Book review: Advanced Nutrition and Dietetics in Gastroenterology
Reviewed by Yvonne McKenzie, Clinical lead in IBS of the BDA Gastroenterology Specialist Group.
Edited by Miranda Lomer
Series Editor Kevin Whelan.
The gastrointestinal (GI) and hepatobiliary tract cuts into the heart of nutrition as the playing field that affects numerous functions throughout the human body and ultimately determines the risk for disorders and diseases in and beyond the gut such as obesity, diabetes and cardiovascular disease.
No surprise, then, that Advanced Nutrition and Dietetics in Gastroenterology is the first
title in a new book series, between the British Dietetic Association and the publishers, Wiley-Blackwell, of the new fifth edition of the Manual of Dietetic Practice.
Pitched at an advanced level to the Manual, 313 pages divide into four sections:
- Physiology and function of the GI and hepatobiliary tract including all the major organs, the gastrointestinal microbiota and the role of the gut neuroendocrine system in appetite regulation
- Dietary components relevant to GI
- health, on fibre, short-chain fermentable
- carbohydrates, probiotics and prebiotics
- GI disorders
- Hepatobiliary disorders
The last two sections relate to the pathogenesis, nutritional consequences and dietary management of disease, complementing the format of the Manual.
The 43 chapters were edited by Senior Consultant Dietitian Miranda Lomer, the first chair of the BDA Gastroenterology Specialist Group (GSG) and this year’s award winner
of the BDA’s prestigious Elsie Widdowson annual lecture. The book is an outstanding, authoritative collaboration with 71 key opinion leaders dedicated to gastroenterology and hepatology: over 80% are UK dietitians, gastroenterologists, surgeons and scientists.
Just under 40% are dietitians, a justifiable number as reflected in the forward by Professor Colm O’Morain, President of the United European Gastroenterology Federation 2011-13: “the first question the patient asks when faced with gastrointestinal problems is regarding diet”.
Among the intended readership are clinical dietitians treating adults or children, research dietitians and those in tertiary dietetics and nutrition education (educators and final year BSc and MSc students). And who better to oversee such a major initiative than Kevin Whelan, Professor of Dietetics and Associate Editor-in-Chief for the Journal
of Human Nutrition and Dietetics? This comprehensive yet handy (24.4x17x1.5cm), sturdy paperback costs £39.99 , you may find it discounted by about £5.00.
Also available as an e-book: with Apple iBooks on a Mac or iOS device (£31.99) or Kindle (£30.69). The book is presented well in black and white, although a few figures would have
been more meaningful in colour. The book’s logical layout is commendable, helping readers to efficiently utilise the book.
Small bites of information are aided by:
- clear subheadings to focus on concise details (e.g. nutritional status of colorectal cancer patients, p257-260)
- useful tables and figures (e.g. ESPEN guidelines on enteral nutrition: non-surgical oncology, giving recommendations with grade of evidence, investigation of persistent symptoms on a gluten-free diet, figure, p165)
- sign posting (e.g. guidelines for the provision of enteral nutrition as primary therapy in Crohn’s disease, table, p192)
In individual chapters, with pathways of knowledge gained through the concise linking of disorder/disease causality to evidence-based critical reviews relating to food and nutrition to considered judgment for treatment to insight into future research. For example, in chapter 3.3 on Gastro-oesophageal reflux disease, compared to its equivalent in the Manual, a deeper understanding may be gained of the evidence-base on diet:
a) causing reflux (meal volume, consistency and macronutrient intakes, as well as beverages and eating behaviour) and
b) as efficacious treatment, with detail given on research needs.
Non-dietary factors, such as physical activity, pharmacotherapy and other therapies, provide a helpful perspective to treatment strategies.
Hot topics in gastroenterology include our GI microbiota and the effects of dietary
carbohydrates (e.g. FODMAPs). These chapters are well worth reading as part of your paediatric or adult dietetic CPD: “Current research has shown a connection between the microbiota and health issues such as obesity, diabetes, cancer, autism, allergies, inflammatory bowel disease and irritable bowel syndrome” (p45) - text to inspire your own further education or research?
As a former acting chair of the GSG of the BDA, I highly recommend this book. It belongs on the bookshelf (real or virtual) of every dietetic department or practice, and is
unlikely to collect dust.
The BDA has launched an advanced nutrition book series featuring books that cover a range of dietetic specialisms. Find out more about the book series here.