CHAPTER 7 Nutrition Roger A Shewmaker The goal of this chapter is to provide evidence-based information to help clinicians counsel patients regarding the latest nutritional approaches to di isease prevention and health promotion. It also attempts to clarify the strong relationships between nutrition and the prevention of chronic disease and the important influence of nutrient deficiencies and excesses For a large majority of the population, the food choices made daily over time, will either benefit or impair health. Food choices and habits are very complex and personal issues that reflect preferences developed through association with family and friends, as well as habits developed through ones ethnic heritage, culture, traditions, ethnicity religion, and social interactions Food is used for celebrations of all aspects of life and therefore can serve as"comfort foods, "especially at emotionally stressful times. In the current rushed environment, the availability, convenience, and economy of food often sway personal choices. Individuals select foods for a variety of reasons but the diet ingested over time can make important contributions to health Nutrient effects are a common thread that runs through many of the chronic diseases that affect populations Consuming a diet high in refined carbohydrates and fat, along with low-fiber intake, high caloric density, low nutrient density, and inadequate physical activity, are common risk factors for cardiovascular disease, diabetes, obesity, and hypertension among other diseases and negative health conditions. As discussed in Chapter 8 the prevalence of overweight and obesity is increasing in the United States, which in turn increases the risk of many chronic diseases(e. g, hypertension, diabetes, and some forms of cancer)and of premature death. See Chapter 8 for further details on the assessment and treatment of overweight and obesity According to the American Heart Association(AHA)(1) 1."There are dietary and other lifestyle practices that all individuals can safely follow throughout the lifespan as a foundation for achieving and maintaining cardiovascular and overall health over an extended period of time and not on the intake of a single meal take 2. Healthy dietary practices are based on one's overall pattern of food in