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Beth Israel Deaconess Medical Center West Campus 1 Deaconess Road Boston, MA 02215 E-mail: bbistria{at}caregroup.harvard.edu
Clinical nutrition, the application of nutritional knowledge to the management and treatment of disease, entered a golden age of rapid acquisition of new knowledge after the development of the innovative feeding techniques of total enteral and parenteral nutrition. It appears now that clinical nutrition in the hospital setting is in its maturity: its effectiveness as a medical therapy is generally recognized and used by most practitioners, but the pace of innovation has slowed. However, the body of extant nutritional knowledge is sufficiently large that a comprehensive compilation of current knowledge in this field should be periodically accumulated in a textbook. Although multiauthored textbooks, even the very best ones, often fail to maintain the same high standards throughout, most of the contributions in this volume are of high quality and some are even of noteworthy quality. Among the latter are the introductory chapters "Metabolic Response to Starvation, Injury and Sepsis" by Marinos Elia, "Protein and Amino Acid Metabolism in the Whole Body and in the Tissues" by Michael Rennie and Daniel Cuthbertson, "Physiology of Nutrient Absorption and Patterns of Intestinal Metabolism" by George Grimble, and "Parenteral Nutrition Substrates" by Peter Furst, Katharina Kuhn, and Peter Stehle. Especially well written in the chapters on disease-related nutrition are "Nutrition Support in Human Immunodeficiency Virus Infection" by Derek Macallan, Jaqui Cotton, and George Griffin and "Nutrition Support in Patients with Cancer" by Federico Bozzetti. These chapters alone, which are written by internationally known authors, warrant purchase of this excellent book. In addition, the editors are to be commended, not only for their choice of topics but also for the minimal overlap in the book. One minor disadvantage of this generally superb textbook for US readers is that some of the information provided, as expected, concerns products, policies, and epidemiologic data from the United Kingdom locale of the editors and publisher. I enthusiastically recommend this contribution to specialists in hospital nutrition, such as critical care physicians, trauma surgeons, and gastroenterologists. It would also serve for other specialists who are integral to the provision of nutrition support, including dietitians, pharmacists, and nutrition-support nurses. Finally, for nutrition scientists who would like to keep abreast of the new developments in the field of hospital nutrition, this book is a well-written commentary on the present role that nutrition now plays in clinical care.