Understanding Normal and Clinical Nutrition

free

"nutritionally trivial" and unlikely to have a physiological con- sequence; synonyms include without, no, and zero. A food that does not contain a nutrient naturally may make such a claim, but only as it applies to all similar foods (for example, "applesauce, a fat-free food").

low saturated fat

1 gram or less of saturated fat and less than 0.5 gram of trans fat per serving.

high potency

100% or more of the Daily Value for the nutrient in a single supplement and for at least two-thirds of the nutrients in a multinutrient supplement.

low sodium

140 milligrams or less per serving.

low cholesterol

20 milligrams or less of cholesterol per serving and 2 grams or less of saturated fat and trans fat combined per serving.

high

20 percent or more of the Daily Value for a given nutrient per serving; synonyms include rich in or excellent source of.

less cholesterol

25 percent or less cholesterol than the comparison food (reflecting a reduction of at least 20 milligrams per serving), and 2 grams or less of saturated fat and trans fat combined per serving.

less fat

25 percent or less fat than the comparison food.

less saturated fat

25 percent or less of saturated fat and trans fat combined than the comparison food.

low fat

3 grams or less of fat per serving.

very low sodium

35 milligrams or less per serving.

low kcalorie

40 kcalories or less per serving.

high fiber

5 grams or more of fiber per serving. A high-fiber claim made on a food that contains more than 3 grams of fat per serving and per 100 grams of food must also declare total fat.

websites

Internet resources composed of text and graphic files, each with a unique URL (Uniform Resource Locator) that names the site (for example, www.usda.gov).

small intestine

a 10-foot length of small-diameter intestine that is the major site of digestion of food and absorption of nutrients. Its segments are the duodenum, jejunum, and ileum.

acetyl CoA (ASS-eh-teel or ah-SEET-il, coh-AY)

a 2-carbon compound (acetate or acetic acid) to which a molecule of CoA is attached.

lactate

a 3-carbon compound produced from pyruvate during anaerobic metabolism.

pyruvate (PIE-roo-vate)

a 3-carbon compound that plays a key role in energy metabolism.

vitamin B12

a B vitamin characterized by the presence of cobalt. The active forms of coenzyme B12 are methylcobalamin and deoxyadenosylcobalamin.

biotin (BY-oh-tin)

a B vitamin that functions as a coenzyme in metabolism.

thiamin (THIGH-ah-min)

a B vitamin. The coenzyme form is TPP (thiamin pyrophosphate).

riboflavin (RYE-boh-flay-vin)

a B vitamin. The coenzyme forms are FMN (flavin mononucleotide) and FAD (flavin adenine dinucleotide).

niacin (NIGH-a-sin)

a B vitamin. The coenzyme forms are NAD (nicotinamide adenine dinucleotide) and NADP (the phosphate form of NAD). Niacin can be eaten preformed or made in the body from its precursor, tryptophan, an essential amino acid.

pantothenic (PAN-toe-THEN-ick) acid

a B vitamin. The principal active form is part of coenzyme A, commonly called "CoA".

folate (FOLE-ate)

a B vitamin; also known as folic acid, folacin, or pteroylglutamic (tare-o-EEL-glue-TAM-ick) acid (PGA). The coenzyme forms are DHF (dihydrofolate) and THF (tetrahydrofolate).

clinically severe obesity

a BMI of 40 or greater or a BMI of 35 or greater with additional medical problems. A less preferred term used to describe the same condition is morbid obesity.

osteopathic (OS-tee-oh-PATH-ic) manipulation

a CAM technique performed by a doctor of osteopathy (D.O., or osteopath) that includes deep tissue massage and manipulation of the joints, spine, and soft tis- sues. A D.O. is a fully trained and licensed medical physician, although osteopathic manipulation has not been proved to be an effective treatment.

low birthweight (LBW)

a birthweight of 5½ pounds (2500 grams) or less; indicates probable poor health in the newborn and poor nutrition status in the mother during pregnancy, before pregnancy, or both. Optimal birthweight for a full-term baby is about 6½ to 8 pounds.

thrombus

a blood clot formed within a blood vessel that remains attached to its place of origin.

pernicious (per-NISH-us) anemia

a blood disorder that reflects a vita- min B12 deficiency caused by lack of intrinsic factor and characterized by abnormally large and immature red blood cells. Other symptoms include muscle weakness and irreversible neurological damage.

peripheral blood smear

a blood sample spread on a glass slide and stained for analysis under a microscope. Peripheral refers to the use of circulating blood rather than tissue blood.

cyanosis (sigh-ah-NOH-sis)

a bluish cast in the skin due to the color of deoxygenated hemoglobin. Cyanosis is most evident in individuals with lighter, thinner skin; it is mostly seen on lips, cheeks, and ears and under the nails.

peptide bond

a bond that connects the acid end of one amino acid with the amino end of another, forming a link in a protein chain.

osteomalacia (OS-tee-oh-ma-LAY-shuh)

a bone disease characterized by softening of the bones. Symptoms include bending of the spine and bowing of the legs. The disease occurs most often in adult women.

renal osteodystrophy

a bone disorder that develops in patients with chronic kidney disease as a result of increased secretion of parathyroid hormone, reduced serum calcium, acidosis, and impaired vitamin D activation in the kidneys.

hypothalamus (high-po-THAL-ah-mus)

a brain center that controls activities such as maintenance of water balance, regulation of body temperature, and control of appetite.

heartburn

a burning sensation in the chest region.

whey protein

a by-product of cheese production; falsely promoted as increasing muscle mass. Whey is the watery part of milk that separates from the curds.

osteocalcin (os-teo-KAL-sen)

a calcium-binding protein in bones, essential for normal mineralization.

calmodulin (cal-MOD-you-lin)

a calcium-binding protein that regulates such cell activities as muscle contractions.

calbindin

a calcium-binding transport protein that requires vitamin D for its synthesis.

oxaloacetate (OKS-ah-low-AS-eh-tate)

a carbohydrate intermediate of the TCA cycle.

magnesium

a cation within the body's cells, active in many enzyme systems.

allergy

a certain type of hypersensitivity reaction, characterized by an inappropriate immune response to a harmless substance.

placebo effect

a change that occurs in response to expectations about the effectiveness of a treatment that actually has no pharmaceutical effects.

hydrogenation (HIGH-dro-jen-AY-shun or high-DROJ-eh-NAY-shun)

a chemical process by which hydrogens are added to monounsaturated or polyunsaturated fatty acids to reduce the number of double bonds, making the fats more saturated (solid) and more resistant to oxidation (protecting against rancidity). Hydrogenation produces trans-fatty acids.

neuropeptide Y

a chemical produced in the brain that stimulates appetite, diminishes energy expenditure, and increases fat storage.

hydrolysis (high-DROL-ih-sis)

a chemical reaction in which one molecule is split into two molecules, with hydrogen (H) added to one and a hydroxyl group (OH) to the other (from water, H2O). (The noun is hydrolysis; the verb is hydrolyze.)

condensation

a chemical reaction in which water is released as two molecules combine to form one larger product.

acne

a chronic inflammation of the skin's follicles and oil-producing glands, which leads to an accumulation of oils inside the ducts that surround hairs; usually associated with the maturation of young adults.

coronary heart disease (CHD)

a chronic, progressive disease characterized by obstructed blood flow in the coronary arteries; also called coronary artery disease.

sphincter (SFINK-ter)

a circular muscle surrounding, and able to close, a body opening. Sphincters are found at specific points along the GI tract and regulate the flow of food particles.

proton-pump inhibitors

a class of drugs that inhibit the enzyme that pumps hydrogen ions (protons) into the stomach. Examples include omeprazole (Prilosec) and lansoprazole (Prevacid).

histamine-2 receptor blockers

a class of drugs that suppress acid secretion by inhibiting receptors on acid-producing cells; commonly called H2 blockers. Examples include cimetidine (Tagamet), ranitidine (Zantac), and famotidine (Pepcid).

alcohol

a class of organic compounds containing hydroxyl (OH) groups.

metabolic syndrome

a cluster of interrelated disorders, including abdominal obesity, insulin resistance, high blood pressure, and abnormal blood lipids, which together increase the risk of diabetes and cardiovascular disease; also known as insulin resistance syndrome or syndrome X.

fetal alcohol syndrome (FAS)

a cluster of physical, behavioral, and cognitive abnormalities associated with prenatal alcohol exposure, including facial malformations, growth retardation, and central nervous disorders.

dumping syndrome

a cluster of symptoms that result from the rapid emptying of an osmotic load from the stomach into the small intestine.

diabetic coma

a coma that occurs in uncontrolled diabetes; may be due to diabetic ketoacidosis, the hyperosmolar hyperglycemic syn- drome, or severe hypoglycemia. Diabetic coma was a frequent cause of death before insulin was routinely used to manage diabetes.

Kaposi's (kah-POH-seez) sarcoma

a common cancer in HIV-infected persons that is characterized by lesions in the skin, lungs, and GI tract.

gout (GOWT)

a common form of arthritis characterized by deposits of uric acid crystals in the joints.

ATP, or adenosine (ah-DEN-oh-seen) triphosphate (try-FOS-fate)

a common high-energy compound composed of a purine (adenine), a sugar (ribose), and three phosphate groups. ATP 5 A-P~P~P, with each ~ denoting a "high-energy" bond.

herpes simplex virus

a common virus that can cause blisterlike lesions on the lips and in the mouth.

antagonist

a competing factor that counteracts the action of another factor. When a drug displaces a vitamin from its site of action, the drug renders the vitamin ineffective and thus acts as a vitamin antagonist.

salt

a compound composed of a positive ion other than H+ and a negative ion other than OH-. An example is sodium chloride (Na+Cl-).

dolomite

a compound of minerals (calcium magnesium carbonate) found in limestone and marble. Dolomite is powdered and is sold as a calcium-magnesium supplement. However, it may be contaminated with toxic minerals, is not well absorbed, and interferes with absorp- tion of other essential minerals.

RNA (ribonucleic acid)

a compound similar to DNA, but RNA is a single strand with a ribose sugar instead of a deoxyribose sugar and uracil instead of thymine as one of its bases.

phospholipid (FOS-foe-LIP-id)

a compound similar to a triglyceride but having a phosphate and choline (or another nitrogen-containing compound) in place of one of the fatty acids.

catalyst (CAT-uh-list)

a compound that facilitates chemical reactions without itself being changed in the process.

ammonia

a compound with the chemical formula NH3, produced during the deamination of amino acids.

carbonic acid

a compound with the formula H2CO3 that results from the combination of carbon dioxide (CO2) and water (H2O); of particular importance in maintaining the body's acid-base balance.

nutrition assessment

a comprehensive analysis of a person's nutrition status that uses health, socioeconomic, drug, and diet histories; anthropometric measurements; physical examinations; and laboratory tests.

angina (an-JYE-nah or AN-ji-nah) pectoris

a condition caused by ischemia in the heart muscle that results in discomfort or dull pain in the chest region. The pain often radiates to the left shoulder, arms, neck, back, or jaw.

respiratory stress

a condition characterized by abnormal oxygen and carbon dioxide levels in body tissues due to abnormal gas exchange between the air and blood.

eclampsia (eh-KLAMP-see-ah)

a condition characterized by extremely high blood pressure, elevated protein in the urine, seizures, and possibly coma.

preeclampsia (PRE-ee-KLAMP-see-ah)

a condition characterized by high blood pressure and some protein in the urine.

peripheral vascular disease

a condition characterized by impaired blood circulation in the limbs.

heart failure

a condition characterized by the heart's inability to pump adequate blood to the body's cells, resulting in fluid accumulation in the tissues; also called congestive heart failure.

Barrett's esophagus

a condition in which esophageal cells dam- aged by chronic exposure to stomach acid are replaced by cells that resemble those in the stomach or small intestine, sometimes becoming cancerous.

graft-versus-host disease

a condition in which the immune cells in transplanted tissue (the graft) attack recipient (host) cells, leading to widespread tissue damage.

oxidative stress

a condition in which the production of oxidants and free radicals exceeds the body's ability to handle them and prevent damage.

hiatal hernia

a condition in which the upper portion of the stomach protrudes above the diaphragm; most cases are asymptomatic.

hyperosmolar hyperglycemic syndrome

a condition of extreme hyperglycemia associated with dehydration, hyperosmolar blood, and altered mental status; sometimes called the hyperosmolar hyperglycemic nonketotic state.

risk factor

a condition or behavior associated with an elevated frequency of a disease but not proved to be causal. Leading risk factors for chronic diseases include obesity, cigarette smoking, high blood pressure, high blood cholesterol, physical inactivity, and a diet high in added fats and low in vegetables, fruits, and whole grains.

persistent vegetative state

a condition resulting from brain injury in which an awake individual is unresponsive and shows no signs of higher brain function for a prolonged period; usually permanent.

lactose intolerance

a condition that results from the inability to digest the milk sugar lactose; characterized by bloating, gas, abdominal discomfort, and diarrhea. Lactose intolerance differs from milk allergy, which is caused by an immune reaction to the protein in milk.

cretinism (CREE-tin-ism)

a congenital disease characterized by mental and physical retardation and commonly caused by maternal iodine deficiency during pregnancy.

thirst

a conscious desire to drink.

pica (PIE-ka)

a craving for and consumption of nonfood substances. Pica is known as geophagia (gee-oh-FAY-gee-uh) when referring to eating clay, baby powder, chalk, ash, ceramics, paper, paint chips, or charcoal; pagophagia (pag-oh- FAY-gee-uh) when referring to eating large quantities of ice; and amylophagia (AM-ee-low-FAY-gee-ah) when referring to eating uncooked starch (flour, laundry starch, or raw rice).

Bowman's (BOE-minz) capsule

a cuplike component of the nephron that surrounds the glomerulus and collects the filtrate that is passed to the tubules.

subclinical deficiency

a deficiency in the early stages, before the outward signs have appeared.

Alzheimer's (AHLZ-high-merz) disease

a degenerative disease of the brain involving memory loss and major structural changes in neuron networks; also known as senile dementia of the Alzheimer's type (SDAT), primary degenerative dementia of senile onset, or chronic brain syndrome.

food record

a detailed log of food eaten during a specified time period, usually several days; also called a food diary. A food record may also include information regarding medications, disease symptoms, and physical activity.

clear liquid diet

a diet that consists of foods that are liquid at room temperature, require minimal digestion, and leave little residue (undigested material) in the colon.

modified diet

a diet that contains foods altered in texture, consistency, or nutrient content or that includes or omits specific foods; may also be called a therapeutic diet.

regular diet

a diet that includes all foods and meets the nutrient needs of healthy people; may also be called a standard diet, general diet, normal diet, or house diet.

dietetic technician, registered (DTR)

a dietetic technician who has passed a national examination and maintains registration through continuing professional education.

peptidase

a digestive enzyme that hydrolyzes peptide bonds. Tripeptidases cleave tripeptides; dipeptidases cleave dipeptides.

intestinal ischemia (is-KEY-me-ah)

a diminished blood flow to the intestines that is characterized by abdominal pain, forceful bowel movements, and blood in the stool.

sucrose (SUE-krose)

a disaccharide composed of glucose and fructose; commonly known as table sugar, beet sugar, or cane sugar. Sucrose also occurs in many fruits and some vegetables and grains.

lactose (LAK-tose)

a disaccharide composed of glucose and galactose; commonly known as milk sugar.

maltose (MAWL-tose)

a disaccharide composed of two glucose units; sometimes known as malt sugar.

hemorrhagic (hem-oh-RAJ-ik) disease

a disease characterized by excessive bleeding.

osteoporosis (OS-tee-oh-pore-OH-sis)

a disease in which the bones become porous and fragile due to loss of minerals; also called adult bone loss.

rheumatoid (ROO-ma-toyd) arthritis

a disease of the immune system involving painful inflammation of the joints and related structures.

metabolic stress

a disruption in the body's chemical environment due to the effects of disease or injury. Metabolic stress is characterized by changes in metabolic rate, heart rate, blood pressure, hormonal status, and nutrient metabolism.

acetone breath

a distinctive fruity odor on the breath of a person with ketosis.

drink

a dose of any alcoholic beverage that delivers ½ ounce of pure ethanol; for example, 5 ounces of wine, 10 ounces of wine cooler, 12 ounces of beer, or 1½ ounces of liquor (80 proof whiskey, scotch, rum, or vodka).

narcotic (nar-KOT-ic)

a drug that dulls the senses, induces sleep, and becomes addictive with prolonged use.

generic drug

a drug that lacks patent protection. Examples include the sedative diazepam, which is equivalent to the brand-name drug Valium, and the diuretic furosemide, equivalent to the brand-name drug Lasix.

analgesic

a drug that relieves pain.

lipids

a family of compounds that includes triglycerides, phospho- lipids, and sterols. Lipids are characterized by their insolubility in water. (Lipids also include the fat-soluble vitamins.)

vitamin B6

a family of compounds—pyridoxal, pyridoxine, and pyridoxamine. The primary active coenzyme form is PLP (pyridoxal phosphate).

wheat gluten (GLU-ten)

a family of water-insoluble proteins in wheat; includes the gliadin (GLY-ah-din) fractions that are toxic to persons with celiac disease.

saturated fatty acid

a fatty acid carrying the maximum possible number of hydrogen atoms—for example, stearic acid. A saturated fat is composed of triglycerides in which most of the fatty acids are saturated.

polyunsaturated fatty acid

a fatty acid that lacks four or more hydro- gen atoms and has two or more double bonds between carbons; abbre- viated PUFA. Examples include linoleic acid (two double bonds) and linolenic acid (three double bonds). A polyunsaturated fat is composed of triglycerides in which most of the fatty acids are polyunsaturated.

unsaturated fatty acid

a fatty acid that lacks hydrogen atoms and has at least one double bond between carbons (includes monounsaturated and polyunsaturated fatty acids). An unsaturated fat is composed of triglycerides in which most of the fatty acids are unsaturated.

monounsaturated fatty acid

a fatty acid that lacks two hydrogen atoms and has one double bond between carbons; abbreviated MUFA. Examples include palmitoleic acid and oleic acid. A monounsaturated fat is composed of triglycerides in which most of the fatty acids are monounsaturated.

kefir (keh-FUR)

a fermented milk created by adding Lactobacillus acidophilus and other bacteria that break down lactose to glucose and galactose, producing a sweet, lactose-free product.

food and symptom diary

a food record kept by a patient to determine the cause of an adverse reaction; includes the specific foods and bever- ages consumed, symptoms experienced, and the timing of meals and symptom onset.

gluten-free

a food that contains less than 20 parts per million of gluten from any source; synonyms include no gluten, free of gluten, or without gluten.

healthy

a food that is low in fat, saturated fat, cholesterol, and sodium and that contains at least 10 percent of the Daily Values for vitamin D, potassium, iron, calcium, protein, or fiber.

cryptosporidiosis (KRIP-toe-spor-ih-dee-OH-sis)

a foodborne illness caused by the parasite Cryptosporidium parvum.

vulnerable plaque

a form of plaque, highly susceptible to rupture, that is lipid-rich and has only a thin, fibrous barrier separating its lipid core from the arterial lumen.

candidiasis

a fungal infection that can affect mucous membranes of the oral cavity and elsewhere; usually caused by Candida albicans.

pepsin

a gastric enzyme that hydrolyzes protein. Pepsin is secreted in an inactive form, pepsinogen, which is activated by hydrochloric acid in the stomach.

viscous

a gel-like consistency.

Down syndrome

a genetic abnormality that causes mental retarda- tion, short stature, and flattened facial features.

cystic fibrosis

a genetic disorder characterized by abnormal chloride and sodium levels in exocrine secretions; often leads to respiratory ill- ness and pancreatic insufficiency.

cystinuria (SIS-tin-NOO-ree-ah)

a genetic disorder characterized by the elevated urinary excretion of several amino acids, including cystine.

Wilson's disease

a genetic disorder of copper metabolism that creates a copper toxicity and results in neurologic symptoms such as tremors, impaired speech, inappropriate behaviors, and personality changes.

Menkes disease

a genetic disorder of copper transport that creates a copper deficiency and results in mental retardation, poor muscle tone, seizures, brittle kinky hair, and failure to thrive.

hemochromatosis (HE-moh-KRO-ma-toe-sis)

a genetically deter- mined failure to prevent absorption of unneeded dietary iron that is characterized by iron overload and tissue damage.

pancreas

a gland that secretes digestive enzymes and juices into the duodenum. (The pancreas also secretes hormones into the blood that help to maintain glucose homeostasis.)

dermatitis herpetiformis (HER-peh-tih-FOR-mis)

a gluten-sensitive disorder characterized by a severe skin rash.

intrinsic factor

a glycoprotein (a protein with short polysaccharide chains attached) secreted by the stomach cells that binds with vitamin

whole grain

a grain that maintains the same relative proportions of starchy endosperm, germ, and bran as the original (all but the husk); not refined.

experimental group

a group of individuals similar in all possible respects to the control group except for the treatment. The experimental group receives the real treatment.

control group

a group of individuals similar in all possible respects to the experimental group except for the treatment. Ideally, the control group receives a placebo while the experimental group receives a real treatment.

chronic obstructive pulmonary disease (COPD)

a group of lung dis- eases characterized by persistent obstructed airflow through the lungs and airways; includes chronic bronchitis and emphysema.

refeeding syndrome

a group of metabolic abnormalities that may result from aggressive refeeding in severely malnourished persons; characterized by shifts in fluid and electrolyte levels that can lead to organ failure and other complications.

diabetes (DYE-ah-BEE-teez) mellitus

a group of metabolic disorders characterized by hyperglycemia and disordered insulin metabolism. (An unrelated condition with a similar name is diabetes insipidus, a pituitary disorder.)

inflammatory response

a group of nonspecific immune responses to infection or injury.

complement

a group of plasma proteins that assist the activities of antibodies and phagocytes.

dental plaque

a gummy mass of bacteria that grows on teeth and can lead to dental caries and gum disease.

fibrocystic (FYE-bro-SIS-tik) breast disease

a harmless condition in which the breasts develop lumps, sometimes associated with caffeine consumption. In some, it responds to abstinence from caffeine; in others, it can be treated with vitamin E.

Certified Diabetes Educator (CDE)

a health care professional who specializes in diabetes management education; certification is obtained from the National Certification Board for Diabetes Educators.

hemophilia (HE-moh-FEEL-ee-ah)

a hereditary disease in which the blood is unable to clot because it lacks the ability to synthesize certain clotting factors.

sickle-cell anemia

a hereditary form of anemia characterized by abnormal sickle- or crescent-shaped red blood cells. Sickled cells inter- fere with oxygen transport and blood flow. Symptoms are precipitated by dehydration and insufficient oxygen (as may occur at high altitudes) and include hemolytic anemia (red blood cells burst), fever, and severe pain in the joints and abdomen.

mutation

a heritable change in the DNA sequence of a gene.

high energy density

a high number of kcalories per unit weight of food; foods of high energy density are generally high in fat and low in water content.

hypermetabolism

a higher-than-normal metabolic rate.

parathyroid hormone

a hormone from the parathyroid glands that regulates blood calcium by raising it when levels fall too low; also known as parathormone (PAIR-ah-THOR-moan).

angiotensin II

a hormone involved in blood pressure regulation.

erythropoietin (eh-RITH-ro-POY-eh-tin)

a hormone made by the kidneys that stimulates red blood cell production.

epinephrine (EP-ih-NEFF-rin)

a hormone of the adrenal gland that modulates the stress response; formerly called adrenaline. When administered by injection, epinephrine counteracts anaphylactic shock by opening the airways and maintaining heartbeat and blood pressure.

secretin (see-CREET-in)

a hormone produced by cells in the duodenum wall. Target organ: the pancreas. Response: secretion of bicar- bonate-rich pancreatic juice.

cholecystokinin (COAL-ee-SIS-toe-KINE-in), or CCK

a hormone produced by cells of the intestinal wall. Target organ: the gallbladder. Response: release of bile and slowing of GI motility.

hepcidin

a hormone produced by the liver that regulates iron balance.

antidiuretic hormone (ADH)

a hormone produced by the pituitary gland in response to dehydration (or a high sodium concentration in the blood) that stimulates the kidneys to reabsorb more water and therefore to excrete less. In addition to its antidiuretic effect, ADH elevates blood pressure and so is also called vasopressin (VAS-oh-PRES-in).

gastrin

a hormone secreted by cells in the stomach wall. Target organ: the glands of the stomach. Response: secretion of gastric acid.

insulin (IN-suh-lin)

a hormone secreted by special cells in the pancreas in response to (among other things) elevated blood glucose concentration. Insulin controls the transport of glucose from the bloodstream into the muscle and fat cells.

glucagon (GLOO-ka-gon)

a hormone secreted by special cells in the pancreas in response to low blood glucose concentration. Glucagon elicits release of glucose from liver glycogen stores.

aldosterone (al-DOS-ter-own)

a hormone secreted by the adrenal glands that regulates blood pressure by increasing the reabsorption of sodium by the kidneys. Aldosterone also regulates chloride and potassium concentrations.

calcitonin (KAL-seh-TOE-nin)

a hormone secreted by the thyroid gland that regulates blood calcium by lowering it when levels rise too high.

prolactin (pro-LAK-tin)

a hormone secreted from the anterior pituitary gland that acts on the mammary glands to promote the production of milk. The release of prolactin is mediated by prolactin-inhibiting hormone (PIH).

oxytocin (OCK-see-TOH-sin)

a hormone that stimulates the mammary glands to eject milk during lactation and the uterus to contract during childbirth.

lactase deficiency

a lack of the enzyme required to digest the disaccharide lactose into its component monosaccharides (glucose and galactose).

durable power of attorney

a legal document (sometimes called a health care proxy) that gives legal authority to another (a health care agent) to make medical decisions in the event of incapacitation.

peptic ulcer

a lesion in the mucous membrane of either the stomach (a gastric ulcer) or the duodenum (a duodenal ulcer).

ulcer

a lesion of the skin or mucous membranes characterized by inflammation and damaged tissues; see also peptic ulcer.

anaphylactic (ana-fill-LAC-tic) shock

a life-threatening, whole-body allergic reaction to an offending substance.

rhodopsin (ro-DOP-sin)

a light-sensitive pigment of the retina that contains the retinal form of vitamin A and the protein opsin.

full liquid diet

a liquid diet that includes clear liquids, milk, yogurt, ice cream, and liquid nutritional supplements (such as Ensure).

fibrinogen (fye-BRIN-oh-jen)

a liver protein that promotes blood clot formation.

lymphatic (lim-FAT-ic) system

a loosely organized system of vessels and ducts that convey fluids toward the heart. The GI part of the lymphatic system carries the products of fat digestion into the bloodstream.

neutropenia

a low white blood cell (neutrophil) count, which increases susceptibility to infection.

chronic bronchitis (bron-KYE-tis)

a lung disorder characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs.

T cell

a lymphocyte that attacks antigens; functions in cell-mediated immunity.

B cell

a lymphocyte that produces antibodies.

dialyzer (DYE-ah-LYE-zer)

a machine used in hemodialysis to filter the blood; also called an artificial kidney.

phosphorus

a major mineral found mostly in the body's bones and teeth.

alpha-lactalbumin (lact-AL-byoo-min)

a major protein in human breast milk, as opposed to casein (CAY-seen), a major protein in cow's milk.

nanotechnology

a manufacturing technology that manipulates atoms to change the structure of matter.

body mass index (BMI)

a measure of a person's weight relative to height; determined by dividing the weight (in kilograms) by the square of the height (in meters).

bone density

a measure of bone strength. When minerals fill the bone matrix (making it dense), they give it strength.

calories

a measure of heat energy. Energy provided by foods and beverages is measured in kilocalories (1000 calories equal 1 kilocalorie), abbreviated kcalories or kcal. One kcalorie is the amount of heat necessary to raise the temperature of 1 kilogram (kg) of water 1°C. The scientific use of the term kcalorie is the same as the popular use of the term calorie.

protein digestibility

a measure of the amount of amino acids absorbed from a given protein intake.

energy density

a measure of the energy a food provides relative to the weight of the food (kcalories per gram).

nutrient density

a measure of the nutrients a food provides relative to the energy it provides. The more nutrients and the fewer kcalories, the higher the nutrient density.

risk

a measure of the probability and severity of harm.

retinol activity equivalents (RAE)

a measure of vitamin A activity; the amount of retinol that the body will derive from a food containing preformed retinol or its precursor, beta-carotene.

Healthy Eating Index

a measure that assesses how well a diet meets the recommendations of the Dietary Guidelines for Americans.

fructosamine test

a measurement of glycated serum proteins that reflects glycemic control over the preceding 2 to 3 weeks; also known as the glycated albumin test or the glycated serum protein test.

semipermeable membrane

a membrane that allows some, but not all, particles to pass through.

glycemic index

a method of classifying foods according to their potential for raising blood glucose.

urea kinetic modeling

a method of determining the adequacy of dialysis treatment by calculating the urea clearance from blood.

chiropractic (KYE-roh-PRAK-tic)

a method of treatment based on the unproven theory that spinal manipulation can restore health.

colostrum (ko-LAHS-trum)

a milklike secretion from the breast, present during the first few days after delivery before milk appears; rich in protective factors.

sulfur

a mineral present in the body as part of some proteins.

invert sugar

a mixture of glucose and fructose formed by the hydro- lysis of sucrose in a chemical process; sold only in liquid form and sweeter than sucrose. Invert sugar is used as a food additive to help preserve freshness and prevent shrinkage.

pigment

a molecule capable of absorbing certain wavelengths of light so that it reflects only those that we perceive as a certain color.

galactose (ga-LAK-tose)

a monosaccharide; part of the disaccharide lactose.

glucose (GLOO-kose)

a monosaccharide; sometimes known as blood sugar in the body or dextrose in foods.

fructose (FRUK-tose or FROOK-tose)

a monosaccharide; sometimes known as fruit sugar or levulose. Fructose is found abundantly in fruits, honey, and saps.

stomach

a muscular, elastic, saclike portion of the digestive tract that grinds and churns swallowed food, mixing it with acid and enzymes to form chyme.

appendix

a narrow blind sac extending from the beginning of the colon that contains bacteria and lymph cells.

Healthy People

a national public health initiative under the jurisdiction of the US Department of Health and Human Services (DHHS) that identifies the most significant preventable threats to health and focuses efforts toward eliminating them.

hepatic encephalopathy (en-sef-ah-LOP-ah-thie)

a neurological com- plication of advanced liver disease that is characterized by changes in personality, mood, behavior, mental ability, and motor functions.

Wernicke-Korsakoff (VER-nee-key KORE-sah-kof) syndrome

a neurological disorder typically associated with chronic alcoholism and caused by a deficiency of the B vitamin thiamin; also called alcohol- related dementia.

serotonin (SER-oh-TONE-in)

a neurotransmitter important in sleep regulation, appetite control, and sensory perception, among other roles. Serotonin is synthesized in the body from the amino acid tryptophan with the help of vitamin B6.

choline (KOH-leen)

a nitrogen-containing compound found in foods and made in the body from the amino acid methionine. Choline is part of the phospholipid lecithin and the neurotransmitter acetylcholine.

inositol (in-OSS-ih-tall)

a nonessential nutrient that can be made in the body from glucose. Inositol is a part of cell membrane structures.

carnitine (CAR-neh-teen)

a nonessential, nonprotein amino acid made in the body from lysine that helps transport fatty acids across the mitochondrial membrane.

phytic (FYE-tick) acid

a nonnutrient component of plant seeds; also called phytate (FYE-tate). Phytic acid occurs in the husks of grains, legumes, and seeds and is capable of binding minerals such as zinc, iron, calcium, magnesium, and copper in insoluble complexes in the intestine, which the body excretes unused.

shock-wave lithotripsy

a nonsurgical procedure that uses high-amplitude sound waves to fragment gallstones or kidney stones.

primary deficiency

a nutrient deficiency caused by inadequate dietary intake of a nutrient.

secondary deficiency

a nutrient deficiency caused by something other than an inadequate intake such as a disease condition or drug interaction that reduces absorption, accelerates use, hastens excretion, or destroys the nutrient.

conditionally essential nutrient

a nutrient that is normally nonessential, but must be supplied by the diet in special circumstances when the need for it exceeds the body's ability to produce it.

Meals on Wheels

a nutrition program that delivers food for the elderly to their homes.

osteoarthritis

a painful, degenerative disease of the joints that occurs when the cartilage in a joint deteriorates; joint structure is damaged, with loss of function; also called degenerative arthritis.

total nutrient admixture (TNA)

a parenteral solution that contains dextrose, amino acids, and lipids; also called a 3-in-1 solution or an all- in-one solution.

FDA (Food and Drug Administration)

a part of the Department of Health and Human Services' Public Health Service that is responsible for ensuring the safety and wholesomeness of all dietary supplements and food processed and sold in interstate commerce except meat, poultry, and eggs (which are under the jurisdiction of the USDA); inspecting food plants and imported foods; and setting standards for food composition and product labeling.

ethanol

a particular type of alcohol found in beer, wine, and liquor; also called ethyl alcohol.

transjugular intrahepatic portosystemic shunt

a passage within the liver that connects a portion of the portal vein to the hepatic vein using a stent; access to the liver is gained via the jugular vein in the neck.

informed consent

a patient's or caregiver's agreement to undergo a treatment that has been adequately disclosed. Persons must be men- tally competent in order to make the decision.

alcoholism

a pattern of drinking that includes a strong craving for alcohol, a loss of control and an inability to stop drinking once begun, withdrawal symptoms (nausea, sweating, shakiness, and anxiety) after heavy drinking, and the need for increasing amounts of alcohol to feel "high."

alcohol abuse

a pattern of drinking that includes failure to fulfill work, school, or home responsibilities; drinking in situations that are physically dangerous (as in driving while intoxicated); recurring alcohol-related legal problems (as in aggravated assault charges); or

MFP factor

a peptide released during the digestion of meat, fish, and poultry that enhances nonheme iron absorption.

segmentation (SEG-men-TAY-shun)

a periodic squeezing or partitioning of the intestine at intervals along its length by its circular muscles. reflux: a backward flow.

health care agent

a person given legal authority to make medical decisions for another in the event of incapacitation.

dietitian

a person trained in nutrition, food science, and diet planning; see also registered dietitian nutritionist.

certified nutritionist or certified nutritional consultant or certified nutrition therapist

a person who has been granted a document declaring his or her authority as a nutrition professional.

registered dietitian nutritionist (RDN)

a person who has completed a minimum of a bachelor's degree from an accredited university or college, has completed approved course work and a supervised practice program, has passed a national examination, and maintains registration through continuing professional education; also called registered dietitian (RD).

dietetic technician

a person who has completed a minimum of an associate's degree from an accredited university or college and an approved dietetic technician program that includes a supervised practice experience; see also dietetic technician, registered.

physiological age

a person's age as estimated from her or his body's health and probable life expectancy.

chronological age

a person's age in years from his or her date of birth.

quality of life

a person's perceived physical and mental well-being

anecdote

a personal account of an experience or event; not reliable scientific information.

lycopene (LYE-koh-peen)

a pigment responsible for the red color of tomatoes and other red-hued vegetables; a phytochemical that may act as an antioxidant in the body.

lutein (LOO-teen)

a plant pigment of yellow hue; a phytochemical believed to play roles in eye functioning and health.

omega-6 fatty acid

a polyunsaturated fatty acid in which the closest double bond to the methyl (CH3) end of the carbon chain is six car- bons away.

omega-3 fatty acid

a polyunsaturated fatty acid in which the closest double bond to the methyl (CH3) end of the carbon chain is three carbons away.

empty-kcalorie foods

a popular term used to denote foods that con- tribute energy but lack protein, vitamins, and minerals.

bolus (BOH-lus)

a portion; with respect to food, the amount swal- lowed at one time.

female athlete triad

a potentially fatal combination of three medical problems—disordered eating, amenorrhea, and osteoporosis.

respiratory failure

a potentially life-threatening condition in which inadequate respiratory function impairs gas exchange between the air and circulating blood, resulting in abnormal levels of tissue gases.

homeopathic (HO-mee-oh-PATH-ic) medicine

a practice based on the theory that "like cures like"; that is, substances believed to cause certain symptoms are prescribed at extremely low concentrations for curing diseases with similar symptoms.

angiotensinogen

a precursor protein that is hydrolyzed to angiotensin I by renin.

erythrocyte protoporphyrin (PRO-toe-PORE-fe-rin)

a precursor to hemoglobin.

low-risk pregnancy

a pregnancy characterized by factors that make it likely the birth will be normal and the infant healthy.

high-risk pregnancy

a pregnancy characterized by risk factors that make it likely the birth will be surrounded by problems such as premature delivery, difficult birth, restricted growth, birth defects, and early infant death.

patient autonomy

a principle of self-determination, such that patients (or surrogate decision makers) are free to choose the medical interventions that are acceptable to them, even if they choose to refuse interventions that may extend their lives.

indirect calorimetry

a procedure that estimates energy expenditure by measuring oxygen consumption and carbon dioxide production.

peer review

a process in which a panel of scientists rigorously evaluates a research study to ensure that the scientific method was followed.

randomization (RAN-dom-ih-ZAY-shun)

a process of choosing the members of the experimental and control groups without bias.

oyster shell

a product made from the powdered shells of oysters that is sold as a calcium supplement, but it is not well absorbed by the digestive system.

emphysema (EM-fih-ZEE-mah)

a progressive lung disease character- ized by the breakdown of the lungs' elastic structure and destruction of the walls of the respiratory bronchioles and alveoli, reducing the surface area involved in respiration.

calcium-binding protein

a protein in the intestinal cells, made with the help of vitamin D, that facilitates calcium absorption.

adiponectin (AH-dih-poe-NECK-tin)

a protein produced by adipose cells that inhibits inflammation and protects against insulin resistance, type 2 diabetes, and cardiovascular disease.

resistin (ree-ZIS-tin)

a protein produced by adipose cells that pro- motes inflammation and causes insulin resistance.

leptin

a protein produced by fat cells under direction of the ob gene that decreases appetite and increases energy expenditure.

ghrelin (GRELL-in)

a protein produced by the stomach cells that enhances appetite and decreases energy expenditure.

plasminogen activator inhibitor-1

a protein that promotes blood clotting by inhibiting blood clot degradation within blood vessels.

muscle dysmorphia (dis-MORE-fee-ah)

a psychiatric disorder characterized by a preoccupation with building body mass.

mineral oil

a purified liquid derived from petroleum and used to treat constipation.

fetal alcohol spectrum disorder

a range of physical, behavioral, and cognitive abnormalities caused by prenatal alcohol exposure.

hypocaloric feeding

a reduced-kcalorie regimen that includes sufficient protein and micronutrients to maintain nitrogen balance and prevent malnutrition; also called permissive underfeeding.

do-not-resuscitate (DNR) order

a request by a patient or surrogate to withhold cardiopulmonary resuscitation.

diet manual

a resource that specifies the foods or preparation methods to include in or exclude from modified diets and provides sample menus.

sulfate

a salt produced from the oxidation of sulfur.

meditation

a self-directed technique of calming the mind and relaxing the body.

TCA cycle or tricarboxylic (try-car-box-ILL-ick) acid cycle

a series of metabolic reactions that break down molecules of acetyl CoA to carbon dioxide and hydrogen atoms; also called the citric acid cycle or the Krebs cycle after the biochemist who elucidated its reactions.

breast milk bank

a service that collects, screens, processes, and dis- tributes donated human milk.

Dietary Reference Intakes (DRI)

a set of nutrient intake values for healthy people in the United States and Canada. These values are used for planning and assessing diets and include, Estimated Average Requirements (EAR), Recommended Dietary Allowances (RDA), Adequate Intakes (AI), and Tolerable Upper Intake Levels (UL).

anaphylaxis

a severe allergic reaction that may include gastrointestinal upset, skin inflammation, breathing difficulty, and low blood pressure, potentially leading to shock.

shock

a severe reduction in blood flow that deprives the body's tis- sues of oxygen and nutrients; characterized by reduced blood pressure, raised heart and respiratory rates, and muscle weakness.

mucus (MYOO-kus)

a slippery substance secreted by cells of the GI lining (and other body linings) that protects the cells from exposure to digestive juices (and other destructive agents). The lining of the GI tract with its coat of mucus is a mucous membrane. (The noun is mucus; the adjective is mucous.)

continuous renal replacement therapy (CRRT)

a slow, continuous method of removing solutes and/or fluids from the blood by gently pumping the blood across a filtration membrane over a prolonged time period.

cofactor

a small, inorganic or organic substance that facilitates the action of an enzyme.

hazard

a source of danger; used to refer to circumstances in which harm is possible under normal conditions of use.

Helicobacter pylori (H. pylori)

a species of bacterium that colonizes gastric mucosa; a primary cause of gastritis and peptic ulcer disease.

esophageal sphincter

a sphincter muscle at the upper or lower end of the esophagus. The lower esophageal sphincter is also called the cardiac sphincter because of its proximity to the heart.

reference protein

a standard against which to measure the quality of other proteins

protein-energy malnutrition (PEM)

a state of malnutrition characterized by depletion of tissue proteins and energy stores, usually accompanied by micronutrient deficiencies.

PES statement

a statement that describes a nutrition problem in a format that includes the problem (P), the etiology or cause (E), and the signs and symptoms (S).

shear stress

a stress that occurs sideways against a surface rather than perpendicular to a surface.

cathartic (ka-THAR-tik)

a strong laxative.

histamine (HISS-tah-mean or HISS-tah-men)

a substance produced by cells of the immune system as part of a local immune reaction to an antigen.

chelate (KEY-late)

a substance that can grasp the positive ions of a mineral.

drug

a substance that can modify one or more of the body's functions.

teratogen (ter-AT-oh-jen)

a substance that causes abnormal fetal development and birth defects.

vasoconstrictor (VAS-oh-kon-STRIK-tor)

a substance that constricts or narrows the blood vessels.

goitrogen (GOY-troh-jen)

a substance that enlarges the thyroid gland and causes toxic goiter. Goitrogens occur naturally in such foods as cabbage, kale, brussels sprouts, cauliflower, broccoli, and kohlrabi. good source of the product provides between 10 and 19 percent of the Daily Value for a given nutrient per serving.

allergen

a substance that stimulates an allergic reaction; usually a protein fragment.

emulsifier (ee-MUL-sih-fire)

a substance with both water-soluble and fat-soluble portions that promotes the mixing of oils and fats in a watery solution.

surrogate

a substitute; a person who takes the place of another.

spasm

a sudden, forceful, and involuntary muscle contraction.

maple sugar

a sugar (mostly sucrose) purified from the concentrated sap of the sugar maple tree.

nectar

a sugary fluid secreted by plants to encourage pollination by insects.

metallothionein (meh-TAL-oh-THIGH-oh-neen)

a sulfur-rich protein that avidly binds with and transports metals such as zinc.

colostomy (co-LAH-stoe-me)

a surgical passage through the abdominal wall into the colon.

ileostomy (ill-ee-AH-stoe-me)

a surgical passage through the abdominal wall into the ileum.

cesarean (si-ZAIR-ee-un) delivery

a surgically assisted birth involving removal of the fetus by an incision into the uterus, usually by way of the abdominal wall.

stoma (STOE-ma)

a surgically created opening in a body tissue or organ.

food frequency questionnaire

a survey of foods routinely consumed. Some questionnaires ask about the types of food eaten and yield only qualitative information; others include questions about portions consumed and yield semiquantitative data as well.

malt syrup

a sweetener made from sprouted barley and containing mostly maltose.

nephrotic (neh-FROT-ik) syndrome

a syndrome caused by significant urinary protein losses (more than 3 to 3½ grams daily), as a result of severe glomerular damage.

relative energy deficiency in sport (RED-S)

a syndrome of impaired physiological functions caused by relative energy deficiency (too little energy intake for the energy expended).

olestra

a synthetic fat made from sucrose and fatty acids that provides 0 kcalories per gram; also known as sucrose polyester.

corn syrup

a syrup made from cornstarch that has been treated with acid, high temperatures, and enzymes to produce glucose, maltose, and dextrins. It may be dried and used as corn syrup solids. See also high- fructose corn syrup (HFCS).

high-fructose corn syrup (HFCS)

a syrup made from cornstarch that has been treated with an enzyme that converts some of the glucose to the sweeter fructose; made especially for use in processed foods and beverages, where it is the predominant sweetener. With a chemical structure similar to sucrose, most HFCS has a fructose content of 42 or 55 percent, with glucose making up the remainder.

MEOS or microsomal (my-krow-SO-mal) ethanol-oxidizing system

a system of enzymes in the liver that oxidize not only alcohol but also several classes of drugs.

nutrition care process

a systematic approach used by dietetics professionals to evaluate and treat nutrition-related problems.

Hazard Analysis Critical Control Points (HACCP)

a systematic plan to identify and correct potential microbial hazards in the manufacturing, distribution, and commercial use of food products; commonly referred to as "HASS-ip."

Heimlich (HIME-lick) maneuver (abdominal thrusts)

a technique for dislodging an object from the trachea of a choking person; named for the physician who developed it.

therapeutic touch

a technique of passing hands over a patient to purportedly identify energy imbalances and transfer healing power from therapist to patient; also called laying on of hands.

reflexology

a technique that applies pressure or massage on areas of the hands or feet to allegedly cure disease or relieve pain in other areas of the body; sometimes called zone therapy.

hypnotherapy

a technique that uses hypnosis and the power of suggestion to improve health behaviors, relieve pain, and promote healing.

niacin flush

a temporary burning, tingling, and itching sensation that occurs when a person takes a large dose of nicotinic acid; often accompanied by a headache and reddened face, arms, and chest.

theory

a tentative explanation that integrates many diverse findings to further the understanding of a defined topic.

vitamin A activity

a term referring to both the active forms of vitamin A and the precursor forms in foods without distinguishing between them.

false negative

a test result indicating that a condition is not present (negative) when in fact it is present (therefore false).

false positive

a test result indicating that a condition is present (positive) when in fact it is not present (therefore false).

oral glucose tolerance test

a test that evaluates a person's ability to tolerate an oral glucose load.

acupuncture (AK-you-PUNK-chur)

a therapy that involves inserting thin needles into the skin at specific anatomical points, allegedly to correct disruptions in the flow of energy within the body.

catheter

a thin tube placed within a narrow lumen (such as a blood vessel) or body cavity; can be used to infuse or withdraw fluids or to keep a passage open.

qi gong (chee-GUNG)

a traditional Chinese system that combines movement, meditation, and breathing techniques and allegedly cures illness by enhancing the flow of qi (energy) within the body.

ayurveda

a traditional medical system from India that promotes the use of diet, herbs, meditation, massage, and yoga for preventing and treating illness.

transnasal

a transnasal feeding tube is one that is inserted through the nose.

hemodialysis (HE-moe-dye-AL-ih-sis)

a treatment that removes fluids and wastes from the blood by passing the blood through a dialyzer.

peritoneal (PEH-rih-toe-NEE-al) dialysis

a treatment that removes fluids and wastes from the blood by using the body's peritoneal mem- brane as a filter.

dialysis (dye-AH-lih-sis)

a treatment that removes wastes and excess fluid from the blood after the kidneys have stopped functioning.

glomerulus (gloh-MEHR-yoo-lus)

a tuft of capillaries within the nephron that filters water and solutes from the blood as urine produc- tion begins (plural: glomeruli).

atherosclerosis (ATH-er-oh-scler-OH-sis)

a type of artery disease characterized by plaques (accumulations of lipid-containing material) on the inner walls of the arteries.

cancer cachexia (ka-KEK-see-ah)

a wasting syndrome associated with cancer that is characterized by anorexia, muscle wasting, weight loss, and fatigue.

keratin (KARE-uh-tin)

a water-insoluble protein; the normal protein of hair and nails.

proof

a way of stating the percentage of alcohol in distilled liquor. Liquor that is 100 proof is 50 percent alcohol; 90 proof is 45 percent, and so forth.

sepsis

a whole-body inflammatory response caused by infection; characterized by signs and symptoms similar to those of the systemic inflammatory response syndrome (SIRS).

systemic inflammatory response syndrome (SIRS)

a whole-body inflammatory response caused by severe illness or trauma; character- ized by raised heart and respiratory rates, abnormal white blood cell counts, and fever.

Internet (the Net)

a worldwide network of millions of computers linked together to share information.

atherogenic

able to initiate or promote atherosclerosis.

xerosis (zee-ROW-sis)

abnormal drying of the skin and mucous mem- branes; a sign of vitamin A deficiency.

cardiac arrhythmias

abnormal heart rhythms.

stricture

abnormal narrowing of a passageway; often due to inflammation, scarring, or a congenital abnormality.

fistulas (FIST-you-luz)

abnormal passages between organs or tissues that allow the passage of fluids or secretions.

lipodystrophy (LIP-oh-DIS-tro-fee)

abnormalities in body fat and fat metabolism that may result from drug treatments for HIV infection. The accumulation of abdominal fat is sometimes called protease paunch.

alcohol-related neurodevelopmental disorder (ARND)

abnormalities in the central nervous system and cognitive development associated with prenatal alcohol exposure.

varices (VAH-rih-seez)

abnormally dilated blood vessels (singular -varix).

hyperinsulinemia

abnormally high levels of insulin in the blood.

macrosomia (mak-roh-SO-me-ah)

abnormally large body size. In the case of infants, a birthweight at the 90th percentile or higher for gestational age (roughly 9 lb—or 4000 g—or more); macrosomia results from prepregnancy obesity, excessive weight gain during pregnancy, or uncontrolled gestational diabetes.

hypochlorhydria (HIGH-poe-clor-HIGH-dree-ah)

abnormally low gastric acid secretions.

hyponatremia (HIGH-poe-nah-TREE-me-ah)

abnormally low sodium levels in the blood; a possible result of fluid overload.

achlorhydria (AY-clor-HIGH-dree-ah)

absence of gastric acid secretions.

food security

access to enough food to sustain a healthy and active life. Food security categories include high food security, which reflects no indications of food-access problems or limitations and marginal food security, which reflects one or two indications of food-access problems but with little or no change in food intake.

keratinization

accumulation of keratin in a tissue; a sign of vitamin A deficiency.

successful weight-loss maintenance

achieving a weight loss of at least 5 to 10 percent of initial body weight and maintaining the loss for at least 1 year.

ketone (KEE-tone) bodies

acidic compounds produced by the liver during the incomplete breakdown of fat when carbohydrate is not available.

adaptive thermogenesis

adjustments in energy expenditure related to changes in environment such as extreme cold and to physiological events such as overfeeding, trauma, and changes in hormone status.

cyclic parenteral nutrition

administration of parenteral solutions over an 8- to 14-hour period each day.

cirrhosis (seer-OH-sis)

advanced liver disease in which liver cells turn orange, die, and harden, permanently losing their function; often associated with alcoholism.

food intolerances

adverse reactions to foods that do not involve the immune system.

systemic (sih-STEM-ic)

affecting the entire body.

alveoli (al-VEE-oh-lie)

air sacs in the lungs. One air sac is an alveolus.

vitamin A

all naturally occurring compounds with the biological activity of retinol, the alcohol form of vitamin A.

proteome

all proteins in a cell. The study of all proteins produced by a species is called proteomics.

obesogenic (oh-BES-oh-JEN-ick) environment

all the factors sur- rounding a person that promote weight gain, such as increased food intake, especially of unhealthy choices, and decreased physical activity.

gene pool

all the genetic information of a population at a given time.

digestive system

all the organs and glands associated with the ingestion and digestion of food.

nonessential amino acids

amino acids that the body can make; also called dispensable amino acids.

essential amino acids

amino acids that the body requires but cannot make, and so must be obtained from the diet; also called indispensable amino acids.

ascites (ah-SIGH-teez)

an abnormal accumulation of fluid in the abdominal cavity.

aneurysm (AN-you-rih-zum)

an abnormal enlargement or bulging of a blood vessel (usually an artery) caused by weakness in the blood vessel wall.

embolus (EM-boh-lus)

an abnormal particle, such as a blood clot or air bubble, that travels in the blood.

tumor

an abnormal tissue mass that has no physiological function; also called a neoplasm (NEE-oh-plazm). Tumors may be malignant (can- cerous) or benign (noncancerous).

oliguria (OL-lih-GOO-ree-ah)

an abnormally low amount of urine, often less than 400 mL/day.

hypoglycemia (HIGH-po-gly-SEE-me-ah)

an abnormally low blood glucose concentration.

plaque (PLACK)

an accumulation of fatty deposits, smooth muscle cells, and fibrous connective tissue that develops in the artery walls in atherosclerosis. Plaque associated with atherosclerosis is known as atheromatous (ATH-er-OH-ma-tus) plaque.

hydrochloric acid

an acid composed of hydrogen and chloride atoms (HCl) that is normally produced by the gastric glands.

ketoacidosis (KEY-toe-ass-ih-DOE-sis)

an acidosis (lowering of blood pH) that results from the excessive production of ketone bodies.

FODMAPs

an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are incompletely digested or poorly absorbed carbohydrates that are fermented in the large intestine; a low-FODMAP diet may help to reduce flatulence, abdominal disten- tion, and diarrhea.

beneficence (be-NEF-eh-sense)

an action that benefits other individuals.

maleficence (mah-LEF-eh-sense)

an action that is harmful to other individuals.

C-reactive protein

an acute-phase protein produced in substantial amounts during acute inflammation; it binds dead or dying cells to activate certain immune responses. C-reactive protein is considered the best clinical indicator of the acute-phase response, although it is elevated during many chronic illnesses.

end-stage renal disease

an advanced stage of chronic kidney disease in which dialysis or a kidney transplant is necessary to sustain life.

food allergy

an adverse reaction to food that involves an immune response; also called food-hypersensitivity reaction.

emetic (em-ET T-ic)

an agent that causes vomiting.

glycerol (GLISS-er-ol)

an alcohol composed of a three-carbon chain, which can serve as the backbone for a triglyceride.

beer

an alcoholic beverage traditionally brewed by fermenting malted barley and adding hops for flavor.

wine

an alcoholic beverage traditionally made by fermenting a sugar source such as grape juice.

liquor or distilled spirits

an alcoholic beverage traditionally made by fermenting and distilling a carbohydrate source such as molasses, potatoes, rye, beets, barley, or corn.

bicarbonate

an alkaline compound with the formula HCO3 that is produced in all cell fluids from the dissociation of carbonic acid to help maintain the body's acid-base balance. Bicarbonate is also secreted from the pancreas as part of the pancreatic juice.

hives

an allergic reaction characterized by raised, swollen patches of skin or mucous membranes that are associated with intense itching; also called urticaria.

oral allergy syndrome

an allergic response in which symptoms of hives, swelling, or itching occur only in the mouth and throat; usually a short-lived response that resolves quickly.

registered dietitian (RD)

an alternative term for an RDN.

homocysteine

an amino acid produced during the conversion of methionine to cysteine; blood homocysteine levels are influenced by intakes of folate, vitamin B12, and vitamin B6.

conditionally essential amino acid

an amino acid that is normally nonessential, but must be supplied by the diet in special circumstances when the need for it exceeds the body's ability to make it.

low

an amount that would allow frequent consumption of a food without exceeding the Daily Value for the nutrient. A food that is naturally low in a nutrient may make such a claim, but only as it applies to all similar foods (for example, "fresh cauliflower, a low-sodium food"); synonyms include little, few, and low source of.

glycogen (GLY-ko-jen)

an animal polysaccharide composed of glucose; a storage form of glucose manufactured and stored in the liver and muscles. Glycogen is not a significant food source of carbohydrate and is not counted as a dietary carbohydrate in foods.

waist circumference

an anthropometric measurement used to assess a person's abdominal fat.

methotrexate

an anticancer drug that inhibits cell division. Methotrexate closely resembles the B vitamin folate, which is needed for DNA synthesis; the drug works by blocking activity of the enzyme that converts folate to its active form.

warfarin

an anticoagulant that works by interfering with vitamin K's blood-clotting function; patients using warfarin need to maintain a consistent vitamin K intake from day to day.

Traditional Chinese Medicine (TCM)

an approach to health care based on the concept that illness can be cured by enhancing the flow of qi (energy) within a person's body. Treatments may include herbal therapies, physical exercises, meditation, acupuncture, and remedial massage.

naturopathic (NAY-chur-oh-PATH-ic) medicine

an approach to health care using practices alleged to enhance the body's natural heal- ing abilities. Treatments may include a variety of alternative therapies, including dietary supplements, herbal remedies, exercise, and homeopathy.

nutrition screening

an assessment procedure that helps to identify patients who are malnourished or at risk for malnutrition.

Sjögren's syndrome

an autoimmune disease characterized by the destruction of secretory glands, resulting in dry mouth and dry eyes.

fatty liver

an early stage of liver deterioration seen in several diseases, including obesity and alcoholic liver disease. Fatty liver is characterized by an accumulation of fat in the liver cells.

anorexia (an-oh-RECK-see-ah) nervosa

an eating disorder characterized by a refusal to maintain a minimally normal body weight and a distortion in perception of body shape and weight.

binge-eating disorder

an eating disorder characterized by recurring episodes of eating a significant amount of food in a short period of time with marked feelings of lack of control.

bulimia (byoo-LEEM-ee-ah) nervosa

an eating disorder characterized by repeated episodes of binge eating usually followed by self- induced vomiting, misuse of laxatives or diuretics, fasting, or excessive exercise.

bile

an emulsifier that prepares fats and oils for digestion; an exocrine secretion made by the liver, stored in the gallbladder, and released into the small intestine when needed.

goiter (GOY-ter)

an enlargement of the thyroid gland due to an iodine deficiency, malfunction of the gland, or overconsumption of a goitrogen. Goiter caused by iodine deficiency is sometimes called simple goiter.

alcohol dehydrogenase (dee-high- DROJ-eh-nayz)

an enzyme active in the stomach and the liver that converts ethanol to acetaldehyde.

renin (REN-in)

an enzyme from the kidneys that hydrolyzes the protein angiotensinogen to angiotensin I, which results in the kidneys reabsorbing sodium.

hormone-sensitive lipase

an enzyme inside adipose cells that responds to the body's need for fuel by hydrolyzing triglycerides so that their parts (glycerol and fatty acids) escape into the general circulation and thus become available to other cells for fuel. The signals to which this enzyme responds include epinephrine and glucagon, which oppose insulin.

amylase (AM-ih-lace)

an enzyme that hydrolyzes amylose (a form of starch). Amylase is a carbohydrase, an enzyme that breaks down carbohydrates.

lactase

an enzyme that hydrolyzes lactose.

maltase

an enzyme that hydrolyzes maltose.

protease (PRO-tee-ase)

an enzyme that hydrolyzes proteins.

sucrase

an enzyme that hydrolyzes sucrose.

lipoprotein lipase (LPL)

an enzyme that hydrolyzes triglycerides passing by in the bloodstream and directs their parts into the cells, where they can be metabolized or reassembled for storage.

lysozyme (LYE-so-zyme)

an enzyme with antibacterial properties; found in immune cells and body secretions such as tears, saliva, and sweat.

achalasia (ack-ah-LAY-zhah)

an esophageal disorder characterized by the absence of peristalsis and impaired relaxation of the lower esopha- geal sphincter.

linolenic (lin-oh-LEN-ick) acid

an essential fatty acid with 18 car- bons and three double bonds.

linoleic (lin-oh-LAY-ick) acid

an essential fatty acid with 18 carbons and two double bonds.

manganese

an essential trace mineral that acts as a cofactor for many enzymes.

molybdenum (mo-LIB-duh-num)

an essential trace mineral that acts as a cofactor for many enzymes.

chromium (KRO-mee-um)

an essential trace mineral that enhances the activity of insulin.

iodine

an essential trace mineral that is needed for the synthesis of thyroid hormones.

iron

an essential trace mineral that is needed for the transport of oxygen and the metabolism of energy nutrients.

selenium (se-LEEN-ee-um)

an essential trace mineral that is part of an antioxidant enzyme.

zinc

an essential trace mineral that is part of many enzymes and a constituent of insulin.

copper

an essential trace mineral that is part of many enzymes.

fluoride

an essential trace mineral that makes teeth stronger and more resistant to decay.

thermic effect of food (TEF)

an estimation of the energy required to process food (digest, absorb, transport, metabolize, and store ingested nutrients); also called the specific dynamic effect (SDE) of food or the specific dynamic activity (SDA) of food. The sum of the TEF and any increase in the metabolic rate due to overeating is known as diet-induced thermogenesis (DIT).

double-blind experiment

an experiment in which neither the sub- jects nor the researchers know which subjects are members of the experimental group and which are serving as control subjects, until after the experiment is over.

blind experiment

an experiment in which the subjects do not know whether they are members of the experimental group or the control group.

foodborne illness

an illness transmitted to human beings through food and water, caused by either an infectious agent (foodborne infection) or a poisonous substance (food intoxication); commonly known as food poisoning.

inflammation

an immunological response to cellular injury characterized by an increase in white blood cells.

angiotensin I (AN-gee-oh-TEN-sin)

an inactive precursor that is con- verted by an enzyme to yield active angiotensin II.

food insufficiency

an inadequate amount of food due to a lack of resources.

placebo (pla-SEE-bo)

an inert, harmless medication given to provide comfort and hope; a sham treatment used in controlled research studies.

listeriosis (lis-TEAR-ee-OH-sis)

an infection caused by eating food contaminated with the bacterium Listeria monocytogenes, which can be killed by pasteurization and cooking but can survive at refrigerated temperatures; certain ready-to-eat foods, such as hot dogs and deli meats, may become contaminated after cooking or processing, but before packaging.

ulcerative colitis (ko-LY-tis)

an inflammatory bowel disease that involves the rectum and colon; the inflammation affects the mucosa and submucosa of the intestinal wall.

Crohn's disease

an inflammatory bowel disease that usually occurs in the lower portion of the small intestine and the colon; the inflammation may pervade the entire intestinal wall.

phenylketonuria (FEN-il-KEY-toe- NEW-ree-ah) or PKU

an inherited disorder characterized by failure to metabolize the amino acid phenyl- alanine to tyrosine.

galactosemia (ga-LAK-toe-SEE-me-ah)

an inherited disorder that impairs galactose metabolism; may cause damage to the brain, liver, kidneys, and lens in untreated patients.

inborn error of metabolism

an inherited trait (one that is present at birth) that causes the absence, deficiency, or malfunction of a protein that has a critical metabolic role.

bomb calorimeter (KAL-oh-RIM-eh-ter)

an instrument that measures the heat energy released when foods are burned, thus providing an estimate of the potential energy of the foods.

acetaldehyde (ass-et-AL-duh-hide)

an intermediate in alcohol metabolism.

fibrosis (fye-BROH-sis)

an intermediate stage of liver deterioration seen in several diseases, including viral hepatitis and alcoholic liver disease. In fibrosis, the liver cells lose their function and assume the characteristics of connective tissue cells (fibers).

celiac (SEE-lee-ack) disease

an intestinal disorder in which the inability to absorb gluten results in an immune response that dam- ages intestinal cells; also called celiac sprue, nontropical sprue, or gluten- sensitive enteropathy.

irritable bowel syndrome

an intestinal disorder of unknown cause that disturbs the functioning of the large intestine; symptoms include abdominal pain, flatulence, diarrhea, and constipation.

hemosiderin (heem-oh-SID-er-in)

an iron-storage protein primarily made in times of iron overload.

gastric outlet obstruction

an obstruction that prevents the normal emptying of stomach contents into the duodenum.

botulism (BOT-chew-lism)

an often fatal foodborne illness caused by the ingestion of foods containing a toxin produced by bacteria that grow without oxygen.

bovine spongiform encephalopathy (BOH-vine SPON-jih-form in- SEF-eh-LOP-eh-thee) or BSE

an often fatal illness of cattle and wild game that affects the nervous system and is transmitted to people by eating infected meats; commonly called mad cow disease.

levulose

an older name for fructose.

eicosapentaenoic (EYE-cossa-PENTA-ee-NO-ick) acid (EPA)

an omega-3 polyunsaturated fatty acid with 20 carbons and five double bonds; present in fatty fish and synthesized in limited amounts in the body from linolenic acid.

docosahexaenoic (DOE-cossa-HEXA-ee-NO-ick) acid (DHA)

an omega-3 polyunsaturated fatty acid with 22 carbons and six double bonds; present in fatty fish and synthesized in limited amounts in the body from linolenic acid.

arachidonic (a-RACK-ih-DON-ic) acid

an omega-6 polyunsaturated fatty acid with 20 carbons and four double bonds; present in small amounts in meat and other animal products and synthesized in the body from linoleic acid.

enterostomy (EN-ter-AH-stoe-mee)

an opening into the GI tract through the abdominal wall.

jejunostomy (JEH-ju-NAH-stoe-mee)

an opening into the jejunum through which a feeding tube can be passed. A nonsurgical technique for creating a jejunostomy is called percutaneous endoscopic jejunostomy (PEJ). The tube can either be guided into the jejunum via a gastrostomy or passed directly into the jejunum (direct PEJ).

gastrostomy (gah-STRAH-stoe-mee)

an opening into the stomach through which a feeding tube can be passed. A nonsurgical technique for creating a gastrostomy under local anesthesia is called percutaneous endoscopic gastrostomy (PEG).

keto (KEY-toe) acid

an organic acid that contains a carbonyl group (C5O).

anencephaly (AN-en-SEF-a-lee)

an uncommon and always fatal type of neural tube defect, characterized by the absence of a brain.

ketosis (kee-TOE-sis)

an undesirably high concentration of ketone bodies in the blood and urine.

hypothesis (hi-POTH-eh-sis)

an unproven statement that tentatively explains the relationships between two or more variables.

free radical

an unstable molecule with one or more unpaired electrons.

megaloblastic anemia

anemia characterized by large (macrocytic), immature red blood cells, as occurs in folate or vitamin B12 deficiency.

microcytic anemia

anemia characterized by small, hypochromic (pale) red blood cells, as occurs in iron deficiency.

aplastic anemia

anemia characterized by the inability of bone mar- row to produce adequate numbers of blood cells. Causes include drug toxicity, viruses, and genetic defects.

anemia of chronic disease

anemia that develops in persons with chronic illness; may resemble iron-deficiency anemia even though iron stores are often adequate; also called anemia of chronic inflammation.

monoclonal antibodies

antibodies made by a line of cultured immune cells that recognize and attach to a particular protein.

immune checkpoint inhibitors

anticancer drugs that block proteins on cancer cells (or sometimes, immune cells) that inhibit the immune system's ability to identify and attack the cancer cells.

malnutrition

any condition caused by excess or deficient food energy or nutrient intake or by an imbalance of nutrients.

eating disorder

any of several psychological disorders characterized by serious disturbances in eating behavior that jeopardize a person's physical or psychological health.

dietary supplement

any pill, capsule, tablet, liquid, or powder that contains vitamins, minerals, herbs, or amino acids intended to increase dietary intake of these substances.

stress

any threat to a person's well-being; a demand placed on the body to adapt.

accredited

approved; in the case of medical centers or universities, certified by an agency recognized by the US Department of Education.

antioxidants

as a food additive, preservatives that delay or prevent rancidity of fats in foods and other damage to food caused by oxygen; in the body, substances that significantly decrease the adverse effects of free radicals on normal physiological functions.

more

at least 10 percent more of the Daily Value for a given nutrient than the comparison food; synonyms include added and extra.

reduced kcalorie

at least 25 percent fewer kcalories per serving than the comparison food.

less

at least 25 percent less of a given nutrient or kcalories than the comparison food (see individual nutrients); synonyms include fewer and reduced.

ions (EYE-uns)

atoms or molecules that have gained or lost electrons and therefore have electrical charges. Examples include the positively charged sodium ion (Na+) and the negatively charged chloride ion (Cl-).

bacterial cholangitis (KOH-lan-JYE-tis)

bacterial infection involving the bile ducts.

subcutaneous (sub-cue-TAY-nee-us)

beneath the skin.

lipomas (lih-POE-muz)

benign tumors composed of fatty tissue.

full term

births occurring at 39 through 40 weeks of gestation.

preterm (premature)

births occurring before 37 weeks of gestation; births occurring at 37 to 38 weeks of gestation are designated early term.

leukocytes

blood cells that function in immunity; also called white blood cells.

hematuria (HE-mah-TOO-ree-ah)

blood in the urine.

collateral vessels

blood vessels that enlarge or newly form to allow an alternative pathway for diverted blood.

overweight

body weight greater than the weight range that is considered healthy; BMI 25 to 29.9.

underweight

body weight lower than the weight range that is considered healthy; BMI less than 18.5.

stress fractures

bone damage or breaks caused by stress on bone surfaces during exercise.

transient ischemic attacks (TIAs)

brief ischemic strokes that cause short-term neurological symptoms.

amino (a-MEEN-oh) acids

building blocks of proteins. Each contains an amino group, an acid group, a hydrogen atom, and a distinctive side group, all attached to a central carbon atom.

blind loops

bypassed sections of small intestine that are cut off from the normal flow of food material, allowing bacteria to flourish; created in certain types of gastrectomy procedures.

cancer immunotherapy

cancer treatments that improve immune responses that fight cancer.

pathogenic

capable of causing disease.

monosaccharides (mon-oh-SACK-uh-rides)

carbohydrates of the general formula CnH2nOn that typically form a single ring. The mono- saccharides important in nutrition are hexoses, sugars with six atoms of carbon and the formula C6H12O6.

epiglottis (epp-ih-GLOTT-iss)

cartilage in the throat that guards the entrance to the trachea and prevents fluid or food from entering it when a person swallows.

teratogenic (ter-AT-oh-jen-ik)

causing abnormal fetal development and birth defects.

goblet cells

cells of the GI tract (and lungs) that secrete mucus.

epithelial (ep-i-THEE-lee-ul) cells

cells on the surface of the skin and mucous membranes.

glands

cells or groups of cells that secrete materials for special uses in the body. Glands may be exocrine (EKS-oh-crin) glands, secreting their materials "out" (into the digestive tract or onto the surface of the skin), or endocrine (EN-doe-crin) glands, secreting their materials "in" (into the blood).

monocytes (MON-oh-sites)

cells released from the bone marrow that move into tissues and mature into macrophages.

endothelial cells

cells that line the inner surfaces of blood vessels, lymphatic vessels, and body cavities.

mast cells

cells within connective tissue that produce and release histamine.

acute-phase response

changes in body chemistry resulting from infection, inflammation, or injury; characterized by alterations in plasma proteins.

soaps

chemical compounds formed from fatty acids and positively charged minerals.

binders

chemical compounds in foods that combine with nutrients (especially minerals) to form complexes the body cannot absorb. Examples include phytates (FYE-tates) and oxalates (OCK-sa-lates).

hormones

chemical messengers. Hormones are secreted by a variety of glands in response to altered conditions in the body. Each hormone travels to one or more specific target tissues or organs, where it elicits a specific response to maintain homeostasis.

nutrients

chemical substances obtained from food and used in the body to provide energy, structural materials, and regulating agents to support growth, maintenance, and repair of the body's tissues. Nutrients may also reduce the risks of some diseases.

retinoids (RET-ih-noyds)

chemically related compounds with biological activity similar to that of retinol; metabolites of retinol.

neurotransmitters

chemicals that are released at the end of a nerve cell when a nerve impulse arrives there. They diffuse across the gap to the next cell and alter the membrane of that second cell to either inhibit or excite it.

atrophic (a-TRO-fik) gastritis (gas-TRY-tis)

chronic inflammation of the stomach accompanied by a diminished size and functioning of the mucous membranes and glands. This condition is also characterized by inadequate hydrochloric acid and intrinsic factor—two substances needed for vitamin B12 absorption.

nursing diagnoses

clinical judgments about actual or potential health problems that provide the basis for selecting appropriate nursing interventions.

cataracts (KAT-ah-rakts)

clouding of the eye lenses that impairs vision and can lead to blindness.

senile plaques

clumps of the protein fragment beta-amyloid on the nerve cells, commonly found in the brains of people with Alzheimer's dementia.

lipoproteins (LIP-oh-PRO-teenz)

clusters of lipids associated with proteins that serve as transport vehicles for lipids in the lymph and blood.

CoA (coh-AY)

coenzyme A; the coenzyme derived from the B vitamin pantothenic acid and central to energy metabolism.

food recovery

collecting wholesome food for distribution to low- income people who are hungry. Four common methods of food recovery include field gleaning, which involves collecting crops from fields that either have already been harvested or are not profitable to harvest; perishable food rescue or salvage, which involves collecting perishable produce from wholesalers and markets; prepared food rescue, which involves collecting prepared foods from commercial kitchens; and non- perishable food collection, which involves collecting processed foods from wholesalers and markets.

coenzymes

complex organic molecules that work with enzymes to facilitate the enzymes' activity. Many coenzymes have B vitamins as part of their structures.

oxidants (OKS-ih-dants)

compounds (such as oxygen itself) that oxidize other compounds. Compounds that prevent oxidation are called antioxidants, whereas those that promote it are called prooxidants.

proteins

compounds composed of carbon, hydrogen, oxygen, and nitrogen atoms, arranged into amino acids linked in a chain. Some amino acids also contain sulfur atoms.

carbohydrates

compounds composed of carbon, oxygen, and hydro- gen arranged as monosaccharides or multiples of monosaccharides. Most, but not all, carbohydrates have a ratio of one carbon molecule to one water molecule (CH O) .

polysaccharides

compounds composed of many monosaccharides linked together. An intermediate string of 3 to 10 monosaccharides is an oligosaccharide.

sterols (STARE-ols or STEER-ols)

compounds containing a four-ring carbon structure with side chains attached.

purines

compounds of nitrogen-containing bases such as adenine, guanine, and caffeine. Purines that originate from the body are endog- enous and those that derive from foods are exogenous.

bases

compounds that accept hydrogen ions in a solution.

fuel

compounds that cells can use for energy. The major fuels include glucose, fatty acids, and amino acids; other fuels include ketone bodies, lactate, glycerol, and alcohol.

buffers

compounds that keep a solution's pH constant when acids or bases are added.

acids

compounds that release hydrogen ions in a solution.

continuous parenteral nutrition

continuous administration of par- enteral solutions over a 24-hour period.

continuous glucose monitoring

continuous monitoring of tissue glucose levels using a small sensor placed under the skin.

clinical pathways

coordinated programs of treatment that merge the care plans of different health practitioners; also called care pathways, care maps, or critical pathways.

corn sweeteners

corn syrup and sugars derived from corn.

bone meal or powdered bone

crushed or ground bone preparations intended to supply calcium to the diet. Calcium from bone is not well absorbed and is often contaminated with toxic minerals such as arse- nic, mercury, lead, and cadmium.

kidney stones

crystalline masses that form in the urinary tract; also called renal calculi or nephrolithiasis.

hydroxyapatite (high-drox-ee-APP-ah-tite)

crystals made of calcium and phosphorus.

struvite (STROO-vite)

crystals of magnesium ammonium phosphate.

eating patterns

customary quantities, proportions, and frequencies of consuming various foods and beverages over time.

peripheral neuropathy

damage to nerves leading to the arms, hands, legs, and feet; symptoms may include numbness, tingling, and pain in the extremities; muscle weakness; and diminished reflexes.

autonomic neuropathy

damage to nerves that control involuntary bodily functions, such as those that affect the internal organs and glands; symptoms may include problems with digestion, bowel function, bladder function, sexual response, and perspiration.

diabetic nephropathy (neh-FRAH-pah-thee)

damage to the kidneys that results from long-term diabetes.

myocardial (MY-oh-CAR-dee-al) infarction (in-FARK-shun), or MI

death of heart muscle caused by a sudden obstruction in blood flow to heart muscle; also called a heart attack.

gangrene

death of tissue due to a deficient blood supply and/or infection.

dental caries

decay of teeth.

undernutrition

deficient energy or nutrients.

gastroparesis

delayed stomach emptying; most often a consequence of diabetes, gastric surgery, or neurological disorders.

eicosanoids (eye-COSS-uh-noyds)

derivatives of 20-carbon fatty acids; biologically active compounds that help to regulate blood pres- sure, blood clotting, and other body functions. They include prosta- glandins (PROS-tah-GLAND-ins), thromboxanes (throm-BOX-ains), and leukotrienes (LOO-ko-TRY-eens).

malignant (ma-LIG-nent)

describes a cancerous cell or tumor, which can injure healthy tissue and spread cancer to other regions of the body.

nasointestinal

describes a feeding tube placed into the GI tract via the nose; refers to nasoduodenal and nasojejunal feeding routes (also known as nasoenteric feeding routes).

nasoduodenal (ND)

describes a feeding tube placed into the duodenum via the nose.

nasojejunal (NJ)

describes a feeding tube placed into the jejunum via the nose.

nasogastric (NG)

describes a feeding tube placed into the stomach via the nose.

futile

describes medical care that will not improve the medical circumstances of a patient.

graft rejection

destruction of donor tissue by the recipient's immune system, which recognizes the donor cells as foreign.

macular (MACK-you-lar) degeneration

deterioration of the macular area of the eye that can lead to loss of central vision and eventual blindness. The macula is a small, oval, yellowish region in the center of the retina that provides the sharp, straight-ahead vision so critical to reading and driving.

syringes

devices used for injecting medications. A syringe consists of a hypodermic needle attached to a hollow tube with a plunger inside.

food lists

diet-planning tools that organize foods by their proportions of carbohydrate, fat, and protein; formerly known as exchange lists. Foods on any single list can be used interchangeably.

food group plans

diet-planning tools that sort foods into groups based on nutrient content and then specify that people should eat certain amounts of foods from each group.

high-quality proteins

dietary proteins containing all the essential amino acids in relatively the same amounts that human beings require. They may also contain nonessential amino acids.

preformed vitamin A

dietary vitamin A in its active form.

public health dietitians

dietitians who specialize in providing nutrition services through organized community efforts.

esophageal dysphagia

difficulty passing food through the esophagus; usually caused by an obstruction or a motility disorder.

dysphagia (dis-FAY-jah)

difficulty swallowing.

oropharyngeal dysphagia

difficulty transferring food from the mouth and pharynx to the esophagus to initiate the swallowing process; usually caused by a neuromuscular or structural disorder.

fluorosis (floor-OH-sis)

discoloration and pitting of tooth enamel caused by excess fluoride during tooth development.

periodontal disease

disease that involves the connective tissues that support the teeth.

AIDS-defining illnesses

diseases and complications associated with the later stages of an HIV infection, including recurrent bacterial pneumonia, opportunistic infections, certain cancers, and wasting of muscle tissue.

autoimmune diseases

diseases characterized by inappropriate immune responses against the body's own cells.

chronic diseases

diseases characterized by slow progression and long duration. Examples include heart disease, diabetes, and some cancers.

cancers

diseases characterized by the uncontrolled growth of a group of abnormal cells, which can destroy adjacent tissues and spread to other areas of the body via the lymph or blood.

cardiovascular disease (CVD)

diseases of the heart and blood vessels throughout the body. Atherosclerosis is the main cause of CVD. When the arteries that carry blood to the heart muscle become blocked, the heart suffers damage known as coronary heart disease (CHD).

macrovascular complications

disorders that affect large blood vessels, including the coronary arteries and arteries of the limbs.

microvascular complications

disorders that affect small blood vessels, including those in the retina and kidneys.

bottled water

drinking water sold in bottles.

first-pass elimination

drug losses that occur before the drug reaches the general circulation, mostly due to degradation by liver enzymes.

antineoplastic drugs

drugs that control or kill cancer cells.

antiemetics

drugs that prevent vomiting.

anticonvulsants

drugs that treat epileptic seizures.

antiretroviral drugs

drugs that treat retroviral infections, such as infection with human immunodeficiency virus (HIV).

xerostomia (ZEE-roh-STOE-me-ah)

dry mouth caused by reduced salivary flow.

variety (dietary)

eating a wide selection of foods within and among the major food groups.

disordered eating

eating behaviors that are neither normal nor healthy, including restrained eating, fasting, binge eating, and purging.

hyperglycemia

elevated blood glucose concentrations. Normal fasting plasma glucose levels are less than 100 mg/dL. Fasting plasma glucose levels between 100 and 125 mg/dL suggest prediabetes; values of 126 mg/dL and above suggest diabetes.

portal hypertension

elevated blood pressure in the hepatic portal vein due to obstructed blood flow through the liver and a greater inflow of portal blood.

hypertriglyceridemia

elevated blood triglyceride levels. Blood triglycerides are transported in very-low-density lipoproteins (VLDL).

hypercalcemia (HIGH-per-kal-SEE-me-ah)

elevated serum calcium levels.

hyperphosphatemia (HIGH-per-fos-fa-TEE-me-ah)

elevated serum phosphate levels. Note that the phosphorus in body fluids is present as phosphate; hence, the terms serum phosphate and serum phosphorus are often used interchangeably.

hyperkalemia (HIGH-per-ka-LEE-me-ah)

elevated serum potassium levels.

hypercalciuria (HIGH-per-kal-see-YOO-ree-ah)

elevated urinary calcium levels.

hyperoxaluria (HIGH-per-ox-ah-LOO-ree-ah)

elevated urinary oxalate levels.

hepatomegaly (HEP-ah-toe-MEG-ah-lee)

enlargement of the liver.

diploma mills

entities without valid accreditation that provide worthless degrees.

stressors

environmental elements, physical or psychological, that cause stress.

metalloenzymes (meh-TAL-oh-EN-zimes)

enzymes that contain one or more minerals as part of their structures.

lipases (LYE-pasez)

enzymes that hydrolyze lipids. Lingual lipase is a fat-digesting enzyme secreted from the salivary gland at the base of the tongue; gastric lipase is a fat-digesting enzyme secreted from the cells of the stomach.

major minerals

essential mineral nutrients the human body requires in relatively large amounts (greater than 100 milligrams per day); sometimes called macrominerals.

trace minerals

essential mineral nutrients the human body requires in relatively small amounts (less than 100 milligrams per day); some- times called microminerals.

kcalorie counts

estimates of food energy (and often, protein) consumed by patients for one or more days.

overnutrition

excess energy or nutrients.

central obesity

excess fat around the trunk of the body; also called abdominal fat or upper-body fat.

bacterial overgrowth

excessive bacterial colonization of the stomach and small intestine; may be due to low gastric acidity, altered GI motility, mucosal damage, or contamination.

hypercapnia (high-per-CAP-nee-ah)

excessive carbon dioxide in the blood.

steatorrhea (stee-AT-or-REE-ah)

excessive fat in the stool due to fat malabsorption; characterized by stools that are loose, frothy, and foul smelling because of a high fat content.

polyphagia (POL-ee-FAY-jee-ah)

excessive hunger or food intake.

polydipsia (POL-ee-DIP-see-ah)

excessive thirst.

polyuria (POL-ee-YOOR-ree-ah)

excessive urine production.

gastric glands

exocrine glands in the stomach wall that secrete gastric juice into the stomach.

salivary glands

exocrine glands that secrete saliva into the mouth.

vomiting

expulsion of the contents of the stomach up through the esophagus to the mouth.

nursing bottle tooth decay

extensive tooth decay due to prolonged tooth contact with formula, milk, fruit juice, or other carbohydrate- rich liquid offered to an infant in a bottle.

food banks

facilities that collect and distribute food donations to authorized organizations feeding the hungry.

variables

factors that change. A variable may depend on another variable (for example, a child's height depends on his age), or it may be independent (for example, a child's height does not depend on the color of her eyes). Sometimes both variables correlate with a third vari- able (a child's height and eye color both depend on genetics).

misinformation

false or misleading information.

subcutaneous fat

fat stored directly under the skin.

visceral fat

fat stored within the abdominal cavity in association with the internal abdominal organs; also called intra-abdominal fat.

foam cells

fat-laden macrophages that reside in the artery wall.

solid fats

fats that are not usually liquid at room temperature; commonly found in most foods derived from animals and vegetable oils that have been hydrogenated. Solid fats typically contain more saturated and trans fats than most oils.

essential fatty acids

fatty acids that the body requires but cannot make, and so must be obtained from the diet; both linoleic acid and linolenic acid are essential fatty acids.

trans-fatty acids

fatty acids with hydrogens on opposite sides of the double bond.

kcalorie-free

fewer than 5 kcalories per serving.

confectioners' sugar

finely powdered sucrose, 99.9 percent pure.

villi (VILL-ee or VILL-eye)

fingerlike projections from the folds of the small intestine; singular villus.

critical periods

finite periods during development in which certain events occur that will have irreversible effects on later developmental stages; usually a period of rapid cell division.

interstitial (IN-ter-STISH-al) fluid

fluid between the cells (intercellular), usually high in sodium and chloride. Interstitial fluid is a large component of extracellular fluid.

intracellular fluid

fluid inside the cells, usually high in potassium and phosphate. Intracellular fluid accounts for approximately two- thirds of the body's water.

extracellular fluid

fluid outside the cells. Extracellular fluid includes two main components—the interstitial fluid between cells and the intravascular fluid inside blood vessels. Extracellular fluid accounts for approximately one-third of the body's water.

intravascular fluid

fluid within blood vessels.

prebiotics

food components (such as fibers) that are not digested by the human body but are used as food by the GI bacteria to promote their growth and activity.

food substitutes

foods that are designed to replace other foods.

functional foods

foods that have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis at effective levels.

processed foods

foods that have been treated to change their physical, chemical, microbiological, or sensory properties.

imitation foods

foods that substitute for and resemble another food, but are nutritionally inferior to it with respect to vitamin, mineral, or protein content. If the substitute is not inferior to the food it resembles and if its name provides an accurate description of the product, it need not be labeled "imitation."

deep vein thrombosis

formation of a stationary blood clot (thrombus) in a deep vein, usually in the leg, which causes inflammation, pain, and swelling, and is potentially fatal.

cholelithiasis (KOH-leh-lih-THIGH-ah-sis)

formation of gallstones.

sterile

free of microorganisms, such as bacteria.

exogenous (eks-ODGE-eh-nus)

from outside the body.

endogenous (en-DODGE-eh-nus)

from within the body.

adrenal glands

glands adjacent to, and just above, each kidney.

mammary glands

glands of the female breast that secrete milk.

gestational diabetes

glucose intolerance with onset or first recognition during pregnancy.

white sugar

granulated sucrose or "table sugar," produced by dissolving, concentrating, and recrystallizing raw sugar.

calcium rigor

hardness or stiffness of the muscles caused by high blood calcium concentrations.

hyperosmolar

having an abnormally high osmolarity; osmolarity refers to the concentration of osmotically active particles in solution. Hyperglycemia may cause some body fluids to become hyperosmolar.

cultural competence

having an awareness and acceptance of cultures and the ability to interact effectively with people of diverse cultures.

satiating

having the power to suppress hunger and inhibit eating.

validity (va-LID-ih-tee)

having the quality of being founded on fact or evidence.

biofield therapies

healing methods based on the belief that illnesses can be cured by manipulating energy fields that purportedly surround and penetrate the body. Examples include acupuncture, qi gong, and therapeutic touch.

complementary and alternative medicine (CAM)

health care practices that have not been proved to be effective and consequently are not included as part of conventional treatment.

nutrition support teams

health care professionals responsible for the provision of nutrients by tube feeding or intravenous infusion.

certified lactation consultants

health care providers who specialize in helping new mothers establish a healthy breastfeeding relationship with their newborn. These consultants are often registered nurses with specialized training in breast and infant anatomy and physiology.

pasteurization

heat processing of food that inactivates some, but not all, microorganisms in the food; not a sterilization process. Bacteria that cause spoilage are still present.

glycated hemoglobin (HbA1c)

hemoglobin that has nonenzymatically attached to glucose; the level of HbA1c in the blood helps to diagnose diabetes and evaluate long-term glycemic control; alos called glycosylated hemoglobin.

covert (KOH-vert)

hidden, as if under covers.

hypertension

high blood pressure

gestational hypertension

high blood pressure that develops in the second half of pregnancy and resolves after childbirth, usually without affecting the outcome of the pregnancy.

acidosis (assi-DOE-sis)

higher-than-normal acidity in the blood and body fluids.

alkalosis (alka-LOE-sis)

higher-than-normal alkalinity (base) in the blood and body fluids.

self-monitoring of blood glucose

home monitoring of blood glucose levels using a glucose meter.

food poverty

hunger resulting from inadequate access to available food for various reasons, including inadequate resources, political obstacles, social disruptions, poor weather conditions, and lack of transportation.

rebound hyperglycemia

hyperglycemia that results from the release of counterregulatory hormones following nighttime hypoglycemia; also called the Somogyi effect.

fasting hyperglycemia

hyperglycemia that typically develops in the early morning after an overnight fast of at least 8 hours.

secondary hypertension

hypertension that results from a known physiological abnormality.

primary hypertension

hypertension with an unknown cause; also known as essential hypertension.

reticulocytes

immature red blood cells released into the blood by the bone marrow.

phagocytes (FAG-oh-sites)

immune cells (neutrophils and macro- phages) that have the ability to engulf and destroy antigens.

hypersensitivity

immune responses that are excessive or inappropriate. One type of hypersensitivity is allergy.

humoral immunity

immunity conferred by B cells, which produce and release antibodies into body fluids.

cell-mediated immunity

immunity conferred by T cells and macrophages.

innate immunity

immunity that is present at birth, unchanging throughout life, and nonspecific for particular antigens; also called natural immunity.

adaptive immunity

immunity that is specific for particular antigens; it adapts to antigens in an individual's environment and is characterized by "memory" for particular antigens; also called acquired immunity.

peripheral artery disease

impaired blood flow in the arteries of the legs; may cause pain and weakness in the legs and feet, especially during exercise.

half-life

in blood tests, refers to the length of time that a substance remains in plasma. The albumin in plasma has a half-life of 14 to 20 days, meaning that half of the amount circulating in plasma is degraded in this time period.

organic

in chemistry, substances or molecules containing carbon-car- bon bonds or carbon-hydrogen bonds that are characteristic of living organisms. The four classes of nutrients that are organic are carbohydrates, lipids (fats), proteins, and vitamins.

dietary fibers

in plant foods, the nonstarch polysaccharides that are not digested by human digestive enzymes, although some are digested by GI tract bacteria.

ischemia (iss-KEE-mee-a)

inadequate blood supply within a tissue due to obstructed blood flow.

deficient

inadequate; a nutrient amount that fails to meet the body's needs and eventually results in deficiency symptoms.

hyperactivity

inattentive and impulsive behavior that is more frequent and severe than is typical of others a similar age; professionally called attention-deficit/hyperactivity disorder (ADHD).

indigestion

incomplete or uncomfortable digestion, usually accompanied by pain, nausea, vomiting, heartburn, intestinal gas, or belching.

diverticulitis (DYE-ver-tic-you-LYE-tis)

infected or inflamed diverticula.

opportunistic infections

infections caused by microorganisms that normally do not cause disease in healthy people but are damaging to persons with compromised immune function.

reflux esophagitis

inflammation in the esophagus resulting from the reflux of acidic stomach contents.

arthritis

inflammation of a joint, usually accompanied by pain, swelling, and structural changes.

phlebitis (fleh-BYE-tiss)

inflammation of a vein.

radiation enteritis

inflammation of intestinal tissue caused by radiation therapy.

gastritis

inflammation of stomach tissue. (The suffix -itis refers to the presence of inflammation in an organ or tissue.)

colitis (ko-LYE-tis)

inflammation of the colon.

cholecystitis (KOH-leh-sih-STY-tis)

inflammation of the gallbladder, usually caused by obstruction of the cystic duct by gallstones.

gingivitis (jin-jeh-VYE-tus)

inflammation of the gums, characterized by redness, swelling, and bleeding.

hepatitis (hep-ah-TYE-tis)

inflammation of the liver.

oral mucositis

inflammation of the oral mucosa; signs may include swelling, redness, mouth sores, bleeding, or ulcerations in mucosal tissue.

peritonitis

inflammation of the peritoneal membrane, which lines the abdominal cavity.

periodontitis

inflammation or degeneration of the tissues that sup- port the teeth.

fat replacers

ingredients that replace some or all of the functions of fat and may or may not provide energy.

aromatherapy

inhalation of oil extracts from plants to cure illness or enhance health.

fatty streaks

initial lesions of atherosclerosis that form on the artery wall, characterized by accumulations of foam cells, lipid material, and connective tissue.

minerals

inorganic elements. Some minerals are essential nutrients required in small amounts by the body for health.

biofeedback training

instruction in techniques that allow individuals to gain voluntary control of certain physiological processes, such as skin temperature or brain wave activity, to help reduce stress and anxiety.

calcium tetany (TET-ah-nee)

intermittent spasm of the extremities due to nervous and muscular excitability caused by low blood calcium concentrations.

esophageal (ee-SOFF-ah-GEE-al)

involving the esophagus.

oropharyngeal (OR-oh-fah-ren-JEE-al)

involving the mouth and pharynx.

contamination iron

iron found in foods as the result of contamination by inorganic iron salts from iron cookware, iron-containing soils, and the like.

milk anemia

iron-deficiency anemia that develops when an excessive milk intake displaces iron-rich foods from the diet.

Gastroesophageal reflux disease (GERD)

is characterized by symptoms of reflux occurring two or more times a week.

pruritus

itchy skin.

chronic kidney disease

kidney disease characterized by gradual, irreversible deterioration of the kidneys; also called chronic renal failure.

anorexia

lack of appetite.

immunoglobulins (im-you-no-GLOB-you-linz)

large globular proteins produced by B cells that function as antibodies.

antibodies

large proteins of the blood and body fluids, produced by the immune system in response to the invasion of the body by foreign molecules (usually proteins called antigens). Antibodies combine with and inactivate the foreign invaders, thus protecting the body.

fat-free

less than 0.5 gram of fat per serving (and no added fat or oil); synonyms include zero-fat, no-fat, and nonfat.

saturated fat-free

less than 0.5 gram of saturated fat and 0.5 gram of

sugar-free

less than 0.5 gram of sugar per serving.

trans fat-free

less than 0.5 gram of trans fat and less than 0.5 gram of saturated fat per serving.

lean

less than 10 grams of fat, 4.5 grams of saturated fat and trans fat combined, and 95 milligrams of cholesterol per serving and per 100 grams of meat, poultry, and seafood. For mixed dishes such as burritos and sandwiches, less than 8 grams of fat, 3.5 grams of satu- rated fat, and 80 milligrams of cholesterol per reference amount customarily consumed.

cholesterol-free

less than 2 milligrams of cholesterol per serving and 2 grams or less of saturated fat and trans fat combined per serving.

extra lean

less than 5 grams of fat, 2 grams of saturated fat and trans fat combined, and 95 milligrams of cholesterol per serving and per 100 grams of meat, poultry, and seafood.

sodium-free and salt-free

less than 5 milligrams of sodium per serving.

mechanical ventilation

life-sustaining treatment in which a mechanical ventilator assists or replaces spontaneous breathing; substitutes for a patient's failing lungs.

defibrillation

life-sustaining treatment in which an electronic device is used to shock the heart and reestablish a pattern of normal contractions. Defibrillation is used when the heart has arrhythmias or has experienced arrest.

cardiopulmonary resuscitation (CPR)

life-sustaining treatment that supplies oxygen and restores a person's ability to breathe and pump blood.

food insecurity

limited or uncertain access to foods of sufficient quality or quantity to sustain a healthy and active life. Food insecurity categories include low food security, which reflects reduced quality of life with little or no indication of reduced food intake (formerly known as food insecurity without hunger) and very low food security, which reflects multiple indications of disrupted eating patterns and reduced food intake (formerly known as food insecurity with hunger).

oils

lipids that are liquid at room temperature (77ºF, or 25ºC).

fats

lipids that are solid at room temperature (77ºF, or 25ºC).

HDL (high-density lipoprotein)

lipoproteins that help to remove cholesterol from the blood by transporting it to the liver for reuse or disposal.

high-density lipoproteins (HDL)

lipoproteins that help to remove cholesterol from the blood by transporting it to the liver for reuse or disposal.

LDL (low-density lipoprotein)

lipoproteins that transport cholesterol in the blood.

low-density lipoproteins (LDL)

lipoproteins that transport cholesterol in the blood.

VLDL (very-low-density lipoprotein)

lipoproteins that transport triglycerides from the liver to other tissues. In clinical practice, VLDL are commonly referred to as blood triglycerides.

very-low-density lipoproteins (VLDL)

lipoproteins that transport triglycerides from the liver to other tissues. In clinical practice, VLDL are commonly referred to as blood triglycerides.

tube feedings

liquid formulas delivered through a tube placed in the stomach or intestine.

registration

listing; with respect to health professionals, listing with a professional organization that requires specific course work, experience, and passing of an examination.

anemia (ah-NEE-me-ah)

literally, "too little blood." Anemia is any condition in which too few red blood cells are present, or the red blood cells are immature (and therefore large) or too small or contain too little hemoglobin to carry the normal amount of oxygen to the tissues. Anemia is not a disease itself but can be a consequence of many different disease conditions, including many nutrient deficiencies, bleeding, exces- sive red blood cell destruction, and defective red blood cell formation.

sludge

literally, a semisolid mass. Biliary sludge is made up of mucus, cholesterol crystals, and bilirubin granules.

steatohepatitis (STEE-ah-to-HEP-ah-TYE-tis)

liver inflammation that is associated with fatty liver.

probiotics

living microorganisms found in foods and dietary supplements that, when consumed in sufficient quantities, are beneficial to health.

pressure sores

localized injuries to the skin and/or underlying tissue due to prolonged pressure on the affected area by an external object, such as a bed, wheelchair, or cast; vulnerable areas of the body include buttocks, hips, and heels; also called pressure ulcers or decubitus (deh-KYU-bih-tus) ulcers.

hepatic coma

loss of consciousness resulting from severe liver disease.

sarcopenia (SAR-koh-PEE-nee-ah)

loss of skeletal muscle mass, strength, and quality.

hypovolemia (HIGH-poe-voe-LEE-me-ah)

low blood volume. hypoxemia (high-pock-SEE-me-ah): insufficient oxygen in the blood. hypoxia (high-POCK-see-ah): insufficient oxygen in body tissues.

hypoalbuminemia

low plasma albumin concentrations. Plasma proteins such as albumin help to maintain fluid balance within the blood; thus, low levels contribute to edema.

hypokalemia (HIGH-po-ka-LEE-me-ah)

low serum potassium levels.

hypocitraturia (HIGH-poe-sih-tra-TOO-ree-ah)

low urinary citrate levels. Citrate is a metabolite of the TCA cycle and is also a natural component of fruits (especially citrus fruits) and some other foods.

natural killer cells

lymphocytes that confer nonspecific immunity by destroying a wide array of viruses and tumor cells.

helper T cells

lymphocytes that have a specific protein called CD4 on their surfaces and therefore are also known as CD4+T cells; these are the cells most affected in HIV infection.

weight management

maintaining body weight in a healthy range by preventing gradual weight gains over time and losing weight if overweight, and by preventing weight losses and gaining weight if underweight.

fluid balance

maintenance of the proper types and amounts of fluid in each compartment of the body fluids.

alcohol-related birth defects (ARBD)

malformations in the skeletal and organ systems (heart, kidneys, eyes, ears) associated with prenatal alcohol exposure.

neural tube defects

malformations of the brain, spinal cord, or both during embryonic development that often result in lifelong disability or death. The two main types of neural tube defects are spina bifida (literally "split spine") and anencephaly ("no brain").

kcalorie (energy) control

management of food energy intake.

massage therapy

manual manipulation of muscles to reduce tension, increase blood circulation, improve joint mobility, and promote heal- ing of injuries.

polypeptide

many (10 or more) amino acids bonded together.

brown adipose tissue

masses of specialized fat cells packed with

residue

material left in the intestine after digestion; includes dietary fiber, undigested starches and proteins, GI secretions, and cellular debris.

percent fat-free

may be used only if the product meets the definition of low fat or fat-free and must reflect the amount of fat in 100 grams (for example, a food that contains 2.5 grams of fat per 50 grams can claim to be "95 percent fat-free").

prehypertension

medical classification for a blood pressure level that is higher than normal but not high enough to be classified as hypertension.

acid controllers

medications used to prevent or relieve indigestion by suppressing production of acid in the stomach; also called H2 blockers. Common brands include Pepcid AC, Tagamet HB, Zantac 75, and Axid AR.

antacids

medications used to relieve indigestion by neutralizing acid in the stomach. Common brands include Alka-Seltzer, Maalox, Rolaids, and Tums.

tocotrienols (TOE-koh-try-EE-nawls)

members of the vitamin E fam- ily having the chemical structure of a complex ring structure with a long unsaturated side chain.

tocopherols (tuh-KOFF-uh-rawls)

members of the vitamin E family having the chemical structure of a complex ring structure with a long saturated side chain.

selective menus

menus that provide choices in some or all menu categories.

pathogens (PATH-oh-jenz)

microorganisms capable of producing disease.

microbes (MY-krobes)

microscopically small organisms including bacteria, viruses, fungi, and protozoa; also called microorganisms.

yogurt

milk product that results from the fermentation of lactic acid in milk by Lactobacillus bulgaricus and Streptococcus thermophilus.

heavy metals

mineral ions such as mercury and lead, so called because they are of relatively high atomic weight. Many heavy metals are poisonous.

dental calculus

mineralized dental plaque, often associated with inflammation and progressive gum disease.

monoglycerides

molecules of glycerol with one fatty acid attached. A molecule of glycerol with two fatty acids attached is a diglyceride.

heavy drinking

more than three drinks on any day for women and more than four drinks on any day for men.

dawn phenomenon

morning hyperglycemia that is caused by the early- morning release of growth hormone, which reduces insulin sensitivity.

diffusion

movement of solutes from an area of high concentration to one of low concentration.

osmosis

movement of water across a membrane toward the side where solutes are more concentrated.

anions (AN-eye-uns)

negatively charged ions.

food deserts

neighborhoods and communities characterized by limited access to nutritious and affordable foods.

neurons

nerve cells; the structural and functional units of the nervous system. Neurons initiate and conduct nerve impulse transmissions.

diabetic neuropathy (nur-RAH-pah-thee)

nerve damage that results from long-term diabetes.

phytochemicals (FIE-toe-KEM-ih-cals)

nonnutrient compounds found in plants. Some phytochemicals have biological activity in the body.

soluble fibers

nonstarch polysaccharides that dissolve in water to form a gel. An example is pectin from fruit, which is used to thicken jellies.

insoluble fibers

nonstarch polysaccharides that do not dissolve in water. Examples include the tough, fibrous structures found in the strings of celery and the skins of corn kernels.

nonpathogenic

not capable of causing disease.

inorganic

not containing carbon or pertaining to living organisms. The two classes of nutrients that are inorganic are minerals and water.

intractable

not easily managed or controlled.

anaerobic (AN-air-ROE-bic)

not requiring oxygen.

essential nutrients

nutrients a person must obtain from food because the body cannot make them for itself in sufficient quantity to meet physiological needs; also called indispensable nutrients. About 40 nutrients are currently known to be essential for human beings.

medical nutrition therapy

nutrition care provided by a registered dietitian; includes assessing nutrition status, diagnosing nutrition problems, and providing nutrition care.

congregate meals

nutrition programs that provide food for the elderly in conveniently located settings such as community centers.

organic

on food labels, that at least 95 percent of the product's ingredients have been grown and processed according to USDA regulations defining the use of fertilizers, herbicides, insecticides, fungicides, preservatives, and other chemical ingredients.

cis

on the near side of; refers to a chemical configuration in which the hydrogen atoms are located on the same side of a double bond.

trans

on the other side of; refers to a chemical configuration in which the hydrogen atoms are located on opposite sides of a double bond.

beta-carotene (BAY-tah KARE-oh-teen)

one of the carotenoids; an orange pigment and vitamin A precursor found in plants.

spina (SPY-nah) bifida (BIFF-ih-dah)

one of the most common types of neural tube defects, characterized by the incomplete closure of the spinal cord and its bony encasement.

lecithin (LESS-uh-thin)

one of the phospholipids. Lecithin acts as an emulsifier to combine water-soluble and fat-soluble ingredients that do not ordinarily mix, such as water and oil.

cholesterol (koh-LESS-ter-ol)

one of the sterols containing a four-ring carbon structure with a carbon side chain.

ascorbic acid

one of the two active forms of vitamin C. Many people refer to vitamin C by this name.

light or lite

one-third fewer kcalories than the comparison food; 50 percent or less of the fat or sodium than the comparison food; any use of the term other than as defined must specify what it is referring to (for example, "light in color" or "light in texture").

fatty acids

organic compounds composed of a carbon chain with hydrogens attached and an acid group (COOH) at one end and a methyl group (CH3) at the other end.

vitamins

organic, essential nutrients required in small amounts by the body for health. Vitamins regulate body processes that support growth and maintain life.

overt (oh-VERT)

out in the open and easy to observe.

claudication (CLAW-dih-KAY-shun)

pain in the legs while walking; usually due to an inadequate supply of blood to muscles.

hemorrhoids (HEM-oh-royds)

painful swelling of the veins surrounding the rectum.

coupled reactions

pairs of chemical reactions in which some of the energy released from the breakdown of one compound is used to create a bond in the formation of another compound.

disaccharides (dye-SACK-uh-rides)

pairs of monosaccharides linked together.

flatulence

passage of excessive amounts of intestinal gas.

binge drinking

pattern of drinking that raises blood alcohol concentration to 0.08 percent or higher; usually corresponds to four or more drinks for women and five or more drinks for men on a single occasion, generally within a couple of hours.

license to practice

permission under state or federal law, granted on meeting specified criteria, to use a certain title (such as dietitian) and offer certain services. Licensed dietitians may use the initials LD after their names.

ethical

pertaining to accepted principles of right and wrong. ethnic foods: foods associated with particular cultural groups. excessive drinking: heavy drinking, binge drinking, or both.

glycemic (gly-SEEMic)

pertaining to blood glucose.

laparoscopic

pertaining to procedures that use a laparoscope for internal examination or surgery. A laparoscope is a narrow surgical telescope that is inserted into the abdominal cavity through a small incision. A video camera is usually attached so that the procedure can be viewed on a television monitor.

bariatric

pertaining to the field of medicine that specializes in treating obesity.

renal (REE-nal)

pertaining to the kidneys.

exocrine

pertains to external secretions, such as those of the mucous membranes or the skin. Opposite of endocrine, which pertains to hormonal secretions into the blood.

macrophages

phagocytic cells that protect tissues by engulfing pathogens and cellular debris; they are derived from white blood cells called monocytes.

dissociates (dis-SO-see-aites)

physically separates.

intestinal adaptation

physiological changes in the small intestine that increase its absorptive capacity after resection.

lignans

phytochemicals present in flaxseed that are converted to phytosterols by intestinal bacteria and are under study as possible anticancer agents.

phytoestrogens

phytochemicals structurally similar to human estro- gen that weakly mimic or modulate estrogen's action in the body. Phytoestrogens include the isoflavones genistein, daidzein, and glycitein.

plant sterols

phytochemicals that have structural similarities to cholesterol and lower blood cholesterol by interfering with cholesterol absorption. Plant sterols include sterol esters and stanol esters.

carotenoids (kah-ROT-eh-noyds)

pigments commonly found in plants and animals, some of which have vitamin A activity. The carotenoid with the greatest vitamin A activity is beta-carotene.

xanthophylls (ZAN-tho-fills)

pigments found in plants responsible for the color changes seen in autumn leaves.

oxalates

plant compounds found in green leafy vegetables and some other foods; these compounds can bind to minerals in the GI tract and form complexes that cannot be absorbed.

starches

plant polysaccharides composed of many glucose molecules.

legumes (lay-GYOOMS or LEG-yooms)

plants of the bean and pea family, with seeds that are rich in protein compared with other plant- derived foods.

acute-phase proteins

plasma proteins released from the liver at the onset of acute infection. An example is C-reactive protein, which is considered one of the main indicators of severe infection and has antimicrobial effects.

tagatose (TAG-ah-tose)

poorly absorbed monosaccharide similar in structure to fructose; naturally occurring or derived from lactose.

fad diets

popular eating plans that promise quick weight loss. Most fad diets severely limit certain foods or overemphasize oth- ers (for example, never eat potatoes or pasta, or eat cabbage soup daily).

cations (CAT-eye-uns)

positively charged ions.

textured vegetable protein

processed soybean protein used in vegetarian products such as soy burgers.

lactation

production and secretion of breast milk for the purpose of nourishing an infant.

erythropoiesis (eh-RIH-throh-poy-EE-sis)

production of red blood cells within the bone marrow.

foods

products derived from plants or animals that can be taken into the body to yield energy and nutrients for the maintenance of life and the growth and repair of tissues.

metabolites

products of metabolism; compounds produced by a biochemical pathway.

xerophthalmia (zer-off-THAL-mee-uh)

progressive blindness caused by inadequate mucus production due to severe vitamin A deficiency.

digestive enzymes

proteins found in digestive juices that act on food substances, causing them to break down into simpler compounds.

gluten (GLOO-tuhn)

proteins in grains that give dough its elastic texture; in people with celiac disease, gluten damages the small intestine.

adipokines (ADD-ih-poe-kines)

proteins synthesized and secreted by adipose cells.

transcription factors

proteins that bind to specific sites in DNA and alter gene expression.

enzymes

proteins that facilitate chemical reactions without being changed in the process; protein catalysts.

adequacy (dietary)

providing all the essential nutrients, fiber, and energy in amounts sufficient to maintain health.

moderation (dietary)

providing enough but not too much of a substance.

balance (dietary)

providing foods in proportion to one another and in proportion to the body's needs.

Acceptable Macronutrient Distribution Ranges (AMDR)

ranges of intakes for the energy nutrients that provide adequate energy and nutrients and reduce the risk of chronic diseases.

nutrient profiling

ranking foods based on their nutrient composition.

catabolism (ca-TAB-o-lism)

reactions in which large molecules are broken down to smaller ones. Catabolic reactions release energy.

anabolism (an-AB-o-lism)

reactions in which small molecules are put together to build larger ones. Anabolic reactions require energy.

advanced glycation end products (AGEs)

reactive compounds formed after glucose combines with protein; AGEs can damage tissues and lead to diabetic complications.

Daily Values (DV)

reference values developed by the FDA specifically for use on food labels.

perinatal

referring to the time between the twenty-eighth week of gestation and 1 month after birth.

autoimmune

refers to an immune response directed against the body's own tissues.

enteric coated

refers to medications or enzyme preparations that are coated to withstand stomach acidity and dissolve only at the higher pH of the small intestine.

brown sugar

refined white sugar crystals to which manufacturers have added molasses syrup with natural flavor and color; 91 to 96 percent pure sucrose.

anthropometric (AN-throw-poe-MET-rick)

relating to measurement of the physical characteristics of the body, such as height and weight.

colectomy

removal of a portion or all of the colon.

hemofiltration

removal of fluid and solutes from the blood by pumping the blood across a membrane; no osmotic gradients are created during the process.

ultrafiltration

removal of fluids and solutes from the blood by using pressure to transfer the blood across a semipermeable membrane.

deamination (dee-AM-ih-NAY-shun)

removal of the amino (NH2) group from a compound such as an amino acid.

replication (REP-lih-KAY-shun)

repeating an experiment and getting the same results.

aerobic (air-ROE-bic)

requiring oxygen.

microarray technology

research tools that analyze the expression of thousands of genes simultaneously and search for particular gene changes associated with a disease. DNA microarrays are also called DNA chips.

acute respiratory distress syndrome (ARDS)

respiratory failure trig- gered by severe lung injury; a medical emergency that causes dyspnea and pulmonary edema and usually requires mechanical ventilation.

blood lipid profile

results of blood tests that reveal a person's total cholesterol, triglycerides, and various lipoproteins.

diabetic retinopathy (REH-tih-NAH-pah-thee)

retinal damage that results from long-term diabetes.

diverticula (dye-ver-TIC-you-la)

sacs or pouches that develop in the weakened areas of the intestinal wall (like bulges in an inner tube where the tire wall is weak).

electrolytes

salts that dissolve in water and dissociate into charged particles called ions.

genes

sections of chromosomes that contain the instructions needed to make one or more proteins.

RDN

see registered dietitian nutritionist.

conjugated linoleic acids

several fatty acids that have the same chemical formula as linoleic acid (18 carbons, two double bonds) but with different configurations (the double bonds occur on adjacent carbons).

intermittent claudication (klaw-dih-KAY-shun)

severe calf pain caused by inadequate blood supply. It occurs when walking and sub- sides during rest.

iron-deficiency anemia

severe depletion of iron stores that results in low hemoglobin and small, pale red blood cells. Iron-deficiency anemia is a microcytic (my-cro-SIT-ic) hypochromic (high-po-KROME-ic) anemia.

cardiac cachexia

severe malnutrition that develops in heart failure patients; characterized by weight loss and tissue wasting.

dyspnea (DISP-nee-ah)

shortness of breath.

cytokines (SIGH-toe-kines)

signaling proteins produced by the body's cells; many cytokines are produced by immune cells and regulate immune responses.

resting metabolic rate (RMR)

similar to the basal metabolic rate (BMR), a measure of energy use for a person at rest in a comfortable setting, but with less stringent criteria for recent food intake and physical activity. Consequently, the RMR is slightly higher than the BMR.

sugars

simple carbohydrates composed of monosaccharides, disaccharides, or both.

night blindness

slow recovery of vision after flashes of bright light at night or an inability to see in dim light; an early symptom of vitamin A deficiency.

capillaries (CAP-ill-aries)

small vessels that branch from an artery. Capillaries connect arteries to veins. Exchange of oxygen, nutrients, and waste materials takes place across capillary walls.

neurofibrillary tangles

snarls of the threadlike strands that extend from the nerve cells, commonly found in the brains of people with Alzheimer's dementia.

keratomalacia (KARE-ah-toe-ma-LAY-shuh)

softening of the cor- nea that leads to irreversible blindness; a sign of severe vitamin A deficiency.

enema

solution inserted into the rectum and colon to stimulate a bowel movement and empty the lower large intestine.

electrolyte solutions

solutions that can conduct electricity.

lymphoid tissues

specialized connective tissues involved in the development or functioning of lymphocytes.

diet orders

specific instructions regarding dietary management; also called diet prescriptions or nutrition prescriptions.

resistant starches

starches that escape digestion and absorption in the small intestine of healthy people.

nutrient claims

statements that characterize the quantity of a nutrient in a food.

health claims

statements that characterize the relationship between a nutrient or other substance in a food and a disease or health-related condition.

structure-function claims

statements that characterize the relationship between a nutrient or other substance in a food and its role in the body.

gallstones

stones that form in the gallbladder from crystalline depos- its of cholesterol and/or bilirubin; also called choleliths.

nutrition care plans

strategies for meeting an individual's nutritional needs.

hemorrhagic strokes

strokes caused by bleeding within the brain, which destroys or compresses brain tissue.

ischemic strokes

strokes caused by the obstruction of blood flow to brain tissue.

food aversions

strong desires to avoid particular foods.

food cravings

strong desires to eat particular foods.

chromosomes

structures within the nucleus of a cell made of DNA and associated proteins. Human beings have 46 chromosomes in 23 pairs. Each chromosome has many genes.

prenatal alcohol exposure

subjecting a fetus to a pattern of excessive alcohol intake characterized by substantial regular use or heavy epi- sodic drinking.

carcinogens (CAR-sin-oh-jenz or car-SIN-oh-jenz)

substances that can cause cancer (the adjective is carcinogenic).

antigens

substances that elicit the formation of antibodies or an inflammation reaction from the immune system. A bacterium, a virus, a toxin, and a protein in food that causes allergy are all examples of antigens.

laxatives

substances that loosen the bowels and thereby prevent or treat constipation.

precursors

substances that precede others; with regard to vitamins, compounds that can be converted into active vitamins; also known as provitamins.

prooxidants

substances that significantly induce oxidative stress.

nanoceuticals

substances with extremely small particles that have been manufactured by nanotechnology.

stroke

sudden death of brain cells due to impaired blood flow to the brain or rupture of an artery in the brain; also called a cerebrovascular accident.

honey

sugar formed from nectar gathered by bees. Composition and flavor vary, but honey always contains a mixture of mostly fructose, some glucose, and a little sucrose.

turbinado (ter-bih-NOD-oh) sugar

sugar produced using the same refining process as white sugar, but without the bleaching and anticak- ing treatment. Traces of molasses give turbinado its sandy color.

artificial sweeteners

sugar substitutes that provide negligible, if any, energy; sometimes called nonnutritive sweeteners.

sugar alcohols

sugarlike compounds that can be derived from fruits or commercially produced from dextrose; also called polyols. Examples include erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol, and xylitol.

added sugars

sugars and other kcaloric sweeteners that are added to foods during processing, preparation, or at the table. Added sugars do not include the naturally occurring sugars found in fruits and milk products.

genetic counseling

support for families at risk of genetic disorders; involves diagnosis of disease, identification of inheritance patterns within the family, and review of reproductive options.

bariatric (BAH-ree-AH-trik) surgery

surgery that treats severe obesity.

cholecystectomy (KOH-leh-sis-TEK-toe-mee)

surgical removal of the gallbladder.

nutritive sweeteners

sweeteners that yield energy, including both sugars and sugar alcohols.

nonnutritive sweeteners

sweeteners that yield no energy (or insignificant energy in the case of aspartame).

dyspepsia

symptoms of pain or discomfort in the upper abdominal area, often called indigestion; a symptom of illness rather than a disease itself.

amniotic (am-nee-OT T-ic) sac

the "bag of waters" in the uterus, in which the fetus floats.

toxicity

the ability of a substance to harm living organisms. All sub- stances are toxic if high enough concentrations are used.

cross-reactivity

the ability of an antibody to react to an antigen that is similar, but not identical, to the one that induced the antibody's formation.

decision-making capacity

the ability to understand pertinent information and make appropriate decisions; known within the legal system as decision-making competency.

amenorrhea (ay-MEN-oh-REE-ah)

the absence of or cessation of menstruation. Primary amenorrhea is menarche delayed beyond 15 years of age. Secondary amenorrhea is the absence of three consecutive menstrual cycles.

anuria (ah-NOO-ree-ah)

the absence of urine, often identified as a urine output that is less than about 50 to 75 mL/day.

buffalo hump

the accumulation of fatty tissue at the base of the neck.

uremia (you-REE-me-ah)

the accumulation of nitrogenous and various other waste products in the blood (literally, "urine in the blood"); may also be used to indicate the toxic state that results when wastes are retained in the blood. The related term azotemia refers specifically to the accumulation of nitrogenous wastes in the blood.

retinoic (RET-ih-NO-ick) acid

the acid form of vitamin A.

disclosure

the act of revealing pertinent information. For example, clinicians should accurately describe proposed tests and procedures, their benefits and risks, and alternative approaches.

protein-sparing action

the action of carbohydrate (and fat) in providing energy that allows protein to be used for other purposes.

alpha-tocopherol

the active vitamin E compound.

methylation

the addition of a methyl group (CH3).

fortified

the addition to a food of nutrients that were either not originally present or present in insignificant amounts. Fortification can be used to correct or prevent a widespread nutrient deficiency or to balance the total nutrient profile of a food.

enriched

the addition to a food of specific nutrients to replace losses that occur during processing so that the food will meet a specified standard.

piggyback

the administration of a second solution using a separate port in an intravenous catheter.

oral rehydration therapy (ORT)

the administration of a simple solution of sugar, salt, and water, taken by mouth, to treat dehydration caused by diarrhea.

trachea (TRAKE-ee-uh)

the air passageway from the larynx to the lungs; also called the windpipe.

retinol (RET-ih-nol)

the alcohol form of vitamin A.

retinal (RET-ih-nal)

the aldehyde form of vitamin A.

aromatic amino acids

the amino acids phenylalanine, tyrosine, and tryptophan, which have carbon rings in their side groups.

carbohydrate-to-insulin ratio

the amount of carbohydrate that can be handled per unit of insulin; on average, every 15 grams of carbohydrate requires about 1 unit of rapid- or short-acting insulin.

dietary folate equivalents (DFE)

the amount of folate available to the body from naturally occurring sources, fortified foods, and supplements, accounting for differences in the bioavailability from each source.

niacin equivalents (NE)

the amount of niacin present in food, including the niacin that can theoretically be made from its precursor, tryptophan, present in the food.

nitrogen balance

the amount of nitrogen consumed (N in) as compared with the amount of nitrogen excreted (N out) in a given period of time.

osmotic pressure

the amount of pressure needed to prevent the movement of water across a membrane.

epidemic (ep-ih-DEM-ick)

the appearance of a disease (usually infec- tious) or condition that attacks many people at the same time in the same region.

Recommended Dietary Allowance (RDA)

the average daily amount of a nutrient considered adequate to meet the known nutrient needs of practically all healthy people; a goal for dietary intake by individuals.

Adequate Intake (AI)

the average daily amount of a nutrient that appears sufficient to maintain a specified criterion; a value used as a guide for nutrient intake when an RDA cannot be determined.

Estimated Average Requirement (EAR)

the average daily amount of a nutrient that will maintain a specific biochemical or physiological function in half the healthy people of a given age and gender group.

Estimated Energy Requirement (EER)

the average dietary energy intake that maintains energy balance and good health in a person of a given age, gender, weight, height, and level of physical activity.

life expectancy

the average number of years lived by people in a given society.

gastroesophageal reflux

the backflow of stomach acid into the esophagus, causing damage to the cells of the esophagus and the sensa- tion of heartburn; commonly known as heartburn or acid indigestion.

menaquinone (men-ah-KWYN-own)

the bacteria-produced form of vitamin K; also called vitamin K2.

water balance

the balance between water intake and output (losses).

matrix (MAY-tricks)

the basic substance that gives form to a developing structure; in the body, the formative cells from which teeth and bones grow.

renal threshold

the blood concentration of a substance that exceeds the kidneys' capacity for reabsorption, causing the substance to be passed into the urine.

lymph (LIMF)

the body fluid carried in lymphatic vessels, which is collected from the extracellular fluid of body tissues. Lymph contains water, proteins, salts, organic substances, and some cells (such as lymphocytes).

lean body mass

the body minus its fat.

immunity

the body's ability to defend itself against diseases.

immune system

the body's defense system against foreign substances.

adipose (ADD-ih-poce) tissue

the body's fat tissue; consists of masses of triglyceride-storing cells.

stress response

the body's response to stress, mediated by both nerves and hormones.

wasting

the breakdown of muscle tissue that results from disease or malnutrition.

erythrocyte (eh-RITH-ro-cite) hemolysis (he-MOLL-uh-sis)

the breaking open of red blood cells (erythrocytes); a symptom of vitamin E-deficiency disease in human beings.

fertility

the capacity of a woman to produce a normal ovum periodically and of a man to produce normal sperm; the ability to reproduce.

energy

the capacity to do work. The energy in food is chemical energy. The body can convert this chemical energy to mechanical, electrical, or heat energy.

mitochondria (my-toh-KON-dree-uh)

the cellular organelles responsible for producing ATP aerobically; made of membranes with enzymes mounted on them. (The singular is mitochondrion.)

denaturation (dee-NAY-chur-AY-shun)

the change in a protein's shape and consequent loss of its function brought about by heat, agitation, acid, base, alcohol, heavy metals, or other agents.

pressure gradient

the change in pressure over a given distance. In dialysis, a pressure gradient is created between the blood and the dialysate.

behavior modification

the changing of behavior by the manipulation of antecedents (cues or environmental factors that trigger behavior), the behavior itself, and consequences (the penalties or rewards attached to behavior).

triglycerides (try-GLISS-er-rides)

the chief form of fat in the diet and the major storage form of fat in the body; composed of a molecule of glycerol with three fatty acids attached; also called triacylglycerols (try-ay-seel-GLiSS-er-ols).

pyloric (pie-LORE-ic) sphincter

the circular muscle that separates the stomach from the small intestine and regulates the flow of par- tially digested food into the small intestine; also called pylorus or pyloric valve.

enteropancreatic (EN-ter-oh-PAN-kree-AT-ik) circulation

the circulatory route from the pancreas to the small intestine and back to the pancreas.

chylomicrons (kye-lo-MY-cronz)

the class of lipoproteins that trans- port lipids from the intestinal cells to the rest of the body.

uremic syndrome

the cluster of disorders caused by inadequate kidney function; complications include fluid, electrolyte, and hormonal imbalances; altered heart function; neuromuscular disturbances; and other metabolic derangements.

microbiome

the collection of microbes found in or on the human body.

human genome (GEE-nome)

the complete set of genetic material (DNA) in a human being.

genome (GEE-nome)

the complete set of genetic material (DNA) in an organism or a cell. The study of genomes is called genomics.

milliequivalents per liter (mEq/L)

the concentration of electrolytes in a volume of solution. Milliequivalents reveal characteristics about the solution that are not evident when the concentration is expressed in terms of weight.

osmolarity

the concentration of osmotically active solutes in a solution, expressed as milliosmoles per liter of solution (mOsm/L). Osmolality (mOsm/kg) is an alternative measure used to describe a solution's osmotic properties.

dehydration

the condition in which body water output exceeds water input. Symptoms include thirst, dry skin and mucous membranes, rapid heartbeat, low blood pressure, and weakness.

safety

the condition of being free from harm or danger.

diverticulosis (DYE-ver-tic-you-LOH-sis)

the condition of having diverticula. Diverticulosis affects more than 50 percent of adults in later life.

constipation

the condition of having infrequent or difficult bowel movements.

hemolytic (HE-moh-LIT-ick) anemia

the condition of having too few red blood cells as a result of erythrocyte hemolysis.

dermis

the connective tissue layer underneath the epidermis that contains the skin's blood vessels and nerves.

cross-contamination

the contamination of food by bacteria that occurs when the food comes into contact with surfaces previously touched by raw meat, poultry, or seafood.

protein turnover

the continuous degradation and synthesis of the body's proteins.

embryo (EM-bree-oh)

the developing infant from 2 to 8 weeks after conception.

fetus (FEET-us)

the developing infant from 8 weeks after conception until term.

blastocyst (BLASS-toe-sist)

the developmental stage of the zygote when it is about 5 days old and ready for implantation.

gastric juice

the digestive secretion of the gastric glands of the stomach.

gastrointestinal (GI) tract

the digestive tract. The principal organs are the stomach and intestines.

remodeling

the dismantling and re-formation of a structure.

length

the distance from the top of the head to the soles of the feet while a person is recumbent (lying down). In contrast, height is measured while a person is standing upright.

point of unsaturation

the double bond of a fatty acid, where hydro- gen atoms can easily be added to the structure.

DNA (deoxyribonucleic acid)

the double helix molecules of which genes are made.

implantation (IM-plan-TAY-shun)

the embedding of the blastocyst in the inner lining of the uterus.

neural tube

the embryonic tissue that forms the brain and spinal cord.

energy balance

the energy (kcalories) consumed from foods and beverages compared with the energy expended through metabolic processes and physical activities.

basal metabolism

the energy needed to maintain life when a body is at complete digestive, physical, and emotional rest.

larynx (LAIR-inks)

the entryway to the trachea that contains the vocal cords; also called the voice box.

acid-base balance

the equilibrium in the body between acid and base concentrations.

distributive justice

the equitable distribution of resources. diuresis (DYE-uh-REE-sis): increased urine production. diuretics: drugs that promote urine production.

limiting amino acid

the essential amino acid found in the shortest supply relative to the amounts needed for protein synthesis in the body. The four amino acids most likely to be limiting are lysine, methionine, threonine, and tryptophan.

branched-chain amino acids

the essential amino acids leucine, isoleucine, and valine, which are present in large amounts in skeletal muscle tissue; falsely promoted as fuel for exercising muscles.

Acceptable Daily Intake (ADI)

the estimated amount of a sweetener that individuals can safely consume each day over the course of a life- time without adverse effect.

pancreatic (pank-ree-AT-ic) juice

the exocrine secretion of the pancreas that contains both enzymes for the digestion of carbohydrate, fat, and protein as well as bicarbonate, a neutralizing agent. The juice flows from the pancreas into the small intestine through the pancreatic duct. (The pancreas also has an endocrine function, the secretion of insulin and other hormones.)

glycemic response

the extent to which a food raises the blood glucose concentration and elicits an insulin response.

fermentable

the extent to which bacteria in the GI tract can break down fibers to fragments that the body can use.

satiety (sah-TIE-eh-tee)

the feeling of fullness and satisfaction that occurs after a meal and inhibits eating until the next meal. Satiety determines how much time passes between meals.

satiation (say-she-AY-shun)

the feeling of satisfaction and fullness that occurs during a meal and halts eating. Satiation determines how much food is consumed during a meal.

ovum (OH-vum)

the female reproductive cell, capable of developing into a new organism upon fertilization; commonly referred to as an egg.

electron transport chain

the final pathway in energy metabolism that transports electrons from hydrogen to oxygen and captures the energy released in the bonds of ATP; also called the respiratory chain.

raw sugar

the first crop of crystals harvested during sugar processing. Raw sugar cannot be sold in the United States because it contains too much filth (dirt, insect fragments, and the like). Sugar sold as "raw sugar" domestically has actually gone through more than half of the refining steps.

jejunum (je-JOON-um)

the first two-fifths of the small intestine beyond the duodenum.

esophagus (ee-SOFF-ah-gus)

the food pipe; the conduit from the mouth to the stomach.

diet

the foods and beverages a person eats and drinks.

thrombosis (throm-BOH-sis)

the formation or presence of a blood clot in blood vessels. A coronary thrombosis occurs in a coronary artery, and a cerebral thrombosis occurs in an artery that supplies blood to the brain.

diarrhea

the frequent passage of watery bowel movements.

nephron (NEF-ron)

the functional unit of the kidneys, consisting of a glomerulus and tubules.

thermogenesis

the generation of heat; used in physiology and nutrition studies as an index of how much energy the body is expending.

hemoglobin (HE-moh-GLO-bin)

the globular protein of the red blood cells that transports oxygen from the lungs to tissues throughout the body; hemoglobin accounts for 80 percent of the body's iron.

chlorophyll (KLO-row-fil)

the green pigment of plants, which absorbs light and transfers the energy to other molecules, thereby initiating photosynthesis.

gingiva (jin-JYE-va, JIN-jeh-va)

the gums.

Keshan (KESH-an or ka-SHAWN) disease

the heart disease associated with selenium deficiency; named for one of the provinces of China where it was first studied. Keshan disease is characterized by heart enlargement and insufficiency; fibrous tissue replaces the muscle tissue that normally composes the middle layer of the walls of the heart.

peak bone mass

the highest attainable bone density for an individual, developed during the first three decades of life.

fetal programming

the influence of substances during fetal growth on the development of diseases in later life.

total parenteral nutrition (TPN)

the infusion of nutrient solutions into a central vein; also called central parenteral nutrition (CPN).

peripheral parenteral nutrition (PPN)

the infusion of nutrient solutions into peripheral veins, usually a vein in the arm or back of the hand.

intradialytic parenteral nutrition

the infusion of nutrients during hemodialysis, often providing amino acids, dextrose, lipids, and some trace minerals.

zygote (ZY-goat)

the initial product of the union of ovum and sperm; a fertilized ovum.

retina (RET-in-uh)

the innermost membrane of the eye, composed of several layers, including one that contains the rods and cones.

appetite

the integrated response to the sight, smell, thought, or taste of food that initiates or delays eating.

renal colic

the intense pain that occurs when a kidney stone passes through the ureter; the pain typically begins in the back and intensifies as the stone travels toward the bladder.

heme (HEEM) iron

the iron in foods that is bound to the hemoglobin and myoglobin proteins; found only in meat, fish, and poultry.

nonheme iron

the iron in foods that is not bound to proteins; found in both plant-derived and animal-derived foods.

ferritin (FAIR-ih-tin)

the iron storage protein.

transferrin (trans-FAIR-in)

the iron transport protein.

discretionary kcalories

the kcalories remaining in a person's energy allowance after consuming enough nutrient-dense foods to meet all nutrient needs for a day; also referred to as kcalories available for other uses.

trabecular (tra-BECK-you-lar) bone

the lacy inner structure of calcium crystals that supports the bone's structure and provides a calcium storage bank.

aorta (ay-OR-tuh)

the large, primary artery that conducts blood from the heart to the body's smaller arteries.

central veins

the large-diameter veins located close to the heart.

omega

the last letter of the Greek alphabet (v), used by chemists to refer to the position of the closest double bond to the methyl (CH3) end of a fatty acid.

collecting duct

the last portion of a nephron's tubule, where the final concentration of urine occurs. One collecting duct is shared by several nephrons.

ileum (ILL-ee-um)

the last segment of the small intestine.

acquired immunodeficiency syndrome (AIDS)

the late stage of illness caused by infection with the human immunodeficiency virus (HIV); characterized by severe damage to immune function.

epithelial tissue

the layer of the body that serves as a selective barrier between the body's interior and the environment. Examples are the cornea of the eyes, the skin, the respiratory lining of the lungs, and the lining of the digestive tract.

type 1 diabetes

the less common type of diabetes in which the pancreas produces little or no insulin. Type 1 diabetes usually results from autoimmune destruction of pancreatic beta cells.

senile dementia

the loss of brain function beyond the normal loss of physical adeptness and memory that occurs with aging.

large intestine or colon (COAL-un)

the lower portion of intestine that completes the digestive process. Its segments are the ascending colon, the transverse colon, the descending colon, and the sigmoid colon.

requirement

the lowest continuing intake of a nutrient that will maintain a specified criterion of adequacy.

bronchi (BRON-key), bronchioles (BRON-key-oles)

the main airways of the lungs. The singular form of bronchi is bronchus.

thoracic (thor-ASS-ic) duct

the main lymphatic vessel that collects lymph and drains into the left subclavian vein.

homeostasis (HOME-ee-oh-STAY-sis)

the maintenance of constant internal conditions (such as blood chemistry, temperature, and blood pressure) by the body's control systems. A homeostatic system is constantly reacting to external forces to maintain limits set by the body's needs.

chloride (KLO-ride)

the major anion in the extracellular fluids of the body. Chloride is the ionic form of chlorine, Cl-.

gluconeogenesis (gloo-ko-nee-oh-JEN-ih-sis)

the making of glucose from a noncarbohydrate source such as amino acids or glycerol.

short bowel syndrome

the malabsorption syndrome that follows resection of the small intestine; characterized by inadequate absorptive capacity in the remaining intestine.

sperm

the male reproductive cell, capable of fertilizing an ovum.

tolerance level

the maximum amount of residue permitted in a food when a pesticide is used according to the label directions.

Tolerable Upper Intake Level (UL)

the maximum daily amount of a nutrient that appears safe for most healthy people and beyond which there is an increased risk of adverse health effects.

life span

the maximum number of years of life attainable by a member of a species.

mucous (MYOO-kus) membranes

the membranes, composed of mucus-secreting cells, that line the surfaces of body tissues.

fatty acid oxidation

the metabolic breakdown of fatty acids to acetyl CoA; also called beta oxidation.

glycolysis (gly-COLL-ih-sis)

the metabolic breakdown of glucose to pyruvate. Glycolysis does not require oxygen (anaerobic).

bacterial translocation

the migration of viable bacteria and/or bacterial products from the GI tract to normally sterile tissues such as the bloodstream, lymph nodes, or internal organs, potentially causing infection or tissue injury.

obligatory (ah-BLIG-ah-TORE-ee) water excretion

the minimum amount of water the body has to excrete each day to dispose of its wastes—about 500 milliliters (about 2 cups, or 1 pint).

type 2 diabetes

the more common type of diabetes in which the cells fail to respond to insulin. Type 2 diabetes usually accompanies obesity and results from insulin resistance coupled with insufficient insulin secretion.

calcium

the most abundant mineral in the body; found primarily in the body's bones and teeth.

continuous ambulatory peritoneal dialysis (CAPD)

the most com- mon method of peritoneal dialysis; involves frequent exchanges of dialysate, which remains in the peritoneal cavity throughout the day.

neutrophils (NEW-tro-fills)

the most common type of white blood cell. Neutrophils destroy antigens by phagocytosis.

uterus (YOU-ter-us)

the muscular organ within which the infant develops before birth.

rectum

the muscular terminal part of the intestine, extending from the sigmoid colon to the anus.

dextrose

the name food manufacturers use for the sugar that is chemically the same as glucose; anhydrous dextrose is similar, differing primarily in the temperature of crystallization.

pellagra (pell-AY-gra)

the niacin-deficiency disease, characterized by diarrhea, dermatitis, dementia, and eventually death.

nucleotide bases

the nitrogen-containing building blocks of DNA and RNA—cytosine (C), thymine (T), uracil (U), guanine (G), and adenine (A). In DNA, the base pairs are A-T and C-G and in RNA, the base pairs are A-U and C-G.

postpartum amenorrhea (ay-MEN-oh-REE-ah)

the normal temporary absence of menstrual periods immediately following childbirth.

physiological fuel value

the number of kcalories that the body derives from a food, in contrast to the number of kcalories determined by calorimetry.

energy-yielding nutrients

the nutrients that break down to yield energy the body can use (carbohydrate, fat, and protein).

embolism (EM-boh-lizm)

the obstruction of a blood vessel by an embolus, causing sudden tissue death.

mouth

the oral cavity containing the tongue and teeth.

placenta (plah-SEN-tuh)

the organ that develops inside the uterus early in pregnancy, through which the fetus receives nutrients and oxygen and returns carbon dioxide and other waste products to be excreted.

liver

the organ that manufactures bile, among many other functions.

gallbladder

the organ that stores and concentrates bile. When it receives the signal that fat is present in the duodenum, the gallbladder contracts and squirts bile through the bile duct into the duodenum.

antiscorbutic (AN-tee-skor-BUE-tik) factor

the original name for vitamin C.

epidermis (eh-pih-DER-miss)

the outer layer of the skin.

myoglobin

the oxygen-holding protein of the muscle cells.

hunger

the painful sensation caused by a lack of food that initiates food-seeking behavior.

pharynx (FAIR-inks)

the passageway leading from the nose and mouth to the larynx and esophagus, respectively.

Cori cycle

the pathway in which glucose is metabolized to lactate (by anaerobic glycolysis) in the muscle, lactate is converted back to glucose in the liver, and then glucose is returned to the muscle; named after the scientist who elucidated this pathway.

subjects

the people or animals participating in a research project.

percent Daily Value (%DV)

the percentage of a Daily Value recommendation found in a specified serving of food for key nutrients based on a 2000-kcalorie diet.

hematocrit (hee-MAT-oh-krit)

the percentage of total blood volume that consists of red blood cells.

gestation (jes-TAY-shun)

the period from conception to birth. For human beings, the average length of a healthy gestation is 40 weeks. Pregnancy is often divided into 3-month periods, called trimesters.

adolescence

the period from the beginning of puberty until maturity.

puberty

the period in life in which a person becomes physically capable of reproduction.

phylloquinone (fill-oh-KWYN-own)

the plant form of vitamin K; also called vitamin K1.

set point

the point at which controls are set (for example, on a thermostat). The set-point theory that relates to body weight proposes that the body tends to maintain a certain weight by means of its own internal controls.

colonic irrigation

the popular, but potentially harmful practice of "washing" the large intestine with a powerful enema machine; also called colonic hydrotherapy.

albuminuria

the presence of albumin (a blood protein) in the urine, a sign of diabetic nephropathy.

glycosuria (GLY-co-SOOR-ee-ah)

the presence of glucose in the urine.

ketonuria (KEY-toe-NOOR-ee-ah)

the presence of ketone bodies in the urine.

proteinuria (PRO-teen-NOO-ree-ah)

the presence of protein in the urine. When only urinary albumin is measured, the term used is albuminuria.

oncotic pressure

the pressure exerted by fluid on one side of a membrane as a result of osmosis.

sodium

the principal cation in the extracellular fluids of the body; critical to the maintenance of fluid balance, nerve impulse transmissions, and muscle contractions.

potassium

the principal cation within the body's cells; critical to the maintenance of fluid balance, nerve impulse transmissions, and muscle contractions.

urea (you-REE-uh)

the principal nitrogen-excretion product of protein metabolism. Two ammonia fragments are combined with carbon dioxide to form urea.

gene expression

the process by which a cell converts the genetic code into RNA and protein.

digestion

the process by which food is broken down into absorbable units.

cell differentiation (DIF-er-EN-she-AY-shun)

the process by which immature cells develop specific functions different from those of the original that are characteristic of their mature cell type.

phagocytosis (FAG-oh-sigh-TOE-sis)

the process by which phagocytes engulf and destroy pathogens and cellular debris.

refined

the process by which the coarse parts of a food are removed. When wheat is refined into flour, the bran, germ, and husk are removed, leaving only the endosperm.

mineralization

the process in which calcium, phosphorus, and other minerals crystallize on the collagen matrix of a growing bone, hardening the bone.

photosynthesis

the process in which green plants use the sun's energy to make carbohydrates from carbon dioxide and water.

oxidation (OKS-ee-day-shun)

the process of a substance combining with oxygen; oxidation reactions involve the loss of electrons.

carcinogenesis (CAR-sin-oh-JEN-eh-sis)

the process of cancer development.

transcription

the process of messenger RNA being made from a template of DNA.

translation

the process of messenger RNA directing the sequence of amino acids and synthesis of proteins.

Academy of Nutrition and Dietetics

the professional organization of dietitians in the United States; formerly the American Dietetic Association.

multiple organ dysfunction syndrome

the progressive dysfunction of two or more organ systems that develops during intensive care; often results in death.

fraudulent

the promotion, for financial gain, of devices, treatments, ser- vices, plans, or products (including diets and supplements) that alter or claim to alter a human condition without proof of safety or effectiveness.

body composition

the proportions of muscle, bone, fat, and other tissue that make up a person's total body weight.

opsin (OP-sin)

the protein portion of visual pigment molecules.

parenteral nutrition

the provision of nutrients by vein, bypassing the intestine.

portion sizes

the quantity of a food served or eaten at one meal or snack; not a standard amount.

acute kidney injury

the rapid decline of kidney function over a period of hours or days; potentially a cause of acute renal failure.

water intoxication

the rare condition in which body water contents are too high in all body fluid compartments.

bioavailability

the rate at and the extent to which a nutrient is absorbed and used.

glomerular filtration rate (GFR)

the rate at which filtrate is formed within the kidneys, normally about 125 mL/min in healthy young adults.

basal metabolic rate (BMR)

the rate of energy use for metabolism under specified conditions: after a 12-hour fast and restful sleep, with- out any physical activity or emotional excitement, and in a comfortable setting. It is usually expressed as kcalories per kilogram of body weight per hour.

insulin resistance

the reduced sensitivity to insulin in liver, muscle, and adipose cells.

let-down reflex

the reflex that forces milk to the front of the breast when the infant begins to nurse.

belching

the release of air or gas from the stomach through the mouth.

umbilical (um-BILL-ih-cul) cord

the ropelike structure through which the fetus's veins and arteries reach the placenta; the route of nourishment and oxygen to the fetus and the route of waste disposal from the fetus. The scar in the middle of the abdomen that marks the former attachment of the umbilical cord is the umbilicus (um-BILL-ih- cus), commonly known as the "belly button."

nutritional genomics

the science of how nutrients affect the activities of genes (nutrigenomics) and how genes affect the activities of nutrients (nutrigenetics).

nutrition

the science of the nutrients in foods and their actions within the body. A broader definition includes the study of human behaviors related to food and eating.

saliva

the secretion of the salivary glands. Its principal enzyme begins carbohydrate digestion.

chyme (KIME)

the semiliquid mass of partly digested food expelled by the stomach into the duodenum.

acid regurgitation

the sensation of gastric contents backing up into the esophagus, possibly reaching the throat or mouth.

correlation (CORE-ee-LAY-shun)

the simultaneous increase, decrease, or change in two variables. If A increases as B increases, or if A decreases as B decreases, the correlation is positive. (This does not mean that A causes B or vice versa.) If A increases as B decreases, or if A decreases as B increases, the correlation is negative. (This does not mean that A prevents B or vice versa.) Some third factor may account for both A and B.

flaxseeds

the small brown seeds of the flax plant; valued in nutrition as a source of fiber, lignans, and omega-3 fatty acids.

sinusoids

the small, capillary-like passages that carry blood through liver tissue.

peripheral veins

the small-diameter veins that carry blood from the limbs.

dialysate (dye-AL-ih-sate)

the solution used in dialysis to draw fluids and wastes from the blood.

lumen (LOO-men)

the space within a vessel such as the intestine.

retinol-binding protein (RBP)

the specific protein responsible for transporting retinol.

ileocecal (ill-ee-oh-SEEK-ul) valve

the sphincter separating the small and large intestines.

fluorapatite (floor-APP-uh-tite)

the stabilized form of tooth crystal, in which fluoride has replaced the hydroxyl groups of hydroxyapatite.

serving sizes

the standardized quantity of a food; such information allows comparisons when reading food labels and consistency when following the Dietary Guidelines.

iron deficiency

the state of having depleted iron stores.

prediabetes

the state of having plasma glucose levels that are higher than normal but not high enough to be diagnosed as diabetes; occurs in individuals who have metabolic defects that often lead to type 2 diabetes.

collagen (KOL-ah-jen)

the structural protein from which connective tissues such as scars, tendons, ligaments, and the foundations of bones and teeth are made.

genomics

the study of all the genes in an organism and their interactions with environmental factors.

genetics

the study of genes and inheritance.

epigenetics

the study of heritable changes in gene function that occur without a change in the DNA sequence.

solutes (SOLL-yutes)

the substances that are dissolved in a solution. The number of molecules in a given volume of fluid is the solute concentration.

filtrate

the substances that pass through the glomerulus and travel through the nephron's tubules, eventually forming urine.

nucleotides

the subunits of DNA and RNA molecules, composed of a phosphate group, a 5-carbon sugar (deoxyribose for DNA and ribose for RNA), and a nitrogen-containing base.

metabolism

the sum total of all the chemical reactions that go on in living cells. Energy metabolism includes all the reactions by which the body obtains and expends the energy from food.

amino acid pool

the supply of amino acids derived from either food proteins or body proteins that collect in the cells and circulating blood and stand ready to be incorporated in proteins and other compounds or used for energy.

paracentesis (pah-rah-sen-TEE-sis)

the surgical puncture of a body cavity with an aspirator to draw out excess fluid.

debridement

the surgical removal of dead, damaged, or contaminated tissue resulting from burns or wounds; helps to prevent infection and hasten healing.

resection

the surgical removal of part of an organ or body structure.

gastrectomy (gah-STREK-ta-mee)

the surgical removal of part of the stomach (partial gastrectomy) or the entire stomach (total gastrectomy).

edema (eh-DEEM-uh)

the swelling of body tissue caused by excessive amounts of fluid in the interstitial spaces; seen in protein deficiency (among other conditions).

anus (AY-nus)

the terminal outlet of the GI tract.

beriberi

the thiamin-deficiency disease characterized by muscle weakness, edema, or both

molasses

the thick brown syrup produced during sugar refining. Molasses retains residual sugar and other by-products and a few minerals; blackstrap molasses contains significant amounts of calcium and iron.

periodontium

the tissues that support the teeth, including the gums, cementum (bonelike material covering the dentin layer of the tooth), periodontal ligament, and underlying bone.

duodenum (doo-oh-DEEN-um or doo-ODD-num)

the top portion of the small intestine (about "12 fingers' breadth" long in ancient terminology).

transamination (TRANS-am-ih-NAY-shun)

the transfer of an amino group from one amino acid to a keto acid, producing a new nonessential amino acid and a new keto acid.

cornea (KOR-nee-uh)

the transparent membrane covering the outside of the eye.

orogastric

the tube is inserted into the stomach through the mouth. This method is often used to feed infants because a nasogastric tube may hinder the infant's breathing.

sudden infant death syndrome (SIDS)

the unexpected and unexplained death of an apparently well infant; the most common cause of death of infants between the second week and the end of the first year of life; also called crib death.

conception

the union of the male sperm and the female ovum; fertilization.

pH

the unit of measure expressing a substance's acidity or alkalinity. The lower the pH, the higher the H+ ion concentration and the stron- ger the acid. A pH above 7 is alkaline, or base (a solution in which OH- ions predominate).

radiation therapy

the use of X-rays, gamma rays, or atomic particles to destroy cancer cells.

chemotherapy

the use of drugs to arrest or destroy cancer cells; these drugs are called antineoplastic agents.

imagery

the use of mental images of things or events to aid relaxation or promote self-healing.

faith healing

the use of prayer or belief in divine intervention to promote healing.

hepatic portal vein

the vein that collects blood from the GI tract and conducts it to the liver.

hepatic vein

the vein that collects blood from the liver and returns it to the heart.

subclavian (sub-KLAY-vee-an) vein

the vein that provides passageway from the lymphatic system to the vascular system.

cortical bone

the very dense bone tissue that forms the outer shell surrounding trabecular bone and comprises the shaft of a long bone.

human immunodeficiency virus (HIV)

the virus that causes acquired immunodeficiency syndrome (AIDS). HIV destroys immune cells and progressively impedes the body's ability to fight infections and certain cancers.

scurvy

the vitamin C-deficiency disease.

rickets

the vitamin D-deficiency disease in children characterized by inadequate mineralization of bone (manifested in bowed legs or knock-knees, outward-bowed chest, and "beads" on ribs). A rare type of rickets, not caused by vitamin D deficiency, is known as vitamin D- refractory rickets.

minute ventilation

the volume of air a person inhales or exhales each minute.

cardiac output

the volume of blood pumped by the heart within a specified period of time.

creatinine

the waste product of creatine, a nitrogen-containing compound in muscle cells that supplies energy for muscle contraction.

phlebotomy

the withdrawal of blood from the body.

bioelectrical or bioelectromagnetic therapies

therapies that involve the unconventional use of electric or magnetic fields to cure illness.

tripeptide

three amino acids bonded together.

micelles (MY-cells)

tiny spherical complexes of emulsified fat that arise during digestion; most contain bile salts and the products of lipid digestion, including fatty acids, monoglycerides, and cholesterol.

microvilli (MY-cro-VILL-ee or MY-cro-VILL-eye)

tiny, hairlike projections on each cell of every villus that can trap nutrient particles and transport them into the cells; singular microvillus.

wean

to gradually replace breast milk with infant formula or other foods appropriate to an infant's diet.

defecate (DEF-uh-cate)

to move the bowels and eliminate waste.

metastasize (meh-TAS-tah-size)

to spread from one part of the body to another; refers to cancer cells.

obese

too much body fat with adverse health effects; BMI 30 or more.

nephrotoxic

toxic to the kidneys.

iron overload

toxicity from excess iron.

hematopoietic stem cell transplantation

transplantation of the stem cells that produce red blood cells and white blood cells; the stem cells are obtained from bone marrow (bone marrow transplantation) or circulating blood.

gene therapy

treatment for inherited disorders in which DNA sequences are introduced into the chromosomes of affected cells, prompting the cells to express the protein needed to correct the disease.

medium-chain triglycerides (MCT)

triglycerides with fatty acids that are 8 to 10 carbons in length. MCT do not require digestion and can be absorbed in the absence of lipase or bile.

tubules

tubelike structures of the nephron that process filtrate during urine production. The tubules are surrounded by capillaries that reab- sorb substances retained by tubule cells.

crypts (KRIPTS)

tubular glands that lie between the intestinal villi and secrete intestinal juices into the small intestine.

dipeptide (dye-PEP-tide)

two amino acids bonded together.

outbreaks

two or more cases of a similar illness resulting from the ingestion of a common food.

complementary proteins

two or more dietary proteins whose amino acid assortments complement each other in such a way that the essential amino acids missing from one are supplied by the other.

bloating

uncomfortable abdominal fullness or distention.

adverse reactions

unusual responses to food (including intolerances and allergies).

moderation (alcohol)

up to one drink per day for women and up to two drinks per day for men.

arteries

vessels that carry blood from the heart to the tissues.

veins (VANES)

vessels that carry blood to the heart.

lymphatic vessels

vessels that carry lymph.

sushi

vinegar-flavored rice and seafood, typically wrapped in seaweed and stuffed with colorful vegetables. Some sushi is stuffed with raw fish; other varieties contain cooked seafood.

vitamin D3

vitamin D derived from animals in the diet or made in the skin from 7-dehydrocholesterol, a precursor of cholesterol, with the help of sunlight; also called cholecalciferol (KO-lee-kal-SIF-er-ol) or calciol. After hydroxylation in the liver, calciol becomes calcidiol and after hydroxylation in the kidneys, calcidiol becomes calcitriol.

vitamin D2

vitamin D derived from plants in the diet; also called

calciferol (kal-SIF-er-ol)

vitamin D.

intractable vomiting

vomiting that is not easily managed or controlled.

stool

waste matter discharged from the colon; also called feces (FEE-seez).

artesian water

water drawn from a well that taps a confined aquifer in which the water is under pressure.

well water

water drawn from groundwater by tapping into an aquifer.

public water

water from a municipal or county water system that has been treated and disinfected.

mineral water

water from a spring or well that naturally contains at least 250 parts per million (ppm) of minerals. Minerals give water a distinctive flavor. Many mineral waters are high in sodium.

metabolic water

water generated during metabolism.

natural water

water obtained from a spring or well that is certified to be safe and sanitary. The mineral content may not be changed, but the water may be treated in other ways such as with ozone or by filtration.

spring water

water originating from an underground spring or well. It may be bubbly (carbonated), or "flat" or "still," meaning not carbon- ated. Brand names such as "Spring Pure" do not necessarily mean that the water comes from a spring.

carbonated water

water that contains carbon dioxide gas, either naturally occurring or added, that causes bubbles to form in it; also called bubbling or sparkling water. The FDA defines seltzer, soda, and tonic waters as soft drinks; they are not regulated as water.

purified water

water that has been treated by distillation or other physical or chemical processes that remove dissolved solids. Because purified water contains no minerals or contaminants, it is useful for medical and research purposes.

distilled water

water that has been vaporized and recondensed, leav- ing it free of dissolved minerals.

filtered water

water treated by filtration, usually through activated car- bon filters that reduce the lead in tap water, or by reverse osmosis units that force pressurized water across a membrane removing lead, arsenic, and some microorganisms from tap water.

hard water

water with a high calcium and magnesium content.

soft water

water with a high sodium or potassium content.

hydrophobic (high-dro-FOE-bick)

water-fearing, or non-water-soluble, substances; also known as lipophilic (fat loving).

hydrophilic (high-dro-FIL-ick)

water-loving, or water-soluble, substances.

peristalsis (per-ih-STALL-sis)

wavelike muscular contractions of the GI tract that push its contents along.

lymphocytes (LIM-foe-sites)

white blood cells that recognize specific antigens and therefore function in adaptive immunity; include T cells and B cells.

brite adipocytes

white fat cells with brown fat cell characteristics; also called beige adipocytes.

gatekeepers

with respect to nutrition, key people who control other people's access to foods and thereby exert profound impacts on their nutrition. Examples are the spouse who buys and cooks the food, the parent who feeds the children, and the caregiver in a day-care center.

advance health care directive

written or oral instructions regarding one's preferences for medical treatment to be used in the event of becoming incapacitated; also called an advance medical directive or a living will.

jaundice (JAWN-dis)

yellow discoloration of the skin and eyes due to an accumulation of bilirubin, a breakdown product of hemoglobin that normally exits the body via bile secretions.

flavonoids (FLAY-von-oyds)

yellow pigments in foods; phytochemicals that may exert physiological effects on the body.

artificial fats

zero-energy fat replacers that are chemically synthesized to mimic the sensory and cooking qualities of naturally occurring fats but are totally or partially resistant to digestion.