Nutritional Aspects and Clinical Management of Chronic Disorders and Diseases,

edited by Felix Bronner, 2003, 335 pages, hardcover, $129.95. CRC Press, Boca Raton, FL.

Section of GI/Nutrition, University of Chicago, 5841 South Maryland Avenue, MC 4080, Chicago, IL 60637, E-mail:jnewton{at}medicine.bsd.uchicago

The editor of this book has gathered a diverse group of experienced authors to provide an evidence-based approach to the nutritional aspects of chronic disease states. Beginning with the review of nutrition support in children as discussed by authors Valentine, Griffin, and Abrams in chapter 1, there is an effort to provide practical recommendations for clinical practice. Each section is arranged in succinct paragraphs that define the specific disease states and briefly discuss the etiology and prevalence of the diseases. Common symptoms are reviewed, followed by evidence-based approaches to treatment. Each group of authors has carefully noted aspects of nutritional assessment that are essential to determining the needs of a particular patient, beginning with nutritional assessment.

In the United States, malnutrition results typically from an imbalance of macronutrients, a deficiency of micronutrients, or both—a contrast from classic deficiency states. To aid time-challenged practitioners, many of the chapters contain tables that provide quick references and useful summaries of national dietary guidelines. Key issues, such as parenteral compared with enteral nutrition, are addressed for specific disease states. The importance of milk or modified milk products in childhood and the underrecognition of diseases of diet intolerance and functional bowel disorders (eg, irritable-bowel syndrome) are a few of the aspects of nutritional management highlighted.

In addition to traditional aspects of medicine, emerging data relative to complementary and alternative medicines are briefly discussed. The use of nutrients as pharmaceuticals is noted for specific disease states and clinical conditions, and a list of practical considerations, especially for cancer and diabetic patients, is also included. The recognition of potential drug-nutrient and nutrient-nutrient interactions is vital in modern medicine. In addition to reviews of the current literature, some of the authors address the need for additional research to address issues relevant to patient care.

This book is suitable for all specialties because it highlights the need to recognize the importance of nutrition, which affects the outcome of many common chronic diseases seen in both pediatric and adult medicine. The book is easy to read, well-organized, accurate, and useful in clinical practice. The book’s only real deficit is its lack of information dedicated to the nutritional management of elderly patients—one of the fastest growing segments of the population and who are often the population most affected by chronic diseases. Overall, I recommend this book as a quick guide for practical nutritional management.