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Pediatric Nutrition, 7th Edition

By AAP Committee on Nutrition
Edited by Ronald E. Kleinman, MD, FAAP and Frank R. Greer, MD, FAAP
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Prepared by the AAP Committee on Nutrition with contributions from more than 100 experienced practitioners, the new 7th edition puts today’s most current nutrition-related information at your fingertips.

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  1. Page xxvii
    Part I. Nutrient-Gene Interactions
    1. Page 3
      1. Nutrient-Gene Interactions
      1. Page 3
        Introduction
      2. Page 4
        Nutrigenetics (Also Called Nutrigenics)
      3. Page 6
        Nutrigenomics
      4. Page 6
        Epigenetics
      5. Page 7
        Systems Biology
      6. Page 9
        The Future
  2. Page 13
    Part II. Feeding the Infant
    1. Page 15
      2. Development of Gastrointestinal Function
      1. Page 15
        Development of Gastrointestinal Function
      2. Page 18
        Infant Nutrient Assimilation
      3. Page 19
        Dietary Fats
      4. Page 21
        Dietary Carbohydrates
      5. Page 24
        Dietary Protein
      6. Page 27
        Vitamins and Minerals
      7. Page 27
        Human Milk
      8. Page 30
        Intestinal Microbiota in the Infant
    2. Page 41
      3. Breastfeeding
      1. Page 41
        Introduction
      2. Page 41
        Recent Epidemiology
      3. Page 42
        Milk
      4. Page 48
        Duration of Breastfeeding
      5. Page 49
        Contraindications to Breastfeeding
      6. Page 50
        How to Support Breastfeeding
      7. Page 53
        Nutrition of the Lactating Mother
      8. Page 54
        Growth of the Breastfed Infant
      9. Page 55
        Expressing and Storing Milk
      10. Page 55
        Special Situations
      11. Page 56
        Conclusion
    3. Page 61
      4. Formula Feeding of Term Infants
      1. Page 61
        General Considerations
      2. Page 61
        Rates of Breastfeeding and Formula Feeding
      3. Page 62
        Indications for the Use of Infant Formula
      4. Page 62
        History of Infant Formula Development
      5. Page 63
        Rationale for Development of Current Infant Formulas
      6. Page 64
        Available Forms of Infant Formula
      7. Page 64
        Infant Formula Labels
      8. Page 65
        Safe Preparation of Infant Formula
      9. Page 68
        Safe Handling and Storage of Infant Formula
      10. Page 68
        Guidelines for Length of Exclusive Formula Feeding and Supplementation With Solid Foods
      11. Page 69
        Intact Cow Milk Protein-Based Formulas
      12. Page 73
        Soy Formulas
      13. Page 76
        Protein Hydrolysate Formulas
      14. Page 77
        Other Formulas
      15. Page 78
        Cow Milk
    4. Page 83
      5. Nutritional Needs of the Preterm Infant
      1. Page 83
        Introduction
      2. Page 86
        Parenteral Nutrition
      3. Page 90
        Parenteral to Enteral Transition
      4. Page 90
        Enteral Feeding
      5. Page 103
        Human Milk
      6. Page 104
        Facilitating Lactation and Human Milk Handling
      7. Page 106
        Commercial Formulas for Preterm Infants
      8. Page 107
        Methods of Enteral Feeding
      9. Page 109
        Feeding the Preterm Infant After Discharge
      10. Page 110
        Conclusion
    5. Page 123
      6. Complementary Feeding
      1. Page 123
        Introduction
      2. Page 124
        Nutritional Considerations
      3. Page 129
        Physiologic and Developmental Considerations
      4. Page 134
        How to Guide Complementary Feeding
  3. Page 141
    Part III. Feeding the Child and Adolescent
    1. Page 143
      7. Feeding the Child
      1. Page 143
        Introduction
      2. Page 143
        Toddlerhood
      3. Page 146
        Preschool-Aged Children
      4. Page 147
        School-Aged Children
      5. Page 148
        Eating Patterns and Nutrient Needs
      6. Page 152
        Parenting and the Feeding Relationship
      7. Page 156
        Special Topics
      8. Page 162
        The Role of Anticipatory Guidance in Promoting Healthy Eating Behaviors
    2. Page 175
      8. Adolescent Nutrition
      1. Page 175
        Introduction
      2. Page 175
        Factors Influencing Nutritional Needs of Adolescents
      3. Page 176
        Dietary Reference Intakes
      4. Page 178
        Nutrition Concerns During Adolescence
      5. Page 179
        Nutritional Concerns for Adolescent Bone Health
      6. Page 180
        Nutritional Considerations During Pregnancy
      7. Page 181
        Assessing and Maintaining Adequate Nutrition in Adolescents
    3. Page 189
      9. Nutrition in School, Preschool, and Child Care
      1. Page 189
        Introduction
      2. Page 189
        The US Nutritional Safety Net
      3. Page 190
        The History of School Meals
      4. Page 191
        New Nutrition Standards for School Meals
      5. Page 194
        The Infrastructure of School Food Service
      6. Page 195
        The Economics of the School Meal
      7. Page 196
        The Commodity School Program
      8. Page 197
        The Nutritional Effectiveness of the School Meal Programs
      9. Page 197
        Nutrition Goals and the National School Lunch Program
      10. Page 198
        The Nutrition Potential of the School Breakfast Program
      11. Page 199
        Special Challenges for School Food Service
      12. Page 201
        Food Safety
      13. Page 202
        Competitive Foods in Schools
      14. Page 203
        National Standards for Competitive Foods in Schools
      15. Page 204
        Wellness Advisory Committees and School Nutrition Policies
      16. Page 204
        Controversies Surrounding School Nutrition
      17. Page 209
        Nutrition Standards in Preschool and Child Care
      18. Page 211
        Summary
    4. Page 219
      10. Cultural Considerations in Feeding Infants and Young Children
      1. Page 219
        Importance of Addressing Cultural Influence on Feeding Practices
      2. Page 220
        Cultural Diversity in the United States
      3. Page 221
        How Is Culture Linked to Health?
      4. Page 221
        Cultural Influences on Feeding Practices
      5. Page 222
        Early Infant Feeding
      6. Page 223
        Cultural Influences on Breastfeeding Practices
      7. Page 233
        Building Skills in Advising Parents and Caregivers
      8. Page 235
        Summary
    5. Page 241
      11. Nutritional Aspects of Vegetarian Diets
      1. Page 241
        Vegetarian Diets
      2. Page 243
        Trends
      3. Page 244
        Additional Implications of Vegetarianism
      4. Page 250
        Nutrient Intake Guidelines
      5. Page 250
        Whole Foods Concept
      6. Page 250
        Nutritional Considerations
      7. Page 255
        Vegetarian Diets for Special Populations
      8. Page 257
        Vegetarian Diets in Management of the Metabolic Syndrome and Type 2 Diabetes Mellitus
      9. Page 258
        Vegetarian Diets and Obesity
      10. Page 258
        Conclusion
    6. Page 265
      12. Sports Nutrition
      1. Page 265
        Introduction
      2. Page 266
        Fuels for Activity
      3. Page 271
        Fluids for the Workout
      4. Page 274
        Building Blocks for Recovery
      5. Page 281
        Determination of Optimal Body Weight in Young Athletes
      6. Page 287
        Vegetarian Athletes
      7. Page 287
        Dietary Supplements/Ergogenic Aids
    7. Page 299
      13. Fast Foods, Organic Foods, Fad Diets, and Herbs, Herbals, and Botanicals
      1. Page 299
        Fast Food
      2. Page 317
        Organic Foods
      3. Page 325
        Fad Diets
      4. Page 334
        Use of Botanicals by Children and Adolescents
  4. Page 357
    Part IV. Micronutrients and Macronutrients
    1. Page 359
      14. Energy
      1. Page 359
        Introduction
      2. Page 359
        Energy Balance
      3. Page 360
        Components of Energy Expenditure
      4. Page 362
        Measurement of Energy Expenditure
      5. Page 363
        Energy Cost of Growth
      6. Page 364
        Energy Requirements of Infants, Children, and Adolescents
      7. Page 365
        Macronutrient Distribution Ranges
      8. Page 365
        Altered Energy Requirements
    2. Page 369
      15. Protein
      1. Page 369
        Introduction
      2. Page 371
        Recommended Dietary Intake for Protein and Amino Acids
      3. Page 373
        Methods for Determining Protein and Amino Acid Requirements
      4. Page 376
        Protein Quality
      5. Page 378
        Protein Requirements
      6. Page 383
        Effects of Insufficient and Excessive Protein Intake
    3. Page 387
      16. Carbohydrate and Dietary Fiber
      1. Page 387
        Overview
      2. Page 389
        Digestion of Disaccharides and Starches
      3. Page 390
        Absorption of Monosaccharides
      4. Page 393
        Metabolism of Glucose
      5. Page 395
        Lactose
      6. Page 397
        Starches
      7. Page 397
        Fiber
      8. Page 398
        Glycemic Index
      9. Page 399
        Potential Benefits of Fiber Intake
      10. Page 400
        Potential Adverse Effects of Fiber Intake
      11. Page 401
        Current Dietary Recommendations
    4. Page 407
      17. Fats and Fatty Acids
      1. Page 407
        General Considerations
      2. Page 407
        Dietary Fats
      3. Page 409
        Fat Digestion, Absorption, Transport, and Metabolism
      4. Page 411
        Essential Fatty Acids
      5. Page 413
        Long-Chain Polyunsaturated Fatty Acids
    5. Page 435
      18. Calcium, Phosphorus, and Magnesium
      1. Page 435
        Basic Physiology/Homeostasis
      2. Page 437
        Calcium Requirements
      3. Page 442
        Phosphorous Requirements
      4. Page 442
        Magnesium Requirements
      5. Page 443
        Dietary Sources: Calcium and Phosphorus
      6. Page 445
        Dietary Sources: Magnesium
    6. Page 449
      19. Iron
      1. Page 449
        Introduction
      2. Page 449
        Iron Metabolism
      3. Page 450
        Nutritional Requirements for Iron
      4. Page 460
        Screening for ID and IDA
      5. Page 461
        Iron Supplements
      6. Page 462
        Summary
    7. Page 467
      20. Trace Elements
      1. Page 467
        Introduction
      2. Page 467
        Zinc
      3. Page 474
        Copper
      4. Page 478
        Manganese
      5. Page 480
        Selenium
      6. Page 483
        Iodine
      7. Page 484
        Other Trace Elements
    8. Page 495
      21. Fat-Soluble Vitamins
      1. Page 495
        Introduction
      2. Page 495
        Vitamin A
      3. Page 506
        Vitamin D
      4. Page 508
        Vitamin E
      5. Page 510
        Vitamin K
    9. Page 517
      21. Water-Soluble Vitamins
      1. Page 517
        Introduction
      2. Page 518
        Thiamine (Vitamin B1)
      3. Page 519
        Riboflavin (Vitamin B2)
      4. Page 520
        Niacin (Vitamin B3)
      5. Page 522
        Pyridoxine (Vitamin B6)
      6. Page 523
        Folate
      7. Page 525
        Cobalamin (Vitamin B12)
      8. Page 526
        Vitamin C
      9. Page 528
        Other Water-Soluble Vitamins
      10. Page 528
        Conclusion
    10. Page 535
      22. Federal Regulation of Foods and Infant Formulas, Including Addition of New Ingredients: Food Additives and Substances Generally Recognized as Safe (GRAS)
      1. Page 535
        Introduction
      2. Page 536
        Federal Regulation of Ingredients Added To Food
      3. Page 544
        “Functional Foods” and Provisions for Claims
      4. Page 545
        Regulation of Infant Formula
      5. Page 546
        Infant Formula Ingredients, Including New Ingredients
      6. Page 554
        Newer Food Ingredients for the General Population
      7. Page 560
        Biotechnology in the Development of New Food Ingredients
      8. Page 563
        Conclusions
  5. Page 569
    Part V. Nutrient Delivery Systems
    1. Page 571
      23. Parenteral Nutrition
      1. Page 571
        Introduction
      2. Page 571
        Indications for Parenteral Nutrition
      3. Page 571
        Routes of Administration
      4. Page 573
        Composition of Solutions for Infants and Children
      5. Page 582
        Ordering Parenteral Nutrition
      6. Page 582
        Gastrointestinal and Hepatic Effects of Parenteral Nutrition
      7. Page 584
        Transition to Enteral Feedings
      8. Page 584
        Conclusion
    2. Page 591
      24. Enteral Nutrition
      1. Page 591
        Introduction
      2. Page 591
        Indications for Enteral Tube Feedings: Management of Nutrition-Related Disorders
      3. Page 597
        Enteral Formula Selection for Children 1 to 13 Years of Age
      4. Page 598
        Enteral Formulas for Use in Children Older Than 13 Years of Age: Standard Tube-Feeding Formulas
      5. Page 598
        Peptide-Based and Elemental Formulas
      6. Page 599
        Oral Supplements
      7. Page 600
        Blenderized Formulas
      8. Page 600
        Formula Concentration and Supplementation With Use of Modular Components
      9. Page 601
        Tube Feeding
      10. Page 603
        Continuous Versus Intermittent Enteral Feeding
      11. Page 603
        One Final Note of Caution
  6. Page 607
    Part VI. Nutrition in Acute and Chronic Illness
    1. Page 609
      25. Assessment of Nutritional Status
      1. Page 609
        Introduction
      2. Page 609
        Assessment of Dietary Intake
      3. Page 610
        Clinical Assessment
      4. Page 611
        Growth Assessment
      5. Page 617
        Assessment Tools for Anthropometric Measurements by Age Group
      6. Page 621
        Anthropometric Measurements
      7. Page 625
        Nutritional Assessment Through the Measurement of Body Composition
      8. Page 626
        Research Body Composition Assessment Techniques
      9. Page 629
        Clinical Assessment Tools for Body Composition Assessment
      10. Page 633
        Laboratory Assessment
    2. Page 643
      26. Pediatric Feeding and Swallowing Disorders
      1. Page 643
        Introduction
      2. Page 643
        Differential Diagnosis of Feeding Versus Swallowing Disorders
      3. Page 647
        Summary of Feeding Disorders
      4. Page 650
        Summary of Swallowing Problems
      5. Page 650
        Evaluation of Pediatric Dysphagia
      6. Page 654
        Treatment
      7. Page 656
        Dysphagia and the Preterm Infant
      8. Page 657
        Assessment and Treatment Updates for Pediatric Dysphagia
      9. Page 657
        Conclusion
    3. Page 663
      27. Failure to Thrive
      1. Page 663
        Introduction
      2. Page 663
        Ecologic Context
      3. Page 665
        Medical Issues in Evaluation and Treatment
      4. Page 675
        Physical Examination and Laboratory Evaluation
      5. Page 677
        Medical Management
      6. Page 677
        Nutritional Evaluation and Treatment
      7. Page 686
        Psychosocial Issues in Evaluation and Treatment
      8. Page 688
        Intervention
      9. Page 691
        Conclusion
    4. Page 701
      28. Chronic Diarrheal Disease
      1. Page 701
        Introduction and Pathophysiology
      2. Page 702
        Evaluation of the Infant and Child With Persistent Diarrhea
      3. Page 705
        Differential Diagnosis of Chronic Diarrhea
      4. Page 714
        Summary
    5. Page 717
      29. Oral Therapy for Acute Diarrhea
      1. Page 717
        Introduction
      2. Page 717
        Physiologic Principles
      3. Page 719
        The Search for a More Effective ORS
      4. Page 720
        Early, Appropriate Feeding
      5. Page 720
        Oral Therapy for Diarrhea
      6. Page 723
        Common Concerns About ORS Solutions in the United States
    6. Page 727
      30. Inborn Errors of Metabolism
      1. Page 727
        Definitions
      2. Page 727
        Inheritance
      3. Page 727
        Newborn Screening for IEMs
      4. Page 728
        Signs and Symptoms of IEMs
      5. Page 729
        Emergency Therapy of Suspected IEM
      6. Page 730
        Nutritional Therapy Using Synthetic Medical Foods
      7. Page 733
        Other Nutritional Therapies
      8. Page 736
        Other Therapeutic Modalities
      9. Page 737
        Conclusion
    7. Page 741
      31. Nutrition Therapy for Children and Adolescents With Type 1 and Type 2 Diabetes Mellitus
      1. Page 741
        Introduction
      2. Page 741
        Background
      3. Page 744
        Guidelines For Nutritional Medical Management of T1DM
      4. Page 758
        Therapy For T2DM and Prediabetes
      5. Page 760
        Special Situations and Chronic Diseases Associated With Diabetes Mellitus in Children
      6. Page 763
        Summary/Conclusion
    8. Page 771
      32. Hypoglycemia in Infants and Children
      1. Page 771
        Introduction and Definition of Hypoglycemia
      2. Page 773
        Clinical Manifestations of Hypoglycemia
      3. Page 774
        Etiology of Hypoglycemia
      4. Page 775
        Evaluation of Hypoglycemia
      5. Page 778
        Differential Diagnosis of Hypoglycemia
      6. Page 783
        Treatment of Hypoglycemia
      7. Page 786
        Summary
    9. Page 791
      33. Hyperlipidemia
      1. Page 791
        Introduction
      2. Page 792
        Lipoproteins
      3. Page 793
        Types of Hyperlipidemia
      4. Page 795
        Prevention of Atherosclerosis and Prudent Lifestyle and Diet
      5. Page 799
        Treatment
    10. Page 805
      34. Pediatric Obesity
      1. Page 805
        Introduction
      2. Page 805
        Adipose Tissue: An Organ
      3. Page 806
        Pathophysiology
      4. Page 810
        Genetics
      5. Page 812
        Assessment
      6. Page 813
        Epidemiology of Pediatric Obesity
      7. Page 815
        Influence of the Life Cycle on Pediatric Obesity
      8. Page 820
        Comorbidities of Obesity
      9. Page 823
        Prevention of Childhood Obesity
      10. Page 827
        Treatment of Pediatric Obesity
      11. Page 833
        Resources
    11. Page 845
      35. Food Allergy
      1. Page 846
        Pathophysiology
      2. Page 846
        Food Allergens
      3. Page 847
        Prevalence
      4. Page 848
        Clinical Disorders
      5. Page 850
        Diagnosis
      6. Page 853
        Treatment
      7. Page 855
        Medical Management
      8. Page 856
        Natural History
      9. Page 856
        Prevention
      10. Page 857
        Summary
    12. Page 863
      36. Nutrition and Immunity
      1. Page 863
        Introduction
      2. Page 864
        Early Nutritional-Immunologic System Interactions
      3. Page 869
        Preterm and Low Birth Weight Infants
      4. Page 869
        Micronutrients and Immunity
      5. Page 874
        Summary
    13. Page 883
      37. Nutritional Support for Children With Developmental Disabilities
      1. Page 883
        Introduction
      2. Page 883
        Growth Abnormalities in Children With Neurologic Impairment
      3. Page 884
        Growth Standards
      4. Page 884
        Pathophysiology
      5. Page 887
        Assessment
      6. Page 892
        Nutritional Intervention
      7. Page 899
        Ethical Considerations
      8. Page 899
        Conclusion
    14. Page 907
      38. Nutrition of Children Who Are Critically Ill
      1. Page 907
        Introduction
      2. Page 907
        Malnutrition and Metabolic Reserves
      3. Page 908
        Protein Metabolism
      4. Page 909
        Carbohydrate and Lipid Metabolism
      5. Page 910
        Energy Requirement During Critical Illness
      6. Page 911
        Micronutrients
      7. Page 911
        Immunonutrition
      8. Page 912
        Nutrient Delivery in the PICU – Challenges
      9. Page 913
        Summary
    15. Page 917
      39. Nutritional Support of Pediatric Patients With Eating Disorders
      1. Page 917
        Introduction
      2. Page 918
        Clinical Features
      3. Page 926
        Assessment
      4. Page 929
        Treatment
      5. Page 936
        Conclusions
    16. Page 939
      40. HIV Infection
      1. Page 939
        Introduction
      2. Page 939
        Nutrition and the Immune System
      3. Page 941
        Nutrition in Pediatric HIV for Children Naive or Resisant to Antiretroviral Therapy
      4. Page 952
        Nutrition in Pediatric HIV With Effective Viral Suppression and Immune Reconstitution
      5. Page 959
        Nutritional Assessment and Interventions
      6. Page 964
        Nutrition in HIV-Exposed, Uninfected Children
      7. Page 965
        Conclusion
    17. Page 979
      41. Nutrition for Children With Sickle Cell Disease and Thalassemia
      1. Page 979
        Introduction
      2. Page 980
        Macronutrient Intake, Requirements, and Energy Expenditure
      3. Page 982
        Specific Micronutrient Deficiencies
      4. Page 988
        Nutritional Status in Subpopulations of SCD and Thal
      5. Page 989
        Unique Nutritional Situations
      6. Page 990
        Nutritional Guidelines for SCD and Thal
      7. Page 992
        Conclusions
    18. Page 999
      42. Nutritional Management of Children With Kidney Disease
      1. Page 999
        Introduction
      2. Page 1003
        Urinary Tract Infections, Vesicoureteral Reflux, and Urinary Incontinence
      3. Page 1004
        Hypertension
      4. Page 1005
        Kidney Stone Disorders
      5. Page 1007
        Renal Tubular Defects
      6. Page 1008
        Nephrotic Syndrome
      7. Page 1009
        Glomerulonephritis
      8. Page 1010
        Acute Renal Failure
      9. Page 1012
        Chronic Renal Failure
      10. Page 1014
        Vitamins and Trace Minerals
      11. Page 1015
        Children on Dialysis
      12. Page 1015
        Renal Transplantation
    19. Page 1021
      43. Nutritional Management of Children With Cancer
      1. Page 1021
        Introduction
      2. Page 1021
        Nutritional Status at Diagnosis
      3. Page 1022
        Host-Related Effects
      4. Page 1022
        Therapy-Related Complications
      5. Page 1023
        Psychological Factors
      6. Page 1024
        Nutritional Screening
      7. Page 1027
        Nutritional Interventions
      8. Page 1030
        Conclusion
    20. Page 1035
      44. The Nutritional Aspects of Inflammatory Bowel Disease in Pediatric Patients
      1. Page 1035
        Introduction
      2. Page 1035
        Growth Failure
      3. Page 1037
        Monitoring of Nutritional Status
      4. Page 1044
        Nutritional Therapy for IBD
      5. Page 1048
        Psychosocial Impact of Nutritional Interventions in the Care of Children With IBD
      6. Page 1049
        Summary
    21. Page 1057
      45. Liver Disease
      1. Page 1057
        Introduction
      2. Page 1058
        Nutritional Assessment of the Child With Liver Disease
      3. Page 1059
        Malabsorption in Chronic Liver Disease
      4. Page 1070
        Ascites Management
      5. Page 1071
        Liver Failure
      6. Page 1074
        Parenteral Nutrition-Associated Liver Disease
    22. Page 1077
      46. Cardiac Disease
      1. Page 1077
        Introduction
      2. Page 1078
        Undernutrition in CHD
      3. Page 1083
        Management
    23. Page 1095
      47. Nutrition in Children With Short Bowel Syndrome
      1. Page 1095
        Background
      2. Page 1096
        Intestinal Adaptation
      3. Page 1097
        Intestinal Physiology
      4. Page 1098
        Nutritional Assessment
      5. Page 1099
        Nutritional Management
      6. Page 1103
        Medical Therapies
      7. Page 1105
        Complications
      8. Page 1109
        Summary
    24. Page 1113
      48. Nutrition in Cystic Fibrosis
      1. Page 1113
        Introduction
      2. Page 1114
        Diagnosis
      3. Page 1116
        Overview of Therapy
      4. Page 1117
        Nutritional Care
      5. Page 1127
        Specific Guidelines for Nutritional Management
      6. Page 1137
        Conclusions
    25. Page 1147
      49. The Ketogenic Diet
      1. Page 1147
        Introduction
      2. Page 1147
        History
      3. Page 1148
        Physiologic Basis
      4. Page 1149
        Mechanisms of Action
      5. Page 1150
        Indications
      6. Page 1151
        Efficacy
      7. Page 1152
        Contraindications
      8. Page 1153
        Adverse Effects
      9. Page 1154
        The Keto Team
      10. Page 1155
        Calculation of the Ketogenic Diet
      11. Page 1156
        Micronutrient Supplementation
      12. Page 1156
        Initiation Protocol
      13. Page 1158
        Maintenance and Follow-Up
      14. Page 1158
        Concurrent Medications and Occult Carbohydrates
      15. Page 1159
        Adjusting the Diet for Optimal Seizure Control
      16. Page 1159
        Discontinuation of the Ketogenic Diet
      17. Page 1160
        Alternative Dietary Therapy
      18. Page 1161
        Conclusions
    26. Page 1167
      50. Nutrition and Oral Health
      1. Page 1167
        Introduction
      2. Page 1167
        Dental Caries—an Infectious Disease
      3. Page 1168
        Dietary Influences
      4. Page 1171
        The Costs Are Enormous
      5. Page 1172
        Nutritional Effects
      6. Page 1172
        Fluoride: Background
      7. Page 1173
        Fluoride Supplements
      8. Page 1175
        Fluoride Varnish
      9. Page 1176
        Fluorosis
      10. Page 1178
        Fluoride Toxicity
      11. Page 1178
        Role of the Pediatrician
  7. Page 1185
    Part VII. Nutrition and Public Health
    1. Page 1187
      51. Community Nutrition Services
      1. Page 1187
        Introduction
      2. Page 1187
        Nutrition Services Provided Through Federal, State, and Local Health and Nutrition Agencies
      3. Page 1192
        Health and Nutrition Agencies: A Nutrition Resource to Provide Services and Identify Qualified Providers
      4. Page 1194
        Nutrition-Assistance Programs
      5. Page 1198
        Supplemental Food Programs
      6. Page 1200
        Food Distribution Programs
      7. Page 1203
        Where to Seek Nutrition Assistance for Clients
      8. Page 1203
        Other Federal Agencies Providing Nutrition Services to Improve Pediatric Health and Well-Being
      9. Page 1206
        Conclusion
    2. Page 1209
      52. Food Labeling
      1. Page 1209
        Introduction
      2. Page 1209
        Ingredient Labeling
      3. Page 1210
        The Nutrition Facts Panel
      4. Page 1213
        Food Labels for Infants Younger Than 2 Years and Children Between 2 and 4 Years of Age
      5. Page 1213
        Nutrition Claims
      6. Page 1219
        Package Dating
      7. Page 1220
        Front-of-Package Nutrition Rating Systems and Symbols
      8. Page 1221
        Conclusion
    3. Page 1225
      53. Food Safety: Infectious Disease
      1. Page 1225
        Introduction
      2. Page 1225
        Epidemiology of Foodborne Disease
      3. Page 1230
        Clinical Manifestations
      4. Page 1230
        Laboratory Testing
      5. Page 1233
        Management
      6. Page 1234
        Surveillance for Foodborne Diseases
      7. Page 1237
        Food Safety and Prevention of Foodborne Illness
    4. Page 1251
      54. Food Safety: Pesticides, Industrial Chemicals, Toxins, Antimicrobial Preservatives, Irradiation, and Food Contact Substances
      1. Page 1251
        Introduction
      2. Page 1252
        US Food Safety Regulations
      3. Page 1254
        Sources of Concern for Chemical Food Safety
      4. Page 1264
        Toxins
      5. Page 1267
        Antimicrobial Preservatives
      6. Page 1267
        Food Irradiation
      7. Page 1272
        Nonnutritive Additives
      8. Page 1276
        Chemical Byproducts From Food Processing
  8. Page 1313
    Appendices
    1. Page 1313
      Appendix A
      1. Page 1287
        Growth Charts
    2. Page 1339
      Appendix B
      1. Page 1341
        Recommended Nutrient Levels of Infant Formula
    3. Page 1343
      Appendix C
      1. Page 1345
        Increasing the Caloric Density of Infant Formula
    4. Page 1347
      Appendix D
      1. Page 1348
        D-1 Formulas for Preterm and Low Birth Weight Infants
      2. Page 1352
        D-2 Human Milk Fortifiers
    5. Page 1353
      Appendix E
      1. Page 1355
        E-1 DRI: Recommended Intakes
      2. Page 1358
        E-2 DRI Tolerable Upper Intake
    6. Page 1361
      Appendix F
      1. Page 1362
        MyPlate
      2. Page 1363
        MyPyramid
      3. Page 1364
        Simplified MyPyramid
      4. Page 1365
        Advanced MyPyramid
    7. Page 1367
      Appendix G
      1. Page 1371
        G-1 Drugs for Which Absorption Is Increased By Food
      2. Page 1371
        G-2 Drugs for Which Absorption May Be Delayed By Food
      3. Page 1372
        G-3 Drugs That Should Be Administered On An Empty Stomach
      4. Page 1373
        G-4 Drugs That Should Be Administered With Food
      5. Page 1373
        G-5 Miscellaneous Food-Nutrient Effects
      6. Page 1375
        G-6 Drug-Grapefruit Juice Interactions
    8. Page 1377
      Appendix H
      1. Page 1379
        Calories and Electrolytes in Beverages
    9. Page 1381
      Appendix I
      1. Page 1383
        I-1 Selected Food Sources Ranked by Amount of Dietary Fiber and Calories per Standard Portion
      2. Page 1384
        I-2 Available Over-the-Counter Fiber Preparations
    10. Page 1385
      Appendix J
      1. Page 1387
        J-1 Good Sources of Calcium
      2. Page 1388
        J-2 Calcium Contents of Foods
    11. Page 1389
      Appendix K
      1. Page 1391
        Iron Content of Selected Foods
    12. Page 1393
      Appendix L
      1. Page 1395
        Zinc Content of Selected Foods
    13. Page 1397
      Appendix M
      1. Page 1399
        Parenteral Nutrition Solutions
    14. Page 1401
      Appendix N
      1. Page 1403
        N-1 Selected Enteral Products for Special Indications
      2. Page 1414
        N-2 Enteral Products Grouped by Usage Indication
      3. Page 1415
        N-3 Sources of Medical Food Modules and Modified Low-Protein Foods for Treatment of Inborn Errors of Metabolism
    15. Page 1417
      Appendix O
      1. Page 1419
        Sports/Nutrition Bars
    16. Page 1421
      Appendix P
      1. Page 1423
        Sodium Content of Foods
    17. Page 1425
      Appendix Q
      1. Page 1427
        Saturated and Polyunsaturated Fat and Cholesterol Content of Common Foods
    18. Page 1429
      Appendix R
      1. Page 1431
        Representative Values for Constituents of Human Milk

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