Scientific Evidence for Musculoskeletal, Bariatric, And Sports Nutrition

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ISBN: 9780849337246 | 0849337240
Cover: Hardcover
Copyright: 1/26/2006

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A reference for the evidence-based integration of nutrition into medical treatment, this book discusses clinical recommendations for optimizing muscle, bone, and fat metabolism based on biologic rationale, animal studies, epidemiology, clinical trials, ongoing research initiatives, and food industry statistics. The text explains how new technology can be incorporated into practice, elaborating on nutraceuticals with effects similar to medications. It highlights the importance of nutrition in the treatment of fibromyalgia, sarcopenia, steroid-induced muscle hypertrophy, obesity, osteoarthritis, gout, post-bariatric surgery, anorexia, osteomalacia, toxicity, and more.

Section I: Frontiers and Technologic Advances

Chapter 1 Body Composition: Quantifying the Musculoskeletal System

(24)

Ian Janssen

Introduction

(1)

Body Composition Rules

(2)

Five-Level Body Composition Model

(1)

Atomic Level

(1)

Molecular Level

(1)

Cellular Level

(1)

Tissue Level

(1)

Body Composition Methods

(11)

Measurement Method Principles

(1)

Anthropometry

(4)

Densitometry

(1)

Bioelectrical Impedance Analysis

(1)

Dual-Energy X-Ray Absorptiometry

(2)

Computed Tomography and Magnetic Resonance Imaging

(1)

Reference Body Composition Data

(5)

Children

(2)

Adults

(3)

Summary and Conclusion

(1)

References

(4)

Chapter 2 Nutrigenomics: Strategic Prevention of Musculoskeletal Disorders of Aging

(16)

Jeffrey S. Bland

Defining Nutrigenomics

(1)

The Nutritional Environment

(3)

Nutrigenomics and the Health Care System

(8)

Shared Mechanisms

(1)

Measuring Nutrigenomic Factors

(2)

Achieving Healthspan

(1)

Personalized Medicine

(2)

Conclusion

(1)

References

(4)

Chapter 3 Early Environments: Fetal and Infant Nutrition

(24)

See Wai Chan and Gilberto Pereira

Introduction

(1)

Fetal Growth and Alterations in Body Composition

(1)

Reference Fetal Growth Curves

(1)

Definition of Fetal Growth Discrepancies

(1)

Aberrant Fetal Growth and Their Consequences

(2)

Nutritional Requirements for Neonates and Infants

(2)

Nutrition During the Immediate Postnatal Period

(1)

Enteral Nutrition

(7)

Minimal Volume Trophic Enteral Feedings

(1)

Composition of Enteral Feedings

(6)

References

(10)

Section II: Key Nutrients

Chapter 4 Fat

(14)

Mary G. Enig and Ingrid Kohlstadt

Overview of Lipid Biochemistry

(2)

Overview of Food Preparation

(4)

Overview of Lipids in Human Physiology and Disease

(5)

Growth

(2)

Body Composition

(2)

Endurance Athletics

(1)

References

(3)

Chapter 5 Carbohydrate

(14)

John D. Bagnulo

Introduction

(1)

Reduced Carbohydrate Diets

(1)

Carbohydrate Quality

(1)

Sugars

(3)

Simple Starches

(1)

Resistant Starches

(1)

Fiber

(1)

Carbohydrate Uptake and Hormonal Control

(2)

Metabolic Stores of Carbohydrate

(1)

Carbohydrates Promote Hydration

(1)

Glycemic Index

(1)

Glycosylation

(1)

Summary of Clinical Applications

(1)

References

(3)

Chapter 6 Protein

(16)

David I. Minkoff

Introduction

(1)

Protein as a Macronutrient

(1)

Classification of Amino Acids

(1)

Digestion and Absorption of Protein

(1)

Protein Quality

(1)

Nitrogen Balance

(1)

Protein Turnover

(1)

Clinical Evaluation of Protein Status

100

(1)

Excess Protein Intake

100

(2)

Protein Deficiencies — Underlying Causes

102

(1)

Protein and Exercise Requirements

103

(1)

Protein and Skeletal Muscle

103

(1)

Protein and Bone Health

104

(1)

Protein and Immune Function

104

(1)

Protein and Red Blood Cell Production

105

(1)

Protein and Injuries

105

(1)

Amino Acids as Therapeutic Agents

105

(2)

Summary

107

(1)

References

107

(4)

Chapter 7 Antioxidants

111

(16)

Gabriel K. Harris and David J. Baer

Introduction

111

(1)

The Biochemistry of Antioxidants

112

(2)

Exogenous and Endogenous Sources of Antioxidants

114

(3)

The Dynamic Balance of Oxidation and Reduction

117

(1)

Quantifying Oxidative Stress

118

(1)

Antioxidants and Athletic Performance

119

(2)

Antioxidants and Oxidative Stress in Musculoskeletal Disease and Aging

121

(2)

Antioxidants and Oxidative Stress in Pre- and Postoperative States

123

(1)

Antioxidants and Oxidative Stress in Obesity

123

(1)

Summary

123

(1)

References

124

(3)

Chapter 8 Water: A Driving Force in the Musculoskeletal System

127

(10)

Fereydoon Batmanghelidj and Ingrid Kohlstadt

How the Body Manages Drought

128

(1)

How Water Transport is Challenged in the Obese State

128

(1)

How Water Helps Maintain Cellular Health

129

(1)

How Dehydration May Contribute to Knee Osteoarthritis

130

(2)

How Dehydration May Exacerbate Back Pain

132

(1)

How Water Reduces Food Intake

133

(1)

How to Put Hydration into Practice

133

(1)

References

134

(3)

Chapter 9 Magnesium

137

(16)

Aileen P. Burford-Mason

Introduction

137

(1)

Magnesium Requirements

138

(1)

Magnesium and Musculoskeletal Health

138

(1)

Magnesium Homeostasis

139

(1)

Diet and Magnesium Status

140

(1)

Nondietary Factors and Magnesium Status

141

(2)

Calcium and Magnesium Balance

143

(1)

Diet and Calcium-Magnesium Balance

143

(2)

Identification of Magnesium Deficits

145

(1)

Magnesium Supplements

145

(2)

Caution: Excess Magnesium

147

(1)

Acknowledgment

148

(1)

References

148

(5)

Chapter 10 Vitamin D: Importance for Musculoskeletal Function and Health

153

(22)

Michael F. Holick

Introduction

153

(1)

History

154

(1)

The Dawn of Rickets

154

(3)

Photosynthesis of Vitamin D and Factors That Influence It

157

(3)

Sources of Vitamin D

160

(2)

Vitamin D Metabolism and Functions on Calcium Metabolism

162

(2)

Noncalcium Functions of Vitamin D

164

(1)

Role of Vitamin D in Skeletal Muscle Function

165

(2)

Detection of Vitamin D Deficiency

167

(1)

Strategies to Treat Vitamin D Deficiency

168

(1)

Vitamin D Intoxication

169

(1)

Conclusion

169

(1)

Acknowledgment

170

(1)

References

171

(4)

Chapter 11 Chromium: Roles in the Regulation of Lean Body Mass and Body Weight

175

(18)

Richard A. Anderson

Chromium and Human Health

175

(1)

Signs and Symptoms of Chromium Deficiency in Humans

176

(4)

Chromium and Lean Body Mass and Body Weight

178

(2)

Chromium Intake and Requirements

180

(3)

Trace Levels of Chromium

182

(1)

Form of Chromium

182

(1)

Safety of Chromium

183

(2)

Summary

185

(1)

References

185

(8)

Section III: Fat Tissue

Chapter 12 Energy Balance

193

(18)

Wayne C. Miller

Metabolic Rate

193

(8)

Thermic Effect of Food

193

(1)

Resting Metabolic Rate

194

(1)

Body Composition

195

(1)

Gender and Race

196

(1)

Calorie-Restricted Diets

197

(1)

Exercise

198

(1)

Diet and Exercise Interactions

198

(2)

Exercise Energy Expenditure

200

(1)

Energy Costs of Exercise

200

(1)

Postexercise Energy Costs

200

(1)

Determining Energy Intake and Expenditure

201

(5)

Assessing Energy Intake

201

(1)

Assessing Energy Expenditure

202

(1)

Direct Calorimetry

203

(1)

Indirect Calorimetry

203

(1)

Predicting Resting Energy Expenditure

205

(1)

Predicting Exercise Energy Expenditure

205

(1)

Exercise Energy Needs for the Previously Obese Patient

206

(1)

Exercise Energy Needs for the Anorexic Patient

206

(1)

Summary

207

(1)

References

207

(4)

Chapter 13 Neuroendoctine Regulation of Appetite

211

(20)

Carlo Contoreggi and Ingrid Kohlstadt

Introduction

212

(1)

Control Centers

212

(1)

Neuroendocrine Messengers

213

(9)

Neuropeptides

214

(1)

Neurotransmitters

214

(1)

Opiates

214

(1)

Serotonin

215

(1)

Norepinephrine

215

(1)

Dopamine

216

(1)

Gamma Amino Butyric Acid

216

(1)

Histamine

217

(1)

Peripheral Hormones

217

(1)

Insulin

217

(1)

Glucagon-like Peptide-1

218

(1)

Ghrelin

218

(1)

Adrenal Steroid Hormones

219

(1)

Cholecystokinin

219

(1)

Leptin

220

(1)

Adipocytokines

220

(1)

Nutritional Modifiers

220

(1)

Neuroendocrine Synchronicity

221

(1)

Summary

222

(1)

Adjusting a Redundant System

222

(1)

Applying Combination Therapy

222

(1)

Broadening Combination Therapy

222

(1)

References

223

(8)

Chapter 14 Estrogen's Role in the Regulation of Appetite and Body Fat

231

(22)

Paula J. Geiselman and Steven R. Smith

Introduction

231

(1)

Gender and Racial Considerations in Obesity

232

(1)

Estrogen and Food Intake

233

(1)

Estrogen and Food Selection

234

(1)

Estrogen and the Ethnic Gap

235

(1)

Pregnancy, Estrogen, and Food Intake

236

(1)

Lactation and Postpartum Weight Control

236

(1)

Estrogen Deficiency and the Laboratory Rat

237

(1)

Loss of Ovarian Function

237

(1)

Menopause and Obesity

237

(3)

Replacing Estrogen During Menopause

240

(1)

Choosing Estrogen Replacement

241

(1)

Estrogen as a Neuroendocrine Response Modifier

241

(2)

Polycystic Ovary Syndrome

243

(1)

Conclusion

244

(1)

Acknowledgments

244

(1)

References

245

(8)

Chapter 15 Childhood Obesity

253

(18)

Arline D. Salbe, Marlene B. Schwartz, and Ingrid Kohlstadt

Prevalence

254

(1)

Case Definition

254

(1)

Critical Periods

254

(2)

Prenatal

254

(1)

Adiposity Rebound

255

(1)

Adolescence

255

(1)

Genetics and the Early Environment

256

(1)

Population Case Study of Childhood Obesity and Type 2 Diabetes

257

(1)

Medical Consequences of Obesity

258

(2)

Behavioral Interventions

260

(5)

Empathize with Parents

260

(1)

Cultivate Healthy Food Preferences

261

(1)

Discuss Safe Ways to Restrict Food Selection

262

(1)

Reduce Advertising

262

(1)

Limit Television Time

263

(1)

Eat Family Meals

263

(1)

Make Changes as a Family

263

(1)

Keep Schools Accountable

264

(1)

Alleviate Concerns about Eating Disorders

264

(1)

Keep a Public Health Perspective

265

(1)

Summary

265

(1)

References

266

(5)

Chapter 16 Bariatric Surgery: More Effective with Nutrition

271

(12)

Ingrid Kohlstadt

Surgery Reduces Weight

271

(1)

Mechanisms by Which Surgery Reduces Weight

272

(1)

Methods by Which Nutrition Can Augment Obesity Surgery

273

(7)

Antioxidants

275

(1)

Alkalinizing Foods

275

(1)

Amino Acids

275

(1)

Bone Nutrients

276

(1)

Biotics

276

(1)

Correct Deficiencies

276

(2)

Comorbidities

278

(1)

Carnitine

279

(1)

Detoxification

279

(1)

Dehydroepiandrosterone and Sex Steroids

279

(1)

Summary

280

(1)

References

280

(3)

Chapter 17 Malnutrition: Applying the Physiology of Food Restriction to Clinical Practice

283

(22)

Altoon S. Dweck

Physiology of Food Restriction

284

(1)

Clinical Findings Associated with Food Restriction

285

(3)

Clinical Applications

288

(9)

Assess for Malnutrition

288

(1)

Treat Electrolyte and Nutritional Imbalances

289

(1)

Take Steps to Prevent Refeeding Syndrome

290

(1)

Monitor Laboratory Tests

291

(1)

Abnormal Fluid Balance

292

(1)

Altered Glucose Metabolism

292

(1)

Vitamin B1 (Thiamine) Deficiency

292

(1)

Hypophosphatemia

292

(1)

Hypomagnesemia

293

(1)

Hypokalemia

294

(1)

Hypocalcemia

294

(1)

Hepatic Steatosis

294

(1)

Establish Guidelines

294

(1)

Treat Related Musculoskeletal Conditions

295

(1)

The Malnutrition–Obesity Connection

295

(1)

Loss of Lean Tissue

296

(1)

Life-long Osteoporosis Risk

296

(1)

Malnutrition Can Affect the Next Generation

297

(1)

References

298

(7)

Section IV: Muscle Tissue

Chapter 18 Muscle Atrophy During Aging

305

(32)

Kevin R. Short

Introduction

305

(1)

Definition and Prevalence of Sarcopenia

305

(2)

Clinical Significance of Sarcopenia

307

(1)

Potential Mechanisms of Sarcopenia

308

(2)

Exercise can Attenuate Sarcopenia and Its Effects

310

(1)

Dietary Protein and Amino Acids Play a Role in Preventing Sarcopenia

311

(5)

Additional Dietary Supplement Strategies in Treating Sarcopenia

316

(1)

Growth Hormone and Muscle Mass

317

(1)

Insulin-Like Growth Hormone I and Muscle Mass

318

(1)

Testosterone and Muscle Mass

319

(1)

Oxandrolone and Muscle Mass

319

(1)

Estrogen and Muscle Mass

320

(1)

DHEA and Muscle Mass

320

(2)

Summary and Recommendations

322

(1)

References

322

(15)

Chapter 19 Muscle Strain

337

(18)

Ingrid Kohlstadt, Eric Schweitzer, Karen Mutter, and Lawrence B. Godwin

Introduction

337

(1)

Biomechanics

338

(1)

Tissue Response to Biomechanical Forces

339

(1)

Physical Therapy

340

(4)

Acute Phase

340

(1)

Subacute Phase

341

(2)

Advanced Strengthening Phase

343

(1)

Return-to-Function Phase

343

(1)

Osteopathic Approach

344

(2)

Acupuncture

346

(3)

Nutrition

349

(2)

Summary

351

(1)

References

351

(4)

Chapter 20 Muscle Hypertrophy

355

(36)

Stephen E. Alway

Muscle Growth

356

(2)

Introduction

356

(1)

Muscle Hypertrophy Results from Increased Protein Accumulation

356

(1)

Exercise as a Stimulus for Muscle Growth

357

(1)

Muscle Hypertrophy Requires Adding New Nuclei

357

(1)

The Stimulus for Muscle Growth May Also Increase Muscle Breakdown

358

(1)

Acute Exercise May Increase Muscle Protein Breakdown

358

(1)

The Stimulus for Muscle Growth Can Exceed the Body's Ability to Adequately Nourish the Muscle

359

(3)

What Limits Muscle Hypertrophy?

359

(3)

Physiologic Effects of Exogenous Testosterone and Nutrients Aimed at Stimulating Endogenous Testosterone Production

362

(3)

Effects of Exogenous Testosterone

362

(1)

Medical Use of Exogenous Testosterone

363

(1)

Testosterone Therapy in Women

363

(1)

Testosterone Therapy and Anabolic Steroids to Improve Muscle Hypertrophy

364

(1)

Anabolic Prohormones — Their Misuse Among Athletes and Nutritional Product Manufacturers

365

(4)

Introduction

365

(1)

Androstenedione and Dehydroepiandrosterone

365

(1)

Effects of Androstenedione on Blood Hormonal Levels and Muscle Hypertrophy

366

(2)

Gender Differences with Androstenedione

368

(1)

Physical Exam and Laboratory Screening — False Positives and False Negatives

369

(7)

Clinical and Laboratory Characteristics of Exogenous Testosterone Use

369

(1)

Sexual and Physical Characteristics

369

(1)

Behavioral Changes

372

(1)

Immune Function

372

(1)

Cardiovascular Risks

373

(1)

Blood and Thrombogenic Characteristics

374

(1)

Blood Pressure

374

(1)

Hepatic Function

374

(1)

Endocrine Modifications

375

(1)

Growth in Adolescents

376

(1)

Drug Testing — False Positives and False Negatives

376

(3)

False Negative Tests

376

(1)

False Positives

377

(1)

Designer Drugs and Getting Around Drug Tests

378

(1)

Conclusion

379

(1)

References

379

(12)

Section V: Soft Tissue

Chapter 21 Osteoarthritis

391

(16)

Laurie Mischley and David Musnick

Definition

391

(1)

Pathophysiology

392

(2)

Treatment Goals

394

(3)

Pain Control

394

(1)

Biomechanics

394

(1)

Weight Management

395

(1)

Reduce Inflammation

395

(1)

Regenerate Cartilage

395

(2)

Nutritional Substrates for Cartilage Repair and Regeneration

397

(5)

Glucosamine

397

(1)

Chondroitin Sulfate

398

(1)

S-Adenosyl Methionine (SAMe)

399

(1)

Hyaluronic Acid

399

(1)

Omega-3 Fatty Acids

400

(1)

Vitamin C (Ascorbic Acid)

401

(1)

Avocado/Soybean Unsaponifiable Residues (ASU)

401

(1)

Niacinamide (Vitamin B3)

401

(1)

Additional Nutrients

402

(1)

Duration and Selection of Joint Support Supplementation

402

(1)

Summary

403

(1)

References

403

(4)

Chapter 22 Fibromyalgia

407

(18)

Jacob Teitelbaum

Overview

407

(1)

Diagnosis

408

(2)

Treatment

410

(11)

Disordered Sleep (S)

411

(1)

Hormonal Dysfunction (H)

412

(1)

Thyroid Function

413

(1)

Adrenal Insufficiency

414

(1)

Dehydroepiandrosterone

416

(1)

Low Estrogen and Testosterone

416

(1)

Testosterone Deficiency

417

(1)

Immune Dysfunction and Infections (I)

417

(2)

Nutritional Deficiencies (N)

419

(1)

General Pain Relief

420

(1)

Autonomic Dysfunction

420

(1)

Psychological Well-Being

421

(1)

References

421

(4)

Chapter 23 Gout

425

(6)

Tony Heiman

Clinical Presentation

425

(1)

Etiology

425

(1)

Nutritional Factors

426

(2)

Urate Formation

426

(1)

Antioxidants

427

(1)

Xanthine Oxidase Inhibitors

427

(1)

Calcium and Vitamin D

428

(1)

Clinical Applications

428

(1)

References

429

(2)

Chapter 24 Oral Markers of Tissue Health

431

(12)

Helyn Luechauer and Kathryn Poleson

The Tongue, Palate, Gums, and Gingiva

432

(1)

Examining Teeth

433

(1)

Observing Saliva

434

(1)

Vitamin C for Soft Tissue Health

434

(1)

Osteoporosis

435

(1)

Iatrogenic Heavy-Metal Exposure

435

(1)

Conclusion

435

(1)

References

436

(7)

Section VI: Bone

Chapter 25 Bone Nutrition

443

(30)

Susan Brown

Rethinking Bone Strength

444

(1)

Bone Reserves

444

(1)

Protein

445

(3)

Minerals

448

(7)

Calcium

448

(2)

Phosphorous

450

(1)

Magnesium

451

(1)

Manganese

451

(1)

Zinc

452

(1)

Copper

453

(1)

Boron

454

(1)

Potassium

454

(1)

Vitamins

455

(4)

Vitamin D

455

(1)

Vitamin C

456

(1)

Vitamin A

457

(1)

Vitamin K

457

(1)

B Vitamins

458

(1)

Essential Fatty Acids

458

(1)

Base-forming Foods

459

(2)

Phytoestrogens

461

(1)

Water

462

(1)

Antinutrients

463

(2)

Salt (NaCl)

463

(1)

Caffeine

463

(1)

Alcohol

464

(1)

Soft Drinks and Sodas

464

(1)

Mineral Toxins

464

(1)

Tobacco

465

(1)

Summary Clinical Guidelines

465

(1)

References

466

(7)

Chapter 26 Osteoporosis

473

(18)

Joseph J. Lamb

Osteoporosis — a Silent Disease

473

(1)

New Definitions for New Understandings of the Disease Process

474

(2)

Physiology

476

(1)

Pathophysiology

477

(8)

Decreased Peak Bone Mass

478

(1)

Decreased Mineral Availability

479

(1)

Decreased Osteoblast Activity

480

(1)

Increased Osteoclast Activity

481

(2)

Impaired Protein Metabolism

483

(1)

Inflammation

483

(1)

Unclear Etiologies

484

(1)

Breaking the Silence

485

(1)

Treatment

485

(3)

Calcium

486

(1)

Magnesium

486

(1)

Boron

486

(1)

Vitamin D

487

(1)

Vitamin K

487

(1)

Isoflavones

487

(1)

Dehydroepiandrosterone

487

(1)

Conclusion

488

(1)

References

488

(3)

Chapter 27 Fractures

491

(16)

Craig Nadelson and Kevin Gebke

Functions of Bone

491

(1)

Bone Structure

492

(2)

Bone Remodeling and Coupling

494

(1)

Fracture Classification

494

(6)

Gender Differences

496

(1)

Fractures during Infancy

497

(1)

Fracture during Childhood

497

(1)

Fractures during Adolescence

497

(1)

Eating Disorders and Fracture Risk, a Special Consideration during Adolescence

498

(1)

Fractures during Young Adulthood

499

(1)

Fractures in Middle Adulthood

500

(1)

Fractures in Older Adults

500

(1)

Exercise for Bone Health

500

(1)

Nutrition for Bone Health

501

(1)

Summary

502

(1)

References

502

(5)

Section VII: Physical Stress

Chapter 28 Preparing for Orthopedic Surgery

507

(14)

Vilma A. Joseph and Ingrid Kohlstadt

Overview

508

(1)

Herb-Surgery Interactions

508

(4)

Echinacea

510

(1)

Feverfew

510

(1)

Garlic

510

(1)

Ginger

510

(1)

Ginkgo

510

(1)

Ginseng

510

(1)

Kava

511

(1)

St. John's Wort

511

(1)

Valerian

511

(1)

Caffeine

511

(1)

Preoperative Fasting Guidelines

512

(1)

Strategic Nutrition

513

(4)

Antioxidants

513

(1)

Alkalinizing Foods

514

(1)

Amino Acids

514

(1)

Biotics

515

(1)

Bone Nutrients

516

(1)

Correct Deficiencies

516

(1)

Comorbidities

516

(1)

Carnitine

517

(1)

Detoxification

517

(1)

Dehydroepiandostrone

517

(1)

Conclusion

518

(1)

References

518

(3)

Chapter 29 Xenobiotics: Managing Toxic Metals, Biocides, Hormone Mimics, Solvents, and Chemical Disruptors

521

(24)

Russell Jaffe

Introduction

522

(1)

Persistent Organic Pollutants

523

(1)

Toxic Metals

523

(9)

Absence of Evidence is not Evidence of Absence

526

(1)

Risk of Bioaccumulation of Toxicants: A Matter of Balance and Homeostasis

527

(1)

Increasing Output to Reduce Bioaccumulation

528

(1)

Reducing Iatrogenic Input

529

(3)

Quantifying Individual Exposure

532

(7)

Removing TMs and POPs

533

(1)

Penicillamine Protocol for Determining Toxic and Nutritional Mineral Status in Cells by Noninvasive Provocation into the Urine

533

(1)

Interpretation and Substantiation of Penicillamine Protocol

534

(1)

Managing Modest Amounts of Provoked TMs

535

(1)

Managing More Than Modest Amounts of Provoked TMs

536

(1)

Penicillamine in Clinical Practice

537

(1)

Lead, Mercury, Arsenic, Cadmium, and Nickel Mobilization by Penicillamine

537

(2)

Conclusion: Diagnosing and Managing Musculoskeletal Conditions

539

(1)

References

540

(5)

Chapter 30 Ergogenics: Maintaining Performance During Physical Stress

545

(18)

Luke R. Bucci

Introduction

545

(2)

Long-Term Endurance Exercise Performance

547

(2)

Muscle Mass and Strength

549

(1)

Indirect Ergogenic Aids

549

(3)

Mental Effects

551

(1)

Musculoskeletal Integrity

551

(1)

Immune Function

552

(1)

Tissue Repair and Recovery

552

(1)

Summary

552

(1)

Acknowledgments

553

(1)

References

553

(10)

Chapter 31 Terrestrial Extremes: Nutritional Considerations for High Altitude and Cold and Hot Climates

563

(30)

Matthew A. Pikosky and Andrew J. Young

Introduction

564

(1)

Nutritional Needs during High-Altitude Sojourns

564

(9)

The Hypoxic Environment and the Oxygen Transport "Cascade"

564

(2)

Physiological Adjustments to Exercise at High Altitude

566

(1)

Respiratory Exchange

566

(1)

Systemic O2 Transport

567

(1)

Energy Metabolism—The Lactate Paradox

568

(1)

Work Capacity and Physical Performance

569

(1)

Nutrition during Sojourns at High Altitude

570

(1)

High-Altitude Weight Loss: Energy and Water Balance

570

(1)

Macronutrient Requirements at High Altitude

572

(1)

Micronutrient Requirements at High Altitude

573

(1)

Nutritional Needs in Hot and Cold Environments

573

(12)

Regulation of Thermal Balance

573

(1)

Biophysics of Heat Exchange Between Humans and Environment

573

(1)

Human Thermoregulatory Control System

574

(1)

Cold Stress

575

(1)

Physiological Responses During Cold Exposure

575

(1)

Factors Modifying Physiological Responses to Cold.

576

(1)

Impact of Cold Exposure on Nutritional Requirements

578

(2)

Heat Stress

580

(1)

Physiological Responses to Heat Stress

580

(1)

Factors Modifying Physiological Responses to Heat Stress

582

(1)

Impact of Heat Stress on Nutritional Requirements

583

(2)

Summary

585

(1)

Disclaimer

586

(1)

References

586

(7)

Index

593

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Scientific Evidence for Musculoskeletal, Bariatric, And Sports Nutrition

Summary

Table of Contents

Supplemental Materials