Nutrition in the prevention and treatment of disease. (Book Reviews).

Coulston A, Rock C, Monsen E (editors), Academic Press, San Diego, 2001, 801 pages, $238.70, ISBN 0-12-193155-2

This is a major review text, edited by leaders in the field, and designed to 'provide an update of current knowledge in clinical nutrition'. It addresses 'basic principles and concepts that are central to major clinical nutrition related activities' and 'the roles of clinical nutrition...in the prevention and treatment of major disease-specific conditions'. It is designed for the nutrition professional. While it would be eminently suitable for students studying medical nutrition therapy, the book is not in the format of a classic text, not having learning objectives or study questions, meal plans, food lists or similar tools for the implementation of therapies. Rather it is in the form of 48 chapters each of which is a review of the topic and extensively referenced. There is an assumption that the reader has some familiarity with the topic. In order to cover the extensive content 84 authors from specialist fields within medical nutrition therapy have contributed to it. Fifty-one of the authors have doctorates and 45 are registered dietitians, drawn from across the US.

The content is grouped into two sections. The first section, Basic Concepts and Principles, includes five chapters on examining the relationship between diet, nutrition and disease, five on nutrition intervention, four on genetic influences on nutritional health and three on supplements and food replacements. The second section, Disease Specific Intervention: Prevention and Treatment, includes four chapters on cardiovascular disease, five on cancer prevention and therapy, four on diabetes, five on obesity, four on gastrointestinal diseases, eight chapters on other major diseases including renal disease, osteoporosis and a single chapter on overall disease prevention.

Each of the separate chapters takes the reader from an introduction, through the latest evidence to a summary or conclusion and references. For example, the chapter on Physical Assessment, written by Edward Saltzman from Tufts University and Kris Mogensen from the New England Medical Centre, commences with an introduction to the topic, then the components of clinical assessment, anthropometric assessment, clinical manifestations in specific disease states which follows through body systems from oral health to neurologic and psychiatric conditions, prognostic indicators and screening tools for older adults, a summary and 94 references.

The strength of this book lies in the recency, the easy to follow chapters and the large number of contributors. Its weakness, however, lies in that it takes a very particular perspective, that of the US and does not include practical implementation guidelines. Hence in the chapter described above, the tools listed and described are those favoured within the US, rather than an overview of the total pool of tools available to therapists and there is no detail provided of how to undertake anthropometric measurements (this is assumed). The book is large, over 800 pages of quarto size and is somewhat unwieldy and therefore the authors have focussed on theoretical issues given its size. It is well written, contains relatively few graphs, diagrams and illustrations but is well indexed with an excellent table of contents.

Having said this, the book does bring together in one place a wealth of up-to-date information on topics of current interest and as such is an excellent resource for dietitians implementing medical nutrition therapy, providing updates for practitioners in areas in which they do not normally practice. It has not been written for and would not be of interest to students or practitioners of general nutrition, public health, service management, food and nutrition policy or persons without the necessary background in biomedical sciences. Its price reflects its specialist nature and, while expensive, it is reasonable for a book of this size, quality and content.