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Book Reviews |
Defence Nutrition Research Centre, 76 George St., Scottsdale TAS 7260, Australia
This is an easily readable text, which presents its information in a fashion that is readily accessible to both clinicians and students. The contents are set out in four parts: Basic Concepts, Consumption, Deficiency, and Toxicity; Trace Element and Mineral Nutrition in Healthy People; Trace Element and Mineral Nutrition in Disease, and an index and guide to relevant literature. This format particularly suits the nutrition practitioner in patient care. However, an extensive index also enables the researcher or student to find basic information relating to individual trace elements or minerals. Each chapter provides a review of relevant recent research and an extensive reference list, which could further assist the researcher or student. For each of the nine trace elements currently considered essential (chromium, copper, fluoride, iron, iodine, molybdenum, manganese, selenium, and zinc) and three major essential minerals (calcium, magnesium, and phosphorus), information regarding the recommended dietary intake, possible toxicity, estimated dietary intake, laboratory measurement, and role in health and disease is provided.
In Part One, the reader is made aware of the difficulties facing the scientist in the area of trace element research. Laboratory measurement of trace element status suffers not only from analytical difficulties, which result from method interferences, sample contamination, and low biological concentrations, but also from a poor understanding of the storage and metabolism of many of the elements. The dangers in recommending dietary supplementation with trace elements and minerals is emphasized by a description of the complex interactions between the dietary elements. For example, chronic supplementation with relatively high doses of zinc might produce copper-deficiency anemia, and supplementation with calcium might reduce the absorption of zinc and iron from the diet. These interactions are not well understood and compromise the accurate estimation of DRIs (dietary reference intake values). The clinician is made aware of the caution required when interpreting the results of clinical investigations. Unique features of this section are the discussion of both prehistoric and current consumption of trace elements and minerals and the epidemiology of trace element and mineral deficiencies.
Parts Two and Three discuss, within each chapter, all of the essential elements relevant to a particular condition or group of diseases. The particular needs of human pregnancy, human lactation, adolescence, and old age are provided in Part Two. Part Three discusses trace element and mineral nutrition in various disease states, including genetic, endocrine, skeletal, cardiovascular, kidney, gastrointestinal, infectious, surgical, and ophthalmologic disorders. The copper-deficiency theory of ischemic heart disease is presented as a balanced and thoughtful argument; however, it was disappointing that the argument did not extend to suggested clinical dietary intervention. From a clinicians point of view, the one weakness with this text relates to a lack of specific dietary information. In particular, a concluding summary of major dietary implications and suggested dietary strategies at the end of each chapter would greatly enhance the usefulness of this text.
In summary, this text deserves a place in the clinical nutritionists library. The text provides an excellent mixture of current research and practical clinical nutrition, which can be used as a reference for patient care and for general trace element research, in an easily readable format.
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