Balanced Diet - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

BALANCED DIET A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

ii

ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Balanced Diet: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00123-3 1. Balanced Diet-Popular works. I. Title.

iii

Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

iv

Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on balanced diet. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

v

About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

vi

About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

vii

Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON BALANCED DIET ....................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Balanced Diet .............................................................................. 14 The National Library of Medicine: PubMed ................................................................................ 15 CHAPTER 2. NUTRITION AND BALANCED DIET ............................................................................. 19 Overview...................................................................................................................................... 19 Finding Nutrition Studies on Balanced Diet............................................................................... 19 Federal Resources on Nutrition ................................................................................................... 20 Additional Web Resources ........................................................................................................... 20 CHAPTER 3. ALTERNATIVE MEDICINE AND BALANCED DIET ....................................................... 23 Overview...................................................................................................................................... 23 National Center for Complementary and Alternative Medicine.................................................. 23 Additional Web Resources ........................................................................................................... 24 General References ....................................................................................................................... 26 CHAPTER 4. BOOKS ON BALANCED DIET ....................................................................................... 27 Overview...................................................................................................................................... 27 Book Summaries: Federal Agencies.............................................................................................. 27 Book Summaries: Online Booksellers........................................................................................... 29 Chapters on Balanced Diet........................................................................................................... 30 CHAPTER 5. MULTIMEDIA ON BALANCED DIET ............................................................................. 33 Overview...................................................................................................................................... 33 Video Recordings ......................................................................................................................... 33 CHAPTER 6. PERIODICALS AND NEWS ON BALANCED DIET .......................................................... 37 Overview...................................................................................................................................... 37 News Services and Press Releases................................................................................................ 37 Newsletters on Balanced Diet ...................................................................................................... 38 Newsletter Articles ...................................................................................................................... 39 Academic Periodicals covering Balanced Diet ............................................................................. 41 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 43 Overview...................................................................................................................................... 43 U.S. Pharmacopeia....................................................................................................................... 43 Commercial Databases ................................................................................................................. 44 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 49 Overview...................................................................................................................................... 49 NIH Guidelines............................................................................................................................ 49 NIH Databases............................................................................................................................. 51 Other Commercial Databases....................................................................................................... 53 APPENDIX B. PATIENT RESOURCES ................................................................................................. 55 Overview...................................................................................................................................... 55 Patient Guideline Sources............................................................................................................ 55 Finding Associations.................................................................................................................... 57 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 59 Overview...................................................................................................................................... 59 Preparation................................................................................................................................... 59 Finding a Local Medical Library.................................................................................................. 59 Medical Libraries in the U.S. and Canada ................................................................................... 59 ONLINE GLOSSARIES.................................................................................................................. 65 Online Dictionary Directories ..................................................................................................... 66

viii Contents

BALANCED DIET DICTIONARY ............................................................................................... 67 INDEX ................................................................................................................................................ 95

1

FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with balanced diet is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about balanced diet, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to balanced diet, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on balanced diet. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to balanced diet, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on balanced diet. The Editors

1

From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

3

CHAPTER 1. STUDIES ON BALANCED DIET Overview In this chapter, we will show you how to locate peer-reviewed references and studies on balanced diet.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and balanced diet, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “balanced diet” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Does Child Obesity Treatment Increase the Risk for the Development of Bulimia Nervosa? Source: Healthy Weight Journal. 16(1):2-3. January/February 2002. Summary: A study published in the Journal of Pediatrics followed 64 children aged 8 to 12 for 2 years to determine if pediatric weight management programs that incorporate dieting increase the risk of developing bulimia nervosa. Children and their families were randomly assigned to one of three groups receiving different program support. In one group, problem-solving skills were taught to parents and children. In another, problem-solving skills were taught to children only. No additional problem-solving skills were taught to the last group. All groups received information on diet, activity, and behavior change techniques. The Traffic Light Diet was used to decrease calorie intake and promote a balanced diet. This diet classifies foods as red, yellow, or green

4

Balanced Diet

based on caloric content and nutrient density. An activity program focused on increasing lifestyle physical activity. The Kids Eating Disorder Survey (KEDS) was used to evaluate disordered eating symptoms among the children. The researchers found a mean decrease of 12.5 in percent overweight among the children. No significant changes in children's self-reported symptoms of disordered eating, purging, or weight dissatisfaction were detected. •

Comparing Two Weight Paradigms Source: Healthy Weight Journal. 14(2):29-30. March/April 2000. Summary: Berg compares two approaches to weight, the weight-centered paradigm and the Health at Any Size approach. The first focuses on weight loss through restrictive eating, counting calories, exercise for its own sake, obsession with appearance and weight, a perfectionist attitude, and a language of control. The second concentrates on exercise as a pleasurable activity, physical activity as a part of daily life, food as nutrition, eating a balanced diet, all foods can fit, and self-acceptance. These approaches are illustrated in charts.

•

Oral Rehabilitation of a Bulimic Patient: A Case Report Source: Quintessence International. 32(6): 469-475. June 2001. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. Summary: Bulimia nervosa is among the most common health problems in contemporary society. Bulimia nervosa is a self-induced weight loss syndrome associated with distinct dental manifestations involving physical and psychological symptoms. Bulimia is characterized by recurrent binge-purge episodes that occur at least once a day. This article describes the complete mouth rehabilitation of a 29 year old female patient with bulimia who had generalized enamel erosion of her dentition and a poor esthetic appearance. The patient was informed that any restorative dental care could not be successfully performed unless her binge-purge behavior was stopped. Therefore, four factors were emphasized to the patient: acceptance of eating disorder; commitment to psychotherapy to stop purging; desire for dental treatment; and balanced diet and improvement of oral hygiene. Porcelain-fused-to-metal restorations were used as the definitive treatment. Good esthetics and high self-esteem were the final results. Comprehensive restorative therapy was applied in this clinical case report to achieve both function and esthetics in a demanding situation. 11 figures. 32 references.

•

Incidence of Cleft Lips, Palates Rising Source: JADA. Journal of the American Dental Association. Volume 123: 61-65. November 1992. Summary: Cleft lip or cleft palate occur in about 1 in 700 live human births. This article explores some of the socioeconomic factors that may be responsible for the recent rise in the incidence of these congenital anomalies. Topics covered include public health education; the etiology and incidence of cleft lip and palate; the roles of genetic and environmental factors; other risk factors, including lack of prenatal care during pregnancy, alcohol consumption, lack of a balanced diet, and the chronic use of nonprescribed drugs or substance abuse; feeding, hearing, and learning problems in

Studies

5

children with cleft lip or palate; prevention issues; and genetic research, including advances in developmental biology. •

Dietary Guidelines for Oral Health Source: Pediatric Dentistry. 21(5): 39. Reference Manual 1999-2000. Contact: Available from American Academy of Pediatric Dentistry. Publications Department, 211 East Chicago Avenue, Suite 700, Chicago, IL 60611-2616. Summary: Dental caries (cavities) and its sequelae are among the most common health problems facing American children. Several studies have identified frequent ingestion of carbohydrates and their prolonged contact with teeth as particular risk factors in the development of dental caries. This brief chapter from the American Academy of Pediatric Dentistry's (AAPD) Reference Manual offers four recommendations for dietary guidelines related to oral health: pediatric dentists should educate the public about the known association between frequent consumption of carbohydrates and dental caries; school health education programs and food services should be encouraged to promote balanced, low caries risk diets; research, education, and appropriate legislation to promote diverse and balanced diets should be supported; and the AAPD endorses the Dietary Guidelines for Americans (1995, U.S. Department of Agriculture), using the Food Guide Pyramid, a guide to daily food choices, for patient and parent education. 1 figure.

•

Body and Soul Source: Walking. 14(3): 66-71. May/June 1999. Summary: Ginsburg describes her journey from overweight exerciser eating a carbohydrate-heavy diet to a healthy weight yoga practitioner eating a balanced diet. Her nutritional counselor helped her change her diet and suggested that Ginsburg try yoga for exercise. Ashtanga yoga is an aerobic form of yoga, both challenging and strengthening, according to Ginsburg. Five yoga poses are described and illustrated in this article. They include: the foot spreading posture, triangle pose, downward dog, upward dog, and bridge shoulderstand. Ginsburg says that Ashtanga yoga provides a healthy workout and contributes to weight loss.

•

The Secrets of Good Taste Source: Cooking Light. p.72, 74-76. September 1998. Summary: Laliberte explores the subject of taste, especially recent studies examining how people taste. According to this research, some individuals, called tasters, have more taste buds than others, and therefore are more sensitive to strong flavors. Some tasters are extremely sensitive and are thus called supertasters. This group perceives fat more strongly than the other groups as well. Taste sensitivities, says Laliberte, could have implications for weight control, rates of cancer, and fat and sugar substitutes. He cites studies showing that supertasters do not eat as much fat as tasters and nontasters. However, he says, supertasters may also stay away from strong-tasting foods such as many fruits and vegetables, which are important for a balanced diet. Laliberte also offers strategies for all groups to improve their diet.

•

Nutritional Support for the AIDS Patient Source: Caring Magazine. 9(10): 70-74. October 1990.

6

Balanced Diet

Summary: Maintaining the nutritional status of the AIDS patient can help offset the weight and energy loss associated with the disease, helping the patient to function more normally. However, AIDS and its many manifestations present a number of obstacles to sustaining a nutritionally balanced diet. This article discusses these obstacles and the role of home health care providers in overcoming them. Specific difficulties discussed include anorexia, decreased appetite, oral and esophageal pain or lesions, chewing and swallowing difficulties, nausea and vomiting, gastrointestinal complications, altered taste perception, and fad diets undertaken as alternative remedies for the disease. A brief section discusses pediatric AIDS. 1 table. (AA-M). •

Evidence of Poor Vitamin Status in Coeliac Patients on a Gluten-free Diet for 10 Years Source: Alimentary Pharmacology and Therapeutics. 16(7):1333-1339. July 2002. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: Patients with celiac disease are advised to keep to a lifelong gluten-free diet to remain well. Uncertainty still exists as to whether this gives a nutritionally balanced diet. This article reports on a study undertaken to assess the vitamin nutrition status of a series of celiac patients living on a gluten-free diet for 10 years. The study included 30 adults with celiac disease (mean age 55 years, range 45 to 64 years, 60 percent women), in biopsy-proven remission following 8 to 12 years of dietary treatment. The authors found that celiac patients showed a higher total plasma homocysteine level than the general population, indicative of a poor vitamin status. The mean daily intakes of folate and vitamin B12, but not of vitamin B6, were significantly lower in celiac patients than in controls. The authors conclude that half of the adult celiac patients carefully treated with a gluten-free diet for several years showed signs of a poor vitamin status. This may have clinical implications considering the linkage between vitamin deficiency, elevated total plasma homocysteine levels, and cardiovascular disease. The results may suggest that, when following up adults with celiac disease, the vitamin status should be reviewed. 3 tables. 37 references.

•

Fat Replacements: Magic Potions Or Wishful Dreaming? Source: Living Well With Diabetes. 6(2): 15-17. Spring 1991. Summary: The food industry is currently researching fat replacements to help meet consumer demand for decreased fat and calories in food. This article describes the current status of fat replacement. Three categories of fat replacements are considered: calorie-reduced substitutes, calorie-free substitutes, and fat-free versions of traditional foods. Specific products discussed include Simplesse, N-Oil, Paselli SA2, Sta-Slim 143, UltraFreeze 400, Maltrin 030 Maltodextrin, and Olestra. The author emphasizes that even with the use of low-fat or fat-free foods, a balanced diet including a variety of foods is still essential. 2 tables.

•

Diabetes Among Seniors: Your Diabetes Control Can Make a Difference at Any Age Source: Diabetes Forecast. 52(11): 54-60. November 1999. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article addresses issues relevant to diabetes in older adults. The number of older Americans with diabetes is increasing because people who develop diabetes

Studies

7

early in life are living longer and the chance of developing diabetes increases with age. The first step older adults need to take in the self management of their diabetes is to get their diabetes under as good control as possible. Many seniors who have diabetes are taking oral medications but not attaining the best possible results, so they should ask their doctor about several new classes of medications that are currently available. A switch to insulin may be needed to achieve the best possible control. Once a patient and doctor have decided upon an approach to diabetes management, regular blood glucose monitoring is important. In addition, older adults who have diabetes need to eat a balanced diet and exercise regularly. Both help keep blood sugars in a healthy range and provide many other health benefits. Many changes that people experience as they age may actually stem from undiagnosed or uncontrolled diabetes, including failing eyesight, an increased number of falls, depression, forgetfulness and confusion, excessive or uncontrolled urination, and sexual dysfunction. The article includes diet and exercise guidelines for people who were diagnosed with diabetes 10 to 15 years ago or longer and have not had a recent reevaluation and offers suggestions for avoiding negative drug interactions. •

A Healthy Approach to the 'Health at Any Size' Movement Source: Healthy Weight Journal. 16(3):45-47. May/June 2002. Summary: This article advocates two principles of the 'health at any size' movement. The first principle is to acknowledge that permanent weight loss is difficult, if not impossible, for many obese people to achieve. The other guiding principle is that one can be both overweight and healthy at the same time 'if one exercises on a reasonably regular basis, eats a reasonably balanced diet (doing both without a focus on weight loss),' and engages in other healthy behaviors. According to the author, the notion that obesity is not harmful to health should be disregarded. Recognizing that obesity is a health risk does not weaken the health at any size movement, but strengthens it. The belief that obesity is not harmful to health is not scientifically supportable. The author notes that it also gets in the way of 'promoting any kind of health-promoting behavior change among the obese population'.

•

Quick Bites Source: Consumer Reports. p. 44-47. March 2001. Summary: This article compares the fat, calories, and sodium of some of the most popular menu items at national fast food hamburger and chicken chains. A sidebar shows how to make fast food more healthful by choosing a relatively healthy meal at three of the restaurants profiled. The nutritional analysis table provides the serving size, total fat, saturated fat, and sodium for hamburgers and cheeseburgers, chicken sandwiches, chicken nuggets or tenders, chicken Caesar salads, fish sandwiches, and French fries. The article notes that although fast food is generally high in fat and sodium, if one plans carefully and indulges occasionally, any of the menu items can fit into a balanced diet.

•

Nutritional Supplement for Improving Oral Health Source: Contemporary Oral Hygiene. 1(3): 43-44. November-December 2001. Contact: Available from Contemporary Oral Hygiene. 241 Forsgate Drive, Jamesburg, NJ 08831. (800) 926-7636.

8

Balanced Diet

Summary: This article considers the use of nutritional supplements for improving oral health. The author first reminds readers of the increasing recognition of the relationship between general health and oral health, then notes that lifestyle behaviors, including the lack of a well-balanced diet, pose risks on total health and oral health. Frequently, vitamin and mineral deficiencies manifest themselves in the oral cavity before they are reflected in other body structures. In addition to inadequate dietary intake of nutrients, there are certain conditions, drug therapies, and lifestyle behaviors that may increase the body's need for certain nutrients. The author extols the use of a recently introduced nutritional supplement, Dentaplex (CollaGenex Pharmaceuticals, Inc.) that provides essential vitamins, minerals, and trace elements for daily dietary support. The author concludes by reiterating that supplementing the diet with vitamins and minerals is an easy and convenient way to achieve a well balanced diet for total health. 1 figure. 17 references. •

Six Diet Don'ts That Can Make You Fat Source: Heart and Soul. 8(2):92. March 2001. Summary: This article debunks six weight loss dieting myths. Myth one: The less I eat, the more I lose--but this can slow metabolism and make it difficult to lose weight. Jane Pentz, a nutrition professional at Lifestyle Management Associates in Roxbury, Massachusetts, advises staying clear of diets that allow only 1,000 to 1,500 calories a day because they can promote muscle loss rather than fat loss. Myth two: Over-the-counter diet pills are a safe way to curb appetite--but these drugs work by suppressing appetite, and once someone stops taking the pills, the weight returns. Myth three: A scale is the best way to monitor weight loss--but if someone is weight training, the scale can be discouraging because muscle weighs more than fat. A better method is to have body fat measured periodically at a hospital or college, or to use a measuring tape to keep a record of inches lost from waist and hips. Myth four: Avoid carbohydrates--but this can mean risking vitamin and mineral deficiencies. A balanced diet has been proven effective, and a high protein diet that eliminates carbohydrates can cause muscle loss, headaches, and constipation as well as increases in blood cholesterol and pressure. Myth five: Never eat at night--which is false because spreading meals out through out the day is better. Pentz says, however, that having a small snack such as a piece of fruit or a cup of yogurt before bedtime is acceptable. Myth six: Have a target weight--but this can get a dieter too caught up on a number. Going by how one looks and feels is better.

•

Dietary Chromium Intake: Freely Chosen Diets, Institutional Diets, and Individual Foods Source: Biological Trace Element Research. Volume 32: 117-121. January-March 1992. Summary: This article describes dietary chromium intake of institutional and freely chosen diets, as well as chromium content of selected foods. The authors note that values for selected foods are presented as representative values and should not be used as specific values to calculate dietary intake due to the large variation in individual chromium concentrations of types and batches of foods. The chromium content of 22 daily diets, designed by nutritionists to be well balanced, ranged from 8.4 to 23.7 ug/1000 calories. The authors reiterate that chromium content of individual foods varies and is dependent upon chromium introduced in the growing, transport, processing, and fortification of the food. Even well-balanced diets may contain suboptimal levels of dietary chromium. 1 table. 7 references. (AA-M).

Studies

•

9

Birth of the Modern Diet Source: Scientific American. 283(2):76-81. August 2000. Summary: This article describes the origins of modern Western cooking. Before 1650, the prevailing dietary wisdom was that the process of digesting foods was actually a form of cooking and that health was preserved by maintaining a proper equilibrium of bodily fluids by eating a suitably balanced diet. Doctors and chefs of the time believed that four fluids circulated in the body: blood, phlegm, yellow bile, and black bile. Foods were assigned degrees of heat, coldness, wetness, and dryness. After 1650, physicians began to think that digestion involved fermentation rather than cooking. Fermentation turned grains and fruits into bread, beer, and wine, which the digestive system could ferment further. These changes in the understanding of the digestive process changed the way cooks prepared food. Chefs now welcomed oysters, anchovies, green vegetables, mushrooms, and fruits because they fermented so readily and thus did not need complicated preparation in the kitchen to be predigested. As cooks incorporated fresh produce into their dishes, horticultural and botanical gardens became popular. Sugar, which previously was freely added to many dishes, now fell out of favor and was served only in desserts. Alcoholic spirits were regarded as useful medicines. The Western cuisine born in the 17th century has long outlived the dietary theory that inspired it.

•

True Waist-Watcher Confessions Source: Heart and Soul. p.46,48. April-May, 1997. Summary: This article describes the weight-loss strategies of a cross-section of American women. The author points out that these strategies are not very useful in the long run. A sidebar offers suggestions on weight control such as eating a balanced diet, getting more exercise, and avoiding sugary or fatty foods.

•

How Healthy is Your Diet? Source: Shape. 17(1):38,40,43; Sept 1997. Summary: This article discusses healthful eating and how to ensure a balanced diet. The author reviews the dietary guidelines and examines how they can be followed on a daily basis. She recommends eating a variety of foods to ensure sufficient vitamin and mineral intake. Hermann also warns against eliminating whole groups of foods from the diet, such as grains, red meat or dairy products. She offers suggestions on how to eat a variety of foods within the guidelines.

•

Don't Accept Gallbladder Disease as a Fact of Life Source: Digestive Health and Nutrition. p. 8-11. November-December 2002. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: This article explores the causes of gallstones (cholelithiasis) and offers strategies for preventing their recurrence. Topics include the symptoms of a typical gallstone attack, dietary risk factors, how gallstones form, the epidemiology of gallstones, the role of genetics, strategies for preventing gallstones through diet, the importance of weight loss, diagnostic tests used to confirm gallstones, and treatment strategies, including surgical removal, and laparoscopic removal of the gallbladder

10

Balanced Diet

(cholecystectomy). The author stresses that healthy, slow weight loss along with a balanced diet and moderate exercise is the key. The article concludes with two web site addresses through which readers can obtain more information. •

Vitamin and Mineral Supplements: Do You Need One? Source: Diabetes Self-Management. 15: 7-8, 10-12. September-October 1998. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Website: www.diabetes-self-mgmt.com. Summary: This article helps readers with diabetes understand the use of vitamin and mineral dietary supplements and decide whether they might utilize such supplements. The author emphasizes that supplements cannot compensate for bad eating habits, counteract the damage done by poor blood glucose (sugar) control, or make up for a sedentary lifestyle. Supplements also cannot take the place of food. The author cautions that while it is very difficult to get too much of a vitamin or mineral in food, there is a danger of overdosing with supplements, especially when a pill contains 10 to 20 times the Recommended Dietary Allowance (RDA). Another potential problem lies in the complicated interactions between nutrients that take place in the body, and even moderate amounts of some vitamins and minerals can interfere with some drugs. The author discusses the RDA and how it was established, and notes some of the specific problems that can come from ingesting more than the recommended amounts of some vitamins and minerals. The author then discusses factors that can alter nutritional needs, including age, pregnancy, certain medications, and poor dietary habits. The article concludes with an exploration of some specific vitamins and minerals, including antioxidants (beta carotene, vitamin E, and vitamin C), folate, calcium and vitamin D, magnesium, and chromium. The author concludes that the bottom line is to start with a balanced diet that is high in fruits, vegetables, and low fat dairy products, then consider taking a broad multivitamin and mineral supplement. One sidebar lists and debunks common myths about supplements.

•

APECED Syndrome in a Child with Early Presentation of Type 1 Diabetes Mellitus Source: International Pediatrics. 15(3): 155-158. 2000. Contact: Available from International Pediatrics. 3100 Southwest 62nd Avenue, Miami, FL 33155. (800) 950-6511 or (305) 663-6823. Summary: This article is a case report of a male child who presented with a clinical picture of autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED) syndrome and early onset type 1 diabetes. APECED is an autosomal recessive disease characterized by autoimmune destruction of endocrine glands, chronic superficial candidiasis, and ectodermal dystrophies, including hypoplasia of the dental enamel, alopecia, and nail dystrophy. Type 1 diabetes occurs uncommonly in type 1 polyglandular autoimmune syndrome. The boy in the case report, aged 2.5 years, presented with growth failure, weight loss, alopecia, and breath holding attacks. Physical examination revealed alopecia totalis, absence of eyelashes, nail dystrophy on all of his fingers and toes, onychomycosis, dysplastic teeth with a number of caries, genital dermatitis, and hyperpigmented areas around the umbilicus. The boy was treated with oral iron, zinc, and multivitamin supplementation, anticandidal preparations, and a balanced diet. He did well with this treatment, but 6 months later, he developed type 1 diabetes. The article describes the characteristics of APECED syndrome and its association with type 1 diabetes. 3 figures. 29 references. (AA-M).

Studies

•

11

Is the Low-Fat Message Giving People a License to Eat More? Source: Journal of the American College of Nutrition. 16(6): 535-543. 1997. Summary: This article is designed to review the types of fat-replacers currently used, examine the studies that have used fat-replaced foods to reduce fat and energy intake, and assess the usefulness of using such foods in reducing body weight. The authors note that 137 million Americans (about 3 out of 4 adults) regularly consume reduced-fat foods. Many of these individuals are interested in reducing fat and energy intake. However, in order to maintain high palatability, some reduced-fat and fat-free foods have added sugars and other energy-bearing substances. Using such products as substitutes for higher-fat versions of foods is likely to bring about only small reductions in energy intake. A better strategy to reduce energy intake is to consume a low-fat diet consisting of low-energy density foods such as fruits, vegetables, and other foods high in fiber and complex carbohydrates. The authors conclude that weight loss can best be accomplished by eating a balanced diet that is low in both fat content and energy. 2 tables. 28 references. (AA-M).

•

Truth About Fat Substitutes Source: Digestive Health and Nutrition. p. 29-32. July-August 1999. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: This article offers information about fat substitutes, which work in different ways to replace the high fat content and reduce the calories normally found in foods like chips, ice cream, chocolate, and candy. Before being employed as fat and calorie fighters, some had already been approved by the Food and Drug Administration (FDA) for other uses in foods. Other fat substitutes were developed specifically to cut fat and calories. The author notes that, in small quantities, natural fats are an important part of a balanced diet. However, high fat intake can contribute to excessive caloric intake and resulting obesity, an increased risk of several types of cancer, and the formation of plaque, which clogs arteries, leading to heart disease. Americans, while knowledgeable about the need to reduce fat intake, have been slow in changing their dietary habits. The author describes carbohydrate based fat substitutes, protein based fat substitutes, fat based fat substitutes, the Olestra controversy (a fat substitute which can cause gastrointestinal problems like loose stools, gas, and abdominal cramping, and which reduces the absorption of fat soluble vitamins and carotenoids), and the importance of good eating habits. The author concludes that, to the extent that they fulfill needs for taste, variety, and moderation while lowering caloric intake, foods made from fat substitutes can be an important dietary component. The use of these foods may help readers achieve an overall healthier approach to diet. 4 references.

•

The Great Debate: Protein vs. Carbohydrates Source: Living Fit. 4(4):76-81; March 1997. Summary: This article presents the two sides of the diet debate over protein and carbohydrates. Some researchers feel that protein is more important in weight loss, while others believe that a diet high in carbohydrates is better. A sidebar contains sample menus from a high-carbohydrate diet, a high-protein diet, and a balanced diet, allowing the reader to decide which one makes the most sense.

12

•

Balanced Diet

Healthy People 2010: Overweight and Obesity Source: Healthy Weight Journal. 15(1):4-5. January/February 2001. Summary: This article provides an overview of Healthy People 2010's overweight and obesity health objectives. Healthy People 2010 is the document that sets the prevention agenda for the United States for the next decade and is designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats. Overweight and obesity are a major part of the nutrition section of the document. The major objectives for tracking progress in this area are to reduce the proportion of children and adolescents who are overweight or obese, reduce the proportion of adults who are obese, and increase the proportion of adults who are at a healthy weight. Currently 11 percent of youth ages 6 to 19 are overweight or obese, and the target is to reduce the prevalence to 5 percent. Data for adults ages 20 and over show that 23 percent are obese; the target is 15 percent. Only 42 percent of adults are considered to be a healthy weight; the target is 60 percent. The development of obesity is a complex result of many factors including behavioral, social, cultural, physiologic, environmental, and genetics. Any weight reduction in children and adolescents should emphasize physical activity and balanced diet so that healthy growth is maintained.

•

Effects of a Very-Low-Calorie Diet on Long-term Glycemic Control in Obese Type 2 Diabetic Subjects Source: Archives of Internal Medicine. 151(7): 1334-1340. July 1991. Summary: This article reports on a study that tested the hypothesis that the use of a very-low-calorie diet (VLCD) in combination with behavior modification would promote long-term glycemic control in obese patients with noninsulin-dependent diabetes mellitus (NIDDM). Thirty-six people with diabetes were randomly assigned to a standard behavior therapy program or to a behavior therapy program that included an 8-week period of VLCD. The behavior therapy group consumed a balanced diet of 4200 to 6300 J/d throughout the 20-week program. The VLCD group consumed a balanced diet of 4200 to 6300 J for weeks 1 to 4, followed by a VLCD (1680 J/d of lean meat, fish, and fowl) for weeks 5 to 12. The VLCD group then gradually reintroduced other foods during weeks 13 to 16 and consumed a balanced diet of 4200 to 6300 J/d for weeks 17 to 20. Use of the VLCD produced greater decreases in fasting glucose at the end of the 20week program and at 1-year follow-up and greater long-term reductions in HbA1. The authors conclude that the improved glycemic control with the VLCD appeared to be due to increased insulin secretion, but further research is needed to confirm this. 3 figures. 6 tables. 40 references. (AA-M).

•

Diets with Either Beef or Plant Proteins Reduce Risk of Calcium Oxalate Precipitation in Patients with a History of Calcium Kidney Stones Source: Journal of the American Dietetic Association. 101(3): 326-331. March 2001. Contact: Available from American Dietetic Association. 216 West Jackson Boulevard, Suite 800, Chicago, IL 60606-6995. (800) 877-4746. Summary: This article reports on a study undertaken to determine the effect of substituting equal amounts of dietary protein as animal protein (beef) for plant protein (legumes, seeds, nuts, and grains) on urinary components associated with calcium oxalate precipitability risk (which can lead to kidney stones made of calcium). The randomized crossover trial included 23 patients with normal levels of calcium in their urine who had a history of calcium kidney stones (8 women and 15 men, mean age 50.7

Studies

13

years plus or minus 14.6 years). The study included a 4 day, free living adaptation period, followed by a 2 day metabolic unit study. The study compared consumption of two servings of beef (43 g protein for women and 50 g for men) daily with an equal amount of protein from plant foods including legumes, nuts, and grains. Urinary calcium, oxalate, magnesium, citrate, phosphorus, volume, and Tiselius risk index (TRI) did not differ between diets. Urinary sodium and potassium were higher for patients on the plant protein diet. After correcting for variations in urinary sodium and potassium between diets, the difference in urinary calcium remained insignificant. The authors conclude that balanced diets containing moderate amounts of either beef or plant protein are equally effective in reducing calcium oxalate kidney stone risk based on changes in urinary composition. 4 tables. 27 references. •

Balance Complex Carbohydrates with Other Nutrients in Meal Plan Source: Diabetes in the News. 10(3): 25-26. June 1991. Contact: Available from Ames Center for Diabetes Education. Ames Division, Miles Laboratories, P.O. Box 3115, Elkhart, IN 46515. (312) 664-9782 or (800) 348-8100. Summary: This article reviews the role of complex carbohydrates in a balanced meal plan used as part of a complete diabetes management program. The author reviews the physiology of digestion and the fat storage process, and explains how high blood glucose levels develop. Other topics include how exchange lists can be used to ensure a balanced diet, the role of fiber, food additives and food processing, and the use of raw fruits and vegetables in the diabetes meal plan. A checklist of simple and complex carbohydrates is included.

•

Ring-Be-Gone Source: Consumer Reports. p.59. July 2000. Summary: This is a short review of a product called the "Fat-Be-Gone Ring." The reviewer could not contact the manufacturer since the manufacturer's name or contact information were not given, but suspects that the disclaimer on the back of the package holds the key to any weight reduction. It says "For best results, maintain a nutritionally balanced diet and exercise regularly while wearing your ring".

•

Aging and the Etiopathogenesis and Treatment of Osteoarthritis Source: Rheumatic Disease Clinics of North America. 26(3): 547-567. August 2000. Summary: This journal article provides health professionals with information on the epidemiology and management of osteoarthritis (OA) of the knee in the aging patient. Although the incidence and prevalence of OA increases directly with age, OA is not a time dependent wear and tear process of articular joints. Risk factors for knee OA include age, obesity, a prior history of knee injury, female gender, muscle weakness, poor proprioception, heavy physical activity, and lack of estrogen replacement. OA results from an imbalance between anabolic and catabolic processes occurring in joint tissues. Aging related changes within joint tissues contribute to the development of OA by making the joint more susceptible to injury and less able to repair damage. Aging of the musculoskeletal tissues and of other organ systems affects the management of OA. The therapeutic approach in older adults should emphasize methods of improving physical function. A combination of simple analgesics and nonpharmacologic measures, including exercises to strengthen the knee extensors, weight loss if overweight, patient education, social support, proper footwear, and assistive devices, should be used.

14

Balanced Diet

Patients can also benefit from aerobic exercises, such as a walking or swimming program, and strategies for joint protection. When medications are needed, the least toxic drugs should be used, given the increased susceptibility of older adults to unwanted side effects. Pharmacological choices include acetaminophen, other nonnarcotic analgesics, intra articular agents, and narcotic type analgesics. Alternative therapies for knee OA include using the nutritional supplement glucosamine with or without chondroitin sulfate, eating a well balanced diet containing sufficient amounts of vitamins C and D, and undergoing surgery. 2 figures, 2 tables, and 99 references. (AA-M). •

Diabetes Among Alaska Natives: An Emerging Epidemic Source: Alburquerque, NM: National Indian Council on Aging. 1999. [4 p.]. Contact: Available from National Indian Council on Aging. 10501 Montgomery Boulevard., NE, Suite 210, Albuquerque, NM 87111. (505) 292-2001. Fax (505) 292-1922. E-mail: [email protected]. Website: www.nicoa.org. PRICE: Single copy free. Summary: This short monograph reviews current epidemiological evidence that illustrates a growing epidemic of diabetes among Alaska native peoples. The author notes that although the American Indian and Alaska Native population as a whole has a high rate of diabetes, until recently, the rate of diabetes for Alaska Natives was far lower than for most of Indian country. The prevalence of diabetes in the Anchorage Service Unit is about the same as the prevalence in the United States in all races. In some areas of Alaska, however, the prevalence is almost four times as high. In areas that traditionally have had very little diabetes (Y-K Delta, Norton Sound), the rate of increase in new cases is very rapid: over 150 percent in 12 years. The author focuses on causes (etiology) related to changes in lifestyle. As people move away from traditional hunting and fishing practices, becoming more sedentary and as a consequence becoming overweight, increases in obesity and diabetes rates seem to follow. The author stresses the importance of prevention: healthy lifestyles with balanced diets, increased physical activity, stress management, and community support are all crucial. In addition, screening is a vital component of prevention: diabetes diagnosed early is easier to control with lifestyle changes (without resorting to medications). The monograph concludes with a brief description of the basics of diabetes and its complications (predominantly due to years of high levels of blood glucose, or sugar). The monograph includes 2 illustrations of the diabetes rate and percent change in diabetes in Alaska (since 1985). 2 figures.

Federally Funded Research on Balanced Diet The U.S. Government supports a variety of research studies relating to balanced diet. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions.

2

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

Studies

15

Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to balanced diet. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore balanced diet.

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with balanced diet, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “balanced diet” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for balanced diet (hyperlinks lead to article summaries): •

Acceptability of recommended balanced diets in adult males. Author(s): Pasricha S. Source: The Indian Journal of Medical Research. 1981 January; 73: 61-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7239618

•

An Index of Nutritional Quality for a balanced diet. New help for an old problem. Author(s): Sorenson AW, Wyse BW, Wittwer AJ, Hansen RG. Source: Journal of the American Dietetic Association. 1976 March; 68(3): 236-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=55430

•

Antigen presentation: a balanced diet. Author(s): Brenner M, Porcelli S. Source: Science. 1997 July 18; 277(5324): 332. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9518365

3

PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

16

Balanced Diet

•

Balanced diet? Author(s): Lyons-Davis J. Source: Nurs Mirror Midwives J. 1975 February 13; 140(7): 44. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1038695

•

Can the mineral elements intakes recommended for the French population be provided by a balanced diet? Author(s): Mareschi JP, Magliola C, Aubree E, Couzy F. Source: Int J Vitam Nutr Res. 1987; 57(2): 225-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3654115

•

Defining the role of milkfat in balanced diets. Author(s): Berner LA. Source: Adv Food Nutr Res. 1993; 37: 131-257. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8398045

•

Editorial. The role of adequate nutrition and a well balanced diet. Author(s): Best EJ. Source: Dent Dig. 1969 December; 75(12): 512. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5260902

•

Influence of the desire to lose weight on food habits, and knowledge of the characteristics of a balanced diet, in a group of Madrid university students. Author(s): Navia B, Ortega RM, Requejo AM, Mena MC, Perea JM, Lopez-Sobaler AM. Source: European Journal of Clinical Nutrition. 2003 September; 57 Suppl 1: S90-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12947464

•

Modifications of serum-free amino acid patterns of Babinga adult pygmies after short-term feeding of a balanced diet. Author(s): Paolucci AM, Spadoni MA, Pennetti V. Source: The American Journal of Clinical Nutrition. 1973 April; 26(4): 429-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4712421

•

Planning a balanced diet for children of age 10-12 years by operations research. Author(s): Chaurasia AR. Source: Indian J Pediatr. 1980 May-June; 47(386): 183-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7239622

•

Planning of a balanced diet--practical considerations. Author(s): Halder K. Source: J Indian Med Assoc. 1974 April 1; 62(7): 227-30. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4415087

Studies

17

•

Seasonal changes in the cost of balanced diets. Author(s): Pasricha S, Thimmayamma BV, Radhaiah G. Source: The Indian Journal of Medical Research. 1983 March; 77: 359-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6874018

•

Similar weight loss with low-energy food combining or balanced diets. Author(s): Golay A, Allaz AF, Ybarra J, Bianchi P, Saraiva S, Mensi N, Gomis R, de Tonnac N. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2000 April; 24(4): 492-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10805507

•

South Carolina prisoners to get balanced diets. Author(s): Lease EJ, Ledesma RE, Dudley BW. Source: J S C Med Assoc. 1968 March; 64(3): 75-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5238565

•

The food square: helping people of different cultures understand balanced diets. Author(s): Mandelbaum JK. Source: Pediatric Nursing. 1983 January-February; 9(1): 20-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6549819

•

The importance of a balanced diet in an expanding urban population. Author(s): Mann I. Source: East Afr Med J. 1968 May; 45(5): 311-27. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5674011

•

The well-balanced diet and the "at risk" micronutriments: a forecasting nutritional index. Author(s): Mareschi JP, Magliola C, Couzy F, Aubree E. Source: Int J Vitam Nutr Res. 1987; 57(1): 79-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3583598

•

Vitamin supplements vs the balanced diet. Author(s): Mennen BG. Source: Postgraduate Medicine. 1980 May; 67(5): 39, 42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7375409

18

•

Balanced Diet

Vitamins and health: the role of a balanced diet. Author(s): Moores J, Peck K. Source: Community Nurse. 1998 May; 4(4): 15-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9763952

19

CHAPTER 2. NUTRITION AND BALANCED DIET Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and balanced diet.

Finding Nutrition Studies on Balanced Diet The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “balanced diet” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

20

Balanced Diet

The following information is typical of that found when using the “Full IBIDS Database” to search for “balanced diet” (or a synonym): •

A balanced diet may be best defense against disease. Source: Oehlke, B. Environ-Nutr. New York, N.Y. : Environmental Nutrition, Inc. Sept 1989. volume 12 (9) page 1, 3. charts. 0893-4452

•

Eating well: vitamin supplements are fine, but a balanced diet won't hurt, either. Source: Burros, M. N-Y-Times. [New York, N.Y. : H.J. Raymond & Co.]. June 24, 1992. page B4. 0362-4331

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

•

The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

•

The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

•

Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

•

Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

•

Google: http://directory.google.com/Top/Health/Nutrition/

•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

Nutrition

•

Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

•

WebMDHealth: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

21

The following is a specific Web list relating to balanced diet; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Provitamin A Source: Integrative Medicine Communications; www.drkoop.com Pyridoxine Source: Integrative Medicine Communications; www.drkoop.com Vitamin B6 (Pyridoxine) Source: Integrative Medicine Communications; www.drkoop.com Vitamin E Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,906,00.html

•

Minerals Chromium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10018,00.html Sulfur Source: Integrative Medicine Communications; www.drkoop.com

•

Food and Diet Juices Source: Healthnotes, Inc.; www.healthnotes.com Macrobiotic Diet Source: Healthnotes, Inc.; www.healthnotes.com

23

CHAPTER 3. ALTERNATIVE MEDICINE AND BALANCED DIET Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to balanced diet. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to balanced diet and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “balanced diet” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to balanced diet: •

A comparison of dietary fish oil and corn oil in experimental colorectal carcinogenesis. Author(s): Nelson RL, Tanure JC, Andrianopoulos G, Souza G, Lands WE. Source: Nutrition and Cancer. 1988; 11(4): 215-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3217260

•

A hypothesis on the etiological role of diet on age of menarche. Author(s): Sanchez A, Kissinger DG, Phillips RI. Source: Medical Hypotheses. 1981 November; 7(11): 1339-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7321920

24

Balanced Diet

•

A new relationship between total/high density lipoprotein cholesterol and polyunsaturated fatty acids. Author(s): Siguel E. Source: Lipids. 1996 March; 31 Suppl: S51-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8729094

•

A possible preventive effect of low-dose fish oil on early delivery and pre-eclampsia: indications from a 50-year-old controlled trial. Author(s): Olsen SF, Secher NJ. Source: The British Journal of Nutrition. 1990 November; 64(3): 599-609. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2265175

•

Advising the vegetarian family on a balanced diet. Author(s): Bysshe J. Source: Prof Care Mother Child. 1999; 9(6): 163-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10855230

•

K(ATP) channel regulators: balanced diets include carbohydrates, proteins, and fats. Author(s): Nichols CG, Cukras CA. Source: Circulation Research. 2001 May 11; 88(9): 849-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11348990

•

Taurine deficiency in Newfoundlands fed commercially available complete and balanced diets. Author(s): Backus RC, Cohen G, Pion PD, Good KL, Rogers QR, Fascetti AJ. Source: J Am Vet Med Assoc. 2003 October 15; 223(8): 1130-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14584742

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•

AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

•

drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

•

Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

•

Google: http://directory.google.com/Top/Health/Alternative/

•

Healthnotes: http://www.healthnotes.com/

Alternative Medicine 25

•

MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

•

Open Directory Project: http://dmoz.org/Health/Alternative/

•

HealthGate: http://www.tnp.com/

•

WebMDHealth: http://my.webmd.com/drugs_and_herbs

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to balanced diet; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Anemia Source: Integrative Medicine Communications; www.drkoop.com Benign Prostatic Hyperplasia Source: Integrative Medicine Communications; www.drkoop.com BPH Source: Integrative Medicine Communications; www.drkoop.com Depression Source: Integrative Medicine Communications; www.drkoop.com Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com Hair Disorders Source: Integrative Medicine Communications; www.drkoop.com Hirsuitism Source: Integrative Medicine Communications; www.drkoop.com Insulin Resistance Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Obesity Source: Integrative Medicine Communications; www.drkoop.com Prostate Enlargement Source: Integrative Medicine Communications; www.drkoop.com Yeast Infection Source: Healthnotes, Inc.; www.healthnotes.com

26

•

Balanced Diet

Herbs and Supplements Amino Acids Overview Source: Healthnotes, Inc.; www.healthnotes.com Antioxidants Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10004,00.html B-Carotene Source: Integrative Medicine Communications; www.drkoop.com Beta-Carotene Alternative names: b-carotene, Trans-beta Carotene; Provitamin A, Betacarotenum Source: Integrative Medicine Communications; www.drkoop.com Betacarotenum Source: Integrative Medicine Communications; www.drkoop.com Glutamine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10030,00.html Trans-Beta-Carotene Source: Integrative Medicine Communications; www.drkoop.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

27

CHAPTER 4. BOOKS ON BALANCED DIET Overview This chapter provides bibliographic book references relating to balanced diet. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on balanced diet include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “balanced diet” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on balanced diet: •

Food Allergies Source: Minneapolis, MN: Chronimed Publishing. 1998. 93 p. Contact: Available from American Dietetic Association. P.O. Box 97215, Chicago, IL 60678-7215. (800) 877-1600 ext. 5000. Fax (312) 899-4899. Website: www.eatright.org. PRICE: $6.00 for ADA members; $6.95 for nonmembers. ISBN: 0764551264. Summary: A food allergy, sometimes called a food hypersensitivity, is an abnormal response by the immune system to a harmless food protein that the body mistakenly identifies as a harmful invader. This book from the American Dietetic Association answers common questions about food allergies. The book discusses how food allergies are diagnosed and how to manage the most common ones, with day to day strategies for avoiding problem foods and making substitutions to ensure a balanced diet. A special chapter on food allergies and children explains how to prevent or delay allergies in children and how to manage their food allergies while ensuring proper growth and

28

Balanced Diet

development. Specific food allergies are discussed, including allergies to milk, eggs, peanuts, soybeans, tree nuts, fish, shellfish, and wheat. Other topics covered include potential sources of cross contamination, food labeling regulations, traveling and eating out, and ways to handle a food allergy emergency. The book includes a sample food diary, allergy-free menus and recipes, a glossary of allergy terms, a resource guide (where to find specialty items and where to get additional information), and a subject index. •

Aging Myths: Reversible Causes of Mind and Memory Loss Source: New York, NY: McGraw-Hill Book Company. 1986. 278 p. Contact: This publication may be available from your local medical library. Call for information. Summary: This book discusses reversible conditions of memory loss such as depression and medication effects as well as irreversible conditions like Alzheimer's disease and Parkinson's disease. It lists organizations available for assistance and information for the elderly and local chapters of the Alzheimer's Association (AA). It also provides a guide for a balanced diet for people with hypertension.

•

Exercise for Osteoporosis Source: Long Island City, NY: Hatherleigh Press. 2000. 144 p. Contact: Available from Hatherleigh Press. 5-22 46th Avenue, Long Island City, NY 11101. (800) 528-2550. Fax: (800) 621-8892. Website: www.hatherleighpress.com. Email: [email protected]. Price: $14.95 plus shipping. ISBN: 1578260760. Summary: This book presents exercises that will help the osteoporosis patient strengthen their bones and improve their balance and flexibility. Osteoporosis is a disease that is characterized by abnormal loss of bone density. Although it is perceived that osteoporosis is a disease of older women, osteoporosis can affect men and women who are young or middle-aged. It is estimated that 25 million Americans suffer from osteoporosis and if preventive measures are not taken now, the incidence of this disease may double within 25 years. To prevent osteoporosis, the patient should stop smoking cigarettes, taking steroids, consuming large amounts of alcohol, and choose to eat a balanced diet and live an active lifestyle. Questions to determine osteoporosis risk are listed. Fractures most commonly occur at the wrist, spine, and hip. Exercise precautions are listed. The exercises in the book are divided into sections by body part: spine, hip, wrist, chest and arms, and abdominals. Each exercise is illustrated. In addition, exercises for balance and breathing are included. Suggested exercise routines are included as well as an equipment and resource list. 4 references and numerous pictures.

•

Lupus Eritematoso: Manual para medicos, pacientes y familiares, 2a. Edicion Source: Washington, DC: La Fundacion Americana para el Lupus. 1998. 66 p. Contact: Available from Lupus Foundation of America, Inc. 1300 Piccard Drive, Suite 200, Rockville, MD 20850-4303. (800) 558-0121 toll-free or (301) 670-9292. Website: www.lupus.org/lupus. PRICE: $3.00 plus shipping and handling. Summary: This illustrated handbook, written in Spanish, provides health professionals and patients who have lupus and their families with information on this chronic immune system disease. The handbook begins by describing the types of lupus, including discoid lupus and systemic lupus erythematosus. This is followed by

Books

29

information on incidence and prevalence and some common symptoms. Other topics include the cause of lupus, diagnosis based on clinical evidence, the role of heredity, pregnancy and lupus, exacerbation and remission, treatment options, and prognosis. In addition, the handbook discusses the importance of a balanced diet, treatments under investigation, and the activities of the American Foundation for Lupus and the National Institutes of Health. The handbook concludes with a list of recommended readings. •

Building your activity pyramid Source: [Minneapolis, MN?]: Health Education Center, Institute for Research and Education HealthSystem Minnesota. 1996. 50 pp. Contact: Available from Nutrition Counseling Education Services, 1904 East 123rd Street, Olathe, KS 66061-5886. Telephone: (800) 445-5653 or (314) 872-8370 / fax: (314) 432-1380 / e-mail: [email protected] / Web site: http://www.mosby.com. $17.85 plus $4.50 shipping and handling; prepayment required. Summary: This publication was developed to assist individuals to find ways to add physical activity to their daily routine. Similar to the U.S. Department of Agriculture's Food Guide Pyramid, the Activity Pyramid illustrates a 'balanced diet' of weekly physical activity and various forms of 'traditional' exercise. It contains several self-tests followed by suggestions, using a pyramid with physical activities to do every day, three to five times a week, two or three times a week, and on top, sedentary activities to cut down on. There is a short section on physical activity and weight management and many ideas on how to integrate physical activity into a busy daily schedule.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “balanced diet” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “balanced diet” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “balanced diet” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Barbara Naylor's The basic ingredient: The becomer's balanced diet & complete weight loss program by Barbara Naylor; ISBN: 0877880573; http://www.amazon.com/exec/obidos/ASIN/0877880573/icongroupinterna

•

Healing Planet Earth: Guidelines for an Ecologically Balanced Diet and Lifestyle by Edward Esko; ISBN: 0962852856; http://www.amazon.com/exec/obidos/ASIN/0962852856/icongroupinterna

•

Taste for Health: A Balanced Diet for Good Health by Libby Day; ISBN: 0572012993; http://www.amazon.com/exec/obidos/ASIN/0572012993/icongroupinterna

30

Balanced Diet

Chapters on Balanced Diet In order to find chapters that specifically relate to balanced diet, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and balanced diet using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “balanced diet” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on balanced diet: •

Periodontal (Gum) Disease Source: in Sutton, A.L. Dental Care and Oral Health Sourcebook. 2nd ed. Detroit, MI: Omnigraphics. 2003. p. 227-260. Contact: Available from Omnigraphics. 615 Griswold Street, Detroit, MI 48226. (313) 961-1340. Fax: (313) 961-1383. E-mail: [email protected]. www.omnigraphics.com. PRICE: $78.00; plus shipping and handling. ISBN: 780806344. Summary: In the early stages (gingivitis), marked by red or swollen gums that bleed easily, gum disease is reversible and can be detected by the dentist during regular checkups. As the disease progresses (periodontitis), it can destroy the bone and soft tissues that support the teeth. This lengthy chapter on periodontal (gum) disease is from a book that provides information about dental care and oral health at all stages of life. The chapter offers three sections: receding gums; periodontal diseases; and strategies to fight gum disease. Topics include coping with receding gums, common forms of periodontal diseases, symptoms of periodontal disease, diagnostic techniques used to confirm periodontal diseases, causes of periodontal diseases, prevention strategies, risk factors for getting periodontal disease (including smoking and genetics), periodontitis as a risk factor for systemic diseases, economic considerations, periodontal treatment, periodontists, surgical procedures, non-surgical treatment options, laser treatments, antibiotics, and the interplay between oral health and overall health. The positive news is that gum disease is easily prevented through brushing and flossing daily, eating a balanced diet, and visiting the dentist regularly for professional cleanings. Following this simple regimen, adults can look forward to keeping their natural teeth throughout their lives. 22 references.

•

Strength Training and Nutritional Supplements Source: in Devlin, J.T. and Schneider, S.H., eds. Handbook of Exercise in Diabetes. Alexandria, VA: American Diabetes Association. 2002. p.625-638. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $69.95 plus shipping and handling. ISBN: 1580400191. Summary: Physicians and other health care professionals should be familiar with concepts associated with prescribing resistance exercise for athletes and should be able to advise patient athletes on training practices that may interfere with glycemic (blood glucose) control or place these patients at unnecessary risk. This chapter on strength training and nutritional supplements is from a book that provides a practical, comprehensive guide to diabetes and exercise for health care professionals involved in

Books

31

patient care. The authors note that there is no evidence that training with heavy or maximal loads is unsafe for fit diabetic patients without long term complications. Sufficient protein intake should always be considered within the context of total energy intake. Resistance trained individuals who consume adequate amounts of protein as part of a balanced diet do not generally require additional sources of protein. It is likely that taking creatine and carbohydrates together may require an adjustment in insulin therapy that should take into account the carbohydrate amount, the creatine dose, and the training activity. Athletes with diabetes should avoid taking anabolic steroids and large amounts of steroid precursors. Use of nutritional supplements should always be discussed by the athlete with a physician or other qualified member of the diabetes health care team. 27 references. •

Diet and Gastrointestinal Problems Source: in Townsend, C.E. and Roth, R.A. Nutrition and Diet Therapy. 7th ed. Albany, NY: Delmar Publishers. 1999. 343-360 p. Contact: Available from Delmar Publishers. 3 Columbia Circle, Albany, NY 12212. (800) 865-5840. E-mail: [email protected]. PRICE: $44.95 plus shipping and handling. ISBN: 0766802965. Summary: This chapter on diet and gastrointestinal problems is from an undergraduate textbook on nutrition and diet therapy. The chapter describes the uses of diet therapy in gastrointestinal illness; identifies foods allowed and disallowed in the therapeutic diets covered; and helps readers learn to adapt normal diets to meet the requirements of various illnesses. The authors note that disturbances of the gastrointestinal tract require many different therapeutic diets. Peptic ulcers are treated with drugs, and diet therapy generally involves only avoiding alcohol and caffeine. Diverticulosis may be treated with a high fiber diet, whereas diverticulitis is treated with a gradual progression from a clear liquid to a high fiber diet. Ulcerative colitis may require a low residue diet combined with high protein and high kcal. Cirrhosis (liver scarring) requires a substantial, balanced diet, with occasional restrictions on fat, protein, salt, or fluids. Diet therapy for hepatitis can include a full, well balanced diet, although protein may be restricted, depending on the patient's condition. Patients with cholecystitis (gallbladder infection) and cholelithiasis (gallstones) require a fat restricted diet and, in cases of overweight, a kcal restricted diet as well. Pancreatitis diet therapy ranges from total parenteral nutrition to an individualized diet as tolerated. The chapter includes lists of key terms to learn, recommended discussion topics, and suggested supplemental activities, and a section of review questions so readers can test their comprehension of the material. Two illustrative case studies are appended. 1 figure. 8 tables.

•

Solving Kidney Problems Source: in Touchette, N. Diabetes Problem Solver. Alexandria, VA: American Diabetes Association. 1999. p. 217-229. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $19.95 for members; plus shipping and handling. ISBN: 1570400091. Summary: This chapter on kidney problems is from a patient education handbook on managing diabetes related problems. Diabetic nephropathy (kidney disease related to diabetes) progresses through five stages: hyperfiltration, microalbuminuria (microscopic proteins in the urine), nephrotic syndrome, renal insufficiency, and end stage renal

32

Balanced Diet

disease (ESRD). There are diagnostic tests that can detect the early stages of kidney disease. By paying attention to these early signs, patients can take steps to prevent or delay serious kidney damage and live a longer and healthier life. The author reviews the symptoms, management strategies, and prevention of each of the five stages noted above. The treatment section for ESRD explores the options of hemodialysis, peritoneal dialysis, and kidney transplantation. The author emphasizes that, to prevent or delay microalbuminuria from progressing to the other stages of nephropathy, it is important to control high blood pressure, to keep blood glucose levels under control, and to eat a balanced diet. The chapter is written to help patients understand the diagnostic tests used to monitor their kidneys and to enable them to incorporate practical preventive strategies into their daily lives. •

Nutrition Basics Source: in Korn, D. Kids with Celiac Disease: A Family Guide to Raising Happy, Healthy, Gluten-Free Children. Bethesda, MD: Woodbine House. 2001. p. 159-182. Contact: Available from Woodbine House. 6510 Bells Mill Road, Bethesda, MD 20817. (800) 843-7323 or (301) 897-3570. Fax (301) 897-5838. E-mail: [email protected]. Website: www.woodbinehouse.com. PRICE: $17.95 plus shipping and handling. ISBN: 1890627216. Summary: This chapter on nutrition is from a practical survival guide for families of children and teenagers with celiac disease, a lifelong digestive disorder that affects nearly two million Americans. Celiac disease results from an intolerance of gluten, a protein found in wheat, rye, barley, and oats, and any food made with these grains. Removing gluten from the diet is the only known treatment for this illness. Left untreated, the disease can lead to serious conditions such as damage to the central nervous system, osteoporosis, and cancer. In this chapter, the author helps parents and children achieve a healthy, balanced diet when so many foods are forbidden. In addition, before the child's celiac disease is controlled, he or she can have nutritional deficiencies that need to be addressed and corrected. And, as with any children, parents may encounter special nutritional issues, such as a child who wants to become a vegetarian, or one who goes on food jags, or one who needs additional calories. The author discusses the food guide pyramid, the five food groups used in the pyramid (with specific suggestions offered in each group), nutrient imbalances and deficiencies related to celiac disease (carbohydrates, protein, fat, fat soluble vitamins, calcium, magnesium, zinc, iron, folate or folic acid, vitamin B12, and electrolytes), disaccharide intolerance (including lactose intolerance), making snacks healthy and fun, managing food jags, boosting calories and nutrients in the child's diet, and the importance of working with a dietitian with any additional questions parents may have. The chapter includes black and white photographs of children, and sidebars sharing quotations from parents.

33

CHAPTER 5. MULTIMEDIA ON BALANCED DIET Overview In this chapter, we show you how to keep current on multimedia sources of information on balanced diet. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on balanced diet is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “balanced diet” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “balanced diet” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on balanced diet: •

Control of Food Intake Source: Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1992, 60 minutes. Contact: WIN, 1 WIN WAY, Bethesda, MD 20892-3665. Summary: In this lecture Dr. Rolls describes her research on two aspects of the control of food intake: how the variety of food available and restriction of fat intake affect overall food consumption. Dr. Rolls reviews studies conducted with humans in which she and her colleagues identified a phenomenon called "sensory-specific satiety," or the change in the palatability of a food as it is eaten. Because of sensory-specific satiety, people switch from food to food during a meal and thus eat a variety of foods, says Dr. Rolls. This research suggests abnormal sensory-specific satiety may be a factor in eating disorders such as anorexia nervosa and bulimia, as well as in malnutrition among the elderly. Further, since subjects tended to eat more when a greater variety of food was available, apparently appetite reduction could be encouraged by decreasing the variety

34

Balanced Diet

of foods offered to the minimum necessary for a balanced diet. Dr. Rolls also discusses the results of studies that looked at how human subjects' food intake was affected by controlling fat and carbohydrate intake and by use of "fat substitutes." The researchers found that carbohydrate and fat have similar effects on hunger and satiety. The use of fat substitutes was associated with a decrease in fat intake, but no change in daily energy intake. Studies suggesting that subjects who ate a low-fat diet were able to lose weight even when their total caloric intake was not controlled are also discussed. •

Balancing Your Act Source: St. Charles, IL: O'Brien Budd, Inc, 17.04 min., 1990. Contact: O'Brien Budd, Inc., 3620 Swenson Avenue, PO Box 1307, St. Charles, IL 601747307. Summary: This video features basketball super star Michael Jordan leading a nutrition and fitness lesson for school children ages 9-12. The video begins with instructions for ways in which the teacher can use the program in an interactive manner in the classroom. The lesson covers nutrition basics, the importance of a balanced diet that includes a variety of foods from each of the food groups, and emphasizes the need to exercise on a regular basis.

•

Sharing Stories : Getting the Most Out of Your Therapy With Crixivan (Indinavir Sulfate) Contact: Merck and Company, PO Box 4, West Point, PA, 19486-0004, (215) 652-5000, http://www.merck.com. Summary: This video, through the personal anecdotes of persons with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), explains the therapeutic drug crixivan and its treatment regimen. The video examines the way that crixivan has affected the lives HIV-positive persons. It explains how HIV affects the immune system and how crixivan, a protease inhibitor, helps to prevent the virus from replicating. The video advises the viewers to maintain adherence to their drug regimen in order to prevent the development of multidrug-resistant. It emphasizes the importance of exercise and a balanced diet and explains dosing information for crixivan. The video identifies some of the side effects of crixivan.

•

Nutrition for Persons With HIV Infection Contact: University of Michigan, Medical Center, Biomedical Communications, Media Library, 1327 Jones Dr, Ann Arbor, MI, 48105, (313) 763-2074. Summary: This videorecording tells home-care workers who take care of persons with HIV infection about their special nutritional needs. It says that proper nutrition is one way that an HIV-infected person can exert come control over his or her health, and outlines a balanced diet for someone with AIDS. It emphasizes their special need for extra calories and gives tips on adding calories to food. It encourages persons with AIDS (PWAs) to eat junk foods for additional calories as needed after meeting their nutritional requirements, because they cannot afford to loss body weight. Those who have trouble eating a lot at one time are encouraged to eat several smaller meals, and dietary supplements are recommended as needed. Home-care workers learn about the symptoms of HIV infection, such as diarrhea, that may affect a person's appetite, and how to cope with these symptoms. If symptoms remain persistent, consult a dietitian.

Multimedia 35

The videorecording gives information on the safest way to handle food to avoid food poisoning and tips on how to motivate patients to eat.

37

CHAPTER 6. PERIODICALS AND NEWS ON BALANCED DIET Overview In this chapter, we suggest a number of news sources and present various periodicals that cover balanced diet.

News Services and Press Releases One of the simplest ways of tracking press releases on balanced diet is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “balanced diet” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to balanced diet. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “balanced diet” (or synonyms). The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date

38

Balanced Diet

at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “balanced diet” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “balanced diet” (or synonyms). If you know the name of a company that is relevant to balanced diet, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “balanced diet” (or synonyms).

Newsletters on Balanced Diet Find newsletters on balanced diet using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “balanced diet.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “balanced diet” (or synonyms) into the “For these words:” box. The following list was generated using the options described above:

Periodicals and News

•

39

Kidney Disease Source: Sarcoidosis Networking. 8(3): 2. May-June 2000. Contact: Available from Sarcoid Network Association. Sarcoidosis Networking, 13925 80th Street East, Puyallup, WA 98372-3614. Email: [email protected]. Summary: Sarcoidosis is a chronic, progressive systemic granulomatous (causing lesions) disease of unknown cause (etiology), involving almost any organ or tissue, including the skin, lungs, lymph nodes, liver, spleen, eyes, and small bones of the hands or feet. This brief article, from a newsletter for patients with sarcoidosis, reviews kidney disease, its types, diagnosis, and management. The article begins with a summary of the anatomy and function of the kidneys, which filter the blood (removing waste and excess body fluids), and maintain the balance of some essential nutrients helping to regulate blood pressure, red blood cells, and elements such as potassium and calcium. Without functioning kidneys, one cannot live without dialysis, the mechanical filtration of the blood. Kidneys fail for a variety of reasons, including trauma to the kidney, toxins, heart failure, obstruction (kidney stones), overuse of some medications, and diseases that invade the kidney, such as sarcoidosis. Diabetes and high blood pressure are the most common causes for loss of kidney function. Warning signs of kidney disease are high blood pressure (hypertension), blood or protein in the urine, creatinine level greater than 1.2 in women or 1.4 in men, more frequent urination (especially at night), difficult or painful urination, and puffy eyes or swelling of the hands or feet (especially in children). Loss of kidney function can produce symptoms including fatigue, weakness, nausea, vomiting, diarrhea or constipation, headaches, loss of appetite, increased edema (fluid retention), and fever or chills. Kidney failure is characterized as acute kidney failure, chronic kidney insufficiency, and chronic kidney failure. The need to put a person on dialysis depends upon the levels of creatinine and urea nitrogen in the blood and the evaluation of body parameters such as fluid status, and symptoms of toxicity. The author encourages readers to practice preventive measures which include drinking 8 to 10 glasses of water per day, preventing or treating diabetes and high blood pressure, avoiding tobacco, eating a well balanced diet, practicing good hygiene, treating wounds and infections, limiting exposure to heavy metals and toxic chemicals, and avoiding unnecessary over the counter drug use.

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “balanced diet” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on balanced diet: •

Exploding the Myth: Dieting Makes You Thin Source: Healthy Weight Journal. 13(1):7-8. January/February, 1999. Contact: Healthy Living Institute, 402 S. 14th St., Hettinger, ND 58639. (701) 567-2645.

40

Balanced Diet

Summary: The authors examine why it is difficult for individuals to lose weight. They note that genetic predisposition is an important factor. Studies have also shown that even when individuals are able to lose weight, the amount lost is usually a trivial percentage of their total body weight, and they often gain the weight back within a few years. According to Heatherton and Tickle, diets fail because the human body has a weight set point that regulates weight gain and loss to remain within a certain parameters. Another reason diets often do not work is that individuals who restrain their eating rely on perceptions and cognitive control to regulate their eating. When they fail to refrain from eating a food they consider too high in calories, they tend to continue to eat high-calorie foods. The authors conclude that a nutritionally balanced diet which avoids high- calorie, low-nutrition foods, and a moderate amount of exercise are the best ways to control weight. •

Answering Your Questions About Immunity Source: University of California, Berkeley, Wellness Letter. 17(8):4-5. May 2001. Contact: Health Letter Associates. P.O. Box 412, Prince Street Station, New York, NY 10012-0007. Summary: This article addresses various questions about the immune system and its disease-fighting properties. Some evidence suggests that physically active people have a more vigorous immune system than those who are sedentary. Moderate activity, such as a walking program undertaken by previously sedentary people, seems to improve immune function. Evidence also suggests that excessive exercise may depress the immune system. High-intensity or prolonged endurance exercise increases the output of adrenaline and cortisol, which can depress various components of the immune system. Because the health benefits of physical activity are clear, the notion that immune cells might not show a response to an exercise program should not deter sedentary individuals from exercising or from starting a fitness regime. The article also recommends consuming a varied and balanced diet to nurture the immune system.

•

Paediatric Ileostomy Patients Can Eat Virtually Anything Source: Messenger: Newsletter of the American Pseudo-Obstruction and Hirschsprung's Disease Society, Inc. 7(2): 7. Summer 1995. Contact: Available from APHS. 158 Pleasant Street, North Andover, MA 01845-2797. (508) 685-4477. Fax (508) 685-4488. E-mail: [email protected]. Summary: This brief newsletter article discusses dietary concerns that one may encounter in a child with an ileostomy. The author stresses that if the child with an ileostomy has no other medical problems, a normal balanced diet appropriate to their age is recommended. The author, a pediatric nurse, goes on the encourage parents and provide guidelines for introducing new foods and maintaining a healthy diet in these children. Topics include determining which foods should be excluded from the diet; problems with constipation, diarrhea, and increased odor; problems encountered with an artificial sweetener, sorbitol; ways to reduce or manage odor problems; the absorption of food and nutrients; ensuring adequate fluid intake; and psychosocial and quality of life considerations. 4 references.

•

Preventing Osteoporosis : Why Milk Matters Now for Female Teens Source: NIH News and Features. 65-66.

Periodicals and News

41

Summary: This newsletter article for the general public discusses the importance of a nutritionally balanced diet during childhood and adolescence in preventing the onset of damaging adult illness such as osteoporosis. Nutritional imbalances during adolescence results in this bone-crippling disease because the occurrence of osteoporosis is influenced by bone mass attained during the first three decades of life and the bone lost after a menopause. The article presents the recommended daily allowance of calcium for adolescent females, and it reports on nutrition research on factors affecting acquisition of peak bone mass in female adolescents and on a study of calcium requirements during adolescent pregnancies. In addition, the article discusses the impact of osteopenia, amenorrhea, and disordered eating on the adolescent female athlete, and it considers the public health implications of the declining calcium intake in female adolescents.

Academic Periodicals covering Balanced Diet Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to balanced diet. In addition to these sources, you can search for articles covering balanced diet that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

43

CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for balanced diet. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with balanced diet. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

44

Balanced Diet

following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to balanced diet: Alendronate •

Systemic - U.S. Brands: Fosamax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202794.html

Etidronate •

Systemic - U.S. Brands: Didronel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202233.html

Magnesium Supplements •

Systemic - U.S. Brands: Almora; Chloromag; Citroma; Concentrated Phillips' Milk of Magnesia; Mag-200; Mag-L-100; Magonate; Mag-Ox 400; Mag-Tab SR; Magtrate; Maox; MGP; Phillips' Chewable Tablets; Phillips' Milk of Magnesia; Slow-Mag; Uro-Mag http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202644.html

Potassium Supplements •

Systemic - U.S. Brands: Cena-K; Effer-K; Gen-K; Glu-K; K+ 10; K+ Care; K+ Care ET; K-8; Kaochlor 10%; Kaochlor S-F 10%; Kaon; Kaon-Cl; Kaon-Cl 20% Liquid; Kaon-Cl-10; Kato; Kay Ciel; Kaylixir; K-Dur; K-Electrolyte; K-G Elixir; K-Ide; KLease; K-Lor; Klor-Con 10; Klor-Con 8; Klor-Con Powder; Klor-Con/25 Powder; Klor-Con/EF; Klorvess; Klorvess 10% Liquid; Klorvess Effervescent Granules; Klotrix; K-Lyte; K-Lyte DS; K-Lyte/Cl; K-Lyte/Cl 50; K-Lyte/Cl Powder; KNorm; Kolyum; K-Sol; K-Tab; K-Vescent; Micro-K; Micro-K 10; Micro-K LS; Potasalan; Rum-K; Slow-K; Ten-K; Tri-K; Twin-K http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202473.html

Risedronate •

Systemic - U.S. Brands: Actonel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203554.html

Tiludronate •

Systemic - U.S. Brands: Skelid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203480.html

Vitamin K •

Systemic - U.S. Brands: AquaMEPHYTON; Mephyton http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202599.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Researching Medications

45

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

47

APPENDICES

49

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute5: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

5

These publications are typically written by one or more of the various NIH Institutes.

50

Balanced Diet

•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources

51

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.6 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:7 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

6

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 7 See http://www.nlm.nih.gov/databases/databases.html.

52

Balanced Diet

•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway8 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.9 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “balanced diet” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 2132 73 792 12 83 3092

HSTAT10 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.11 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.12 Simply search by “balanced diet” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

8

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

9

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 10 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 11 12

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources

53

Coffee Break: Tutorials for Biologists13 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.14 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.15 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

13 Adapted 14

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 15 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

55

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on balanced diet can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to balanced diet. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to balanced diet. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “balanced diet”:

56

Balanced Diet

Child Nutrition http://www.nlm.nih.gov/medlineplus/childnutrition.html Nutrition for Seniors http://www.nlm.nih.gov/medlineplus/nutritionforseniors.html Sports Fitness http://www.nlm.nih.gov/medlineplus/sportsfitness.html Weight Loss and Dieting http://www.nlm.nih.gov/medlineplus/weightlossanddieting.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on balanced diet. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

How to Enjoy a Balanced Diet on a Balanced Budget Source: South Deerfield, MA: Channing L. Bete Company, Inc. 1996. 15 p. Contact: Available from Channing L. Bete Company, Inc. 200 State Road, South Deerfield, MA 01373-0200. (800) 628-7733. Fax (800) 499-6464. PRICE: $1.25 each for 1-24 copies; discounts available for larger orders. Summary: This booklet provides basic information about eating nutritiously on a limited budget. Written in non-technical language, the booklet defines and describes what is meant by 'a balanced diet on a balanced diet' and covers topics including: the importance of proper nutrition; planning ahead; the Food Guide Pyramid and how to use it; food serving sizes; creative meal planning; shopping hints and recommendations; and how to choose from the five basic food groups. The booklet concludes with a brief summary and section of questions and answers. The booklet is illustrated with simple, cartoon figures, as well as charts and tables. Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database:

Patient Resources

•

57

What Are Soy Foods? Summary: Americans are consuming more soy than ever because of its benefits as part of a balanced diet - soy is a great source of protein and contains other nutrients such as iron and calcium. Source: Nemours Foundation http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7253 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to balanced diet. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to balanced diet. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with balanced diet. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about balanced diet. For more information, see

58

Balanced Diet

the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “balanced diet” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “balanced diet”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “balanced diet” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “balanced diet” (or a synonym) into the search box, and click “Submit Query.”

59

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.16

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

16

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

60

Balanced Diet

libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)17: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

17

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

61

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

62

Balanced Diet

•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

63

•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

64

Balanced Diet

•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

65

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on balanced diet: •

Basic Guidelines for Balanced Diet Balanced diet Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002449.htm

•

Signs & Symptoms for Balanced Diet Muscle Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm

•

Nutrition for Balanced Diet Carbohydrate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002469.htm Fats Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002468.htm Protein Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002467.htm

66

Balanced Diet

Simple sugars Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002469.htm Yogurt Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002463.htm •

Background Topics for Balanced Diet Food Guide Pyramid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002093.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

67

BALANCED DIET DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenaline: A hormone. Also called epinephrine. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean

68

Balanced Diet

intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Allergens: Antigen-type substances (hypersensitivity, immediate). [NIH]

that

produce

immediate

hypersensitivity

Alopecia: Absence of hair from areas where it is normally present. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anabolic Steroids: Chemical derivatives of testosterone that are used for anabolic promotion of growth and repair of body tissues and the development of male sexual characteristics. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH]

Dictionary 69

Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antibiotics: Substances produced by microorganisms that can inhibit or suppress the growth of other microorganisms. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU] Anti-Infective Agents: Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antioxidants: Naturally occurring or synthetic substances that inhibit or retard the oxidation of a substance to which it is added. They counteract the harmful and damaging effects of oxidation in animal tissues. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anuria: Inability to form or excrete urine. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Articular: Of or pertaining to a joint. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Basal cells: Small, round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU]

70

Balanced Diet

Beer: An alcoholic beverage usually made from malted cereal grain (as barley), flavored with hops, and brewed by slow fermentation. [NIH] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Beta carotene: A vitamin A precursor. Beta carotene belongs to the family of fat-soluble vitamins called carotenoids. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH]

Dictionary 71

Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Oxalate: The calcium salt of oxalic acid, occurring in the urine as crystals and in certain calculi. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]

Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart

72

Balanced Diet

and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carotenoids: Substance found in yellow and orange fruits and vegetables and in dark green, leafy vegetables. May reduce the risk of developing cancer. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Cholecystitis: Inflammation of the gallbladder. [NIH] Cholelithiasis: Presence or formation of gallstones. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Chondroitin sulfate: The major glycosaminoglycan (a type of sugar molecule) in cartilage. [NIH]

Chorda Tympani Nerve: A branch of the facial (7th cranial) nerve which passes through the middle ear and continues through the petrotympanic fissure. The chorda tympani nerve carries taste sensation from the anterior two-thirds of the tongue and conveys parasympathetic efferents to the salivary glands. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Claviceps: A genus of ascomycetous fungi, family Clavicipitaceae, order Hypocreales,

Dictionary 73

parasitic on various grasses. The sclerotia contain several toxic alkaloids. Claviceps purpurea on rye causes ergotism. [NIH] Cleft Lip: Congenital defect in the upper lip where the maxillary prominence fails to merge with the merged medial nasal prominences. It is thought to be caused by faulty migration of the mesoderm in the head region. [NIH] Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Colitis: Inflammation of the colon. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the

74

Balanced Diet

standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Corn Oil: Oil from corn or corn plant. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]

Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH]

Dictionary 75

Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dentists: Individuals licensed to practice dentistry. [NIH] Dentition: The teeth in the dental arch; ordinarily used to designate the natural teeth in position in their alveoli. [EU] Dermatitis: Any inflammation of the skin. [NIH] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Developmental Biology: The field of biology which deals with the process of the growth and differentiation of an organism. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]

Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discoid: Shaped like a disk. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Diuresis: Increased excretion of urine. [EU]

76

Balanced Diet

Diuretic: A drug that increases the production of urine. [NIH] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duodenum: The first part of the small intestine. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Ego: The conscious portion of the personality structure which serves to mediate between the demands of the primitive instinctual drives, (the id), of internalized parental and social prohibitions or the conscience, (the superego), and of reality. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Energy Intake: Total number of calories taken in daily whether ingested or by parenteral routes. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local

Dictionary 77

anesthetics. [NIH] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH] Excrete: To get rid of waste from the body. [NIH] Extracellular: Outside a cell or cells. [EU] Facial: Of or pertaining to the face. [EU] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fat Substitutes: Compounds used in food or in food preparation to replace dietary fats. They may be carbohydrate-, protein-, or fat-based. Fat substitutes are usually lower in calories but provide the same texture as fats. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU]

78

Balanced Diet

Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Flatus: Gas passed through the rectum. [NIH] Flavoring Agents: Substances added to foods and medicine to improve the quality of taste. [NIH]

Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Food Additives: Substances which are of little or no nutritive value, but are used in the processing or storage of foods or animal feed, especially in the developed countries; includes antioxidants, food preservatives, food coloring agents, flavoring agents, anti-infective agents (both plain and local), vehicles, excipients and other similarly used substances. Many of the same substances are pharmaceutic aids when added to pharmaceuticals rather than to foods. [NIH]

Food Coloring Agents: Natural or synthetic dyes used as coloring agents in processed foods. [NIH] Food Hypersensitivity: Gastrointestinal disturbances, skin eruptions, or shock due to allergic reactions to allergens ingested in food. [NIH] Food Labeling: Use of written, printed, or graphic materials upon or accompanying a food or its container or wrapper. The concept includes ingredients, nutritional value, directions, warnings, and other relevant information. [NIH] Food Preservatives: Substances capable of inhibiting, retarding or arresting the process of fermentation, acidification or other deterioration of foods. [NIH] Food Services: Functions, equipment, and facilities concerned with the preparation and distribution of ready-to-eat food. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Dictionary 79

Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycosaminoglycan: A type of long, unbranched polysaccharide molecule. Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [NIH] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH]

80

Balanced Diet

Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis C: A form of hepatitis, similar to type B post-transfusion hepatitis, but caused by a virus which is serologically distinct from the agents of hepatitis A, B, and E, and which may persist in the blood of chronic asymptomatic carriers. Hepatitis C is parenterally transmitted and associated with transfusions and drug abuse. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Ice Cream: A frozen dairy food made from cream or butterfat, milk, sugar, and flavorings. Frozen custard and French-type ice creams also contain eggs. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins,

Dictionary 81

intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal

82

Balanced Diet

function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Low-calorie diet: Caloric restriction of about 800 to 1,500 calories (approximately 12 to 15 kcal/kg of body weight) per day. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph

Dictionary 83

nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menarche: The establishment or beginning of the menstrual function. [EU] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mesoderm: The middle germ layer of the embryo. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH]

84

Balanced Diet

Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH]

Dictionary 85

Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Nutritive Value: An indication of the contribution of a food to the nutrient content of the diet. This value depends on the quantity of a food which is digested and absorbed and the amounts of the essential nutrients (protein, fat, carbohydrate, minerals, vitamins) which it contains. This value can be affected by soil and growing conditions, handling and storage, and processing. [NIH] Obsession: A recurrent, persistent thought, image, or impulse that is unwanted and distressing (ego-dystonic) and comes involuntarily to mind despite attempts to ignore or suppress it. Common obsessions involve thoughts of violence, contamination, and selfdoubt. [EU] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Onychomycosis: Mycosis of the nails, possibly due to some extent to humidity. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Oxalate: A chemical that combines with calcium in urine to form the most common type of kidney stone (calcium oxalate stone). [NIH] Oxalic Acid: A strong dicarboxylic acid occurring in many plants and vegetables. It is produced in the body by metabolism of glyoxylic acid or ascorbic acid. It is not metabolized but excreted in the urine. It is used as an analytical reagent and general reducing agent. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal,

86

Balanced Diet

intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmaceutic Aids: Substances which are of little or no therapeutic value, but are necessary in the manufacture, compounding, storage, etc., of pharmaceutical preparations or drug dosage forms. They include solvents, diluting agents, and suspending agents, and emulsifying agents. Also, antioxidants; preservatives, pharmaceutical; dyes (coloring agents); flavoring agents; vehicles; excipients; ointment bases. [NIH]

Dictionary 87

Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH]

88

Balanced Diet

Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Pre-Eclampsia: Development of hypertension with proteinuria, edema, or both, due to pregnancy or the influence of a recent pregnancy. It occurs after the 20th week of gestation, but it may develop before this time in the presence of trophoblastic disease. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prenatal Care: Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proprioception: The mechanism involved in the self-regulation of posture and movement through stimuli originating in the receptors imbedded in the joints, tendons, muscles, and labyrinth. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH]

Dictionary 89

Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Rickets: A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rye: A hardy grain crop, Secale cereale, grown in northern climates. It is the most frequent host to ergot (claviceps), the toxic fungus. Its hybrid with wheat is triticale, another grain. [NIH]

Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each

90

Balanced Diet

consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH]

Dictionary 91

Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sorbitol: A polyhydric alcohol with about half the sweetness of sucrose. Sorbitol occurs naturally and is also produced synthetically from glucose. It was formerly used as a diuretic and may still be used as a laxative and in irrigating solutions for some surgical procedures. It is also used in many manufacturing processes, as a pharmaceutical aid, and in several research applications. [NIH] Soybean Oil: Oil from soybean or soybean plant. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress management: A set of techniques used to help an individual cope more effectively with difficult situations in order to feel better emotionally, improve behavioral skills, and often to enhance feelings of control. Stress management may include relaxation exercises, assertiveness training, cognitive restructuring, time management, and social support. It can be delivered either on a one-to-one basis or in a group format. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions

92

Balanced Diet

of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Taste Buds: Small sensory organs which contain gustatory receptor cells, basal cells, and supporting cells. Taste buds in humans are found in the epithelia of the tongue, palate, and pharynx. They are innervated by the chorda tympani nerve (a branch of the facial nerve) and the glossopharyngeal nerve. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrush: A disease due to infection with species of fungi of the genus Candida. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH]

Dictionary 93

Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Umbilical Cord: The flexible structure, giving passage to the umbilical arteries and vein, which connects the embryo or fetus to the placenta. [NIH] Umbilicus: The pit in the center of the abdominal wall marking the point where the umbilical cord entered in the fetus. [NIH] Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas. [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some

94

Balanced Diet

viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitamin D: The vitamin that mediates intestinal calcium absorption, bone calcium metabolism, and probably muscle activity. It usually acts as a hormone precursor, requiring 2 stages of metabolism before reaching actual hormonal form. It is isolated from fish liver oils and used in the treatment and prevention of rickets. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

95

INDEX A Abdominal, 11, 67, 85, 86, 93 Acetaminophen, 14, 67 Adaptation, 13, 67 Adenosine, 67, 71, 87 Adjustment, 31, 67 Adolescence, 41, 67 Adrenal Cortex, 67, 74, 88 Adrenaline, 40, 67 Adverse Effect, 67, 90 Aerobic, 5, 14, 67 Aerobic Exercise, 14, 67 Affinity, 67, 90 Agar, 68, 87 Alertness, 68, 71 Algorithms, 68, 70 Alimentary, 6, 68, 81, 85, 86 Alkaline, 68, 71 Allergens, 68, 78 Alopecia, 10, 68 Alternative medicine, 38, 68 Alveoli, 68, 75 Amenorrhea, 41, 68, 69 Amino Acids, 26, 68, 86, 88, 93 Ammonia, 68, 93 Anabolic, 13, 31, 68 Anabolic Steroids, 31, 68 Analgesic, 67, 68, 84 Anatomical, 68, 76 Anemia, 25, 68, 78 Anesthesia, 68 Anomalies, 4, 68 Anorexia, 6, 33, 68, 69 Anorexia Nervosa, 33, 69 Antagonism, 69, 71 Antibiotics, 30, 69 Antibody, 67, 69, 73, 81 Antigen, 15, 67, 68, 69, 73, 81 Anti-infective, 69, 78 Anti-Infective Agents, 69, 78 Anti-inflammatory, 67, 69 Antioxidants, 10, 26, 69, 78, 86 Antipyretic, 67, 69 Anuria, 69, 81 Apolipoproteins, 69, 82 Arterial, 69, 72, 80, 88, 92 Arteries, 11, 69, 70, 74, 82, 93 Articular, 13, 69, 85

Asymptomatic, 69, 80 B Bacteria, 69, 70, 75, 77, 83, 93 Bacterial Physiology, 67, 69 Basal cells, 69, 92 Base, 69, 77, 81, 82 Beer, 9, 70 Behavior Therapy, 12, 70 Beta carotene, 10, 70 Bewilderment, 70, 74 Bile, 9, 70, 78, 82, 91 Bile Acids, 70, 91 Bile Acids and Salts, 70 Biochemical, 70, 81, 85 Biopsy, 6, 70 Biotechnology, 15, 38, 51, 70 Bladder, 70, 89, 93 Blood Coagulation, 70, 71 Blood Glucose, 7, 10, 13, 14, 30, 32, 70, 81 Blood pressure, 32, 39, 70, 72, 80, 84, 90 Blood vessel, 70, 71, 72, 83, 90, 91, 93 Body Fluids, 39, 70, 90 Body Mass Index, 70, 85 Bone Density, 28, 70 Bowel, 70, 75, 82, 86 Bowel Movement, 70, 75 Buccal, 71, 82 Bulimia, 3, 4, 33, 71 C Caffeine, 31, 71 Calcium, 10, 12, 32, 39, 41, 57, 71, 73, 85, 94 Calcium Oxalate, 12, 71, 85 Calculi, 71 Caloric intake, 11, 34, 71 Candidiasis, 10, 71 Candidosis, 71 Carbohydrate, 5, 11, 31, 34, 65, 71, 77, 85 Carcinogenesis, 23, 71 Carcinogenic, 71, 91 Carcinogens, 71, 72 Cardiac, 71, 76, 91 Cardiorespiratory, 67, 71 Cardiovascular, 6, 71 Cardiovascular disease, 6, 71 Carotene, 26, 70, 72 Carotenoids, 11, 70, 72 Case report, 4, 10, 72

96

Balanced Diet

Celiac Disease, 6, 32, 72 Cell, 67, 69, 70, 72, 73, 77, 78, 81, 83, 84, 87, 89 Central Nervous System, 32, 71, 72, 79, 84 Cerebrovascular, 72 Character, 72, 75, 79 Cholecystectomy, 10, 72 Cholecystitis, 31, 72 Cholelithiasis, 9, 31, 72 Cholesterol, 8, 24, 70, 72, 74, 82, 91 Cholesterol Esters, 72, 82 Chondroitin sulfate, 14, 72 Chorda Tympani Nerve, 72, 92 Chromium, 8, 10, 21, 72 Chromosome, 72, 82 Chronic, 4, 10, 28, 39, 72, 80, 81, 82, 91, 92 Chylomicrons, 72, 82 Claviceps, 72, 89 Cleft Lip, 4, 73 Cleft Palate, 4, 73 Clinical trial, 15, 51, 73, 89 Cloning, 70, 73 Cognitive restructuring, 73, 91 Colitis, 31, 73 Colon, 73, 82 Colorectal, 23, 73 Complement, 73 Complementary and alternative medicine, 23, 26, 73 Complementary medicine, 23, 73 Complete remission, 74, 89 Computational Biology, 51, 74 Confusion, 7, 74, 75, 93 Connective Tissue, 74, 77, 82, 92 Consciousness, 68, 74 Constipation, 8, 39, 40, 74 Contamination, 28, 74, 85 Contraindications, ii, 74 Corn Oil, 23, 74 Coronary, 72, 74 Coronary heart disease, 72, 74 Cortisol, 40, 74 Creatine, 31, 74 Creatinine, 39, 74, 81 Curative, 74, 89, 92 Cutaneous, 71, 74, 82 Cyclic, 71, 74 D Dairy Products, 9, 10, 74 Deamination, 75, 93 Degenerative, 75, 80, 85 Dental Care, 4, 30, 75

Dental Caries, 5, 75 Dentists, 5, 75 Dentition, 4, 75 Dermatitis, 10, 75 Developed Countries, 75, 78 Developmental Biology, 5, 75 Diabetes Mellitus, 10, 12, 25, 75, 79 Diagnostic procedure, 38, 75 Dialyzer, 75, 80 Diarrhea, 34, 39, 40, 75 Diastolic, 75, 80 Dietary Fats, 75, 77 Dietitian, 32, 34, 75 Digestion, 9, 13, 68, 70, 75, 82, 91 Digestive system, 9, 75 Direct, iii, 43, 75, 89 Discoid, 28, 75 Disorientation, 74, 75 Diuresis, 71, 75 Diuretic, 76, 91 Diverticula, 76 Diverticulitis, 31, 76 Diverticulum, 76 Drug Interactions, 7, 45, 76 Duodenum, 70, 76, 91 Dystrophy, 10, 76 E Eating Disorders, 33, 76 Edema, 39, 76, 84, 88 Ego, 76, 85 Elastic, 76, 79 Electrolyte, 44, 76, 82, 87, 90 Enamel, 4, 10, 75, 76 Endocarditis, 71, 76 Endocrine Glands, 10, 76 Energy Intake, 11, 31, 34, 76 Environmental Health, 50, 52, 76 Enzymatic, 71, 72, 73, 75, 76 Enzyme, 76, 77, 88 Epidemic, 14, 76 Epidemiological, 14, 76 Epinephrine, 67, 76 Ergot, 77, 89 Erythrocytes, 68, 77, 89 Esophageal, 6, 77 Esophagus, 75, 77, 87, 91 Estrogen, 13, 77 Ethanol, 77 Evacuation, 74, 77, 82 Excipients, 77, 78, 86 Excrete, 69, 77, 81 Extracellular, 74, 77, 90

97

F Facial, 72, 77, 86, 92 Facial Nerve, 77, 86, 92 Family Planning, 51, 77 Fat, 5, 6, 7, 8, 10, 11, 13, 31, 32, 33, 70, 72, 74, 77, 82, 85, 87, 91 Fat Substitutes, 11, 34, 77 Fatigue, 39, 77, 80 Feces, 74, 77 Fermentation, 9, 70, 77, 78 Fetus, 77, 88, 93 Fibrosis, 77, 90 Filtration, 39, 77, 81 Fissure, 72, 73, 78 Flatus, 78 Flavoring Agents, 78, 86 Folate, 6, 10, 32, 78 Folic Acid, 32, 78 Food Additives, 13, 78 Food Coloring Agents, 78 Food Hypersensitivity, 27, 78 Food Labeling, 28, 78 Food Preservatives, 78 Food Services, 5, 78 Forearm, 70, 78 Fungus, 71, 77, 78, 89 G Gallbladder, 9, 31, 67, 72, 75, 78 Gas, 11, 68, 78, 80, 84, 92 Gastrointestinal, 6, 11, 31, 76, 77, 78, 92 Gastrointestinal tract, 31, 77, 78 Gene, 70, 78 Genetics, 9, 12, 30, 79 Genital, 10, 79 Gestation, 79, 88 Gingivitis, 30, 79 Gland, 67, 79, 82, 85, 86, 90 Glossopharyngeal Nerve, 79, 92 Glucose, 12, 70, 72, 75, 79, 81, 90, 91 Glucose Intolerance, 75, 79 Glutamic Acid, 78, 79 Gluten, 6, 32, 72, 79 Glycosaminoglycan, 72, 79 Goats, 74, 79 Gonadal, 79, 91 Governing Board, 79, 87 Grasses, 73, 78, 79 H Headache, 71, 79 Health Education, 5, 29, 79 Heart attack, 72, 80 Heart failure, 39, 80

Hemodialysis, 32, 75, 80, 81, 82 Hepatitis, 31, 80 Hepatitis C, 31, 80 Hepatocytes, 80 Heredity, 29, 78, 79, 80 Hormonal, 80, 94 Hormone, 67, 74, 76, 80, 81, 88, 92, 94 Hybrid, 80, 89 Hydrogen, 69, 71, 80, 84, 85, 86 Hydrophobic, 80, 82 Hypertension, 28, 39, 72, 79, 80, 88 Hypoplasia, 10, 80 I Ice Cream, 11, 80 Idiopathic, 80, 90 Ileostomy, 40, 80 Ileum, 80 Immune response, 69, 80, 92, 94 Immune system, 27, 28, 34, 40, 80 Immunodeficiency, 34, 80 Infection, 25, 31, 34, 69, 71, 80, 82, 83, 91, 92 Inflammation, 69, 72, 73, 75, 76, 77, 79, 80, 81, 86, 87, 92, 93 Ingestion, 5, 81, 87 Inhalation, 81, 87 Insulin, 7, 12, 25, 31, 81 Insulin-dependent diabetes mellitus, 81 Intermittent, 81, 86 Intestinal, 72, 81, 83, 94 Intestinal Mucosa, 72, 81 Intestines, 67, 72, 77, 78, 81 Intracellular, 71, 81, 87 Intramuscular, 81, 85 Intravenous, 81, 86 Ions, 69, 76, 80, 81 K Kb, 50, 81 Keratolytic, 75, 81 Kidney Disease, 31, 33, 39, 50, 81 Kidney Failure, 39, 81 Kidney Failure, Acute, 81 Kidney Failure, Chronic, 39, 81 Kidney stone, 12, 39, 82, 85 Kidney Transplantation, 32, 82 L Labyrinth, 82, 88 Large Intestine, 75, 81, 82, 89 Latent, 82, 88 Laxative, 68, 82, 91 Linkage, 6, 82 Lip, 4, 73, 82

98

Balanced Diet

Lipid, 69, 81, 82 Lipoprotein, 24, 82 Liver, 31, 39, 67, 70, 75, 77, 78, 80, 82, 90, 93, 94 Localized, 75, 81, 82, 87 Low-calorie diet, 12, 82 Low-density lipoprotein, 82 Lupus, 28, 82, 92 Lymph, 39, 82, 83, 90 Lymph node, 39, 82, 83, 90 Lymphatic, 81, 82, 83, 91 Lymphatic system, 82, 83, 91 Lymphocytes, 69, 82, 83, 91 M Malabsorption, 72, 83 Malnutrition, 33, 83 Manifest, 8, 83 Maxillary, 73, 83 Meat, 9, 12, 75, 83 Medial, 73, 83 MEDLINE, 51, 83 Megaloblastic, 78, 83 Membrane, 73, 75, 83, 84, 86, 87 Memory, 28, 68, 83 Menarche, 23, 83 Meninges, 72, 83 Menopause, 41, 83, 87 Menstruation, 68, 83 Mental, iv, 14, 50, 52, 74, 75, 77, 83, 88, 93 Mental Health, iv, 14, 50, 52, 83, 88 Mesoderm, 73, 83 Microbe, 83, 92 Microbiology, 67, 83 Micro-organism, 75, 83, 87 Migration, 73, 83 Milliliter, 70, 84 Modification, 12, 84, 89 Molecular, 51, 53, 70, 74, 84 Molecule, 69, 72, 73, 79, 84, 85, 89 Monitor, 8, 32, 74, 84 Morphine, 84 Motion Sickness, 84 Mucosa, 82, 84 N Narcosis, 84 Narcotic, 14, 84 Nausea, 6, 39, 84, 93 Necrosis, 84, 90 Nephropathy, 31, 81, 84 Nephrosis, 84 Nephrotic, 31, 84 Nephrotic Syndrome, 31, 84

Nervous System, 72, 84, 91 Nitrogen, 39, 81, 84 Nonverbal Communication, 84, 88 Nucleic acid, 84 Nutritional Status, 6, 85 Nutritive Value, 78, 85 O Obsession, 4, 85 Oliguria, 81, 85 Onychomycosis, 10, 85 Oral Health, 5, 7, 8, 30, 85 Oral Hygiene, 4, 7, 85 Osteoarthritis, 13, 85 Osteoporosis, 28, 32, 40, 41, 85 Overweight, 4, 5, 7, 12, 13, 14, 20, 31, 85 Oxalate, 13, 85 Oxalic Acid, 71, 85 Oxidation, 69, 85 P Palate, 4, 73, 79, 85, 92 Palliative, 85, 92 Pancreas, 67, 75, 81, 85 Parenteral, 31, 76, 85, 86 Parenteral Nutrition, 31, 86 Parotid, 79, 86, 90 Partial remission, 86, 89 Pathologic, 70, 71, 74, 86 Patient Education, 13, 31, 56, 60, 62, 66, 86 Peptide, 86, 88 Perception, 6, 86 Pericardium, 86, 92 Periodontal disease, 30, 86 Periodontitis, 30, 79, 86 Peritoneal, 32, 86 Peritoneal Cavity, 86 Peritoneal Dialysis, 32, 86 Peritoneum, 86 PH, 70, 86 Pharmaceutic Aids, 78, 86 Pharmacologic, 68, 87, 92 Pharynx, 87, 92 Phospholipids, 77, 82, 87 Phosphorus, 13, 71, 87 Physiologic, 12, 83, 87, 89 Physiology, 13, 87 Pigments, 72, 87 Plants, 79, 85, 87, 89, 92 Plaque, 11, 87 Plasma, 6, 72, 79, 81, 87 Pneumonia, 74, 87 Poisoning, 35, 77, 84, 87 Polyunsaturated fat, 24, 87

99

Posterior, 79, 85, 87 Postmenopausal, 85, 87 Potassium, 13, 39, 44, 87 Practice Guidelines, 52, 87 Precursor, 70, 76, 88, 94 Predisposition, 40, 88 Pre-Eclampsia, 24, 88 Prenatal, 4, 88 Prenatal Care, 4, 88 Prevalence, 12, 13, 14, 29, 88 Progesterone, 88, 91 Progression, 31, 88 Progressive, 39, 81, 84, 85, 88 Proprioception, 13, 88 Protease, 34, 88 Protein C, 69, 82, 88, 93 Protein S, 70, 88 Proteins, 12, 24, 31, 68, 69, 73, 84, 86, 87, 88, 90, 92, 93 Proteinuria, 84, 88 Psychotherapy, 4, 88 Public Health, 4, 41, 52, 88 Public Policy, 51, 88 Pulmonary, 70, 81, 88, 89 Pulmonary Artery, 70, 88 Pulmonary Edema, 81, 89 Pulse, 84, 89 Q Quality of Life, 40, 89 R Randomized, 12, 89 Receptor, 67, 69, 89, 92 Rectum, 70, 73, 75, 78, 82, 89 Recurrence, 9, 89 Red blood cells, 39, 77, 89, 90 Refer, 1, 71, 73, 89 Regimen, 30, 34, 89 Remission, 6, 29, 89 Renal pelvis, 82, 89 Respiration, 84, 89 Retinoids, 89, 94 Rickets, 89, 94 Risk factor, 4, 5, 9, 13, 30, 89 Rye, 32, 73, 77, 89 S Salivary, 72, 75, 77, 89 Salivary glands, 72, 75, 77, 89 Saponins, 89, 91 Sarcoidosis, 39, 90 Screening, 14, 73, 90 Secretion, 12, 81, 90 Sedentary, 10, 14, 29, 40, 90

Senile, 85, 90 Serum, 16, 73, 81, 82, 90 Sex Characteristics, 67, 90, 92 Shock, 78, 90, 93 Side effect, 14, 34, 43, 67, 90, 92 Signs and Symptoms, 89, 90 Smooth muscle, 71, 84, 90, 92 Social Environment, 89, 90 Social Support, 13, 90, 91 Socioeconomic Factors, 4, 90 Sodium, 7, 13, 90 Soft tissue, 30, 91 Somatic, 67, 79, 91 Sorbitol, 40, 91 Soybean Oil, 87, 91 Specialist, 58, 91 Spinal cord, 72, 83, 84, 91 Spleen, 39, 82, 83, 90, 91 Steroid, 31, 70, 74, 90, 91 Stimulant, 71, 91 Stomach, 67, 75, 77, 78, 80, 81, 84, 86, 87, 91 Stress, 14, 74, 84, 88, 91 Stress management, 14, 91 Stroke, 50, 72, 91 Stupor, 84, 91 Subacute, 81, 91 Subclinical, 81, 91 Subcutaneous, 76, 85, 91 Substance P, 90, 91 Suction, 77, 92 Supplementation, 10, 92 Systemic, 28, 30, 39, 44, 70, 71, 76, 81, 90, 92 Systemic disease, 30, 92 Systemic lupus erythematosus, 28, 92 Systolic, 80, 92 T Taste Buds, 5, 92 Testosterone, 68, 92 Therapeutics, 6, 45, 92 Threshold, 80, 92 Thrush, 71, 92 Tissue, 39, 69, 70, 74, 76, 78, 80, 82, 83, 85, 86, 89, 90, 91, 92 Tomography, 70, 92 Tone, 85, 92 Tooth Preparation, 67, 92 Toxic, iv, 14, 39, 73, 79, 89, 92 Toxicity, 39, 76, 92 Toxicology, 52, 92 Toxins, 39, 69, 80, 92

100

Balanced Diet

Trace element, 8, 72, 93 Transfection, 70, 93 Transfusion, 80, 93 Trauma, 39, 79, 84, 93 Tuberculosis, 82, 93 U Umbilical Cord, 93 Umbilicus, 10, 93 Urban Population, 17, 93 Urea, 39, 81, 93 Uremia, 81, 93 Ureters, 82, 93 Urethra, 93 Urinary, 12, 71, 85, 93

Urine, 12, 31, 39, 69, 70, 71, 74, 75, 76, 81, 82, 85, 88, 89, 93 V Vaccines, 93, 94 Vagina, 71, 83, 93 Vaginitis, 71, 93 Vascular, 81, 93 Veterinary Medicine, 51, 93 Villous, 72, 93 Virulence, 92, 93 Virus, 34, 80, 87, 93 Vitamin A, 8, 9, 10, 94 Vitamin D, 6, 89, 94 X X-ray, 70, 94