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Contents in Brief
Preface xxi CHAPteR 13

CHAPteR 1
Child and
Nutrition Basics 1 Preadolescent Nutrition 343
Conditions and Interventions
CHAPteR 2
CHAPteR 14
Preconception Nutrition 50
Adolescent Nutrition 361
CHAPteR 3
CHAPteR 15
Preconception Nutrition 70
Conditions and Interventions Adolescent Nutrition 386
CHAPteR 4
CHAPteR 16
Nutrition During Pregnancy 87
Adult Nutrition 407
CHAPteR 5
CHAPteR 17
Conditions and Interventions Adult Nutrition 428
CHAPteR 6
CHAPteR 18
Nutrition During Lactation 164
Nutrition and Older Adults 454
CHAPteR 7
CHAPteR 19
Nutrition During Lactation 197
Conditions and Interventions Nutrition and Older Adults 486
CHAPteR 8
Infant Nutrition 226 Answers to Review Questions AR-1
CHAPteR 9
Appendix A
Infant Nutrition 252 Summary of Research of Effects of
Conditions and Interventions Exercise Activities on Health of Older
Adults A-1
CHAPteR 10
Toddler and 272 Appendix B
Preschooler Nutrition Measurement Abbreviations
and Equivalents A-3
CHAPteR 11
Toddler and 302 Appendix C
Preschooler Nutrition Body Mass Index (BMI) A-5
Conditions and Interventions References R-1
CHAPteR 12 Glossary G-1
Child and 318 Index I-1
Preadolescent Nutrition
Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part.
Contents
Preface xix Nutrition Assessment 38

Community-Level Assessment 38
Individual-Level Nutrition Assessment 39
All chapters include Resources and References Dietary Assessment 39
Anthropometric Assessment 40
Biochemical Assessment 41
CHAPteR 1 Monitoring the Nation’s Nutritional Health 42
Nutrition Basics 1 Public Food and Nutrition Programs 42
WIC 43
Introduction 2
Nationwide Priorities for Improvements in Nutritional Health 43
Principles of the Science of Nutrition 2
U.S. Nutrition and Health Guidelines 43
Essential and Nonessential Nutrients 3
Dietary Guidelines for Americans 44
Dietary Intake Standards 3
Carbohydrates 4 MyPlate.gov 45
Protein 6 The USDA’s Food Groups 46
Fats (Lipids) 8
Vitamins 10 CHAPteR 2
Other Substances in Food 13
Minerals 13 Preconception Nutrition 50
Water 22
Introduction 51
Nutritional Labeling 34
Preconception Overview 51
Nutrition Facts Panel 35
2020 Nutrition Objectives for the Nation Related
Ingredient Label 35
to Preconception 51
Dietary Supplement Labeling 35
Herbal Remedies 36 Reproductive Physiology 52
Functional Foods 36 Female Reproductive System 52
Male Reproductive System 55
The Life-Course Approach to Nutrition
and Health 37 Nutrition and Fertility 56
Meeting Nutritional Needs Across the Life Cycle 37 Undernutrition and Fertility 56
Dietary Considerations Based on Ethnicity 38 Body Fat and Fertility 57
Dietary Considerations Based on Religion 38 Nutrient Status and Fertility 58
Nutrition Time Line

H. Armstrong Roberts/
ClassicStock/Alamy
1621 1734
First Thanksgiving Scurvy recognized
feast at Plymouth
colony 1702
First coffeehouse
Photodisc
in America opens
in Philadelphia
vi
Contents vii
Nutrition During the Periconceptional Period 61 Phenylketonuria (PKU) 80

Periconceptional Folate Status 61 Maternal PKU 80
Periconceptional iron Status 63 Nutritional Management of PKU 81
Recommended Dietary Intake for Preconceptional Celiac Disease 81
Women 63 Nutritional Management of Celiac Disease 81
Influence of Contraceptives on Preconceptional
Nutrition Status 64 CHAPteR 4
Nutritional Side Effects of Hormonal Contraception 64
Model Preconceptional Health and Nutrition Programs 64
Preconceptional Benefits of WIC 65 Introduction 88
Decreasing Iron Deficiency in Preconceptional The Status of Pregnancy Outcomes 88
Women in Indonesia 65 Infant Mortality 88
Preconception Care: Preparing for Pregnancy 65 Low Birthweight, Preterm Delivery, and Infant
The Nutrition Care Process 65 Mortality 90
The Nutrition Care Process Related to the Preconception Reducing Infant Mortality and Morbidity 90
Period 67 Physiology of Pregnancy 91
Maternal Physiology 91
Normal Physiological Changes During Pregnancy 92
CHAPteR 3 The Placenta 95
Preconception Nutrition 70 Embryonic and Fetal Growth and Development 97
Conditions and Interventions Critical Periods of Growth and Development 97
Fetal Body Composition 99
Introduction 71 Nutrition, Miscarriage, and Preterm Delivery 102
Premenstrual Syndrome 71 Developmental Programming of Later Disease Risk 103
Treatment of PMS 71 Pregnancy Weight Gain 104
Weight Status and Fertility 72 Pregnancy Weight Gain Recommendations 105
Obesity, Body Fat Distribution, and Fertility 72 Nutrition and the Course and Outcome
Weight Status and Fertility in Men 73 of Pregnancy 108
Weight Status and Fertility in Women 73 Famine and Pregnancy Outcome 108
Negative Energy Balance and Fertility 75 Energy and Nutrient Needs During Pregnancy 109
Anorexia Nervosa, Bulimia Nervosa, and Fertility 75 The Need for Energy 110
The Female Athlete Triad and Fertility 75 The Need for Protein 111
Diabetes Prior to Pregnancy 76 The Need for Fat 111
Nutritional Management of Diabetes Prior The Need for Vitamins and Minerals
to Pregnancy 76 During Pregnancy 113
Calcium 117
Polycystic Ovary Syndrome and Fertility 78 Bioactive Components of Food 121
Nutritional Management of PCOS 79 The Need for Water 122
Nutrition Time Line

John A. Rizzo/
Photodisc
Getty Images
1744 1747 1750 1762

Photodisc/
First record of ice cream Lind publishes Ojibway and Sandwich invented
in America at Maryland “Treatise on Sioux war over by the Earl of
colony Scurvy,” citrus control of wild Sandwich
identified as cure rice stands
C Squared Studios/
Photodisc/Getty
Images
viii Contents
Factors Affecting Dietary Intake During Pregnancy 122 Diabetes in Pregnancy 145
Effect of Taste and Smell Changes on Dietary Intake Gestational Diabetes 145
During Pregnancy 122 Type 2 Diabetes in Pregnancy 150
Cultural Considerations 123 Type 1 Diabetes During Pregnancy 150
Nutritional Management of Type 1 Diabetes in Pregnancy 151
Healthful Diets for Pregnancy 123
Vegetarian Diets in Pregnancy 124 Multifetal Pregnancies 151
Dietary Supplements during Pregnancy 127 Background Information about Multiple Fetuses 152
Multivitamin and Mineral Prenatal Supplements 127 Risks Associated with Multifetal Pregnancy 153
Nutrition and the Outcome of Multifetal Pregnancy 154
Food Safety During Pregnancy 130
Dietary Intake in Twin Pregnancy 155
Mercury Contamination 130
Nutritional Recommendations for Women with
Assessment of Nutritional Status During Pregnancy 130 Multifetal Pregnancy 156
Dietary Assessment During Pregnancy 130
HIV/AIDS During Pregnancy 157
Nutrition Biomarker Assessment 131
Consequences of HIV/AIDS During Pregnancy 158
Exercise and Pregnancy Outcome 131 Nutritional Factors and HIV/AIDS During Pregnancy 158
Exercise Recommendations for Pregnant Women 132 Nutritional Management of Women with HIV/AIDS
During Pregnancy 158
Common Health Problems During Pregnancy 132
Nausea and Vomiting 132 Eating Disorders in Pregnancy 159
Heartburn 133 Consequences of Eating Disorders in Pregnancy 159
Constipation 133 Treatment of Women with Eating Disorders
During Pregnancy 159
Model Nutrition Programs for Risk Reduction Nutritional Interventions for Women with
in Pregnancy 133 Eating Disorders 159
The Montreal Diet Dispensary 133
The WIC Program 134 Fetal Alcohol Spectrum Disorders 159
Nutrition and Adolescent Pregnancy 161
Growth During Adolescent Pregnancy 161
CHAPteR 5
Obesity, Excess Weight Gain, and Adolescent
Nutrition During Pregnancy 138 Pregnancy 161
Nutritional Recommendations for Pregnant Adolescents 161
Conditions and Interventions Evidence-Based Practice 162
Introduction 139
Obesity and Pregnancy 139
Obesity and Infant Outcomes 139 CHAPteR 6
Hypertensive Disorders of Pregnancy 141 Nutrition During Lactation 164
Hypertensive Disorders of Pregnancy, Oxidative Stress, Introduction 165
and Nutrition 141
Chronic Hypertension 141 Lactation Physiology 165
Gestational Hypertension 142 Functional Units of the Mammary Gland 165
Preeclampsia–Eclampsia 142 Mammary Gland Development 165
Nutritional Recommendations and Interventions Lactogenesis 165
for Preeclampsia 145 Hormonal Control of Lactation 166
Nutrition Time Line
1771 1774 1775 1816

Potato heralded Americans drink Lavoisier (“the father Protein and
© Stefano Bianchetti/CORBIS
as famine food more coffee in of the science of amino acids

protest over nutrition”) discovers identified
Britain’s tea tax the energy-producing followed by
property of food carbohydrates
and fats in the
mid 1800s
Contents ix
Secretion of Milk 167 Maternal Diet 181

The Letdown Reflex 167 Nutrition Assessment of Breastfeeding Women 181
Energy and Nutrient Needs 181
Human Milk Composition 168 Maternal Energy Balance and Milk Composition 182
Colostrum 168 Weight Loss During Breastfeeding 182
Water 168 Exercise and Breastfeeding 183
Energy 168 Vitamin and Mineral Supplements 183
Lipids 168 Vitamin and Mineral Intakes 183
Protein 170 Functional Foods 183
Milk Carbohydrates 170 Fluids 184
Fat-Soluble Vitamins 170 Alternative Diets 184
Water-Soluble Vitamins 171 Infant Colic 184
Minerals in Human Milk 171
Taste of Human Milk 172 Public Food and Nutrition Programs 184
USDA WIC Program 184
Benefits of Breastfeeding 172
Breastfeeding Benefits for Mothers 172 Optimal Duration, Influential Factors, and U.S. Goals
Breastfeeding Benefits for Infants 172 for Breastfeeding 185
Benefits 174 Optimal Breastfeeding Duration 185
Factors Influencing Breastfeeding Initiation and Duration 185
Breast Milk Supply and Demand 174 Breastfeeding Goals for The United States 186
Can Women Make Enough Milk? 175
Does the Size of the Breast Limit a Woman’s Ability Breastfeeding Promotion, Facilitation, and Support 187
to Nurse Her Infant? 175 Role of the Health Care System in Supporting
Is Feeding Frequency Related to the Amount of Milk Breastfeeding 187
a Woman Can Make? 175 Prenatal Breastfeeding Education and Support 188
Pumping or Expressing Milk 175 Lactation Support in Hospitals and Birthing Centers 189
Can Women Breastfeed after Breast Reduction Lactation Support after Discharge 191
or Augmentation Surgery? 175 The Workplace 191
What Is the Effect of Silicone Breast Implants The Community 192
on Breastfeeding? 176 National Breastfeeding Policy 193
The Breastfeeding Process 215 Model Breastfeeding Promotion Programs 193

Preparing the Breast for Breastfeeding 176 WIC National Breastfeeding Promotion Project—Loving
Breastfeeding Positioning 176 Support Makes Breastfeeding Work 193
Presenting the Breast to the Suckling Infant 177 The Business Case for Breastfeeding 194
Wellstart International 194
The Breastfeeding Infant 177
Infant Reflexes 177
Mechanics of Breastfeeding 178
CHAPteR 7
Identifying Hunger and Satiety 178
Feeding Frequency 178 Nutrition During Lactation 197
Identifying Breastfeeding Malnutrition 178
Tooth Decay 181
Vitamin Supplements for Breastfeeding Infants 181 Introduction 198
Nutrition Time Line
1833 1871 1895

Beaumont’s Proteins, carbohydrates, First milk station
experiments on and fats determined providing children
© Bettmann/CORBIS
a wounded to be insufficient with uncontaminated

man’s stomach to support life; that milk opens in
© Bettmann/CORBIS
greatly expands there are other New York City

knowledge “essential” components
about digestion
x Contents
Common Breastfeeding Conditions 198 Model Programs 222

Sore Nipples 198 Breastfeeding Promotion in Physicians’ Office
Flat or Inverted Nipples 198 Practices (BPPOP) 222
Letdown Failure 198 The Rush Mothers’ Milk Club 223
Hyperactive Letdown 199
Hyperlactation 199
Engorgement 199 CHAPteR 8
Plugged Duct 199
Mastitis 200 Infant Nutrition 226
Low Milk Supply 200 Introduction 227
Maternal Medications 202 Assessing Newborn Health 227
Herbal Remedies 204 Birthweight as an Outcome 227
Specific Herbs Used in the United States 206 Infant Mortality 227
Milk Thistle/Blessed Thistle 207 Combating Infant Mortality 228
Standard Newborn Growth Assessment 228
Alcohol and Other Drugs and Exposures 207
Alcohol 207 Infant Development 228
Nicotine (Smoking Cigarettes) 209 Motor Development 228
Marijuana 209 Critical Periods 229
Caffeine 210 Cognitive Development 229
Other Drugs of Abuse 210 Digestive System Development 230
Environmental Exposures 210 Parenting 231
Neonatal Jaundice and Kernicterus 211 Energy and Nutrient Needs 232
Bilirubin Metabolism 212 Energy Needs 232
Physiologic Versus Pathologic Newborn Jaundice 212 Protein Needs 232
Hyperbilirubinemia and Breastfeeding 213 Fats 232
Prevention and Treatment for Severe Jaundice 215 Metabolic Rate, Energy, Fats, and Protein—How Do
Information for Parents 215 They All Tie Together? 233
Other Nutrients and Non-nutrients 233
Breastfeeding Multiples 215
Physical Growth Assessment 234
Infant Allergies 216 Interpretation of Growth Data 235
Food allergy (Hypersensitivity) 217
Food Intolerance 217 Feeding in Early Infancy 236
Breast Milk and Formula 236
Late-Preterm Infants 217 Cow’s Milk During Infancy 236
Soy Protein–Based Formulas During Infancy 237
Human Milk and Preterm Infants 219
Development of Infant Feeding Skills 238
Medical Contraindications to Breastfeeding 220
Introduction of Solid Foods 239
Breastfeeding and HIV Infection 220
The Importance of Infant Feeding Position 240
Human Milk Collection and Storage 221 Preparing for Drinking from a Cup 241
Milk Banking 221 Food Texture and Development 242
Nutrition Time Line
1896 1906 1910 1912

Funk suggested
Jonelle Weaver/Photodisc/
Atwater Pure Food and Pasteurized

© Bettmann/CORBIS
publishes Drug Act passed by milk introduced scurvy, beriberi,

Proximate President Theodore and pellagra
Getty Images
Composition Roosevelt to protect caused by

of Food consumers against deficiency of
Materials contaminated foods “vitamines” in
the diet
Contents xi
First Foods 242 Does Intrauterine Growth Predict Growth

Inappropriate and Unsafe Food Choices 242 Outside? 257
Water 243 Interpretation of Growth 260
How Much Food Is Enough for Infants? 243
Nutrition for Infants with Special Health Care
How Infants Learn Food Preferences 244
Needs 260
Nutrition Guidance 244 Nutrition Risks to Development 261
The Infant’s Home Environment 245
Severe Preterm Birth and Nutrition 262
Supplements for Infants 245
How Sick Babies Are Fed 262
Common Nutritional Problems and Concerns 245 What to Feed Preterm Infants 263
Failure to Thrive 245 Preterm Infants and Feeding 264
Nutrition Intervention for Failure to Thrive 246 Infants with Congenital Anomalies and Chronic
Colic 246 Illness 266
Iron-Deficiency Anemia 246 Infants with Genetic Disorders 266
Diarrhea and Constipation 247
Prevention of Baby-Bottle Caries and Ear Infections 247 Feeding Problems 269
Food Allergies and Intolerances 247
Nutrition Interventions 269
Lactose Intolerance 248
Nutrition Services 270
Cross-Cultural Considerations 248
Vegetarian Diets 249
Nutrition Intervention for Risk Reduction 249 CHAPteR 10

Model Program: Newborn Screening 249
Toddler and Preschooler 272
Nutrition
CHAPteR 9 Introduction 273
Definitions of the Life-Cycle Stage 273
Infant Nutrition 252 Importance of Nutrition 273
Tracking Toddler and Preschooler Health 273
Introduction 253 Healthy People 2020 273
Infants at Risk 253
Families of Infants with Special Health Care Needs 254 Normal Growth and Development 273
Measuring Growth 274
Energy and Nutrient Needs 254 The 2000 CDC Growth Charts 275
Energy Needs 254 WHO Growth Standards 276
Protein Requirements 255 Common Problems with Measuring and Plotting
Fats 255 Growth Data 276
Vitamins and Minerals 256
Physiological and Cognitive Development 276
Growth 256 Toddlers 276
Growth in Preterm Infants 257 Preschool-Age Children 278
Nutrition Time Line
1914 1916 1917

C Squared Studios/
Photodisc/Getty
Goldberger identifies the First dietary guidance First food groups

Images
cause of pellagra (niacin material produced for published, The Five Food
deficiency) in poor the public was released. Groups: Milk and Meat;
1913 children to be a missing It was titled “Food for Vegetables and Fruits;
First vitamin component of the diet Young Children.” Cereals; Fats
discovered (vitamin A) rather than a germ as and Fat Foods; Sugars
others believed and Sugary Foods
xii Contents
Temperament Differences 281 Public Food and Nutrition Programs 299

Food Preference Development, Appetite, and Satiety 281 WIC 299
WIC’s Farmers’ Market Nutrition Program 300
Energy and Nutrient Needs 283
Head Start and Early Head Start 300
Energy Needs 283
Supplemental Nutrition Assistance Program
Protein 284
(formerly the Food Stamp Program) 300
Common Nutrition Problems 284
Iron-Deficiency Anemia 284 CHAPteR 11
Dental Caries 285
Constipation 286 Toddler and Preschooler 302
Elevated Blood Lead Levels 286
Food Security 287
Nutrition
Food Safety 287 Conditions and Interventions
Prevention of Nutrition-Related Disorders 288 Introduction 303
Overweight and Obesity in Toddlers
Who Are Children with Special Health Care
and Preschoolers 288
Needs? 303
Assessment of Overweight and Obesity 288
Prevention of Overweight and Obesity 288 Nutrition Needs of Toddlers and Preschoolers
Treatment of Overweight and Obesity Expert Committee with Chronic Conditions 305
Recommendations 289
Dietary Guidelines for Americans 2010 290 Growth Assessment 306
Nutrition and Prevention of Cardiovascular Disease in
Feeding Problems 307
Toddlers and Preschoolers 290
Behavioral Feeding Problems 309
Vitamin and Mineral Supplements 292
Excessive Fluid Intake 309
Herbal Supplements 292
Feeding Problems and Food Safety 309
Dietary and Physical Activity Recommendations 292 Feeding Problems from Disabilities Involving
Dietary Guidelines for Americans 2010 293 Neuromuscular Control 309
MyPlate 293
Nutrition-Related Conditions 310
Recommendations for Intake of Iron, Fiber,
Failure to Thrive 310
Fat, and Calcium 293
Toddler Diarrhea and Celiac Disease 311
Fluids 296
Autism Spectrum Disorders 312
Recommended vs. Actual Food Intake 296
Muscle Coordination Problems and Cerebral Palsy 312
Pulmonary Problems 313
Vegetarian Diets 297
Developmental Delay and Evaluations 314
Child Care Nutrition Standards 298
Physical Activity Recommendations 298 Food Allergies and Intolerance 315
Nutrition Intervention for Risk Reduction 299 Dietary Supplements and Herbal Remedies 315
Nutrition Assessment 299
Model Program 299 Sources of Nutrition Services 315
Nutrition Time Line
1921 1928
First fortified food produced: lodized American Society
GIPhotoStock/Getty Images
salt. It was needed to prevent for Nutritional

widespread iodine deficiency goiter Sciences and
1929
in many parts of the United States the Journal of Essential
Photodisc
Nutrition founded fatty acids

identified
Contents xiii
CHAPteR 12 Recommended vs. Actual Food Intake 333

Child and Preadolescent 318 Vegetarian Diets 334
Nutrition Physical Activity Recommendations 334
Introduction 319 Recommendations vs. Actual Activity 334
Definitions of the Life Cycle Stage 319 Determinants of Physical Activity 335
Importance of Nutrition 319 Organized Sports 335
Tracking Child and Preadolescent Health 319 Nutrition Intervention for Risk Reduction 335
Healthy People 2010 319 Nutrition Education 336
Nutrition Integrity in Schools 336
Normal Growth and Development 319 Nutrition Assessment 337
The 2000 CDC Growth Charts 320 Model Programs 337
WHO Growth References 321
Public Food and Nutrition Programs 339
Physiological and Cognitive Development of The National School Lunch Program 339
School-Age Children 321 School Breakfast Program 339
Physiological Development 321 Summer Food Service Program 340
Cognitive Development 322 Team Nutrition 340
Development of Feeding Skills and
Eating Behaviors 322
Energy and Nutrient Needs of School-Age CHAPteR 13
Children 324
Energy Needs 324
Child and Preadolescent 343
Protein 325 Nutrition
Common Nutrition Problems 325
Introduction 344
Iron Deficiency 325
Dental Caries 325 “Children Are Children First”—What Does
that Mean? 344
Prevention of Nutrition-Related Disorders in
Counting Children with Special Health Care Needs 344
School-Age Children 326
Overweight and Obesity in School-Age Children 326 Nutritional Requirements of Children with Special
Addressing the Problem of Pediatric Overweight Health Care Needs 345
and Obesity 328 Energy Needs 345
Nutrition and Prevention of Cardiovascular Disease Protein Needs 346
in School-Age Children 329 Other Nutrients 346
Dietary Supplements 331
Growth Assessment 346
Dietary Recommendations 330 Growth Interpretation in Children with Chronic
Recommendations for Intake of Iron, Fiber, Fat, Calcium, Conditions 347
Vitamin D, and Fluids 331 Body Composition and Growth 347
Nutrition Time Line
1930s 1937 1941

Vitamin C identified in 1932, Pellagra found to be First refined
followed by pantothenic acid due to a deficiency grain-enrichment
and riboflavin in 1933, and of niacin standards developed
vitamin K in 1934
Photodisc
xiv Contents
Nutrition Recommendations 349 Promoting Healthy Eating and Physical Activity

Methods of Meeting Nutritional Requirements 350 Behaviors 381
Fluids 351 The Home Environment and Parental Involvement 381
School Programs 381
Eating and Feeding Problems in Children with Special
Community Involvement in Nutritionally Supportive
Health Care Needs 352
Environments 384
Specific Disorders 352
Dietary Supplements and Herbal Remedies 357
CHAPteR 15
Sources of Nutrition Services 357
Nutrition Intervention Model Program 359 Adolescent Nutrition 386
CHAPteR 14 Introduction 387
Adolescent Nutrition 361 Overweight and Obesity 387
Health Implications of Adolescent Overweight
Introduction 362
and Obesity 388
Nutritional Needs in a Time of Change 362
Assessment and Treatment of Adolescent Overweight
Normal Physical Growth and Development 362 and Obesity 388
Changes in Weight, Body Composition,
Supplement Use Among Adolescents 391
and Skeletal Mass 364
Vitamin/Mineral Supplements 391
Normal Psychosocial Development 365 Ergogenic Supplements Used by Teens 391
Health and Nutrition-Related Behaviors During Nutrition for Adolescent Athletes 392
Adolescence 366
Special Dietary Concerns Among Adolescents 394
Dietary Requirements, Intake and Adequacy Among Substance Use 394
Adolescents 369 Iron-Deficiency Anemia 395
Energy and Nutrient Requirements of Adolescents 369 Hypertension 396
Energy 369 Hyperlipidemia 396
Protein 371 Children and Adolescents with Chronic Health
Carbohydrates 371 Conditions 398
Dietary Fiber 371
Dieting, Disordered Eating, and Eating Disorders 398
Fat 372
Disordered Eating Behaviors and Eating Disorders 399
Calcium 372
Iron 372
Vitamin D 373 CHAPteR 16
Folate 374
Dietary Intake and Nutritional Adequacy 374 Adult Nutrition 407
Nutrition Screening, Assessment, and Intervention 375 Introduction 408
Nutrition Education and Counseling 376 Importance of Nutrition 408
Nutrition Time Line
1941 1946 1947

Photodisc/Getty Images
First Recommended National Vitamin B12

David Buffington/
Dietary Allowances (RDAs) School Lunch identified

AP Photo
announced by President Act passed

Franklin Roosevelt on radio
Contents xv
Tracking Adult Nutritional Health and its CHAPteR 17

Determinants 409
Health Objectives for the Nation 409 Adult Nutrition 428
Health Disparities Among Groups of Adults 409 Conditions and Interventions
Physiological Changes During the Adult Years 412 Introduction 429
Body Composition Changes in Adults/ Lean Body Mass
and Adiposity 412 Overweight and Obesity 429
Continuum of Nutritional Health 412 Effects of Obesity 429
States of Nutritional Health 413 Etiology of Obesity 430
Screening and Assessment 430
Energy Recommendations 414 Recommendation for Weight-Management Therapy 431
Age-Related Changes in Energy Expenditure 414 Nutrition Assessment 432
Estimating Energy Needs in Adults 414 Nutrition Interventions for Weight Management 432
Energy Adjustments for Weight Change 415 Weight Loss 432
Energy Balance 416 Medical Nutrition Therapy for Weight Management 432
Cognitive Behavioral Therapy for Weight
Nutrient Recommendations 416 Management 432
Macro and Micro Nutrient Recommendations 416 Physical Activity for Weight Management 434
Risk Nutrients 416 The Challenge of Weight Maintenance 434
Pharmacotherapy for Weight Loss 434
Dietary Recommendations for Adults 418
Bariatric Surgery 434
Total Diet Approach 418
Beverage Intake Recommendations 420 Cardiovascular Disease 435
Alcoholic Beverages 420 Prevalence of CVD 436
Water Intake Recommendations 420 Etiology of Atherosclerosis 436
Effects of Caffeine Intake on Water Need 421 Physiological Effects of Atherosclerosis 437
Dietary Supplements and Functional Foods 421 Risk Factors for CVD 437
The Eating Competence Model 422 Screening and Assessment of CVD 437
Nutrition Interventions for CVD 437
Physical Activity Recommendations 423 Primary Prevention 437
Guidelines for Physical Activity 423 Medical Nutrition Therapy for CVD 439
Promotion of Physical Activity 423 Pharmacotherapy of CVD 440
Physical Activity, Body Composition, and Metabolic
Change 424 Metabolic Syndrome 440
Diet and Physical Activity 424 Introduction 440
Prevalence of Metabolic Syndrome 441
Nutrition Intervention for Risk Reduction 424 Etiology of Metabolic Syndrome 441
A Model Health-Promotion Program 425 Effects of Metabolic Syndrome 441
Public Food and Nutrition Programs 426 Screening and Assessment 441
Putting It All Together 427 Nutrition Interventions for Metabolic Syndrome 441
Nutrition Time Line
1953 1965 1966 1968

Double helix Food Stamp Act Child Nutrition First national nutrition
structure passed, Food Stamp Act adds school survey in United States
of DNA program established breakfast to the launched (the Ten
Photodisc
discovered National School State Nutrition

Lunch Program Survey)
xvi Contents
Diabetes Mellitus 442 A Picture of the Aging Population: Vital

Prevalence of Diabetes 443 Statistics 456
Disparities in the Prevalence of Diabetes 443 Global Population Trends: Life Expectancy
Etiology of Diabetes 443 and Life Span 456
Physiological Effects of Diabetes 443 Health Objectives for Older Adults 457
Prevention of Diabetes Complications 443
Theories of Aging 457
Screening and Assessment 444
Programmed Aging 458
Nutrition Assessment 444
Wear-and-Tear Theories of Aging 458
Interventions for Diabetes 444
Calorie Restriction to Increase Longevity 459
Medical Nutrition Therapy for Diabetes 445
ADA Exchange Lists 445 Physiological Changes 459
Carbohydrate Counting 446 Body-Composition Changes 460
Self-Monitored Blood Glucose 446 Changing Sensual Awareness: Taste and Smell,
Physical Activity in Diabetes Management 447 Chewing and Swallowing, Appetite and Thirst 461
Pharmacological Therapy of Type 2 Diabetes 447
Herbal Remedies and Other Dietary Supplements 447 Nutritional Risk Factors 462
Dietary Recommendations for Older Adults 465
Cancer 447
Prevalence of Cancer 447 Nutrient Recommendations 469
Physiological and Psychological Effects of Cancer 448 Estimating Energy Needs 469
Etiology of Cancer 448 Nutrient Recommendations for Older Adults: Energy
Risk Factors for Cancer 448 Sources 470
Screening and Assessment 448 Age-Associated Changes: Nutrients of Concern 473
Nutrition Interventions for Cancer 449 Nutrient Supplements: When, Why, Who, What,
Alternative Medicine and Cancer Treatment 449 and How Much? 475
Dietary Supplements, Functional Foods,
HIV Disease 450
and Complementary Medicine 477
Prevalence of HIV 450
Nutrient Recommendations: Using the Food Label 477
Physiological Effects of HIV 450
Cross-Cultural Considerations in Making Dietary
Etiology of HIV 451
Recommendations 479
Assessment 451
Nutrition Interventions for HIV 451 Food Safety Recommendations 479
Physical Activity Recommendations 480
Physical Activity Guidelines 480
CHAPteR 18
Nutrition Policy and Intervention for Risk
Nutrition and Older Adults 454 Reduction 481
Nutrition Education 481
Introduction 455
What Counts as Old Depends on Who Is Counting 455 Community Food and Nutrition Programs 482
Food Matters: Nutrition Contributes to a Long Store-to-Door: A Nongovernmental Service that
and Healthy Life 455 Supports Aging in Place 483
Nutrition Time Line
1970 1972 1977 1978

First Canadian national Special Supplemental Dietary Goals First Health
nutrition survey launched Food and Nutrition for the United Objectives
(Nutrition Canada Program for Women, States issued for the Nation
National Survey) Infants, and Children released
(WIC) established
Contents xvii
Senior Nutrition Program: Promoting Socialization Prevalence 498

and Improved Nutrition 483 Etiology 498
The Promise of Prevention: Health Promotion 484 Effects of Osteoporosis 499
Nutritional Remedies 500
Other Issues Impacting Nutritional Remedies 501
CHAPteR 19
Oral Health 501
Nutrition and Older Adults 486 Gastrointestinal Diseases 502
Conditions and Interventions Gastroesophageal Reflux Disease (GERD) 502
Stomach Conditions Affect Nutrient Availability:
Introduction: The Importance of Nutrition 487
Vitamin B12 Malabsorption 503
Nutrition and Health 487 Constipation 504
Heart Disease 488 Inflammatory Diseases: Osteoarthritis 506
Prevalence 488 Definition and Prevalence 506
Risk Factors 488 Etiology 507
Nutritional Remedies for Cardiovascular Diseases 489 Effects of Osteoarthritis 507
Risk Factors 508
Stroke 490
Definition 490
Prevalence 490 Cognitive Impairment, Dementia and Alzheimer's
Etiology 491 Disease 508
Effects of Stroke 491 Definition 508
Risk Factors 491 Prevalence 509
Nutritional Remedies 491 Etiology of Cognitive Impairment 509
Effects of Cognitive Impairment 510
Hypertension 492
Nutrition Interventions for Cognitive Impairment 510
Definition 492
Prevalence 492 Polypharmacy: Prescription and Over-the-Counter
Etiology 492 Medications 510
Effects of Hypertension 492
Low Body Weight /Unintentional Weight Loss 512
Risk Factors 492
Definition 512
Etiology and Effects 513
Diabetes: Special Concerns for Older Adults 494 Nutrition Interventions 514
Effects of Diabetes 494
Dehydration 514
Nutritional Interventions 494
Definition 514
Obesity 495 Etiology 515
Definition 495 Effects of Dehydration 515
Prevalence 496 Nutritional Interventions 515
Etiology, Effects, and Risk Factors of Obesity 496 Rehydrate Slowly 516
Nutritional Remedies 497 Dehydration at End of Life 516
Osteoporosis 498 Bereavement 516
Definition 498 Addendum 516
Nutrition Time Line
1997 1998 2003 2009

RDAs Folic acid Sequencing of Obesity and
expanded fortification DNA in the human diabetes
to Dietary of refined genome completed. become
USDA
Reference grain Marks beginning global 2011

Jeff Greenberg/Alamy
Intakes products of new era of epidemics USDA introduces

(DRIs) begins research in the MyPlate icon and
nutrient–gene ChooseMyPlate.gov food
interactions and dietary guidance
xviii Contents
Answers to Review Questions AR-1 Appendix C

Appendix A Body Mass Index (BMI) A-5
Summary of Research of Effects References R-1
of Exercise Activities on Health
Glossary G-1
of Older Adults A-1
Index I-1
Appendix B
Measurement Abbreviations
and Equivalents A-3
Chapter 1: Nutrition Basics xix
Preface
It is our privilege to offer you the fifth edition of Nutrition New to the Fifth Edition
Through the Life Cycle. This text was initially developed, Advances in knowledge about nutrition and health
and has been revised, to address the needs of instructors through the life cycle are expanding at a remarkably
teaching, and students taking, a two- to four-credit course high rate. New research is taking our understanding of the
in life-cycle nutrition. It is written at a level that assumes roles played by healthful diets, nutrients, gene variants and
students have had an introductory nutrition course. nutrient–gene interactions, body fat, physical activity, and
Overall, the text is intended to give instructors a tool they dietary supplements to new levels. The continued escala-
can productively use to enhance their teaching efforts, and tion of rates of overweight, obesity, and type 2 diabetes are
to give students an engaging and rewarding educational having broad effects on the incidence of disease throughout
experience they will carry with them throughout their lives the life cycle. New knowledge about nutrition and health
and careers. through the life cycle requires that we understand the ef-
The authors of Nutrition Through the Life Cycle fects of nutrients and body fat on hormonal activity, nutri-
represent a group of experts who are actively engaged in ent triggers to gene expression, and the roles of nutrients in
clinical practice, teaching, and research related to nutrition the development and correction of chronic inflammation,
during specific phases of the life cycle. All of us remain oxidative stress, and endothelial dysfunction. Recommen-
totally dedicated to the goals established for the text at dations for dietary and nutrient supplement intake and for
its conception: to make the text comprehensive, logically physical activity in health and disease are changing due to
organized, evidence-based, realistic, and relevant to the these understandings.
needs of instructors and students. The practice of dietetics and nutrition is changing due
Chapter 1 summarizes key elements of introductory to the emerging emphasis on electronic medical records,
nutrition and gives students who need it a chance to evidence-based health care services, and standardization of
update or renew their knowledge. Students can “test” their care delivery. The American Academy of Food and Nutrition
knowledge of many aspects of introductory nutrition by is responding to these changes though the development and
answering the review questions listed at the end of the implementation of nutrition care process standards. These
chapter. Coverage of the life-cycle phases begins with pre- standards are intended to provide a systematic approach to
conception nutrition and continues with each major phase the delivery of nutrition care to patients and clients.
of the life cycle through adulthood and the special needs of You will see these emerging areas of direct relevance
the elderly. Each of these 19 chapters was developed based to nutrition and updated information about nutrition
on a common organizational framework that includes incorporated throughout the fifth edition of Nutrition
key nutrition concepts, prevalence statistics, physiological Through the Life Cycle. It differs from the previous edition
principles, nutritional needs and recommendations, model in several important ways. We have:
programs, case studies, and recommended practices. created learning objectives relevant to each major
To meet the knowledge needs of students with the vari- topic covered in the chapters;
ety of career goals represented in many life-cycle nutrition expanded the number and types of review questions
courses, we include two chapters for each life-cycle phase. listed at the end of the chapters;
The first chapter for each phase covers normal nutrition inserted new photographs, tables, and figures to
topics, and the second covers nutrition-related conditions enhance instruction and student understanding of
and interventions. Every chapter focuses on scientifically material presented; and
based information and employs up-to-date resources and incorporated information from ChooseMyPlate,
references. Each chapter begins with learning objectives the 2010 Dietary Guidelines, and the 2020 Health
and ends with a list of key points and review questions. Objectives for the Nation into this edition.
Answers to the case studies and review questions,
and Internet resources that lead to reliable information on Chapter-by-Chapter Changes
topics presented in the chapters, are now located on the In addition to the enhancements just listed for every
web and can be accessed through www.cengagebrain.com. chapter, we have extensively revised and updated the text
Web addresses that lead to scientific consensus and other based on the most current research. The following list
reports coming out within a year or two are also listed. summarizes the major changes.
xix
xx Preface
Chapter 1: Nutrition Basics Added content on the effects of the famine in China
Expanded coverage of the effects of gene variants (1959–61) on pregnancy outcome.
and nutrient–gene interactions that influence health Added multiple examples of diet for pregnancy from
and disease risk ChooseMyPlate.gov
Updated recommendations on EPA, DHA intake Extensively revised content on postpartum weight
and health retention
Incorporated 2010 Dietary Guidelines and Expanded review questions from Chapters 11 to 33
ChooseMyPlate recommendations into the content, as
well as the Healthy People 2020 nutrition objectives Chapter 5: Nutrition During Pregnancy: Conditions
Added a section related to the use of USDA’s and Interventions
ChooseMyPlate interactive diet planning and evalua- Extensively revised content on gestational and
tion tools type 2 diabetes in pregnancy
Reorganized and re-focused content on healthy Added content on newly identified gene variants and
diets, expanded coverage of the DASH Eating Plan their effect on nutrient metabolism and disease and
Added 20 review questions to the end of the chapter disorder risk during pregnancy
Redirected content on fetal alcohol spectrum to
Chapter 2: Preconception Nutrition fetal alcohol spectrum disorders and provided
Extensively modified content on nutritional new definitions and information about these
implications of traditional contraceptives and a look disorders
at proposed male hormonal contraceptives Added information about alcohol intake and its ef-
Expanded coverage on the periconceptional period, in- fects on pregnancy outcome
cluding effects of nutrient intake and nutritional status Added content on recently released nutrition
during this period on fertility and pregnancy outcome recommendations for pregnant women
Added emphasis on gene variants and nutrient with HIV/AIDS
utilization
Added content on culturally and ethnically based Chapter 6: Nutrition During Lactation
differences in folate status, neural tube defect Updated to reflect more current breastfeeding rates
prevalence, and availability and utilization of folic and the progress in initiation that has been made
acid–fortified foods Added the composition of a human milk substitute
Replaced MyPyramid with ChooseMyPlate content on (formula) to the table along with human and cow’s
healthy diets for women and men prior to conception milk composition
Expanded review questions from Chapters 12 to 29 Updated Mypyramid data to MyPlate data
Added a figure demonstrating the lay-back position
Chapter 3: Preconception Nutrition: Conditions for nursing
and Interventions
New content on “Negative Energy Balance and Chapter 7: Nutrition During Lactation: Conditions
Fertility” and Interventions
Major sections of content are reorganized within the Mastitis incidence updated
chapter Added caution regarding herbal galactogogues from
New illustrations appear Academy of Breastfeeding Medicine
Content on medical nutrition therapy for various Added information on Domperidone’s orphan drug
conditions has been condensed status
Content on herbal remedies is now incorporated Alcohol section updated to reflect current recom-
into chapter contents mendations on use during lactation
Review questions expanded from Smoking and lactation section updated
Chapters 12 to 24 Caffeine section updated to include recommended
intake of coffee
Chapter 4: Nutrition During Pregnancy Food allergy and intolerance section updated
Several major content sections are reorganized to include recommendations from the National
within the chapter Institute of Allergy and Infectious Diseases
Expanded coverage of food safety during pregnancy American Academy of Pediatrics practice
Changes “Fetal Origins Hypothesis” to “Develop- recommendations on use of human milk for preterm
mental Origins” and added new examples of nutri- infants updated
tional triggers to later disease development 2010 WHO recommendations on breastfeeding and
Replaced illustrations to reflect updated content and HIV included
recommendations Milk Banking statistics updated
Preface xxi
Chapter 8: Infant Nutrition Revised overweight and obesity data to the

Incorporated Nutrition Care process language NHANES 2009-10 data
Introduced standardized language in nutrition Updated data for common nutritional problems of
diagnosis for iron deficiency anemia in contrast to toddlers and preschoolers, including iron deficiency,
medical diagnosis dental caries, abnormal blood lead levels, and food
Incorporating Healthy People 2020 objectives and insecurity
2010 Dietary Guidelines in text and in replaced and Dietary Guidelines for Americans updated
expanded Table 8.1 to 2010 version
New table about CDC and WHO growth charts Updated information found in Consumer Nutrition
Incorporated Iron recommendations from the Education tool from MyPlate.gov
AAP in text Added recommendations from NHLBI expert
Incorporated Vitamin D recommendations panel on evidence-based cardiovascular guidelines,
Incorporated WHO growth standard including the CHILD-1, CHILD-2-LDL, and
recommendation from CDC for <24 months CHILD-2-TG diet patterns
Incorporated 2010 AAP clinical report on iron and Updated intake data to NHANES 2009–2010 data
iron deficiency recommendations for infants
Replaced Infant Exercise topic changed to Chapter 11: Toddler and Preschooler Nutrition:
Environmental Recommendations Conditions and Interventions
Infant mortality updated Incorporated Nutrition Care process language
Added NIH allergy guidelines for lactose and soy Based on the increased primary care developmental
formula screening related to autism spectrum disorders,
Updated Table 8.6, adding prebiotics and nucleo- chapter has been updated with clarification of
tides to formula education laws (IDEA and Part C), with two new
tables: Table 11.1 on Early Intervention Nutrition
Chapter 9: Infant Nutrition: Conditions Services for 3- to 5-year-old children (related to
and Interventions expansion of education), Table 11.2 provides notes
Incorporated Nutrition Care process language for educational, medical, and nutrition problems for
Explained the difference between medical diagnoses one toddler and one preschooler
and nutrition diagnoses in two chronic conditions: Added text about nutrition assessment and its
Down syndrome and severe prematurity benefits in the growth section
Added text about probiotics and prebiotics in Added text with example to emphasize medicine
preemies and nutrition for home care of complexly
Added text about US-ASPEN 2009 enteral nutrition ill children
practice including milk banking New Illustration 11.2 on WHO growth chart
Added text about WHO growth charts, Fenton and
Olsen charts Chapter 12: Child and Preadolescent Nutrition
Included text and references on near-term preemie Statistics on child and preadolescent health updated
outcomes Revised health objectives to Healthy People 2020
Confirmed and updated Table 9.2 formula composition objectives
New illustration showing the WHO growth chart Updated overweight and obesity data to NHANES
for an infant who has correction for prematurity 2009–10 data
New illustration depicting how a boy with IUGR grows Added information about the NHLBI expert panel
over time as plotted on a standard WHO growth chart recommendations on evidence-based cardiovascular
Replaced VCFS with preferred term Chromosome health guidelines
22q11.2 Updated intake data to NHANES 2009–10 data
Updated terminology for fetal, infant and prenatal Updated nutrition standards in the National School
deaths based on AAP 2011 report Lunch and School Breakfast Programs to current
Updated vital statistics, 2005 Dietary Guidelines USDA standards
and 2010 Healthy People objectives
Added text to emphasize outcome research and cut Chapter 13: Child and Preadolescent Nutrition:
back on infant mortality Conditions and Interventions
Incorporated Nutrition Care process language
Chapter 10: Toddler and Preschooler Nutrition Updated text about Down syndrome growth charts
Children’s health status data updated Added role of parent and child at home,
Updated health objectives to Healthy People 2020 showing technology dependency in Nutrition
objectives Recommendations
xxii Preface
Added text about growth hormone use and its im- Guidelines for management of diabetes reflect new
pact in growth assessment views regarding individualization of A1C goals for
Updated prevalence for each chronic condition those with longer duration of diabetes
(e.g., diabetes) Newest version of the ADA Exchange Lists for
Added prevalence of and information about celiac diabetes meal planning
disease to chronic conditions Content revised to reflect evolving recommendations
regarding the percentage of calories from
Chapter 14: Adolescent Nutrition carbohydrates and fat
Revised and rearranged content on eating behaviors Information about chronic disease being a greater
and dietary quality concern in HIV included
Dietary adequacy information arranged to fit in
nutrition needs portion of the chapter Chapter 18: Nutrition and Older Adults
Updated common dietary behaviors and nutrient Graphics for the most recent food guidance tools
concerns updated
National data on nutrient inadequacies revised Revised supplement guidance and dietary reference
intake information for vitamins and minerals
Chapter 15: Adolescent Nutrition: Conditions Updated tables on “What We Eat in America”
and Interventions New table on poverty benchmarks among older adults
Updated information on sports nutrition New vital health statistics, including longevity
(moved from Chapter 14) around the world and Healthy People 2020
New table showing recommendations for food and
beverages prior to sports events Chapter 19: Nutrition and Older Adults: Conditions
Rearranged special needs nutrition section to fall and Interventions
under the special dietary concerns information Reviewed and updated all text sections, integrating
New table showing recommendations for fluid new treatment effectiveness evidence
intake during strenuous physical activity Included table addressing budgetary constraints that
affect food purchasing
Chapter 16: Adult Nutrition Updated tables, including prevalence of chronic
Chapter reorganized to flow from defining disease, treatment of heart disease, and oral health
nutritional needs of adults to dietary guidance and status of older adults
interventions to meet needs Included table of nutritional values of cereal grains,
New information on the determinants of nutritional including glycemic index
health includes environmental factors
The continuum of nutritional health is now part of Instructor Resources
physiological changes during the adult years Updated for the fifth edition is a Power Lecture DVD-ROM
New section on Energy Recommendations better that contains Microsoft PowerPoint™ lecture presentations
organizes energy requirements and methods of with artwork, chapter outlines, classroom activities, lecture
estimating energy expenditure launchers, Internet exercises, discussion questions, hyperlinks
Added information about risk nutrients , including to relevant websites, and case studies. The DVD-ROM also
how they are grouped by similar functions, and pre- includes a Test Bank, expanded and improved, that contains
sented newest research about excesses or inadequacies multiple-choice, true/false, matching, and discussion exercises.
Updated information from the Dietary Guidelines
includes the Total Diet Approach Acknowledgments
The Eating Competence Model is presented as a It takes the combined talents and efforts of authors, edi-
contrast to the “prescriptive” Dietary Guidelines tors, assistants, and the publisher to develop a new edition
New illustration showing the determinants and of a textbook and its instructional resources. The positive
overarching goals of Healthy People 2020 attitude and efforts of Marni Rolfes, Developmental Edi-
tor, in the fifth edition are applauded by all of the authors.
Chapter 17: Adult Nutrition: Conditions We are fortunate to have Peggy Williams, Senior Acquisi-
and Interventions tions Editor, heading up the team that supports the growth
New information about the three compartments for fat and development of Nutrition Through the Life Cycle.
storage, and expanded explanation of central adiposity
Included conclusions from recent systematic reviews Reviewers
of evidence Many thanks to the following reviewers, whose careful
Revised content and tables to reflect new reading and thoughtful comments helped enormously in
perspectives of Healthy People 2020 shaping both earlier editions and this fifth edition.
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like articles of Porto Rican manufacture: Provided, That on
and after the date when this Act shall take effect, all
merchandise and articles, except coffee, not dutiable under
the tariff laws of the United States, and all merchandise and
articles entered in Porto Rico free of duty under' orders
heretofore made by the Secretary of War, shall be admitted
into the several ports thereof, when imported from the United
States, free of duty, all laws or parts of laws to the
contrary notwithstanding; and whenever the legislative
assembly of Porto Rico shall have enacted and put into
operation a system of local taxation to meet the necessities
of the government of Porto Rico, by this Act established, and
shall by resolution duly passed so notify the President, he
shall make proclamation thereof, and thereupon all tariff
duties on merchandise and articles going into Porto Rico from
the United States or coming into the United States from Porto
Rico shall cease, and from and after such date all such
merchandise and articles shall be entered at the several ports
of entry free of duty; and in no event shall any duties be
collected after the first day of March, nineteen hundred and
two, on merchandise and articles going into Porto Rico from
the United States or coming into the United States from Porto
Rico.
"SECTION 4.
That the duties and taxes collected in Porto Rico in pursuance
of this Act, less the cost of collecting the same, and the
gross amount of all collections of duties and taxes in the
United States upon articles of merchandise coming from Porto
Rico, shall not be covered into the general fund of the
Treasury, but shall be held as a separate fund, and shall be
placed at the disposal of the President to be used for the
government and benefit of Porto Rico until the government of
Porto Rico herein provided for shall have been organized, when
all moneys theretofore collected under the provisions hereof,
then unexpended, shall be transferred to the local treasury of
Porto Rico, and the Secretary of the Treasury shall designate
the several ports and sub-ports of entry in Porto Rico, and
shall make such rules and regulations and appoint such agents
as may be necessary to collect the duties and taxes authorized
to be levied, collected, and paid in Porto Rico by the
provisions of this Act, and he shall fix the compensation and
provide for the payment thereof of all such officers, agents,
and assistants as he may find it necessary to employ to carry
out the provisions hereof: Provided, however, That as soon as
a civil government for Porto Rico shall have been organized in
accordance with the provisions of this Act and notice thereof
shall have been given to the President he shall make
proclamation thereof, and thereafter all collections of duties
and taxes in Porto Rico under the provisions of this Act shall
be paid into the treasury of Porto Rico, to be expended as
required by law for the government and benefit thereof instead
of being paid into the Treasury of the United States."
PORTO RICO: A. D. 1900 (April).

Act to provide temporarily for the civil government
of the Island.
The fundamental provisions of the act of the Congress of the

United States to provide temporarily for the civil government
of Porto Rico, which the President approved April 12, 1900,
are the following:
"SECTION 6.
That the capital of Porto Rico shall be at the city of San
Juan and the seat of government shall be maintained there.
"SECTION 7.
That all inhabitants continuing to reside therein who were
Spanish subjects on the eleventh day of April, eighteen
hundred and ninety-nine, and then resided in Porto Rico, and
their children born subsequent thereto, shall be deemed and
held to be citizens of Porto Rico, and as such entitled to the
protection of the United States, except such as shall have
elected to preserve their allegiance to the Crown of Spain on
or before the eleventh day of April, nineteen hundred, in
accordance with the provisions of the treaty of peace between
the United States and Spain entered into on the eleventh day
of April, eighteen hundred and ninety-nine; and they, together
with such citizens of the United States as may reside in Porto
Rico, shall constitute a body politic under the name of The
People of Porto Rico, with governmental powers as hereinafter
conferred, and with power to sue and be sued as such.
{416}
"SECTION 8.
That the laws and ordinances of Porto Rico now in force shall
continue in full force and effect, except as altered, amended,
or modified hereinafter, or as altered or modified by military
orders and decrees in force when this Act shall take effect,
and so far as the same are not inconsistent or in conflict
with the statutory laws of the United States not locally
inapplicable, or the provisions hereof, until altered,
amended, or repealed by the legislative authority hereinafter
provided for Porto Rico or by Act of Congress of the United
States: Provided, That so much of the law which was in force
at the time of cession, April eleventh, eighteen hundred and
ninety-nine, forbidding the marriage of priests, ministers, or
followers of any faith because of vows they may have taken,
being paragraph four, article eighty-three, chapter three,
civil code, and which was continued by the order of the
secretary of justice of Porto Rico, dated March seventeenth,
eighteen hundred and ninety-nine, and promulgated by
Major-General Guy V. Henry, United States Volunteers, is
hereby repealed and annulled, and all persons lawfully married
in Porto Rico shall have all the rights and remedies conferred
by law upon parties to either civil or religious marriages:
And provided further, That paragraph one, article one hundred
and five, section four, divorce, civil code, and paragraph
two, section nineteen, of the order of the minister of justice
of Porto Rico, dated March seventeenth, eighteen hundred and
ninety-nine, and promulgated by Major-General Guy V. Henry,
United States Volunteers, be, and the same hereby are, so
amended as to read: 'Adultery on the part of either the
husband or the wife.' …
"SECTION 14.
That the statutory laws of the United States not locally
inapplicable, except as hereinbefore or hereinafter otherwise
provided, shall have the same force and effect in Porto Rico
as in the United States, except the internal-revenue laws,
which, in view of the provisions of section three, shall not
have force and effect in Porto Rico.
"SECTION 15.
That the legislative authority hereinafter provided shall have
power by due enactment to amend, alter, modify, or repeal any
law or ordinance, civil or criminal, continued in force by
this Act, as it may from time to time see fit.
"SECTION 16.
That all judicial process shall run in the name of 'United
States of America, ss: the President of the United States,'
and all criminal or penal prosecutions in the local courts
shall be conducted in the name and by the authority of 'The
People of Porto Rico'; and all officials authorized by this
Act shall before entering upon the duties of their respective
offices take an oath to support the Constitution of the United
States and the laws of Porto Rico.
"SECTION 17.
That the official title of the chief executive officer shall
be 'The Governor of Porto Rico.' He shall be appointed by the
President, by and with the advice and consent of the Senate;
he shall hold his office for a term of four years and until
his successor is chosen and qualified unless sooner removed by
the President; he shall reside in Porto Rico during his
official incumbency, and shall maintain his office at the seat
of government; he may grant pardons and reprieves, and remit
fines and forfeitures for offenses against the laws of Porto
Rico, and respites for offenses against the laws of the United
States, until the decision of the President can be
ascertained; he shall commission all officers that he may be
authorized to appoint, and may veto any legislation enacted,
as hereinafter provided; he shall be the commander in chief of
the militia, and shall at all times faithfully execute the
laws, and he shall in that behalf have all the powers of
governors of the Territories of the United States that are not
locally inapplicable; and he shall annually, and at such other
times as he may be required, make official report of the
transactions of the government in Porto Rico, through the
Secretary of State, to the President of the United States:
Provided, That the President may, in his discretion, delegate
and assign to him such executive duties and functions as may
in pursuance with law be so delegated and assigned.
"SECTION 18.
That there shall be appointed by the President, by and with
the advice and consent of the Senate, for the period of four
years, unless sooner removed by the President, a secretary, an
attorney-general, a treasurer, an auditor, a commissioner of
the interior, and a commissioner of education, each of whom
shall reside in Porto Rico during his official incumbency and
have the powers and duties hereinafter provided for them,
respectively, and who, together with five other persons of
good repute, to be also appointed by the President for a like
term of four years, by and with the advice and consent of the
Senate, shall constitute an executive council, at least five
of whom shall be native inhabitants of Porto Rico, and, in
addition to the legislative duties hereinafter imposed upon
them as a body, shall exercise such powers and perform such
duties as are hereinafter provided for them, respectively, and
who shall have power to employ all necessary deputies and
assistants for the proper discharge of their duties as such
officials and as such executive council. …
"SECTION 27.
That all local legislative powers hereby granted shall be
vested in a legislative assembly which shall consist of two
houses; one the executive council, as hereinbefore
constituted, and the other a house of delegates, to consist of
thirty-five members elected biennially by the qualified voters
as hereinafter provided; and the two houses thus constituted
shall be designated 'The legislative assembly of Porto Rico.'
"SECTION 28.
That for the purposes of such elections Porto Rico shall be
divided by the executive council into seven districts,
composed of contiguous territory and as nearly equal as may be
in population, and each district shall be entitled to five
members of the house of delegates.
SECTION 29.
That the first election for delegates shall be held on such
date and under such regulations as to ballots and voting as
the executive council may prescribe. … At such elections all
citizens of Porto Rico shall be allowed to vote who have been
bona fide residents for one year and who possess the other
qualifications of voters under the laws and military orders in
force on the first day of March, 1900, subject to such
modifications and additional qualifications and such
regulations and restrictions as to registration as may be
prescribed by the executive council. …
{417}
"SECTION 32.
That the legislative authority herein provided shall extend to
all matters of a legislative character not locally inapplicable,
including power to create, consolidate, and reorganize the
municipalities, so far as may be necessary, and to provide and
repeal laws and ordinances therefor; and also the power to
alter, amend, modify, and repeal any and all laws and
ordinances of every character now in force in Porto Rico, or
any municipality or district thereof, not inconsistent with
the provisions hereof: Provided, however, That all grants of
franchises, rights, and privileges or concessions of a public
or quasi-public nature shall be made by the executive council,
with the approval of the governor, and all franchises granted
in Porto Rico shall be reported to Congress, which hereby
reserves the power to annul or modify the same.
"SECTION 33.
That the judicial power shall be vested in the courts and
tribunals of Porto Rico as already established and now in
operation, including municipal courts. …
"SECTION 34.
That Porto Rico shall constitute a judicial district to be
called 'the district of Porto Rico.' The President, by and
with the advice and consent of the Senate, shall appoint a
district judge, a district attorney, and a marshal for said
district, each for a term of four years, unless sooner removed
by the President. The district court for said district shall
be called the district court of the United States for Porto
Rico.
"SECTION 35.
That writs of error and appeals from the final decisions of
the supreme court of Porto Rico and the district court of the
United States shall be allowed and may be taken to the Supreme
Court of the United States in the same manner and under the
same regulations and in the same cases as from the supreme
courts of the Territories of the United States. …
"SECTION 39.
That the qualified voters of Porto Rico shall, on the first
Tuesday after the first Monday of November, anno Domini
nineteen hundred, and every two years thereafter, choose a
resident commissioner to the United States, who shall be
entitled to official recognition as such by all Departments,
upon presentation to the Department of State of a certificate
of election of the governor of Porto Rico, and who shall be
entitled to a salary, payable monthly by the United States, at
the rate of five thousand dollars per annum: Provided, That no
person shall be eligible to such election who is not a bona
fide citizen of Porto Rico, who is not thirty years of age,
and who does not read and write the English language.
"SECTION 40.
That a commission, to consist of three members, at least one
of whom shall be a native citizen of Porto Rico, shall be
appointed by the President, by and with the advice and consent
of the Senate, to compile and revise the laws of Porto Rico; also
the various codes of procedure and systems of municipal
government now in force, and to frame and report such
legislation as may be necessary to make a simple, harmonious,
and economical government, establish justice and secure its
prompt and efficient administration, inaugurate a general
system of education and public instruction, provide buildings
and funds therefor, equalize and simplify taxation and all the
methods of raising revenue, and make all other provisions that
may be necessary to secure and extend the benefits of a
republican form of government to all the inhabitants of Porto
Rico."
PORTO RICO: A. D. 1900 (May).

Organization of civil government.
Appointment of Governor Allen.
Under the Act to establish civil government in Porto Rico,

Honorable. Charles H. Allen, formerly a representative in
Congress from Massachusetts, and lately Assistant-Secretary of
the Navy, was appointed to the governorship of the island. Mr.
J. H. Hollander, of Maryland, was appointed Treasurer, and Mr.
John R. Garrison, of the District of Columbia, Auditor.
Governor Allen was inducted into office with considerable
ceremony, at San Juan, on the 1st of May.
PORTO RICO: A. D. 1900 (August-October).

First steps in the creation of a public school system.
"The report of M. G. Brumbaugh, commissioner of education, on

education in Porto Rico, dated October 15, 1900, shows what
has been accomplished in the short time that elapsed after the
commissioner entered upon his duties on August 4, 1900. … The
people want schools … and the pupils will attend them. In
1899, 616 schools were opened in Porto Rico. In 1900 the
department will maintain at least 800 schools, an increase of
30 per cent, which will provide for nearly 9,000 additional
pupils.
"In 1899 there were 67 Americans in the teaching force of the

island. Since October 1, 1900, the number has increased to
100. The commissioner criticises one class of teachers who are
'seekers after novelty and new experiences, who imposed upon the
administration and the children, and who used the salary and
position of teacher solely to see a new country for a year and
then return. … The people of Porto Rico have patiently borne
with these adventurers, and quietly longed for their
departure.' This class of teachers is now gone and the newly
selected American teachers have some knowledge of Spanish and
are graduates of universities, colleges, and normal schools in
the States, and are for the most part young men and women of
ability and discretion. The salaries of American teachers were
fixed by law at $40 per month for nine months in cities of
less than 5,000 population. In cities of larger population the
salary was $50 per month for nine months and both are
inadequate, although at the time the salaries were fixed the
War Department provided free transportation from and to the
United States. This transportation may now be withdrawn at any
time, and the small inducement held out by the meager salary
offered to teachers is not calculated to invite the best class
of them to the island.
"The new normal and industrial school at Fajardo, which was to

have been established by the joint efforts of the local
municipality and the American Government, was only so far
advanced that the land had been purchased by the end of
September, 1900. The normal department was opened October 1,
in a rented building, while the industrial department cannot
be opened until suitable quarters are provided. The
commissioner recommends that the United States make this place
the site of an agricultural experiment station for which it is
pre-eminently fitted. On account of the industries of the
country—coffee, sugar, tobacco, and fruit—agriculture could be
well studied here, and free boarding, lodging, and tuition would
be given the students, who would be for the most part poor
boys and girls.
"As to the school accommodation, the commissioner states that

there are no public school buildings in Porto Rico. The
schools are conducted in rented houses or rooms which are
often unfit for the purpose, and the hygienic conditions are
bad. There is a wide field, or rather a demand, for
improvement in this direction, as well as in the school
equipment and material.
{418}
In 1899, $33,000 was expended for school-books, and in 1900,

$20,000 will be expended for books and supplies, which shall
be free. In the United States 'free books' means usually their
purchase by local boards and free use by the pupils. In Porto
Rico the books and supplies will be free to the pupils without
expense to the local boards. A pedagogical museum and library
has been established for the benefit of teachers and others.
About 300 volumes have been contributed to the library from
friends in the States, and the Department will make the number
up to 500 by purchase. A library of 5,000 volumes of standard
Spanish and American literature was found in a building in San
Juan, which has been installed in suitable rooms as a public
library.
"Many of the leading institutions of the United States have

responded cordially to the application of the Department of
Education on behalf of young Porto Ricans who wish to
prosecute their studies in colleges and universities. Some
have offered free tuition, some have added free lodging, while
others have offered even free living to all such students as
wish to avail themselves of their instruction. Many young
Porto Ricans have availed themselves of these generous offers.
"There are now 800 schools in Porto Rico, and 38,000 pupils
attending them, while there are 300,000 children of school age
for whom there are no accommodations. But the commissioner
expresses the hope that gradually the great illiteracy in
Porto Rico will be reduced, and the people prepared for the
duties of citizenship in a democracy by means of the schools
that shall be established. … The total expenditure for
education in Porto Rico from the 1st of May to the end of
September was $91,057.32."
United States, Secretary of the Interior,

Annual Report, November 28, 1900, page 116.
PORTO RICO: A. D. 1900 (November-December).

The first election under U. S. law.
Meeting of the Legislative Assembly.
The first election in the Island under the provisions of the

Act recited above occurred on the 6th of November
simultaneously with the elections in the United States. It
seems to have been almost entirely a one-sided vote. "About
two weeks before election day," says a despatch from San Juan,
November 7, "the Federal Party, which carried the island at
the election of less than a year ago by a majority of 6,500
votes, suddenly withdrew from the electoral contest. The
Federal leaders sent instruction to their followers not to
appear at the polls, but the Federal Election Judges were
instructed to appear and watch the proceedings until the
elections were concluded in order to gather evidence of any
unfairness in the registration and any irregularity in the
voting. The Federal Party intends to institute court
proceedings after the election in the hope of nullifying it,
claiming that gross irregularities in the registration and
voting will be shown, and alleging that the districting was
not done according to law." Only about 200 Federals voted, it
is stated, while some 60,000 votes were cast for the
candidates of the Republicans. Governor Allen cabled the
following announcement of the election to President McKinley:
"I am gratified and delighted. The outcome in Porto Rico is a
guarantee of the island's future. To bring people who had long
been under different rules and conditions to their first
general election, to have the election pass off as quietly and
orderly as in any State of the North conducted by the people
without let or hindrance, and without a soldier or armed force
of any sort, and to have nearly 60.000 men march to the polls
to deposit their first ballot for self-government in such a
manner, are good reasons for congratulation, not only to the
people of the island, but to the painstaking members of the
Administration, who had worked diligently and patiently to
this end. This overwhelming Republican victory also means
legislation for the good of the island in line with the
American Administration. It means stable government and the
protection of property interests, with which prospective
investors in Porto Rico are deeply concerned. It means
education, public works, and all the beneficent works which
follow legislation wisely and conscientiously undertaken. It
is an emphatic declaration of unqualified loyalty to the
United States."
The newly elected Legislative Assembly met and the House of

Delegates was organized December 3. A correspondent of the
"New York Tribune," writing a week later, said: "Already
nineteen bills have been introduced. To introduce nineteen
bills in six days after organizing, as well as forming the
regular committees, is not bad work when it is considered that
not one of the members had the slightest idea of parliamentary
procedure. During the session one of the members may be seen
making frequent trips to the Executive Mansion, where he
confers with Secretary Hunt in regard to some doubtful point.
It is said by some that in a short time the lower house will
be controlled entirely by the portfolio members of the
Council. It is known that the five Porto Rican members of the
Council, when considering the question of franchises, etc.,
often vote contrary to their own ideas in order that the
Council may continue harmonious. But it is not likely that the
heads of departments will be able to control the thirty-five
members of the House. The House, although regularly elected,
is not representative of the island; the Federals refraining
from voting kept over half the natives from the polls. The
Federal party, it is asserted, is made up of the richest and
best element of Porto Rico. The Republicans, though in power,
do not feel that they are able to run things alone, so the
majority is willing to be dictated to by the Council.
Nevertheless there is a certain element in the House which
will not be dictated to. So soon as any really important bill
comes up for debate it is predicted that the House will divide
against itself. And a little later, when the House passes some
pet bill and the Council rejects it, the House will probably
resign in a body. It is a natural trait of the people.'
After another fortnight had passed, the same correspondent

wrote very discouragingly of the disposition shown by a
majority of the members of the House of Delegates, and their
conduct of business, and stated: "The popular opinion among
the Americans, even among some of the higher officials, is
that if the House continues as it is Congress will abolish it
altogether, and govern the island through a Governor and
Cabinet. Such irregular procedure has been followed that it is
a question here whether any business has been legally done."
{419}
PORTO RICO: A. D. 1901 (January),

Close of the first session of the Legislative Assembly.
The first session of the first Legislative Assembly of the

island came to a close on the 31st of January, 1901, and the
following remarks on its work were made in a newspaper
despatch of that date from San Juan: "Over one hundred bills
have been introduced in the House of Delegates, and dozens
have been passed by both houses, and are awaiting the
Governor's approval. … Committees have a hard day's work if
they get together and agree to pass the bills on hand before
midnight to-night. Ever since the House of Delegates resumed
business after the new year, eight or nine members have been
continually absent. There are only thirty-five members
altogether, and the island is small, yet twenty-six has been
the average attendance. A full attendance for even one day is
not recorded. It was predicted that a number of the members
would resign; they did not. They simply remained away, like
truant schoolboys. A bill has been passed providing for the
education of certain young Porto Rican men and women in the
United States, about two hundred of them having petitioned the
House of Delegates to be sent north at the island's expense.
It is not known on what ground these petitions have been made.
The island expends about $400,000 yearly on education, and
excellent educational facilities are offered. But the people,
in a way, seem to discredit the value of the opportunities at
hand."
PORTO RICO: A. D. 1901 (April).

Distress of the workingmen of the Island.
Their appeal to the President of the United States.
The following petition, signed by 6,000 of the workingmen of
Porto Rico, was brought to the United States by a delegate
from the Federation of Labor in Porto Rico and presented to
President McKinley on the 15th of April:
"The undersigned, workers of Porto Rico, without distinction

of color, political or religious creed, have the honor to
bring to your attention the following facts: Misery, with all
its horrible consequences, is spreading in our homes with
wonderful rapidity. It has already reached such an extreme
that many workers are starving to death while others, that
have not the courage to see their mothers, wives, sisters and
children perish of hunger, commit suicide by drowning
themselves in the rivers or hanging themselves from branches
of trees. All this, honorable sir, is due to the scarcity of
work, which keeps us in enforced idleness, the mother of our
misery. Our beautiful estates are idle; our lands are not
being cultivated; our shops remain closed; and our Chambers do
absolutely nothing to prevent our misery on this once so rich
an island. The Government and municipality do not undertake
any public works to keep us out of idleness. The emigration of
workers, unknown in this island before, increases day by day,
in proportion as misery increases. Under these trying
conditions we are no longer a happy and contented people. We
therefore, beg of you, honorable sir, to interest yourself in
our cause, leading us, as the father of our country, in the
path that will bring us work, and with it the means of
subsistence. We want work; nothing but work. We want to earn
the means of subsistence by the sweat of our brows; and nobody
better than our Chief Magistrate can help us by lending ear to
our appeals. "
----------PORTO RICO: End--------
PORTUGAL: A. D. 1891-1900.
Delagoa Bay Arbitration.
See (in this volume)
DELAGOA BAY ARBITRATION.
PORTUGAL: A. D. 1898.
Alleged Treaty with Great Britain.
There is said to be knowledge in diplomatic circles of a

treaty between Great Britain and Portugal, concluded in 1898,
which has never been made public, but which is understood to
engage the former to assist the latter financially and to
protect the kingdom as against dangers both external and
internal. In return it is believed that England received the
right to embark and disembark troops, stores and ammunitions
at any point on Portuguese territory in Africa, to keep them
there, or to convey them across Portuguese territory to any
point she might see fit, irrespective as to whether she was at
war with any third Power. Circumstances have given some
support to this rumor, but it has no positive confirmation.
PORTUGAL: A. D. 1899.
Reciprocity Treaty with the United States.

UNITED STATES OF AMERICA: A. D. 1899-1901.
PORTUGAL: A. D. 1899 (May-July).

Representation in the Peace Conference at The Hague.

PEACE CONFERENCE.
PORTUGUESE EAST AFRICA: A. D. 1895-1896.

War with Gungunhana.

AFRICA: A. D. 1895-1896 (PORTUGUESE EAST AFRICA).
POSTAGE, British Imperial Penny.

ENGLAND: A. D. 1898 (DECEMBER).
POWERS, Concert of the.

CONCERT OF EUROPE.
POWERS, The four great.

NINETEENTH CENTURY: EXPANSION.
PRATT, Consul:
Interviews with Aguinaldo at Singapore.

UNITED STATES OF AMERICA:
A. D. 1898 (APRIL-MAY: PHILIPPINES).
"PREDOMINANT MEMBER," Remarks of Lord Rosebery on the.

ENGLAND: A. D. 1894-1895.
PREHISTORIC DISCOVERIES.

ARCHÆOLOGICAL RESEARCH.
PREMPEH, Overthrow of King.

ASHANTI.
PRESBYTERIAN CHURCHES: Union in Scotland.

SCOTLAND: A. D. 1900.
PRESS, The:
Relaxation of restrictions in Poland.

RUSSIA: A. D. 1897.
PRESS, The:
Prosecutions in Germany.

GERMANY: A. D. 1900 (OCTOBER 9).
PRETORIA: A. D. 1894.
Demonstration of British residents.

SOUTH AFRICA (THE TRANSVAAL): A. D. 1894.
PRETORIA: A. D. 1900.
Taken by the British forces.

SOUTH AFRICA (THE FIELD OF WAR):
A. D. 1900 (MAY-JUNE).
PRIMARY ELECTION LAW.

NEW YORK STATE: A. D. 1898.
PRINCE EDWARD'S ISLAND.

CANADA.
{420}
PRINCETON UNIVERSITY:
Celebration of 250th anniversary.
Assumption of new name.

EDUCATION (UNITED STATES): A. D. 1896.
PRINSLOO, Commandant: Surrender.

SOUTH AFRICA (THE FIELD OF WAR):
A. D. 1900 (JUNE-DECEMBER).
PROCTOR, Senator Redfield:

Account of the condition of the Cuban Reconcentrados.

CUBA: A. D. 1897-1898 (DECEMBER-MARCH).
PROGRESSISTS,
PROGRESSIVES.

AUSTRIA-HUNGARY: A. D. 1897;
JAPAN: A. D. 1890-1898, and after;
SOUTH AFRICA (CAPE COLONY): A. D. 1898,
and 1898 (MARCH-OCTOBER).
PROHIBITION PARTY, The.

A. D. 1896 (JUNE-NOVEMBER);
and 1900 (MAY-NOVEMBER).
PROHIBITION PLEBISCITE, Canadian.

CANADA: A. D. 1898 (SEPTEMBER).
PROTECTIVE TARIFFS.

TARIFF LEGISLATION.
PROTOCOL, for suspension of Spanish-American War.

A. D. 1898 (JULY-DECEMBER).
PRUSSIA: Census, 1895.

GERMANY: A. D. 1895 (JUNE-DECEMBER).
PRUSSIA: A. D. 1899-1901.
Canal projects.

GERMANY: A. D. 1899 (AUGUST); and 1901 (JANUARY).
PRUSSIA: A. D. 1901.
Bicentenary celebration.
The bicentenary of the coronation of the first King of Prussia

was celebrated with much ceremony and festivity on the 18th of
January, 1901.

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(eBook PDF) Nutrition Through the Life

Cycle 5th Edition

Preface xxi CHAPteR 13

Preface xix Nutrition Assessment 38

Nutrition Time Line

Nutrition During the Periconceptional Period 61 Phenylketonuria (PKU) 80

Nutrition Time Line

1744 1747 1750 1762

Nutrition Time Line

1771 1774 1775 1816

as famine food more coffee in of the science of amino acids

Secretion of Milk 167 Maternal Diet 181

The Breastfeeding Process 215 Model Breastfeeding Promotion Programs 193

Nutrition Time Line

1833 1871 1895

a wounded to be insufficient with uncontaminated

greatly expands there are other New York City

Common Breastfeeding Conditions 198 Model Programs 222

Nutrition Time Line

1896 1906 1910 1912

Atwater Pure Food and Pasteurized

publishes Drug Act passed by milk introduced scurvy, beriberi,

Composition Roosevelt to protect caused by

First Foods 242 Does Intrauterine Growth Predict Growth

Nutrition Intervention for Risk Reduction 249 CHAPteR 10

Nutrition Time Line

1914 1916 1917

Goldberger identifies the First dietary guidance First food groups

Temperament Differences 281 Public Food and Nutrition Programs 299

Nutrition Time Line

salt. It was needed to prevent for Nutritional

Nutrition founded fatty acids

CHAPteR 12 Recommended vs. Actual Food Intake 333

Nutrition Time Line

1930s 1937 1941

Nutrition Recommendations 349 Promoting Healthy Eating and Physical Activity

Nutrition Time Line

1941 1946 1947

First Recommended National Vitamin B12

Dietary Allowances (RDAs) School Lunch identified

announced by President Act passed

Tracking Adult Nutritional Health and its CHAPteR 17

Nutrition Time Line

1953 1965 1966 1968

discovered National School State Nutrition

Diabetes Mellitus 442 A Picture of the Aging Population: Vital

Nutrition Time Line

1970 1972 1977 1978

Senior Nutrition Program: Promoting Socialization Prevalence 498

Nutrition Time Line

1997 1998 2003 2009

Reference grain Marks beginning global 2011

Intakes products of new era of epidemics USDA introduces

Answers to Review Questions AR-1 Appendix C

Chapter 8: Infant Nutrition Revised overweight and obesity data to the

PORTO RICO: A. D. 1900 (April).

The fundamental provisions of the act of the Congress of the

PORTO RICO: A. D. 1900 (May).

Under the Act to establish civil government in Porto Rico,

PORTO RICO: A. D. 1900 (August-October).

"The report of M. G. Brumbaugh, commissioner of education, on

"In 1899 there were 67 Americans in the teaching force of the

"The new normal and industrial school at Fajardo, which was to