Nutrition and Diagnosis-Related Care, 5th ed, by Escott-Stump S. Baltimore, Md: Lippincott Williams & Wilkins; 2002. Softbound text, 847 pages, $59.95.
The updates made to this new edition of Nutrition and Diagnosis-Related Care are timely, appropriate, and technologically advanced. The text is available for $59.95 in your choice of formats, a soft-cover text or a searchable, interactive electronic version on CD-ROM, which can be downloaded to your personal digital assistant (PDA). If you just can't decide which format you'd like best, you can order both for only $79.95.
To keep pace with changes in the practice of nutrition, the text has a new appendix entitled Complementary Nutrition-Herbals and Botanicals. The appendix is fairly extensive and includes a sample patient questionnaire, as well as a table on potential interactions between supplements/botanicals and prescription medications. There is also a listing of related agencies and their Web sites and/or phone numbers for additional information.
The organization of the book is similar to the fourth edition; it is divided into sections that are grouped topically. The beginning sections relate to normal nutrition throughout the lifecycle, which includes information on pregnancy and lactation and infancy up through geriatric nutrition. The later sections are more clinical in nature and are grouped by organ systems. At the end of each section, references are cited by topic and other readings are suggested for additional information, which could be very helpful to students and practitioners.
The format for each individual topic is standardized, making this book quite efficient for use in daily practice. The first part addresses definitions and background on the disease followed by objectives for nutritional care, and dietary and nutritional recommendations. Next there is a list of laboratory values, a review of common drugs used for that specific diagnosis, and the potential side effects of the drugs. A similar section has been added to the new edition that addresses the herbs, botanicals, and supplements commonly used and their potential side effects. The last portion of the text emphasizes patient education for particular disorders or diseases. This standard format streamlines the information for quick reference, and could be helpful in establishing and prioritizing a patient's care plan. While the book thoroughly addresses each topic, it does not integrate coexisting conditions for a single diagnosis, requiring the user to look up each condition separately. For example, a patient with cirrhosis of the liver may also present with ascites, hepatic encephalopathy, and esophageal varices. A clinician with nutritional care experience for this disease will consider the need to restrict sodium, fluid, protein, and abrasive foods, respectively, for each of these conditions. The practitioners who lack experience may overlook relevant nutritional intervention if they are not prompted to look up each condition separately. Prioritizing nutritional care for conditions with conflicting priorities could also become confusing.
The information provided on acute renal failure was substantial. However, the edition does not differentiate between prerenal, postrenal, or intrinsic etiologies of this diagnosis, or the dramatic differences that can exist in the prioritization of nutritional care for each etiology. Another section discusses pressure sores and recommends the use of supplements, "especially vitamin A," but does not caution about the potential for toxicity. In spite of these minor shortcomings, this book is an excellent reference for use in conjunction with other relevant nutritional and medical resources, as the author contends in the preface. It is organized, concise, comprehensive, well researched, and up-to-date, including diagnoses with minor, but recent, practice changes, such as HIV.
The text is a great resource for students, who are usually encouraged to look up many clinical details in their preprofessional training. It could also be quite valuable for nutrition practitioners, particularly as a reference for infrequent medical diagnoses that have specific nutritional interventions. Some of these interventions cannot easily be found using other popular medical or nutritional resources.
Dietitian Bronx Veterans Affairs Medical Center Adjunct Instructor Medical Nutrition Therapy New York University