Manual of dietetic practice. Third edition. (Book Reviews).

Thomas B, editor, Blackwell Science, London, 2001, 758 pages, $210.10. ISBN 0-632-05524-3.

This Manual of Dietetic Practice was first published in 1988 and had to be reprinted. The second edition (1994) was reprinted seven times! This is as near as one can get to a best-seller in the fairly small dietetics-nutrition market. The manual covers nearly all aspects of a British dietitian's work. Dame Barbara Clayton, the Honorary President of the British Dietetic Association (BDA) writes in the foreword that she is overwhelmed by the thoroughness of the coverage. She tried to find something that was missing and failed.

The manual is published in conjunction with the BDA (clearly stated on the cover) and Dr Briony Thomas, the editor, worked with five other dietitians as the steering committee, with 36 major contributors (all but one SRDs) and 56 other contributors (all but two being SRDs). There was also input from 18 different special interest and advisory groups of the BDA and from another 28 other people and organisations (including dietitians in industry).

The 99 chapters are grouped in six sections. The first 19 are on general dietetic principles, from healthy eating, food composition tables, through dietary modifications, different feeding methods to professional practice, clinical effectiveness and healthcare ethics. Section two has 12 chapters on carbohydrates, proteins, flits, etc, but also on biologically active constituents, food law and labelling.

The third section has 12 chapters on nutritional needs of different subgroups. Particularly interesting is the substantial chapter on the food habits of the main ethnic minority groups in Britain. Section four has 39 chapters on all the different diseases that a dietitian might be asked to help manage. Prader Willi syndrome gets 11 pages and diabetes is (appropriately) the longest chapter. There are many good things in this major section. I was particularly interested in a second supplementary short chapter on obesity (chapter 4.18) which, in effect discusses sensibly how we can make the best of the situation for those obese people who are not going to lose much weight. Section 5 has chapters on the dietetic management of different types of acute trauma, starting with metabolic consequences of injury and the principles of intensive care. The last section is appendixes--dietary reference data energy prediction references, nutritional supplements, etc, and concludes (chapter 6.8) with 400 very useful medical a bbreviations: A + W, FBC, NAD, PUO, TCA, UTT and many more. With each chapter there is a good list of up to date references, predominantly British, and useful addresses of patient associations.

This book is indeed a magnum opus. Presumably every practising dietitian and dietetics student in the UK has their own copy--or one provided by their institution. Australian dietitians who have the first edition may well want to exchange it for this new one and those who do not know the manual should seriously weigh up whether to invest in this third edition. The market in Australia is not big enough for us to have our own manual of this quality and most of the material here is of relevance to practice in the Antipodes.

Challenged by Dame Barbara I looked hard for something missing. Inborn errors of metabolism (briefly covered in the first edition) are not here, and I could not find mention of Meals-on-Wheels. For coronary heart disease, [omega]-6 (or n-6) PUFA and linoleac acid have been rather pushed aside by trendy [omega]-3s, and for hypertension some numerical details about low salt diets would strengthen this chapter.