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May 2006

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Section Clinical Essentials

IV Diet and Exercise
Harvey B. Simon, M.D., F.A.C.P.
Associate Professor of Medicine, Harvard Medical School and Whitaker College of Health Sciences and Technology, Massachusetts Institute of Technology, and Physician, Massachusetts General Hospital

Poor nutrition and inadequate exercise substantially increase the risk of such maladies as coronary artery disease, hypertension, stroke, diabetes, obesity, osteoporosis, and certain cancers and account for about 300,000 deaths in the United States each year. This chapter is divided into sections on diet and on exercise. In the section on diet, discussion focuses on the body's energy requirements and the various nutrients that meet those needs—namely, fat, carbohydrates, dietary fiber, protein, vitamins, and minerals. Also discussed are the main foods from which nutrients are derived, including fruits and vegetables, legumes, grains, meat and poultry, dairy products and eggs, fish, cooking oils, and nuts. The exercise section describes the body's cardiovascular, pulmonary, musculoskeletal, metabolic, hematologic, and psychological responses to exercise and discusses the positive impact that exercise has on aging and longevity, with focus on primary and secondary prevention of heart disease. Recommendations are given for prescribing exercise for individuals of differing age and health status, as well as for the prevention and management of medical complications associated with exercise. Tables present the recommended daily allowances of essential minerals; recommendations for fat intake; food sources of dietary fiber; functions, deficiency effects, and recommended daily allowances of vitamins; dietary guidelines for healthy people; exercise requirements; and exercise advice for patients. Figures illustrate how exercise burns fat, as well as the molecular structures of fat and cholesterol. This chapter contains 157 references.


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