Advanced Nutrition And Dietetics In Obesity
Advanced Nutritionand Dietetics in Obesity
Advanced Nutritionand Dietetics in ObesityEdited byCatherine Hankey PhD RDSeries EditorKevin Whelan PhD RD FBDA
This edition first published 2018 2018 by John Wiley & Sons LtdAll rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Adviceon how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.The right of Catherine Hankey to be identified as the author the editorial material in this work has been asserted inaccordance with law.Registered Office(s)John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USAJohn Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UKEditorial Office9600 Garsington Road, Oxford, OX4 2DQ, UKFor details of our global editorial offices, customer services, and more information about Wiley products, visit us atwww.wiley.com.Wiley also publishes its books in a variety of electronic formats and by print‐on‐demand. Some content that appears instandard print versions of this book may not be available in other formats.Limit of Liability/Disclaimer of WarrantyThe contents of this work are intended to further general scientific research, understanding, and discussion only and arenot intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment byphysicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmentalregulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the readeris urged to review and evaluate the information provided in the package insert or instructions for each medicine,equipment, or device for, among other things, any changes in the instructions or indication of usage and for addedwarnings and precautions. While the publisher and authors have used their best efforts in preparing this work, theymake no representations or warranties with respect to the accuracy or completeness of the contents of this work andspecifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness fora particular purpose. No warranty may be created or extended by sales representatives, written sales materials orpromotional statements for this work. The fact that an organization, website, or product is referred to in this work as acitation and/or potential source of further information does not mean that the publisher and authors endorse theinformation or services the organization, website, or product may provide or recommendations it may make. This workis sold with the understanding that the publisher is not engaged in rendering professional services. The advice andstrategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate.Further, readers should be aware that websites listed in this work may have changed or disappeared between when thiswork was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any othercommercial damages, including but not limited to special, incidental, consequential, or other damages.Library of Congress Cataloging‐in‐Publication data applied forISBN: 9780470670767(PB)Cover Design: WileySet in 9/11.5pt Times by SPi Global, Pondicherry, India10987654321
ADVANCED NUTRITION AND DIETETICS BOOK SERIESDietary recommendations need to be based on solid evidence, but where can you find this information?The British Dietetic Association and the publishers of the Manual of Dietetic Practice present an essentialand authoritative reference series on the evidence base relating to advanced aspects of nutrition and dieteticsin selected clinical specialties. Each book provides a comprehensive and critical review of key literature inthe area. Each covers established areas of understanding, current controversies and areas of future development and investigation, and is oriented around six key themes: Disease processes, including metabolism, physiology and genetics Disease consequences, including morbidity, mortality and patient perspectives Clinical investigation and management Nutritional consequences of disease Nutritional assessment, including anthropometric, biochemical, clinical, dietary, economic and socialapproaches Nutritional and dietary management of diseaseTrustworthy, international in scope, and accessible, Advanced Nutrition and Dietetics is a vital resource fora range of practitioners, researchers and educators in nutrition and dietetics, including dietitians, nutritionists,doctors and specialist nurses.
ContentsPreface Foreword Editor biographies Contributors Abbreviations SECTION 1 Introduction 1.11.21.31.41.5Definition, prevalence and historical perspectives of obesity in adultsDefinition, prevalence and historical perspectives of obesity in childrenDevelopment of overweight and obesity across the life courseDiagnostic criteria and assessment of obesity in adultsDiagnostic criteria and assessment of obesity in childrenixxixiiixvxix1311182431SECTION 2 Consequences and comorbidities associated with obesity392.12.22.341492.42.52.6Obesity in the development of type 2 diabetesObesity in the development of cardiovascular diseaseObesity as a risk factor in the development of cancerObesity as a risk factor in osteoarthritis and pulmonary diseasePsychology and mental health issues in obesityBinge eating and obesitySECTION 3 Aetiology of obesity in adults 3.13.23.33.43.53.63.7Genetics and epigenetics in the aetiology of obesityFood intake and appetite in the aetiology of obesityPhysiological control of appetite and food intakeObesogenic medication in the aetiology of obesityGut microbiome in obesityPhysical activity and physical inactivity in the aetiology of obesityObesogenic environment and obesogenic behaviours56647178858797106113118126132
viiiContentsSECTION 4 Weight management in .16Macronutrient composition for weight loss in obesityMeal replacements for weight loss in obesityFormula diets for weight loss in obesityGroup‐based interventions for weight loss in obesityCommercial weight management organisations for weight loss in obesityFad diets and fasting for weight loss in obesityPharmacological management of weight loss in obesityDiet to support pharmacological management of weight lossSurgical management of weight loss in obesityDiet to support surgical management of weight lossPhysical activity for weight loss in obesityPsychological interventions for weight loss in obesityWeight loss interventions in specific groups: overweight and obese menWeight loss interventions in specific groups: Adults with intellectualdisabilities and obesityWeight maintenance following weight loss in obesityEconomic cost of obesity and the cost‐effectiveness of weight management235242252SECTION 5 Aetiology of obesity in children2615.15.25.3263271277Genetics, epigenetics and obesity: focus on studies in childrenFood intake, eating behaviour and obesity in childrenPhysical activity and inactivity in the aetiology of obesity in childrenSECTION 6 Weight management in t in the management of weight loss in childhood obesityPhysical activity in the management of weight loss in childhood obesityPsychological and behavioural interventions in childhood obesityResidential programmes and weight loss camps in childhood obesityPharmacological management of weight loss in childhood obesitySurgical management of weight loss in childhood obesitySECTION 7 Public health and the prevention of obesity7.17.27.3National campaigns to modify eating behaviour in theprevention of obesityIncreasing physical activity to prevent childhood obesityDesigning public health initiatives for the prevention of obesity329331339349Index 355
PrefaceObesity, which is often described using terms suchas fat, stout or corpulent, is in fact derived from theLatin word obesus. Obesity is a disease, and as suchhas had an International Classification of Diseasecode since just after World War II. Despite havingthe status and recognition as a disease, obesitytreatment has often been overlooked as a regularcomponent of medical management. Comorbiditiesassociated with obesity, such as type 2 diabetes,hypertension and hyperlipidaemia, have themselvesbeen treated, while interventions that aim to reducebody weight are less rigorously and consistentlyemployed.The first clinical guidelines for obesity were published in 1996, advocating roles and responsibilitiesfor a range of health professionals – includingdoctors (general practitioners/family physicians),nurses and dietitians – to manage obesity. In thelight of these clinical guidelines, researchers soughtthe views of health professionals whose practicewas either in the community (primary care) or in aspeciality based in a hospital (secondary care).Hospital consultants across all specialities agreedthat effective weight management could, withoutexception, improve treatment outcomes. However,none had a treatment protocol in place, suggestingthat obesity management was ad hoc. A majorityfelt unable to resource weight management, suggesting that community (primary care) and generalpractice were more suitable as locations for treatment. General practice staff, general practitionersand practice nurses also felt that reduction in bodyweight would improve the health of many adultswho consulted them. Once more, they themselvesfelt unable, for the same reasons, to address theneed for weight loss as part of their care. Manyconsidered obesity an inevitable result of aging, anintractable and persistent condition and a time‐consuming issue that they were unable to treateffectively. Any treatments they considered werelong term, resource intensive and only poorly effective. Sadly, these data from the 1990s have beenreplicated many times.Advanced Nutrition and Dietetics in Obesitytakes on the huge task of describing the aetiologyof obesity across the life course. There are largesections devoted to the disease in children and inadults. Treatments including surgical, pharmacological and lifestyle interventions are considered.Prevention of weight gain and obesity, the role ofthe environment, new town design and transportpolicy too are discussed. The occurrence of obesityhas reached epidemic proportions worldwide, andthis text aims to provide the reader with a broadunderstanding of the multifactorial causes of excessive and unwanted weight gain. After reading thisbook, I hope the reader will feel that obesity is not asimple problem, but a global phenomenon that ismultifactorial in nature, requiring a multidisciplinaryapproach for management and prevention. Mucheffort, commitment and research are still required tochallenge this chronic and persistent disease.This book is aimed at all those whose workembraces any aspect of obesity. This includes clinicians, researchers, public health experts, educatorsand health economics specialists. Those undertaking further studies in health and disease too mayfind this a useful reference and resource.Catherine Hankey PhD RDSenior Lecturer in Human NutritionUniversity of Glasgow, UKEditorAdvanced Nutrition and Dietetics in Obesity
x PrefaceThis book is the third title in a series (AdvancedNutrition and Dietetics Book Series) commissionedas part of a major initiative between the BritishDietetic Association and Wiley. Each book in theseries provides a comprehensive and critical review ofthe key literature in a clinical area. Each book isedited by one or more experts who have themselvesundertaken extensive research and published widelyin the relevant topic area. Each book chapter is writtenby experts drawn from an international audienceand from a variety of disciplines as required of therelevant chapter (e.g. dietetics, medicine, public health,psychology, biomedical sciences). A future title inthis series will cover nutritional support.The editor and I are proud to present the third titlein the series, Advanced Nutrition and Dietetics inObesity. We hope that it will impact on healthprofessionals’ understanding and application of nutrition and dietetics in the management and preventionof obesity. Effective weight management improvesthe health of both adults and children. Prevention ofthe chronic weight gain of adulthood in many partsof the world are essential, and approaches to addressthis issue so far are discussed.Kevin Whelan PhD RD FBDAProfessor of DieteticsKing’s College London, UKSeries EditorAdvanced Nutrition and Dietetics Book Series
ForewordThis book is a very timely synthesis of the dimensions of the problems of obesity and how to managethem in what is rapidly now becoming the mostintractable issue in both clinical management andpublic health across the globe. This book, writtenby contributors from the UK, Europe and throughoutthe world, comes at a time when it looks as thoughpoliticians are finally waking up to the fact thathealth services are already overwhelmed by thenumbers of people with multiple obesity‐relatedconditions. As healthcare professionals becomeever more sophisticated at coping with the immediate risk factors of type 2 diabetes and cardiovasculardisease, we still see most clinical teams neglectingobesity as the underlying driver, with all its proximal causes. Given the magnitude of the currentlyescalating health burden, it is timely that this book,essentially geared to the clinical teams involved inobesity prevention and treatment, is now published.The descriptions cover the full range of new ideasand evidence of both the underlying pressures onthe majority of our population and how to beginto effectively manage such a challenging organisational and multidimensional problem.Many of these expert contributors have decades ofexperience in trying to establish effective approachesto the management and prevention of obesity. Thehistorical account emphasises the struggle thathas gone on for decades, with the first semi‐officialreports on appropriate clinical schemes for managing the problem only emerging 20 years ago in bothScotland and the USA. Much of the drive, as isusual in medical management, has come with thesearch for suitable pharmacological strategies;nevertheless, as other chapters emphasise, the neglectof the transformation of both the dietary modification and physical activity required necessitates notonly an understanding of the underlying featuresof appetite control but also the need for routinephysical activity incorporated into most individuals’normal habits. There are very authoritative accountsof the genetic, endocrinological and clinical aspectsof the epidemic in adults as well as in children, inwhom obesity only emerged in the last 20 years as amajor burden in paediatric practice. Although thechildhood obesity epidemic seems to be slowing inmany European countries, the overall prevalence ofchildhood overweight and obesity are still horrifying.Hence, we can expect to see vicious combinationsof genetic and epigenetic influences as thesechildren and the next generation enter adulthood,with their clinical care becoming ever more difficult. Thus, young overweight women now enteringpregnancy seem unaware of the challenges that newresearch suggests lies in wait for their families andfamily practitioners. With rapidly rising rates ofgestational diabetes, especially in Europe’s ethnicminorities, we are already witnessing far earlieronsets of adult abdominal obesity and type 2 diabetes, with its sustained challenges for maintainingmedical care of chronically sick patients. Thechapters on the co‐morbidities should thereforehelp to amplify a broader approach to the management of an array of risk factors, and this bookbenefits from adding musculoskeletal and psychological comorbidities to the traditional cardiovascularfoci of concern.There are very appropriate chapters first on thediagnostic criteria that should be used in bothscreening and monitoring clinical progress in childrenand adults, followed by a comprehensive description and analysis of dietary approaches that havebeen tried and progressively evaluated. Then comeassessments of the value of pharmacological and
xiiForewordsurgical management, as well as interventions toimprove physical activity levels.Fitting all this together with the issues of obesity prevention and how this can link into clinicalpractice is a real challenge. This book thereforegives us both an overview and the detail that is sonecessary if we are to engineer a revolution inclinical practice. One just wishes that the manyintegrated contributions could have been produceda decade ago, but then we would not have benefittedfrom so much of the new research and analysesthat are presented here.W. Philip T. JamesProfessor, London School of Hygiene andTropical MedicinePast president of the World Obesity Federation
Editor biographiesCatherine Hankey PhD RDCatherine Hankey is a Senior Lecturer in HumanNutrition in the School of Medicine at the Universityof Glasgow. Her research investigates clinical andpublic health aspects of obesity and weight management. Examples of research include the optimization of weight management during smokingcessation and in those with intellectual disabilities.Dr Hankey was a group member for the ScottishIntercollegiate Guidelines Network (SIGN) guideline for the Management of Obesity and the updateof the SIGN prevention and management of cardiovascular disease. She is the author of the WeightManagement chapter in the Manual of DieteticPractice and is co-editing the forthcoming versionof the ABC of Nutrition.Kevin Whelan PhD RD FBDAKevin Whelan is the Professor of Dietetics and theHead of Department of Nutritional Sciences at King’sCollege London. He is a Principal Investigator leading a research programme exploring the interactionbetween the gastrointestinal microbiota, diet andhealth and disease. In 2012 he was awarded theNutrition Society Cuthbertson Medal for researchin clinical nutrition and in 2017 was appointed aFellow of the British Dietetic Association. ProfWhelan is on the editorial boards of AlimentaryPharmacology and Therapeutics and the Journal ofHuman Nutrition and Dietetics and is the SeriesEditor for the British Dietetic Association AdvancedNutrition and Dietetics book series.
ContributorsGhalia Abdeen PhDLecturer in NutritionKing Saud UniversityRiyadh, Saudi ArabiaKaren Allan PhD RDAHP Practice Education CoordinatorNHS Education for ScotlandEdinburgh, Scotland, UKWerd Al‐Najim PhDPostdoctoral ResearcherUniversity College DublinDublin, IrelandAnnie S Anderson PhD RDProfessor of Public Health NutritionUniversity of DundeeDundee, UKDaryll Archibald PhDResearch FellowUniversity of EdinburghEdinburgh, UKAlison Avenell MD FRCPProfessor of Health Services ResearchUniversity of AberdeenAberdeen, UKAmanda Avery PhD RDAssistant Professor in Nutrition and DieteticsUniversity of NottinghamNottingham, UKPanagiotis Balaskas MScUniversity of GlasgowGlasgow, UKJohn E Blundell PhDProfessor of PsychobiologyUniversity of LeedsLeeds, UKEmma J Boyland PhDLecturer in Psychological SciencesUniversity of LiverpoolLiverpool, UKWendy J Brown PhDProfessor of Physical Activity and HealthUniversity of QueenslandQueensland, AustraliaDuff Bruce MBChB FRCSVisiting Professor of SurgeryRobert Gordon UniversityAberdeen, UKJohannes Brug PhDProfessor of EpidemiologyEMGO Institute for Health and Care ResearchAmsterdam, NetherlandsJanet Cade PhD RNutrProfessor of Nutritional Epidemiologyand Public HealthUniversity of LeedsLeeds, UKMagdalin Cheong MPH RDHead of Department of Dietetics and Food ServicesChangi General Hospi
No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any . The right of Catherine Hankey to be identified as the author the editorial material in this work has been asserted in accordance with law. Registered Office(s) John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA
Dietetics and Nutrition Practice Council www.flrules.org Revised September 2019 Page 4 of 37 468.501 Short title.—This part may be cited as the “Dietetics and Nutrition Practice Act.” History.—ss. 1, 20, ch. 88-236; s. 4, ch. 91-429; s. 1, ch. 96-367. 468.502 Purpose and intent.—The Legislature finds that the practice of dietetics and nutrition
Advanced Nutrition and Dietetics Book Series. Foreword. It is an honour and a privilege to write a foreword for this exceptional book devoted to nutrition and dietetics in gastrointestinal health and disease. Nutrition is a majo
When hiring employees for work in the nutrition/dietetics field, employers look for the RD credential. In fact, most positions in the nutrition/dietetics field require it JOBS/CAREERS IN DIETETICS AND NUTRITION You will find dietitians working in a wide variety of employment settings and in a variety of sp
Dietetics and Applied Nutrition students in culinary labs such as Vegetarian Cuisine and also participate in undergraduate courses such as Medical Nutrition Therapy and Advanced Medical Nutrition Therapy. Dietetics and Applied Nutrition students can participate in unde
TEXT BOOKS 1. Shubhangini A. Joshi,(1992)' "Nutrition and Dietetics"Tata Mc Grow- Hill publishing Company Ltd, New Delhi. 2. Srilakshmi. B - "Nutrition Science", V Edn, New Age International (P) Ltd, Publishers, Chennai REFERENCE BOOKS 1. Passmone R.and Eastwood M.A,(1986), "Human Nutrition and Dietetics",English language book
Mary Pat Raimondi, MS, RD VP Strategic Policy and Partnerships at Academy of Nutrition and Dietetics Learning Objectives: 1. Outline the member driven structure of the Academy’s legislative platform 2. Share how the Academy of Nutrition and Dietetics' policy priorities initiatives and priorities have been developed and are member driven 3.
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3. Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitian Nutritionists. . J Acad Nutr Diet 2018; 118: 132-140. 4. Academy of Nutrition and Dietetics "Diversity Philosophy Statement" (adopted by the House of Delegates and Board of Directors .
