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Krause and Mahan's Food and the Nutrition Care Process
A trusted classic for over 50 years, Krause and Mahan's Food & the Nutrition Care Process, 15th Edition presents the most up-to-date dietetics content available in this ever-changing field to ensure you provide optimal nutritional care. It offers cutting-edge, comprehensive coverage of a full range of dietetics topics, all in one book. You'll benefit from in-depth information from clinical specialists that provides practical and evidence-based recommendations related to nutrition assessment and intervention, nutritional needs of individuals in different stages of the life cycle, nutrition for health and fitness, and medical nutrition therapy.
UNIQUE! Pathophysiology algorithms present the cause, pathophysiology, and medical nutrition management for a variety of disorders and conditions to help you provide optimal nutritional care.
UPDATED! Inflammation and the Pathophysiology of Chronic Disease chapter offers vital information to help you understand how diet and nutrition affect the body and contribute to disease processes.
UPDATED! Part III: Nutrition in the Life Cycle section of chapters explains the newest nutrition guidelines from pregnancy through adult years to increase your understanding of the nutritional needs of patients at every age.
Clinical case studies help you translate academic knowledge into practical patient care using the nutrition care process.
Nutrition Diagnosis boxes present a problem, its etiology, and its signs and symptoms before concluding with a sample nutrition diagnosis, providing you with real-life scenarios you may encounter in practice.
Clinical Insight boxes expand on clinical information, highlight new areas of focus, and contain clinical resources for your studies.
UNIQUE! Pathophysiology algorithms present the cause, pathophysiology, and medical nutrition management for a variety of disorders and conditions to help you provide optimal nutritional care.
UPDATED! Inflammation and the Pathophysiology of Chronic Disease chapter offers vital information to help you understand how diet and nutrition affect the body and contribute to disease processes.
UPDATED! Part III: Nutrition in the Life Cycle section of chapters explains the newest nutrition guidelines from pregnancy through adult years to increase your understanding of the nutritional needs of patients at every age.
Clinical case studies help you translate academic knowledge into practical patient care using the nutrition care process.
Nutrition Diagnosis boxes present a problem, its etiology, and its signs and symptoms before concluding with a sample nutrition diagnosis, providing you with real-life scenarios you may encounter in practice.
Clinical Insight boxes expand on clinical information, highlight new areas of focus, and contain clinical resources for your studies.
4838 pages, Kindle Edition
First published January 1, 2011
81 people are currently reading
421 people want to read
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Displaying 1 - 7 of 7 reviews
January 20, 2015
This is an excellent book for anyone wishing to go into the nutrition field. I used this book for a class and will be using this book in the field for a reference as well.
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April 4, 2024fiber and resistant carbohydrates, digestion and absorption of food is completed essentially in the small intestine.
vitamin B12 absorption in the ileum
The feces generally consist of 75% water and 25% solids, but the proportions vary greatly. Approximately two-thirds of the contents of the wet weight of the stool is bacteria
A diet that includes abundant fruits, vegetables, legumes, and whole grains typically results in a shorter overall GIT transit time, more frequent defecation, and larger and softer stools.
prebiotics, probiotics, and synbiotics
Good dietary sources of prebiotic carbohydrates include vegetables (including onions, garlic, and asparagus), fruits (especially bananas, apples, stone fruits, and mangos), grains, legumes, chicory, Jerusalem artichokes, soybeans, and wheat bran
Current recommendations are for the consumption of approximately 14 g of dietary fiber per 1000 kcal consumed each day.
the most effective oral rehydration solutions often include both sugar and salt, in addition to water.
The exact mechanisms that cause a food to become an allergen are not entirely clear, but these foods tend to be high in protein, to be relatively resistant to complete digestion, and to produce an immunoglobulin response
Almost all protein is absorbed by the time it reaches the end of the jejunum, and only 1% of ingested protein is found in the feces.
Useful websites:
- American Gastroenterological Association (AGA)
- NIH Digestive Diseases
- NIH Human Microbiome Project
The standard unit for measuring energy is the calorie, which is the amount of heat energy required to raise the temperature of 1 mL of water at 15°C by 1°C.
The joule (J) measures energy in terms of mechanical work and is the amount of energy required to accelerate with a force of 1 Newton (N) for a distance of 1 m. One kcal is equivalent to 4.184 kilojoules (kJ).
The doubly labeled water (DLW) technique for measuring TEE is considered the gold standard for determining energy requirements and energy balance in humans.
Harris-Benedict equations were some of the most widely used equations to estimate REE. The Harris-Benedict equations have been found to overestimate REE in normal-weight and obese individuals by 7% to 27%.
A MET value of 1 is the oxygen metabolized at rest (3.5 mL of oxygen per kilogram of body weight per minute in adults) and can be expressed as 1 kcal/kg of body weight per hour. or example, an adult who weighs 65 kg and is walking moderately at a pace of 4 mph (which is a MET value of 4.5) would expend 293 calories in 1 hour (4.5 kcal × 65 kg × 1 = 293).
Not all of the energy in foods and alcohol is available to the body’s cells, because the processes of digestion and absorption are not completely efficient.
Fiber is an “unavailable carbohydrate” that resists digestion and absorption; its energy contribution is minimal.
Water accounts for 60% to 70% of total body weight in the lean adult but only 45% to 55% in the obese adult. Total body water is higher in athletes than in nonathletes, decreases with age, and decreases with diminished muscle mass.
Loss of 20% of body water (dehydration) may cause death; loss of only 10% may lead to damage to essential body systems. Even mild dehydration (loss of 1% to 2%) can lead to loss of cognitive function and alertness, an increase in heart rate, and a decrease in exercise performance.
Thirst is regulated by the hypothalamus
men should consume about 11.5 cups and women need 7 cups of fluids daily. A lactating woman’s need for water also increases, approximately 2 ½ to 3 cups per day for milk production.
here is no gold standard to assess hydration status.
The major extracellular electrolytes are sodium, calcium, chloride, and bicarbonate. Potassium, magnesium, and phosphate are the major intracellular electrolytes.
Ca⁺⁺ 1000 - 3000 mg/day. Excessive intake of Ca++ may lead to kidney stones and gastrointestinal side effects like constipation.
Na⁺ 1.2 - 2.3 g/day. Na+ level greater than 145 mEq/L is classified as hypernatremia. persistent excessive Na+ intake has been implicated in development of hypertension.
Mg²⁺ 310 to 420 mg/day. ymptoms of hypomagnesemia include muscle weakness, tetany, ataxia, nystagmus, and, in severe cases, ventricular arrhythmia.
P 700 - 4000 mg. Phosphorus absorption decreases when vitamin D deficiency occur.
K⁺ 4700 mg/day - No upper limit. Insufficient K+ intake has been linked to hypertension and cardiac arrhythmia.
If the iron deficiency is detected in the early stages through a ferritin test. the imbalance will lead to overt anemia and chronic fatigue.
Clients can photograph food and beverages consumed
tolerable upper level (UL)
Fasting glucose >125 mg/dL indicates DM (oral glucose tolerance tests are not needed for diagnosis); fasting glucose >100 mg/dL is indicator of insulin resistance
a stool sample and can reveal excessive amounts of fat (an indication of malabsorption)
Inflammation is a protective response by the immune system to infection, acute illness, trauma, toxins, many chronic diseases, and physical stress
Red Blood Cell (RBC) Folate concentration is a better indicator of folate status than serum folate, because folate is much more concentrated in red blood cells than in the serum.
Fat-soluble vitamins. Fat malabsorption often results in impaired absorption of vitamins A, E, D, and K.
Vitamin A status can be estimated using serum retinol, and the normal level in adults is 30 to 80 mcg/dL. vitamin A toxicity is defined as retinol levels greater than 100 mcg/dL
Vitamin D sufficiency is defined as 25(OH)D3 at 75 nmol/L, or 30 ng/mL (AGS, 2014). Serum levels even higher at 90 to 100 nmol/L (36 to 40 ng/mL) are recommended by some (Bischoff-Ferrari, 2014).
Stadiometer
A commonly used method of determining ideal body weight is the Hamwi Equation (Hamwi et al, 1964).
Men: 106 lb for first 5 feet of height and 6 lb per inch over 5 feet; or 6 lb subtracted for each inch under 5 feet
Women: 100 lb for first 5 feet of height and 5 lb per inch over 5 feet; or 5 lb subtracted for each inch under 5 feet
blacks have greater bone mineral density and body protein compared with whites (Wagner and Heyward, 2000)
A waist circumference of greater than 40 inches (102 cm) for men and greater than 35 inches (88 cm) for women is an independent risk factor for metabolic disease (CDC, 2014; Stone et al, 2013). These measurements may not be as useful for those less than 60 inches tall or with a BMI of 35 or greater (CDC, 2014).
The waist-to-height ratio (WHtR) is defined as the waist circumference divided by the measured height. WHtR is a measure of the distribution of adipose tissue. Generally speaking, the higher the values of WHtR, the greater the risk of metabolic syndrome and obesity-related atherosclerotic cardiovascular diseases (Schneider et al, 2010). Desirable ratios are less than 0.5 in adults 40 years and younger, between 0.5 and 0.6 in adults aged 40 to 50 years, and 0.6 or less in adults over 50. These targets apply to both males and females and a variety of ethnic groups.
Dual-energy x-ray absorptiometry (DXA) measures fat, bone mineral, and fat-free soft tissue. Generally, it is found to be a reliable measurement of percentage body fat.
Indirect calorimetry is the most accurate method for estimating energy expenditure by measuring inspired and expired oxygen and carbon dioxide.
Low grip strength is associated consistently with a greater likelihood of premature mortality
health-promoting factors include nutrition, exercise, adequate sleep, healthy relationships
Genetics is the science of heredity
The Human Genome Project (HGP) was a $15 billion international effort that began in 1990, headquartered within the U.S. by the Department of Energy and the National Institutes of Health. The initial goal was to identify each of the 3 billion nucleotides in human DNA. epigenetics, which has been a bit of a “missing link” in understanding how genes give rise to chronic diseases.
Genetic variability can lead to differing function in these enzymes, which explains why a drug may have the intended effects for one person, be ineffective for another, and be harmful to a third. By identifying known mutations in biochemical pathways involved in the drug’s metabolism, it becomes possible to identify individuals for whom the drug therapy will be beneficial but also to assist with calculating the appropriate dose from the outset of therapy.
warfarin was one of the earliest drugs to which pharmacogenomics was applied. Variation in the CYP2C9, VKORC1, or CYP4F2 genes influence its safe use.
Epigenetics is concerned with the processes involved in regulating gene expression, how genes are turned on or off and the mechanisms involved. Epigenomics, in contrast, is the collective set of epigenetic tags in a genome.
Somatic (body) cells also pass on their epigenetic marks each time they divide, which is essential for cells to maintain their specialization (as heart cells, kidney cells, etc.).
vitamin B12 absorption in the ileum
The feces generally consist of 75% water and 25% solids, but the proportions vary greatly. Approximately two-thirds of the contents of the wet weight of the stool is bacteria
A diet that includes abundant fruits, vegetables, legumes, and whole grains typically results in a shorter overall GIT transit time, more frequent defecation, and larger and softer stools.
prebiotics, probiotics, and synbiotics
Good dietary sources of prebiotic carbohydrates include vegetables (including onions, garlic, and asparagus), fruits (especially bananas, apples, stone fruits, and mangos), grains, legumes, chicory, Jerusalem artichokes, soybeans, and wheat bran
Current recommendations are for the consumption of approximately 14 g of dietary fiber per 1000 kcal consumed each day.
the most effective oral rehydration solutions often include both sugar and salt, in addition to water.
The exact mechanisms that cause a food to become an allergen are not entirely clear, but these foods tend to be high in protein, to be relatively resistant to complete digestion, and to produce an immunoglobulin response
Almost all protein is absorbed by the time it reaches the end of the jejunum, and only 1% of ingested protein is found in the feces.
Useful websites:
- American Gastroenterological Association (AGA)
- NIH Digestive Diseases
- NIH Human Microbiome Project
The standard unit for measuring energy is the calorie, which is the amount of heat energy required to raise the temperature of 1 mL of water at 15°C by 1°C.
The joule (J) measures energy in terms of mechanical work and is the amount of energy required to accelerate with a force of 1 Newton (N) for a distance of 1 m. One kcal is equivalent to 4.184 kilojoules (kJ).
The doubly labeled water (DLW) technique for measuring TEE is considered the gold standard for determining energy requirements and energy balance in humans.
Harris-Benedict equations were some of the most widely used equations to estimate REE. The Harris-Benedict equations have been found to overestimate REE in normal-weight and obese individuals by 7% to 27%.
A MET value of 1 is the oxygen metabolized at rest (3.5 mL of oxygen per kilogram of body weight per minute in adults) and can be expressed as 1 kcal/kg of body weight per hour. or example, an adult who weighs 65 kg and is walking moderately at a pace of 4 mph (which is a MET value of 4.5) would expend 293 calories in 1 hour (4.5 kcal × 65 kg × 1 = 293).
Not all of the energy in foods and alcohol is available to the body’s cells, because the processes of digestion and absorption are not completely efficient.
Fiber is an “unavailable carbohydrate” that resists digestion and absorption; its energy contribution is minimal.
Water accounts for 60% to 70% of total body weight in the lean adult but only 45% to 55% in the obese adult. Total body water is higher in athletes than in nonathletes, decreases with age, and decreases with diminished muscle mass.
Loss of 20% of body water (dehydration) may cause death; loss of only 10% may lead to damage to essential body systems. Even mild dehydration (loss of 1% to 2%) can lead to loss of cognitive function and alertness, an increase in heart rate, and a decrease in exercise performance.
Thirst is regulated by the hypothalamus
men should consume about 11.5 cups and women need 7 cups of fluids daily. A lactating woman’s need for water also increases, approximately 2 ½ to 3 cups per day for milk production.
here is no gold standard to assess hydration status.
The major extracellular electrolytes are sodium, calcium, chloride, and bicarbonate. Potassium, magnesium, and phosphate are the major intracellular electrolytes.
Ca⁺⁺ 1000 - 3000 mg/day. Excessive intake of Ca++ may lead to kidney stones and gastrointestinal side effects like constipation.
Na⁺ 1.2 - 2.3 g/day. Na+ level greater than 145 mEq/L is classified as hypernatremia. persistent excessive Na+ intake has been implicated in development of hypertension.
Mg²⁺ 310 to 420 mg/day. ymptoms of hypomagnesemia include muscle weakness, tetany, ataxia, nystagmus, and, in severe cases, ventricular arrhythmia.
P 700 - 4000 mg. Phosphorus absorption decreases when vitamin D deficiency occur.
K⁺ 4700 mg/day - No upper limit. Insufficient K+ intake has been linked to hypertension and cardiac arrhythmia.
If the iron deficiency is detected in the early stages through a ferritin test. the imbalance will lead to overt anemia and chronic fatigue.
Clients can photograph food and beverages consumed
tolerable upper level (UL)
Fasting glucose >125 mg/dL indicates DM (oral glucose tolerance tests are not needed for diagnosis); fasting glucose >100 mg/dL is indicator of insulin resistance
a stool sample and can reveal excessive amounts of fat (an indication of malabsorption)
Inflammation is a protective response by the immune system to infection, acute illness, trauma, toxins, many chronic diseases, and physical stress
Red Blood Cell (RBC) Folate concentration is a better indicator of folate status than serum folate, because folate is much more concentrated in red blood cells than in the serum.
Fat-soluble vitamins. Fat malabsorption often results in impaired absorption of vitamins A, E, D, and K.
Vitamin A status can be estimated using serum retinol, and the normal level in adults is 30 to 80 mcg/dL. vitamin A toxicity is defined as retinol levels greater than 100 mcg/dL
Vitamin D sufficiency is defined as 25(OH)D3 at 75 nmol/L, or 30 ng/mL (AGS, 2014). Serum levels even higher at 90 to 100 nmol/L (36 to 40 ng/mL) are recommended by some (Bischoff-Ferrari, 2014).
Stadiometer
A commonly used method of determining ideal body weight is the Hamwi Equation (Hamwi et al, 1964).
Men: 106 lb for first 5 feet of height and 6 lb per inch over 5 feet; or 6 lb subtracted for each inch under 5 feet
Women: 100 lb for first 5 feet of height and 5 lb per inch over 5 feet; or 5 lb subtracted for each inch under 5 feet
blacks have greater bone mineral density and body protein compared with whites (Wagner and Heyward, 2000)
A waist circumference of greater than 40 inches (102 cm) for men and greater than 35 inches (88 cm) for women is an independent risk factor for metabolic disease (CDC, 2014; Stone et al, 2013). These measurements may not be as useful for those less than 60 inches tall or with a BMI of 35 or greater (CDC, 2014).
The waist-to-height ratio (WHtR) is defined as the waist circumference divided by the measured height. WHtR is a measure of the distribution of adipose tissue. Generally speaking, the higher the values of WHtR, the greater the risk of metabolic syndrome and obesity-related atherosclerotic cardiovascular diseases (Schneider et al, 2010). Desirable ratios are less than 0.5 in adults 40 years and younger, between 0.5 and 0.6 in adults aged 40 to 50 years, and 0.6 or less in adults over 50. These targets apply to both males and females and a variety of ethnic groups.
Dual-energy x-ray absorptiometry (DXA) measures fat, bone mineral, and fat-free soft tissue. Generally, it is found to be a reliable measurement of percentage body fat.
Indirect calorimetry is the most accurate method for estimating energy expenditure by measuring inspired and expired oxygen and carbon dioxide.
Low grip strength is associated consistently with a greater likelihood of premature mortality
health-promoting factors include nutrition, exercise, adequate sleep, healthy relationships
Genetics is the science of heredity
The Human Genome Project (HGP) was a $15 billion international effort that began in 1990, headquartered within the U.S. by the Department of Energy and the National Institutes of Health. The initial goal was to identify each of the 3 billion nucleotides in human DNA. epigenetics, which has been a bit of a “missing link” in understanding how genes give rise to chronic diseases.
Genetic variability can lead to differing function in these enzymes, which explains why a drug may have the intended effects for one person, be ineffective for another, and be harmful to a third. By identifying known mutations in biochemical pathways involved in the drug’s metabolism, it becomes possible to identify individuals for whom the drug therapy will be beneficial but also to assist with calculating the appropriate dose from the outset of therapy.
warfarin was one of the earliest drugs to which pharmacogenomics was applied. Variation in the CYP2C9, VKORC1, or CYP4F2 genes influence its safe use.
Epigenetics is concerned with the processes involved in regulating gene expression, how genes are turned on or off and the mechanisms involved. Epigenomics, in contrast, is the collective set of epigenetic tags in a genome.
Somatic (body) cells also pass on their epigenetic marks each time they divide, which is essential for cells to maintain their specialization (as heart cells, kidney cells, etc.).
November 10, 2022
I bought the 13th edition.
First off, the authors advocate for the Food Pyramid, now called MyPlate. Since 1980, when these misguided nutritional guidelines were published, obesity and all of its health related maladies have exploded.
They explain that brown adipose tissue (BAT) gets its color from, "extensive vascularization". While there are capillaries in BAT, it is now widely accepted that the color is due to the density of mitochondria within the brown adipose cells.
Their section on "Management of Obesity in Adults" fails to even mention the root cause: Insulin resistance caused by eating a high carbohydrate diet.
If you want to learn true medicinal nutrition, don't get this book. If you plan to work for Big Food or Big Pharma and want to keep spreading corporate lies, this is your book.
First off, the authors advocate for the Food Pyramid, now called MyPlate. Since 1980, when these misguided nutritional guidelines were published, obesity and all of its health related maladies have exploded.
They explain that brown adipose tissue (BAT) gets its color from, "extensive vascularization". While there are capillaries in BAT, it is now widely accepted that the color is due to the density of mitochondria within the brown adipose cells.
Their section on "Management of Obesity in Adults" fails to even mention the root cause: Insulin resistance caused by eating a high carbohydrate diet.
If you want to learn true medicinal nutrition, don't get this book. If you plan to work for Big Food or Big Pharma and want to keep spreading corporate lies, this is your book.
December 31, 2018
Excellent reference book for RDNs. I like the changes to the layout over previous editions. But I was somewhat horrified to see a chapter (and some smatterings in other chapters as well) on integrative and functional nutrition. Weak and misleading sources are cited to support this area of practice. I rely on Krause to be a go-to for evidence-based practice and I think it drops the ball here. I worry that newer RDNs will conclude there is stronger evidence than there actually is for this area of practice based simply on the basis of Krause's reputation as the gold standard for evidence-based information. Very disappointing.
May 6, 2024
This was a long time in finishing. But it IS a textbook. There is a plethora of information about different systems and specific diets for different diseases and disorders. However, I have to disagree with the “standard” treatments that are considered in the book. I feel Krause, along with much of the American medical system, is trying to isolate nutritional problems and needs to consider the overall approach. My beliefs are "heal the gut first, allowing for optimal absorption, eat REAL food, and then work on the particulars of nutrient deficiencies."
June 4, 2017
4.5 stars
July 20, 2019
Best book
Displaying 1 - 7 of 7 reviews