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Nutritional Pathophysiology of Obesity and its Comorbidities
A Case-Study Approach
1st Edition - September 1, 2016
Author: Susan Ettinger
Hardback ISBN:9780128030134
9 7 8 - 0 - 1 2 - 8 0 3 0 1 3 - 4
eBook ISBN:9780128030349
9 7 8 - 0 - 1 2 - 8 0 3 0 3 4 - 9
Nutritional Pathophysiology of Obesity and Its Comorbidities: A Case-Study Approach challenges students and practitioners to understand the role of nutrients within the… Read more
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Nutritional Pathophysiology of Obesity and Its Comorbidities: A Case-Study Approach challenges students and practitioners to understand the role of nutrients within the pathophysiology and development of disease, specifically those diseases which develop as a result of obesity. Through a case-based approach, the author presents complex clinical scenarios that require multiple treatment strategies, including targeted diet modification as an adjuvant to medical therapy.
The book is divided into 9 modules and 5 appendices each of which covers aspects of obesity and its comorbidities. Within each module, a case is detailed with relevant history, laboratory and physical data, and follow-up information. Each case is followed by a resource section which delineates current understanding of the pathophysiology of the condition, as well as the actions of nutrients and food components shown to modify these processes. A "further readings" section cites current supporting clinical and basic literature as well as published guidelines.
Explores how obesity is a key player in the pathophysiology of many diseases, including diabetes mellitus, chronic renal failure, hypertension, and atherosclerosis
Integrates current understandings of the molecular mechanisms of nutrient action on the processes of disease development and treatment
Presents students and early practitioners with complex clinical scenarios through a practical case-based approach
Medical students, fellows and residents in endocrinology and pathology; graduate students in pathology and nutrition.
Foreword
Foreword
Preface
Chapter 1. Obesity and Metabolic Syndrome
Abstract
Chief Complaint (Typical Patient)
Medical History
Family History
Physical Examination
Laboratory Data
Diet History
A 24-hour Dietary Recall
Resources
1.2 Nutrient Sensors and Downstream Targets
1.3 AT Form and Function
1.4 AT Dysregulation and Metabolic Syndrome
1.5 Gut Microbiota and Obesity
1.6 Goals and Practical Issues in Weight Loss Management
1.7 Management of MS
1.8 Diet Patterns That Modify Risk for Obesity and MS
1.9 Specific Diet Components That Target Obesity and MT
1.10 Future Research Needs
References
Further Reading
Chapter 2. The Obese Gunshot Patient: Injury and Septic Shock
Abstract
Chief Complaint (Typical Patient)
Patient History
Physical Examination
Pertinent Laboratory Data
Medical and Nutrition History
Emergency Treatment
Hospital Course
Resources
2.2 Traumatic Injury: Gunshot Wounds
2.3 Innate Host Defense
2.4 Mediators of the Acute-Phase Response
2.5 Hyperinflammation, Sepsis, and Shock
2.6 Body Composition and Macronutrient Changes in APR
2.7 Targeted Nutrient Strategies for Wound Healing
2.8 Micronutrients, Pathogens, and Response to Injury
2.9 Current Recommendations for Patient Feeding
References
Further Reading
Chapter 3. Type I Diabetes and Celiac Disease
Abstract
Chief Complaint (Typical Patient)
Past Medical History and Medication
Social History
Resources
3.2 Type I DM as Dysregulated Immune Response
3.3 Metabolic Dysregulation, Clinical Presentation, and Diagnosis of Type I DM
3.4 Standards of Care for Type I Diabetes
3.5 Evidence for Targeted Nutrient Modification in Type I DM
3.6 Autoimmune Conditions that Complicate Type I DM
3.7 Medical Nutrition Therapy for Celiac Disease
3.8 Future Research Needs
References
Further Reading
Chapter 4. Type II Diabetes, Peripheral Neuropathy, and Gout
Abstract
Chief Complaint (Adapted from)
Past Medical History and Medication
Family Medical History
Social History
Presenting Symptoms
Physical Examination
24-Hour Diet Recall
Diet Analysis
Resources
4.2 Dysregulation of Insulin Secretion and Signaling
4.3 Nutrients, Insulin Secretion, Insulin Signaling, and Type II DM Risk
4.4 Recommended Nutrition Therapy to Manage Diabetes
4.5 Differential Diagnosis of Peripheral Neuropathy in Diabetes
4.6 Nutrient-Associated Neuropathy
4.7 Nutrient-Associated Gout
4.8 Future Research Needs
References
Further Reading
Chapter 5. Cardiopathy and Congestive Heart Failure
Abstract
Chief Complaint (Adapted from)
Past Medical History and Medications
Lifestyle and Family History
Nutrition History
Intake Examination
Cardiac Catheterization Data
Resources
5.1 The Compromised Heart
5.2 Cardiomyocyte Excitation–Contraction
5.3 Myocardial Injury and Consequences
5.4 Targets for Myocardial Protection: Macronutrient Dysregulation
5.5 Targets for Myocardial Protection: Oxidative Damage
5.6 Targets for Myocardial Protection: Calcium and Hypercontracture
5.7 Targets for Myocardial Protection: Cardiac Remodeling
5.8 Chronic Heart Failure and Cardiac Cachexia
5.9 Dietary Guidelines to Prevent Cardiomyopathy and Manage Chronic Heart Failure
5.10 Targeted Diet Modification to Reduce Risk for Cardiomyopathy
5.11 Future Research Needs
References
Further Reading
Chapter 6. Atherosclerosis and Arterial Calcification
Abstract
Chief Complaint (Typical Patient)
Patient History
Medical History
Diet and Lifestyle History
Physical Examination
Diet History
Hospital Course
Resources
6.2 Pathogenesis of the Complex Atherosclerotic Plaque
6.3 Targets for Atherosclerotic Prevention and Control
6.4 Increased AS Risk Related to Obesity and its Comorbities
6.5 Influence of the Microbiome on AS Risk
6.6 Metabolic Targets for Diet Modification
6.7 Nutrients that Potentially Increase AS Risk
6.8 Nutrient Dysregulations that Lead to Arterial Calcification
6.9 Published Diet Recommendations for Cardiovascular Risk Reduction
7.2 Targets for Slowing Progression of Diabetic Nephropathy
7.3 Macronutrient Implications in Diabetic Nephropathy Progression
7.4 Current Published Recommendations to Slow Progression to ESKD
7.5 Targeted Macronutrient Modification to Slow CKD Progression
7.6 Strategies to Ameliorate Micronutrient Alterations Due to Impaired Kidney Function
7.7 Future Research Needs
References
Further Reading
Chapter 8. Asthma and Obesity
Abstract
Chief Complaint (Adapted from Wechsler, M.E., 2007)
Medical History
Family History
Physical Examination (Hospital Day 2)
Dietary History
Discharge Instructions
Resources
8.2 Asthma Symptoms, Statistics, and Management
8.3 Pathophysiology of Asthma
8.4 Pathology of the Asthma Attack
8.5 Targets for Asthma Control: Airway Remodeling and Mucus Production
8.6 Targets for Asthma Control: Obesity and Lifestyle Risks
8.7 Diet in the Management of Airway Hypersensitivity
8.8 Future Research Needs
Appendix Drugs Used for Asthma
References
Further Reading
Chapter 9. Osteoporosis and Fracture Risk
Abstract
Chief Complaint (Adapted from)
Past Medical History and Medications
Life Style and Family History
Nutrition History
Anthropometrics
Resources
9.2 Bone Cells and Normal Mechanisms of Bone Remodeling
9.3 Integration of Bone and Intermediary Metabolism
9.4 Impact of Hormones, Obesity, and Aging on Bone
9.5 Clinical Diagnosis and Management of the Fracture-Risk Patient
9.6 Targets for Dietary Intervention in Osteoporosis and Fracture Risk
9.7 Nutrients for Bone Matrix and Collagen Crosslinking
9.8 Antiresorptive Effects of Dietary Factors
9.9 Future Research Needs
References
Further Reading
Essentials I. Life in an Aerobic World
EI.1 Nutrients, Mitochondrial Antioxidants, and Antioxidant Protection
EI.2 Nutrients and Transcriptional Control of Antioxidant Protection
EI.3 Single-Unit Antioxidant Nutrients
EI.4 Tocopherols; Tocotrienols (Vitamin E)
EI.5 Ascorbate (Vitamin C)
EI.6 Selenium (Se)
EI.7 Riboflavin (Vitamin B2)
EI.8 Coenzyme Q-10 (CoQ10)
References
Essentials II. Heavy Metals, Retinoids, and Precursors
EII.1 Iron
EII.2 Zinc
EII.3 Copper
EII.4 Retinoid and Iron Interactions in Obesity and Metabolic Syndrome
EII.5 Carotenoids
Essentials III. Nutrients for Bone Structure and Calcification
EIII.1 Klotho
EIII.2 Integrated Regulation of Calcium, Phosphorus, and Vitamin D Homeostasis
EIII.3 Mineral Metabolism
EIII.4 Vitamin Metabolism
Essentials IV. Diet, Microbial Diversity, and Gut Integrity
EIV.1 Microbial Diversity, Function, and Diet
EIV.2 Influence of Diet on Gut Barrier Function
Essentials V. Nutrition Support in Critically Ill Patients,
EV.1 Nutrition Support Recommendations: 2015
EV.2 Strategies to Initiate Enteral Feeding
EV.3 When to Use PN
EV.4 Strategies for Enteral Feeding
EV.5 Recommendations for the Obese Patient
EV.6 Monitoring Tolerance and Adequacy of EN
EV.7 Selection of Appropriate Enteral Formulation
EV.8 Adjunctive Therapy
EV.9 When Indicated, Maximize Efficacy of PN
Index
No. of pages: 334
Language: English
Published: September 1, 2016
Imprint: Academic Press
Hardback ISBN: 9780128030134
eBook ISBN: 9780128030349
SE
Susan Ettinger
Susan Ettinger has focused her career at the interface of nutrition science and medicine. She began her nutrition studies with the hypothesis that the non-physician medical nutrition scientist was urgently needed to liaison with clinicians and researchers to translate nutritional findings from bench to bedside. She undertook a doctoral curriculum combining nutrition and medical sciences at Columbia University and postdoctoral training in the molecular biology of cancer, aging and immunology at Cornell University Medical Center. She was awarded an R25 grant from NCI to study the feasibility of training post-masters students in cancer nutrition and subsequently joined Dr. Pi Sunyer at the New York Obesity Research Center to test the curriculum with postdoctoral candidates. She continues to collaborate with faculty at Columbia University Medical Center to develop a curriculum to disseminate information at the interface of nutrition, obesity and cancer to health science professionals at multiple training levels.
Affiliations and expertise
Past Associate Professor and Chair, Clinical Nutrition Department, New York Institute of Technology; Adjunct Associate Professor, Nutrition and Food Science, Hunter College, City University of New York, New York, NY, USA; Research Associate, Division of Endocrinology Diabetes & Nutrition, Mount Sinai St. Luke's-Roosevelt Hospital, New York NY, USA