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NUTRITION NOW
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Print Number: 01 Print Year: 2019
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About the Author
JUDITH E. BROWN is Professor Emerita of Nutrition at the School of Public
Health, and of the Department of Obstetrics and Gynecology at the University
of Minnesota. She received her Ph.D. in human nutrition from Florida State
University and her M.P.H. in public health nutrition from the University of
Michigan. Dr. Brown has received competitively funded research grants from the
National Institutes of Health, the Centers for Disease Control and Prevention,
and the Maternal and Child Health Bureau and has over 100 publications in the
scientific literature including the New England Journal of Medicine, the Journal
of the American Medical Association, and the Journal of the American Dietetic
Association. A recipient of the Agnes Higgins Award in Maternal Nutrition from
the March of Dimes, Dr. Brown is a registered dietitian and the successful author
of Everywoman’s Guide to Nutrition, Nutrition for Your Pregnancy, and What to Eat
Before, During, and After Pregnancy.
the au thor
Cour tesy of
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21651_fm_ptg01.indd 4 11/20/18 4:03 PM
Contents in Brief
Preface xviii UNIT 23 Good Things to Know about Minerals 23-1
UNIT 1 Key Nutrition Concepts and Terms 1-1 UNIT 24 Dietary Supplements 24-1
UNIT 2 The Inside Story about Nutrition UNIT 25 Water Is an Essential Nutrient 25-1
and Health 2-1
UNIT 26 Nutrient–Gene Interactions in Health
UNIT 3 Ways of Knowing about Nutrition 3-1 and Disease 26-1
UNIT 4 Understanding Food and Nutrition Labels 4-1 UNIT 27 Nutrition and Physical Fitness
for Everyone 27-1
UNIT 5 Nutrition, Attitudes, and Behavior 5-1
UNIT 28 Nutrition and Physical Performance 28-1
UNIT 6 Healthy Dietary Patterns, Dietary Guidelines,
MyPlate, and More 6-1 UNIT 29 Good Nutrition for Life: Pregnancy, Breast-
feeding, and Infancy 29-1
UNIT 7 How the Body Uses Food: Digestion
and Absorption 7-1 UNIT 30 Nutrition for the Growing Years: Childhood
through Adolescence 30-1
UNIT 8 Calories! Food, Energy, and Energy
Balance 8-1 UNIT 31 Nutrition and Health Maintenance for Adults of
All Ages 31-1
UNIT 9 Obesity to Underweight: The Highs
and Lows of Weight Status 9-1 UNIT 32 The Multiple Dimensions of Food Safety 32-1
UNIT 10 Weight Control: The Myths and Realities 10-1 UNIT 33 Aspects of Global Nutrition 33-1
UNIT 11 Disordered Eating: Anorexia and Bulimia Appendix A Table of Food Composition A-1
Nervosa, Binge-Eating Disorder,
and Pica 11-1 Appendix B Reliable Sources of Nutrition
Information B-1
UNIT 12 Useful Facts about Sugars, Starches,
and Fiber 12-1 Appendix C Aids to Calculations C-1
UNIT 13 Diabetes Now 13-1 Appendix D Table of Intentional Food Additives D-1
UNIT 14 Alcohol: The Positives and Negatives 14-1 Appendix E Cells E-1
UNIT 15 Proteins and Amino Acids 15-1 Appendix F Feedback and Answers to Nutrition Up
Close and Review Questions F-1
UNIT 16 Vegetarian Dietary Patterns 16-1
Glossary GL-1
UNIT 17 Food Allergies and Intolerances 17-1
References R-1
UNIT 18 Fats and Health 18-1
Index I-1
UNIT 19 Nutrition and Heart Disease 19-1
UNIT 20 Vitamins and Your Health 20-1
UNIT 21 Phytochemicals 21-1
UNIT 22 Diet and Cancer 22-1
CO N T E N T S I N B R I E F v
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Contents
UNIT 1 Key Nutrition Concepts and Terms 1-1
The Meaning of Nutrition 1-2
Nutrition Defined 1-2
Foundation Knowledge for Thinking about Nutrition 1-5

Who Are the Food Insecure? 1-6
Calories 1-6
Nutrients 1-6
Other Substances in Food 1-7
Jose Luis Pelaez, Inc/Blend Images/Corbis

NUTRITION UP CLOSE Nutrition Concepts Review 1-17
Review Questions 1-17
Nutrition Scoreboard Answers 1-18
UNIT 2 The Inside Story about Nutrition and Health 2-1

Nutrition in the Context of Overall Health 2-2
The Nutritional State of the Nation 2-3
The Importance of Food Choices 2-5
Diet and Diseases of Western Civilization 2-5

Our Bodies Haven’t Changed 2-5
Different Diets, Different Disease Rates 2-7
The Power of Prevention 2-8
Improving the American Diet 2-9

What Should We Eat? 2-10
Nutrition Surveys: Tracking the American Diet 2-10
NUTRITION UP CLOSE Food Types for Healthful Diets 2-11

UNIT 3 Ways of Knowing about Nutrition 3-1

How Do I Know if What I Read or Hear about Nutrition Is True? 3-2
Profits, Prophets, and Proof 3-2
nutrition timeline
1621 1702 1734 1744
First Thanksgiving feast First coffeehouse in America Scurvy recognized First record of ice cream in America
at Plymouth colony opens in Philadelphia at Maryland colony
Courtesy of Wellcome Library,
PhotoDisc
PhotoDisc
London
PhotoDisc
vi C ONTENTS
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How to Identify Nutrition Truths 3-6
Sources of Reliable Nutrition Information 3-7
The Methods of Science 3-9
Developing the Plan 3-9
The Hypothesis: Making the Question Testable 3-10
The Research Design: Gathering the Right Information 3-11
Obtaining Approval to Study Human Subjects 3-14
Implementing the Study 3-14
Making Sense of the Results 3-14
NUTRITION UP CLOSE Checking Out a Fat-Loss Product 3-15

UNIT 4 Understanding Food and Nutrition Labels 4-1

Nutrition Labeling 4-2
Key Elements of Nutrition Labeling Standards 4-2
Dietary Supplement Labeling 4-8
Structure or Function Claims 4-9
The COOL Rule 4-9
Organic Foods 4-9
Labeling Organic Foods 4-9
Other Nutrition Labeling Systems 4-10
Calories on Display 4-11
Upcoming Nutrition Label Revisions 4-11
Beyond Nutrition Labels 4-12
NUTRITION UP CLOSE Understanding Food Labels 4-14
Alistair Berg/Digital Vision/Getty Images
UNIT 5 Nutrition, Attitudes, and Behavior 5-1

Origins of Food Choices 5-2
We Don’t Instinctively Know What to Eat 5-2
Food Preferences 5-3
Food Preferences and Choices Do Change 5-5
How Do Food Choices Change? 5-6
Successful Changes in Food Choices 5-7
1747 1750 1762 1771 1774

Lind publishes “Treatise on Scurvy,” Ojibway and Sioux war over control Sandwich invented by the Earl Potato heralded as famine food Americans drink more coffee in
citrus identified as cure of wild rice stands of Sandwich protest over Britain’s tea tax
PhotoDisc
PhotoDisc
CO N T E N T S vii
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Does Diet Affect Behavior? 5-8
Malnutrition and Mental Performance 5-9
The Future of Diet and Behavior Research 5-11
NUTRITION UP CLOSE Improving Food Choices 5-12
UNIT 6 H
ealthy Dietary Patterns, Dietary Guidelines,
MyPlate, and More 6-1
Healthy Eating: Achieving a Balance between Good Taste
Digital Vision/Alamy
and Good for You 6-2
Characteristics of Healthy Dietary Patterns 6-3
Healthy Dietary Patterns Identified for the United States 6-4
National Guides for Healthful Diets 6-5
Dietary Guidelines for Americans 6-6
ChooseMyPlate 6-9
ChooseMyPlate.gov Healthy Eating Messages 6-9
Healthy U.S.-Style Dietary Pattern 6-10
The DASH Eating Plan 6-13
The Healthy Mediterranean Dietary Pattern 6-13
Realities of the Food Environment 6-14
Portion Distortion 6-15
Bon Appétit! 6-17
NUTRITION UP CLOSE The Pros and Cons of Fast Food Dining 6-19
UNIT 7 How the Body Uses Food: Digestion and Absorption 7-1
My Body, My Food 7-2
How Do Nutrients in Food Become Available for the Body’s Use? 7-2
Digestive Disorders 7-9
Constipation 7-9
Ulcers 7-11
Heartburn 7-11
Irritable Bowel Syndrome 7-11
Diarrhea 7-11
Flatulence 7-12
nutrition timeline
1775 1816 1833 1862 1871
Lavoisier (“the father of the science Protein and amino acids identified, Beaumont’s experiments on a U.S. Department of Agriculture Proteins, carbohydrates, and fats
of nutrition”) discovers the energy- followed by carbohydrates and fats wounded man’s stomach greatly founded by authorization of Presi- determined to be insufficient to sup-
producing property of food in the mid-1800s expand dent Abraham Lincoln port life; there are other “essential”
knowledge components
about digestion
Stefano Bianchetti/CORBIS
© Bettmann/Corbis
viii C ONTENTS
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NUTRITION UP CLOSE Carbohydrate, Fat, and Protein Digestion 7-13

UNIT 8 Calories! Food, Energy, and Energy Balance 8-1

Energy! 8-2
The Body’s Need for Energy 8-2
Where’s the Energy in Foods? 8-5

Most Foods Are a Mixture 8-7
Energy Density 8-8
How Are Food and Energy Intake Regulated
by the Body? 8-8
Keep Calories in Perspective 8-10
NUTRITION UP CLOSE Food as a Source of Calories 8-11

UNIT 9 O
besity to Underweight: The Highs and Lows
of Weight Status 9-1
Variations in Body Weight 9-2
How Is Weight Status Defined? 9-2
Body Mass Index 9-3
Overweight and Obesity 9-3

Body Fat and Health: Location, Location, Location 9-5
Assessment of Body Fat Content 9-8
What Causes Obesity? 9-8
Obesity: The Future Lies in Its Prevention 9-11
Underweight 9-12
Underweight Defined 9-12
Underweight and Longevity in Adults 9-12
Toward a Realistic View of Body Weight 9-13
Scott Goodwin Photography
Size Acceptance 9-13
NUTRITION UP CLOSE Are You an Apple? 9-15

1895 1896 1906 1910 1912

First milk station providing children Atwater publishes Proximate Pure Food and Drug Act signed by Pasteurized milk introduced Funk suggests scurvy, beriberi, and
with uncontaminated milk opens in Composition of Food Materials President Theodore Roosevelt to pellagra caused by deficiency of
New York City protect consumers against “vitamines” in the diet
contaminated foods
Bettman/CORBIS
Bettman/CORBIS
PhotoDisc
CO N T E N T S ix
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UNIT 10 Weight Control: The Myths and Realities 10-1
Weight Control Nation 10-2
Weight Loss versus Weight Control 10-2
Weight Control 10-4

Weight-Control Methods: The Evidence 10-5
John E. Kelly/Photolibrary/Getty Images

Successful Weight-Control Programs 10-7
Obesity Surgery 10-8
Weight Loss: Making It Last 10-10
NUTRITION UP CLOSE Setting Small Behavior
Change Goals 10-13
UNIT 11 D
isordered Eating: Anorexia and Bulimia Nervosa,
Binge-Eating Disorder, and Pica 11-1
Eating Disorders 11-2
Anorexia Nervosa 11-2
Bulimia Nervosa 11-5
Binge-Eating Disorder 11-6
Pica 11-7
Proposed Eating Disorders 11-9
Resources for Eating Disorders 11-10
Prevention of Eating Disorders 11-11
NUTRITION UP CLOSE Eating Attitudes Test 11-12

UNIT 12 Useful Facts about Sugars, Starches, and Fiber 12-1

Carbohydrates 12-2
Simple Sugar Facts 12-3
The Alcohol Sugars—What Are They? 12-6
Artificial Sweetener Facts 12-7
Complex Carbohydrate Facts 12-10
Glycemic Index of Carbohydrates 12-14
Carbohydrates and Dental Health 12-15

There’s More to Tooth Decay Than Sugar Per Se 12-16
nutrition timeline
1913 1914 1916 1917 1921
First vitamin discovered (vitamin A) Goldberger identifies the cause of First dietary guidance material First food groups published—the First fortified food produced: iodized
pellagra (niacin deficiency) in poor produced for the public released; Five Food Groups: Milk and Meat; salt, needed to prevent widespread
children to be a missing component title is “Food for Young Children” Vegetables and Fruits; Cereals; Fats iodine-deficiency goiter in many
of the diet rather than a germ as and Fat Foods; Sugars and parts of the
others believed Sugary Foods United States
PhotoDisc
Shutterstock.com
LunaseeStudios/
x C ONT E NTS
21651_fm_ptg01.indd 10 11/20/18 4:03 PM

Lactose Maldigestion and Intolerance 12-17
How Is Lactose Maldigestion Managed? 12-19
NUTRITION UP CLOSE Does Your Fiber Intake Measure Up? 12-20
UNIT 13 Diabetes Now 13-1

The Diabetes Epidemic 13-2
Health Consequences of Diabetes 13-3
Type 2 Diabetes 13-3
Managing Type 2 Diabetes 13-5
Prevention of Type 2 Diabetes 13-8
Type 1 Diabetes 13-9
Gestational Diabetes 13-10
Hypoglycemia 13-11
Diabetes in the Future 13-11
NUTRITION UP CLOSE Calculating Carbohydrates 13-12
UNIT 14 Alcohol: The Positives and Negatives 14-1

Alcohol Facts 14-2
The Positive 14-2
The Negative 14-3
Alcohol Intake, Diet Quality, and Nutrient Status 14-4
How the Body Handles Alcohol 14-5
What Causes Alcohol Dependency? 14-8
NUTRITION UP CLOSE Effects of Alcohol Intake 14-9
UNIT 15 Proteins and Amino Acids 15-1

ROSENFELD/AGE Fotostock
Protein 15-2
Functions of Protein 15-2
Amino Acids 15-4
Protein Quality 15-5
Food as a Source of Protein 15-7
1928 1929 1930s 1937 1938 1941

American Society for Essential fatty acids identified Vitamin C identified in 1932, Pellagra found to be due Health Canada issues nutrient First refined grain enrichment
Nutritional Sciences and the followed by pantothenic acid to a deficiency of niacin intake standards standards developed
Journal of Nutrition founded and riboflavin in 1933 and
vitamin K in 1934
PhotoDisc
PhotoDisc
CO N T E N T S xi
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NUTRITION UP CLOSE My Protein Intake 15-10

UNIT 16 Vegetarian Dietary Patterns 16-1

Perspectives on Vegetarian Dietary Patterns 16-2
Reasons for Vegetarianism 16-2
Health Implications of Vegetarian Dietary Patterns 16-4
Dietary Recommendations for Vegetarians 16-5
Where to Go for More Information on Vegetarian Diets 16-10
Creatas/Fotosearch
NUTRITION UP CLOSE Vegetarian Main Dish Options 16-11
UNIT 17 Food Allergies and Intolerances 17-1

Food Allergy 17-2
Prevalence of Food Allergy 17-2
Adverse Reactions to Foods 17-3
Diagnosis: Is It a Food Allergy? 17-6
Treatment of Food Allergies 17-7
Prevention of Food Allergies 17-7
Food Intolerances 17-7

Lactose Maldigestion and Intolerance 17-8
Sulfite Sensitivity 17-8
Red Wine, Aged Cheese, and Migraines 17-9
MSG and the “Chinese Restaurant Syndrome” 17-9
Food Allergy and Intolerance Precautions 17-9
NUTRITION UP CLOSE Gluten-Free Cuisine 17-10
UNIT 18 Fats and Health 18-1

Fat Intake and Health 18-2
Facts about Fats 18-2
Types of Fat 18-4
The Essential Fatty Acids 18-7
Hydrogenated Fats 18-8
nutrition timeline
1941 1946 1947 1953 1956
First Recommended Dietary Allow- National School Lunch Act passed Vitamin B12 identified Double helix structure of DNA Basic Four Food Groups released by
ances (RDAs) announced by Presi- discovered the U.S. Department of Agriculture
dent Franklin Roosevelt on radio
C
G A
T G
C T
A
Presidential Library and
G
PhotoDisc
Franklin D. Roosevelt
C
T
A
C
A G
T
PhotoDisc
Museum
T G
C
A C
G
xii C ONTENTS
21651_fm_ptg01.indd 12 11/20/18 4:03 PM

Cholesterol 18-9
Food Sources of Fat 18-10
The Low-Fat Era Is Over 18-12
NUTRITION UP CLOSE A Focus on DHA and EPA Safe Food Sources 18-14

UNIT 19 Nutrition and Heart Disease 19-1

Nutrition and Heart Disease 19-2
A Primer on Heart Disease 19-2
Who’s at Risk for Heart Disease? 19-5
Healthy Dietary Patterns for Heart Health 19-6
NUTRITION UP CLOSE Evaluate Your Dietary and Lifestyle Strengths for Heart
Disease Prevention 19-10
UNIT 20 Vitamins and Your Health 20-1

Vitamins: They’re on Center Stage 20-2
Vitamin Facts 20-2
What Do Vitamins Do? 20-3
Vitamins and the Prevention and Treatment of Disorders 20-10
Preserving the Vitamin Content of Foods 20-13
Vitamins: Getting Enough Without Getting Too Much 20-14
NUTRITION UP CLOSE Antioxidant Vitamins: How Adequate

Is Your Diet? 20-22
UNIT 21 Phytochemicals 21-1

Phytochemicals: The “What Else”
©JIL Photo/Shutterstock.com
in Your Food 21-2

Characteristics of Phytochemicals 21-3
Functions of Phytochemicals in Humans 21-4
Food Sources of Phytochemicals 21-8
Naturally Occurring Toxins in Food 21-8
1965 1966 1968 1970 1972

Food Stamp Act passed, Food Stamp Child Nutrition Act adds school First national nutrition survey in First Canadian national nutrition Special Supplemental Food and Nu-
program established breakfast to the National School U.S. launched (Ten State Nutrition survey launched (Nutrition Canada trition Program for Women, Infants,
Lunch Program Survey) National Survey) and Children (WIC) established
PhotoDisc
CO N T E N T S xiii
21651_fm_ptg01.indd 13 11/20/18 4:03 PM

NUTRITION UP CLOSE Have You Had Your Phytochemicals Today? 21-9
UNIT 22 Diet and Cancer 22-1

What Is Cancer? 22-2
How Does Cancer Develop? 22-2
What Causes DNA Damage? 22-3
Fighting Cancer with a Fork 22-4
Digital Vision/Getty Images

How Do Healthy Dietary Patterns Help Prevent Cancer? 22-4
Bogus Cancer Treatments 22-6
NUTRITION UP CLOSE A Cancer Risk Checkup 22-7
UNIT 23 Good Things to Know about Minerals 23-1

Mineral Facts 23-2
Getting a Charge Out of Minerals 23-2
Selected Minerals: Calcium 23-4
Osteoporosis 23-5
Selected Minerals: Iron 23-12
Selected Minerals: Sodium 23-15
NUTRITION UP CLOSE Processed Foods and Your Diet 23-27
UNIT 24 Dietary Supplements 24-1

Dietary Supplements 24-2
Regulation of Dietary Supplements 24-2
Vitamin and Mineral Supplements: Enough Is as Good as a Feast 24-4
Herbal Remedies 24-5
Prebiotics and Probiotics 24-7
Final Thoughts 24-9
NUTRITION UP CLOSE Supplement Use and Misuse 24-11
nutrition timeline
1977 1978 1989 1992 1997
Dietary Goals for the United States First Health Objectives for the Nation First national scientific consensus The Food Guide pyramid is released RDAs expanded to Dietary Reference
issued released report on diet and chronic disease by the USDA Intakes (DRIs)
published
USDA
xiv C O NTENTS
21651_fm_ptg01.indd 14 11/20/18 4:03 PM

UNIT 25 Water Is an Essential Nutrient 25-1
Water: Where Would We Be Without It? 25-2
Water’s Role as an Essential Nutrient 25-2
Meeting Our Need for Water 25-4
Water Deficiency 25-5
Water Toxicity 25-5
The Nature of Our Water Supply 25-6

Water Sources 25-6
NUTRITION UP CLOSE Foods as a Source of Water 25-9

UNIT 26 Nutrient–Gene Interactions in

Health and Disease 26-1
Nutrition and Genomics 26-2
Genetic Secrets Unfolded 26-2
Single-Gene Defects 26-4
Genetics of Taste 26-5
Nutrition Tomorrow 26-6
NUTRITION UP CLOSE Nature and Nurture 26-7
UNIT 27 N
utrition and Physical Fitness for
Everyone 27-1
Physical Activity: It Offers Something for
Everyone 27-2
The “Happy Consequences” of Physical Activity 27-2
What Is Physical Fitness? 27-3
Bill Milne/StockFood Creative/Getty Images
Flexibility 27-7
Fueling Physical Activity 27-8
Achieving Physical Fitness 27-9
NUTRITION UP CLOSE Exercise: Your Options 27-12

1998 2003 2015 2018

Folic acid fortification of refined Sequencing of DNA in the human Increasing rates of obesity and type 2 Advances in knowledge of the
grain products begins genome completed; marks beginning diabetes become global epidemics effects of gene variants on nutri-
of new era of research in nutrient– tional status and health begin the
gene interactions “personalized approach” to dietary
recommendations.
Richard Anderson
CO N T E N T S xv
21651_fm_ptg01.indd 15 11/20/18 4:03 PM

UNIT 28 Nutrition and Physical Performance 28-1
Sports Nutrition 28-2
Basic Components of Energy Formation during Exercise 28-2
Nutrition and Physical Performance 28-4
Hydration 28-7
Nutrition-Related Concerns of Athletes 28-10
Ergogenic Aids: The Athlete’s Dilemma 28-11
NUTRITION UP CLOSE Testing Performance Aids 28-13
Kablonk! RF/Golden Pixels LLC/Alamy

UNIT 29 G
ood Nutrition for Life: Pregnancy,
Breastfeeding, and Infancy 29-1
Nutrition and a Healthy Start in Life 29-2
Improving the Health of U.S. Infants 29-3
Nutrition and Pregnancy 29-3

Critical Periods of Growth and Development 29-3
Developmental Origins of Later Disease Risk 29-4
Prepregnancy Weight Status, Pregnancy Weight Gain, and Pregnancy Outcomes 29-5
The Need for Calories and Key Nutrients during Pregnancy 29-6
Other Dietary Components 29-10
What’s a Good Diet for Pregnancy? 29-11
Breastfeeding 29-12
What’s So Special about Breastmilk? 29-12
Is Breastfeeding Best for All New Mothers and Infants? 29-12
How Breastfeeding Works 29-14

Nutrition and Breastfeeding 29-14
Infant Nutrition 29-15

Infant Growth 29-15
Infant Feeding Recommendations 29-17
The Development of Healthy Eating Habits Begins in Infancy 29-18
NUTRITION UP CLOSE You Be the Judge! 29-20

UNIT 30 N
utrition for the Growing Years: Childhood through
Adolescence 30-1
The Span of Growth and Development 30-2
The Nutritional Foundation 30-2
Characteristics of Growth in Children 30-2
Nutrition for the Growing Years 30-8

Nutrient Needs of Children and Adolescents 30-10
Helping Children Learn the Right Lessons about Food 30-13
NUTRITION UP CLOSE Obesity Prevention Close to Home 30-15

xvi C O NTENTS
21651_fm_ptg01.indd 16 11/20/18 4:03 PM

UNIT 31 N
utrition and Health Maintenance for Adults
of All Ages 31-1
Nutrition for Adults of All Ages 31-2
The Age Wave 31-2
Diet and Health Promotion for Adults of All Ages 31-4

Nutrient Needs 31-4
Dietary Recommendations for Adults of All Ages 31-5
Physical Activity Recommendations for Adults 31-8
NUTRITION UP CLOSE Does He Who Laughs, Last? 31-10

UNIT 32 The Multiple Dimensions of Food Safety 32-1

Threats to the Safety of the Food Supply 32-2
How Good Foods Go Bad 32-2
Causes and Consequences of Food-Borne Illness 32-4
Other Causes of Food-Borne Illnesses 32-5
Preventing Food-Borne Illnesses 32-8

Food Safety Regulations 32-8
Food Safety Basics 32-9
NUTRITION UP CLOSE Food Safety Detective 32-15

UNIT 33 Aspects of Global Nutrition 33-1

State of the World’s Health 33-2
©Stephane Bidouze/Shutterstock.com
The “Nutrition Transition” 33-2

Food and Nutrition: The Global Challenge 33-4
The Future 33-8
NUTRITION UP CLOSE Ethnic Foods Treasure Hunt 33-9

Appendix A Table of Food Composition A-1

Appendix B Reliable Sources of Nutrition Information B-1
Appendix C Aids to Calculations C-1
Appendix D Table of Intentional Food Additives D-1
Appendix E Cells E-1
Appendix F F
eedback and Answers to Nutrition Up Close
and Review Questions F-1
Glossary GL-1
References R-1
Index I-1
CO N T E N T S xvii
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Preface
“Everything should be made as simple as possible. But not simpler.”
—ALBERT EINSTEIN
Welcome to the enhanced 8th edition of Nutrition Now, an introductory, science-based, and
application-oriented textbook for your nutrition courses. The text contains multiple
critical thinking and decision-making activities for students, organized around key
nutrition concepts and specific learning objectives. This updated release of Nutrition Now
reflects a move toward increased use of a broad variety of digital resources intended to
enhance student learning, and to lighten the weight and cost of this text book.
This edition of Nutrition Now catches up with advances in the field of nutrition:
●● MyPlate resources
●● healthy dietary patterns and health
●● prevention of peanut allergy
●● the prevalence of food allergies and likely reasons for it
●● microbiota, diet, and inflammation
●● nutrition label components
●● health effects of refined carbohydrates and highly processed foods
●● “relative energy deficiency in sports” (RED-S)
●● wheat intolerance syndrome
●● effects of total fat and saturated fat on health
●● functions and health effects of brown fat and white fat
●● “best sources” of fish and recommendations for intake
●● origins of gene variants, their interaction with dietary intake, and health effects related
to gene variants and diet
●● the lack of benefit of vitamin and mineral supplements, and other dietary supplements
●● salt intake, salt sensitivity, and blood pressure
●● physical activity recommendations
●● dietary and supplement recommendations for pregnancy
●● diagnostic standards for fetal alcohol syndrome
●● health effects of artificial sweeteners
●● infant feeding recommendations and the weight status group of “severe obesity” in
children
●● dietary and lifestyle factors related to recent decline in longevity
●● nutrition and menopause in women and andropause in men
xviii P REFACE
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●● health effects of worldwide, increased availability of inexpensive sugary, fast, and highly
processed foods that replace foods traditionally consumed
●● the effects of climate changes on availability of croplands, water, food supplies, and
malnutrition.
In addition, “Nutrition Up Close,” “Reality Check,” “Take Action,” and review ques-
tions have been modified to reflect content changes.
Nutrition Now continues to be oriented toward enhancing instructors’
teaching experiences and helping students build a firm foundation of scientific
knowledge and understanding about nutrition that will serve them well throughout
their careers and life.
Pedagogical Features
There are 33 units in Nutrition Now, and all but the first unit can be used in any
order. Each unit begins with learning objectives, and content and review questions at
the end of the units are organized around the learning objectives. Student group and
individual activities based on real-life situations are presented online in MindTap,
along with a variety of videos, review questions, and interactive learning activities.
Activities include taste testing to identify genetically determined sensitivity to
bitterness, developing a dietary behavioral change plan, anthropometry lab,
designing fraudulent nutrition products, a physical activity assessment, and an
assessment of three days of dietary intake.
Resources for the Instructor

●● Nutrition MindTap for Nutrition Now. Instant Access Code, ISBN-13: 9781305868304.
MindTap is well beyond an e-book, a homework solution or digital supplement, a
resource center website, a course delivery platform, or a learning management system.
More than 70 percent of students surveyed said it was unlike anything they have seen
before. MindTap is a new personal learning experience that combines all your digital
assets—readings, multimedia, activities, and assessments—into a singular learning
path to improve student outcomes.
●● Diet & Wellness Plus The Diet & Wellness Plus app in MindTap helps you gain a better
understanding of how nutrition relates to your personal health goals. It enables you
to track your diet and activity, generate reports, and analyze the nutritional value of
the food you eat! It includes more than 55,000 foods in the database, custom food and
recipe features, the latest dietary references, as well as your goal and actual percentages
of essential nutrients, vitamins, and minerals. It also helps you identify a problem
behavior and make a positive change. After completing a wellness profile question-
naire, Diet & Wellness Plus will rate the level of concern for eight different areas of
wellness, helping you determine the areas where you are most at risk. It then helps you
put together a plan for positive change by helping you select a goal to work toward—
complete with a reward for all your hard work.
The Diet & Wellness Plus app is accessed from the app dock in MindTap and can
be used throughout the course for students to track their diet and activity and behavior
change. There are activities and labs in the course that have students access the app
to further extend learning and integrate course content.
●● Instructor Companion Site Everything you need for your course in one place! This
collection of book-specific lecture and class tools is available online via www.cengage
.com/login. Access and download PowerPoint presentations, images, instructor’s
manual, videos, and more.
P R E FACE xix
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●● Cengage Learning Testing Powered by Cognero Cengage Learning Testing Powered
by Cognero is a flexible online system that allows you to:
●● author, edit, and manage test bank content from multiple Cengage
Learning solutions
●● create multiple test versions in an instant
●● deliver tests from your LMS, your classroom, or wherever you want
●● Global Nutrition Watch Bring currency to the classroom with Global Nutrition
Watch from Cengage Learning! This user-friendly website provides convenient access
to thousands of trusted sources, including academic journals, newspapers, videos, and
podcasts, for you to use for research projects or classroom discussion. Global Nutrition
Watch is updated daily to offer the most current news about topics related to nutrition.
Acknowledgments
My thanks and appreciation go out to Oden Connolly, Content Manager for Sciences
at Cengage. Oden effectively managed to build the complex web that now incorporates
updates to the Nutrition Now text and its expanding digital components.
It is said that instructors adopt a specific textbook but that students play a major role
in instructors’ decision to keep it. I am honored that you chose to adopt Nutrition Now
and deeply pleased with the thought that students are helping you decide to keep it.
Reviewers’ feedback is the lifeline of text writing, and the reviewers of the eighth
edition conveyed very useful advice that was incorporated into the eighth edition. The
advice led me to some very interesting places on specific topics that changed my
thinking and writing. Thank you for the helpful information and please keep your
comments coming.
xx P REFACE
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Key Nutrition NUTRITION SCOREBOARD
UNIT
1
1 Calories are a component of food. True/False
Concepts and
2 Nutrients are substances in food that are used by the
body for growth and health. True/False
3 Inadequate intakes of vitamins and minerals can harm
Terms
health, but high intakes do not. True/False
4 “Dietary Reference Intakes” (DRIs) provide science-
based standards for nutrient intake. True/False
Answers can be found at the end of the unit.
Jose Luis Pelaez, Inc/Blend Images/Corbis
1-1
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LEARNING OBJECTIVES The Meaning of Nutrition
After completing Unit 1 you ●●
Explain the scope of nutrition as an area of study.
will be able to:
What is nutrition? It can be explained by situations captured in photographs as well as by
●●
Explain the scope of nutrition words. This introduction presents a photographic tour of real-life situations that depict
as an area of study.
aspects of the study of nutrition.
●●
Demonstrate a working Before the tour begins, take a moment to make yourself comfortable and clear your
knowledge of the meaning of mind of clutter. Take a careful look at the photographs shown below and on the next
the 10 nutrition concepts. two pages, pausing to mentally describe in two or three sentences what each photograph
shows.
Not everyone who thinks about the photographs will describe them in the same way.
Reactions will vary somewhat due to personal experiences, interests, beliefs, and cultural
background. An individual trying to gain weight will probably react differently to the pho-
tograph of the person on the scale than someone who is trying to lose weight. The photo
of a dad measuring his son’s growth progress may bring back memories of the “measuring
wall” you knew as a child, and how you were encouraged to eat your vegetables to grow
up strong and tall. Depending on your experience and background, you may recognize
the photo of ham hocks, greens, and beans as your favorite holiday meal. The final photo,
showing a crowd of children and adults at a soup kitchen, may have reminded you that
food is essential for life.
Although knowledge about nutrition is generated by impersonal and objective
methods, it can be a very personal subject.
Nutrition Defined
nutrition The study of foods, their In a nutshell, nutrition is the study of foods and health. It is a science that focuses on foods,
nutrients and other chemical constituents, their nutrient and other chemical constituents, and the effects of food and food constituents
and the effects that foods and food on body processes and health. The scope of nutrition extends from food choices to the
constituents have on health.
effects of diet and specific food components on biological processes and health.
Gary Conner/PhotoEdit
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Photodisc Royalty free/Corbis
Uschi Gerschner/Newscom
anyaivanova/Shutterstock.com
T h e Meanin g o f N utritio n
Jupiterimages/Photolibrary/Getty Images
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Nutrition Is a “Melting Pot” Science The broad scope of nutrition makes it an
interdisciplinary science. Knowledge provided by the behavioral and social sciences, for
example, is needed in studies that examine how food preferences develop and how they
may be changed. Information generated by the biological, chemical, physical, and food
sciences is required to propose and explain diet and disease relationships. The knowl-
edge and skills of mathematicians and statisticians are needed to develop and imple-
ment appropriate research designs and analysis strategies that produce objective, reliable
research results. The study of nutrition will bring you into contact with information from
a variety of disciplines.
Nutrition Knowledge Is Applicable As you study the science of nutrition,
you will discover answers to a number of questions about your own diet, health, and
eating behaviors. Is obesity primarily due to eating habits, physical inactivity, the food
environment, or your genes? How do you know whether new information you hear about
nutrition is true? Can sugar harm more than your teeth? Can the right diet or supplement
give you a competitive edge? What is a healthful diet and how do you know if you have
one? If improvements seem warranted, what’s the best way to go about changing your
diet for the better? These are just a few of the questions that will be addressed during the
course of your study of nutrition. You will take from this learning experience not only
knowledge about nutrition and health, but also skills that will keep the information and
insights working to your advantage for a long time to come.
Foundation Knowledge for Thinking

about Nutrition
●●
Demonstrate a working knowledge of the meaning of the 10 nutrition
concepts.
food security Access at all times to a
You don’t have to be a bona fide nutritionist to think like one. What you need is a grasp
sufficient supply of safe, nutritious foods.
of the language and basic concepts of the science. The purpose of this unit is to give you
food insecurity Limited or uncertain
that background. The essential topics covered here are explored in greater depth in units
availability of safe, nutritious foods—or the
to come, and they build on this foundation of knowledge. With a working knowledge of ability to acquire them in socially accept-
nutrition terms and concepts, you will have an uncommonly good sense of nutrition. able ways.
NUTRITION CONCEPT # 1
Food is a basic need of humans.
Humans need enough food to live, and they need the right amount
and assortment of foods for optimal health. In the best of all worlds,
the need for food is combined with the condition of food security.
People who experience food security have access at all times to a suf-
ficient supply of the safe, nutritious foods that are needed for an active
and healthy life. They are able to acquire acceptable foods in socially
acceptable ways; they do not have to scavenge or steal food in order
to survive or to feed their families. It is important to note that food
security emphasizes access to an adequate supply of nutritious food
rather than simply sufficient food. Food insecurity exists whenever
the availability of safe, nutritious foods—or the ability to acquire them
David Bacon/Alamy
in socially acceptable ways—is limited or uncertain (Illustration 1.1).1

Adults who live in food-insecure households are more likely
to have poor-quality diets, to be obese, and to have hyperten-
sion, heart disease, or diabetes than adults who are poor but food Illustration 1.1 “It is possible to go an entire lifetime without knowing
secure.2 The ready availability of inexpensive, high-calorie foods; about people’s experiences with hunger.”
poverty; the absence of local supermarkets; limited opportunities —Meghan LeCates, Capital Area Food Bank
F oundati on Kn ow l edg e for T hinkin g a b out N utritio n 1-5
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for exercise; and lack of cooking facilities may be partly responsible for the higher rates of
obesity and chronic disease among food-insecure adults.3 Although many children living
in food-insecure households are nourished adequately, successful in school, and develop
high levels of social skills, as a group they are at higher risk of poor school performance
and social and behavioral problems.4
Food insecurity exists in 12.3% of U.S. and 7.7% of Canadian households.5,6 The rate in
the United States is over twice as high as the target of 6% established as a national health goal.7
Who Are the Food Insecure?

Although unemployment, disabilities, and homelessness contribute to food insecurity,
most food-insecure individuals live in households with one or more full-time worker.8
One in four of such households include an adult serving in the military.9 College
students are being increasingly recognized as a risk group for food insecurity. Over 120
U.S. colleges have established food pantries for students, and more are being developed
as you read this.10 Low wages and high food costs can limit the ability of households and
college students to afford sufficient, nutritious food.
Food Security and Stainable Diets Climate change is affecting worldwide food
security. Floods and drought precipitated by global warming can displace fertile farmlands
carbon footprint Generally defined as
and water supplies, and reduce crop yields and fish and seafood availability.11 Food pro-
the amount of the greenhouse gas carbon duction, in turn, affects climate change by contributing greenhouse gases that trap heat in
dioxide emitted by farming, food produc- the atmosphere.12 Fossil fuels, which are widely used in food production, processing, and
tion, a person’s activities, or a product’s transport, are the largest source of greenhouse gas emissions in the United States.13
manufacture and transport. The extent of production of greenhouse gases is generally assessed by measuring the
sustainable agriculture Broadly amount of carbon dioxide released into the atmosphere as a result of food production and
defined as the use of farming methods, other processes. The result is referred to as the “carbon footprint.” In general, plant foods
environmental practices, and economic
policies that meet society’s present food
such as grains and vegetables leave a lower carbon footprint than dairy and meats.
needs without compromising the ability of The world’s history of famine due to crop failures, floods, drought, and epidemics of crop
future generations to meet their own needs. and livestock diseases has taught us the importance of using farming and environmental
calorie A unit of measure of the amount practices that support healthy crops, livestock, and people. Farming and environmental
of energy supplied by food. (Also known as methods that support nutritious food production and farm profitability, and protect the
a kilocalorie, abbreviated kcal, or the large environment are part and parcel of what is now called “sustainable agriculture.”14,15
Calorie with a capital C.)
nutrients Chemical substances in food
that are used by the body for growth and NUTRITION CONCEPT # 2
health. The six categories of nutrients are
carbohydrates, proteins, fats, vitamins, Foods provide energy (calories), nutrients, and other substances
minerals, and water.
needed for growth and health.
People eat foods for many different reasons. The most compelling reason
is that we need the calories, nutrients, and other substances supplied by
foods for growth and health.
Calories
A calorie is a unit of measure of the amount of energy in a food—and of
how much energy will be transferred to the person who eats it. Although
we often refer to the number of calories in this food or that one, calories
Brand X Pictures/Getty Images
are not a substance present in food. And, because calories are a unit of
measure, they do not qualify as a nutrient.
Nutrients
Nutrients are chemical substances present in food that are used by the
Illustration 1.2 Foods provide nutrients. “Please pass the
body to sustain growth and health (Illustration 1.2). Essentially every-
complex carbohydrates, thiamin, and niacin . . . I mean, the thing that’s in our body was once a component of the food we consumed.
bread!”
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There are six categories of nutrients (Table 1.1). Each category (except water) consists Table 1.1 The six categories
of a number of different substances that are used by the body for growth and health. The of nutrients
carbohydrate category includes simple sugars and complex carbohydrates (starches and 1. Carbohydrate
dietary fiber). The protein category includes 20 amino acids, the chemical units that serve
2. Protein
as the “building blocks” for proteins. Several different types of fat are included in the fat
category. Of primary concern are the saturated fats, unsaturated fats, essential fatty acids, 3. Fat
trans fats, and cholesterol. The vitamin category consists of 14 vitamins, and the mineral 4. Vitamins
category includes 15 minerals. Water makes up a nutrient category by itself.
Carbohydrates, proteins, and fats supply calories and are called the energy nutrients. 5. Minerals
Although each of these three types of nutrients performs a variety of functions, they share the 6. Water
property of being the body’s only sources of fuel. Vitamins, minerals, and water are chemi-
cals that the body needs for converting carbohydrates, proteins, and fats into energy and for
building and maintaining muscles, blood components, bones, and other tissues in the body.
Other Substances in Food

Food also contains many other substances, some of which are biologically active in the
body. One major type of such substances is the phytochemicals. There are thousands of phytochemicals Chemical substances
them in plants. Illustration 1.3 presents examples of plant foods that are particularly rich in plants (phyto 5 plant). Some phyto-
chemicals perform important functions in
sources of phytochemicals. Phytochemicals provide plants with color, give them flavor,
the human body. They give plants color
foster their growth, and protect them from insects and diseases. In humans, consump- and flavor, participate in processes that
tion of certain phytochemicals in diets is strongly related to a reduced risk of developing enable plants to grow, and protect plants
certain types of cancer, heart disease, infections, and other disorders.16 against insects and diseases. Also called
Specific phytochemicals have names that may be hard to pronounce and difficult to phytonutrients.
remember. Nevertheless, here are a few examples. Plant pigments, such as lycopene (like-
o-peen), which help make tomatoes red, anthocyanins (an-tho-sigh-an-ins), which give
blueberries their characteristic blue color, and beta-carotene (bay-tah-kar-o-teen), which
imparts an orange color to carrots, are phytochemicals that act as antioxidants. antioxidants Chemical substances that
They protect plant cells—and in some cases, human cells, too—from damage that prevent or repair damage to cells caused
by exposure to oxidizing agents such as
can make them susceptible to disease. Various types of sulfur-containing phytochemicals
environmental pollutants, smoke, ozone,
are present in cabbage, broccoli, cauliflower, brussels sprouts, and other vegetables of the and oxygen. Oxidation reactions are a
same family. These substances help prevent a number of different types of cancer in people normal part of cellular processes.
with specific gene types.17
Some Nutrients Must Be Provided by the Diet Many nutrients are required for
growth and health. The body can manufacture some of these from raw materials sup-
plied by food, but others must come assembled. Nutrients that the body cannot generally
produce, or cannot produce in sufficient quantity, are referred to as essential nutrients. essential nutrients Nutrients required
Here essential means “required in the diet.” Vitamin A, iron, and calcium are examples of for normal growth and health that the body
can generally not produce, or produce in
essential nutrients. Table 1.2 lists all the known essential nutrients.
sufficient amounts. Essential nutrients must
Nutrients used for growth and health that can be manufactured by the body from be obtained in the diet.
components of food in our diet are considered nonessential. Cholesterol, creatine, and
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Illustration 1.3 Examples of good food sources of beneficial phytochemicals.
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Table 1.2 Essential nutrients for humans: A reference table
Energy Nutrients Vitamins Minerals Water

Carbohydrates Biotin Calcium Water
Fats a
Folate Chloride
Proteinsb Niacin (B3) Chromium
Pantothenic acid Copper
Riboflavin (B2) Fluoride
Thiamin (B1) Iodine
Vitamin A Iron
Vitamin B6 (pyroxidine) Magnesium
Vitamin B12 Manganese
Vitamin C (ascorbic acid) Molybdenum
Vitamin D Phosphorus
Vitamin E Potassium
Vitamin K Selenium
Choline c
Sodium
Zinc
a
Fats supply the essential nutrients linoleic and alpha-linolenic acids.
b
Proteins are the source of nine “essential amino acids”: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. The other 11 amino
acids are not a required part of our diet; they are considered “nonessential.”
c
A dietary source of choline, a vitamin-like nutrient, may not be required during all stages of the life cycle.
nonessential nutrients Nutrients glucose are examples of nonessential nutrients. Nonessential nutrients are present in
required for normal growth and health that food and used by the body, but they are not required parts of our diet because we can
the body can manufacture in sufficient produce them ourselves.
quantities from other components of the
Both essential and nonessential nutrients are required for growth and health. The
diet. We do not require a dietary source of
nonessential nutrients. difference between them is whether or not we need to obtain the nutrient from a dietary
source. A dietary deficiency of an essential nutrient will cause a specific deficiency disease,
but a dietary lack of a nonessential nutrient will not. People develop scurvy (the vitamin C–
deficiency disease), for example, if they do not consume enough vitamin C. But you could
have zero cholesterol in your diet and not become “cholesterol deficient,” because your
liver produces cholesterol.
Our Requirements for Essential Nutrients The amount of essential nutrients
humans need each day varies a great deal, from amounts measured in cups to micro-
grams. (See Table 1.3 to get a notion of the amount represented by a gram, milligram, and
other measure.) Generally speaking, adults need 11 to 15 cups of water from fluids and
foods, 9 tablespoons of protein, one-fourth teaspoon of calcium, and only one-thousandth
teaspoon (a 30-microgram speck) of vitamin B12 each day.
We all need the same nutrients, but not always in the same amounts. The amounts
needed vary among people based on:
●●
Age
●●
Sex
●●
Growth status
●●
Body size
●●
Genetic traits
and the presence of conditions such as:
●●
Pregnancy
●●
Breastfeeding
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Table 1.3 Units of measure commonly employed in nutrition
Measure Abbreviation Equivalents
Kilogram kg 1 kg 5 2.2 lb 5 1,000 grams
Pound lb 1 lb 5 16 oz 5 454 grams 5 2 cups (liquid)
Ounce oz 1 oz 5 28 grams 5 2 tablespoons (liquid)
Gram g 1 g 5 1/28 oz 5 1,000 milligrams
Milligram mg 1 mg 5 1/28,000 oz 5 1,000 micrograms
Microgram mcg, µg 1 mcg 5 1/28,000,000 oz
Photodisc
1 egg 5 50 grams or 13/4 oz; 212 milli- 1 slice of bread 5 1 nickel 5 5 grams
grams (0.2 grams) of cholesterol in yolk 1 oz 5 28 grams
1 teaspoon of sugar 5 4 grams,
1 grain of sugar 5 200 micrograms
●●
Illnesses
●●
Drug/medication use
●●
Exposure to environmental contaminants
Each of these factors, and others, can influence nutrient requirements. General diet
recommendations usually make allowances for major factors that influence the level of
nutrient need, but they cannot allow for all of the factors.
Nutrient Intake Standards Recommendations for daily levels of nutrient intake were
first developed in the United States in 1943 and have been updated periodically since then.
Called the Recommended Dietary Allowances (RDAs), these standards were established in
Judith Brown
response to the high rejection rate of World War II recruits, many of whom were under-
weight and had nutrient deficiencies. The recommended levels of nutrient intake provided
are based on age, gender, and condition (pregnant or breastfeeding). Because the science Illustration 1.4 The latest DRI report
underlying nutrient intake and health advances with time, these standards are periodically (2010) on calcium and vitamin D.
revised and expanded (Illustration 1.4).
Table 1.4 Examples of primary
Dietary Reference Intakes Nutrient intake standards now in place are referred to endpoints used to estimate DRIs
as Dietary Reference Intakes (DRIs); they include categories of nutrient intake in addition
to the RDAs. The current RDAs referenced in the DRIs reflect nutrient intake levels that Carbohydrate: Amount needed to
protect almost all healthy individuals from developing deficiency disease and that also supply optimal levels of energy to
the brain.
reduce the risk of common chronic diseases. Table 1.4 provides examples of endpoints
aimed at chronic disease prevention used by the DRI Committee to determine the RDAs. Total Fiber: Amount shown to pro-
vide the greatest protection against
A category labeled Adequate Intakes (AIs) has been added to indicate “tentative RDAs” for
heart disease.
a few nutrients such as vitamin K and fluoride, for which too few reliable scientific studies
have been done to establish an RDA. Folate: Amount that maintains normal
red blood cell folate concentration.
The DRI standards include a category called Estimated Average Requirement (EAR).
This category represents nutrient intake levels that are estimated to meet the nutrient Iodine: Amount that corresponds to
intake requirements of 50% of individuals within an age, sex, and condition (pregnant or optimal functioning of the thyroid
gland.
breastfeeding) group.
DRI standards consider the effects of excessively high intake of nutrients, primarily Selenium: Amount that maximizes
its function in protecting cells from
from supplements and fortified foods, on health. These standards are labeled Tolerable
damage.
Upper Intake Levels, abbreviated ULs for “upper levels.” Table 1.5 graphically displays the
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Table 1.5 Terms and abbreviations used in the DRIs and a graphic representation
of their meaning
Estimated Average Requirement (EAR)
Recommended Dietary
Risk of overdose reactions

100% 100%
Risk of dietary deficiency

Allowance (RDA)
50% 50%
Adequate Intake (AI)
Tolerable Upper
Intake Level (UL)
Nutrient intake
Low High
●● Dietary Reference Intakes (DRIs). This is the general term used for nutrient intake
standards for healthy people.
●● Recommended Dietary Allowances (RDAs). These are levels of essential nutrient
intake judged to be adequate to meet the known nutrient needs of practically all healthy
persons while decreasing the risk of certain chronic diseases.
●● Adequate Intakes (AIs). These are “tentative” RDAs. AIs are based on less conclusive
scientific information than are the RDAs.
●● Estimated Average Requirements (EARs). These are nutrient intake values that are
estimated to meet the requirements of half the healthy individuals in a group. The EARs
are used to assess adequacy of intakes of population groups.
●● Tolerable Upper Intake Levels (ULs). These are upper limits of nutrient intake
compatible with health. The ULs do not reflect desired levels of intake. Rather, they
represent total daily levels of nutrient intake from food, fortified foods, and supplements
that should not normally be exceeded.
relationships between nutrient intake level and the various categories of the
DRI standards now in use, and presents definitions of the DRI nutrient intake
categories.
Developed by nutrition scientists from the United States and Canada,
the RDAs apply to 97 to 98% of all healthy people in both countries.
The fundamental premise of the first RDAs—that nutrient intake should
come primarily from foods—is maintained in the current nutrient intake
standards.
DRI tables are located at the back of this text. Check out these tables. They
can be used to identify recommended daily levels of essential nutrient intake
and levels of intake that should not normally be exceeded.
NUTRITION CONCEPT #3
Health problems related to nutrition originate within cells.

Cells are the main employers of nutrients (Illustration 1.5). All body
Illustration 1.5 Schematic representation of the processes required for growth and health take place within cells and the fluid
structure of a human cell. that surrounds them. Humans contain over 100 trillion cells in body tissues
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(and around 100 times more than that number if bacteria and other microorganisms
in the large intestine are included).18 The functions of each cell are maintained by the
nutrients it receives. Problems begin when a cell’s need for nutrients differs from the
available supply.19
Nutrient Functions at the Cellular Level Cells are the building blocks of tissues
(such as muscles and bones), organs (such as the kidneys, heart, and liver), and systems
(such as the respiratory, reproductive, circulatory, and nervous systems). Normal cell
health and functioning are maintained when a nutritional and environmental utopia
exists within and around the cells. Such circumstances allow metabolism—the chemical metabolism The chemical changes that
changes that take place within and outside of cells—to proceed flawlessly. Disruptions take place in the body. The formation of
energy from carbohydrates is an example
in the availability of nutrients—or the presence of harmful substances in the cell’s
of a metabolic process.
environment—initiate diseases and disorders that eventually affect tissues, organs,
and systems. Here are two examples of how cell functions can be disrupted by the
presence of low or high concentrations of nutrients:
1. Folate, a B vitamin, is required for protein synthesis within cells. When too little folate
is available, cells produce proteins with abnormal shapes and functions. Abnormali-
ties in the shape of red blood cell proteins, for example, lead to functional changes
that produce loss of appetite, weakness, and irritability.20
2. When too much iron is present in cells, the excess reacts with and damages cell
components. If cellular levels of iron remain high, the damage spreads, impairing the
functions of organs such as the liver, pancreas, and heart.21
Health problems in general begin with disruptions in the normal activity of cells.
Humans are as healthy as their cells.
Poor nutrition can result from both inadequate and excessive levels of
nutrient intake.
For each nutrient, every individual has a range of optimal intake that produces the best
level for cell and body functions. On either side of the optimal range are levels of intake
associated with impaired body functions.22 This concept is presented in Illustration 1.6.
Inadequate essential nutrient intake, if prolonged, results in obvious deficiency diseases.
Marginally deficient nutrient intake generally produces subtle changes in behavior or physi-
cal condition. If the optimal intake range is exceeded, mild to severe changes in mental
and physical functions occur, depending on the amount of the excess and the nutrient.
Severe zinc deficiency, for example, is related to diarrhea, respiratory infection, and stunted
growth. Mild zinc deficiency causes disturbances in the sense of taste and smell, and reduces
appetite and food intake. Excessive intake of zinc is associated with vomiting and
a decline in the body’s ability to fight infections.23 Nearly all cases of vitamin and
mineral overdose result from excessive use of supplements or errors made in the 100%
level of nutrient fortification of food products. They are almost never caused by
Nutrient Function
foods. For nutrients, “enough is as good as a feast.”

Steps in the Development of Nutrient Deficiencies and
Toxicities Poor nutrition due to inadequate diet generally develops in the
stages outlined in Illustration 1.7. To help explain the stages, this illustration
includes an example of how vitamin A deficiency develops.
After a period of deficient intake of an essential nutrient, the body’s tissue 0%
Death Deficiency Marginal Optimal Marginal Toxicity Death
reserves of the nutrient become depleted. Blood levels of the nutrient then
decrease because there are no reserves left to replenish the blood supply. With- Increasing concentration or intake of nutrient
out an adequate supply of the nutrient in the blood, cells get shortchanged. Illustration 1.6 For every nutrient, there is a range of
They no longer have the supply of nutrients needed to maintain normal optimal intake that corresponds to the optimal functioning
function. If the dietary deficiency is prolonged, the malfunctioning cells cause of that nutrient in the body.
Foundation K n ow l edge for T h inking a b o ut N utriti o n 1-11
21651_ch01_ptg01.indd 11 11/20/18 3:25 PM

Illustration 1.7 The
usual sequence of events Depletion of Decreased blood Decreased
Inadequate
tissue stores of levels of nutrient available
in the development of a dietary intake
the nutrient the nutrient to cells
nutrient deficiency and an
example of how vitamin A
EXAMPLE: EXAMPLE: EXAMPLE: EXAMPLE: Decreased
deficiency develops.24,25
Deficient Reduced liver stores Reduced blood levels vitamin A available
vitamin A intake of vitamin A of vitamin A to cells within eye
ICI Pharmaceuticals
Photodisc
Photodisc
Long-term Physical signs
Impaired cellular
impairment and symptoms
functions
of health of deficiency
EXAMPLE: EXAMPLE: Outer EXAMPLE

Outer covering covering of the eyes Impaired ability to
of the eyes dries dries out, thickens, see in dim light
out and thickens; and becomes
vision is lost susceptible to infection
Photodisc
sufficient impairment to produce physically obvious signs of a deficiency disease. Eventu-

ally, some of the problems produced by the deficiency may no longer be repairable, and
permanent changes in health and function may occur. In most cases, the problems result-
ing from the deficiency can be reversed if the nutrient is supplied before this final stage
occurs.
Excessively high intake of many nutrients such as vitamin A and selenium produces
toxicity diseases. The vitamin A toxicity disease is called hypervitaminosis A, and the
disease for selenium toxicity is called selenosis. Signs of the toxicity disease stem from
increased levels of the nutrient in the blood
and subsequent oversupply of the nutrient to
the cells. The high nutrient load upsets the
balance needed for normal cell function. The
changes in cell functions lead to the signs and
symptoms of the toxicity disease.
For both deficiency and toxicity diseases,
the best time to correct the problem is usually
at the level of dietary intake, before tissue
stores are adversely affected. In that case, no
harmful effects on health and cell function
occur—they are prevented.26
Nutrient Deficiencies Are Often
Multiple Most foods contain many nutri-
Chad Johnston/Masterfile
ents, so poor diets will affect the intake level

of more than one nutrient (Illustration 1.8).
Inadequate diets generally produce a spectrum
of signs and symptoms related to multiple
nutrient deficiencies. For example, protein,
Illustration 1.8 This woman has iron deficiency anemia. Chances are good that she has
poor status of other nutrients in addition to iron.
vitamin B12, iron, and zinc are packaged
1-12 U NIT 1
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together in many high-protein foods. The protein-deficient, starving children you may see
in news reports are rarely deficient just in protein. They may also be deficient in iron, zinc,
and vitamin B12.
The “Ripple Effect” Dietary changes affect the level of intake of many nutrients.
Switching from a high-fat to a low-fat diet, for instance, may result in a higher intake of
protein, carbohydrate, or both; a higher intake of cholesterol and vitamin E; and increased
intake of vitamin A, vitamin C, and iron. So dietary changes introduced for the purpose of
improving the intake level of a particular nutrient produce a ripple effect on the intake of
other nutrients.
Humans have adaptive mechanisms for managing fluctuations

in nutrient intake.
Healthy humans are equipped with a number of adaptive mechanisms that partially
protect the body from poor health due to fluctuations in dietary intake. In the context of
nutrition, adaptive mechanisms act to conserve nutrients when dietary supply is low and
to eliminate them when they are present in excessively high amounts. Dietary surpluses of
energy and some nutrients—such as vitamin A and vitamin B12—can be stored within tis-
sues for later use. In the case of iron, copper, and calcium, the body regulates the amounts
absorbed in response to its need for them. The body is unable to store excess amino acids
for very long. It uses excess amino acids consumed primarily as a source of energy.27
Here are some other examples of how the body adapts to changes in dietary intake:
●●
When calorie intake is reduced by fasting, starvation, or dieting, the body adapts to the
decreased supply by lowering energy expenditure. Declines in body temperature and
the capacity to do physical work also act to decrease the body’s need for calories. When
caloric intake exceeds the body’s need for energy, the excess is stored as fat for energy
needs in the future.
●●
The ability of the gastrointestinal tract to absorb dietary iron increases when the body’s
stores of iron are low. To help protect the body from iron overdose, the mechanisms that
facilitate iron absorption in times of need shut down when enough iron has been stored.
●●
The body can protect itself from excessively high levels of intake of vitamin C from
supplements by excreting the excess in the urine.
Although these built-in mechanisms do not protect humans from all the consequences
of poor diets, they do provide an important buffer against the development of nutrient-
related health problems.
Malnutrition can result from poor diets and from disease states, genetic
factors, or combinations of these factors.
Malnutrition means poor nutrition; it results from both inadequate and excessive malnutrition Poor nutrition resulting
availability of calories and nutrients in the body. Vitamin A toxicity, obesity, vitamin C from an excess or lack of calories or
nutrients.
deficiency (scurvy), and underweight are examples of malnutrition.
Malnutrition can result from poor diets and also from diseases that interfere with
the body’s ability to use the nutrients consumed. Diarrhea, alcoholism, cancer, bleeding
ulcers, and HIV/AIDS, for example, may be primarily responsible for the development of
malnutrition in people with these disorders.
In addition, a percentage of the population is susceptible to malnutrition and
increased disease risk due to genetic factors. For example, people may be born with a
Foundation K n ow l edge for T h inking a b o ut N utriti o n 1-13
21651_ch01_ptg01.indd 13 11/20/18 3:25 PM

genetic tendency to produce excessive amounts of cholesterol, absorb high
levels of iron, or use folate poorly. Some cases of obesity, diabetes, heart disease,
and cancer are related to a combination of genetic and dietary factors.28
Some groups of people are at higher risk of becoming

inadequately nourished than others.
Women who are pregnant or breastfeeding, infants, growing children, the
frail elderly, the ill, and those recovering from illness have a greater need for
nutrients than other people. As a result, they are at higher risk than other
people of becoming inadequately nourished (Illustration 1.9). The fetus during
Ericka McConnell/The Image Bank/Getty Images

pregnancy and infants are developing rapidly and are particularly vulnerable
to the adverse affects of poor nutrition. Poor nutrition experienced early in
life can induce changes in gene function that adversely affect health status for
a lifetime.29 In cases of widespread food shortages, such as those induced by
natural disasters or war, the health of these nutritionally vulnerable groups is
compromised the soonest and the most.
Within the nutritionally vulnerable groups, certain people and families are
at particularly high risk of malnutrition. These are people and families who are
poor and least able to secure food, shelter, and high-quality medical services.
Illustration 1.9 Women who are pregnant or breast- The risk of malnutrition is not shared equally among all persons within a
feeding and infants are among the people who are at a population.
higher risk of becoming inadequately nourished.
Poor nutrition can influence the development of certain chronic

chronic diseases Slow-developing, and other diseases.
long-lasting diseases that are not con-
tagious (e.g., heart disease, diabetes, Poor nutrition does not result only in nutrient deficiency or toxicity diseases. Faulty diets
and cancer). They can be treated but not play important roles in the development of chronic diseases such as hypertension, heart
always cured.
disease, cancer, and osteoporosis. Diets high in salt, for example, are related to the devel-
dietary pattern The quantities, propor- opment of hypertension; those low in vegetables and fruit to cancer; low-calcium diets
tions, variety, or combination of different
foods, drinks, and nutrients in diets, and
and poor vitamin D status to osteoporosis; and high-sugar diets to tooth decay. The harm-
the frequency with which they are habitually ful effects of poor dietary practices on chronic disease development generally accumulate
consumed. over the course of years.30
Adequacy, variety, and balance are key characteristics of healthy

dietary patterns.
Healthy diets correspond to a dietary pattern associated with normal growth and
development, a healthy body weight, health maintenance, and disease prevention. One
such pattern is represented by the USDA’s ChooseMyPlate food group intake guide
ChooseMyPlate.gov/USDA
(Illustration 1.10). Several other types of dietary patterns, including the Mediterranean-
style dietary pattern and the DASH Eating Plan, have also been found to promote health
and foster disease prevention.15 Healthy dietary patterns are characterized by regular
consumption of moderate portions of a variety of foods from each of the basic food
groups. No specific foods or food preparation techniques are excluded in a healthy
Illustration 1.10 ChooseMyPlate is the
dietary pattern.
icon for the USDA’s food guidance system.
It is intended to visually help people choose Healthy dietary patterns are plant-food based and include the regular consumption of
healthy meals. vegetables, fruits, dried beans, fish and seafood, low-fat dairy products, poultry and lean
1-14 U NIT 1
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Illustration 1.11 Calorie and nutrient content of an empty-calorie and
Percent contribution to a nutrient-dense food. Percentages given represent percent contributions
adult female RDAs to adult female RDAs.
Cola
soft drink, Skim milk,
1 cup 1 cup
0% 10% 20% 30% 40% 0% 10% 20% 30% 40%
Calories
Protein
Vitamin A
Vitamin C
Thiamin (B1)
Riboflavin (B2)
Niacin (B3)
Calcium
Iron
meats, nuts and seeds, and whole grains. Dietary patterns that include large or frequent
servings of foods containing high amounts of trans fat, added sugars, salt, or alcohol
miss the healthy dietary pattern mark. Healthy dietary patterns supply needed nutrients
and beneficial phytochemicals through food rather than supplements or special dietary
products.31
Energy and Nutrient Density Most Americans consume more calories than needed,
become overweight as a result, and consume inadequate diets. This situation is partly due
to over-consumption of energy-dense foods such as processed and high-fat meats, chips, energy-dense foods Foods that provide
candy, many desserts, and full-fat dairy products. Energy-dense foods have relatively high relatively high levels of calories per unit
calorie values per unit weight of the food. Intake of energy-dense diets is related to the weight of the food. Fried chicken; cheese-
burgers; a biscuit, egg, and sausage
consumption of excess calories and to the development of overweight and diabetes.32 sandwich; and potato chips are energy-
Many energy-dense foods are nutrient poor, meaning they contain low levels of nutri- dense foods.
ents given their caloric value. These foods are sometimes referred to as empty-calorie empty-calorie foods Foods that pro-
foods; these include products such as soft drinks, sherbet, hard candy, alcohol, and cheese vide an excess of energy or calories in rela-
twists. Excess intake of energy-dense and empty-calorie foods increases the likelihood tion to nutrients. Soft drinks, candy, sugar,
that calorie needs will be met or exceeded before nutrients needs are met.33 Diets most alcohol, and animal fats are considered
likely to meet nutrient requirements without exceeding calorie needs contain primarily empty-calorie foods.
nutrient-dense foods, foods with high levels of nutrients and relatively low calorie value. nutrient-dense foods Foods that
Nutrient-dense foods such as non-fat milk and yogurt, lean meat, dried beans, vegetables, contain relatively high amounts of nutrients
compared to their calorie value. Broccoli,
and fruits provide relatively high amounts of nutrients compared to their calorie value.32 collards, bread, cantaloupe, and lean
Illustration 1.11 shows a comparison of the calorie and nutrient content of an empty- meats are examples of nutrient-dense
calorie and a nutrient-dense food. foods.
There are no “good” or “bad” foods.

People tend to classify foods as being “good” or “bad,” but such opinions over-simplify
each food’s potential contribution to a diet.31 Typically hot dogs, ice cream, candy, bacon,
F oundatio n K now l edg e for T hinkin g a b out Nutritio n 1-15
21651_ch01_ptg01.indd 15 11/20/18 3:25 PM

and french fries are judged to be “bad,” whereas vegetables, fruits, and whole-grain
products are given the “good” stamp. Unless we’re talking about spoiled stew, poison
mushrooms, or something similar, however, no food can be firmly labeled as “good” or
“bad.” Ice cream can be a “good” food for physically active, normal-weight individu-
als with a high calorie need who have otherwise met their nutrient requirements by
consuming nutrient-dense foods. Some people who eat only what they consider to be
“good” foods such as broccoli, berries, brown rice, and tofu may still miss the healthful
diet mark due to inadequate consumption of essential fatty acids and certain vitamins
and minerals.
All foods can fit into a healthy dietary pattern as long as nutrient needs are met at
calorie intake levels that maintain a healthy body weight.31 If nutrient needs are not being
met and calorie intake levels are too high, then the diet likely includes too many energy-
dense or empty-calorie foods. Substituting nutrient-dense for energy-dense foods would
help bring the diet back into balance.
The basic nutrition concepts presented here are listed in Table 1.6. It may help you
remember the concepts and to start thinking like a bona fide nutritionist if you go back
over each concept and give several examples related to it. If you understand these con-
cepts, you will have gained a good deal of insight into nutrition.
Table 1.6 Nutrition concepts

1. Food is a basic need of humans.
2. Foods provide energy (calories), nutrients, and other substances needed for growth
and health.
3. Health problems related to nutrition originate within cells.
4. Poor nutrition can result from both inadequate and excessive levels of nutrient intake.
5. Humans have adaptive mechanisms for managing fluctuations in nutrient intake.
6. Malnutrition can result from poor diets and from disease states, genetic factors, or
combinations of these factors.
7. Some groups of people are at higher risk of becoming inadequately nourished than
others.
8. Poor nutrition can influence the development of certain chronic and other diseases.
9. Adequacy, variety, and balance are key characteristics of healthy dietary patterns.
10. There are no “good” or “bad” foods.
1-16 U NIT 1
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NUTRITION
Jose Luis Pelaez, Inc/Blend

Nutrition Concepts Review
Images/Corbis
Focal Point: Nutrition concepts apply to diet and Write the number of the nutrition concept from Table 1.6 that most
health relationships. closely applies to the situation described. Use each concept and do not
repeat concept numbers in your response.
Nutrition concept number Situation

1. ____ The Irish potato famine caused thousands of deaths.
2. ____and ____ Otis mistakenly thought that as long as he consumed enough calories from food along with
vitamin and mineral supplements, he would stay healthy no matter what he ate.
3. ____ I feel guilty every time I eat potato chips. I wish they weren’t bad for me.
4. ____ Phyllis was relieved to learn that her chronic diarrhea was due to the high level of vitamin C
supplements she had been taking.
5. ____ A low amount of iron in Tawana’s red blood cells was the reason for her loss of appetite and
low energy level.
6. ____ Far more young children than soldiers died as a result of the 10-year civil war in Sudan.
7. ____ For the past 20 years, Don’s idea of dinner was a big steak and potatoes. His recent heart
attack changed his view of what’s for dinner.
8. ____ During the two weeks they were backpacking in the Netherlands, Tomás and Ozzie ate very
few vegetables and fruits. Their health remained robust, however.
9. ____ Zhang wasn’t aware that he had the inherited condition hemochromatosis until he began tak-
ing iron supplements and developed iron overload symptoms.
Feedback on Nutrition Up Close is located in Appendix F.
REVIEW QUESTIONS
●● Explain the scope of nutrition as an area of study. 4. Food insecurity is a problem in developing countries,
but it is not a problem in the United States or Canada.
1. Nutrition is defined as “the study of foods, their nutrients
True/False
and other chemical constituents, and the effects that food
constituents have on health.” True/False 5. Nutrients are classified into five basic groups:
carbohydrates, protein, fats, vitamins, and
2. ____ Cassandra is on her way to her first nutrition class
water. True/False
and is thinking about what the course will cover. Listed
below are her ideas. Three of the ideas correspond to the 6. The development of standards for nutrient intake lev-
scope of the study of nutrition. Which idea is not a compo- els was prompted in part by the high rejection rate of
nent of the scope of the study of nutrition? World War II recruits due to underweight and nutrient
deficiencies. True/False
a. diet and disease relationships
b. components of healthful diets 7. Tissue stores of nutrients decline after blood levels of the
c. magical powers of super foods for weight loss nutrients decline. True/False
d. nutrient composition of foods 8. To maintain health, all essential nutrients must be
●● Demonstrate a working knowledge of the meaning consumed at the recommended level daily.
True/False
of the 10 nutrition concepts.
9. An individual’s genetic traits play a role in how nutrient
3. The word nonessential as in nonessential nutrient means intake affects disease risk. True/False
that the nutrient is not required for growth and health.
True/False
REV I E W QU E S T ION S 1-17
21651_ch01_ptg01.indd 17 11/20/18 3:25 PM

10. ____ If you wanted to know the Recommended Dietary to oxidizing agents such as
Allowance for protein for a 7-month-old infant, you would environmental pollutants,
refer to tables on the: smoke, ozone, and oxygen.
a. Dietary Guidelines for Americans ____16. Food insecurity c. Foods that contain relatively
b. Infant Nutritional Recommendations for Americans high amounts of nutrients
c. Recommended Daily Intakes in relation to their calorie
d. Recommended Dietary Allowances value.
11. ____ The Tolerable Upper Intake Level for iron for a ____17. Antioxidants d. The chemical changes that
65-year-old male in milligrams per day (mg/d) is: take place in the body.
a. 1,100 ____18. Calorie e. Limited or uncertain avail-
b. 45 ability of safe, nutritious
c. 350 foods—or the ability to
d. 3.5 acquire them in socially
12. Certain phytochemicals, or________, such as lycopene acceptable ways.
and anthocyanins, act as ____________. ____19. Metabolism f. A unit of measure of the
13. Groups of people at higher risk than others of becoming amount of energy supplied
inadequately nourished include _______ and ________. by food.
For the questions below, match the term in column A with its ____20. Malnutrition g. Nutrients required for
definition in column B. normal growth and health
Column A Column B that the body can generally
not produce, or produce in
____14. Essential nutrients a. Chemical substances in food
sufficient amounts.
that are used by the body for
growth and health. ____21. Nutrient dense h. Poor nutrition resulting from
an excess or lack of calories
____15. Nutrients b. Chemical substances that
or nutrients.
prevent or repair damage
to cells caused by exposure Answers to these questions can be found in Appendix F.
NUTRITION SCOREBOARD ANSWERS

1. Calories are a measure of the amount of energy supplied by 3. Excessive as well as inadequate intake levels of vitamins
food. They’re a property of food, not a substance present in and minerals can be harmful to health. False
food. False 4. The DRIs are located at the back of this text. True
2. That’s the definition of nutrients. True
1-18 UNIT 1
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The Inside NUTRITION SCOREBOARD
UNIT
2
1 How long people live and how healthy they are
primarily depends on four factors: lifestyle behaviors,
Story about the environments to which they are exposed, genetic

factors, and access to quality health care. True/False
2 Diet is related to the top two causes of death in the United
Nutrition and States. True/False

3 Biological processes of modern humans were designed
over 40,000 years ago. True/False
Health 4 Most economically developed countries regularly monitor

levels of various contaminants and nutrients in foods and
diets, but the United States does not. True/False
Answers can be found at the end of the unit.
Ariel Skelley/Blend Images/Jupiter Images
2-1
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LEARNING OBJECTIVES Nutrition in the Context
After completing Unit 2 you
will be able to: of Overall Health
●●
Identify characteristics ●●
Identify characteristics of diets related to the development of specific
of diets related to the diseases.
development of specific
diseases.
Think of your body as a machine. How well this machine performs depends on a number
of related factors: the quality of its design and construction, the appropriateness of the
●●
Explain how differences in materials used to produce it, and how well it is maintained.
diets of early versus modern A machine designed to produce 10,000 copies a day will break down sooner if it is
humans may promote the used to make 20,000 copies a day. The repair call will, in all probability, come earlier if the
development of certain
machine is overused and poorly maintained or if it has a part that doesn’t work well. On
diseases.
the other hand, chances are good the copy machine will function at full capacity if it is free
●●
List the types of food that are from design flaws, skillfully constructed from appropriate materials, properly used, and
core components of healthful kept in good shape through regular maintenance.
diets. Although much more complex and sophisticated, the human body is like a machine
in some important ways. How well the body works and how long it lasts depend on a vari-
ety of interrelated factors. The health and fitness of the human machine depend on genetic
traits (the design part of the machine), the quality of the materials used in its construction
(your diet), and regular maintenance (your diet, other lifestyle factors, and health care).
Lifestyles exert the strongest overall influence on health and longevity (Illustration 2.1).2
Behaviors that constitute our lifestyle—such as diet, smoking habits, illicit drug use or
excessive drinking, level of physical activity or psychological stress, and the amount of
sleep we get—largely determine whether we are promoting health or disease. Of the
lifestyle factors that affect health, our diet is one of the most important.3 In a sense, it is
fortunate that diet is related to disease development and prevention. Unlike age, gender,
and genetic makeup, our diets are within our control.
People have an intimate relationship with food—each year we put over a thousand
pounds of it into our bodies! Food supplies the raw materials the body needs for growth
and health; these, in turn, are affected by the types of food we usually eat. The diet we
feed the human machine can hasten, delay, or prevent the onset of an impressive group of
today’s most common health problems.
KEY NUTRITION CONCEPTS
Unit 1 presents 10 key nutrition concepts that are fundamental to the science of nutrition. The
content on diet and health covered in this unit directly relates to three of them:
1. Nutrition Concept #3: Health problems related to nutrition originate within cells.
Illustration 2.1 Conditions that contrib-

Health Environmental Genetic
ute to death among adults under the age of
care exposures Lifestyles makeup
75 in the United States. Health care refers
to access to quality care; environmental
exposures include the safety of one’s
surroundings and the presence of toxins
and disease-causing organisms in the
environment; lifestyle factors include diet,
exercise, obesity, smoking, genetic traits,
and alcohol and drug use.3,4
Photodisc
2-2 U N IT 2
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Illustration 2.2 Vitamin D deficiency
(rickets shown on the left) and niacin defi-
ciency (pellagra pictured on the right) were
leading causes of hospitalization of children
in the United States in the 1930s.
BioPhoto Associates/Photoresearchers, Inc.

Biophoto Associates/Science Source
chronic diseases Slow-developing,

long-lasting diseases that are not conta-
gious (e.g., heart disease, cancer, diabetes).
(a) (b) They can be treated but not always cured.
diabetes Short for the term diabetes
mellitus, a disease characterized by
abnormal utilization of glucose by the body
2. Nutrition Concept #6: Malnutrition can result from poor diets and from disease states,
and elevated blood glucose levels. There
genetic factors, or combinations of these factors. are three main types of diabetes: type 1,
type 2, and gestational diabetes. The
3. Nutrition Concept #8: Poor nutrition can influence the development of certain chronic
word diabetes in this text refers to type 2
diseases. diabetes, by far the most common.
hypertension High blood pressure. It is
defined as blood pressure exerted inside
The Nutritional State of the Nation of blood vessel walls that typically exceeds
Since early in the twentieth century, researchers have known that what we eat is related to 140/90 mm Hg (millimeters of mercury).
the development of vitamin and mineral deficiency diseases, to compromised growth and
impaired mental development in children, and to the body’s ability
to fight infectious diseases. Seventy years ago in the United States,
% of total deaths
widespread vitamin deficiency diseases filled children’s hospital
wards and contributed to serious illness and death in adults Heart diseases
(Illustration 2.2). Now, however, dietary excesses are filling hospital Cancers
beds and reducing the quality of life for millions of Americans. Chronic obstructive
Today, the major causes of death among Americans and in Lung diseasea
other developed countries are slow-developing, lifestyle-related Strokes
chronic diseases.6 Based on government survey data, 44% of Accidents
Americans have a chronic condition such as diabetes, heart
Alzheimer’s disease
disease, cancer, hypertension, or high cholesterol levels; 13%
have three or more of these conditions.7 Diabetes
The leading causes of death among Americans are heart dis- Pneumonia
and influenza
ease and cancer (see Illustration 2.3). Together they account for Kidney disease
47% of all deaths. Western-type dietary patterns that are gener-
Suicide
ally low in vegetables, fruits, whole grains, dried beans, poultry,
nuts, and fish and relatively high in meat, refined grains, sugars, 5% 10% 15% 20% 25% 30% 35%
calories, and salt are linked to the development of a number of
a
chronic diseases.8 People who consume Western-type diets are at Principally includes bronchitis, emphysema, and asthma.
higher risk of developing obesity, diabetes, cancer, heart disease,

and hypertension.3,9 Examples of diseases and disorders associ- Illustration 2.3 Percentage of total deaths for the top 10 leading causes
of death in the United States, 2015.5
ated with dietary intake are shown in Table 2.1. Source: NCHS Data Brief No. 267, December 2016.
N ut rition in the C ontext o f Ove rall H ealth 2-3
21651_ch02_ptg01.indd 3 11/20/18 11:27 AM

Table 2.1 Examples of diseases and disorders linked to diet8–14
Disease or disorder Dietary connections
Heart disease Excessive body fat, high intake of trans fat, added sugar, and salt; low vegetable, fruit, fish, nuts, and
whole-grain intake
Cancer Low vegetable and fruit intake; excessive body fat and alcohol intake; regular consumption of processed meats
Stroke Low vegetable and fruit intake; excessive alcohol intake; high animal-fat diets
Diabetes (type 2) Excessive body fat; low vegetable, whole grain, and fruit intake; high added sugar intake
Cirrhosis of the liver Excessive alcohol consumption; poor overall diet
Hypertension Excessive sodium (salt) and low potassium intake; excess alcohol intake; low vegetable and fruit intake;
excessive levels of body fat
Iron-deficiency anemia Low iron intake
Tooth decay and gum Excessive and frequent sugar consumption; inadequate fluoride intake
disease
Osteoporosis Inadequate calcium and vitamin D; low intake of vegetables and fruits
Obesity Excessive calorie intake; overconsumption of energy-dense, nutrient-poor foods
Chronic inflammation Excessive calorie intake; excessive body fat; high animal-fat diets; low intake of whole grains, vegetables, fruit,
and oxidative stress and fish
Alzheimer’s disease Regular intake of high animal-fat products; low intake of olive oil, vegetables, fruits, fish, wine, and whole grains
chronic inflammation Low-grade inflam- Shared Dietary Risk Factors A number of the diseases and disorders listed in
mation that lasts weeks, months, or years. In- Table 2.1 share the common risk factors of low intake of vegetables, fruits, and whole grains;
flammation is the first response of the body’s excess body fat and alcohol intake; and high animal-fat intake. These risk factors are associ-
immune system to infectious agents, toxins, ated with the development of chronic inflammation and oxidative stress, conditions that
or irritants. It triggers the release of biologically
active substances that promote oxidation and
are strongly related to the development of heart disease, diabetes, osteoporosis, Alzheimer’s
other reactions to counteract the infection, disease, cancer, and other chronic diseases.15
toxin, or irritant. A side effect of chronic inflam-
mation is that it may also damage lipids, cells,
Inflammation and Oxidative Stress Inflammation is an important part of the
tissues, and certain body processes. Also body’s defense systems against cell and tissue damage due to the presence of infectious
called low-grade inflammation. agents, chemical irritants, toxins, or physical injury. It can be classified as acute or chronic.
oxidative stress A condition that occurs Most of us are familiar with acute inflammation. That’s a temporary reaction that occurs
when cells are exposed to more oxidiz- when you sprain your ankle or develop a fever. The ankle you injured or your head feels
ing molecules (such as free radicals) than very warm to the touch and hurts, and your head may ache from the fever. Acute inflam-
to antioxidant molecules that neutralize mation goes away with time as your body heals itself. Chronic, low-grade inflammation
them. Over time, oxidative stress causes
damage to lipids, DNA, cells and tissues. It
doesn’t hurt; it occurs silently within the fluids, tissues, and cells inside your body; and
increases the risk of heart disease, type 2 it lasts weeks, months, or years. An important part of the body’s inflammatory response
diabetes, cancer, and other diseases. is the production and release of oxidizing agents such as free radicals that destroy the
osteoporosis A condition in which bones offending substances. In the process, however, free radicals may also oxidize fats (lipids),
become fragile and susceptible to fracture cell membranes, and DNA inside of cells. In the short term, damage induced by oxidation
due to a loss of calcium and other minerals. reactions can generally be reduced by antioxidants produced by the body and consumed
free radicals Chemical substances (often in vegetables, fruits, whole-grain products, and other plant foods.16
oxygen-based) that are missing electrons. Inflammation is related to chronic disease development when it is present at a low
The absence of electrons makes the chemical level for a long time, or is chronic. Chronic inflammation and the resulting oxidative stress
substance reactive and prone to oxidiz-
ing nearby molecules by stealing electrons
are sustained by irritants continually present in the body. Excess body fat and habitually
from them. Free radicals can damage lipids, high intake of foods high in saturated fats and added sugar are examples of such irritants.
proteins, cells, DNA, and eventually tissues by If not countered by a sufficient supply of antioxidants, chronic inflammatory processes and
altering their chemical structure and functions. oxidative stress impair the normal functioning of cells and tissues. Chronic inflammation
antioxidants Chemical substances that represents a major pathway by which diet influences the development of chronic disease.39
prevent or repair damage to cells caused Loss of excess body fat and a dietary pattern high in whole grains, colorful vegetables,
by oxidizing agents such as pollutants, fruit, poultry, and fish and low in refined grains, added sugars, red and processed meat, high-
ozone, smoke, and reactive oxygen. Oxida-
tion reactions are a normal part of cellular
fat dairy products, and sweetened beverages is associated with lower levels of inflammation
processes. Vitamins C and E and certain compared to dietary patterns that do not.17, 18 Table 2.2 summarizes the types of foods included
phytochemicals function as antioxidants. in dietary patterns that tend to decrease or increase oxidative stress and inflammation.
2-4 UNI T 2
21651_ch02_ptg01.indd 4 11/20/18 11:27 AM

Nutrient–Gene Interactions and Health Some diseases are promoted by interactions Table 2.2 Types of food associated
between nutrients and genes. One example of such an interaction involves gene types and the with decreased or increased
health effects of cruciferous vegetables such as broccoli, cauliflower, brussels sprouts, and cab- inflammation, oxidative stress,
or both11,14,15
bage. These vegetables contain isothiocyanates (pronounced ice-o-thee-o-sigh-ah-nates), which
are involved in the prevention of cancer development. Individuals carrying certain types of Decreased
genes that lead to the rapid breakdown of isothiocyanates and related compounds are more Colorful fruits and vegetables
susceptible to cancer development than others who break down these substances slowly.
Isothiocyanates appear to block mechanisms that promote tumor development.19 Another Dried beans
example of nutrient–gene interactions that influence health relates to obesity. The causes of Whole grains
obesity are complex and include interactions between a number of gene types and envi-
Fish and seafood, fish oils
ronmental factors. One contributing genetic factor appears to be the form of the FTO gene
present. This gene participates in processes that regulate appetite and food intake. People Red wines
with the “high-risk” form of the FTO gene experience a higher lifetime risk of becoming Dark chocolates
overweight or obese compared to those who have the “low-risk” form of the gene.20
Olive oil
Knowledge of nutrient–gene interactions in health and disease is expanding rapidly
and is greatly enhancing our understanding of the relationship between diet and health. Nuts
This knowledge will contribute to the development of personalized nutritional interven- Coffee, tea
tions targeted at an individual’s genetic characteristics.21
Increased
The Importance of Food Choices Processed and high-fat meats
People are not born with an internal compass that directs them to select a healthy diet— High-fat dairy products
and it shows. If given access to a food supply like that available in the United States, people Baked products, snack foods with
show a marked tendency to choose a diet that is high in energy-dense, nutrient-poor trans fats
foods22 (Illustration 2.4). Such a diet tends to include processed foods high in saturated
Soft drinks, other high-sugar
fat, salt, or sugar and low in whole grains, vegetables, fruits, and other basic foods. This beverages
type of diet poses the greatest risks to the health of Americans.22
Excess alcohol
Diet and Diseases Refined grain products (rice, white

bread, pastries)
of Western Civilization
●●
Explain how differences in diets of early versus modern humans may
promote the development of certain diseases.
Why is the U.S. diet—a “Western” style of eating—hazardous to our health in so many
ways? What is it about a diet that is high in animal fat, salt, and sugar and low in veg-
etables, fruits, and whole grains that promotes certain chronic diseases? A good deal of
evidence indicates that the chronic diseases now prevalent in the United States and other
Westernized countries have roots in dietary changes that have taken place over centuries.
Our Bodies Haven’t Changed

The biological processes that control what the human body does with food were devel-
oped over the course of our evolution tens of thousands of years ago. These processes exist
today because they are linked to the genetic makeup of humans and continue to influence
how diet affects health.23,24
Then . . . For the first 200 centuries of their existence, humans survived by hunting and
gathering (Illustration 2.5). They were constantly on the move, pursuing wild game or
following the seasonal maturation of fruits and vegetables. Meat, berries, and many other
plant products obtained from successful hunting and gathering journeys spoiled quickly,
so they had to be consumed in a short time. Feasts would be followed by famines that
lasted until the next successful hunt or harvest.23
. . . and Now The bodies of modern humans, adapted to exist on a diet of wild game,
fish, fruits, nuts, seeds, roots, vegetables, and grubs; to survive periods of famine; and to
sustain a physically demanding lifestyle are now exposed to a different set of circumstances.
Diet and Diseases o f W ester n Ci v ili z ation 2-5
21651_ch02_ptg01.indd 5 11/20/18 11:27 AM

Illustration 2.4 Lopsided, all-American
food choices.
Thomas Firak Photography/

Photolibrary/Getty Images
Photodisc
Photodisc
Photodisc
The foods we eat bear little resemblance to the foods available to our early ancestors (Illus-
tration 2.6). Sugar, salt, alcohol, food additives, oils, margarine, dairy products, refined
grain products, and processed foods were not a part of their diets. These ingredients and
foods came with Western civilization.23 Furthermore, we do not have to engage in strenu-
ous physical activity to obtain food, and our feasts are no longer followed by famines.
The human body developed other survival mechanisms that are not the assets they
used to be. Mechanisms that stimulate hunger in the presence of excess body fat stores,
conserve the body’s supply of sodium, and confer an innate preference for sweet-tasting
foods—as well as a digestive system that functions best on a high-fiber diet—were advan-
tages for early humans. They are not advantageous for modern humans, however, because
our diets and lifestyles are now vastly different.
Nat Farbman/The LIFE Picture Collection/Getty Images

Christophe Courteau/Gamma-Rapho/Getty Images
(a) (b)
Illustration 2.5 Hunter-gatherers still exist in the world, but their numbers are diminishing. It is estimated that hunter-gatherers consume
approximately 3,000 calories daily due to their physically demanding way of life.
2-6 U N IT 2
21651_ch02_ptg01.indd 6 11/20/18 11:27 AM

Another random document with
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this works. Take a normal waisted form with a coat which fits well in
the back and place a sack of flour, or any other weight of fifty
pounds, in front of this waist, supported by the arms, and the whole
upper body will throw itself backward in order to keep its balance,
and the back of this coat will become too long across the hollow of
the waist behind, because the front of the coat cannot stretch like the
body itself.
Diagram VIIIa is made especially for the erect form, and is in all
respects like Dia. VIII except the “V” closed up across the hollow of
the waist, and the three-eighths stretch of the side piece upward,
and the consequent shortening of the back of 1¼. The difference at
the front edge cannot be considered a fitting point. If Dia. VIIIa is
used for a large waisted form, which is mostly always erect, then the
gore between the back and side piece should be cut like Dia. VIII, or
nearly so. In all cases, whenever the waist becomes fuller, or the
person more erect, the spring over the seat may be enlarged, and if
it becomes too large, it is less trouble to reduce it than if the spring is
too small. A good outlet over the seat and center of back of a sack
coat comes very handy sometimes, but such a seam should be
sewed by hand, because the machine will usually cut its edges.
Now, in considering the above, a cutter must observe if the form
he intends to fit is erect or stooping, or large waisted, or if there is a
combination of such, or other abnormal conditions. The single erect,
or stooping, or large waist, or long or short necked person is very
seldom to be found; there is mostly a combination of two or three
abnormal conditions combined in one person.
The gores between the back and the fore part of both Dia. VIII and
VIIIa are cut out pretty close at the hollow of the waist, and it will
never hurt any sack, cut over either of them, to have one-half inch
more at line 17½. Dia. VIIIa may be used for the normal form,
providing the depth of the back is made 12¾ numbers above line 9,
and I have often used it for such with good results.
A sack coat with two seams and which is intended to conform
partly to the hollow of the waist in the back must have a spring over
the center of the seat, starting at the most hollow part of the hollow
of the waist. Said spring cannot be obtained by allowing it at the side
of the back which may be six or seven inches wide. Even if said
spring were able to push the coat back over the seat it would at the
same time push the coat upward and backward and away from the
waist, and make it too wide and too long there. The only way to
make such a coat good is to cut the spring, intended for the center of
the back, at the side, and stretch the side of the back, under the iron,
and at the hollow of the waist, and press the whole back in the shape
of the pattern as in Dia. VIII and deduct the seam behind.
Sacks without any downward seams will never be in demand until
we come closer to oriental fashions, or until we fall back upon
cloaks. For the purpose of finding out how close I could come to
making a reasonably good fitting sack in the back of the waist,
without any seams downward, I have made four of them during the
last 12 years. The first one I had to rip up again and make it up into a
smaller size as a three seamer. The second and third I sold as cheap
coats and the purchasers never found out that they wore seamless
coats. They were better than a great many five seamers seen on the
street, though they were loose coats at and around the back of the
waist. One of them I had photographed on myself, both front and
back views, and have the photo still in my possession. One back and
one front view I sent to the office of the then “American Tailor,” and
a letter in my possession says that they consider it a good fit for such
a coat. The last seamless coat I made last summer, 1891, and have
it on hand now, and I intend to keep it at least for the present. A front
and a back view of that coat will be found in “Figures and Diagrams.”
For the last six months I have kept it for a show coat, with a card on
it offering $25 to any cutter or tailor who will make one like it, and
which fits as good or better. So far I have had no call for the $25, nor
did I expect a response, because it will not pay anybody to make one
even for $25, and risk a fit. I made the offer to advertise my work,
that was all.
The fit of a seamless coat must be put in by the maker, and it
takes a cutter and a maker who knows what he is about, and one
who don’t care how long it takes to make one and what it costs; in
fact, it must be a work done for pleasure—not for profit, except
perhaps to gain knowledge, for “Knowledge is Power.” Now I will
give a description of how such a coat may be made:
Select a good fitting sack coat pattern with three seams, and one
which is not cut very close at the side of the waist, that is a sack cut
pretty straight. The one I have on hand now is cut over Dia. VIII, and
as size 36. The height of the back above line 9 over the front should
not be over 13, but the top of the back should be placed at 2½, so
that the portion over the blade is short and the top of back cut close
to the point of the angle of 135 deg. If the top of back becomes too
close to the neck, it can be cut down after the coat is tried on. On
account of the short back, the armhole must be cut pretty low and
well forward. The front must also be cut large and fitted to the body
after the back has been regulated. After the pattern is thus cut,
proceed as follows: Close the back and the front from the bottom to
the hollow of the waist, lapping the seams; at the bottom of the
armscye the front and back will lap over about 1¼ inch; fit the pattern
to the back so that one seam is deducted from behind at the neck
and at least two seams at the bottom, so that the hollow of waist
shows as little surplus cloth as possible. Over the seat, the cloth may
be stretched in width, thus obtaining some artificial spring over the
seat. Cut the back, and the back of the armhole to within 1½ inch to
the front of the armhole and not quite as deep as the pattern. In
cutting the pattern the back shoulder seam must be cut pretty low at
the armhole and should be at least as low as 8 for the reason that
the lap of the pattern at the side seam will bring both back and front
shoulder seam too close together and would have to be pieced, but if
the back shoulder seam is thrown down, and the front up, both will
come out right. Now the next thing to be observed is to make an
artificial wedge of whatever the back and the forepart lap at the
bottom of the armscye, running out to nothing at the waist. This must
be done by stretching the bottom of the armhole in width, and which
stretch must be extended down to the waist, but nothing must be
stretched at the waist, for the waist is too wide already, owing to the
hollow of the back, in the pattern which can not be imitated on the
straight coat back. That stretch must start at the point of the shoulder
blade say about 4 in. from the center of the back, and must continue
to the front of armhole. The stretch will throw the front of armhole
forward of whatever the stretch amounts to, and for this reason, the
front of the armhole must be cut 1½ in. backward, of what it is
intended to be. After that artificial wedge is stretched in, the back
side seam may be marked and stitches drawn in, and the forepart
fitted to it and the front of armhole may be cut complete.
That all of this can not be done without trying on ever so many
times is self evident. Otherwise such a job must be made of material
which stretches well, and must be made up thin and the lining put in
plenty large, so it can give, and it would be best to make up without
lining. Nothing can be accomplished by shrinking. Everything must
be done by stretching. Plenty outlets should be left at the neck and
shoulder seams and in front of the breast. Such a coat can not be
fitted on the cutting board, but must be fitted on the body.
May be it is nonsense to write about a seamless coat, but I have
seen so many absurd ideas advanced about cutting garments, that
this may not be the worst. But a cutter who knows the true difference
between coats with different seams, certainly knows more than if he
is compelled to swallow anything the Fashion Reports please to dish
out for us, in the shape of diagrams for new “Styles.”
Narrow and Broad Backs.
In the position of Dia. I or IV, it makes little difference if a back is cut
narrower or wider at the bottom of the armhole, because all parts lie
near to their natural position, which they must assume when the
garment is on the body. A narrower and a broader frock coat back,
cut with the same gore and with the same height as in Dia. II is apt to
change the fit and may spoil it entirely. Dia. I, II, III and IV show a
different height of the back. In Dia. I the height of front is 9 and that
of the back is 14⅜. In Dia. IV the height of back is 14 on line 9 in
front. In Dia. II the height of back is 15, but at the junction of the back
and the sidepiece the line is dislocated and turned up, 15 deg. along
the back. In Dia. III the frock coat back is 14¼ above line 9, and the
sack coat back is only 13½ above line 9, though both sack and frock
coat backs are even, and the same, from top. The difference of
distance, to the point, where both strike line 9 on the front is caused
by the smaller frock coat back and the wider sack coat back at their
junction, and that position must be well understood by a cutter,
because most all diagrams sent out by Reporters of Fashions are
laid out in position as Dia. II, or nearly so, not because it is a true
position, but, because all parts can be cut without piecing.
Now, it must be admitted, that the position of the front, the back
and the sidepiece of Dia. I are nearer in position to the body, at, and
around the waist, than Dia. II or III, and though Dia. I is not in perfect
harmony with the body, we must admit, that Dia. II and III are far
more out of the way. It will be seen, that if the frock coat back of Dia.
I were cut 1 in. wider at the junction with line 9 over the front, it would
become ¼ shorter on top as soon as it was thrown in position of Dia.
II, and the variation would be still greater, if it were done on a broad
sack coat back. Observe that the frock coat back in Dia. III is higher
on and above line 9, but when both are thrown down and in at the
waist and parallel with the front base, both will assume the same
height. As long as all the parts are cut in the same proportion, it
matters little or nothing in what position we place them on the cutting
board, but it matters a great deal whether they are in the right
position when on the body.
The angle of 135 deg. is always the same, and from it the shoulder
slope is 22½ deg., but, if we take the square of 17½ and make
calculations from that base, the shoulder slope is 30 deg., but the
parts are all the same. As long as the diagrams are laid out in a
square of 20, as Dia. I and IV, the back may be made a trifle
narrower or wider, and it will not endanger the fit of the garment,
although it is always bad policy to change a diagram, and particularly
a curved seam. A seam always represents something taken out, or
something placed there, and a seam calculated for a certain point,
and 1 in. one way or the other may make a decided change in the
appearance, or in the fit.
The simplest garment is the vest as far as Merchant Tailoring
goes; but simple as it is, there are seldom two cutters who produce it
in the same way, and with the same result; and the same is true of
coat and pants. This goes far to show that no true system of
garment-cutting is in existence, or if it be, it is in the hands of cutters
who do not know it as such, even by those who may use it—certain it
is, that no such system is in print.
Now, I will consider the vest in its natural position, on a square of
20, although the gore under the arm will bring it out of that position
again as soon as the seam is sewed up. Back and front being in their
natural positions, or nearly so, we can cut the under arm seam
further backward or forward without injury to the fit. But as soon as
we make the width of the back considerably wider or smaller, we find
that the height of the back above the arm-hole changes—when the
back is thrown into an angle of 15 deg., or in a square of 17½. The
smaller the back is cut, on the square of 20, the shorter it will
become above the armscye, when thrown in a square of 17½,
providing always that the turning of the back starts somewhere at
line 9, which crosses line 11¼ under the armhole, at an angle of 15
deg.
When both frock and sack backs are thrown downward and in a
square with line 9, or parallel to the front base, then it will be found
that the backs are all of the same length. Further, I refer to Dia. III,
and line 9 on the front base. Lines 9 and 11¼ cross each other in the
center of a square of 20, and the crossing lines are at an angle of 15
deg., for the simple reason that their bases are 15 deg. apart. The
width of an angle of 15 deg. is ¼ of its length. In the case of forming
a diagram within a circle, and on a diameter of 20 units, as in this
work, we find the half-diameter 10 units, or 10 in., or 10 numbers of
the scale, just as we may please to term it. That angle of 15 deg. is
2½ in. wide at 10 in. length. It spreads ¼ of an inch in every inch of
its length.
Now, in case of cutting a vest, the back and front are cut through
in the center of the square of 20 on line 9, and if the back is swung
into a square of 17½ and parallel to line 11¼, the height of back
remains 14. But had the back been cut 1 in. wider, its height would
be 14¼; and had it been 1 in. smaller, the height would be 13¾. Had
the back been cut 3 in. smaller, as for a sack coat, its height would
become 13¼, and had the back been cut 6 in. smaller, that is, 4 in.
wide, then its height would become 12½ only.
This is a regular “Fig.-mill,” and has been bothering me for the last
ten years, and strange as it may appear, I could never comprehend it
myself, much less explain it to others, until now and during the years
of 1888 and 1889. Here, then, is the result: If we have a good pattern
we cannot change the width of the back while it remains in an angle
of 15 deg., or in a square of 17½, without changing the height above
the armscye. All patterns, or most all of them, are cut in, or pretty
nearly in the position of the angle of 15 deg., or the square of 17½,
for the reason that it is the most convenient way of cutting. A cutter
must understand that; and, although it is convenient to the cutter, the
parts of the garment are in an unnatural position at the waist, and he
must be able to know how much they are at variance.
During the last ten years I have been pronounced as a “crank”
when I claimed that I would yet show, that the height of the top of the
back depended upon its width at the bottom of the armscye and not
upon certain proof measures which are not proof at all. As to
“crankism,” I can console myself with the host of “cranks” who have
preceded me, and who are to-day revolutionizing the world with their
so-called cranky ideas. If it were not for the “cranks,” the oxen would
still be the principal “threshers” of the wheat to-day. Persons of small
minds, and contracted ideas, who have never had an idea which
they could sell for anything, or which anybody would accept for
nothing, are the ones who are quick with reproaching another for
being “cranks.” But the term “crank” has no reproach for me,
because all the various machinery which is used throughout the
world to-day is turned and kept in motion by some kind of a crank, no
matter if it be turned by hand, or foot, or by horse or steam power, or
by electricity. Without “cranks” the world’s machinery would soon
rust, but as long as the boiler is not bursted, or the crank is not
broken, just so long will we be kept flying, and by constant friction,
we will be kept bright, and we shall be able to fulfill our destiny in this
world, by doing our share toward making mankind, whatever the
Supreme Architect has ordained it to be.
Garment fitting is not a positive rule. A garment is not made of
sheet iron, where every sixteenth of an inch variation would give a
great amount of friction. A garment that cannot stand one-eighth to
one-fourth of an inch variation on almost any point is a misfit from
the start. Again, the present style of men’s garments is loose—
always has been and always will be. Even when tight pants were in
fashion they were loose over the body itself. Who will be umpire in
the case of fits? Who will prove that a certain pants leg must be just
so wide in order to make a fit, or conform to style? Who will contend
that the waist of a coat must have just so much space, and no more
nor less, to make a fit? Almost any reasonably well fitting coat can
stand a little alteration in the heighth of the neck one way or another
without injuring it. A well balanced 36 coat will hang well on sizes 35
and 37. If that is the case (and very few will dispute it), then it proves
that a well balanced coat may be an excellent fit even if it has more
or less cloth surface in some places than it might have.
Dia. III is especially made to illustrate my idea about the width of
the back part of different garments, at the bottom of the armscye.
The vest, with its height of back at 14, might also be placed thereon,
but it is not, because I thought too many lines would spoil the
illustrations.
In practical garment cutting, a cutter is often compelled to cut
some backs narrower or smaller on the same kind of a garment in
order to save material, or in some cases, when a larger garment is to
be cut down to a smaller size, where the points around the back of
the armhole, or at the shoulders, cannot be made even with our
patterns, then it comes handy for a cutter, if he be able, to place
certain quantities on either back or front and take it off on the other.
Whenever that has to be done, lay your garments, or the pattern, out
in a square of 20 or its equivalent, and change the parts in that
position, and the lengths of the backs will take care of themselves.
This brings me to another point. An extremely broad frock coat
back at the bottom line of the armhole requires a pretty straight
sidepiece toward the back, and such a seam may be the better off, if
the back is held a trifle full over the blade; while an extremely narrow
frock coat back requires a very curved sidepiece toward the back,
and such a back should be basted or sewed pretty close on the
sidepiece toward the blade. Each of such backs assumes a different
height of back when laid out in the angle of 15 degrees, and each
requires a different treatment when sewed on the sidepiece.
All the heights of the frock and sack coat backs in this work are
calculated to be of certain width at lines 9 and 11¼ over the front,
and all back widths at that point should be as shown in the diagrams.
The swing of the back, or the turning point of it, is calculated from
line 9, no matter if the back lays in a square of 20, or if the back part
of that line be turned 15 degrees. No article in this work is more
important than this one, and every cutter should make himself
thoroughly familiar with its meaning, because it is a new idea in
garment cutting, and I will predict that in the Twentieth Century all
cutters will recognize that principle. It may be brought to a finer point,
but the principle will stand as long as the square and the compass
are recognized and used. Neither do I expect such recognition
without some “tall kicking” for few men will acknowledge that they
have been groping in the dark while they have been claiming that
they knew all that is worth knowing about garment cutting.
The Neckhole and Shoulder Seam.
If it is not desired to connect the sleeve pattern into the armhole and
on both seams, the shoulder seam may be cut into any shape or
form as long as the balance is retained; but whenever we intend to
connect the sleeve with the armhole, as in Dia. II or VII, we must cut
the normal shoulder seam with a lap or spring of from three-eighths
to one-half at the neck, and which lap must be run down fully to the
middle of the shoulder seam and then reduced to nothing at the
armhole, and in such a shape that the front part is on a curve. On a
vest the angle of 135 degrees furnishes the correct slope, and with
the neck band properly worked and turned up, gives enough spring
around the side of the neck. But a vest collar and necktie give more
bulk, and a coat is also cut closer to the center of the neck, and
consequently a coat requires more width, or spring, in and on top of
the shoulder seam, of which three-eighths is enough and five-eighths
not too much, but it is always better to cut that part close, so that the
collar may be sewed on easily; that is, the sides of the neck
stretched say about one-quarter of an inch. Again, the coat collar
gives more bulk than the vest collar and for this reason the overcoat
requires three-fourths spring, as in Dia. X, which is cut still closer to
the neck.
Policy, no doubt, has caused the fashionable shoulder seam to be
thrown backward of the center of the shoulder, for the reason that it
passes nearer to the shoulder blade, and a curved shoulder seam
helps to fit it. If the shoulder seam were located on top of the
shoulders it could not be curved, but would necessarily be hollow in
the center, though the back and front lap at the neck. The position of
the shoulder seam as in Dia. II allows the sleeve to be connected
with the coat on both the back and front seams, and the lap of sleeve
and shoulder give the sleeve enough width for all fulling purposes,
and the sleeve can never be too large or too small. I have tried my
utmost to lay the shoulders in such a position that no lap would be
found at the shoulder seam; but, after I considered that the back is
never cut on the shoulders, I came to the conclusion that the said
spring might just as well be there, inasmuch as by its use a more
correct sleeve connection can be made.
On account of the lap between the back and front at the shoulder
seam the top of that seam at the neck can not properly be
connected, and for this reason should be notched at the center. The
lap between the back and front of the shoulder seam and toward the
neck may be accounted for in a different way, and as follows: The
diameter of the body at the center of the back and center of front is
almost double what it is at the arms, and if we turn the back forward
and the front backward so that both meet at the shoulder seams,
then the center of the body, or the side of the neck, requires a longer
swing than the side of the body at the arms, hence the three to five-
eighths more at the neck.
The five-eighths lap at about eight numbers from O, may also be
accounted for as being required for the roundness of the shoulder
blade, which is partially reached by the shoulder seam of a coat.
Between the top of the shoulder seam and eight numbers from O,
the lap, of whatever it is made, should not be even, but should be a
trifle less a few inches below the neck, say one-eighth to three-
sixteenth of an inch, as shown in the diagrams. This will give the
finished shoulder a better appearance than if cut and made flat. The
shoulders are hollow there, and the coat must conform to that,
because a coat must fit there to the body and must be made to fit to
the body there, it must hang and balance itself there, and if it don’t fit
there it must make a break, and in fact this is the only place where a
coat is required to actually fit the body.
The shoulder seam for a vest must also be considered in
particular. Dia. IV gives the vest shoulder seam without lap or gore
upon the angle of 135 degs., and the top of back is cut as wide, at
point 5, as the angle of 45 degs., and it may be cut one-half inch
wider in order to bring it fully to the side of the neck, where the spring
is required, but it should not be over 3½ numbers. Dia. IV requires
that in finishing the neck, the neckband must be cut long and sewed
on full at the shoulder seam, say one-quarter inch, or plainer, the
back should be stretched that much at and close to the shoulder
seam. If a cutter prefers to sew the neck band even on the back, he
must allow one-quarter to three-eighths spring at the top of the
shoulder seam, and at the back, starting it about two inches
downward.
Now it will be found that by reducing the spring at the neck of a
coat to nothing, but leaving the five-eighths lap toward the blade, the
great majority of stooping forms may be fitted, for it makes the front
shoulder shorter, and that is all that a forward leaning neck requires.
Stooping persons often throw their shoulders up, and such must be
considered a combination of stooping and square shoulders. The lap
of from three to five-eighths must always depend upon how the collar
is sewed on. A three-eighths lap and one-quarter stretch of the neck-
hole makes a better shoulder than a five-eighths lap with the collar
sewed on close. A tight collar around the back and side will always
spoil the shoulder. If a coat be too wide there, sew in the shoulder
seam, but never draw in the side or the back of the neck with a short
collar. A square shoulder may be produced by a lap of one-half
between the back and front shoulder seam toward the shoulder
blade, and no lap at the neck, and placing top of back at 3½. The
armhole itself must be the same for both the square and for the low
shoulder, or the long neck. The lap of the shoulder seam requires
that seam to be nicked as shown in the diagram. It is better all
around if the jour. has a sure point at the middle to connect said
seam, when he can baste up and down. He is less apt to throw one
side up and the other down than if he makes the connection at the
neck or at the armhole. To connect the shoulder seam with a
satisfactory result, square up from line 11¼ and in front of armhole,
and nick each back and each front on said line, which is even, to
moving the forepart down on the front plumb line until the shoulders
meet. In sewing the shoulder seam together the back should always
be a trifle the fullest, because the back passes over the round
shoulder blade and the front passes over the hollow on top of the
shoulders, and should be stretched a trifle. By a trifle I mean about
one-eighth of an inch on each side of the nick.
Locating the connecting point at the center in the shoulder seam,
the jour. must be instructed to baste up and down, and if any part is
too wide at the neck or at the armhole, to trim it off or let it stand as
an outlet, but in all cases insist that both neck and armhole must
have a nice slope after the collar is sewed on, or the sleeve is sewed
in. If the cutting is done according to this work, there will be no
trouble in obtaining a nice round armhole.
Collars.
(SEE DIA. VII.)
All top collars should be cut bias and without a seam behind. All
under collars should be put on rather loose, but not full, at the side of
the neck. The principle of a standing collar must be well understood,
for it is a permanent thing, and to be applied equally in the
construction of all garments with collars, no matter if it is standing
alone or if a turn-down piece is attached to it. It is true, a separate
collar can be fitted to the neck in any shape, and may be so fitted
that the forepart and collar meet in front, allowing the standing
portion over the back to go down anywhere. But this is not the
principle for a standing collar, for the reason that it cannot so be
applied on a vest, or any other garment, with the standing collar cut
on the forepart. The neck-band of a vest, or the standing collar of
any garment, has a certain function to perform. Whenever a vest is
on the angle of 135 deg., the neck-hand must lap over the back a
certain distance, as shown in the diagrams. Whenever the neck is
finished, said band is turned upward to the top of the neck, and in so
doing it will form a spring near the shoulder seam to permit the neck
to pass through; and it is just the same whether a turn-down piece or
a turn-down collar is attached to it or not. If the neck-band is cut too
low behind, it will form too much spring and the vest will be too wide
at the side of the neck, and must be shrunk, which will never make a
well-fitting job. If the band is cut too high at the back center, it will not
have spring enough at the side, and the vest must be stretched,
which, however, can be done better than if drawn in. But in either
case, whether stretching or shrinking is required, I would advise the
band being ripped open, the stiffening taken out, and re-shaped
under the iron, which can easily be done. If a garment is worth
altering at all, it is worth altering correctly.
A coat or vest of the present style, and likely to be for many years
to come, is intended to reach up to the side of the neck where it (the
neck) shoots nearly straight upward. The collar being an addition to
the coat, it must be so constructed that it will turn aside and permit
the neck to pass through. Now, the position of the standing part of a
coat collar must be the same as on a vest, where the standing collar
is not cut off, for it performs the same function. Take any good coat
pattern that is furnished by a reliable firm and lay the parts out as in
this book, and put the bottom of the standing part of the collar at the
point indicated in the vest diagrams, and you will find that the front of
the neck and front of the collar will not fit together, but lap over each
other from 1 to 3 in. according to the size of the roll. The more it laps,
the less roll it will produce, and if the collar and neck-hole were cut
evenly in front, the collar would pull the lapel down to the bottom of
the skirt. (See Dia. VII.)
I must repeat, however, that it is almost impossible to give a
positive distance for the lap of the coat lapel, or a positive shape of
the collar. We must watch fashion, and see how high the standing
collar is, how much the turn-down is behind, or how wide the front is
to be. A competent coat-maker can take almost any piece of bias
cloth and canvas and press it into shape to make a good collar, but
experience proves that not all coat-makers will or can do it. A vest
with the standing collar cut off must have the neck cut out at the
side, and at the angle of 45 deg., at least from 4½ to 4¾; because
the sewed-on standing collar must fill the place of the neck-band of a
vest with the collar cut on. All vests with the standing collar cut on
should have the top of the back cut as wide as the angle of 45 deg.
at least, in order to bring the spring, created by the turning upward of
the neck-band, to the side of the neck. If the top of the back is cut
too narrow the spring will locate too far behind, and will be loose
there, while at the side of the neck it may be too tight. All vests, with
and without turn-down collars, should be cut alike at the neck. The
turn-down part of the collar is simply a piece cut just like the neck of
the vest, as shown in Dia. IV.
Now, it should be observed that if Dia. IV is made without a turn-
down collar the edge must be turned in, consequently it loses a
seam at the side of the neck, which seam must be reduced on a vest
with a turn-down collar, because the edge is not turned in, but
covered over with the top collar, and the difference should be at least
⅜ of an inch—that is, for a turn-down collar the neck-band at the
side of the neck should be reduced ⅜ of an inch, starting at the
center of the back and running out to nothing anywhere in front. In all
cases the bottom of the neck-band remains at 5 on the angle of 45
deg., as in Dia. IV. This manner of cutting a vest for a turn-down
collar enables the cutter to curve the neck just as he pleases, as the
turn-down piece will always follow the curve.
In this connection it would, no doubt, be proper to speak of the
cutting of the top-collar and its dressing, or pressing in shape, before
it is put on, in order to produce the curve of the flat top-collar.
To cut the top-collar, turn the underside upward in front and above
the top button, and even with the fore-part as far up as possible.
According to the prominence of the curve, the top of the under-collar
will fall over toward the arm-hole and toward the shoulder seam, and
in this shape the top-collar must be cut; and, by all means, should be
on the bias, on the most hollow part of the curve. In making up, the
inside part of the top-collar must be well stretched, and pressed over,
and shaped to the curve of the under-collar, and for this reason must
be cut bias. The collar and the whole facing can be dressed under
the smoothing iron just as the curve of the vest requires it by turning
and pressing the standing collar part under. It requires a few extra
touches to shape the top collar, and some cloth may be wasted in
order to get it bias, but this is the best manner in which to make a
well curved collar on a low-cut vest.
If any one will look up the authority on the cutting of garments of
from 30 to 40 years ago, and particularly the works of Genio C.
Scott, he will find that at that time vests “without” collars were
produced by sewing on a neck-band with a “V” attached to it in the
same shape as I have shown the front of the standing collar part in
Dia. VII. This “V” sewed in produced the spring at the side of the
neck. That sometimes proved a difficult task for me while learning
the trade in order to get in a nice “V,” and I suppose it would be a
difficult task for some of our journeymen of to-day. But the world is
progressing. To-day we accomplish it with a straight piece, and do it
just as well, and perhaps better. All that is necessary for us to
observe is, that the shoulder seam points to the side of the neck
where the spring is required.
But, for the purpose of variety, I will propose another plan. Cut the
vest as in Dia. IV. Leave off the neck-band and simply add ¾ of an
inch to the top of the back and running out to nothing at about 3
inches below the shoulder seam. At the middle of the shoulder seam
commence and put in a spring of about 1 in., giving half to the front
and half to the back; then sew up, and you will find the same task
accomplished.
If we turn the neck-band in Dia. IV upward until it meets with the
top of the back, we shall find that a fold of about 1 inch will form on
and above the shoulder seam, and all that is necessary is to imitate
this by cutting a spring of ½ inch to both the back and front at the top
of the shoulder seam or at point 5. It is somewhat of a question
whether it would be advisable to cut vests in this manner, but they
can be as far as the fit is concerned, more particularly those cut with
a cloth back.
Now I must say a word about coat collars in particular. In visiting
different tailor shops we find that the dressing of the under-collar is
accomplished in many different ways, and for aught I know all may
be right—if they suit the customer, or if the collar is on, as it is
required by the coat. Coats which require a collar to be stretched
nearly into a circle around the back are often cut too low or too wide
at the neck. For such a round-shaped collar may be required to close
well in at the neck, but it will never make an elegant job, and such
coats usually indicate too much cloth in the shape of wrinkles below
the collar, or on the top of the shoulders. A collar must not run with
the slope of the shoulders, but must turn upward at the side of the
neck to permit it to pass through. It must stand up, no matter if a
turn-down part is cut on or if it stands alone, as on military or
clergymen’s coats. A well fitting military or clergyman’s coat requires
for its standing collar nothing but a straight piece of cloth, and sewed
on straight. It will not be too loose at the top, nor will it “saw” the neck
sore in half an hour.
Now, a coat collar, with a turn-down, represents a standing collar
over the top of the back and side of the neck, as shown in Dia. VII,
and on that piece or wedge the turn-down part is added. This wedge,
or the standing collar as shown in Dia. VII, must retain its shape as
on a vest, but as soon as the standing collar is stretched at the
bottom the spring at the neck is destroyed, and a tight or flat collar is
the result at the side of the neck. But to fit the standing collar and
turn-down part together, so that the turn-down part is so much larger
that it will go around the standing part without strain, the collar
should be dressed as follows: Lay the whole under-collar flat on the
table and turn and press the standing part up where it belongs,
without stretching the outer edge of the turn-down part, and the
collar is done. Whatever is trimmed off in front depends upon how far
the lapel is to be drawn down. In this respect we all can learn
something from an ordinary paper collar, which is a quite flat piece of
paper—the break is not on a straight line, but on a curve of about
half an inch at the center behind, and they all fit well. Many a cutter
and many a journeyman would profit by studying the principle of a
turn-down paper collar.
Of late years a great many overcoats, and especially ulsters, have
been made with very wide collars, turning down about five inches or
more. Such necks should be cut with the standing collar on the top of
back and on the side of the forepart and running out to a point at or
near the front sleeve base, and an extra spring of not less than one
inch added to each shoulder seam, and evenly divided on back and
on front. This addition furnishes the standing part of the collar, and
the turn-down collar part is put on, just as it is put on to the vest,
which will give form to the shape of the shoulder and not lie flat, as
most of such collars are seen to-day.
See collar as it is to be pressed.

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21651_fm_ptg01.indd 3 11/20/18 4:03 PM

UNIT 20 Vitamins and Your Health 20-1

UNIT 21 Phytochemicals 21-1

UNIT 22 Diet and Cancer 22-1

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Foundation Knowledge for Thinking about Nutrition 1-5

Jose Luis Pelaez, Inc/Blend Images/Corbis

UNIT 2 The Inside Story about Nutrition and Health 2-1

Diet and Diseases of Western Civilization 2-5

Improving the American Diet 2-9

NUTRITION UP CLOSE Food Types for Healthful Diets 2-11

Review Questions 2-11

UNIT 3 Ways of Knowing about Nutrition 3-1

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NUTRITION UP CLOSE Checking Out a Fat-Loss Product 3-15

UNIT 4 Understanding Food and Nutrition Labels 4-1

UNIT 5 Nutrition, Attitudes, and Behavior 5-1

1747 1750 1762 1771 1774

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21651_fm_ptg01.indd 8 11/20/18 4:03 PM

Review Questions 7-13

UNIT 8 Calories! Food, Energy, and Energy Balance 8-1

Where’s the Energy in Foods? 8-5

NUTRITION UP CLOSE Food as a Source of Calories 8-11

Review Questions 8-12

Overweight and Obesity 9-3

Size Acceptance 9-13

NUTRITION UP CLOSE Are You an Apple? 9-15

Review Questions 9-15

1895 1896 1906 1910 1912

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Weight Control 10-4

John E. Kelly/Photolibrary/Getty Images

NUTRITION UP CLOSE Eating Attitudes Test 11-12

UNIT 21 Phytochemicals 21-1

UNIT 26 Nutrient–Gene Interactions in