition of this textbook to ensure the most updated and extensive coverage of nutrition This review led to the addition of several chapters to each major section of the book In the “General Concepts” section, the macronutrient requirement for growth chapter has been expanded to three chapters separately dealing with fat, carbohydrate, and protein We have added new chapters on nutritional epidemiology, food safety, and international nutrition In a newly added section entitled “Physiology and Pathophysiology,” we have considered the role of nutrition in major body functions and dysfunctions including gene expression, immunophysiology, brain development, obesity, and behavior The “Perinatal Nutrition” section, added to the second edition, has been expanded further to include chapters on maternal nutrition and pregnancy outcome and fetal nutrition and imprinting The section on specific disease states has been expanded to include “The Adolescent Athlete and Dietary Supplements,” “Nutrition and the Prevention of Cancer in Childhood,” and “Evaluation and Management of Obesity.” In keeping with the changing approach of care to pediatric patients, chapters have been added in dietary supplements (nutraceuticals) and special diets in the “Nutrition Support” section Finally, the Appendix has been expanded to provide a more comprehensive resource for nutritional assessment and requirements and updated information on enteral products As in previous editions, authors have been newly selected or retained based on their expertise in the topic of their chapter and their willingness to provide the most updated views on the subject In general, we believe that the third edition will provide a comprehensive resource for the health care provider for children entering the twenty-first century For this edition, Dr Christopher Duggan has been added as an editor His comprehensive knowledge of clinical care for the hospitalized patient, experience in nutritional issues in developing countries, and extensive experience in clinical nutrition research have been welcomed by the editors The editors wish to again thank Ms Suzzette McCarron for her organizational talents and her ability to liaison between authors, editors, and the publisher Without her extensive efforts this textbook would never have been possible We also thank Ms Carlotta Hayes for her many contributions The editors are also grateful to Mr Brian Decker, Ms Jamie White, and the able staff of BC Decker Inc for their help and support in further developing this edition and in the publication of this textbook W Allan Walker John B Watkins Christopher Duggan ix 1088 Index examination of, 8t Gut cystic fibrosis, 674 immunophysiology, 341–357 Gut-associated lymphoid tissue (GALT), 368 Gut flora, 704 malnutrition, 185 HAART, 655–656 Habituation, 389 HACCP 231 , Haemophilus influenzae, 344, 370, 554 Hair analysis of, 17–18 examination of, 8t malnutrition, 181–182 Hand washing for food preparation, 228 Hazard Analysis Critical Control Point System (HACCP), 231 HCT adverse effects, 710 HDL, 134, 801 Head circumference-for-age percentiles boys, 1019 girls, 1021 circumference of, in developmental disabilities, 584–585 Head Start, 156 Healthy Eating Index, 146 Healthy People 2010, 143, 144t web site, 157 Healthy School Meals Resource System web site, 158 Heart disease connected to high cholesterol in young, 799–800 Height, median, 1058t Height velocity boys, 1035f girls, 1036f Helicobacter pylori, 121, 342, 372 vitamin C, 355 Helsinki Heart Study, 135 Hematology malnutrition, 181 Hematopoietic cell transplantation (HCT) adverse effects, 710 Hemicellulose, 71t Hemodialysis end-stage renal disease daily fluid and nutrient recommendations, 616t fluid and nutrient recommendations for, 622t nutritional aspects of, 622 Hemoglobin iron deficiency, 841 Hemolytic anemia premature infant, 837–838 Hemophilus influenzae, 937 Heparin, 243 required for parenteral nutrition, 969 Hepatic See also Liver amino acid metabolism, 481–483 CYP450, 914 drug metabolism nonalcoholic steatohepatitis, 239 enzyme elevations of, 716–717 mitochondrial fatty acid oxidation and ketogenesis, 596f, 597 Hepatitis A foodborne disease, 224 Hepatobiliary dysfunction with parenteral nutrition, 975–976 Herbal products, 928 pregnancy, 435 supplements, 990–991 Herbal teas, 571t Herbicides, 700–701 Hereditary fructose intolerance, 694 Hereditary vitamin D-resistant rickets (HVDRR), 250 HEV, 350 Hexose transporters, 332 Hickman catheter, 969–970, 977 High-calorie diet, 1005–1006 sample meal plan for, 1007 High cholesterol in young connected to heart disease, 799–800 High-density lipoproteins (HDL), 134, 801 High endothelial venules (HEV), 350 High-fiber diets, 1001 impact on drug kinetics, 241 Highly active or combination antiretroviral therapy (HAART), 655–656 Hindmilk, 502 composition of, 502t Hispanics body fat, 35 HIV See Human immunodeficiency virus (HIV) HMG-CoA lyase deficiency, 603 Home enteral nutrition, 953 Home environment food safety in, 227–231 Home parenteral nutrition, 976–980 complications of, 978–979 implementation of, 977–978 indications for, 977 long-term growth and nutritional problems, 979–980 monitoring of, 980 Homing receptor, 351f Homocystinemia and cardiac risk, 800–801 Hormonal replacement, 871 Hormones deficiencies hypoglycemia, 602 impact on bones, 884–885 involved in intestinal adaptation, 776t nutrient stimulation of, 259–260 Hospitalized patient energy requirements in, 1059t protein energy malnutrition, 910–915 child-centered factors, 915 nutritional status, 910–912 Hospital malnutrition, 26, 166, 911–913 Host defense endemic infection, 377–378 malnutrition, 367–379 protein-calorie malnutrition, 370–372 Host response nutrients modifying, 702–703 24-hour energy expenditure, 310–311 24-hour recall, 206–207, 867 Hudson River chemical contaminants in, 230 Human development, 161–162 Human immunodeficiency virus (HIV), 653–666 associated lipodystrophy, 665–666 clinical and biochemical abnormalities, 666t body composition, 654–656 cytokines, 659–660 endocrine disturbances, 660 energy metabolism, 658–659 gastrointestinal absorption, 657–658 growth, 654–656 immunologic abnormalities associated with, 654f malnutrition, 184t causes, 656t indicators of, 664f medications side effects, 657t micronutrients, 660–662 monitoring, diagnosing, treating, 663f nutrient deficiencies, 376–377 nutritional assessment, 662 nutritional interventions, 662–665 nutritional requirements for, 664t psychosocial factors, 660 wasting pathogenesis, 656–660 zinc deficiency in, 99 Human milk, 505–507 and allergic diseases, 555–556 antibacterial oligosaccharides, 554 antibodies, 553–554 anti-inflammatory factors in, 552t, 555–556 antiviral factors, 554 biochemical composition of, 541–542 biosynthesis of, cobalamin output, 835 cognition, 399–401 constituents of, 542t cytokines, 553t direct-acting antimicrobial factors in, 551–552, 552t and drugs, 546 and environmental pollutants, 546–547 essential fatty acids, 502 flavor of, 518 fortification of, 505–506 fortifiers Index comparison of, 506–507, 506t for premature infants, 1065t gene expression, 265 glycoconjugates, 554 HIV, 663 immunologic system in, 551 immunomodulating agents in, 553t, 556–557 increasing caloric density of, 1065t and infant growth, 540–541 iron, 518–519 leukocytes, 554–555 lipids, 501–503 malnutrition, 164, 186–187 medium chain fatty acids, 502–503 micronutrient, 200 nonprotein nitrogen, 542–543 nutrient composition of, 500t nutritional properties of, 539–547 oligosaccharides, 518 polychlorinated biphenyls, 227 protective properties of, 551–557 protein, 501, 541 protein content of, 77 secretory IgA antibodies, 552t storage of, 546 unfortified, 505 vitamin B12 output in, 835 vitamin D, 118 volume and composition of, 540 Humoral immunity malnutrition, 180 Hunger, 406–408 experimental studies, 406–407 HVDRR, 250 Hydralazine, 242 food effect on absorption, 240t Hydrochlorothiazide food effect on absorption, 240t Hydrogen peroxide, 178 Hydrogen peroxide hemolysis test, 837 Hydrometry, 43 Hydroxycobalamin, 837 21-hydroxylase deficiency, 602 Hydroxyl radical, 178 Hyperammonemia, 960 Hypercalcemia from vitamin D intoxication, 250 Hypercholesterolemia, 807 cholesterol levels, 136t Hyperglycemia, 245, 458–459 fetal response to, 459t with ketoacidosis, 723 with parenteral nutrition, 975 Hypericum perforatum, 990 activating P450, 989 Hyperinsulinemia, 598–600 hypoglycemia, 599 treatment of, 605 Hyperkalemia stress, 613 Hyperlipidemia, 801–803, 1008–1010 causes of, 802t diet for, 1011t medications for, 807t with renal transplantation, 626 soy for, 628 Hypermetabolism, 711–712 management of, 715–716 Hypernatremic dehydration, 744–745 Hyperosmolar non-ketotic syndrome, 723 Hyperparathyroidism persistent posttransplantation, 626 Hypervitaminosis, 248–249 Hypervitaminosis A, 249 Hypervitaminosis D, 249 Hypoalbuminemia with peritoneal dialysis, 620 Hypocupremia, 94 Hypogeusia zinc supplements for, 246 Hypoglycemia, 245, 457–458 fasting-induced, 600–601 fetal responses to, 458f hormone deficiencies, 602 hyperinsulinemia, 599 malnutrition, 184t medical and dietary treatment of, 604–606 with parenteral nutrition, 975 prevention of, 185–186 with prolonged fasting, 602–603 studies need during, 599t within to hours of fasting, 598–601 within to 16 hours of fasting, 601–602 Hypoinsulinemia, 177 Hypokalemia, 869 Hypolactasia adult-onset, 819 Hypomagnesemia, 245, 625 Hypophosphatemia, 177, 187 stress, 613 Hypothermia malnutrition, 184t prevention of, 186 IAP 136 , Ibuprofen for inflammatory syndrome, 316 IBW, 11, 871 ICW defined, 33t IDDM See Insulin-dependent diabetes mellitus (IDDM) Ideal body weight (IBW), 11, 871 IDPN, 623 IEC See Intestinal epithelial cells (IEC) IFN-gamma intestines, 345t IFVE, 761, 963t IGF See Insulin-like growth factor (IGF) IL See Interleukin with number (eg: Interlukin-1) Ileocecal valve, 772 Imaging, 45 Immune function enteral feeding, 645 environment, 356–357 malnutrition, 351–352 micronutrients, 372–376 nutrition, 350–356 total parenteral nutrition, 352–353 1089 vitamin C, 121 Immune response cancer risk, 702 malnourished host, 368f neonatal microenvironment, 368–379 Immune status assessment, 20t, 24–25 zinc deficiency, 91 Immune system changes in, 38 depression of, 754 malnutrition, 180 protein-calorie malnutrition, 654 vitamin D, 118 Immunity, 653–654 vitamin A, 114 Immunologic tolerance and human milk, 557 Immunomodulating agents in human milk, 556–557 Immunonutrition, 703–704 Immunosuppressive drugs, 623 Imprinting, 199 fetal nutrition, 442–446 Inadequate energy intake metabolic responses to, 175–176 Inborn errors of fasting adaptation, 591–606 Inborn errors of metabolism, 1010 fasting maladaptation, 598–604, 599t nutritional support for, 693–694 Incremental growth velocity, 10 Indian reservations food distribution of US Department of Agriculture, 155–156 Indicator amino acid balance, 83 Indicator amino acid oxidation, 83 Indinavir food effect on absorption, 240t side effects of, 657t Infant See also Low birth weight infants; Newborns adequate polyunsaturated fatty acids intake, 55f allergic weaning, 534 amino acid requirements of, 81 average daily body weight vs postnatal age, 1039f average weekly length vs postnatal age, 1039f brain size of, 70 breast-fed, 517–519 dietary intake of, energy and protein intakes, 517–518 growth of, 518 copper deficiency in, 97 energy intakes of, 517t energy requirements of, 517 feeding goals of, 515 guide, 536t trends in, 515 fluoride intake of, 105 1090 Index formula-fed, 516f formulas copper content of, 98 fatty acid composition of, 937 increasing caloric density of, 1065t recommended nutrient levels for, 936t weaning, 529–530 growth rate, 1037t head circumference vs postnatal age, 1040f intelligence measures, 389 low birth weight See Low birth weight infants morbidity vitamin A, 115 mortality, 539 nutritional recommendations, 149t nutritional status, 148, 149t premature See Premature infants protein intake, 78t protein requirements for, 77–78 term, 515–527 in utero fat content, 33 Infection growth Guatemala, 199f interaction with, 177–178 malnutrition, 184t, 376–379 nutrition, 198–199 prevention of, 755–756 vitamin A, 115 Infectious disease, 200 Inflammatory bowel disease, 635–647, 890 diet in etiology of, 635–636 indications for nutritional treatment, 638–639 micronutrient deficiencies, 637–638 nutritional complications of, 636–638 osteoporosis, 637 Inflammatory syndrome, 316–317 Information community level, 159 Information processing tests, 389–390 Infuse-A-Port, 977 Inosine monophosphate, 542 Inositol, 974–975 Insulin, 258 fetus, 454t glucose homeostasis, 592t nutrient interaction, 244t nutrient stimulation of, 259 plasma glucose metabolism, 453 premature infants tolerance, 960 Insulin-dependent diabetes mellitus (IDDM), 722 GI diets in, 724–725 medical nutrition therapy for history of, 723 Insulin-like growth factor (IGF) binding protein nutrient stimulation of, 259–260 liver disease, 688 Insulin-like growth factor (IGF-1), 776 binding proteins, 268–269 liver transplantation, 695 malnutrition, 371 nutrient stimulation of, 259–260 Insulin-like growth factor (IGF-2) nutrient stimulation of, 259–260 Intelligence measures, 389 Intelligence quotient (IQ), 386 Intelligence tests, 389 Intensive care enteral vs parenteral feeding, 611 nutritional support, 610–611 Interferon-gamma (IFN-gamma) intestines, 345t Interleukin-1 (IL-1), 178, 709 HIV, 659 with inflammatory bowel disease, 636–637 intestines, 345t protein deprivation, 371 Interleukin-2 (IL-2) intestines, 345t vitamin E, 355 Interleukin-3 (IL-3) intestines, 345t Interleukin-4 (IL-4) intestines, 345t Interleukin-5 (IL-5) intestines, 345t Interleukin-6 (IL-6), 178, 710 critically ill patients, 796 HIV, 659 intestines, 345t protein deprivation, 371 Interleukin-7 (IL-7) intestines, 345t Interleukin-8 (IL-8), 267 intestines, 345t Interleukin-10 (IL-10) intestines, 345t Interleukin-12 (IL-12) intestines, 345t Interleukin-13 (IL-13) intestines, 345t International Atherosclerosis Project (IAP), 136 International nutrition, 195–202 Intestinal adaptation, 773–774 applications of, 777–778 hormones involved in, 776t nutrients stimulation, 778t Intestinal allograft rejection of, 764 Intestinal epithelial cells (IEC), 341, 342–343 epithelium, 267f genes of immunologic importance, 267–268 immunologically relevant genes expressed by, 268t lymphocytes, 344–347 Intestinal failure permanent, 762–763 Intestinal graft function of, 764 Intestinal lumen signaling to mucosal immune system, 266–267 Intestinal motility stages in, 334f Intestinal mucosa immunophysiology, 342–350 Intestinal transplantation, 763–766 candidates for, 766 complications after, 763–764 indications for, 763 nutritional management after, 764–765 nutritional outcome after, 765–766 for short-bowel syndrome, 784–785 Intestines cytokines, 345t Intracellular water (ICW) defined, 33t Intradialytic parenteral nutrition (IDPN), 623 Intrauterine growth retardation (IUGR), 197, 458 fetal weights, glucose concentration, 459f Intrauterine nutrient accretion rates, 492t Intravenous carnitine low birth weight infants, 495 Intravenous fat complications with, 973–974 dosing for, 964t Intravenous fat emulsion (IFVE), 761, 963t Intravenous lipid emulsions, 494–495 Intravenous therapy, 183–184 Intrinsic sugars, 68 In utero nutrition glucose intolerance, 445–446 Inverted nipples, 567 Iodination of salt, 169 Iodine, 105–106 assessment, 20t dietary reference intakes during pregnancy, 430t Iodine deficiency brain development, 392–393 cognition, 403 Iron assessment, 20t blood iron deficiency, 841–842 breast milk, 518–519 deficiency, 356, 839–840 brain development, 393 etiology of, 840 fetal-maternal relationships, 839–840 laboratory findings, 841–842 manifestations of, 840–841 nonhematologic manifestations of, 841t therapy of, 842–843 deficiency anemia, 401–403, 689 in Crohn’s disease, 637–638 pregnancy, 429–430 vitamin A, 116 dietary reference intakes during pregnancy, 430t Index food sources of, 1014t formulas, 519 free radicals, 178 in human milk, 545–546 immune function, 373 low birth weight infants, 504 pregnancy, 429–430 regulatory effects on immune response, 374t required for parenteral nutrition, 968 requirements of, 840 rich diet, 1012 supplements, 187 Irritable bowel syndrome lactose intolerance, 822 Isomil, 522t Isomil 2, 525t Isomil DF 524t , Isoniazid, 239 food effect on absorption, 240t nutrient interaction, 244t, 245 nutrient interactions, 242 Isospora belli, 658 Itraconazole food effect on absorption, 240t IUGR, 197, 458, 459f Jacobi, Abraham, Japan westernized diets in, 58 Jejunal tube feeding complications of, 953t Jejunoileal bypass, 928 Jejunostomy tube, 948–949 Juices fruit foodborne disease, 228 weaning, 533–534 JumpSTART program, 806 Juvenile rheumatoid arthritis acetylsalicylic acid, 238 Kakke, 122 Kaposi’s sarcoma, 653 Kashin-Beck disease (KBD), 99 Keto acids oxidative decarboxylation, 122 Ketoconazole food effect on absorption, 240t side effects of, 657t Ketogenesis defects in, 603 fasting, 595 Ketolysis defects in, 603 fasting, 595 Ketothiolase deficiency, 603 Kidney changes in, 38 function and undernutrition, 610 growth nutritional aspects of, 609 insufficiency lipids, 617 nutritional management, 617–618 nutrition in, 613–614 Kidney disease chronic See Chronic kidney disease end-stage daily fluid and nutrient recommendations, 616t predialysis fluid and nutrient recommendations for, 619t Kitchens clean, 228 Knee-to-heel length, 586f Kwashiorkor, 175, 176f, 178, 179, 181, 352, 753, 838–839 drugs in, 238 zinc deficiency in, 99 Laboratory tests, 13 for nutritional status, 17–27 Lact-Aid, 576, 577f Lactalbumin, 552–553 Lactase genetic background, 331f Lactase-phlorizin hydrolase (LPH), 329–330 Lactation See also Breast feeding adolescents, 151 anatomy and physiology of, 562–563 breast preparation for, 565f calories for, 570 fenugreek, 571 folate, 126 initiation of, 568–569, 568f Lactobacilli, 745 Lactobacillus acidophilus, 991 Lactobacillus casei, 991 Lactoferrin, 265–266, 266, 552 Lactofree, 522t Lactose breath test correlated with ileal aspiration, 818f content in milk products, 825t free diet, 1005, 1006t free formulas, 522t intolerance adult-onset, 819 Lactose Free, 522t La Leche League International, 573 Lamina propria, 347–348 B lymphocytes, 347–348 T lymphocytes, 347 Lamivudine side effects of, 657t L-asparaginase, 246 Latching on, 549f Late-onset hypolactasia, 820 Late-onset lactose intolerance, 819 Later diet behaviors and early diet behaviors, 59 Latin America body fat, 35 malnutrition, 164 obesity urban vs rural, 202f Laxatives, 865 abuse vitamin D malabsorption, 242 LBM, 646 defined, 33t 1091 LCPUFA See Long chain polyunsaturated fatty acids (LCPUFA) LCT, 964 liver disease, 687 LDL, 134, 801 plasma levels of, 57 receptor gene, 58 Lead intoxication, 901 Lean body mass (LBM), 646 defined, 33t Leftover foods refrigeration of, 228 Legumes trace elements in, 95t Length, in developmental disabilities, 582–584 percentiles for, 1033t–1034t Length-for-age percentile boys, 1018 girls, 1020 Leptin, 543, 921 fetus, 464 Let-down reflex, 564 Leucine, 459, 605 placenta, 472 Leukemia, 700 Leukocytes human milk, 554–555 Leukotrienes, 179 Levodopa, 246 Levulose, 67 in diabetes mellitus, 729 source and use of, 67t Lidocaine in obesity, 238 protein effect on, 240 Light chain proteins amino acid transporter, 474–475 Lignin, 71t Linear growth changes in, 40 Lingual lipase, 326 Linoleic acid adequate intakes for children and adolescents, 55f deficiency of, 54 metabolic pathways of, 53f, 54f recommended intakes of, 54–55 Linolenic acid recommended intakes of, 54–55 Lipases in human milk, 544 Lipid, 885 age-based percentiles, 802t arginine, 353–354 assessment, 23–24 biochemistry of, 801 blood, 56–58 chronic kidney disease, 617 digestion, 333–334 disorders and cardiac risk, 800 phenotype and family history, 803t in enteral feeding, 759 essential defined, 33t fetus, 459–460 1092 Index human milk, 501–503 hydroperoxides, 119 levels, 136 liver disease, 690 metabolism, 179 critically ill patients, 794 fetus, 464 for nephrotic child, 627–628 soluble vitamins required for parenteral nutrition, 966–967 uptake placenta, 460–462 Lipopolysaccharide (LPS), 342 Lipoprotein (a) cardiovascular risk, 803–804 Lipoproteins assessment, 23–24 levels of, 57 lipase gene, 58 metabolism, 134 synthesis, 461 Lips examination of, 8t Liquid chromatography, 18 Liquid supplements, 872 Listeria monocytogenes, 222, 228 Lithium, 239 food effect on absorption, 240t nutrient interaction, 244t Liver See also Hepatic biochemical differentiation, 326 malnutrition, 180 morphogenesis, 326 postnatal function, 327 Liver disease anthropometric definitions, 689t cystic fibrosis, 674 formulas for, 690t in long-term parenteral nutrition, 762 malnutrition, 688 clinical manifestations of, 689t pathophysiology, 686–687, 686t nutritional assessment, 689 nutritional deficiency in assessment and management of, 692t nutritional support for, 691f, 693 nutritional therapy, 689–690 Liver transplantation effect on nutritional status, 694–695 nutritional support in, 694t preparation for, 694 Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency, 602–603 Long chain polyunsaturated fatty acids (LCPUFA), 400–401, 526, 543, 937 liver disease, 687–688, 690 Long chain triglycerides (LCT), 964 liver disease, 687 Long-term parenteral nutrition complications of, 762–763 Loratidine food effect on absorption, 240t Lorazepam, 235 Lovastatin, 807t food effect on absorption, 240t Low birth weight infants, 198f, 491–509 calcium, 495–496, 503–504 carbohydrates, 503 carnitine, 503 characteristics, 388 copper, 496, 504 electrolytes, 496 energy needs for, 492t energy source distribution, 492t enteral nutrition for, 491f fat, 501–503 feeding issues, 508 methods, 508 tolerance assessment, 507t formulas for, 1064t glutamine, 961–962 immunity, 370 intravenous carnitine, 495 iron, 504 magnesium, 495–496, 504 malnutrition, 197t minerals, 495–496 nutrient intakes, 491 nutrition assessment, 508–509 parenteral nutrition for, 491f, 958 phosphorus, 495–496, 503–504 potassium, 504 proteins, 500–501 selenium, 496 sodium, 504 total parenteral nutrition, 498t preparation of, 499t trace elements, 496–497, 504–505 TrophAmine, 493 vitamin A, 497 vitamin E, 497 vitamins, 504–505 water-soluble vitamins, 497–498 zinc, 496, 504 zinc deficiency in, 91–92 Low calories food preparation for, 1014–1015 Low-cholesterol diet, 1008 Low-density lipoproteins (LDL), 134, 801 plasma levels of, 57 receptor gene, 58 Lower esophageal sphincter pressure, 325f Lower-leg length, 587f in developmental disabilities, 585, 585f Low-lactose diet guidelines, 1005 Low-saturated fat diet, 1008 Low triceps skinfold, 898 LPAM-1, 350 LPH, 329–330 LPS, 342 Lumbar spine, 37 Lymphocyte Peyer’s patch HEV adhesion molecule (LPAM-1), 350 Lymphocytes intestinal epithelial cells, 344–347 lamina propria, 347–348 malnutrition, 371 Lysozyme, 543, 552–553 Macrocytic anemia, 125 Macroglobulin, 178 Macronutrients exocrine pancreatic disease, 677–679 maldigestion and malabsorption, 678 Macrophages, 349 Magnesium, 752–753 assessment, 20t dietary reference intakes during pregnancy, 430t intensive care, 611–612 low birth weight infants, 495–496, 504 regulatory effects on immune response, 374t supplements, 612t Magnetic resonance imaging (MRI), 45, 390 Maintenance energy requirement (MER), 315 Malabsorption associated with enteral feeding, 952t following small intestine resection, 772 syndromes, 241 Malaria nutritional consequences, 378 vitamin A, 116 Male runners food preoccupations, 865 Malnutrition body composition changes in, 40 cancer immunity, 701–703 changes induced by, 752–754 Chile prevention, 168–170 chronic infection, 376–379 classification of, 175t clinical management, 182–189 control, 166–168 defined, 174–175 dialysis, 622–623 diet, 188–189 dietary management, 186 drug kinetics, 236–237 energy expenditure, 311 energy substrate use, 312 examination and emergency treatment, 182–183 follow-up, 189 global public health problem, 162–164 HIV causes, 656t indicators of, 664f hospital, 26, 166, 911–913 vs community rehabilitation, 182 host defenses, 367–379 host response to cancer, 701–702 immune response, 368f immunologic changes in, 25t liver disease, 688 clinical manifestations of, 689t pathophysiology, 686–687, 686t low birth weight infants, 197t lymphocytes, 371 medical risk factors for, 900–901 Index model, 398f nutritional management, 187f organ changes in, 179 with peritoneal dialysis, 620 rehabilitation, 188–189, 189f systems changes in, 179 treatment cost-effectiveness, 167 selection, 170–171 trends, 197f triage, 182 variables, 164f Maltase-glucoamylase, 331–332 Manganese, 103–104 dietary reference intakes during pregnancy, 430t low birth weight infants, 496 toxicity with parenteral nutrition, 693 Mannitol, 853 Mannose source and use of, 67t Marasmus, 175, 175f, 352 body composition changes in, 40 drugs in, 238 Mast cells, 348 Maternal See Mothers Maternal and Child Health Bureau (MCHB), 144 Maternal and Child Health Service Block Grant, 144 Matrix Gla protein (MGP), 120 Maturity-onset diabetes of youth (MODY), 722 Mayo Clinic Nomogram, 862 M cell diagram, 350f MCHB, 144 MCT See Medium chain triglycerides (MCT) MDI, 389 Meal plan, 731–732 formulation of, 725–730 sample for high-calorie diet, 1007 Mean corpuscular hemoglobin iron deficiency, 841 Mean corpuscular volume iron deficiency, 841 Measles underfeeding, 315 Meat minimum internal temperature, 228 trace elements in, 95t in well-balanced diet, 1012 Meat-based formula, 938 Medical history, Medications and appetite, 246 associated with dyslipidemia, 246t causing protein energy malnutrition, 914–915 Mediterranean diet, 805 Medium chain fatty acids human milk, 502–503 Medium chain triglycerides (MCT), 55–56, 938–939, 964 liver disease, 687, 690 Megaloblastic anemia, 832–833 Megamineral therapy, 405–406 Megavitamin therapy, 248–249, 405–406 Megestrol acetate, 248, 664–665, 714 Melanocortin, 921 Menhaden oil, 777 Menkes’ kinky-hair syndrome, 356 Menstrual cycles, 872t Mental Development Index (MDI), 389 Mental functioning, 402t Menus sample for gluten-restricted diet, 1004t MER, 315 Mercury, 227 Meridia, 927–928 Metabolic acidosis with acute renal failure, 614 Metabolic bone disease, 689 Metabolic disorders, 1075t associated with refeeding syndrome, 755t formulas for, 940 Metabolic programming, 199 Metabolic reserves body composition, 790 Metabolic syndrome, 803–804 Metal deficiencies, 839–844 Metformin, 928 Methandrostenolone (Dianabol), 879 Methotrexate and human milk, 546 inducing folate deficiency, 243, 834 nutrient interaction, 244t Methylmercury, 227 Methylphenidate food effect on absorption, 240t Metoprolol food effect on absorption, 240t protein effect on, 240 Metronidazole, 185, 238 for acute diarrhea, 745 for bacterial overgrowth, 782 Mexican Americans fat intake in, 60 MGP 120 , Microbiota dental caries, 851 Microenvironment neonatal immune response, 368–379 Microflora, 704 Micronutrient, 756 breast milk, 200 deficiencies, 201f brain development, 392 exocrine pancreatic disease, 679 HIV, 660–662 immune function, 372–376 immune response regulatory effects of, 374t malnutrition, 200–201 peritoneal dialysis, 621 Microsporidia, 377, 658 Midarm circumference, 11–12, 898 Midparental height, 11 Mid-upper-arm circumference developmental disability, 587 1093 Milk See also Cow’s milk; Human milk allergy eosinophils, 348 failure to let down, 577–578 free foods, 999 premature, 542 preterm composition of, 540t products lactose content of, 825t programs US Department of Agriculture, 154 protein-free diet, 998–999 pumped storage of, 574t pumping and storing, 573 secretion initiation of, 564–565 selenium content of, 100 suggestions for increasing calories and nutrient density, 1006 supplementation with, 549–550 synthesis pathways, 565f in well-balanced diet, 1012 Milliequivalent-milligram conversion table, 1056t Mineral(s) abnormalities of, 752–754 assessment, 18–19, 20t daily dietary intake, 1055t dietary reference intakes during pregnancy, 430t in human milk, 545 liver disease, 692 low birth weight infants, 495–496 mix solution composition of, 186t oil, 242 nutrient interaction, 244t required for parenteral nutrition, 965t rich diets, 1010–1012 supplements, 187, 989–990 cognition, 403–406 pregnancy, 435 Mineralized tissues nutritional studies on, 849–850 Minimal dehydration, 742 treatment plan, 742 Modular formulas, 940, 1074t MODY, 722 Molecular level model of body composition, 41–42, 42t Molybdenum, 102–103 deficiency clinical features of, 102–103 food sources of, 103 metabolism and diagnosis of, 103 dietary reference intakes during pregnancy, 430t required for parenteral nutrition, 968 toxicity of, 103 Monosaccharides, 67, 813–814 malabsorption of, 824 source and use of, 67t Mortality global trends, 195, 196f, 196t Mothers 1094 Index African American influences on dietary fat intake, 61 diabetic transient hypoglycemia with, 600 diet essential fatty acid supply, 462–463 glucose concentration, 450 glucose production fractional partition of, 458f glucose supply, 449 nutrition, 570–571 pregnancy, 429–438 Motility, 326 ontogeny, 334–335 Motor Development Scale, 401 Motor functioning, 402t Mottled enamel, 854–855 classification of, 854–855 MRFIT, 134 MRI, 45, 390 Mucilage, 71t Mucosal healing enteral feeding, 645–646 Mucosal immune response nutrient support of, 703–704 Mucositis management of, 714 Multicompartment models, 41–42 Multidisciplinary lipid clinic, 807–808 Multiorgan failure syndrome, 711–712 Multiple Risk Factor Intervention Trial (MRFIT), 134 Multivariate nutrient density model, 213–214 Multivitamin supplements cognition, 403–406 pregnancy, 435 Muscles examination of, 8t metabolic rates, 306t MVI-Pediatric, 966–967 Mycobacterium avium causing Crohn’s disease, 636 Mycobacterium avium intracellulare complex, 658 Mycobacterium tuberculosis, 372 NAA, 43 Naficillin food effect on absorption, 240t Nails analysis of, 17–18 examination of, 8t Naloxone, 246 Nandralone, 879 Nasoduodenal tubes, 947 Nasogastric feedings during cancer chemotherapy, 714–715 complications of, 715, 952t risks of, 872 Nasogastric tubes, 947 Nasojejunal tube, 947 National Center for Complementary and Alternative Medicine (NCCAM), 994 National Council for Students Assistance and Scholarships, 169 National Food Consumption Surveys, 60 National Heart, Lung, and Blood Institute (NHLBI) type II trial, 135 National Institutes of Health Office of Dietary Supplements, 994–995 National Nursery Schools Council, 169 National Supplementary Feeding Program (PNAC), 168–169 National System of Health Services, 169 Natural killer (NK) cells, 367 Natural resistance-associated protein (Nramp), 356 Nausea associated with enteral feeding, 952t NCCAM, 994 Near-infrared interactance (NIRI), 46 Necrotizing enterocolitis protection against, 555 Neisseria gonorrhoeae, 344 Neisseria meningitides, 344 Nelfinavir food effect on absorption, 240t side effects of, 657t Neocate, 523t Neomycin nutrient interactions, 242, 244t Nephrotic child dietary management of, 627–628 Nephrotic edema management of, 627 Nephrotic syndrome, 626–627 Neuroblastoma, 700 Neutron activation analysis (NAA), 43 Newborns classification of, 1038t fasting adaptation, 597t gluconeogenesis, 595–598 glucose absorptive capacity, 332–333, 333f glycogenolysis, 595–598 immune response microenvironment, 368–379 micronutrients, 370 neural-visual development in and fatty acids, 56t Next Step, 525t NHLBI type II trial, 135 Niacin, 123–124 deficiency, 124 dietary reference intakes during pregnancy, 430t drug interactions, 249t tolerable upper intake levels, 112t Nicotinamide, 123 Nicotinic acid, 123 Nipple eversion, 567f NIRI, 46 Nitric oxide, 178 Nitrofurantoin food effect on absorption, 240t Nitrogen, 493 balance, 23, 77 in enteral feeding, 758–759 intake, 760–761 NK cells, 367 Nocturnal feeding, 682 Nonalcoholic steatohepatitis hepatic drug metabolism, 239 Noncellulose fiber carbohydrates, 70–71 Non-cystic fibrosis pancreatic diseases, 676t Nonessential fetal lipid supply, 461–462 Non-insulin dependent diabetes mellitus (NIDDM), 730 Non-nutritive sweeteners, 730 Nonprotein nitrogen human milk, 542–543 Nonsteroidal anti-inflammatory agents nutrient interaction, 244t Nontyphoid salmonellosis symptoms of, 220–221 Norwalk virus foodborne disease, 224 Nosocomial infection associated with enteral feeding, 952t Nramp, 356 Nucleotides, 542, 936 in formulas, 520–522 immune function, 354 Nursing supplementer (Lact-Aid), 576, 577f Nutraceuticals See Dietary supplements Nutramigen, 523t Nutrient-gene interactions clinical and therapeutic implications of, 270–271 Nutrient-nutrient interactions, 249 Nutrients absorption of, 242 analysis, 19–24 deficiencies AIDS, 376–377 early development, 369 HIV, 376–377 intervention studies, 391–392 long-term consequences of, 391–392 density suggestions for increasing, 1006–1007 metabolism of, 242–243 modifying host response, 702–703 requirements, 516–517 storage genetic regulation, 258–259 tracking, 212 transport drug effects on, 243 Nutrition assessment, 144–145, 145t, 174–175 low birth weight infants, 508–509 history of, impact on bones, 885–886 infection, 198–199 intervention, 144–145, 145t screening, 144–145, 145t complications of, 716–717 services, 147f support monitoring, 716, 716t transition, 201–202 websites, 930 Nutritional adequacy, 59 Index Nutritional assessment developmental disabilities, 580–589 laboratory tests for, 20t Nutritional deficiency states, 782–783 clinical examination in, 1041t Nutritional deprivation caregiving factors, 390 environmental factors, 390 Nutritional epidemiology, 205–216 Nutritional excesses clinical examination in, 1041t–1043t Nutritional field surveys, 25–26 Nutritional goals Chile, 169f Nutritional inadequacies clinical findings associated with, 8t Nutritional monitoring and surveillance, 145–146 Nutritional plan for adolescents with eating disorders, 871–874 Nutritional requirements, 13–14 defined, 1056t Nutritional status, 147–151 anthropometric indicators, 587 assessment of, 6–14, 18f developmental disability, 587 laboratory assessment of, 17–27, 21t–22t in health and nutrition examination surveys, 26t Nutritional supplements See Dietary supplements Nutritive sweeteners in diabetes mellitus, 729 Nuts trace elements in, 95t Obesity, 149, 416f, 713 behavioral assessment of, 924 behavior therapy, 927 biology of, 920–923 BMI definitions of, 415f and body composition, 24 complications of, 918–919 defined, 414–415, 917–918 and dietary fat, 58–59 diseases associated with, 920t drug kinetics in, 238 energy and substrate regulation in, 419–424 energy expenditure, 420–421 energy intake, 424 epidemiology of, 918–920 evaluation and management of, 917–930, 923–925 genetics, 922–923 vs environmental factors, 417–418 heritable factors, 919 imprinting, 919–920 medical assessment of, 923–924 metabolic programming in, 418–419 nutritional assessment of, 924 nutritional therapy for, 925–927 with renal transplantation, 626 risk factors for, 35 risks of, 415–417 syndromes associated with, 923t tracing of, 919 treatment of, 925–927 type diabetes assessment of, 924t urban vs rural, 202f Observation, 208–209 Octreotide, 245 OKG, 760–761 Oligosaccharides, 67–68, 812–813 breast milk, 518 Olive oil, 463 Omega-3 fatty acids for nephrotic syndrome, 628 Omega-3 polyunsaturated fatty acids, 717–718 Oncotic pressure restoration of, 755 OPERT, 675, 681 Oral cavity, 848–858 disease of, 850–854 Oral contraceptives nutrient interaction, 244t Oral liquid medications osmolality of, 954 Oral pancreatic enzyme replacement therapy (OPERT), 675, 681 Oral rehydration therapy, 183, 230 barriers to, 748 choice of, 747 composition, 185t composition of, 748t limitations of, 744 new, 747–748 physiologic basis for use of, 738–739 for severely malnourishment, 747t Oral rinse fluorides dental benefits of, 857 Oral supplements HIV, 662–663 Organic disease screening failure to thrive, 903–904 Organophosphates, 226 Organs metabolic rates, 306t Orlistat (Xenical), 928 nutrient interaction, 244t Ornithine alpha-ketoglutarate (OKG), 760–761 Oslo Study Diet and Antismoking Trial, 135 Osteoblasts, 883 Osteocalcin, 120 Osteoclasts, 883 Osteomalacia, 679, 887–888 Osteopenia, 870–871 Osteopenia of prematurity with parenteral nutrition, 975 Osteoporosis, 150, 888 adolescents management of, 890 prevention of, 890–891 conditions predisposing to, 885t inflammatory bowel disease, 637 nutritional disease states associated with, 889–890 1095 Otitis media associated with enteral feeding, 952t Overweight, 149 BMI definitions of, 415f Oxalate stones, 249 Oxidation fetus, 480–481 Oxidative stress, 179 Oxytocin, 564 P450 (CYP) hepatic, 914 St John’s wort activating, 989 PAH, 239 Paired-comparison test, 389 Palmar grasp, 576f PAMP 342, 343f , Pancreas atrophy, 179–180 morphogenesis, 327 postnatal development, 327 secretory function, 328f Pancreatic disease with cystic fibrosis, 674–676 fat modification for, 1001 Pancreatic insufficiency nutritional consequences of, 675f nutritional requirements in, 681t Pantothenic acid, 128 dietary reference intakes during pregnancy, 430t sources and functions, 113t tolerable upper intake levels, 112t Para-aminosalicylic acid nutrient interaction, 244t nutrient interactions, 242 Parabiotic animals, 776f Parafollicular T cells, 350 Parasites foodborne disease, 224–225 malnutrition, 185 Parenteral feeding for Crohn’s disease, 639–640 dialysis, 623 in intensive care, 611 liver disease, 692–693 manganese toxicity with, 693 Parenteral nutrition, 492–498, 759–762, 957–980 administration route, 969–970 amino acids, 492–494, 493t in bone marrow transplantation, 711f during cancer chemotherapy, 715 complications of, 499t, 972–976, 972t cyclic, 970–972 guidelines for, 972t HIV, 664 home See Home parenteral nutrition impact on drug kinetics, 241 indications for, 957–958, 958t initiating therapy with, 970 intakes, 760–762 intestinal function, 270 for low birth weight infants, 491f monitoring of, 976, 976t requirements for, 958–959 for short-bowel syndrome, 778–779 1096 Index trace elements, 88t transition to enteral nutrition, 972 vascular access, 759–760 Parenteral nutrition liver disease, 783 PATCH web site, 157 Pathogen-associated molecular patterns (PAMP), 342, 343f Pathological Determinants of Atherosclerosis in Youth (PDAY), 57, 136 Patient and family education in diabetes mellitus, 730–731 Patient care deficiencies in, PCB, 227 PCM, 351 host defense, 370–372 immune system, 654 PDAY Study (Pathological Determinants of Atherosclerosis in Youth), 57, 136 PDCAAS, 80 PDI, 389 Peak height velocity (PHV), 884 Peanut-free diet, 999 Pectins, 71t Pediatric nutrition importance re-emerging, 2–3 as separate discipline, 3–4 subspecialty, 1–4 Pediatric nutrition screen sample, 912t PEG, 815f, 948 Pellagra, 123, 124 PEM See Protein-energy malnutrition (PEM) Penicillamine nutrient interaction, 244t Penicillin, 239 food effect on absorption, 240t nutrient interaction, 244t Pentamidine inducing folate malabsorption, 834 side effects of, 657t Pentoxifylline for inflammatory syndrome, 316 PEPCK, 445, 449–450 Peptidase, 332 Peptide YY, 776 Percent fat anthropometric equations for predicting, 588t Percent ideal body weight, 11 Percent weight loss, 11 Percutaneous endoscopic gastrostomy (PEG), 948 Performance-enhancing dietary supplements, 990–991 discouragement of, 881–882 Performance-enhancing drugs adolescent athletes, 878–882 Peripheral alimentation risks of, 872 Peripheral smear iron deficiency, 841 Peritoneal dialysis end-stage renal disease daily fluid and nutrient recommendations, 616t fluid and nutrient recommendations for, 621t nutritional aspects of, 620–621 Pernicious anemia, 127 juvenile form of, 836 Persistent diarrhea, 747 Persistent posttransplantation hyperparathyroidism, 626 Persistent renal failure, 609–630 Personal Responsibility and Work Opportunity Act, 157 Pesticides, 226–227, 700–701 PET, 390 Peyer’s patches, 349 PGE2, 369 P-glycoprotein (Pgp), 236 Pgp, 236 Phenacetin, 240 vegetarianism effect on, 241 Phendimetrazine, 928 Phenobarbital food effect on absorption, 240t nutrient interaction, 244t Phenolphthalein, 242 Phentermine, 928 Phenytoin (Dilantin), 242 food effect on absorption, 240t inducing folate deficiency, 243, 834 nutrient interaction, 244t in obesity, 238 Phosphate intensive care, 611–612 for nephrotic syndrome, 628 supplements, 612t Phosphate binders, 618 Phosphoenolpyruvate carboxykinase (PEPCK), 445, 449–450 Phosphorous assessment, 20t dietary reference intakes during pregnancy, 430t for end-stage renal disease, 619t hemodialysis, 622t in lactating woman, 570 low birth weight infants, 495–496, 503–504 with PEM, 752–753 peritoneal dialysis, 621t required for parenteral nutrition, 965, 965t transplantation, 625t PHV, 884 Physical activity, 149, 158 web site, 157 Physical contaminants foodborne disease, 227 Physical examination, failure to thrive, 904 growth failure, 906t Physical stimulation malnutrition, 189 Physician’s Desk Reference for Herbal Medicines, 994 Physiologic jaundice in newborn, 327f Piper methysticum, 988 Placenta alternate carbohydrates produced in, 457 amino acid, 471–484 metabolism, 478–479 transporter proteins, 474 essential fatty acid metabolism and transfer by, 462 glucose consumption, 452 gestational development, 456 sources for, 449–450 transport, 457f transporters, 450–451 transport kinetics, 452 uptake and transport, 450–453 leucine, 472 lipid uptake, 460–462 oxidation, 480–481 transport systems, 475t Plantain recall of, 987 Plaque pH caries, 853t Plasma glucose concentration, 456f insulin glucose metabolism, 453 Plasma chromium, 101, 102 Plasma lipids assessment, 23–24 Plasmapheresis for hypercholesterolemia, 807 Plasmodium falciparum, 378 Plate method, 808f PLP 124 , PMP 124 , PNAC, 168–169 Pneumocystis carinii pneumonia, 653 Pneumonia associated with enteral nutrition, 951 Polyamines, 777 synthesis and degradation of, 777f Polychlorinated biphenyls (PCB), 227 Polycose, 614 Polycyclic aromatic hydrocarbons (PAH), 239 Polyethylene glycol (PEG), 815f Polyhydroxy alcohol, 68 Polymeric diet for Crohn’s disease, 640–641 Polysaccharides, 67–68 Polyunsaturated fats definition of, 1008 Polyunsaturated fatty acids, 119, 179 adequate intakes for infants, 55f Ponsky pull technique, 948 Population growth, 202f Pork minimum internal temperature, 228 Port-A-Cath, 977 Portagen, 524t POSCH, 135 Positron emission tomography (PET), 390 Potassium, 177, 179 Index dietary renal insufficiency, 618 for end-stage renal disease, 619t hemodialysis, 622t low birth weight infants, 504 peritoneal dialysis, 620 repletion of, 755 transplantation, 625t Poultry minimum internal temperature, 228 PPD, 370 Pravastatin, 806, 807t Prebiotics, 71–72, 746 Pregestimil, 523t, 780 Pregnancy adolescents, 151 bone mineral density, 436 calcium, 436–438 dietary reference intakes during, 430t fish oil supplements, 435–436 folate, 126 herbal products, 435 maternal nutrition, 429–438 mineral supplements, 435 multivitamin supplements, 435 nutritional status, 148 Pregnancy Nutritional Surveillance, 431 Premature infants enterally fed nutritional assessment of, 508t formulas for, 1064t glucose tolerance in, 960 growth charts, 9–10 hemolytic anemia, 837–838 human milk fortifiers for, 1065t insulin tolerance in, 960 zinc deficiency in, 91–92 Premature milk, 542 Preoperative nutritional support for inflammatory bowel disease, 639 Preschool children nutritional status, 148–149 President’s Council on Physical Fitness and Sports web site, 157 Preterm milk composition of, 540t Preventive nutrition, 134–139 Preventive resin restorations for dental caries, 857 Primary disaccharidase deficiencies, 819–822 Primary lactase deficiency, 819–820 Primary monosaccharide intolerance, 823–824 Primidone nutrient interaction, 244t Probiotics, 704, 745, 991 Problematic nutrients sources of, 536t Programming animal models, 444–445 Program on the Surgical Control of the Hyperlipidemias (POSCH), 135 Proinflammatory cytokines, 178 Prolactin, 565 Prolonged fasting hypoglycemia, 602–603 Propanolol food effect on absorption, 240t Propoxyphene food effect on absorption, 240t Propranolol, 239 protein effect on, 240 ProSobee, 522t Prospective food records, Prostaglandin E2 (PGE2), 369 Prostaglandins, 777 in human milk, 544 synthesis zinc deficiency, 91 Protease inhibitors in human milk, 555 Protein, 137 acute renal failure, 614 assessment, 20t, 22 chronic kidney disease, 615 deficiency energy and, 753–754 deposition, 80t in diabetes mellitus, 728 dietary for nephrotic child, 627 requirements for, 77–78 dietary reference intakes, 1055t digestibility, 79, 80 for end-stage renal disease, 619t formulas, 519 group increasing calories and nutrient density, 1006 growth, 79t hemodialysis, 622t homeostasis, 76 human milk, 501, 541 hydrolysate formulas, 938–939 infants intake, 78t requirements, 77–78 intake, 756 breast-fed infants, 517–518 liver disease, 690–692 liver transplantation, 694t low birth weight infants, 500–501 metabolism chronic renal failure, 313 critically ill patients, 791–792 Crohn’s disease, 646 disease states, 312–313 liver disease, 687 rheumatoid arthritis, 313 in parenteral nutrition, 959t, 960–961 complications from, 975 peritoneal dialysis, 620, 621t quality, 80 requirements of injured children, 792t sparing modified fast diet, 926, 926t synthetic rate fetus, 472f transplantation, 623–624, 625t turnover, 76f Protein-calorie malnutrition (PCM), 351 host defense, 370–372 1097 immune system, 654 Protein digestibility-corrected amino acid score (PDCAAS), 80 Protein-energy malnutrition (PEM), 183t, 386 acetylsalicylic acid, 238 behavior, 397–399 studies, 399t body composition changes during, 40, 755f characteristics, 388 chromium, 101 classification of, 1040t complications, 184t control, 165f copper deficiency, 96 drug absorption, 237 energy expenditure during, 756f hospitalized patient, 910–915 nutritional status, 910–912 pathophysiology, 175–182 Protein S, 120 Prudent diet, 136–138 safety of, 138 Psychomotor Developmental Index (PDI), 389 Pteroylglutamic acid See Folic acid (pteroylglutamic acid) Pubertal development female, 1028t male, 1028t Pubertal growth spurt, 884 Public health defined, 143 Pulmonary disease cystic fibrosis, 673–674 Pulse flux, 481f Pumped milk storage of, 574t Purging, 865 medical complications from, 869–870 Purified protein derivative (PPD), 370 Pyridoxal, 124 Pyridoxal phosphate (PLP), 124 Pyridoxamine, 124 Pyridoxamine phosphate (PMP), 124 Pyridoxine, 124 See also Vitamin B6 (pyridoxine) deficiency of, 830–831 required for parenteral nutrition, 967 Pyridoxine phosphate, 124 Pyrimethamine inducing folate malabsorption, 834 nutrient interaction, 244t Quantitative computed tomography, 888 Questionnaires, 208–209 Racecadotril for acute diarrhea, 745 Radiation therapy adverse effects, 710 RANTES, 343 RARs, 114 Raw foods, 229t safety, 228 1098 Index RDA, 13, 1057t Reactive oxygen species, 178 Recalls, 208–209 Recommended Dietary Allowances (RDA), 13, 1057t Recommended dietary intake in children over two years old, 57t Red blood cell distribution width iron deficiency, 841 folate values, 835t values by age, 831t Reduced food intake, 304 Reduced protein intake adaptation to, 177 REE See Resting energy expenditure (REE) Refeeding, 869 route of, 756–758 Refeeding anorexia nervosa caloric demands, 872 metabolic rate, 872 Refeeding syndrome, 187–188, 237, 639, 976 initial management of, 754–756 metabolic disorders associated with, 755t prevention of, 754–756 Reference standards in developmental disabilities lower-leg length, 585 stature, 584 upper-arm length, 585 weight, 582 Refrigeration of leftover foods, 228 Renal disease chronic See Chronic kidney disease Renal osteodystrophy prevention of, 618 Renal tubular disorders, 628–630 Renal wasting of magnesium, 245 Renal wasting of potassium, 243 Research deficiencies in, Residual model, 213 Resistant starch, 68 in diabetes mellitus, 729 Respiratory quotient (RQ), 19, 418f Respiratory system malnutrition, 180 Resting energy expenditure (REE), 13, 19 adjustment of, 14t in Crohn’s disease, 636–637 developmental disabilities, 581 energy intake, 419f equations for estimating, 22t, 589t measurement of, 793 overweight, 421f Resting metabolic rate (RMR), 305f, 306f, 315 Reticulocyte heme iron deficiency, 842 Retinoic acid receptors (RARs), 114 Retinoid X receptors (RXRs), 114 Retinol supplements, 188 Retinyl palmitate, 111 Rhabdomyosarcoma diet, 701 Rheumatoid arthritis protein metabolism, 313 Riboflavin, 123 deficiency of, 831 dietary reference intakes during pregnancy, 430t required for parenteral nutrition, 967 tolerable upper intake levels, 112t Ribose source and use of, 67t Rice milk diet preparation of, 186t Rickets, 116, 679 Rifampin food effect on absorption, 240t side effects of, 657t Ritonavir food effect on absorption, 240t side effects of, 657t RMR, 305f, 306f, 315 Rotavirus, 658, 745–746 foodborne disease, 224 Roux-en-Y gastric bypass, 928, 929f RQ, 19, 418f RXRs, 114 Saccharin, 730 Saccharomyces boulardii, 745, 777 Sacrosidase, 826 Salmonella, 220–221, 228, 342 Salmonella enteritis, 745 Salt exocrine pancreatic disease, 680 iodination of, 169 Sample food journal, 867t Saquinavir food effect on absorption, 240t side effects of, 657t Saturated fat definition of, 1008 dietary boys, 135t intake suggestions for lowering, 1010 Saturated fatty acids (SFA), 52, 134, 137 Saw palmetto berry (Serenoa repens), 990 SCAN, 61 SCF 348 , intestines, 345t Schofield equations, 14, 1058t School influences on dietary fat intake, 61–62 School-based programs, 158 behavior, 408 School children nutritional status, 148–149 School Feeding Program, 169 School lunch and breakfast programs US Department of Agriculture, 154 Scurvy, 121, 832 Seafood foodborne disease, 230 minimum internal temperature, 228 Sealants for dental caries, 857 Secondary amenorrhea, 873 Secretory cells cycle of, 564f Secretory IgA (S-IgA), 341, 347f, 370, 553–554 antibodies human milk, 552t Selective screening weaning, 530 Selenium, 98–100 assessment, 20t deficiency, 689 clinical features of, 98–99 diagnosis and treatment of, 100 etiology of, 98–99 dietary reference intakes during pregnancy, 430t dietary requirements for, 100 food sources for, 100–101 HIV, 377, 661 in human milk, 546 immune function, 375 low birth weight infants, 496 regulatory effects on immune response, 374t toxicity of, 100 Semielemental diet for Crohn’s disease, 640 Sepsis malnutrition, 184t Septo-optic dysplasia, 602 Serenoa repens, 990 Serine, 459, 482 Serotonin, 248 Serum See Blood Serum markers, 888–889 Severe dehydration acute diarrhea, 743 Severe malnutrition diarrhea with, 747 Sex percentiles for, 10–11 Sexual activity cervical cancer, 700 Sexual maturation, 13 SFA, 52, 134, 137 SGA, 369 Shellfish-free diet, 999 Sheppard-Towner Act of 1921, 144 Shigella, 223 Short-bowel syndrome, 771–785 catheter-related complications, 783 chronic complications, 781–783 clinical management of, 778–781, 779t colonic adaptation in, 778 etiology of, 771 physiologic syndrome, 771–773 surgery for, 783–784 transplantation for, 784–785 Shoshin (cardiac) beriberi, 967 Shoulder-to-elbow length, 586f SI, 329, 331 SIADH, 243 Sibutramine (Meridia), 927–928 S-IgA See Secretory IgA (S-IgA) Index Signal transduction nutrient recognition, 269–270 Similac, 521t, 524t, 525t, 614–615 Simon, Franz, Simvastatin, 807t Sinusitis associated with enteral feeding, 952t Skeletal maturation, 13 Skeleton examination of, 8t Skin examination of, 8t malnutrition, 181–182, 188 Skinfold measurements, 45–46 Skinfold thickness body mass indices, 210t developmental disabilities, 587–588 Sleeping metabolic rate (SMR), 305 Small bowel bacterial overgrowth with HIV, 658 Small for gestational age (SGA), 369 Small intestine elongation, 329f functional differentiation, 329–330 lactase activity, 330f length, 329 morphogenesis and differentiation, 328–332 postnatal development, 330–331 Small size at birth associations with, 442t SMR, 305 Social development, 161–162 Social history failure to thrive, 903 Social Security Act of 1935 Title V, 144 Sodium, 179 in diabetes mellitus, 728 for end-stage renal disease, 619t hemodialysis, 622t limiting intake of, 1008 low birth weight infants, 504 peritoneal dialysis, 620, 621t transplantation, 625t Sodium chloride peritoneal dialysis, 621 Sodium-dependent amino acid transport, 473f Sodium-dependent glucose transporters, 68–69 Sodium overload prevention of, 755 Sodium-restricted diet, 1008, 1009t Soft tissues nutritional studies on, 849 Solid foods breast feeding, 572 introduction of, 230 weaning, 530 Solute-coupled sodium absorption, 739f Sorbitol, 853 in diabetes mellitus, 729 South Asia malnutrition, 163–164 Soy for hyperlipidemia, 628 Soy-based formulas, 937–938, 1062t Soy-free diet, 1000 Soy-free foods, 1000 Spain westernized diets in, 58 Special diets, 997–1016 Special infant formulas composition of, 1066t Special needs children, 151–152, 152t Special Turku Coronary Risk Factor Intervention Project (STRIP), 60, 135, 805 Spironolactone, 243 food effect on absorption, 240t nutrient interaction, 244t SREBP 259 , St John’s wort (Hypericum perforatum), 990 activating P450, 989 Stable isotopes, 18 Standard infant formulas, 935–936 Standardized mortality ratio by birth weight, 443f Standard multivariate model, 213 Staphylococcus aureus, 223 Starches, 68 digestion and absorption, 811–812 Starch intolerance, 818–819 Statins, 806, 807t Stature, in developmental disabilities, 582–584 Stature-for-age boys, 1022 girls, 1025 Stavudine side effects of, 657t Steatorrhea, 55 Stem cell factors (SCF), 348 intestines, 345t Stephen curve, 853f, 854f Step One Diet, 805 for lowering cholesterol, 1010t substitutions for, 805t Step Two Diet guidelines, 728 for lowering cholesterol, 1010t Steroids vs enteral nutrition for Crohn’s disease, 641 Sterol regulatory element binding protein (SREBP), 259 Stockholm Ischaemic Heart Disease Secondary Prevention Study, 135 Stomach intrinsic factor, 325–326 morphogenesis, 325 postnatal acid secretion, 325 Streptococcus mutans, 552 Streptococcus pneumoniae, 554 Streptococcus thermophilus, 991 Streptozotocin adverse effects, 710 for hyperinsulinemia, 605 Stress hyperkalemia, 613 hypophosphatemia, 613 nutritional support, 611 1099 STRIP 805 , STRIP Baby Project, 60, 135 Strongyloides stercoralis, 377 Studies of Childhood Activity and Nutrition (SCAN), 61 Subcutaneous tissue examination of, 8t Sub-Saharan Africa malnutrition, 163–164 Subscapular skinfolds thickness of, 1029t Substrate balance, –424 Succinylcholine nutrient interaction, 244t Succinyl-CoA, 127 Sucking difficulties with, 575 Sucralfate food effect on absorption, 240t Sucralose, 730 Sucrase-isomaltase (SI), 329, 331 Sucrose behavior, 408–409 in diabetes mellitus, 729 foods with low content of, 825t intake, 262–263 Sugar avoiding excess, 1015 dental caries, 851–852 Sugar alcohols in diabetes mellitus, 729 Sulfasalazine inducing folate deficiency, 243 nutrient interaction, 244t Sulfonamides side effects of, 657t Summer camp US Department of Agriculture, 156 Summer food service programs US Department of Agriculture, 154 Support groups allergy, 1000–1001 for celiac disease, 1004 Sweeteners in diabetes mellitus, 729 nutritive in diabetes mellitus, 729 Sweets renal insufficiency, 619 Syndrome of inappropriate antidiuretic hormone (SIADH), 243 Syndromes growth charts for, 1049t Syndrome X See Metabolic syndrome Tanner staging system, 13 Taste changes in with renal insufficiency, 619 Taurine, 542 in formulas, 520 TBK, 37 TBN, 37 TCA, 75 T cells, 346 Teaching deficiencies in, 3–4 1100 Index Teenagers See Adolescents Teeth examination of, 8t TEF 307–309 , Terbutaline nutrient interaction, 244t Term infant, 515–527 Term milk composition of, 540t Testosterone impact on bones, 884–885 Test weighing technique, 208 Tetracycline food effect on absorption, 240t TGF-alpha intestines, 345t T helper (Th1), 341, 368 cytokine secretion by, 347t in human milk, 556–557 T helper (Th2), 368 cytokine secretion by, 347t in human milk, 556–557 Theophylline, 237, 239 nutrient interaction, 244t in obesity, 238 Thermic effect of feeding (TEF), 307, 308–309 Thermogenesis, 309–310 Thiamin, 122–123 deficiency, 122 induced by loop diuretics, 243 dietary reference intakes during pregnancy, 430t required for parenteral nutrition, 967 sources and functions, 113t tolerable upper intake levels, 112t Thiaminase I, 122 Thiaminase II, 122 Thiamin pyrophosphate (TPP), 122 Thiazides, 630 inducing fluid and electrolyte imbalance, 243 inducing hyperglycemia, 245 nutrient interaction, 244t Thiopental in obesity, 238 Thioridazine food effect on absorption, 240t Thiry-Vella fistulae, 774–775, 775f Thymus, 367 Thyroid gland malnutrition, 180 TLR, 342 T lymphocytes, 115 lamina propria, 347 TNF See Tumor necrosis factor (TNF) Tobacco, 886 TOBEC, 44 Tocopherols, 118, 119, 837 Toddlers formulas for, 525t Tolerable upper intake level, 1057t Toll-like receptors (TLR), 342 Tongue examination of, 8t Toothpaste fluoride dental benefits of, 857 fluorides dental benefits of, 857 Total body densitometry anthropometric measurements, 210t Total body electroconductivity (TOBEC), 44 Total body nitrogen (TBN), 37 Total body potassium (TBK), 37 Total body water, 43–44 defined, 33t Total body weight, 36 Total cholesterol plasma levels of, 57 Total dietary fat intakes in children over two years old guidelines for, 56 Total energy expenditure calculation of, 1059t Total energy intake models, 213t Total fat, 137 Total iron-binding capacity iron deficiency, 842 Total parenteral nutrition, 352–353 in intensive care, 611 liver disease prevention of, 784t low birth weight infants preparation of, 499t physician’s order sheet for, 971t tumor growth, 703–704 Toxoplasma gondii, 225 TPP 122 , Trace elements, 86–106 biologic roles, 86, 87f deficiency etiology of, 86–88 dose response, 86 drug interaction, 245 for end-stage renal disease, 619t etiology, 87t in foods, 95t hemodialysis, 622t immune function, 356 laboratory analyses, 88–89 liver disease, 688 low birth weight infants, 496–497, 504–505 nutritional requirements, 88 parenteral nutrition, 88t peritoneal dialysis, 621t required for parenteral nutrition, 966–967, 968t role in human physiology, 86t transplantation, 625t Trace metals exocrine pancreatic disease, 680 HIV, 661–662 liver disease, 688 Trace minerals critically ill patients, 795 Traffic light diet, 926 Trans-fatty acids, 53 Transferrin receptor iron deficiency, 842 Transferrin saturation iron deficiency, 842 Transforming growth factor-alpha (TGFalpha) intestines, 345t Transitional milk, 539 Transplacental glucose concentration gradient, 451–452 Transplantation, 623–626 end-stage renal disease daily fluid and nutrient recommendations, 616t fluid and nutrient recommendations for, 625t liver See Liver transplantation Transport systems placenta, 475t Traveler’s diarrhea, 230 Traveling foodborne disease, 228–230 Treatments causing protein energy malnutrition, 914 Triamterene, 242 nutrient interaction, 244t Tricarboxylic acid (TCA), 75 Triceps skinfold thickness of, 12 thickness of, 1029t Trichinella spiralis mast cells, 348 Trichuris trichiura, 377 Trimethoprim, 243 inducing folate malabsorption, 834 nutrient interaction, 244t Trisavir side effects of, 657t TrophAmine, 960, 961, 962 low birth weight infants, 493 Trophic hormones candidate for, 775–777 Tryptophan, 124, 987 Tube feeding dialysis, 623 in low birth weight infants, 508 Tuberculosis malnutrition, 184t Tumor cachexia, 709–710 Tumor necrosis factor (TNF), 178 critically ill patients, 796 HIV, 659 with inflammatory bowel disease, 636–637 Tumor necrosis factor-alpha (TNF-alpha), 709 intestines, 345t kwashiorkor, 371 Tumor phenotype, 703 Tumor therapy, 710–711 Twenty-one hydroxylase deficiency, 602 Twenty-four hour amino acid balance, 83 24-hour energy expenditure, 310–311 24-hour recall, 206–207, 867 Type I diabetes See Insulin-dependent diabetes mellitus (IDDM) Type II diabetes See Non-insulin dependent diabetes mellitus Index (NIDDM) Tyrosinase, 96 Tyrosinemia, 694 US Pharmacopoeia (USP) Dietary Supplement Verification Program, 988 Ulcerative colitis butyrate causing, 636 indications for nutritional treatment, 638 Umbilical artery catheters for parenteral nutrition, 970 Umbilical uptake amino acid, 479–480 Umbilical vein blood flow fetal weight, 477f Underfeeding energy expenditure, 311 measles, 315 substrate use, 312 Undernutrition and renal function, 610 Unfortified human milk benefits of, 505 limitations of, 505 Universal screening weaning, 530 Upper arm circumference percentiles of, 1030t length, 586f in developmental disabilities, 585, 585f measurement of, muscle area percentiles of, 1031t muscle circumference percentiles of, 1030t Uremia, 620 Urinary concentration nephrogenic defects in, 630 Urinary protein excretion, 23 Urine analysis of, 18 Urokinase for thrombosed central venous catheters, 973 USDA Continuing Surveys of Food Intake of Individuals (CSFII), 60 USDA Dietary Guidelines, 60 US Department of Agriculture charitable institutions, 156 child care food program, 153–154 commodity supplemental food program, 155 CSFP 155 , EFNEP 155 , emergency food assistance program, 156 food distribution of Indian reservations, 155–156 food stamp program, 153 milk programs, 154 school lunch and breakfast programs, 154 summer camp, 156 summer food service programs, 154 web site, 157 WIC program, 154–155 VAD, 114, 188, 200 Valerian root (Valeriana officinalis), 990 Valproic acid inducing folate deficiency, 243 nutrient interaction, 244t Vancomycin for acute diarrhea, 745 Vascular addressins, 350, 351f Vegan mothers, 127 Vegetables foodborne disease, 228, 230 impact on drug kinetics, 240 suggestions for increasing calories and nutrient density, 1006–1007 trace elements in, 95t in well-balanced diet, 1014 Vegetarian diets, 138 Vegetarianism, 873 impact on drug kinetics, 241 Verapamil in obesity, 238 Vertical banded gastroplasty, 928, 929f Very-long chain ayl-CoA dehydrogenase deficiency, 602–603 Very low birth weight (VLBW) glutamine, 961–962 Very low-density lipoproteins (VLDL), 118, 801 Vibrio cholerae, 552, 554 Viral foodborne pathogens, 223–224 Vitalipid, 966 Vitamin(s), 111–128 assessment, 18–19, 20t critically ill patients, 795 dietary reference intakes, 1053t dietary reference intakes during pregnancy, 430t for end-stage renal disease, 619t hemodialysis, 622t liver disease, 692 low birth weight infants, 504–505 peritoneal dialysis, 621, 621t required for parenteral nutrition, 966–967, 966t sources and functions of, 113t supplements, 187, 248–249, 989–990 case-control studies, 214 cohort studies, 214 tolerable upper intake levels, 112t transplantation, 625t Vitamin A, 111–116 deficiency of, 830 dietary reference intakes during pregnancy, 430t drug interactions, 249t exocrine pancreatic disease, 679 functions, 114–116 HIV, 377, 661 in human milk, 544 immune function, 354, 375–376 low birth weight infants, 497 regulatory effects on immune response, 374t 1101 required for parenteral nutrition, 965–966 sources and functions, 113t structure and metabolism, 111–114 tolerable upper intake levels, 112t visual cycle, 115f Vitamin A deficiency (VAD), 114, 200 eyes, 188 Vitamin B HIV, 661 in human milk, 544 Vitamin B1, 122 Vitamin B6 (pyridoxine), 124–125, 830–831, 967 dietary reference intakes during pregnancy, 430t drug interactions, 249t sources and functions, 113t tolerable upper intake levels, 112t Vitamin B12 (cobalamin), 126–127 deficiency, 832, 834–835 clinical manifestations of, 836–837 in Crohn’s disease, 637 diagnosis of, 837 disorder, 126 dietary reference intakes during pregnancy, 430t immune function, 355 malabsorption, 836t output in breast milk, 835 sources and functions, 113t Vitamin C (ascorbic acid), 121 deficiency of, 831–832 dietary reference intakes during pregnancy, 430t drug interaction, 249 Helicobacter pylori, 355 HIV, 377 immune function, 355, 375 regulatory effects on immune response, 374t sources and functions, 113t tolerable upper intake levels, 112t Vitamin D, 116–118, 250 acute renal failure, 614 dietary reference intakes during pregnancy, 430t drug interactions, 249t exocrine pancreatic disease, 679 functions, 117–118 in human milk, 544 impact on bone, 886 influence on bone, 886–887 malabsorption laxative abuse, 242 metabolism, 117f nutrients effect on, 242 regulatory effects on immune response, 374t sources and functions, 113t structure and metabolism, 116–118 tolerable upper intake levels, 112t transplantation, 626 Vitamin deficiency anemias, 830–831 Vitamin-drug interactions, 249t Vitamin E, 118–119, 138 deficiency, 688, 837 1102 Index dietary reference intakes during pregnancy, 430t drug interactions, 249t exocrine pancreatic disease, 679 HIV, 377 in human milk, 544 immune function, 355 low birth weight infants, 497 regulatory effects on immune response, 374t required for parenteral nutrition, 965–966 sources and functions, 113t tolerable upper intake levels, 112t Vitamin E deficiency syndromes, 119 Vitamin F 122 , Vitamin K, 119–120 deficiency, 120, 688 dietary reference intakes during pregnancy, 430t drug interactions, 249t exocrine pancreatic disease, 679–680 in human milk, 544 rich foods warfarin interaction, 250 sources and functions, 113t tolerable upper intake levels, 112t VLBW glutamine, 961–962 VLDL, 118, 801 Volvulus associated with enteral feeding, 953t Vomiting, 870 associated with enteral feeding, 952t chemotherapy-induced, 714 management of, 714 Warfarin nutrient interaction, 244t preventing catheter-related thrombosis, 978 vitamin K-rich foods interaction, 250 Wasting, 196 HIV pathogenesis, 656–660 Water fluoridation dental benefits of, 855–856, 856f Water overload prevention of, 755 supplementation with, 549–550 Water-soluble vitamins exocrine pancreatic disease, 680 in human milk, 544–545 low birth weight infants, 497–498 required for parenteral nutrition, 966 Water supply dietary fluoride in, 857t Watery diarrhea, 782 Weaning, 526–527, 528–537 allergic infant, 534 breast feeding, 572 caregiver behaviors, 537t consequences, 535t defined, 528 in developing countries, 534–535 juice, 533–534 malnutrition, 164 milk and infant formulas, 529–530 neurologic development, 530–531 nutritional needs during, 528–529 pathophysiology of, 528–531 physiologic maturation, 530 policy, 537 practice, 531–533 prudent recommendations for, 535–537 recommendations, 529t selective screening, 530 solid foods, 530 universal screening, 530 Wechsler Intelligence Scale for Children (WISC), 400 Weight, 9, 38t in developmental disabilities, 582 gain and human milk, 540–541 for height, 11 indicating hydration status, 716 median, 1058t percentiles for, 1032t–1033t poor gain of differential diagnosis of, 574t regulation of, 920–921 Weight control, 1012–1015 adolescents, 866 exercise for, 1015 positive changes with, 1015 Weight-for-age percentiles boys, 1018, 1022 girls, 1020, 1025 Weight-for-height indices in developmental disabilities, 584 Weight-for-length percentile boys, 1019 girls, 1021 Weight-for-stature percentiles boys, 1023 girls, 1026 Weight gain changes with, 40 drugs associated with, 925t gestational diet, 438 with renal transplantation, 626 Weight lifting, 874 Weight loss changes with, 40 cholesterol, 805 dietary supplements for, 929t drug, 927–928 surgery, 928–930 Weight velocity, 898 Welchol, 807t Well-balanced diet, 1012–1014 Wernicke-Korsakoff syndrome, 123 Wet beriberi, 123 Wheat-free diet, 1000 foods, 1000 Whey human milk, 541 WHO food safety guidelines, 229t Whole body level model of body composition, 42–43, 42t WIC program US Department of Agriculture, 154–155 web site, 158 WISC, 400 Work return to breast feeding, 572 World Health Organization (WHO) food safety guidelines, 229t Wound healing and zinc deficiency, 90 Wrestling, 874 Xenical, 928 nutrient interaction, 244t Xerophthalmia, 188, 200 Xylitol, 853 in diabetes mellitus, 729 Yellow growth factor, 123 Yersinia enterocolitica, 223, 745 Zafirlukast food effect on absorption, 240t Zidovudine dietary fat effect on, 240 nutrient interaction, 244t side effects of, 657t Zinc, 89–94, 753 absorption and metabolism of, 93 for acrodermatitis enteropathica, 92 assessment, 20t dietary reference intakes during pregnancy, 430t dietary requirements for, 93–94 drug interaction, 245 in foods, 94 HIV, 377, 660, 661–662 in human milk, 546 immune function, 373–374 low birth weight infants, 496, 504 pregnancy, 432–433 protoporphyrin iron deficiency, 842 regulatory effects on immune response, 374t required for parenteral nutrition, 967–968 supplements, 187 for acute diarrhea, 746 for hypogeusia, 246 toxicity of, 93 Zinc deficiency, 89–92, 198, 356, 378, 689 behavioral abnormalities of, 90 brain development, 393 clinical features of, 89t cognition, 403 in Crohn’s disease, 638 diagnosis of, 92 etiology of, 91–92 treatment of, 92–93 Zingiber officinale, 990 ... 1-5 500 9-2 26-X Printed in Canada Sales and Distribution United States BC Decker Inc P.O Box 785 Lewiston, NY 1409 2-0 785 Tel: 90 5-5 2 2-7 017; 80 0-5 6 8-7 281 Fax: 90 5-5 2 2-7 839; 88 8-3 1 1-4 987 E-mail: info@bcdecker.com... N, indirect calorimetry Protein S albumin, S total protein, U protein (dipstick) S transferrin, prealbumin, S retinol-binding protein, creatinine height index U hydroxyproline index; S amino... transport proteins, such as thyroxine-binding prealbumin (transthyretin),71 retinol-binding protein,72 transferrin,73 and ferritin,74 have been proposed as better markers of protein malnutrition because