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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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EXAMINING
SPECIAL
NUTRITIONAL
REQUIREMENTS

IN DISEASE STATES

PROCEEDINGS OF A WORKSHOP

Anne Brown Rodgers, Rapporteur

Food and Nutrition Board

Health and Medicine Division

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Washington, DC
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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This activity was supported by contracts between the National Academy of Sciences and the Academy of Nutrition and Dietetics; American Society for Nutrition; Crohn’s & Colitis Foundation; Health Canada; National Institutes of Health; and U.S. Food and Drug Administration. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-47837-3
International Standard Book Number-10: 0-309-47837-5
Digital Object Identifier: https://doi.org/10.17226/25164

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Examining special nutritional requirements in disease states: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25164.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
×

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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
×

images

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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PLANNING COMMITTEE ON EXAMINING SPECIAL NUTRITIONAL REQUIREMENTS FOR DISEASE STATES—A WORKSHOP1

BARBARA O. SCHNEEMAN (Chair), Professor Emerita, University of California, Davis

PATSY M. BRANNON, Professor, Division of Nutritional Sciences, Cornell University, Ithaca, NY

STEVEN K. CLINTON, Professor, Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus

ALEX R. KEMPER, Chief of the Division of Ambulatory Pediatrics, Nationwide Children’s Hospital, Columbus, OH

ERIN MACLEOD, Director of Metabolic Nutrition, Division of Genetics and Metabolism, Children’s National Health System, Washington, DC

BERNADETTE P. MARRIOTT, Professor, Division of Gastroenterology and Hepatology, Department of Medicine, and Professor, Military Division, Department of Psychiatry, Medical University of South Carolina, Charleston

PATRICK J. STOVER, Vice Chancellor and Dean for Agriculture and Life Sciences at Texas A&M AgriLife, College Station

DAVID L. SUSKIND, Professor of Pediatrics, Division of Gastroenterology, Seattle Children’s Hospital, Washington

GARY D. WU, Ferdinand G. Weisbrod Professor in Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia

Health and Medicine Division Staff

MARIA ORIA, Study Director

ALICE VOROSMARTI, Research Associate

CYPRESS LYNX, Senior Program Assistant

ANN L. YAKTINE, Director, Food and Nutrition Board

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the National Academies.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

JOHN W. ERDMAN, Emeritus, University of Illinois at Urbana-Champaign

DENISE M. NEY, University of Wisconsin–Madison

ROBERT M. RUSSELL, Emeritus, Tufts University School of Medicine

DAVID L. SUSKIND, Seattle Children’s Hospital

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by A. CATHERINE ROSS, The Pennsylvania State University. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Acronyms and Abbreviations

AI

Adequate Intake

AND

Academy of Nutrition and Dietetics

ASN

American Society for Nutrition

ATP

adenosine triphosphate

BBB

blood–brain barrier

BMI

body mass index

BOND

Biomarkers of Nutrition for Development

BRINDA

Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia

CF

cystic fibrosis

CFD

cerebral folate deficiency

CFTR

cystic fibrosis transmembrane conductance regulator

CHOP

Children’s Hospital of Pennsylvania

CKD

chronic kidney disease

CRP

C-reactive protein

CSF

cerebrospinal fluid

DHA

docosahexaenoic acid

DNA

deoxyribonucleic acid

DoD

Department of Defense

DRI

Dietary Reference Intake

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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EAR

Estimated Average Requirement

EEN

exclusive enteral nutrition

EPA

eicosapentaenoic acid

FARMM

Food and Resulting Microbial Metabolites

FDA

U.S. Food and Drug Administration

FODMAP

fermentable oligosaccharides, disaccharides, monosaccharides, and polyols

GFR

glomerular filtration rate

GI

gastrointestinal

GMP

glycomacropeptide

GRADE

Grading of Recommendations Assessment, Development and Evaluation

IBD

inflammatory bowel disease

IOM

Institute of Medicine

MELAS

mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes

MMA

methylmalonic aciduria

NAD+

nicotinamide adenine dinucleotide

NADH

nicotinamide adenine dinucleotide + hydrogen

NADPH

nicotinamide adenine dinucleotide phosphate

NHANES

National Health and Nutrition Examination Survey

NIH

National Institutes of Health

NOS

nitric oxide synthase

PAH

phenylalanine hydroxylase

PEW

protein energy wasting

Phe

phenylalanine

PICO

Population, Intervention, Comparisons, Outcomes

PKU

phenylketonuria

PLP

pyridoxal phosphate

RCT

randomized controlled trial

RD

registered dietitian

RDA

Recommended Dietary Allowance

TBI

traumatic brain injury

Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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UL

Tolerable Upper Intake Level

WCRF-AICR

World Cancer Research Fund and the American Institute for Cancer Research

WHO

World Health Organization

Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Special Nutritional Requirements in Disease States: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25164.
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The amount of nutrients required by an individual is determined by a number of physiological processes, including absorption, metabolism, stability, and bio-activation. These processes determine nutrient needs and provide variations in requirements in the population. All have modifiers and sensitizers, such as sex, genetics, pregnancy, age, pharmaceuticals, toxins, food matrix, and epigenetics. Disease can also be a major modifier of these processes. In April 2018, the National Academies of Science, Engineering and Medicine convened a workshop in order to explore the evidence for special nutritional requirements in disease states and the medical conditions that cannot be met with a normal diet. Participants explored the impact a disease state can have on nutrient metabolism and nutritional status, and attempted to close informational gaps. This publication summarizes the presentations and discussions from the workshop.

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