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Nutritional Pathophysiology of Obesity and its Comorbidities - 1st Edition - ISBN: 9780128030134, 9780128030349

Nutritional Pathophysiology of Obesity and its Comorbidities

1st Edition

A Case-Study Approach

Author: Susan Ettinger
eBook ISBN: 9780128030349
Hardcover ISBN: 9780128030134
Imprint: Academic Press
Published Date: 1st September 2016
Page Count: 334
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Nutritional Pathophysiology of Obesity and Its Comorbidities: A Case-Study Approach challenges students and practitioners to understand the role of nutrients within the pathophysiology and development of disease, specifically those diseases which develop as a result of obesity. Through a case-based approach, the author presents complex clinical scenarios that require multiple treatment strategies, including targeted diet modification as an adjuvant to medical therapy.

The book is divided into 9 modules and 5 appendices each of which covers aspects of obesity and its comorbidities. Within each module, a case is detailed with relevant history, laboratory and physical data, and follow-up information. Each case is followed by a resource section which delineates current understanding of the pathophysiology of the condition, as well as the actions of nutrients and food components shown to modify these processes. A "further readings" section cites current supporting clinical and basic literature as well as published guidelines.

Key Features

  • Explores how obesity is a key player in the pathophysiology of many diseases, including diabetes mellitus, chronic renal failure, hypertension, and atherosclerosis
  • Integrates current understandings of the molecular mechanisms of nutrient action on the processes of disease development and treatment
  • Presents students and early practitioners with complex clinical scenarios through a practical case-based approach


Medical students, fellows and residents in endocrinology and pathology; graduate students in pathology and nutrition.

Table of Contents

  • Foreword
  • Foreword
  • Preface
  • Chapter 1. Obesity and Metabolic Syndrome
    • Abstract
    • Chief Complaint (Typical Patient)
    • Medical History
    • Family History
    • Physical Examination
    • Laboratory Data
    • Diet History
    • A 24-hour Dietary Recall
    • Resources
    • 1.2 Nutrient Sensors and Downstream Targets
    • 1.3 AT Form and Function
    • 1.4 AT Dysregulation and Metabolic Syndrome
    • 1.5 Gut Microbiota and Obesity
    • 1.6 Goals and Practical Issues in Weight Loss Management
    • 1.7 Management of MS
    • 1.8 Diet Patterns That Modify Risk for Obesity and MS
    • 1.9 Specific Diet Components That Target Obesity and MT
    • 1.10 Future Research Needs
    • References
    • Further Reading
  • Chapter 2. The Obese Gunshot Patient: Injury and Septic Shock
    • Abstract
    • Chief Complaint (Typical Patient)
    • Patient History
    • Physical Examination
    • Pertinent Laboratory Data
    • Medical and Nutrition History
    • Emergency Treatment
    • Hospital Course
    • Resources
    • 2.2 Traumatic Injury: Gunshot Wounds
    • 2.3 Innate Host Defense
    • 2.4 Mediators of the Acute-Phase Response
    • 2.5 Hyperinflammation, Sepsis, and Shock
    • 2.6 Body Composition and Macronutrient Changes in APR
    • 2.7 Targeted Nutrient Strategies for Wound Healing
    • 2.8 Micronutrients, Pathogens, and Response to Injury
    • 2.9 Current Recommendations for Patient Feeding
    • References
    • Further Reading
  • Chapter 3. Type I Diabetes and Celiac Disease
    • Abstract
    • Chief Complaint (Typical Patient)
    • Past Medical History and Medication
    • Social History
    • Resources
    • 3.2 Type I DM as Dysregulated Immune Response
    • 3.3 Metabolic Dysregulation, Clinical Presentation, and Diagnosis of Type I DM
    • 3.4 Standards of Care for Type I Diabetes
    • 3.5 Evidence for Targeted Nutrient Modification in Type I DM
    • 3.6 Autoimmune Conditions that Complicate Type I DM
    • 3.7 Medical Nutrition Therapy for Celiac Disease
    • 3.8 Future Research Needs
    • References
    • Further Reading
  • Chapter 4. Type II Diabetes, Peripheral Neuropathy, and Gout
    • Abstract
    • Chief Complaint (Adapted from)
    • Past Medical History and Medication
    • Family Medical History
    • Social History
    • Presenting Symptoms
    • Physical Examination
    • 24-Hour Diet Recall
    • Diet Analysis
    • Resources
    • 4.2 Dysregulation of Insulin Secretion and Signaling
    • 4.3 Nutrients, Insulin Secretion, Insulin Signaling, and Type II DM Risk
    • 4.4 Recommended Nutrition Therapy to Manage Diabetes
    • 4.5 Differential Diagnosis of Peripheral Neuropathy in Diabetes
    • 4.6 Nutrient-Associated Neuropathy
    • 4.7 Nutrient-Associated Gout
    • 4.8 Future Research Needs
    • References
    • Further Reading
  • Chapter 5. Cardiopathy and Congestive Heart Failure
    • Abstract
    • Chief Complaint (Adapted from)
    • Past Medical History and Medications
    • Lifestyle and Family History
    • Nutrition History
    • Intake Examination
    • Cardiac Catheterization Data
    • Resources
    • 5.1 The Compromised Heart
    • 5.2 Cardiomyocyte Excitation–Contraction
    • 5.3 Myocardial Injury and Consequences
    • 5.4 Targets for Myocardial Protection: Macronutrient Dysregulation
    • 5.5 Targets for Myocardial Protection: Oxidative Damage
    • 5.6 Targets for Myocardial Protection: Calcium and Hypercontracture
    • 5.7 Targets for Myocardial Protection: Cardiac Remodeling
    • 5.8 Chronic Heart Failure and Cardiac Cachexia
    • 5.9 Dietary Guidelines to Prevent Cardiomyopathy and Manage Chronic Heart Failure
    • 5.10 Targeted Diet Modification to Reduce Risk for Cardiomyopathy
    • 5.11 Future Research Needs
    • References
    • Further Reading
  • Chapter 6. Atherosclerosis and Arterial Calcification
    • Abstract
    • Chief Complaint (Typical Patient)
    • Patient History
    • Medical History
    • Diet and Lifestyle History
    • Physical Examination
    • Diet History
    • Hospital Course
    • Resources
    • 6.2 Pathogenesis of the Complex Atherosclerotic Plaque
    • 6.3 Targets for Atherosclerotic Prevention and Control
    • 6.4 Increased AS Risk Related to Obesity and its Comorbities
    • 6.5 Influence of the Microbiome on AS Risk
    • 6.6 Metabolic Targets for Diet Modification
    • 6.7 Nutrients that Potentially Increase AS Risk
    • 6.8 Nutrient Dysregulations that Lead to Arterial Calcification
    • 6.9 Published Diet Recommendations for Cardiovascular Risk Reduction
    • 6.10 Future Research Needs
    • References
    • Further Reading
  • Chapter 7. Diabetic Nephropathy, Chronic Kidney Disease
    • Abstract
    • Chief Complaint (Typical Patient)
    • Medical History
    • Current Medications
    • Patient History
    • Physical Examination
    • Diet History
    • Laboratory Data: Blood
    • Laboratory Data: Urine
    • Resources
    • 7.2 Targets for Slowing Progression of Diabetic Nephropathy
    • 7.3 Macronutrient Implications in Diabetic Nephropathy Progression
    • 7.4 Current Published Recommendations to Slow Progression to ESKD
    • 7.5 Targeted Macronutrient Modification to Slow CKD Progression
    • 7.6 Strategies to Ameliorate Micronutrient Alterations Due to Impaired Kidney Function
    • 7.7 Future Research Needs
    • References
    • Further Reading
  • Chapter 8. Asthma and Obesity
    • Abstract
    • Chief Complaint (Adapted from Wechsler, M.E., 2007)
    • Medical History
    • Family History
    • Physical Examination (Hospital Day 2)
    • Dietary History
    • Discharge Instructions
    • Resources
    • 8.2 Asthma Symptoms, Statistics, and Management
    • 8.3 Pathophysiology of Asthma
    • 8.4 Pathology of the Asthma Attack
    • 8.5 Targets for Asthma Control: Airway Remodeling and Mucus Production
    • 8.6 Targets for Asthma Control: Obesity and Lifestyle Risks
    • 8.7 Diet in the Management of Airway Hypersensitivity
    • 8.8 Future Research Needs
    • Appendix Drugs Used for Asthma
    • References
    • Further Reading
  • Chapter 9. Osteoporosis and Fracture Risk
    • Abstract
    • Chief Complaint (Adapted from)
    • Past Medical History and Medications
    • Life Style and Family History
    • Nutrition History
    • Anthropometrics
    • Resources
    • 9.2 Bone Cells and Normal Mechanisms of Bone Remodeling
    • 9.3 Integration of Bone and Intermediary Metabolism
    • 9.4 Impact of Hormones, Obesity, and Aging on Bone
    • 9.5 Clinical Diagnosis and Management of the Fracture-Risk Patient
    • 9.6 Targets for Dietary Intervention in Osteoporosis and Fracture Risk
    • 9.7 Nutrients for Bone Matrix and Collagen Crosslinking
    • 9.8 Antiresorptive Effects of Dietary Factors
    • 9.9 Future Research Needs
    • References
    • Further Reading
  • Essentials I. Life in an Aerobic World
    • EI.1 Nutrients, Mitochondrial Antioxidants, and Antioxidant Protection
    • EI.2 Nutrients and Transcriptional Control of Antioxidant Protection
    • EI.3 Single-Unit Antioxidant Nutrients
    • EI.4 Tocopherols; Tocotrienols (Vitamin E)
    • EI.5 Ascorbate (Vitamin C)
    • EI.6 Selenium (Se)
    • EI.7 Riboflavin (Vitamin B2)
    • EI.8 Coenzyme Q-10 (CoQ10)
    • References
  • Essentials II. Heavy Metals, Retinoids, and Precursors
    • EII.1 Iron
    • EII.2 Zinc
    • EII.3 Copper
    • EII.4 Retinoid and Iron Interactions in Obesity and Metabolic Syndrome
    • EII.5 Carotenoids
  • Essentials III. Nutrients for Bone Structure and Calcification
    • EIII.1 Klotho
    • EIII.2 Integrated Regulation of Calcium, Phosphorus, and Vitamin D Homeostasis
    • EIII.3 Mineral Metabolism
    • EIII.4 Vitamin Metabolism
  • Essentials IV. Diet, Microbial Diversity, and Gut Integrity
    • EIV.1 Microbial Diversity, Function, and Diet
    • EIV.2 Influence of Diet on Gut Barrier Function
  • Essentials V. Nutrition Support in Critically Ill Patients,
    • EV.1 Nutrition Support Recommendations: 2015
    • EV.2 Strategies to Initiate Enteral Feeding
    • EV.3 When to Use PN
    • EV.4 Strategies for Enteral Feeding
    • EV.5 Recommendations for the Obese Patient
    • EV.6 Monitoring Tolerance and Adequacy of EN
    • EV.7 Selection of Appropriate Enteral Formulation
    • EV.8 Adjunctive Therapy
    • EV.9 When Indicated, Maximize Efficacy of PN
  • Index


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© Academic Press 2016
1st September 2016
Academic Press
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About the Author

Susan Ettinger

Susan Ettinger has focused her career at the interface of nutrition science and medicine. She began her nutrition studies with the hypothesis that the non-physician medical nutrition scientist was urgently needed to liaison with clinicians and researchers to translate nutritional findings from bench to bedside. She undertook a doctoral curriculum combining nutrition and medical sciences at Columbia University and postdoctoral training in the molecular biology of cancer, aging and immunology at Cornell University Medical Center. She was awarded an R25 grant from NCI to study the feasibility of training post-masters students in cancer nutrition and subsequently joined Dr. Pi Sunyer at the New York Obesity Research Center to test the curriculum with postdoctoral candidates. She continues to collaborate with faculty at Columbia University Medical Center to develop a curriculum to disseminate information at the interface of nutrition, obesity and cancer to health science professionals at multiple training levels.

Affiliations and Expertise

Past Associate Professor and Chair, Clinical Nutrition Department, New York Institute of Technology; Adjunct Associate Professor, Nutrition and Food Science, Hunter College, City University of New York, New York, NY, USA; Research Associate, Division of Endocrinology Diabetes & Nutrition, Mount Sinai St. Luke's-Roosevelt Hospital, New York NY, USA

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