Modern Nutrition in Health and Disease 9th edition (January 1999): by Maurice E. Shils (Editor), James A. Olson (Editor), Moshe Shike (Editor), A. Catherine Ross (Editor) By Lippincott, Williams & Wilkins By OkDoKeY Modern Nutrition in Health and Disease Contents Editors Preface Acknowledgments Contributors PART I. SPECIFIC DIETARY COMPONENTS Section A. Major Dietary Constituents and Energy Needs Chapter 1. Defining the Essentiality of Nutrients ALFRED E. HARPER Chapter 2. Proteins and Amino Acids DWIGHT E. MATTHEWS Chapter 3. Carbohydrates ROY J. LEVIN Chapter 4. Lipids, Sterols, and Their Metabolites PETER J.H. JONES AND STANLEY KUBOW Chapter 5. Energy Needs: Assessment and Requirements in Humans ERIC T. POEHLMAN AND EDWARD S. HORTON Section B. Minerals Chapter 6. Electrolytes, Water, and Acid-Base Balance MAN S. OH AND JAIME URIBARRI Chapter 7. Calcium CONNIE M. WEAVER AND ROBERT P. HEANEY Chapter 8. Phosphorus JAMES P. KNOCHEL Chapter 9. Magnesium MAURICE E. SHILS Chapter 10. Iron in Medicine and Nutrition VIRGIL F. FAIRBANKS Chapter 11. Zinc JANET C. KING AND CARL L. KEEN Chapter 12. Copper JUDITH R. TURNLUND Chapter 13. Iodine BASIL S. HETZEL AND GRAEME A. CLUGSTON Chapter 14. Selenium RAYMOND F. BURK AND ORVILLE A. LEVANDER Chapter 15. Chromium BARBARA J. STOECKER Chapter 16. Ultratrace Minerals FORREST H. NIELSEN Section C. Vitamins Chapter 17. Vitamin A and Retinoids A. CATHARINE ROSS Chapter 18. Vitamin D MICHAEL F. HOLICK Chapter 19. Vitamin E MARET G. TRABER Chapter 20. Vitamin K ROBERT E. OLSON Chapter 21. Thiamin VICHAI TANPHAICHITR Chapter 22. Riboflavin DONALD B. McCORMICK Chapter 23. Niacin DANIEL CERVANTES-LAUREAN, N. GERARD McELVANEY AND JOEL MOSS Chapter 24. Vitamin B 6 JAMES E. LEKLEM Chapter 25. Pantothenic Acid NORA PLESOFSKY-VIG Chapter 26. Folic Acid VICTOR HERBERT Chapter 27. Vitamin B 12 “Cobalamin” DONALD G. WEIR AND JOHN M. SCOTT Chapter 28. Biotin DONALD M. MOCK Chapter 29. Vitamin C ROBERT A. JACOB Section D. Signs Of Clinical Deficiencies Chapter 30. Clinical Manifestations of Human Vitamin and Mineral Disorders: A Resumé DONALD S. McLAREN Section E. Organic Compounds with Nutritional Relevance Chapter 31. Carnitine CHARLES J. REBOUCHE Chapter 32. Choline and Phosphatidylcholine STEVEN H. ZEISEL Chapter 33. Carotenoids JAMES ALLEN OLSON Chapter 34. Homocysteine, Cysteine, and Taurine MARTHA H. STIPANUK Chapter 35. Glutamine and Arginine STEVE F. ABCOUWER AND WILEY W. SOUBA PART II. NUTRITION IN INTEGRATED BIOLOGIC SYSTEMS Section A. Tutorials in Physiologic Regulation Chapter 36. Nutritional Regulation of Gene Expression ROBERT J. COUSINS Chapter 37. Transmembrane Signaling ROBERT A. GABBAY AND JEFFREY S. FLIER Chapter 38. Membrane Channels and Transporters: Paths of Discovery DAVID ERLIJ Chapter 39. The Alimentary Tract in Nutrition SAMUEL KLEIN, STEVEN M. COHN, AND DAVID H. ALPERS Section B. Genetic, Physiologic, and Metabolic Considerations Chapter 40. Control of Food Intake GERARD P. SMITH Chapter 41. Metabolic Consequences of Starvation L. JOHN HOFFER Chapter 42. Nutrition and the Chemical Senses RICHARD D. MATTES Chapter 43. Fiber and Other Dietary Factors Affecting Nutrient Absorption and Metabolism DAVID J. A. JENKINS, THOMAS M. S. WOLEVER, AND ALEXANDRA L. JENKINS Chapter 44. Hormone, Cytokine, and Nutrient Interactions IRWIN G. BRODSKY Chapter 45. Nutrition and the Immune System STEVEN H. YOSHIDA, CARL L. KEEN, AFTAB A. ANSARI, AND M. ERIC GERSHWIN Chapter 46. Oxidative Stress and Oxidant Defense JAMES A. THOMAS Chapter 47. Diet in Work and Exercise Performance ERIC HULTMAN, ROGER C. HARRIS, AND LAWRENCE L. SPRIET Chapter 48. Nutrition in Space HELEN W. LANE AND SCOTT M. SMITH Section C. Nutritional Needs During the Life Cycle Chapter 49. Body Composition: Influence of Nutrition, Physical Activity, Growth, and Aging GILBERT B. FORBES Chapter 50. Maternal Nutrition WILLIAM J. McGANITY, EARL B. DAWSON, AND JAMES W. VAN HOOK Chapter 51. Nutritional Requirements During Infancy WILLIAM C. HEIRD Chapter 52. Diet, Nutrition, and Adolescence FELIX P. HEALD AND ELIZABETH J. GONG Chapter 53. Nutrition in the Elderly LYNNE M. AUSMAN AND ROBERT M. RUSSELL PART III. DIETARY AND NUTRITIONAL ASSESSMENT OF THE INDIVIDUAL Chapter 54. Clinical Nutrition Assessment of Infants and Children VIRGINIA A. STALLINGS AND ELLEN B. FUNG Chapter 55. Clinical and Functional Assessment of Adults JEANETTE M. NEWTON AND CHARLES H. HALSTED Chapter 56. Nutritional Assessment of Malnutrition by Anthropometric Methods STEVEN B. HEYMSFIELD, RICHARD N. BAUMGARTNER, AND SHEAU-FANG PAN Chapter 57. Laboratory Tests for Assessing Nutritional Status NANCY W. ALCOCK Chapter 58. Dietary Assessment JOHANNA DWYER PART IV. PREVENTION AND MANAGEMENT OF DISEASE Section A. Pediatric and Adolescent Disorders Chapter 59. Protein-Energy Malnutrition BENJAMIN TORUN AND FRANCISCO CHEW Chapter 60. Malnutrition among Children in the United States: The Impact of Poverty ROBERT KARP Chapter 61. Nutritional Support of Inherited Metabolic Disease LOUIS J. ELSAS II AND PHYLLIS B. ACOSTA Chapter 62. Inherited Metabolic Disease: Defects of b-Oxidation JERRY VOCKLEY Chapter 63. Childhood Obesity WILLIAM H. DIETZ Chapter 64. Nutritional Management of Infants and Children with Specific Diseases and/or Conditions WILLIAM C. HEIRD AND ARTHUR COOPER Section B. Disorders of the Alimentary Tract Chapter 65. Assessment of Malabsorption DARLENE G. KELLY Chapter 66. Nutrition in Relation to Dental Medicine DOMINICK P. DEPAOLA, MARY P. FAINE, AND CAROLE A. PALMER Chapter 67. The Esophagus and Stomach WILLIAM F. STENSON Chapter 68. Short Bowel Syndrome JAMES S. SCOLAPIO AND C. RICHARD FLEMING † Chapter 69. Inflammatory Bowel Disease ANNE M. GRIFFITHS Chapter 70. Diseases of the Small Bowel PENNY S. TURTEL AND MOSHE SHIKE Chapter 71. Celiac Disease J. JOSEPH CONNON Chapter 72. Nutrition in Pancreatic Disorders MASSIMO RAIMONDO AND EUGENE P. DIMAGNO Chapter 73. Nutrition in Liver Disorders C. S. LIEBER Section C. Prevention and Management of Cardiovascular Disorders Chapter 74. Nutrient and Genetic Regulation of Lipoprotein Metabolism CLAY F. SEMENKOVICH Chapter 75. Nutrition and Diet in the Management of Hyperlipidemia and Atherosclerosis SCOTT M. GRUNDY Chapter 76. Nutrition, Diet, and Hypertension THEODORE A. KOTCHEN AND JANE MORLEY KOTCHEN Chapter 77. Chronic Congestive Heart Failure CHARLES HUGHES AND PATRICIA KOSTKA Section D. Prevention and Management of Cancer Chapter 78. Molecular Basis of Human Neoplasia PAUL D. SAVAGE Chapter 79. Diet, Nutrition, and the Prevention of Cancer WALTER C. WILLETT Chapter 80. Carcinogens in Foods TAKASHI SUGIMURA AND KEIJI WAKABAYASHI Chapter 81. Chemoprevention of Cancer DIANE F. BIRT, JAMES D. SHULL, AND ANN L. YAKTINE Chapter 82. Nutritional Support of the Cancer Patient MAURICE E. SHILS AND MOSHE SHIKE Section E. Prevention and Management of Skeletal and Joint Disorders Chapter 83. Bone Biology in Health and Disease ROBERT P. HEANEY Chapter 84. Nutrition and Diet in Rheumatic Diseases CLAUDIO GALPERIN, BRUCE J. GERMAN, AND M. ERIC GERSHWIN Chapter 85. Osteoporosis ELIZABETH A. KRALL AND BESS DAWSON-HUGHES Section F. Other Systemic Diseases and Disorders Chapter 86. Nutritional Management of Diabetes Mellitus JAMES W. ANDERSON Chapter 87. Obesity F. XAVIER PI-SUNYER Chapter 88. Nutritional Aspects of Hematologic Disorders ISRAEL CHANARIN Chapter 89. Renal Disorders and Nutrition JOEL D. KOPPLE Chapter 90. Nutrition, Respiratory Function, and Disease MARGARET M. JOHNSON, ROBERT CHIN, JR., AND EDWARD F. HAPONIK Chapter 91. Nutrition and Retinal Degenerations ELIOT L. BERSON Chapter 92. Diagnosis and Management of Food Allergies HUGH A. SAMPSON Section G. Psychiatric, Behavioral, and Neurologic Disorders Chapter 93. Behavioral Disorders Affecting Food Intake: Anorexia Nervosa, Bulimia Nervosa, and Other Psychiatric Conditions DIANE M. HUSE AND ALEXANDER R. LUCAS Chapter 94. Nutrition and Diet in Alcoholism LAWRENCE FEINMAN AND CHARLES S. LIEBER Chapter 95. Nutrition and Diseases of the Nervous System DOUGLAS R. JEFFERY Section H. Nutrition, Infection, and Trauma Chapter 96. The Hypercatabolic State MICHELLE K. SMITH AND STEPHEN F. LOWRY Chapter 97. Nutrition and Infection LUCAS WOLF AND GERALD T. KEUSCH Chapter 98. Diet and Nutrition in the Care of the Patient with Surgery, Trauma, and Sepsis WILEY W. SOUBA AND DOUGLAS W. WILMORE Chapter 99. Diet, Nutrition, and Drug Interactions VIRGINIA UTERMOHLEN Section I. Systems of Nutritional Support Chapter 100. Enteral Feeding MOSHE SHIKE Chapter 101. Parenteral Nutrition MAURICE E. SHILS AND REX O. BROWN Chapter 102. Nutrition and Medical Ethics: The Interplay of Medical Decisions, Patients’ Rights, and the Judicial System MAURICE E. SHILS PART V. DIET AND NUTRITION IN HEALTH OF POPULATIONS Chapter 103. Recommended Dietary Intakes: Individuals and Populations GEORGE H. BEATON Chapter 104. Dietary Goals and Guidelines: National and International Perspectives A. STEWART TRUSWELL Chapter 105. Nutrition Monitoring in the United States MARIE FANELLI KUCZMARSKI AND ROBERT J. KUCZMARSKI Chapter 106. Nutritional Implications of Vegetarian Diets PATRICIA K. JOHNSTON Chapter 107. International Priorities for Clinical and Therapeutic Nutrition in the Context of Public Health Realities NOEL W. SOLOMONS Chapter 108. Social and Cultural Influences on Food Consumption and Nutritional Status SARA A. QUANDT Chapter 109. Fads, Frauds, and Quackery STEPHEN BARRETT AND VICTOR D. HERBERT Chapter 110. Alternative Nutrition Therapies VICTOR D. HERBERT AND STEPHEN BARRETT PART VI. ADEQUACY, SAFETY, AND OVERSIGHT OF THE FOOD SUPPLY Chapter 111. Food Processing: Nutrition, Safety, and Quality Balances ALEXA W. WILLIAMS AND JOHN W. ERDMAN, JR. Chapter 112. Designing Functional Foods WAYNE R. BIDLACK AND WEI WANG Chapter 113. Food Additives, Contaminants, and Natural Toxins JOHN N. HATHCOCK AND JEANNE I. RADER Chapter 114. Risk Assessment of Environmental Chemicals in Food A. M. FAN AND R. S. TOMAR Chapter 115. Food Labeling, Health Claims, and Dietary Supplement Legislation ALLAN L. FORBES AND STEPHEN H. McNAMARA PART VII. APPENDIX ABBY S. BLOCH AND MAURICE E. SHILS Appendix Contents Section I. Conversion Factors, Weights and Measures, and Metabolic Water Formation Section II. National and International Recommended Dietary Reference Values Section III. Energy and Protein Needs and Anthropometric Data Section IV. Nutrients, Lipids, and Other Organic Compounds in Beverages and Selected Foods Section V. Exchange Lists and Therapeutic Diets Section VI. Internet and Other Sources of Nutrition Information Contributors STEVE F. ABCOUWER, Ph.D. Assistant Biochemist Department of Surgical Oncology Massachusetts General Hospital Instructor, Department of Surgery Harvard Medical School Boston, Massachusetts PHYLLIS B. ACOSTA, Dr.P.H. Director, Metabolic Diseases Department of Pediatric Nutrition Research and Development Ross Products Division, Abbott Laboratories Columbus, Ohio NANCY W. ALCOCK, Ph.D. Professor Department of Preventive Medicine and Community Health University of Texas Medical Branch Galveston, Texas DAVID H. ALPERS, M.D. Professor and Chief Division of Gastroenterology Washington University School of Medicine St. Louis, Missouri JAMES ANDERSON, M.D. Professor Medicine and Clinical Nutrition Department of Internal Medicine University of Kentucky Chief, Endocrine Metabolic Section VA Medical Center Lexington, Kentucky AFTAB A. ANSARI, Ph.D. Department of Pathology Emory University School of Medicine Atlanta, Georgia LYNNE M. AUSMAN, D.Sc. Scientist Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University Boston, Massachusetts Professor, School of Nutrition Science and Policy Tufts University Medford, Massachusetts STEPHEN BARRETT, M.D. Consumer Advocate Member, Board of Directors National Council Against Health Fraud, Inc. Allentown, Pennsylvania RICHARD BAUMGARTNER, Ph.D. Associate Professor Division of Epidemiology Department of Medicine University of New Mexico Albuquerque, New Mexico GEORGE H. BEATON, Ph.D. Professor Emeritus Department of Nutritional Sciences University of Toronto Toronto, Ontario, Canada ELIOT L. BERSON, M.D. William F. Chatlos Professor of Ophthalmology Harvard Medical School Director, Berman-Gund Laboratory for the Study of Retinal Degenerations Massachusetts Eye and Ear Infirmary Boston, Massachusetts WAYNE R. BIDLACK, Ph.D. Dean College of Agriculture California State Polytechnic University, Pomona Pomona, California DIANE F. BIRT, Ph.D. Professor Eppley Institute for Research in Cancer and Department of Biochemistry and Molecular Biology College of Medicine University of Nebraska Medical Center Omaha, Nebraska Current address: Department of Food Science and Human Nutrition Iowa State University Ames, Iowa ABBY S. BLOCH, Ph.D., R.D. Coordinator of Clinical Nutrition Research Gastroenterology/Nutrition Service Department of Medicine Memorial Sloan-Kettering Cancer Center New York City, New York IRWIN G. BRODSKY, M.D., M.P.H. Assistant Professor of Medicine and Nutrition Department of Medicine Endocrinology and Metabolism Section University of Illinois at Chicago Chicago, Illinois REX O. BROWN, Pharm.D., BCNSP, FACN Professor Department of Clinical Pharmacy University of Tennessee Nutrition Support Pharmacist Department of Pharmacy Regional Medical Center at Memphis University of Tennessee Medical Center Memphis, Tennessee RAYMOND F. BURK, M.D. Professor of Medicine Director Division of Gastroenterology Department of Medicine Vanderbilt University Nashville, Tennessee DANIEL CERVANTES-LAUREAN, M.D. Pulmonary-Critical Care Medicine Branch National Heart, Lung, and Blood Institute National Institutes of Health Bethesda, Maryland ISRAEL CHANARIN, M.D., F.R.C.Path. Formerly, Chief Division of Hematology Medical Research Council Northwick Park Hospital Centre Harrow, Middlesex, United Kingdom FRANCISCO CHEW, M.D. Head Maternal and Child Health Unit Instituto de Nutricion de Centro America y Panama (INCAP) Guatemala City, Guatemala ROBERT CHIN, Jr., M.D. Associate Professor of Medicine Section on Pulmonary and Critical Care Medicine Wake Forest University School of Medicine Winston-Salem, North Carolina GRAEME A. CLUGSTON, M.B., D.C.H., Ph.D. Chief Nutrition Section World Health Organization Geneva, Switzerland STEVEN COHN, M.D. Assistant Professor of Medicine Division of Gastroenterology Washington University School of Medicine St. Louis, Missouri J. JOSEPH CONNON, M.D., F.R.C.P. (Lond), F.R.C.P.C. Professor of Medicine Department of Medicine University of Toronto Toronto, Ontario, Canada ARTHUR COOPER, M.D., M.S. Associate Professor Chief Pediatric Surgical Critical Care College of Physicians and Surgeons of Columbia University Harlem Hospital Center New York City, New York ROBERT J. COUSINS, Ph.D. Boston Family Professor of Nutrition Food Science and Human Nutrition Department and Center for Nutritional Sciences University of Florida Gainesville, Florida EARL B. DAWSON, Ph.D. Associate Professor Department of Obstetrics and Gynecology University of Texas Medical Branch Galveston, Texas BESS DAWSON-HUGHES, M.D. Chief Calcium and Bone Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging Associate Professor of Medicine Tufts University Boston, Massachusetts DOMINICK P. DEPAOLA, D.D.S., Ph.D. President and Dean College of Dentistry Texas A&M University Dallas, Texas Current address: President and Chief Executive Officer, Forsyth Dental Center Boston, Massachusetts WILLIAM H. DIETZ, M.D., Ph.D. Director of Clinical Nutrition New England Medical Center Boston, Massachusetts Current address: Director, Division of Nutrition and Physical Activity Centers for Disease Control and Prevention Atlanta, Georgia EUGENE P. DIMAGNO, M.D. Professor of Medicine Department of Internal Medicine Director, Department of Gastroenterology Research Unit Mayo Clinic Rochester, Minnesota JOHANNA DWYER, D.Sc., R.D. Professor of Medicine and Community Health Tufts University Schools of Medicine and Nutrition Senior Scientist Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University Director, Frances Stern Nutrition Center New England Medical Center Boston, Massachusetts LOUIS JACOB ELSAS II, M.D. Professor and Director Division of Medical Genetics Pediatrics/Medicine/Biochemistry School of Medicine Emory University Atlanta, Georgia JOHN W. ERDMAN, Jr., M.D. Professor Department of Food Science and Human Nutrition Director of Nutritional Sciences University of Illinois Urbana, Illinois DAVID ERLIJ, M.D., Ph.D. Professor of Physiology State University of New York Health Science Center at Brooklyn Brooklyn, New York MARY P. FAINE, M.S., R.D. Associate Professor and Director of Nutrition Education Department of Prosthodontics School of Dentistry University of Washington Seattle, Washington VIRGIL F. FAIRBANKS, M.D. Consultant Mayo Clinic Professor of Medicine and Laboratory Medicine Mayo Clinic and Mayo Foundation Rochester, Minnesota ANNA M. FAN, Ph.D. Chief Pesticide and Environmental Toxicology Section Office of Environmental Health Hazard Assessment California Environmental Protection Agency Berkeley, California LAWRENCE FEINMAN, M.D. Associate Professor Department of Medicine Mount Sinai School of Medicine (CUNY) New York City, New York Chief, Section of Gastroenterology Veterans Affairs Medical Center Bronx, New York C. RICHARD FLEMING, M.D. † David Murdoch Professor of Nutrition Science Mayo Medical School Chair, Division of Gastroenterology Mayo Clinic Jacksonville, Florida JEFFREY S. FLIER, M.D. Professor of Medicine Harvard Medical School Chief, Division of Endocrinology and Metabolism Beth Israel Deaconess Medical Center Boston, Massachusetts ALLAN L. FORBES, M.D. Medical Consultant (Foods and Nutrition) Formerly, Director Office of Nutrition and Food Sciences Food and Drug Administration Old Farm Rockville, Maryland GILBERT B. FORBES, M.D. Professor of Pediatrics and Biophysics Emeritus School of Medicine and Dentistry University of Rochester Rochester, New York ELLEN B. FUNG, Ph.D. Postdoctoral Fellow Division of Gastroenterology and Nutrition Children’s Hospital of Philadelphia Philadelphia, Pennsylvania ROBERT A. GABBAY, M.D., Ph.D. Instructor Harvard Medical School Endocrine Division Beth Israel Deaconess Medical Center Boston, Massachusetts CLAUDIO GALPERIN, M.D. Postdoctoral Scholar Division of Rheumatology/Allergy and Clinical Immunology University of California at Davis Davis, California Current address: Rua Albuquerque Lins Säo Paulo, Brazil J. BRUCE GERMAN, Ph.D. The John Kinsella Endowed Chair of Food Science University of California at Davis Davis, California M. ERIC GERSHWIN, M.D. The Jack and Donald Chia Professor of Medicine Chief Division of Rheumatology/Allergy and Clinical Immunology University of California at Davis Davis, California ELIZABETH J. GONG, M.Ph., M.S, R.D. Nutrition Research Associate Department of Nutrition University of California at Davis Davis, California ANNE M. GRIFFITHS, M.D., F.R.C.P.C. Associate Professor of Pediatrics Faculty of Medicine University of Toronto Director, Inflammatory Bowel Diseases Program Division of Gastroenterology and Clinical Nutrition The Hospital for Sick Children Toronto, Ontario, Canada SCOTT M. GRUNDY, M.D., Ph.D. Chairman Department of Clinical Nutrition Professor of Internal Medicine Director, Center for Human Nutrition University of Texas Southwestern Medical Center at Dallas Dallas, Texas CHARLES H. HALSTED, M.D. Professor Department of Internal Medicine and Nutrition University of California at Davis Davis, California EDWARD F. HAPONIK, M.D. Professor of Internal Medicine Chief Section of Pulmonary and Critical Care Medicine Wake Forest University School of Medicine Winston-Salem, North Carolina ALFRED E. HARPER, Ph.D. Professor Emeritus Department of Nutritional Sciences Biochemistry University of Wisconsin Madison, Wisconsin ROGER C. HARRIS, Ph.D. Senior Research Fellow Royal Veterinary College University of London London, England JOHN N. HATHCOCK, Ph.D. Director Nutritional and Regulatory Science Council for Responsible Nutrition Washington, DC FELIX P. HEALD, M.D. Professor Emeritus of Pediatrics University of Maryland School of Medicine Baltimore, Maryland ROBERT P. HEANEY, M.D. John A. Creighton University Professor Creighton University Omaha, Nebraska WILLIAM C. HEIRD, M.D. Professor Children’s Nutrition Research Center Department of Pediatrics Baylor College of Medicine Houston, Texas VICTOR D. HERBERT, M.D., J.D. Professor of Medicine Mount Sinai School of Medicine Chief of Hematology and The Nutrition Laboratory Bronx Veteran Affairs Medical Center New York City, New York BASIL S. HETZEL, M.D. Chairman International Council for Control of Iodine Deficiency Disorders Woman’s and Children’s Hospital North Adelaide, Australia STEVEN B. HEYMSFIELD, M.D. Professor of Medicine College of Physicians and Surgeons Columbia University Deputy Director, Obesity Research Center Saint Lukes-Roosevelt Hospital New York City, New York L. JOHN HOFFER, M.D., C.M., Ph.D. Associate Professor Department of Medicine and Dietetics and Human Nutrition McGill University Senior Physician, Division of Endocrinology Department of General Internal Medicine Sir Mortimer B. Davis-Jewish General Hospital Montreal, Quebec, Canada MICHAEL F. HOLICK, M.D., Ph.D. Professor of Medicine, Dermatology, and Physiology Section of Endocrinology, Diabetes, and Metabolism in the Department of Medicine Boston University School of Medicine Boston, Massachusetts EDWARD S. HORTON, M.D. Professor Department of Medicine Harvard Medical School [...]... mass in the body Urinary creatinine excretion increases within a few days after a dietary creatine load, and several more days are required after removal of creatine from the diet before urinary creatinine excretion returns to baseline, indicating that creatine in the diet per se affects creatinine production ( 38) Therefore, consumption of creatine and creatinine in meat-containing foods increases urinary... tyrosine is clearly polar and histidine is also basic Other common groupings are the aliphatic or neutral amino acids (glycine, alanine, isoleucine, leucine, valine, serine, threonine and proline) Proline differs in that its functional group is also attached to the amino group, forming a five-member ring Serine and threonine contain hydroxy groups The branched-chain amino acids (BCAAs: isoleucine, leucine,... 2 Proteins and Amino Acids Modern Nutrition in Health and Disease Chapter 2 Proteins and Amino Acids DWIGHT E MATTHEWS Amino Acids Basic Definitions Amino Acid Pools and Distribution Amino Acid Transport Pathways of Amino Acid Synthesis and Degradation Amino Acid Degradation Pathways Synthesis of Nonessential Amino Acids Incorporation of Amino Acids into Other Compounds Turnover of Proteins in the... different amino acids incorporated into a variety of different proteins in a variety of different organs in the body, but amino acids are consumed in the diet from a variety of protein sources In addition, each amino acid is maintained in part as a free amino acid in solution in blood and inside cells Overall, a wide range of concentrations of amino acids exists across the various protein and free pools... enabling us to manage the enormous number of communications, records, manuscripts, and page proofs involved in the editing process To our respective spouses, Betty, Giovanna, Sherry, and Alex, we extend appreciation and thanks for their understanding and support of the increased demands on our time Chapter 1 Defining the Essentiality of Nutrients Modern Nutrition in Health and Disease Chapter 1 Defining... measuring amino acid and protein kinetics in the whole body using amino acid tracers assume a single, free pool of amino N, as shown in Figure 2.10 Amino acids enter the free pool from dietary amino acid intake (enteral or parenteral) and by amino acids released from protein breakdown Amino acids leave the free pool by amino acid oxidation to end products (CO 2, urea, and ammonia) and from amino acid... differently depending on the functional type of collagen Glycine makes up about one-third of collagen, and there is also considerable proline and hydroxyproline (proline converted after it has been incorporated into collagen) The glycine and proline residues allow the collagen protein chain to turn tightly and intertwine, and the hydroxyproline residues provide for hydrogen-bond cross-linking Generally,... outside muscle in a two-step process ( Fig 2.5) The first step occurs in the kidney and involves transfer of the guanidino group of arginine onto the amino group of glycine to form ornithine and guanidinoacetate Methylation of the guanidinoacetate occurs in the liver via S-adenosylmethionine to create creatine Although glycine donates a nitrogen and carbon backbone to creatine, arginine must be available... 20 amino acids that are recognized by, and bind to, tRNA for incorporation into protein, other amino acids appear commonly in the body These amino acids have important metabolic functions For example, ornithine and citrulline are linked to arginine through the urea cycle Other amino acids appear as modifications after incorporation into proteins; for example, hydroxy-proline, produced when proline residues... this problem by including a protein-free milk preparation in the diets They then demonstrated that proteins from different sources differed in nutritive value and discovered that lysine, sulfur-containing amino acids, and histidine were essential for the rat ( 14) During this time, Hopkins also observed that including small amounts of protein-free extracts of milk in nutritionally inadequate, purified . and considered in separate chapters on individual essential nutrients and in those on taurine, homocysteine, glutamine, arginine, choline, and carnitine. There. successor, the first edition of Modern Nutrition in Health and Disease, appeared in 1955. Its original objective has remained in succeeding editions: to serve