Introduction to human nutrition. (Book Reviews).

Gibney MJ, Vorster HH, Koh FJ, Blackwell Publishing, Oxford, 2002, 342 pages, $88.00, ISBN 0-632-05624-X

The cover shows the logo of the (British) Nutrition Society and states that this is one of the Nutrition Society's Textbook Series-actually the first. Another three textbooks in the series will be Nutrition and Metabolism, Public Health Nutrition and Clinical Nutrition. This means that the material omitted in this first Introduction may be provided in the other volumes scheduled to appear in 2003 and 2004. Quoting the Preface, this introductory textbook 'is designed for students of nutrition and also for the many students who take nutrition as part of their coursework but who major in other subjects, such as pharmacy, food science or nursing'. The former will presumably need two or three of the forthcoming textbooks in the series while for students not majoring in nutrition the questions have to be whether this provides enough of the practical, everyday nutrition that would be useful for pharmacy, food science and nursing.

This volume has an international authorship, from 11 countries plus FAQ. The largest number of chapter authors are from Ireland and the second largest from North America. The 15 chapters start with 'A Global Perspective'. There are expected chapters on Body Composition, Energy Metabolism, Proteins and Amino Acids, Carbohydrates, Lipids, Vitamins and Minerals. The other chapters are on Measuring Food Intake, Dietary Reference Standards, Food Composition, Food Policy and Regulation, Nutrition Research Methodology, Food Safety and the book concludes with 'The Global Challenge'. The references after each chapter range in number from two to 16. For a book published primarily in Oxford and for the Nutrition Society it is perhaps a sign of the times that US spelling is used for 'anemia', 'fiber', and 'lipemia'.

A textbook should have (most of) its statements correct, but at a superficial reading I was surprised to find that the capacity of the human intestine to absorb fructose is enormous (page 70), that human milk oligosaccharides are absent from the Carbohydrate chapter, that squalene reduces plasma cholesterol (page 176), that wet beri beri produces chronic heart failure (page 145), that almost all the dietary intake of tryptophan goes to NAD synthesis (page 150), that soluble fibre lowers plasma cholesterol by a similar mechanism to phytosterols (page 111). The paragraph on assessing potassium status (page 193) seems to imply that clinicians should monitor patients' potassium by whole body counting rather than measure plasma potassium.

A textbook ought to be rather conservative and be cautious about the latest fashionable idea, but, for example, the Lipids chapter links atherosclerosis mainly to postprandial lipaemia (page 93). For undergraduates a textbook should explain the main points in simple language but the paragraph on salt and blood pressure (page 190) must leave the reader puzzled about why there are dietary guidelines about this. 'Dietary guidelines' incidentally are not in the index or in the food policy chapter. Other words I noticed to be missing from the index are breast milk, coronary heart disease, carotenoids, food allergy and fruit.

Textbooks, like lectures for undergraduates, at their best make some of their points with stories that students remember long after they have forgotten the scientific minutiae. The late Reg Passmore was a master of doing this, and some American textbook writers use cartoons. But I could not find any stories, cartoons or poetry to make the text here more memorable.

Against these disappointments there are some good and original chapters here, including 'Body Composition' by Deurenberg and Roubenoff, 'Measuring Food Intake' by Rutishauser and Black. 'Food Composition' by West and Schonfeldt, 'Food Safety' by Reilly et al. and 'The Global Challenge' by Shetty.

In our new millennium, with the internet, photocopying and students in debt, I would think there is a place for two levels of nutrition textbooks: an upper level of collected scientific reviews for the teachers, like Shil's Modern Nutrition, and a simpler, cheaper, 'student friendly' book for undergraduates. The first volume of this four-volume new textbook seems to be somewhere in between.

Having also written for textbooks of nutrition, I suggest that ultimately it will be the students, not reviewers, who vote whether a textbook is adopted or not.