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Nutrition: A Lifespan Approach

Simon Langley-Evans

ISBN: 978-1-118-69956-0 May 2013 Wiley-Blackwell 312 Pages


Traditionally, nutrition textbooks have divided human nutrition into basic science, public health and clinical nutrition, however in this exciting new textbook, Professor Simon Langley-Evans spans these divisions, bringing together the full range of disciplines into one accessible book through the lifespan approach.

Taking the reader through how the body’s demand for nutrients continues to change across the many stages of life, such an approach allows full consideration of how diet relates to health, wellbeing and disease and provides an excellent vehicle to illustrate the key concepts in nutrition science. Carefully structured with the student’s needs in mind, each chapter includes:

  • Learning objectives
  • Research highlights, clearly displayed in boxes
  • Suggested further reading
  • Summary boxes
  • Brief self-assessment tests
  • Additional resources are published on the book’s website:

Nutrition: A Lifespan Approach will provide the undergraduate student of nutrition with an excellent learning resource. The book will also be a valuable tool for those studying areas such as human biology, health studies and sports science, where an understanding of human nutrition is required. Professionals working in nutrition, dietetics and related health sciences will also find much of value within this book. Libraries in all universities and research establishments where nutrition, dietetics, health and medical sciences are studied and taught should have copies of this book available on their shelves.



1. Introduction to Lifespan Nutrition.

1.1 The lifespan approach to nutrition.

1.2 The concept of balance.

1.2.1 A supply and demand model.

1.2.2 Overnutrition.

1.2.3 Undernutrition. Increased demand. The metabolic response to trauma. Compromised supply and deficiency. Malnutrition.

1.2.4 Classical balance studies.

1.2.5 Overall nutritional status.

1.3 Nutrition requirements change across the lifespan.

1.4 Assessment of nutritional status.

1.4.1 Anthropometric measures.

1.4.2 Estimating dietary intakes. Indirect measures. Direct measures.

1.4.3 Biomarkers of nutritional status.

1.4.4 Clinical examination.

1.5 Dietary reference values.

1.5.1 The UK dietary reference value system.

1.5.2 Dietary reference values in other countries.

2. Before Life Begins.

2.1 Introduction.

2.2 Nutrition and female fertility.

2.2.1 Determinants of fertility and infertility. The endocrine control of female reproduction. Disordered reproductive cycling. Polycystic ovary syndrome. Assisted reproductive technologies.

2.2.2 Importance of body fat.

2.2.3 Role of leptin.

2.2.4 Antioxidant nutrients.

2.2.5 Caffeine and alcohol.

2.3 Nutrition and male fertility.

2.3.1 Determinants of fertility and infertility.

2.3.2 Obesity.

2.3.3 Diabetes.

2.3.4 Alcohol.

2.3.5 Zinc.

2.3.6 Antioxidant nutrients.

2.3.7 Selenium.

2.3.8 Phytoestrogens and environmental estrogens. Phthalates. Phytoestrogens. Pesticides.

2.4 Preparation for pregnancy.

2.4.1 Why prepare for pregnancy?

2.4.2 Vitamin A and liver.

2.4.3 Folic acid and neural tube defects. Supplementation with folic acid. Fortification with folic acid.

3. Pregnancy.

3.1 Introduction.

3.2 Physiological demands of pregnancy.

3.2.1 Maternal weight gain and body composition changes.

3.2.2 Blood volume expansion and cardiovascular changes.

3.2.3 Renal changes.

3.2.4 Respiratory changes.

3.2.5 Gastrointestinal changes.

3.2.6 Metabolic adaptations.

3.3 Nutrient requirements in pregnancy.

3.3.1 Energy, protein, and lipids.

3.3.2 Micronutrients. Iron. Calcium and other minerals. Vitamin D.

3.4 Diet in relation to pregnancy outcomes.

3.4.1 Miscarriage and stillbirth.

3.4.2 Premature labor. Pre-pregnancy BMI and pregnancy weight gain. Alcohol and caffeine consumption. Oral health.

3.4.3 Hypertensive disorders of pregnancy. The etiology of PE. Nutrition-related factors and PE.

3.4.4 Abnormal labor.

3.5 Nausea and vomiting of pregnancy (NVP).

3.5.1 NVP as a normal physiological process.

3.5.2 Hyperemesis gravidarum.

3.6 Cravings and aversions.

3.6.1 Pica.

3.7 Gastrointestinal disturbances in pregnancy.

3.8 High-risk pregnancies.

3.8.1 Gestational diabetes.

3.8.2 Multiple pregnancies.

3.8.3 Fetal alcohol spectrum disorders

4. Fetal Nutrition and Disease in Later Life.

4.1 Introduction.

4.2 The developmental origins of adult disease.

4.2.1 The concept of programming.

4.2.2 Fetal programming and human disease.

4.3 Evidence linking maternal nutrition to disease in later life.

4.3.1 Epidemiology.

4.3.2 Criticisms of the programming hypothesis.

4.3.3 Experimental studies. Global undernutrition. Micronutrients. Macronutrients

4.4 Mechanistic basis of fetal programming.

4.4.1 Thrifty phenotypes and genotypes.

4.4.2 Predictive adaptive responses.

4.4.3 Tissue remodeling.

4.4.4 Endocrine imbalance.

4.4.5 Nutrient–gene interactions.

4.4.6 Epigenetic regulation

4.5 Implications of the programming hypothesis.

4.5.1 Public health interventions.

4.5.2 Trans-generational transmission of disease risk.

5. Lactation and Infant Feeding.

5.1 Introduction.

5.2 The physiology of lactation.

5.2.1 Anatomy of the breast. The nipple and areola. The lactiferous ducts. The lactiferous sinuses. The alveolar cells. The rooting reflex.

5.2.2 Synthesis of milk. Foremilk and hindmilk. Time of day. Course of lactation. Synthesis of carbohydrates. Origins of milk fats. Milk proteins.

5.2.3 Endocrine control of lactation. The breast during pregnancy. Established lactation. The breast after weaning.

5.2.4 Maintenance of lactation.

5.2.5 Nutritional demands of lactation.

5.3 The advantages of breast-feeding.

5.3.1 Advantages for the mother.

5.3.2 Advantages for the infant.

5.3.3 Recommendation to feed to 6 months.

5.4 Trends in breast-feeding behavior.

5.4.1 Reasons why women do not breast-feed.

5.4.2 Promoting breast-feeding.

5.5 Situations in which breast-feeding is not advised.

5.6 Alternatives to breast-feeding.

5.6.1 Cows milk formulas. Milk stages and follow-on milk.

5.6.2 Preterm formulas.

5.6.3 Soy formulas.

5.6.4 Hydrolyzed protein and amino-acid-based formulas.

5.6.5 Other formulas.

6. Nutrition and Childhood.

6.1 Introduction.

6.2 Infancy (birth to five).

6.2.1 The key developmental milestones.

6.2.2 Nutrient requirements. Macronutrients and energy. Micronutrients.

6.2.3 Nutrient intakes and infants.

6.2.4 Transition to an adult pattern of food intake. Weaning. Nutrition-related problems. Barriers to healthy nutrition.

6.3 Childhood (five to thirteen).

6.3.1 Nutrient requirements of the older child.

6.3.2 School meals and the promotion of healthy eating.

6.3.3 The importance of breakfast.

6.4 Obesity in children.

6.4.1 The rising prevalence of obesity.

6.4.2 The causes of obesity in childhood. Physical activity. Food intake. Genetic disorders.

6.4.3 The consequences of childhood obesity. Immediate health consequences. Tracking of obesity: consequences for the future.

6.4.4 Treatment of childhood obesity.

6.4.5 Prevention of childhood obesity.

7. Nutrition and Adolescence.

7.1 Introduction.

7.2 Physical development.

7.2.1 Growth rate.

7.2.2 Body composition.

7.2.3 Puberty and sexual maturation.

7.2.4 Bone growth.

7.3 Psychosocial development.

7.4 Nutritional requirements in adolescence.

7.4.1 Macronutrients and energy.

7.4.2 Micronutrients.

7.5 Nutritional intakes in adolescence.

7.5.1 Factors that influence food choice.

7.5.2 Food consumed out of the home.

7.5.3 Meal skipping and snacking.

7.6 Potential problems with nutrition.

7.6.1 Dieting and weight control.

7.6.2 The vegetarian teenager.

7.6.3 Sport and physical activity.

7.6.4 Eating disorders. Anorexia nervosa. Bulimia nervosa.

7.6.5 The pregnant teenager.

7.6.6 Alcohol.

7.6.7 Tobacco smoking.

7.6.8 Drug abuse.

8. The Adult Years.

8.1 Introduction.

8.2 Changing needs for nutrients.

8.3 Guidelines for healthy nutrition.

8.4 Disease states associated with unhealthy nutrition and lifestyle.

8.4.1 Obesity. Classification of overweight and obesity. Prevalence and trends in obesity. Causes of obesity in adulthood. Treatment of obesity.

8.4.2 Type-2 diabetes.

8.4.3 The metabolic syndrome.

8.4.4 Cardiovascular disease. What is cardiovascular disease? Risk factors for cardiovascular disease. Nutrition-related factors and risk of cardiovascular disease.

8.4.5 Cancer. What is cancer? Diet is the main determinant of cancer risk. Nutritional epidemiology and cancer. Dietary factors that may promote cancer. Dietary factors that may reduce cancer risk.

9. Nutrition, Aging, and the Elderly.

9.1 Introduction.

9.2 The aging population.

9.3 The aging process.

9.3.1 Impact on physiological systems.

9.3.2 Mechanisms of cellular senescence. Oxidative senescence. The role of p53 activation. Telomere shortening. The INK4a/ARF axis.

9.3.3 Nutritional modulation of the aging process. Caloric restriction and lifespan. Fetal programming of lifespan. Supplementary antioxidants.

9.4 Nutrient requirements of the elderly.

9.4.1 Macronutrients and energy.

9.4.2 Micronutrients.

9.4.3 Specific guidelines for the elderly.

9.5 Barriers to healthy nutrition in the elderly.

9.5.1 Malnutrition and the elderly.

9.5.2 Poverty.

9.5.3 Social isolation.

9.5.4 Education.

9.5.5 Physical changes.

9.5.6 Combating malnutrition in the elderly.

9.6 Common nutrition-related health problems.

9.6.1 Bone disorders. Bone mineralization and remodeling. Osteoporosis pathology and prevalence. Risk factors for osteoporosis. Dietary interventions for osteoporosis prevention. Pagets disease of bone.

9.6.2 Immunity and infection.

9.6.3 Digestive tract disorders. Mouth and esophagus. Stomach. Small intestine. Large intestine.

9.6.4 Anemia. Iron deficiency anemia. Vitamin B12 deficiency. Folic acid deficiency. Cognitive impairment and anemia.

10. Personalized Nutrition.

10.1 Introduction.

10.2 The individual response to variation in food intake.

10.2.1 Genes may determine food intake. Regulation of food intake. Regulation of macronutrient intake. Regulation of taste.

10.2.2 Genes may determine nutrient bioavailability and utilization.

10.2.3 Nutritional regulation of gene expression.

10.3 Identifying disease risk biomarkers.

10.3.1 Nutrigenomics.

10.3.2 Proteomics.

10.3.3 Metabolomics.

10.4 Genetic influences on response to nutrients and disease risk.

10.4.1 Obesity.

10.4.2 Cardiovascular disease.

10.4.3 Cancer.

10.5 Nutrient–gene interactions—a lifespan approach.

10.6 The future of nutritional advice?

Glossary of Terms.


Additional resources are published on the book’s web site


“Overall, Nutrition: a Lifespan Approach is a useful resource, particularly to undergraduate and postgraduate students studying a degree in dietetics/nutritional sciences or those undergoing courses in public health or clinical nutrition. It provides the reader with a good balance of knowledge in areas such as obesity and different disease states such as diabetes, cardiovascular disease and various cancers. This book is very ‘reader friendly’, with summary boxes at the end of each chapter and self-assessment questions on the content of each chapter. It also provides the reader with more advanced nutritional knowledge in the ‘highlight’ boxes, which give a greater insight into that particular topic. This textbook is ‘a must’ for students wishing to practice nutrition either in a health promotion or clinical setting.” (Nutrition Bulletin, March 2010)

Model Answer to Self-Assessment Question
Chapter Artwork Slides - Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10

  • Looks at the key concepts of nutrition science through a lifespan approach

  • Clearly laid out with learning objectives, summary boxes and research highlights

  • Includes self-assessment tests to facilitate student learning

  • Provides students with a international perspective