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To unlock the meaning of a medical word, first define each wordpart. Then put the word part definitions in order, beginning with thesuffix, then the first word part.

Word Part Word Part DefinitionSUFFIX -ics knowledge, practiceCOMBINING FORM dietet/o- foods, diet

Dietetics: The knowledge and practice of foods and diet.

Medical Language Key

dietet/o-means

foods, diet

dietet/o- -ics-ics

meansknowledge, practice

CHAPTER 21Dietetics

Dietetics (DY-eh-TET-iks) is the medical specialty that studies nutrients

and foods and uses diagnostic tests, medical and surgical procedures,

diets, and drugs to maintain wellness and prevent or treat disease.

MEASURE YOUR PROGRESS: LEARNING OBJECTIVES

After you study this chapter, you should be able to

1. Identify three macronutrients and ten micronutrients and describe their functions in the body.

2. Describe the processes of taste and metabolism.

3. Build dietetic words from combining forms, prefixes, and suffixes.

4. Describe five different types of therapeutic diets.

5. Describe common symptoms, signs, and diseases related to dietetics.

6. Describe common dietetic diagnostic laboratory tests.

7. Describe common dietetic medical and surgical procedures and drug categories.

8. Define common dietetic abbreviations.

9. Correctly spell and pronounce dietetic words.

10. Test your knowledge of dietetics by completing review exercises at the end of the chapter.

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W-32 | Chapter 21 | Dietetics

Anatomy and PhysiologyDietetics is related to several different body systems. Thelimbic system of the brain processes the pleasurable emo-tions and memories associated with food and eating. Theeyes detect the visible presence of food and send thisinformation to the visual cortex of the brain. The nosedetects food smells and sends this information to the olfac-tory cortex of the brain. The tongue detects several differ-ent tastes and sends this information to the gustatory cor-tex of the brain. Food is processed by the gastrointestinalsystem and transformed into nutrients to meet the needs ofthe body.

Nutrients and NutritionA nutrient is a substance that provides nourishment to the body.Nutrients include carbohydrates, proteins, lipids, vitamins, and miner-als. An essential nutrient is one that the body cannot produce itself andmust obtain from food.

Macronutrients are nutrients that the body needs in large amountseach day. Carbohydrates, proteins, and lipids are macronutrients.Macronutrients provide different amounts of energy.

• Carbohydrates provide 4 calories per gram• Proteins provide 4 calories per gram• Lipids provide 9 calories per gram

Micronutrients are nutrients that the body needs in very tinyamounts, sometimes a little as one-millionth of a gram each day.Vitamins and minerals are micronutrients.

Nutrition is the process by which the body uses nutrients to meetits needs for nourishment, growth, and reproduction.

nutrient (NOO-tree-ent)nutri/o- nourishment-ent pertaining to

nutritious (noo-TRISH-us)nutriti/o- nourishment-ous pertaining to

macronutrient (MAK-roh-NOO-tree-ent)macr/o- largenutri/o- nourishment-ent pertaining to

A macronutrient is not a nutrient that islarge in size; it is one that the body needsin large amounts.

micronutrient (MY-kroh-NOO-tree-ent)micr/o- smallnutri/o- nourishment-ent pertaining to

nutrition (noo-TRISH-un)nutri/o- nourishment-tion a process; being or having

nutritional (noo-TRISH-un-al)nutri/o- nourishment-tion a process; being or having-al pertaining to


Dietetics | Chapter 21 | W-33

Figure 21-1 ■ Fructose.Fructose is the sugar found naturally in fruits. A survey conducted by theU.S. Department of Agriculture found that, on a daily basis, 50% of thepeople surveyed did not eat any fruit at all.

To meet future demands for a quick source of energy, the body storesglucose molecules as glycogen in the liver and skeletal muscles.

Disaccharides are composed of two sugar molecules.

• Sucrose (table sugar made from sugar cane) (see Figure 21-2■)• Lactose (sugar found in milk from humans and animals)

glycogen (GLY-koh-jen)glyc/o- glucose (sugar)-gen that which produces

disaccharide (dy-SAK-ah-ride)di- twosacchar/o- sugar-ide chemically modified structure

sucrose (SOO-krohs)sucr/o- sugar (cane sugar)-ose full of

lactose (LAK-tohs)lact/o- milk-ose full of

Add words to make a correct and com-plete definition of lactose: full of [the sugarfound in] milk.

CarbohydratesThe body needs carbohydrates to meet immediate energy needs and tostore energy for future needs. The body must obtain all of the carbo-hydrates it needs from foods in the diet. The enzyme amylase (pro-duced by the salivary glands and the pancreas) breaks down carbohy-drates into individual sugar molecules that can be absorbed into theblood. Carbohydrates include monosaccharides, disaccharides, andpolysaccharides.

Monosaccharides are simple sugars that contain a single sugarmolecule.

• Glucose (sugar in the blood)• Fructose (sugar in fruits) (see Figure 21-1■)

carbohydrate (KAR-boh-HY-drayt)carb/o- carbon atomshydr/o- water; fluid-ate composed of; pertaining to

monosaccharide(MAWN-oh-SAK-ah-ride)mon/o- one, singlesacchar/o- sugar

-ide chemically modified structure

glucose (GLOO-kohs)gluc/o- glucose (sugar)-ose full of

fructose (FRUHK-tohs)fruct/o- fruit-ose full of

Add words to make a correct and com-plete definition of fructose: full of [the



Figure 21-2 ■ Empty calories.Manufactured foods can contain large amounts of sugar (and fat) in which thecalories are in a concentrated form and not associated with the vitamins andminerals found in whole foods.

Polysaccharides are composed of three or more sugar molecules.

• Starch (found in vegetables and plants)• Cellulose (vegetable fiber found in plants)• Pectin (found in fruits)

polysaccharide (PAWL-ee-SAK-ah-ride)poly- many, muchsacchar/o- sugar-ide chemically modified structure

cellulose (SEL-yoo-lohs)cellul/o- cell-ose full of

pectin (PEK-tin)pect/o- stiff-in a substance

Commercially prepared pectin is added tojellies and jams to thicken them.

Did You Know?The first artificial sweetener was named saccharin to emphasize its connection to natural sugar. The combining form sacchar/o-means sugar.

Dextrose is a manufactured sugar. It is also known as d-glucosebecause it is the dextrorotatory or right-handed version of the glucose mole-cule. It is used in intravenous fluids.

For many years, it was felt that simple carbohydrates like table sugarraised the blood sugar quickly while complex carbohydrates like potatoesraised the blood sugar more slowly. Now it has been shown that table sugar raises the blood sugar level at about the same rate as bread orpotatoes.

Your body cannot break apart cellulose or pectin, and so they functionas dietary fiber rather than as carbohydrates.

dextrose (DEKS-trohs)dextr/o- right-ose full of

Add words to make a correct and com-plete definition of dextrose: full of a right [-handed molecule of glucose].



LipidsThe body needs lipids to transport and store vitamins A, D, E, and K;to store energy for future needs; and to make hormones. The bodymust obtain all of the lipids it needs from foods in the diet. Dietarylipids are classified as saturated or polyunsaturated fats. The enzymelipase (produced by the pancreas) breaks down lipids into fatty acidmolecules that can be absorbed into the blood. Saturated fats are lipidsin which a hydrogen atom is bonded to every position in the fatty acidchain. Saturated fats are derived from animal products and are solid atroom temperature (see Figure 21-3 ■). Polyunsaturated fats are lipidsthat have fewer hydrogen atoms. Most polyunsaturated fats (oils) areliquids at room temperature. Vegetable oils (with the exception ofcoconut) contain polyunsaturated fat.

lipid (LIP-id)lip/o- lipid (fat)-id resembling; source or origin

saturated (SATCH-uh-ray-ted)satur/o- filled up-ated pertaining to a condition; com-

posed of

polyunsaturated(PAWL-ee-un-SATCH-uh-ray-ted)poly- many, muchun- notsatur/o- filled up-ated pertaining to a condition; com-

posed of

Did You Know?The body takes amino acids from the food and uses them to make more than 100,000 different protein molecules for use in the body. Each protein can be a chain of 1,000 or more amino acids.

ProteinThe body needs protein to build, repair, or replace all types of tissuesand to synthesize enzymes, hormones, neurotransmitters, antibodies,and hemoglobin. The body obtains the protein it needs from foods inthe diet. The enzyme protease (produced by the stomach) breaks downthe protein in foods into individual amino acids that can be absorbedinto the blood. There are 22 different amino acids. Nine of these areessential amino acids because the body cannot produce them and theymust be obtained from foods. If a single food contains all nine essen-tial amino acids, it is a complete protein. Protein that comes from ananimal (meat, fish, eggs, dairy products) is a complete protein, butsoybeans are a unique example of a complete protein from a plantsource. If a single food does not contain all nine essential amino acids,it is an incomplete protein. Vegetables, whole grains, nuts, and seedsare incomplete proteins; however, a variety of incomplete proteinfoods can be combined to create complete protein.

protein (PROH-teen)prote/o- protein-in a substance

amino acid (ah-MEE-noh AS-id)



Figure 21-3 ■ Saturated fats.Saturated fats in animal products and some plant products like coconut are solidat room temperature.

Did You Know?Margarine begins as a polyunsaturated oil (such as corn oil). Hydrogen atoms are then added to the oil in a process known as hydrogenation. This oil is then hydrogenated, which changes its physical properties so that it remains solid at room temperature. In thisform, it is known as trans fat. Both trans fat and saturated fat are undesir-able in the diet because they raise the level of low-density lipoprotein (LDL),the lipoprotein carrier that deposits cholesterol on the arterial walls.

Omega-3 fatty acids, which are found in fish, may help lower serum choles-terol and triglyceride levels.

The American diet is very high in fat. Approximately 40 to 50% of the totaldaily calories come from fat. Ideally, this should be 30 to 35%.

Lipid-Containing Compounds Lipid-containing compounds—cholesterol, triglycerides, lipoproteins, and phospholipids—containfatty acids combined with another molecule.

Cholesterol is a combination of fatty acids and an alcohol group.Cholesterol is an important part of bile, the sex hormones estradioland testosterone, as well as neurotransmitters and cell membranes.

Triglyceride is a combination of fatty acids and glycerol molecules.Triglycerides are stored as fat that protects the internal organs, insu-lates the body from the cold, provides emergency energy reserves, andholds the fat-soluble vitamins A, D, E, and K. Excessive amounts oftriglycerides are stored in larger deposits as adipose tissue.

Lipoproteins are a combination of fatty acids and protein molecules.They are carrier molecules that transport cholesterol and triglyceridesthrough the blood.

Phospholipids are a combination of fatty acids and phosphorus.They are carrier molecules that transport the fat-soluble vitamins A, D,E, and K through the blood.

cholesterol (koh-LES-ter-awl)Cholesterol is a combination of the com-bining form chol/e- (bile, gall) and thesuffix -sterol. Cholesterol is the main com-ponent of bile. A sterol is a chemical com-pound with an alcohol group (shown bythe suffix -ol).

triglyceride (try-GLIS-er-ide)tri- threeglycer/o- glycerol (sugar alcohol)-ide chemically modified structure

Add words to make a correct and com-plete definition of triglyceride: a chemicallymodified [compound of] three [fatty acidsand one] glycerol.

adipose (AD-ih-pohs)adip/o- fat-ose full of

lipoprotein (LIP-oh-PROH-teen)lip/o- lipid (fat)prote/o- protein-in a substance

phospholipid (FAWS-foh-LIP-id)phosph/o- phosphoruslip/o- lipid (fat)-id resembling; source or origin



VitaminsVitamins are micronutrients that play an important role in many of thechemical reactions of metabolism. There are 13 vitamins—nine water-soluble vitamins and four fat-soluble vitamins.

Water-soluble vitamins include vitamin B1 (thiamin), vitamin B2

(riboflavin), vitamin B3 (niacin), vitamin B5 (pantothenic acid), vitaminB6 (pyridoxine), and vitamin B12 (cyanocobalamin), folate (folic acid),biotin, and vitamin C (ascorbic acid). With the exception of vitaminsB12 and C, water-soluble vitamins are not stored in the body (see Table21-1). Each day, the body needs to replenish its supply of these

Table 21-1 Water-Soluble Vitamins

Vitamin Name Pronunciation Function Dietary Sources

vitamin B1 thiamin (THY-ah-min) Metabolizes carbohydrates Meat, fish, whole grains, beans, nuts(thiamin) Synthesizes neurotransmittors

vitamin B2 riboflavin Helps body to use vitamin B6 Meat, fish, dairy products, whole grains, (riboflavin) (RY-boh-FLAY-vin) Metabolizes amino acids, glucose, and vegetables, beans, nuts

fatty acids

vitamin B3 niacin (NY-ah-sin) Metabolizes carbohydrates Meat, fish, eggs, dairy products, whole (niacin) grains, leafy green vegetables, potatoes,

nutsNote: The body also makes this vitamin from the amino acid tryptophan in the diet.

vitamin B5 pantothenic acid Metabolizes carbohydrates Meat, fish, eggs, dairy products, whole (pantothenic (PAN-toh-THEN-ik Synthesizes fatty acids grains, beans, nutsacid) AS-id) Note: Bacteria in the intestines produce this

vitamin.

vitamin B6 pyridoxine Metabolizes proteins and fats Meat, fish, eggs, whole grains, bananas, (pyridoxine) (PIR-ih-DAWK-seen) beans, nuts

vitamin B12* cyanocobalamin Maintains myelin sheath on nerves Meat, fish, eggs, dairy products. There are

(cyanocobalamin) (SY-an-oh-koh- Helps form red blood cells no plant sources.BAWL-ah-min) Note: Bacteria in the intestines also produce

a small amount of this vitamin.

folate folate Synthesizes DNA and protein Liver, whole grains, beans, green leafy (folic acid) (FOH-layt) Helps form red blood cells vegetables, fruits

folic acid(FOH-lik AS-id)

biotin biotin Metabolizes carbohydrates and fats Liver, eggs, beans, vegetables, nuts(BY-oh-tin) Note: Bacteria in the intestines also produce

this vitamin.

vitamin C ascorbic acid Protects from damage by free radicals in Citrus fruits (see Figure 21-4 ■), green leafy(ascorbic acid) (ah-SKOR-bik the environment vegetables

AS-id) Maintains healthy connective tissueSynthesizes proteinStrengthens immune system

*can only be absorbed if the stomach produces intrinsic factor

vitamin (VITE-ah-min)Vitamin is a combination of the Latin wordvita (life) and the suffix -amine (chemicalcompound containing nitrogen and hydro-gen), but with the final -e deleted.



vitamins through food intake or through dietary supplements. Water-soluble vitamins are destroyed by heat and prolonged cooking. TheB vitamins are lost during the milling process when the outer coveringof a grain like rice or wheat is removed. Manufacturers then replacethe B vitamins and label the product as enriched. Megadoses of water-soluble vitamins, extremely large doses taken as dietary supplements,are mostly excreted in the urine.

Fat-soluble vitamins include vitamins A, D, E, and K. Fat-soluble vit-amins are stored in the fatty tissue of the body (see Table 21-2). Thebody draws on those stores if the amount of fat-soluble vitamins in thediet is inadequate. During the commercial processing of milk, two fat-soluble vitamins (A and D) are added to make the milk fortified.Megadoses of fat-soluble vitamins remain in the body’s fat stores andcan reach toxic levels.

Figure 21-4 ■ Vitamin C.Citrus fruits are a rich source of vitamin C.

A Closer LookVitamin B1 was the first vitamin to be discovered; hence the designation B1. Because B1 contained a nitrogen group known as an amine, the word vitamine was created in 1912 to describe it. Later, when it was discovered that other vitamins did not have an amine group, the spelling was changed to delete the -e.

megadose (MEG-ah-dohs)meg/a- large-dose measured quantity



Word AlertSOUND-ALIKE WORDS

retinol (noun) Vitamin A in food from animal sources

Example: Retinol is a form of vitamin A.

retinal (adjective) Pertaining to the retina in the eye

Example: The retinal artery brings oxygenated blood to the tissuesof the retina.

Table 21-2 Fat-Soluble Vitamins

Vitamin Name Pronunciation Function Dietary Sources

vitamin A retinol (RET-ih-nawl) Builds bones and teeth Meat, liver, dairy products, egg yolks, fruits; (retinol, retinoic Maintains healthy retina and macula in green, leafy, yellow, and orange acid) retinoic acid the eyes vegetables(betacarotene) (RET-ih-NOH-ik Maintains skin and connective tissues

AS-id)

betacarotene(BAY-tah-KAIR-oh-teen)

vitamin D cholecalciferol Builds bones and teeth Cod liver oil, eggs, dairy products, fortified (cholecalciferol) (KOH-lee-kal-SIF- Helps calcium be absorbed from food milk(ergocalciferol) er-awl) Note: The body also makes this vitamin

when sunlight reacts with cholesterol in the ergocalciferol skin.

(AIR-goh-kal-SIF-er-awl)

vitamin E tocopherol Maintains healthy skin and mucous Meat, milk, whole grains, green leafy (tocopherol) (toh-KAWF-er-awl) membranes vegetables, nuts, oils

Strengthens the immune systemKeeps blood from clottingMaintains healthy reproductive organsProtects body from damage by free radicals

vitamin K phytonadione Important in blood clotting Liver, dairy products, green leafy (phytonadione) (FY-toh-nay- vegetables, fruits

DY-awn) Note: Bacteria in the intestines make this vitamin

ConnectionsDermatology (Chapter 7). Topical vitamin A–type drugs are used to treatthe skin diseases of acne vulgaris, severe cystic acne, and psoriasis.



MineralsMinerals are micronutrients that are chemical elements found in thesoil and water. Both plant and animal foods contain minerals becauseplants take up minerals as they grow, and animals ingest mineralswhen they eat plants (see Table 21-3).

Table 21-3 Minerals

Mineral Name Pronunciation Function Dietary Sources

calcium calcium Builds bones and teeth Dairy products, salmon, dark green vegetables.(KAL-see-um) Contracts muscles Orange juice and milk are often fortified with calcium.

iodine iodine (EYE-oh-dine) Component of thyroid Seafood, iodized salthormones

iron iron (EYE-ern) Forms red blood cells Meat, eggs, whole grains

magnesium magnesium Component of enzymes Whole grains, beans, bananas, fruits, nuts, raisins, prunes(mag-NEE-zee-um)

phosphorus phosphorus Builds bones and teeth Meat, fish, eggs, milk, whole grains, beans, nuts(FAWS-for-us) Maintains cell membrane

potassium potassium Contracts muscles Bananas, brewer’s yeast, dried fruits, beans, nuts, molasses(poh-TAS-ee-um)

sodium sodium Maintains fluid balance Most foods and public drinking water, salt tablets(SOH-dee-um) and blood pressure

Conducts nerve impulsesContracts muscles

zinc zinc (ZINGK) Metabolizes carbohydrates Meat, shellfish, eggs, dairy products, legumes, peanut and proteins butterProduces testosterone and sperm

ConnectionsPublic Health. The Recommended Dietary Allowance (RDA) is a guideline prepared by the Food and Nutrition Board of the NationalAcademy of Sciences. It establishes the amount of an essential nutrient thatis needed to meet the nutritional needs of most healthy people. There are18 different categories of RDAs, based on age and sex. There are also spe-cial categories for pregnant women and nursing mothers.

Most water-soluble vitamins and all of the fat-soluble vitamins have arecommended dietary allowance (RDA). There is an RDA for some minerals(calcium, phosphorus, magnesium, iron, zinc, and iodine), and a recom-mended daily range of intake for other minerals. Carbohydrates, lipids, pro-teins, and fiber do not have an RDA.

Sodium plays a role in the development of hypertension. The first step intreating hypertension is to put the patient on a no-added-salt or a low-sodium diet. The American Heart Association recommends a maximum dailysodium intake of 3,000 mg. However, the average American eats 4,000 to5,000 mg of sodium each day. In November 2002, the American PublicHealth Association called for a 50% reduction in the sodium content ofprocessed foods and restaurant foods.



Physiology of Taste and MetabolismAs food enters the oral cavity, food particles touch taste buds on thetongue. The taste buds contain hundreds of different taste receptorsthat sense the taste and relay that information to the gustatory cortexin the brain. Traditionally, the sense of taste has been thought of ashaving four parts: sweet, salty, sour, or bitter. A fifth taste receptor hasbeen identified that detects umami, the savory taste found in meats,monosodium glutamate (MSG), mushrooms, aged cheese, and soysauce.

Foods are broken down into their component nutrients in the gas-trointestinal system. Nutrients are absorbed from the small intestineinto the blood and then distributed throughout the body. When nutri-ents enter a cell, intracellular enzymes break down their molecules intoindividual atoms. Breaking the chemical bonds between atomsreleases heat and energy. The heat, which is measured in calories, isused to warm the body. The energy is stored in the intracellular mole-cule ATP (adenosine triphosphate) and released according to theneeds of the cell. These processes go on continuously in every cell aspart of the process of metabolism. Metabolism includes catabolism(breaking down molecules) and anabolism (assembling molecules).

How people’s bodies use nutrients to build muscle and deposit fatis reflected in their body build or somatotype. There are three soma-totypes: ectomorph, mesomorph, and endomorph. An ectomorphicbody type is long and thin. A mesomorphic body type has a balancedappearance of the trunk and limbs. An endomorphic body type has around trunk with thin extremities.

gustatory (GUS-tah-toh-ree)gustat/o- the sense of taste-ory having the function of

umami (yoo-MAH-mee)Umami is a Japanese word meaning goodtaste.

calorie (KAL-oh-ree)calor/o- heat-ie a thing

caloric (kah-LOR-ik)calor/o- heat-ic pertaining to

metabolism (meh-TAB-oh-lizm)metabol/o- change, transformation-ism process; disease from a specific

causeSome word parts have more than one defi-nition. The best definition of metabolism isprocess of change or transformation.

metabolic (MET-ah-BAWL-ik)metabol/o- change, transformation-ic pertaining to

catabolism (kah-TAB-oh-lizm)catabol/o- breaking down-ism process; disease from a specific

cause

anabolism (ah-NAB-oh-lizm)anabol/o- building up-ism process; disease from a specific

cause

somatotype (SOH-mah-toh-type)somat/o- body-type particular kind of; a model of

ectomorph (EK-toh-morf)ecto- outermost, outsidemorph/o- shape-ic pertaining to

Add words to make a correct and com-plete definition of ectomorph: Pertaining tothe outermost [limbs of the body and their]shape.

mesomorph (MEZ-oh-morf)meso- middlemorph/o- shape-ic pertaining to

endomorph (EN-doh-morf)endo- innermost, withinmorph/o- shape-ic pertaining to

Add words to make a correct and com-plete definition of endomorph: Pertainingto the innermost [central trunk of the bodyand its] shape.



Vocabulary ReviewAnatomy and Physiology

Now that you have studied the anatomy and physiology of dietetics and types of nutrients, take time to review those newwords and descriptions. Memorize the combining forms and their definitions before going on the next section.

Combining Form Word or Phrase and Definition Description

adipose tissue adip/o- Large deposits of triglycerides; body fatfat

amino acids Building blocks of protein molecules

anabolism anabol/o- Assembling new molecules in the bodybuilding up

calorie calor/o- Measurement of the amount of heat produced when food is heat metabolized

carbohydrates carb/o- Category of macronutrient that includes monosaccharides, disaccharides, carbon atoms and polysaccharides

hydr/o-water; fluid

catabolism catabol/o- Breaking down of molecules in the body breaking down

cellulose cellul/o- Polysaccharide type of carbohydrate. Example: Fiber found in plants.cell

cholesterol Lipid-containing compound that is a component of bile (from the gall-bladder), sex hormones, neurotransmitters and cell membranes

complete protein prote/o- A food that contains all nine essential amino acids. Foods from animal protein sources are complete proteins.

dextrose dextr/o- Manufactured sugar that is the right-handed version of naturally right occurring glucose. Used in intravenous fluids. Also known as D-glucose.

disaccharides sacchar/o- Carbohydrates composed of two sugar molecules. Examples: Sucrose, sugar lactose.

enriched Grain products that contain added B vitamins to replace what was lostduring the milling process

essential amino Amino acid that the body must obtain from foods in the diet. There are acid nine of these.

essential nutrient Nutrient that the body cannot produce itself and must obtain fromfoods in the diet

fortified Milk that contains added vitamins A and D

fructose fruct/o- Monosaccharide type of carbohydrate. Fructose is the simple sugar that fruit is in fruit.

gustatory cortex gustat/o- Area of the brain that identifies the different tastes of food: sweet, salty, the sense of taste sour, bitter, and umami

glycogen glyc/o- Glucose in its stored form in the liver and skeletal musclesglucose (sugar)




glucose gluc/o- Monosaccharide type of carbohydrate. Glucose is the simple sugar that glucose (sugar) is in the blood.

incomplete prote/o- A food that does not contain all nine essential amino acids. Foods from protein protein vegetable sources are incomplete proteins (with the exception of soy

beans).

lactose lact/o- Disaccharide type of carbohydrate. Lactose is the sugar in milk that milk comes from humans and animals.

lipid lip/o- Category of macronutrient that includes saturated and polyunsaturated lipid (fat) fats

lipoprotein lip/o- Lipid-containing compound that carries cholesterol and triglycerides lipid (fat) through the blood

prote/o-protein

macronutrient nutri/o- Nutrient that the body needs in large amounts each day. Examples: nourishment Carbohydrates, proteins, and lipids.

megadose meg/a- Extremely large dose of a vitaminlarge

metabolism metabol/o- The ongoing cycle of anabolism and catabolismchange, transformation

minerals Micronutrients in the soil and water that are taken up by plants and byanimals that eat plants. Minerals include calcium, iodine, iron, potas-sium, sodium, and so forth.

micronutrient nutri/o- Nutrient that the body needs in very small amounts. Examples: Vitamins, nourishment minerals.

monosaccharides sacchar/o- Carbohydrates composed of a single sugar molecule. Examples: Glucose, sugar fructose.

nutrient nutri/o- Substance that provides nourishment to the bodynourishment

nutrition nutri/o- Process by which the body uses food to meet its needs for nourishment, nourishment growth, and reproduction

pectin pect/o- Polysaccharide type of carbohydrate from fruits. Example: Used to stiff thicken jams and jellies.

phospholipid phosph/o- Lipid-containing compound that carries vitamins A, D, E, and K through phosphorus the blood

lip/o-lipid (fat)

polysaccharides sacchar/o- Carbohydrates composed of three or more sugar molecules. Examples: sugar Starch, cellulose, and pectin.

polyunsaturated satur/o- Category of lipids that are liquid (oils) at room temperature and come fats filled up from vegetable sources

protein prote/o- Category of macronutrient that is composed of amino acids. Proteins are protein used to build tissues, enzymes, hormones, neurotransmitters, antibodies,

and so forth.

saturated fats satur/o- Category of lipids in which a hydrogen atom is bonded to every position filled up on the fatty acid chain. Animal products contain saturated fat.




somatotype somat/o- Body build. The three somatotypes are ectomorphic (long and thin), body mesomorphic (balanced body type), and endomorphic (round trunk

morph/o- with thin extremities).shape

starch Polysaccharide type of carbohydrate. Examples: Corn starch (used forcooking) and dusting powder.

sucrose sucr/o- Disaccharide type of carbohydrate. Sucrose from sugar cane is made into sugar (cane sugar) table sugar.

trans fat Saturated fat that is made by adding hydrogen atoms (hydrogenation) topolyunsaturated fat

triglyceride glycer/o- Lipid-containing compound that is a reservoir for vitamins A, D, E, and glycerol (sugar alcohol) K. Stored triglycerides are energy reserves. Larger deposits are adipose

tissue.

umami Savory taste found in meats, soy sauce, and other foods. There is a tastereceptor for it on the tongue (along with the sweet, salty, sour, and bit-ter taste receptors).

vitamins Micronutrients that participate in the chemical reactions of metabolism. Fat-soluble vitamins include vitamins A, D, E, and K. Water-soluble vita-mins include vitamins B1, B2, B3, B5, B6, B12, biotin, folate, and vitamin C.

Building Medical WordsCombining FormsHere are the combining forms you have learned so far. Next to each combining form, write its meaning. Use the Answer Keyto check your answers. The first one has been done for you.

Combining Form Medical Meaning Combining Form Medical Meaning

1. hydr/o- _______________________________

2. adip/o- _______________________________

3. anabol/o- _______________________________

4. calor/o- _______________________________

5. carb/o- _______________________________

6. catabol/o- _______________________________

7. cellul/o- _______________________________

8. dextr/o- _______________________________

9. dietet/o- _______________________________

10. fruct/o- _______________________________

11. gluc/o- _______________________________

12. glycer/o- _______________________________

13. glyc/o- _______________________________

14. gustat/o- _______________________________

15. lact/o- _______________________________

16. lip/o- _______________________________

17. macr/o- _______________________________

18. meg/a- _______________________________

19. metabol/o- _______________________________

20. micr/o- _______________________________

21. mon/o- _______________________________

22. morph/o- _______________________________

23. nutri/o- _______________________________

24. nutriti/o- _______________________________

25. pect/o- _______________________________

26. phosph/o- _______________________________

27. prote/o- _______________________________

28. sacchar/o- _______________________________

29. satur/o- _______________________________

30. somat/o- _______________________________

31. sucr/o- _______________________________

water; fluid



Combining Forms and SuffixesRead the definition hint for the medical word you are to build. Look at the combining form that is given. Write the correctsuffix on the blank line. Then write the medical word. (Remember: You may need to remove the combining vowel. Alwaysremove the hyphens and slash.) Use the Answer Key to check your answers. The first one has been done for you.

SUFFIX LIST-ated (pertaining to a condition) -ics (knowledge, practice) -ory (having the function of)-ent (pertaining to) -id (resembling; source or origin) -ose (full of)-gen (that which produces) -ism (process; disease from a specific cause) -tion (a process; being or having)-ic (pertaining to)

Definition Hint Combining Form Suffix Write the Medical Word

1. Pertaining to heat ____________________________

2. Knowledge or practice of foods and diet dietet/o- __________ ____________________________

3. Process of change and transformation metabol/o- __________ ____________________________

4. Having the function of taste gustat/o- __________ ____________________________

5. Full of fat adip/o- __________ ____________________________

6. Process of nourishment nutri/o- __________ ____________________________

7. Resembling fat lip/o- __________ ____________________________

8. That which produces glucose glyc/o- __________ ____________________________

9. Pertaining to a condition of being filled up satur/o- __________ ____________________________

10. Full of sugar gluc/o- __________ ____________________________

11. Pertaining to nourishment nutri/o- __________ ____________________________

caloriccalor/o- -ic



DietsWord Part

Word or Phrase and Definition Description

ADA diet diabetic (DY-ah-BET-ik) Follows the guidelines of the American Diabetes Association (ADA). The diabet/o- diabetes physician specifies the upper limit for the total daily number of calories. -ic pertaining to Example: 1500-calorie ADA diet. The diet is balanced, but the amount

of carbohydrates and fats is limited. Also known as a diabetic diet.diet (DY-et)

MEATS ANDBEANS5.5 oz.

DAIRY3 cups

SWEETSAND OILsparingly

FRUITS2 cups

VEGETABLES2.5 cups

GRAINS6 oz.

Figure 21-5 ■ New Food Pyramid.The new food pyramid was introduced in 2005. The concept of a serving sizewas also updated: one serving of fruits or vegetables equals the size of abaseball, one serving of potato equals the size of a computer mouse, and oneserving of meat or fish equals the size of a bar of soap.

Word AlertSOUND ALIKE WORDS

diabetic (adjective) a descriptive word for a patient with dia-betes mellitus or a diet for that patient

Example: Patients with type 2 diabetes mellitus areoften treated with a diabetic diet and an oral anti-diabetic medicine.

dietetic (adjective) a descriptive word pertaining to foodsand diets

Example: The dietetic department is planning a largebanquet for all staff members.

balanced diet Contains all of the essential nutrients in the proper amounts to ensuregood nutrition and health. As a guide to a balanced diet and daily foodchoices, the first food groups were created in 1940. In 1992, the U.S.Department of Agriculture and the U.S. Department of Health and Human Services created the food pyramid. It was revised and updated in2005 (see Figure 21-5 ■).



Word PartWord or Phrase and Definition Description

bland diet Not stimulating, free from spices, “hot” foods, caffeine, and so forth

challenge diet elimination (ee-LIM-ih-NAY-shun) Test diet for patients suspected of having allergies. After the patient elimin/o- expel, remove fasts, one food at a time is added until an allergic response is detected. -ation a process; being Also known as an elimination diet because all foods are eliminated or having and then only one is introduced at a time.

clear liquid diet Used before surgery (so that the patient will have no stomach contents to aspirate during surgery) or after surgery (to allow the digestive systemtime to recover function). It consists of clear juice, tea, carbonated soda,gelatin, clear broth, and popsicles.

fad diet Contradicts accepted nutritional information and stresses eating onlyone food or food combination to the exclusion of others, or claims it willproduce a quick weight loss that is not realistic.

full liquid diet Used after surgery as the patient progresses from a clear liquid diet to aregular diet. It consists of milk, ice cream, pudding, and cream soup, aswell as foods included in a clear liquid diet.

gluten-free diet gluten (GLOO-ten) Diet for patients who are allergic to gluten. It is free of wheat and Gluten is a Latin word meaning wheat products.glue. Gluten is the protein in wheat flour that gives bread dough its sticky, elastic quality.

high-fiber diet Used to promote regular elimination; prevent constipation, diverticulosis,and hemorrhoids; and decrease the incidence of colon cancer. Dietaryfiber is not digested. It passes through the large intestine, absorbingwater and making the stool softer and bulkier.

kosher diet kosher (KOH-sher) Excludes foods from unclean animals (pork, shellfish, and so forth) andalso follows the dietary laws of Judaism for food preparation.

low-cholesterol Limits the intake of dietary cholesterol. It is prescribed as the first step in diet trying to control elevated levels of cholesterol in the blood.

low-sodium diet Limits the amount of sodium in the diet. The physician specifies theupper limit for total daily intake of sodium. Example: 2-gram sodiumdiet. It is prescribed for patients with hypertension and heart disease. Ano-added-salt diet restricts the use of table salt sprinkled on foods oradded during cooking.

mechanical soft Excludes raw fruits, raw vegetables, and whole nuts and modifies the diet texture of other foods (meat is ground up). It is prescribed for patients

who have difficulty chewing or swallowing regular foods, includingpatients who have had a stroke; had surgery on the mouth, teeth, orthroat; or are edentulous. Also known as a dental soft diet.

n.p.o. The Latin abbreviation n.p.o. Absence of a diet and food intake. Patients who are n.p.o. are not given stands for nil per os (nothing any food or water, usually for a specified period of time prior to surgery. through the mouth). Postoperatively, they can resume p.o. intake.

puree diet puree (pyoo-RAY) (pyoo-REE) Uses foods pureed in a blender and thickened to a specific consistency. Puree is a French word meaning Foods such as mashed potatoes, applesauce, or hot oatmeal are served purified. as is. Pureed foods are prescribed for patients who have a significant

difficulty with chewing or swallowing and are unable to tolerate amechanical soft diet.



Figure 21-6 ■ Regular diet.A regular diet includes all foods withno restrictions as to calories, foods, orfood texture. In the hospital, this is alsoknown as the house diet.

Did You Know?The Greek philosopher Pythagoras is considered the father ofvegetarianism.


regular diet Provides a balanced variety of foods suitable for a hospitalized patientwho has no special dietary restrictions (see Figure 21-6 ■).

subsistence diet Provides barely enough nutrients for the body to subsist on, with noextra nutrients available for growth, reproduction, etc.

tea-and-toast diet Eaten by some elderly people. This diet is limited in variety (tea and toastare the main components), low in nutrients, but is quick to fix, easy tochew, and comforting to eat.

thickened liquids Includes regular solid food, but liquids are thickened with cornstarch ora commercial thickener to a consistency specified by the dietitian. Usedfor patients who have a tendency to aspirate thin liquids.

vegetarian diet vegetarian (VEJ-eh-TAIR-ee-an) Consists entirely of fruits, vegetables, grains, nuts, and seeds. It veget/o- vegetable specifically excludes all animal foods and foods produced by animals -arian pertaining to a person like milk and eggs. Vegetarians are also known as vegans while

lactoovovegetarians eat a vegetarian diet as well as milk and eggs.vegan (VEE-gan)

lactoovovegetarian(LAK-toh-OH-voh-VEJ-eh-TAIR-ee-an)lact/o- milkov/o- eggveget/o- vegetable-arian pertaining to a person



ConnectionsMicrobiology. Large numbers of bacteria in spoiling food causegastrointestinal symptoms in anyone who eats the food. Cam-pylobacter is found in undercooked poultry, unpasteurized milk,and raw eggs. Salmonella is found in undercooked meat andraw eggs. Escherichia coli is found in undercooked beef that wascontaminated with feces during the slaughtering process.Staphylococcus aureus, found in the nose and throat of foodhandlers, is transferred to food by the hands. Both the bacteriaand the toxin it produces can cause food poisoning. Clostridiumbotulinum occurs when low-acid foods have been improperlycanned (usually home canning) or when cans are damaged. Thebacteria grow without oxygen and multiply until the ends of thecan bulge from the pressure. The toxin from this bacteriumaffects the muscles and nervous system and can cause death.This condition is called botulism.

Symptoms, Signs, and DiseasesWord Part


cachexia cachexia (kah-KEK-see-ah) Generalized weight loss, muscle wasting, and malnutrition. Often cac/o- bad, poor present in the elderly who have both malnutrition and several chronic hex/o- habitual condition of diseases. Treatment: Correct the underlying cause.the body

-ia condition, state, thing

cachectic (kah-KEK-tik)cac/o- bad, poor

hec/o- habitual condition of the body-tic pertaining to

emaciation emaciation Excessive weight loss, muscle wasting, and malnutrition often associated (ee-MAY-see-AA-shun) with several different chronic diseases. Treatment: Correct the underlying

emaci/o- to make thin cause.-ation a process; being or having

emaciated (ee-MAY-see-aa-ted)emaci/o- to make thin-ated pertaining to a condition; composed of

failure to thrive Failure of a child to develop physically according to age-specific heightand weight charts. Can be due to diseases of the endocrine or gastroin-testinal systems or poor nutrition. Treatment: Correct the underlying cause.

food allergies Allergic reaction that commonly occurs to eggs, wheat, citrus fruits,milk, and chocolate, but many other foods cause allergies as well. Foodallergies in infants can manifest themselves as eczema or colic.Treatment: Avoidance of those foods, allergy shots.

food poisoning Caused by eating food that has been improperly prepared, refrigerated,canned, or stored. Treatment: Correct the underlying cause.

botulism (BAWT-yoo-lizm)botul/o- sausage-ism process; disease from a specific cause

Add words to make a correct and complete definition of botulism: a disease from a specific cause [of a bacterium that is shaped like a] sausage.




gluten enteropathy gluten (GLOO-ten) Weight loss and tissue damage in the small intestine caused by the immune response’s reaction to the gluten in wheat products. Gluten is

enteropathy the protein in wheat that gives dough its elastic quality. This disease is (EN-ter-AWP-ah-thee) also known as celiac disease. Treatment: Avoidance of wheat products.

enter/o- intestine-pathy disease, suffering

celiac (SEE-lee-ak)celi/o- abdomen-ac pertaining to

lactose intolerance Decreased amount of the enzyme lactase that is needed to digest thesugar in milk (lactose). Lactose intolerance is common in persons fromAsia, Africa, or South America. It also occurs as part of the agingprocess in people over age 50. It causes bloating and diarrhea as bacte-ria in the intestine eat undigested lactose and form gas. Treatment:Avoid dairy products. Take the dietary supplements LactAid or DairyEase, which contain lactase.

malnutrition malnutrition General state of inadequate nutrition caused by too little food, poor (MAL-noo-TRISH-un) food selection, or malabsorption (inadequate absorption of nutrients).

mal- bad; inadequate Treatment: Correct the underlying cause.nutri/o- nourishment-tion a process; being or having

malabsorption(MAL-ab-SORP-shun)

mal- bad; inadequateabsorpt/o- absorb or take in-ion action; condition

micronutrient deficiency (de-FISH-en-see) Decreased levels of a specific micronutrient can be associated with a deficiency diseases defici/o- lacking, inadequate disease (see Table 21-4). Treatment: Dietary supplement of the micro-

-ency condition of being nutrient.




obesity obesity (oh-BEE-sih-tee) Overweight condition with large deposits of adipose tissue. Categories obes/o- fat include exogenous (originating from an external source, i.e., overeat--ity state; condition ing) or endogenous (originating from an internal source, i.e., due to

endocrine gland disorders). An obese person has a body mass index obese (oh-BEES) (BMI) of 30 or higher. On standard height/weight tables, mild obesity is Obese is derived from a Latin greater than 20% over the normal weight for the person’s height. word meaning to devour. Morbid obesity is the condition of weighing at least 2 times more than

the ideal body weight. Large amounts of adipose tissue in the exogenous (eks-AWJ-eh-nus) abdominal area form an abdominal panniculus. Obesity increases the (ek-SAWJ-eh-nus) likelihood of developing diabetes mellitus and osteoarthritis. Treatment:

ex/o- away from, external, Weight loss.outward (continued)

gen/o- arising from; produced by

-ous pertaining to

endogenous (en-DAWJ-eh-nus)endo- innermost, withingen/o- arising from; produced by

-ous pertaining to

Table 21-4 Micronutrient Deficiency Diseases

Micronutrient Symptoms, Signs, and Diseases

vitamin B1 beriberi*

vitamin B2 changes in the skin and eye tissues

vitamin B3 pellegra*

vitamin B12 pernicious anemia, damage to the peripheral nerves

folate neural tube defect in the fetus, folic acid deficiency anemia

vitamin C poor wound healing, bleeding gums, scurvy,* weakenedimmune response

vitamin A nightblindness, softening of the cornea, dry eyes

vitamin D osteomalacia, osteoporosis, rickets*

vitamin K prolonged clotting time, hemorrhagic disease of the newborn

calcium osteoporosis

iodine goiter

iron iron deficiency anemia

potassium muscle weakness, cardiac arrhythmias

sodium low blood pressure

zinc poor wound healing, decreased sense of smell and taste

*Seldom seen in the United StatesMicronutrients not included in this table have no obvious diseases associated withtheir deficiency. A vitamin B6 deficiency is rare because vitamin B6 is found in mostfoods. Deficiencies of vitamin E and biotin are rare.



Across the Life SpanOne in four children in America is overweight. This is due to adecrease in physical activity (more time spent watching TV andplaying computer games, less time playing outside, fewer hoursin gym class at school) and eating an extra 200 calories per day.

For nursing home residents, a weight loss of 5% or more in amonth or greater than 10% in the last 6 months must bereported by law to the state government by dietitians or nurseswho work with the resident.


obesity morbid (MOR-bid)(continued) morb/o- disease

-id resembling; sourceor origin

panniculus (pah-NIK-yoo-lus)Panniculus is a Latin word meaning sheet of cloth. A panniculus lies across the abdomen like a sheet or an apron.

phenylketonuria phenylketonuria Inherited metabolic disorder. There is a deficiency of an enzyme that (PKU) (FEN-il-KEE-toh-NYOO-ree-ah) changes the essential amino acid phenylalanine into another amino acid

Phenylketonuria is a combination that is needed to build nearly every protein in the body. Phenylalanine is of phenyl- (short for the amino in human milk and infant formula. Without the enzyme, phenylalanine acid phenylalanine), keton/o- accumulates in the blood and causes mental retardation. Excess levels (ketones), and the suffix -uria spill into the urine and are detected by the PKU test. To be accurate, this (substance in the urine). test is not done until the newborn has taken milk feedings regularly for

three days. Treatment: Protein-restricted diet, sometimes for life.

pica pica (PY-kah) (PEE-kah) Unnatural craving for and compulsive eating of substances with no Pica is a Latin word meaning nutritional value, such as clay, chalk, dirt, starch, paint, ice, plaster, or magpie. Magpies are birds that hair. Seen in pregnant women or persons with an iron or zinc deficiency. collect unusual materials like Treatment: Correct underlying mineral deficiency.metal or plastic to put in their nests.

polyphagia polyphagia (PAWL-ee-FAY-jee-ah) Excessive overeating. Caused by an overactive thyroid gland, diabetes poly- many, much mellitus, or a psychiatric illness. Treatment: Correct the underlying cause.phag/o- eating, swallowing-ia condition, state, thing



Diagnostic ProceduresWord Part


albumin albumin (al-BYOO-min) Blood test that measures the level of albumin (the most abundant protein in the blood). Decreased levels affect the body’s ability to buildnew tissue and heal wounds. This test is used to monitor patients whohave malnutrition, burns, nonhealing wounds, or decubitus ulcers.

Word AlertSOUND-ALIKE WORDS

albumen (noun) egg white

Example: Albumen is the protein found in eggwhites.

albumin (noun) major protein in the plasma of the blood

Example: The physician ordered a serum albuminlevel because the patient’s wound was not healingwell.

blood smear Blood test that examines the size, shape, and color of red blood cellsunder the microscope to detect anemia caused by dietary deficiencies ofiron, folate, or vitamin B12.

fasting blood Blood test that measures the level of glucose in the blood after the sugar (FBS) patient has fasted. Elevated levels may indicate diabetes mellitus.

lipid profile Blood test that measures the levels of cholesterol and triglycerides, aswell as the lipoproteins (HDL, LDL, and VLDL) that carry them throughthe blood.

Schilling test Schilling (SHIL-ing) Urine test that measures the amount of radioactive vitamin B12 excreted The Schilling test was named by in the urine. Radioactive vitamin B12 is given orally, with and without Victor Schilling (1883–1960), a intrinsic factor. Patients with pernicious anemia will only be able to German hematologist. This is absorb the vitamin B12 (and excrete it in the urine) if it is given with an example of an eponym: a intrinsic factor.person from whom something takes its name.

Medical and Surgical ProceduresWord Part


body mass index Most accurate way to relate the weight to the height of a patient. It is (BMI) calculated as the weight in kilograms divided by the height in meters

squared.



Figure 21-7 ■ Skin fold measurement.The skin of the biceps, triceps, upper back, abdomen,or thigh is pinched and then measured with skincalipers to estimate the percentage of body fat.


skin fold The width of a skin fold can be used to estimate the percentage of body measurement fat (see Figure 21-7 ■).

Did You Know?The first nasogastric tube was developed in the late 1700s andconsisted of eel skin. It was used for five weeks to feed apatient.

feeding tube nasogastric (NAY-zoh-GAS-trik) Tube used to provide temporary or extended access to the gastro-nas/o- nose intestinal tract for the purposes of feeding. A nasogastric (NG) tube is gastr/o- stomach a long, flexible tube inserted through the nose and passed into the -ic pertaining to stomach. A gastrostomy is a surgically created stoma (opening) in the

abdominal wall with a short tube inserted into the stomach. A gastrostomy jejunostomy is a stoma in the abdominal wall with a short tube into (gas-TRAWS-toh-mee) the jejunum.

gastr/o- stomach-stomy surgically created opening

jejunostomy(JEH-jyoo-NAWS-toh-mee)jejun/o- jejunum-stomy surgically created opening

intravenous (IV) intravenous (IN-trah-VEE-nus) Provide hydration and calories to patients who temporarily cannot eat, fluids intra- within usually due to surgery. The most commonly used intravenous fluids

ven/o- vein contain dextrose, saline, electrolytes, or a combination of these.-ous pertaining to

intravenous lipids Specially formulated solution of soybean or safflower oil, water, and eggyolk. It provides essential fatty acids and extra calories to patients who cannot eat and do not have a feeding tube.

intravenous Specially formulated combination of 12 vitamins: nine water-soluble vitamins vitamins and three fat-soluble vitamins (A, D, and E). It is prescribed for

patients who cannot eat and do not have a feeding tube.

obesity surgery Used to help severely obese patients lose weight. The stomach is stapled(gastric stapling) to form a small pouch to which the intestine is attached.The patient is only able to eat small amounts of food at a time.




total parenteral parenteral (pah-REN-ter-al) Intravenous fluid that provides essential amino acids, electrolytes, nutrition (TPN) par- beside vitamins, and minerals—all the nutrients that are lacking in standard

enter/o- intestine intravenous fluids and intravenous lipids. TPN is also known as -al pertaining to hyperalimentation.

The parenteral route of administration is beside (different from) the oral route that involves the intestines.

hyperalimentation(HY-per-AL-ih-men-TAY-shun)

hyper- above; more than normal

aliment/o- food, nourishment

-ation a process; being or having

Drug CategoriesSeveral different categories of drugs are used to treat the symptoms, signs, and diseases associated with dietetics. The mostcommon drugs in each category are listed.

Category Word Analysis Description Examples

liquid nutritional Liquid formulas given through feeding tubes Compleat, Ensure, Resourcesupplements

MCT oil Easy-to-digest oil dietary supplement given to very young and very old patients. It contains medium-chain triglycerides (MCT).

vitamin B12 Given by intramuscular injection or intra- Nascobalnasally as a gel to treat vitamin B12 deficiency and pernicious anemia

vitamin D Used with calcium supplements and other drugs to promote bone growth in patients with osteoporosis

vitamin K Given by intramuscular injection to AquaMEPHYTONnewborns to prevent hemorrhagic disease of the newborn

weight-loss drugs Used to treat obesity, in conjunction with a Meridia, Xenicalreduced-calorie diet. Some are central nervous system stimulants that decrease the appetite. Others prevent fats from being absorbed in the intestines



Career FocusDietitians are allied health professionals with expertise in foods,diets, and menu planning. They motivate and assist patients in choos-ing healthy, balanced diets to prevent disease or help them selectfoods that fit a specific diet recommended or prescribed by theirphysician. Dietitians work in hospitals, clinics, and physician offices.

Family pratice physicians, internal medicine physicians, and spe-cialists in endocrinology or bariatrics treat patients with obesity.Gastroenterologists perform obesity surgery and gastrostomy andjejunostomy surgery.

Meet Karyn, a dietitian.I decided to become a dietician when I was working in food service as a foodservice worker. I was looking around for a career and thought about becoming anurse but decided that I already had a lot of experience in food service. In my firstjob as a dietician, I worked at a small community hospital. The exciting thing aboutbeing a dietician is that there’s always a challenge every day. Every patient is verydifferent. All the types of clinical cases that we see can range from diabetes topancreatitis to tube feedings to parenteral feedings, and you have to learn to adjusteverything that you do according to each patient that you see. Each week, ondifferent units, we have multidisciplinary care plan rounds that involve nurses, caremanagers, physical therapy, pharmacy, and dieticians. Dieticians treat people whoweigh too much, people who have cardiac conditions and diabetes, the very elderlywho have lost a lot of weight, patients who have cancer, premature infants who aregrowing, as well as pediatric cases and adults with different types ofgastrointestinal disorders.

dietitian (DY-eh-TISH-un)diet/o- foods, diet-itian a skilled professional or expert

bariatrics (BAR-ee-AT-riks)bar/o- weightiatr/o- physician; medical treatment-ics knowledge, practice

ADA American Diabetes Association, American Dietetic Association

BMI body mass index

CDE certified diabetes educator

CNS certified nutrition specialist

DTR dietetic technician, registered

FBS fasting blood sugar

HFCS high fructose corn syrup

NG nasogastric

RD registered dietitian

RDA recommended dietary allowance

TPN total parenteral nutrition

WDWN well-developed, well-nourished (person)

Word AlertABBREVIATIONS

Abbreviations are commonly used in all types of medical documentation; however, they can mean different things to different people and their meaning can be mis-interpreted. Always verify that the meaning of the abbreviation makes sense in thecontext of the report.

ADA stands for the American Diabetes Association, the American DieteticAssociation, and the American Dental Association.

CNS stands for certified nutrition specialist, but it also stands for central nervous sys-tem. It also sounds nearly identical to C&S, which stands for culture and sensitivity.

DTR stands for dietetic technician, registered, but it also stands for deep tendonreflexes.

Abbreviations



CHAPTER REVIEW EXERCISESReview all the material in this chapter by completing the review exercises in this section. Use the Answer Key to check your answers.

Anatomy and PhysiologyMatching ExerciseMatch each numbered word or phrase to its description.

1. visual cortex _____ Pertaining to the sense of taste

2. metabolism _____ Sugar found in milk

3. lipase _____ Enzyme that breaks down fats into fatty acids

4. lactose _____ All chemical reactions in the body

5. umami _____ Memories of food

6. olfactory _____ Pertaining to the sense of smell

7. limbic system _____ A type of taste receptor

8. gustatory _____ Where the sight of food is processed

True or FalseIndicate whether each statement is true or false by writing T or F on the line.

1. ____ Nutrition is the process by which the body uses nutrients for nourishment, growth, and reproduction.

2. ____ Proteins and carbohydrates are examples of micronutrients.

3. ____ The body stores extra glucose in the liver and skeletal muscles in the form of sucrose.

4. ____ The sugar found in fruits is known as fructose.

5. ____ Saccharin was the first artificial sweetener.

6. ____ Protein molecules are the building blocks of amino acids.

7. ____ Most saturated fats come from animals.

8. ____ Adipose tissue is composed of deposits of cholesterol.

9. ____ Trans fat is oil that has been hydrogenated so that it is solid.

10. ____ Vitamins A, B, C, and D are the fat-soluble vitamins.

11. ____ Grains that are milled and then have the B vitamins replaced are said to be enriched.

12. ____ A body build that is long and thin is known as an endomorph.



Matching ExerciseMatch each numbered word or phrase to its description.

1. calcium _____ Also known as niacin

2. iodine _____ Also known as retinoic acid

3. iron _____ Vitamin that forms red blood cells

4. vitamin A _____ Mineral found in bones and teeth

5. vitamin B3 _____ Body makes this when sunlight hits the skin

6. vitamin B12 _____ Important in blood clotting

7. vitamin D _____ Mineral found in thyroid hormones

8. vitamin E _____ Mineral that forms red blood cells

9. vitamin K _____ Protects body from free radicals

Multiple ChoiceCircle the best answer to the question from the answers provided.

1. What is a nutrient?

a. a substance contained in food or manufactured by the bodyb. a recommended daily allowancec. glucose stored in the liverd. a complete protein

2. Vitamin B12 can only be absorbed if the stomach produces sufficient amounts of ______________________________.

a. amylaseb. free radicalsc. intrinsic factord. pepsin

3. Milk with added vitamins A and D is said to be ______________________________.

a. fortifiedb. a megadosec. a dietary supplementd. enriched

4. ______________________________ are micronutrients found in the soil and water.

a. Lipidsb. Sugarsc. Mineralsd. Vitamins



1. -al _______ ___________________

2. absorpt/o- _______ ___________________

3. -ac _______ ___________________

4. adip/o- _______ ___________________

5. aliment/o- _______ ___________________

6. anabol/o- _______ ___________________

7. -arian _______ ___________________

8. -ate _______ ___________________

9. -ated _______ ___________________

10. -ation _______ ___________________

11. bar/o- _______ ___________________

12. botul/o- _______ ___________________

13. cac/o- _______ ___________________

14. calor/o- _______ ___________________

15. carb/o- _______ ___________________

16. catabol/o- _______ ___________________

17. celi/o- _______ ___________________

18. cellul/o- _______ ___________________

19. defici/o- _______ ___________________

20. dextr/o- _______ ___________________

21. di- _______ ___________________

22. diabet/o- _______ ___________________

23. dietet/o- _______ ___________________

24. diet/o- _______ ___________________

25. -dose _______ ___________________

26. ecto- _______ ___________________

27. elimin/o- _______ ___________________

28. emaci/o- _______ ___________________

29. -ency _______ ___________________

30. endo- _______ ___________________

31. -ent _______ ___________________

32. enter/o- _______ ___________________

33. ex/o- _______ ___________________

34. fruct/o- _______ ___________________

35. gastr/o- _______ ___________________

36. -gen _______ ___________________

37. gen/o- _______ ___________________

38. gluc/o- _______ ___________________

39. glycer/o- _______ ___________________

40. glyc/o- _______ ___________________

41. gustat/o- _______ ___________________

42. hec/o- _______ ___________________

43. hex/o- _______ ___________________

44. hydr/o- _______ ___________________

45. hyper- _______ ___________________

46. -ia _______ ___________________

47. iatr/o- _______ ___________________

48. -ic _______ ___________________

49. -ics _______ ___________________

50. -id _______ ___________________

51. -ide _______ ___________________

52. -ie _______ ___________________

53. -in _______ ___________________

54. intra- _______ ___________________

55. -ion _______ ___________________

56. -ism _______ ___________________

57. -itian _______ ___________________

58. -ity _______ ___________________

59. jejun/o- _______ ___________________

60. lact/o- _______ ___________________

61. lip/o- _______ ___________________

62. macr/o- _______ ___________________

63. mal- _______ ___________________

64. meg/a- _______ ___________________

65. meso- _______ ___________________

66. metabol/o- _______ ___________________

S pertaining to

Medical Language Word PartsName That Word PartIdentify each of the word parts given here by writing the correct letter (P, C, or S) on the line beside it. Then write the definition of theword part on the blank line. The first one has been done for you.

Prefix = P Combining Form = C Suffix = S

Word Part Definition Word Part Definition



67. micr/o- _______ ___________________

68. mon/o- _______ ___________________

69. morb/o- _______ ___________________

70. morph/o- _______ ___________________

71. nas/o- _______ ___________________

72. nutri/o- _______ ___________________

73. nutriti/o- _______ ___________________

74. obes/o- _______ ___________________

75. -ory _______ ___________________

76. -ose _______ ___________________

77. -ous _______ ___________________

78. ov/o- _______ ___________________

79. par- _______ ___________________

80. -pathy _______ ___________________

81. pect/o- _______ ___________________

82. phag/o- _______ ____________________

83. phosph/o- _______ ___________________

84. poly- _______ ___________________

85. prote/o- _______ ___________________

86. sacchar/o- _______ ___________________

87. satur/o- _______ ___________________

88. somat/o- _______ ___________________

89. -stomy _______ ___________________

90. sucr/o- _______ ___________________

91. -tic _______ ___________________

92. -tion _______ ___________________

93. tri- _______ ___________________

94. -type _______ ___________________

95. un- _______ ___________________

96. veget/o- _______ ___________________

97. ven/o- _______ ___________________

Word Part Definition Word Part Definition

nutrient

Word-Building ExerciseUse the combining forms, prefixes, and suffixes given here to build words that match the definitions given. Write the word you buildon the blank line. Some word parts may be used more than once. The first one has been done for you.

Word Partsadip/o- (fat) gustat/o- (the sense of taste) -ory (having the function of)calor/o- (heat) -ie (a thing) -ose (full of)-dose (measured quantity) -ity (state; condition) -stomy (surgically created opening)-ent (pertaining to) meg/a- (large) somat/o- (body)gastr/o- (stomach) nutri/o- (nourishment) -tion (a process; being or having)gluc/o- (sugar, glucose) obes/o- (fat) -type (particular kind of; a model of)

1. Pertaining to nourishment (You think nutri/o- + -ent). You write ____________________________________________________

2. Having the function of the sense of taste ____________________________________________________________________________

3. A surgically created opening in the stomach __________________________________________________________________________

4. A process of nourishment __________________________________________________________________________________________

5. Full of sugar ______________________________________________________________________________________________________

6. Full of fat _________________________________________________________________________________________________________

7. Large measured quantity ___________________________________________________________________________________________

8. A thing that is a measurement of heat _______________________________________________________________________________

9. Particular kind of a body ___________________________________________________________________________________________

10. A state of being fat ________________________________________________________________________________________________



Nutrients and DietUnscramble and MatchUnscramble the word and write the correct spelling in the blank provided. Then match the word with its definition or description inthe right-hand column. The first one has been done for you.

1. tied _____________________ _____ Sugar in the bloodstream

2. scroues _____________________ _____ Wheat protein that makes bread rise

3. rupee _____________________ _____ Diet that excludes animal foods

4. gleunt _____________________ _____ Combinations of nutrients and foods

5. spplioeiornt _____________________ _____ Diet where foods are processed in a blender

6. laetof _____________________ _____ Component of thyroid hormones

7. lugsoec _____________________ _____ Table sugar

8. vgneeatria _____________________ _____ Active in many chemical reactions

9. iieond _____________________ _____ Molecules that carry lipids in the blood

10. stamvnii _____________________ _____ Prevents neural tube defects in babies

Multiple ChoiceCircle the correct answer from the choices given.

1. The ______________________________ diet includes gelatin and clear juice.

a. fadb. clear liquidc. ADAd. bland

2. In the new food pyramid introduced in 2005, a serving size of one potato equals the size of a ____________________________.

a. spoonfulb. carton of milkc. computer moused. business envelope

3. No raw fruits and vegetables or whole nuts are included in a ______________________________.

a. mechanical soft dietb. high-fiber dietc. gluten-free dietd. no-added-salt diet

4. For a puree diet, foods must have a specific ______________________________.

a. vitamin contentb. colorc. flavord. consistency

5. A ______________________________ diet is comforting to eat and favored by older persons.

a. tea-and-toastb. subsistencec. vegetariand. balanced

6. Another name for a challenge diet is a/an ______________________________.

a. diabetic dietb. fad dietc. tea-and-toast dietd. elimination diet

diet

1



Symptoms, Signs, and DiseasesTrue or FalseIndicate whether each statement is true or false by writing T or F on the line.

1. ____ Pernicious anemia is due to a deficiency of iron.

2. ____ Botulism can be caused by eating low-acid foods that were improperly canned.

3. ____ Endogenous obesity is caused by a thyroid or pituitary disorder.

4. ____ Generalized weight loss with muscle wasting and malnutrition is known as cachexia.

5. ____ Colic and eczema in infants are related to food allergies.

6. ____ Someone who has a gluten intolerance should not eat meat.

7. ____ Pica is a craving during pregnancy for nonfood items.

Circle ExerciseCircle the correct answer from the choices given.

1. Obesity is characterized by (adipose tissue, bulimia, steatorrhea).

2. Gluten enteropathy is also known as (celiac disease, osteomalacia, polyphagia).

3. Patients who are lactose intolerant do not have the (enzyme, micronutrient, vitamin) to digest milk sugar.

4. A lack of vitamin D can cause (abdominal panniculus, nightblindness, osteomalacia).

5. Patients with diabetes mellitus are ordered a/an (ADA, high-fiber, vegetarian) diet.

6. All of these disorders are caused by a vitamin deficiency. Which one is still commonly seen in the United States? (beriberi,pellagra, pernicious anemia, scurvy)

Laboratory, Surgery,Drugs, and Abbreviations

True or FalseIndicate whether each statement is true or false by writing T or F on the line.

1. ____ A lipid profile is used to diagnose pernicious anemia.

2. ____ A patient with a nonhealing wound would have a Schilling test done.

3. ____ Hyperalimentation is also known as total parenteral nutrition.

4. ____ MCT oil contains cholesterol.

5. ____ Vitamin D is given by intramuscular injection to newborns.

6. ____ The American Diabetes Association and the American Dietetic Association share the same abbreviation.



Matching ExerciseMatch each word or phrase to its description.

1. vitamin D _____ Given with calcium to treat osteoporosis

2. intravenous fluids _____ Hyperalimentation

3. jejunostomy _____ Prescription drug for weight loss

4. TPN _____ Recommended amounts of micronutrients

5. RDA _____ Measures blood glucose levels before the patient eats

6. FBS _____ Provide fluids and calories to patients who cannot eat

7. Meridia _____ Feeding tube

8. bariatrics _____ The study and treatment of obesity

Applied SkillsPlural Noun and Adjective SpellingFill in the blanks with the correct word form. Be sure to check your spelling. The first one has been done for you.

Singular Noun Plural Noun Adjective1. emaciation _________________________

2. nutrient _________________________ _________________________

3. calorie _________________________ _________________________

4. metabolism _________________________

5. obesity _________________________

6. cachexia _________________________

emaciated



❏ adipose tissue (AD-ih-pohs TISH-yoo)❏ albumin (al-BYOO-min)❏ amino acid (ah-MEE-noh AS-id)❏ anabolism (ah-NAB-oh-lizm)❏ ascorbic acid (ah-SKOR-bik AS-id)❏ bariatrics (BAR-ee-AT-riks)❏ betacarotene (BAY-tah-KAIR-oh-teen)❏ biotin (BY-oh-tin)❏ botulism (BAWT-yoo-lizm)❏ cachectic (kah-KEK-tik)❏ cachexia (kah-KEK-see-ah)❏ calcium (KAL-see-um)❏ calorie (KAL-oh-ree)❏ caloric (kah-LOR-ik)❏ carbohydrate (KAR-boh-HY-drayt)❏ catabolism (kah-TAB-oh-lizm)❏ celiac disease (SEE-lee-ak DIS-eez)❏ cellulose (SEL-yoo-lohs)❏ cholecalciferol (KOH-lee-kal-SIF-er-awl)❏ cholesterol (koh-LES-ter-awl)❏ cyanocobalamin

(SY-an-oh-koh-BAWL-ah-min)❏ dextrose (DEKS-trohs)❏ diabetic diet (DY-ah-BET-ik DY-et)❏ dietetics (DY-eh-TET-iks)❏ dietitian (DY-eh-TISH-un)❏ disaccharide (dy-SAK-ah-ride)❏ ectomorph (EK-toh-morf)❏ elimination diet (ee-LIM-ih-NAY-shun

DY-et)❏ endomorph (EN-doh-morf)❏ emaciated (ee-MAY-see-aa-ted)❏ emaciation (ee-MAY-see-AA-shun)❏ endogenous obesity (en-DAWJ-eh-nus

oh-BEE-sih-tee)❏ ergocalciferol (AIR-goh-kal-SIF-er-awl)❏ exogenous obesity (eks-AWJ-eh-nus

oh-BEE-sih-tee) (ek-SAWJ-eh-nus)❏ folate (FOH-layt)❏ folic acid (FOH-lik AS-id)❏ fructose (FRUHK-tohs)

❏ gastrostomy (gas-TRAWS-toh-mee)❏ glucose (GLOO-kohs)❏ gluten (GLOO-ten)❏ gluten enteropathy (GLOO-ten

EN-ter-AWP-ah-thee)❏ glycogen (GLY-koh-jen)❏ gustatory cortex (GUS-tah-tor-ee

KOR-teks)❏ hyperalimentation

(HY-per-AL-ih-men-TAY-shun)❏ intravenous (IN-trah-VEE-nus)❏ iodine (EYE-oh-dine)❏ iron (EYE-ern)❏ jejunostomy (JEH-jyoo-NAWS-toh-mee)❏ kosher (KOH-sher)❏ lactoovovegetarian

(LAK-toh-OH-voh-VEJ-eh-TAIR-ee-an)❏ lactose (LAK-tohs)❏ lipid (LIP-id)❏ lipoprotein (LIP-oh-PROH-teen)❏ macronutrient

(MAK-roh-NOO-tree-ent)❏ magnesium (mag-NEE-zee-um)❏ malabsorption (MAL-ab-SORP-shun)❏ malnutrition (MAL-noo-TRISH-un)❏ megadose (MEG-ah-dohs)❏ mesomorph (MEZ-oh-morf)❏ metabolic (MET-ah-BAWL-ik)❏ metabolism (meh-TAB-oh-lizm)❏ micronutrient (MY-kroh-NOO-tree-ent)❏ monosaccharide

(MAWN-oh-SAK-ah-ride)❏ morbid obesity (MOR-bid

oh-BEE-sih-tee)❏ nasogastric tube (NAY-zoh-GAS-trik

TOOB)❏ niacin (NY-ah-sin)❏ nutrient (NOO-tree-ent)❏ nutrition (noo-TRISH-un)❏ nutritional deficiency (noo-TRISH-un-al

de-FISH-en-see)

❏ nutritious (noo-TRISH-us)❏ obese (oh-BEES)❏ obesity (oh-BEE-sih-tee)❏ panniculus (pah-NIK-yoo-lus)❏ pantothenic acid (PAN-toh-THEN-ik

AS-id)❏ parenteral nutrition (pah-REN-ter-al

noo-TRISH-un)❏ pectin (PEK-tin)❏ phenylketonuria

(FEN-il-KEE-toh-NYOO-ree-ah)❏ phospholipid (FAWS-foh-LIP-id)❏ phosphorus (FAWS-for-us)❏ phytonadione (FY-toh-nay-DY-awn)❏ pica (PY-kah) (PEE-kah)❏ polyphagia (PAWL-ee-FAY-jee-ah)❏ polysaccharide (PAWL-ee-SAK-ah-ride)❏ polyunsaturated

(PAWL-ee-un-SATCH-uh-ray-ted)❏ potassium (poh-TAS-ee-um)❏ protein (PROH-teen)❏ puree (pyoo-RAY) (pyoo-REE)❏ pyridoxine (PIR-ih-DAWK-seen)❏ retinol (RET-ih-nawl)❏ retinoic acid (RET-ih-NOH-ik AS-id)❏ riboflavin (RY-boh-FLAY-vin)❏ saturated (SATCH-uh-ray-ted)❏ Schilling test (SHIL-ing test)❏ sodium (SOH-dee-um)❏ somatotype (SOH-mah-toh-type)❏ sucrose (SOO-krohs)❏ thiamin (THY-ah-min)❏ tocopherol (toh-KAWF-er-awl)❏ triglyceride (try-GLIS-er-ide)❏ umami (uh-MAH-mee)❏ vegan (VEE-gan)❏ vegetarian (VEJ-eh-TAIR-ee-an)❏ vitamin (VITE-ah-min)❏ zinc (ZINGK)

Pronunciation ChecklistRead each word and its pronunciation. Practice pronouncing each word. Check the box next to the word after you master itspronunciation.

(Getty Images—Photodisc)(Getty Images—Photodisc)(© Elena Dorfman/Pearson Education)


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