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Modern Nutrition in Health and Disease,

2123 Cumming Road Augusta, GA 30904 E-mail: efeldman{at}csranet.com

9th ed, edited by Maurice E Shils, James A Olson, Moshe Shike, and A Catharine Ross, 1999, 1951 pages, hardcover, $105.00. Williams & Wilkins, Baltimore.

This new edition of the outstanding clinical nutrition textbook is not only a timely and comprehensive update of nutrition information, but is truly a revision of the encyclopedic resource for students, educators, investigators, and practitioners. A Catherine Ross has joined the previous experienced team of editors, led for several decades by Maurice Shils. This edition has been reorganized and enlarged. It contains 10% more pages, weighing 4.35 kg, and has significantly more chapters (115) and authors (169) than the previous edition published in 1994.

Part I reviews dietary components and covers more individual nutrients than does the previous edition, including compounds with nutritional relevance such as glutamine, arginine, and homocysteine and other sulfur-containing amino acids. Part II includes tutorials in the physiologic regulation of integrated body systems that add new basic concepts necessary for an understanding and application of nutrition science. Although the tutorial form is not defined, these excellent chapters cover, among other topics, aspects of molecular and cell biology and genetics. A future edition might consider a separate listing of all of the tutorials—I identified 6 chapters in 3 different parts of the book in which they appear. Part III contains chapters on the dietary and nutritional assessment of infants, children, and adults as well as chapters on laboratory testing and anthropometric methods.

The largest part of the book, part IV, is a presentation on disease prevention and treatment, which has been enhanced and improved (by reorganization) relative to the previous edition. Disorders of the alimentary tract (eg, short-bowel syndrome, inflammatory bowel disease, diseases of the small bowel, and celiac disease) are discussed in separate chapters, as are pancreatic and liver disorders. Each of these chapters has different authors, many of whom are new. New, worthwhile topics covered in added chapters include malnutrition in relation to poverty (eg, the reader can see a picture of a Jukes family member from 1895 whose physiognomy is that of the fetal alcohol syndrome); intriguing defects in ß-oxidation, including diagnosis and management; nutrient and genetic regulation of lipoprotein metabolism, which might provide useful leads for improved intervention; cancer (excellent coverage in 5 chapters); and the increasingly important relation between nutrition and retinal degeneration. In the next edition, the editors might consider coverage of cataract or entitling a chapter "Nutrition and Vision."

Part V covers population health and includes a chapter on the nutritional implications of vegetarian diets. This chapter would be more appealing visually if it included some illustrations or tables. A provocative must-read chapter on clinical and therapeutic nutrition in developing countries (70% of the world's population) contrasts the needs of these populations with the emphasis on applying and transferring principles that may already be outdated in Western, affluent societies. Alternative nutrition therapies is an increasingly important topic that is also addressed in a new chapter. Food safety and quality, including informative chapters on functional foods, environmental chemicals in food, and labeling, health claims, and dietary supplement legislation, are the topics of part VI. Part VII is a comprehensive appendix of up-to-date information, including a section on the Internet as a source of nutritional information.

Undoubtedly, this new edition of the classic textbook should be a part of all nutrition libraries—institutional and personal. Perhaps the publisher can be persuaded to return to the previous edition's 2-volume format in the new millennium because the current version is barely portable.

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