Though much has been realized about individual nutritional requirements in the last several decades, interest in diet and nutrition can be traced back in history for thousands of years. Awareness of the importance of nutrition and diet in human health can be observed in the recordings of the ancient Greeks and Romans (79).
Many Greek writings in this era refer to energy requirements and a balanced diet for health, and that certain diseases can be treated with diet. For example, Hippocrates in the fourth century BC, formed a theory about the relationship between food and health that was followed for centuries (17). These early writ- ings in nutrition laid the foundation for the expansion of our understanding of how food intake affects health, sport, and athletic performance.
Early History of Nutrition for Health
The word “nutrition” in its various forms of the English language appears to have originated somewhere between the fi fteenth and sixteenth century. Throughout the seventeenth and eighteenth centuries, physicians and scientists used nutritional
Table 6.1 Nutritional Strategies for Enhancing Sport and Athletic Performance
NUTRITIONAL STRATEGY
EFFECTS ON PHYSIOLOGIC FUNCTION AND PERFORMANCE
Increased carbohydrate consumption prior to prolonged exercise
Maximizes muscle glycogen prior to exercise, which delays glycogen depletion and fatigue Carbohydrate and fluid ingestion during
exercise
Spares muscle glycogen, maintains blood glucose concentration, maintains plasma volume, and prevents dehydration and fatigue
Adequate protein intake when combined with a resistance exercise training program
Maximizes lean mass development
Hypercholesterolemia The presence of high levels of cholesterol in the blood.
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interventions as part of experiments on diseased individuals. For example, it was observed during this time period that increased iron intake could improve ane- mia and citrus fruit consumption could cure scurvy. During the early nineteenth century, François Magendie noted that dogs fed on only carbohydrate and fat lost body protein and died within a few weeks but dogs fed on a diet of carbohy- drate, fat, and protein survived. This experiment demonstrated the importance of protein in the diet of animals (79).
In the early twentieth century, “diet” and “dietetics” were terms used widely when referring to problems relating to food (79) and several important advance- ments were made. In 1903, W.O. Atwater and Francis Gano Benedict invented a respiration chamber (Figure 6.3) and performed very accurate direct calorimetry and indirect calorimetry measurements of food metabolism and energy balance (67). These experiments formed the foundation for future work in the areas of energy intake and energy expenditure. In 1936, Eugene Du Bois coined the term basal metabolic rate and examined the relationship between age, gender, and weight (74). In 1937, Clive McCay demonstrated that restricting energy intake of rats by 33% led to increased longevity (by 25%), especially if simple carbohydrates were restricted (67). Ancel Keys from the University of Minnesota studied the infl uence of diet on health, in particular, the effects of different kinds of dietary fat on health. Keys was closely associated with two famous diets: Keys rations (more commonly known as K-rations), formulated as balanced meals for combat soldiers in World War II, and the “Mediterranean diet,” which he popularized. Keys was also involved in the Minnesota Starvation Experiment, that provided consider- able insight into the physiologic and psychological effects of severe and prolonged dietary restriction and the effectiveness of dietary rehabilitation strategies (46).
The recognition of nutrition as an academic discipline occurred in 1933 with the founding of the American Institute of Nutrition (AIN), which was instrumental in promoting nutrition as a science. The founding members of the AIN identifi ed their disciplinary fi elds as nutrition, animal nutrition, chemistry, agricultural chem- istry, biochemistry, physiologic chemistry, physiology, and anatomy. This diversity of background remains evident today with individuals from a wide variety of disciplines working in the fi eld of nutrition and nutrition science. Although AIN has changed
FIGURE 6.3 ▼ A human calorimeter.
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its name to the American Society for Nutrition, it remains a premier research society dedicated to improving the quality of life through the science of nutrition (79).
During the early twentieth century, several laboratories were established to advance the understanding of nutrition. In 1904, The Nutrition Laboratory at the Carnegie Institute was created to study nutrition and energy metabolism. Estab- lished in 1927, the Harvard Fatigue Laboratory allowed for the further expansion of scientifi c research in the area of exercise and sport nutrition (78). Early scientifi c research in nutrition aimed to identify all the essential nutrients and the dietary requirements for each nutrient. Additional work was done to determine the distri- bution of each nutrient in various foods in an effort to defi ne a nutritionally ade- quate diet or analyze a diet and determine whether it was nutritionally balanced for good health. This early research provided the foundation for the various computer databases that exist to provide both diet analysis and nutritional prescription (79).
Recent History of Nutrition for Health
The role of nutrition, particularly as it relates to chronic disease development, has received considerable attention over the last 50 years. Epidemiologic studies have provided us with much understanding of how various nutritional patterns infl uence the development of cardiovascular disease, cancer, and other diseases affected by individual’s food intake (39). The Framington Heart Study (44), the Harvard Alumni Study (69), and the National Cholesterol Education Program (87) have helped iden- tify specifi c dietary factors that are associated with cardiovascular disease including the consumption of high levels of saturated fat and cholesterol (62,63).
One of the most signifi cant long-term epidemiologic studies about nutri- tion and health is the National Health and Nutrition Examination Survey (NHANES). NHANES began as a result of the National Health Survey Act of 1956, which was intended to establish a continuing National Health Survey to obtain information about the health status of U.S. citizens, including the services received for or because of health conditions. The fi rst three National Health Examination Surveys (NHES I, II, and III) were conducted between 1959 and 1970. In response to numerous nutrition-related studies, the U.S.
Department of Health, Education, and Welfare established a continuing National Nutrition Surveillance System in 1969 in an effort to measure the nutritional status of the U.S. population and monitor changes over time. The National Nutrition Surveillance System was merged with the National Health Examination Survey creating NHANES (64). Table 6.2 provides the dates and specifi c target groups and foci of the various surveys. Data from NHANES have
Direct calorimetry The measurement of heat produced by a chemical reaction or by the body.
Indirect calorimetry The measurement of energy production by the body using the amount of oxygen consumed and carbon dioxide produced.
Basal metabolic rate The level of metabolism, as measured by energy expenditure, required to maintain the normal physiologic functions of the body.
Epidemiologic studies The study of factors affecting the health and disease of large groups of individuals.
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