- Email: [email protected]
Nutrition and Metabolism of The Surgical Patient, Part I
Nutrition and Metabolism of The Surgical Patient, Part I
Foreword N u t r i t i o n a n d M e t a b o l i s m of T h e Su r g i c a l P a t i e n t , P a r t I
Ronald F. Martin, MD Consulting Editor
"Dis-moi ce que tu manges, je te dirai ce que tu es." [Tell me what you eat and I will tell you what you are]. —Anthelme Brillat-Savarin, 1826 One would be hard pressed to find a medical topic that applies to all people so uniformly and is so widely misunderstood as nutrition. In fact, it is not just the “medical” aspects of nutrition but the everyday aspects of nutrition that are misunderstood as well. In some respects it is not surprising, since there are tremendous forces at play that shape our views and policies about food and nutrition in general. Cultural traditions, religious observances, local preferences, as well as a multitude of other social factors heavily influence the variety and amounts of foodstuffs we all consume. There are also economic (both large and small scale) and political pressures that play out much more than people sometimes realize. At this time of current financial distress on a worldwide basis, the relative prices and availability of food alone are adding to political and economic instability. It is ironic that two of the major medical problems facing us on a global scale are famine and obesity. It is no surprise that the predominant concepts we all have about food and nutrition are more informed by our own history with food than by any scientific understanding of nutrition. Nearly two centuries ago the physiologist Brillat-Savarin asserted that he could tell us what we were if we told him what we ate. The quote above or one of its many derivatives has been used in so many contexts that most people have forgotten (or never knew) that the comment was included in a treatise on the physiology of gout. This issue of the Surgical Clinics of North America is a slight departure from our usual process. Many years ago we decided to contain our topics to single issues. This issue will be the first of a two-part set. The reason for this temporary departure from policy is a confluence of opportunities. The most important reason is that we collectively perceived a gap in the readily available content sources for a comprehensive
Surg Clin N Am 91 (2011) xiii–xiv doi:10.1016/j.suc.2011.04.012 surgical.theclinics.com 0039-6109/11/$ – see front matter Ó 2011 Elsevier Inc. All rights reserved.
xiv
Foreword
but concise collection of articles on the science of nutrition and we felt we had the capability to close that gap. We did, however, realize that if we were to attempt to limit the resources we had to a single issue, we would either lose depth or breadth of the topics to the point where we would not achieve our educational objectives. Our priority is always dissemination of the highest quality content available. That said, all of our content comes from people with real lives and usually more demands put on their time than time to deliver on those requests. Dr Stan Dudrick, who guest edits these two issues with his colleague Dr Juan Sanchez, has played a major if not pivotal role in improving our understanding of nutrition. Dr Dudrick has spent nearly half a century developing an unparalleled understanding of nutrition and in particular how it affects the surgical patient. He has also touched the careers of hundreds if not thousands of surgeons as they trained and practiced. I can personally attest to his kindness and support of not only those people he has worked with directly but also to those who he has met briefly—he is a consummate surgical mentor. Thanks to Dr Dudrick, we have a unique access to an array of people who not only know the facts, as we understand them, about nutrition but many who were responsible for the development of this knowledge. Opportunities to collect such a group of contributors happen rarely; therefore, we decided to seize the chance to provide something truly spectacular for the readership by developing this two-part set. I encourage the reader to devour this issue. Perhaps the knowledge corollary to Brillat-Savarin’s posit might be, “show me what you read and I will tell you what you know.” If so, the consumer of these articles will be considerably better informed about nutrition. Ronald F. Martin, MD Department of Surgery Marshfield Clinic 1000 North Oak Avenue Marshfield, WI 54449, USA E-mail address: [email protected]
Foreword N u t r i t i o n a n d M e t a b o l i s m of T h e Su r g i c a l P a t i e n t , P a r t I
Ronald F. Martin, MD Consulting Editor
"Dis-moi ce que tu manges, je te dirai ce que tu es." [Tell me what you eat and I will tell you what you are]. —Anthelme Brillat-Savarin, 1826 One would be hard pressed to find a medical topic that applies to all people so uniformly and is so widely misunderstood as nutrition. In fact, it is not just the “medical” aspects of nutrition but the everyday aspects of nutrition that are misunderstood as well. In some respects it is not surprising, since there are tremendous forces at play that shape our views and policies about food and nutrition in general. Cultural traditions, religious observances, local preferences, as well as a multitude of other social factors heavily influence the variety and amounts of foodstuffs we all consume. There are also economic (both large and small scale) and political pressures that play out much more than people sometimes realize. At this time of current financial distress on a worldwide basis, the relative prices and availability of food alone are adding to political and economic instability. It is ironic that two of the major medical problems facing us on a global scale are famine and obesity. It is no surprise that the predominant concepts we all have about food and nutrition are more informed by our own history with food than by any scientific understanding of nutrition. Nearly two centuries ago the physiologist Brillat-Savarin asserted that he could tell us what we were if we told him what we ate. The quote above or one of its many derivatives has been used in so many contexts that most people have forgotten (or never knew) that the comment was included in a treatise on the physiology of gout. This issue of the Surgical Clinics of North America is a slight departure from our usual process. Many years ago we decided to contain our topics to single issues. This issue will be the first of a two-part set. The reason for this temporary departure from policy is a confluence of opportunities. The most important reason is that we collectively perceived a gap in the readily available content sources for a comprehensive
Surg Clin N Am 91 (2011) xiii–xiv doi:10.1016/j.suc.2011.04.012 surgical.theclinics.com 0039-6109/11/$ – see front matter Ó 2011 Elsevier Inc. All rights reserved.
xiv
Foreword
but concise collection of articles on the science of nutrition and we felt we had the capability to close that gap. We did, however, realize that if we were to attempt to limit the resources we had to a single issue, we would either lose depth or breadth of the topics to the point where we would not achieve our educational objectives. Our priority is always dissemination of the highest quality content available. That said, all of our content comes from people with real lives and usually more demands put on their time than time to deliver on those requests. Dr Stan Dudrick, who guest edits these two issues with his colleague Dr Juan Sanchez, has played a major if not pivotal role in improving our understanding of nutrition. Dr Dudrick has spent nearly half a century developing an unparalleled understanding of nutrition and in particular how it affects the surgical patient. He has also touched the careers of hundreds if not thousands of surgeons as they trained and practiced. I can personally attest to his kindness and support of not only those people he has worked with directly but also to those who he has met briefly—he is a consummate surgical mentor. Thanks to Dr Dudrick, we have a unique access to an array of people who not only know the facts, as we understand them, about nutrition but many who were responsible for the development of this knowledge. Opportunities to collect such a group of contributors happen rarely; therefore, we decided to seize the chance to provide something truly spectacular for the readership by developing this two-part set. I encourage the reader to devour this issue. Perhaps the knowledge corollary to Brillat-Savarin’s posit might be, “show me what you read and I will tell you what you know.” If so, the consumer of these articles will be considerably better informed about nutrition. Ronald F. Martin, MD Department of Surgery Marshfield Clinic 1000 North Oak Avenue Marshfield, WI 54449, USA E-mail address: [email protected]