Rheumatology, dermatology, and bone health

Osteoarthritis 702 Rheumatoid arthritis 704 Gout 706 Systemic lupus erythematosus 708 Atopic eczema 709 Epidermolysis bullosa 710 Osteoporosis 712 It is estimated that ∼8.5 million people in the UK are affected by osteoarthritis (OA). This is the most common reason for the >50,000 hip replacements undertaken each year. These numbers are likely to increase as the population ages as this condition primarily affects people aged over 40 years. The hands, knees, hips, and feet are most commonly affected....

Nutrition in mental health

Introduction 672 Pharmacotherapy in mental health 673 Who can contribute to nutritional care in mental health? 674 Nutrition in specific mental health conditions 676 Developmental disorders 678 Eating disorders 680 Dementia 684 Mental Capacity Act 2005 687 Nutrition interacts with and influences mental health in a comparable way to physical health: a ‘healthy and varied diet’ can help promote mental well-being whilst an inadequate or excessive intake of food or specific nutrients can have a detrimental effect on mental health (...

Human immunodeficiency virus (HIV) infection

Introduction, nutritional goals, and assessment 664 Unintentional weight and lean tissue loss 666 Cardiovascular risk and complications associated with HIV disease and treatment 667 Additional dietary issues 668 Untreated human immunodeficiency virus (HIV) infection leads to progressive suppression of immune function, eventually rendering the body susceptible to opportunistic infections and tumours. While there is no cure, antiretroviral therapy (ART) is highly effective in suppressing HIV replication. HIV disease is now a chronic condition and causes of death in this population have shifted from traditional AIDS-related illnesses to non-AIDS (Acquired Immune Deficiency Syndrome) events, the most common being atherosclerotic cardiovascular disease, liver disease, end-stage renal disease and non-AIDS–defining malignancies. There are a diverse range of nutritional conditions associated with HIV, reflecting the complexity of the disease and pharmacological management....

Renal disease

Introduction 632 Nutritional assessment 634 Malnutrition in renal disease 636 Nutritional considerations in chronic kidney disease 638 Nutrition in acute kidney injury 641 Nutrition in chronic kidney disease stages 3 and 4 642 Nephrotic syndrome 644 Nutritional requirements in dialysis 646 Nutritional requirements in haemodialysis ...

Pancreatic disease

Pancreatic disorders 612 Pancreatic enzyme replacement therapy 616 See Table 27.1. The major pancreatic disorders include pancreatitis and pancreatic cancer. Pancreatitis results from the auto-digestion of the pancreas by activated pancreatic enzymes. It can be categorized as: • Chronic pancreatitis (CP). • Acute pancreatitis: •...

Sustainable diets

Sustainability and nutrition 380 Sustainable development 382 Food security 383 Climate change and obesity 384 Useful websites and further reading 388 The public health nutrition field has identified a need to encompass the inter-relationship of man with his environment (The Giessen Declaration, 2005). Ecological public health nutrition places nutrition within its wider structural settings including the political, physical, socio-cultural and economic environment that influence individual behaviour and health. As a consequence, it includes the impact of what is eaten on the natural environment as well as the impact of environmental and climate change on all components of food security, i.e. on what food is available, accessible, utilizable and stable (...

Popular diets

This section is included to help orientate health-care professionals to diets that their patients may initiate or possibly seek advice about. It does not validate their efficacy. For many, evidence of benefit in the form of a randomized controlled trial is not available. However, the concerns, described below, about potential harm resulting from some diets are based on scientific principles....

Food labelling, functional foods, nutrigenetics, and nutrigenomics and food supplements

Food labelling 166 Functional foods and nutraceuticals 174 Nutrigenetics and nutrigenomics 178 Food supplements 182 Food labelling in the UK is currently controlled by the Food Labelling Regulations of 1996, subsequent amendments to these regulations, and also by European laws. Legally these regulations fall under the Food Safety Act of 1990. In the UK foods sold loose are exempt from many labelling regulations....

Electrolytes and Fluid balance

Electrolytes: introduction 154 Sodium 154 Potassium 158 Chloride 161 Fluid balance 162 The monovalent electrolytes are Sodium (Na), Chlorine (Cl), and Potassium (K). An adult male (70 kg) has total body Na of 4 mol (92 g); 2000 mmol is in extracellular fluid (ECF), 1500 mmol in bone, and 500 mmol in intracellular fluid (ICF)....

Introduction to nutrition

Definitions and titles 2 Components of the diet 6 Food composition tables 10 Digestion 14 ‘Nutrition is the branch of science that studies the process by which living organisms take in and use food for the maintenance of life, growth, reproduction, the functioning of organs and tissues, and the production of energy.’...