I am a cardiologist—a physician who specializes in the prevention and
medical treatment of heart disease. I have spent the past twenty-five
years fully engaged in the battle to lower the likelihood of heart disease
for my patients and my country. In addition to my work with patients,
I have written several cardiology textbooks and continue to edit the
major intensive care textbook in the country, Irwin and Rippe’s Intensive
Care Medicine. I have also written books for the general public concerning
simple steps that we can all take to lower our risk of heart disease.
It’s the other four-letter word. The D-word. The D-bomb.
Why do we hate that word so much?
Hunger. Failure. Rules. Restrictions. Deprivation. Expectations.
Rebound weight-gain. Eating disorders. Strained relationships.
Bad foods. Bad moods. Bad breath. Guilt.
There are so many negative associations with the word diet, it’s no wonder that over half the North American population is overweight. We hate dieting. It’s torturous. Tacky. Totally depressing. And even worse, dieting doesn’t seem to work.
Refusal to maintain body weight at or above a minimally normal weight for age and height. (This includes a failure to achieve weight gain expected during a period of growth leading to an abnormally low body weight.)
Intense fear of weight gain or becoming fat.
Distortion of body image (e.g., feeling fat despite an objectively low weight or minimizing the seriousness of low weight).
Amenorrhea. (This criterion is met if menstrual periods occur only following hormone—e.g., estrogen—administration.
We asked Rowett to look ahead to 2020 and to map how the diet changes in line with predicted
increases in population. The modelling shows that our diets will not need to change that much from
current guidelines if we are to meet the WWF 2020 GHGE targets. We will still be able to eat meat and
dairy, crisps and chocolate, for example. The weekly menu contains fish and chips, macaroni cheese,
chicken curry and beef chilli, as well as plentiful amounts of fruit and vegetables – so it’s not a mundane
menu. This demonstrates that you do not necessarily...
Table 73-10 Enteral Formulas
STANDARD ENTERAL FORMULA
1. Complete dietary products (+)a
requiring tube feeding; some can be a. Caloric density 1 kcal/mL used orally b. Protein ~14% cals, caseinates,
c. CHO ~60% cals, hydrolyzed corn starch, maltodextrin, sucrose
d. Fat ~30% cals, corn, soy, safflower oils
e. Recommended daily intake of all minerals and vitamins in 1500 kcal/d
f. Osmolality (mosmol/kg): ~300
MODIFIED ENTERAL FORMULAS
1. Caloric density 1.
The concept of nutritional essentiality was firmly established less than 100 years ago. It arose from observations that certain diseases observed in human populations
consuming poor diets could be prevented by including other foods in the diet and that failure of animals fed on diets composed of purified components or restricted to
one or a few foodstuffs to grow and survive could similarly be corrected by including another food or an extract of the food in the diet. The food constituents that were
found to prevent these problems were classified as indispensable (or essential) nutrients.
Nutritional Dietary folate deficiency is common. Indeed, in most patients with folate deficiency a nutritional element is present. Certain individuals are particularly prone to have diets containing inadequate amounts of folate (Table 100-5). In the United States and other countries where fortification of the diet with folic acid has been adopted, the prevalence of folate deficiency has dropped dramatically and is now almost restricted to high-risk groups with increased folate needs.