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Obesity (contemporary issues in clinical nutrition 4)
CLINICAL
NUTRITION
( 1983) 2: 125
Book Reviews
Metabolic
Obesity (Contemporary
Care
David Tweedle Churchill Livingstone,
Issues in Uinical
Nutrition 4)
Edited by M. R. C. Greenwood 1982 264 pages. Price E9.95
Much that needs to be said of the current trends in metabolic care in clinical practice has already been said in the plethora ofbooks which have emanated in the past few years from this country, the USA and Europe. Most of the literature on this topic has assumed a knowledge of the basic concepts, being directed mainly at those working in the field either as clinician or as research worker. This book has the objective of presenting the serious metabolic abnormalities encountered in clinical practice in a straight forward manner for the clinical practitioner who may require more background detail to understand the nature of the metabolic problems he will have to treat. The first few chapters deal with the control of body size and fimction in an easily readable and understandable form, covering body composition, fluid and electrolyte metabolism, acid base balance, shock, starvation and the effect of injury. The approach to these important and fundamental aspects of body function is eminently sensible being without unnecessary detail yet providing an itiormative basis on which to formulate a therapeutic protocol. There are chapters on organ failure and the nutritional requirements in gastrointestinal disease and the remaining four chapters deal with the practical elements ofparenteral and enteral nutrition, there being an especially usefU1 article on paediatric nutrition. This book is excellent, the concise text containing information needed for the management of most metabolic problems which present in clinical practice. It is suitable for the young graduate who needs a handy reference which also contains a great deal of useful basic information on human metabolism. R. G. Clark
QlurchiU Livingstone, 1983214pages. Price k13.00 This book is in two parts: the first five chapters (82 pp) are on ‘Health and treatment’, and the remaining six chapters (121 pp) on ‘New directions in research’. The latter section contains some nuggets for the connoisseur: Drewnowski on measuring palatability, Danforth and Landsberg on thermogenesis, Sullivan and her colleagues with a very thorough review of the potentialities of drug treatment, Johnson and Goldstein on studies on cell lines in culture, and Greenfield and Turkenkopf on genetic aspects of obesity. However, clinicians will be more concerned with the first section, which opens with a chapter by Brunzell, suggesting that the excess cardiovascular mortality in the young obese may reflect genetic disorders (like hyperlipidaemias and diabetes) rather than an effect of the obesity itself. If so, he concludes, “the efforts to modify body weight can be directed against these individuals alone”. If I correctly understand his argument I disagree, but it is an interesting idea. Bj6mtorp contributes a short chapter on adipose tissue cellularity: it is now established that fat cell number is not fixed in childhood, but the prognostic significance of having many fat cells is still controversial. Kral provides a well-balanced review on surgical therapies, and a plea for careful long-term followup of patients after operation. Brownell and Wadden assert that behaviour therapy “is more effective than the alternative treatments to which it has been compared”, but the sceptic may note that only a self-selected subgroup of obese patients is willing to invest the time (and in the USA, money) which is required for behaviour therapy. Stem provides and admirably restrained chapter on diet and excercise, with thumbnail sketches of popular reducing diets at the end. There is a good subject index at the end. I liked the book which does, as Dr Greenwood says in the preface, provide use&l information about obesity treatment and research. J. S. Garrow
NUTRITION
( 1983) 2: 125
Book Reviews
Metabolic
Obesity (Contemporary
Care
David Tweedle Churchill Livingstone,
Issues in Uinical
Nutrition 4)
Edited by M. R. C. Greenwood 1982 264 pages. Price E9.95
Much that needs to be said of the current trends in metabolic care in clinical practice has already been said in the plethora ofbooks which have emanated in the past few years from this country, the USA and Europe. Most of the literature on this topic has assumed a knowledge of the basic concepts, being directed mainly at those working in the field either as clinician or as research worker. This book has the objective of presenting the serious metabolic abnormalities encountered in clinical practice in a straight forward manner for the clinical practitioner who may require more background detail to understand the nature of the metabolic problems he will have to treat. The first few chapters deal with the control of body size and fimction in an easily readable and understandable form, covering body composition, fluid and electrolyte metabolism, acid base balance, shock, starvation and the effect of injury. The approach to these important and fundamental aspects of body function is eminently sensible being without unnecessary detail yet providing an itiormative basis on which to formulate a therapeutic protocol. There are chapters on organ failure and the nutritional requirements in gastrointestinal disease and the remaining four chapters deal with the practical elements ofparenteral and enteral nutrition, there being an especially usefU1 article on paediatric nutrition. This book is excellent, the concise text containing information needed for the management of most metabolic problems which present in clinical practice. It is suitable for the young graduate who needs a handy reference which also contains a great deal of useful basic information on human metabolism. R. G. Clark
QlurchiU Livingstone, 1983214pages. Price k13.00 This book is in two parts: the first five chapters (82 pp) are on ‘Health and treatment’, and the remaining six chapters (121 pp) on ‘New directions in research’. The latter section contains some nuggets for the connoisseur: Drewnowski on measuring palatability, Danforth and Landsberg on thermogenesis, Sullivan and her colleagues with a very thorough review of the potentialities of drug treatment, Johnson and Goldstein on studies on cell lines in culture, and Greenfield and Turkenkopf on genetic aspects of obesity. However, clinicians will be more concerned with the first section, which opens with a chapter by Brunzell, suggesting that the excess cardiovascular mortality in the young obese may reflect genetic disorders (like hyperlipidaemias and diabetes) rather than an effect of the obesity itself. If so, he concludes, “the efforts to modify body weight can be directed against these individuals alone”. If I correctly understand his argument I disagree, but it is an interesting idea. Bj6mtorp contributes a short chapter on adipose tissue cellularity: it is now established that fat cell number is not fixed in childhood, but the prognostic significance of having many fat cells is still controversial. Kral provides a well-balanced review on surgical therapies, and a plea for careful long-term followup of patients after operation. Brownell and Wadden assert that behaviour therapy “is more effective than the alternative treatments to which it has been compared”, but the sceptic may note that only a self-selected subgroup of obese patients is willing to invest the time (and in the USA, money) which is required for behaviour therapy. Stem provides and admirably restrained chapter on diet and excercise, with thumbnail sketches of popular reducing diets at the end. There is a good subject index at the end. I liked the book which does, as Dr Greenwood says in the preface, provide use&l information about obesity treatment and research. J. S. Garrow