Test Bank for Wardlaw's Perspectives in Nutrition: A Functional Approach 3rd Edition by Carol Byrd-B by StudyGuide

CHAPTER 1 1) The science of food; the nutrients and substances therein; and their action, interaction, and balance in relation to health and disease is a definition of ________. A) life B) energy metabolism C) nutrition D) food science

The leading cause of nutrition-related death in the United States is ________. A) heart disease B) homicide C) suicide D) diabetes

3) Nutrients causing some signs of poor health when consumed in less than adequate amounts are called ________. A) essential nutrients B) nonessential nutrients C) nutritional supplements D) trace nutrients

Energy-yielding nutrients include ________.

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A) vitamins, minerals, and water B) carbohydrates, proteins, and fats C) trace minerals and fat-soluble vitamins D) iron, vitamin C, and potassium

Sugars, starches, and dietary fibers are examples of ________. A) proteins B) vitamins C) carbohydrates D) minerals

Which of the following are sources of carbohydrates? A) Grains B) Fruits C) Vegetables D) All of these aresources of carbohydrates.

Which is NOT a complex carbohydrate? A) Glycogen B) Glucose C) Fiber D) Starch

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8) Macronutrients are needed in _______ quantities in the diet, as compared to micronutrients. A) larger B) smaller C) similar

Carbohydrates can be described as ________.

A) sugars, starches, and fibers B) compounds needed in tiny amounts C) made of building blocks called amino acids D) inorganic molecules regulating chemical reactions and comprising part of some body structures

10)

An important function of carbohydrates is to ________. A) supply energy B) provide amino acids C) absorb and transport vitamins D) promote growth and tissue repair

11) Which of the following are complex carbohydrates not broken down by digestive processes: A) glycogen B) enzymes C) fiber D) starches

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12)

Glucose is classified as a ________. A) simple sugar B) dietary starch C) polysaccharide D) dietary fiber

13)

A triglyceride is an example of a ________. A) protein B) carbohydrate C) lipid D) vitamin

14)

Lipids can be described as ________. A) sugars, starches, and fibers B) compounds needed in minute amounts C) mostly fats and oils D) made of building blocks called amino acids

15)

The major form of lipid in foods is a(n) ________. A) triglyceride B) amino acid C) fatty acid D) glycerol

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16)

The main structural material of the body is ________. A) lipid B) carbohydrate C) protein D) minerals

17)

Proteins are formed by linking together ________. A) fatty acids B) amino acids C) glycerol D) chlorine compounds

18)

Proteins can be described as ________.

A) sugars, starches, and fibers B) mostly fats and oils C) made of building blocks called amino acids D) inorganic molecules regulating chemical reactions and comprising part of some body structures

19)

The main function of vitamins is to ________.

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A) provide the main structural building blocks of the body B) provide essential fatty acids C) enable chemical reactions in the body to occur D) improve digestion processes

20)

Examples of water-soluble vitamins include ________. A) vitamins A and E B) vitamins D and K C) vitamin C and the B-vitamins D) calcium and iron

21)

Which of the following is a trace mineral? A) Sodium B) Calcium C) Iron D) Potassium

22)

Minerals are needed for ________. A) skeletal system B) functioning of the nervous system C) water balance D) All of these choices are correct. E) None of these choices are correct.

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23) Which of the following is a vital component of the body, acting as a solvent, lubricant, temperature regulator, and transport medium: A) fat B) carbohydrate C) protein D) water

24)

Energy obtained by the body from food is used to ________. A) build new compounds B) move the muscles C) transmit nerve impulses D) balance ions within cells E) perform all of these functions

25)

Phytochemicals are ________. A) available in vitamin and mineral supplements only B) essential parts of a diet C) chemicals found in plants and animal products D) plant substances that provide health benefits

26) Which of the following is the term for a food that provides health benefits beyond the vitamins and minerals it contains? A) Functional food B) Formative food C) Phytonutrient D) Probiotic

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27) "The amount of heat required to raise the temperature of 1000 grams of water one degree Celsius" is the definition of ________. A) energy B) kilojoule C) kilocalorie D) physiological fuel value

28)

In North America, the main sources of protein are ________. A) rice, beans, and corn B) meat and pasta C) meat, seafood, eggs, and dairy products D) pasta, breads, and potatoes

29)

About 50% of the American dietary intake of carbohydrate is derived from ________. A) animal sources B) dietary fats and oils C) dietary starches D) dietary fiber

30)

Most North Americans could improve their diets by ________.

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A) eating more foods rich in vitamins A and E B) increasing sodium intake C) lowering iron and calcium intake D) eating fewer whole-grain breads

31)

The psychological desire to eat certain foods and reject others is defined by: A) hunger B) the physical needfor food C) appetite D) culture

32) Many factors influence food choices. Which factor relates to the knowledge, beliefs, religion, and traditions shared by a group of people? A) Food marketing B) Lifestyle C) Education and occupation D) Culture

33)

Which factor(s) affect food choice? A) Lifestyle B) Food cost C) Food marketing D) None of these factors affect food choice. E) All of these factors affect food choice

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34) When body systems are operating normally and nutrient stores are being maintained, an individual is said to be ________. A) in desirable nutritional status B) in a state of overnutrition C) experiencing undernutrition D) experiencing malnutrition

35)

Nutrition-related objectives of Healthy People include ________. A) increasing fat intake, vitamin A intake, and reducingobesity B) reducing adult obesity, increasing calcium intake, and increasing sodium intake C) increasing vegetable intake, increasing calcium intake, and reducing childhood

obesity D) lowering fat intake, increasing protein intake, and increasing blood cholesterol

36)

The main objective of Healthy People 2030 is to help Americans ________.

A) attain healthy, thriving lives and well being, free frompreventable disease disability, injury, and premature death. B) lose weight and increase vegetable intake C) by promoting intake of minerals among those age 2 years and older D) increase intake of fruits, vegetables, and whole grains

37)

An environmental assessment includes studying a person's ________.

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A) education and economic background B) family medical history C) usual dietary intake D) medication use

38)

An evaluation of nutritional health includes ________. A) anthropometric measurements B) dietary assessment C) biochemical assessment D) medical history E) All of these choices are correct

39) _____ dictate(s) the types and amounts of nutrients in food that will be transformed and reassembled into body structures and compounds. A) Essential fats B) Genes C) Energy expenditure D) Dietary choices

40)

A possible explanation for a natural phenomenon is a ________. A) law B) model C) theory D) hypothesis

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41)

The study of the distribution of disease in human populations is ________. A) epidemiology B) dermatology C) statistics D) biometry

42) A study that compares matched individuals with and without a known medical condition is known as a ________. A) double-blind study B) matched study C) case-control study D) control group study

43) An inert substance with no biological activity or a fake medicine that is used in controlled experiments is called a ________. A) placebo B) blind substance C) double-blind substance D) controlled substance

44) A study that examines changes in health as people move from one country to another is called a ________.

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A) cohort study B) migrant study C) case-control study D) control group study

45) In a double-blind study, who knows which participants are getting the treatment or placebo? A) Only the researchers B) Only the participants C) Only an independent third party D) Both the researchers and participants

46)

Which is NOT a characteristic of anessential nutrient?

A) It has a specific biological function. B) Removing it from the diet causes a reduction in biological function. C) Adding it to a deficient diet restores body functions back to normal if it is added before permanent damage occurs. D) The body can create these nutrients on its own.

47)

Which nutrients regulate body processes? A) Proteins and carbohydrates B) Carbohydrates, somelipids, and water C) Some lipids, some vitamins, and some minerals. D) All nutrients help regulate body processes.

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48)

Which is true about saturated fats? A) Saturated fats raise blood cholesterol. B) Saturated fats tend to be solid at room temperature. C) Many animal fats are rich in saturated fats. D) Saturated fatsprovide 9 kilocalories per gram. E) All of thesestatements are true.

49)

Which is true about essential fatty acids? A) The body can makethem from nonessential fatty acids. B) They help regulate blood pressure and nerve transmission. C) They are found primarily in deep-fried foods. D) They are linked toincreased risk of heart disease.

50)

Which element is found in protein, but not in carbohydrates? A) Nitrogen B) Carbon C) Hydrogen D) Oxygen

51)

Which nutrients are organic compounds?

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A) Water and carbohydrates B) Carbohydrates and protein C) Fats and minerals D) Water and minerals

52)

Which nutrient is an inorganic substance? A) Vitamin A B) Zinc C) Protein D) Thiamin

53)

Which nutrients do NOT provide energy? A) Water and carbohydrate B) Minerals and vitamins C) Vitamins and protein D) Water, minerals, and lipids

54)

Which is NOT true of water? A) It is a medium for transporting nutrients throughout the body. B) It is an organic substance. C) It is the nutrient needed in the largest quantity. D) It acts as a lubricant in the body.

55) A snack bar contains about 17 grams of carbohydrates, 1 gram of fat, and 1 gram of protein. How many kcals does it contain? Version 1

A) 19 B) 43 C) 81 D) 210

56) One slice of bread contains 18 g carbohydrates, 4 g protein, and 1.5 g fat. Approximately how many kcal are in one slice? A) 24 B) 94 C) 100 D) 210

57) If a total of 2000 kcal were consumed (energy came from 250 grams of carbohydrates, 66 grams of fat, and 102 grams of protein), what percentage of energy comes from carbohydrates, fat, and protein? A) 30% carbohydrate, 50% fat, and 20% protein B) 50% carbohydrate, 35% fat, and 15% protein C) 20% carbohydrate, 30% fat, and 50% protein D) 50% carbohydrate, 30% fat, and 20% protein

58)

Undernutrition can lead to ________. A) depleted nutrient stores B) possible slowdown in metabolic processes C) few symptoms in the early stages D) All of these responses are correct.

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59)

An example of anthropometric assessment is _________. A) analyzing compounds in the blood B) assessing the ability to walk C) measuring skinfold thickness D) taking a medical history

60)

Which is a limitation of nutritional assessment? A) Many signs andsymptoms of nutrient deficiency disease are not very specific. B) Many signs andsymptoms of nutrient deficiency disease take a long time to occur. C) It is hard to linkmany signs and symptoms to dietary intake. D) All of these arelimitations of nutritional assessment. E) None of these are limitations of nutritional assessment.

61) Major chronic diseases, such as heart disease, certain cancers, and cirrhosis of the liver, may be related to ________. A) eating a healthy diet B) eating a poor diet C) exercising regularly D) taking nutritional supplements

62)

A potential health problem associated with high dietary fat intake is ________.

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A) cataracts B) lung cancer C) colon cancer D) osteoporosis

63) A health problem most likely is ________.

NOT associated with low intake of fruits and vegetables

A) colon cancer B) liver disease C) cataracts D) lung cancer

64)

What health practices would reduce the risk for chronic diseases? A) Eating a healthfuldiet B) Not smoking andlimiting alcohol intake C) Limiting stress oradjusting the causes of the stress D) All of these choices are correct. E) None of these choices are correct.

65) A person genetically at risk for heart disease could potentially delay the onset of this disease by ________. A) getting regular exercise B) avoiding obesity C) eating a healthy diet D) All of these choicesare correct. E) None of these choices are correct.

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66) Which of the following is most likely a dependable source for up-to-date, accurate nutrition information? A) Supplement manufacturer's website B) Registered dietitian/nutritionist C) Health food store manager D) Women's magazine

67)

The study of how a person's genes interact with nutrients is termed _____________. A) genetic counseling B) nutritional genomics C) genetic metabolomics D) nutritional nucleic acid pool

68) For which of the following titles must the individual be college educated and pass a national examination administered by the Academy of Nutrition and Dietetics? A) Medical doctor B) Registered dietitian/nutritionist C) Certified nutritionist D) Certified nutrition therapist

69) Which of the following nutritional assessment would best be used to determine if there is a subclinical deficiency present?

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A) Anthropometric assessment B) Clinical assessment C) Environmental assessment D) Biochemical assessment

70)

How is a placebo group used in an experiment?

A) All subjects are similar. B) All subjects receive a treatment. C) Neither subjects nor researchers know who is receiving treatment. D) One group of subjects receives a treatment and the other group receives a fake treatment.

71) A critical evaluation and synthesis of research studies focusing on a specific topic that is useful for health-care providers is a(n) _________________. A) systematic review B) peer-reviewed journal C) hypothesis D) epidemiological study

72)

Which of the following can be used as a tool to help make informed healthcare decisions: A) e-Library of Evidence for Nutrition Actions B) USDA Nutrition Evidence Library C) Evidence Analysis Library D) Cochrane Collaboration E) All of the responses are correct

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73)

Which of the following cannot add fat to the body? A) Alcohol B) Proteins C) Carbohydrates D) Inorganic nutrients

74)

Which of the following is the least reputable source of a nutrition claim? A) Paid spokesperson B) Author affiliated with nationally recognized university C) Medical physician D) Registered dietitian

75)

Which of the follow would be considered the best nutritional advice: A) Recommendations based on a single study. B) All carbohydrates are “bad”. C) Consume more fruits and vegetables. D) Use a diet pill for quick weight loss and easy results.

76)

Polysaccharides are also called simple carbohydrates. ⊚ ⊚

true false

77) A micronutrient is a substance that cannot be separated into simpler substances by chemical processes.

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⊚ ⊚

78)

The term "oil " refers to lipids that are generally liquid at room temperature. ⊚ ⊚

79)

true false

Vitamins can be divided into 3 groups: water-soluble, fat-soluble, and alcohol-soluble. ⊚ ⊚

80)

true false

Water-soluble vitamins are excreted more readily than fat-soluble vitamins. ⊚ ⊚

true false

81) Phytochemicals are physiologically active compounds that areconsidered essential nutrients. ⊚ ⊚

82)

Zoochemicals are physiologically active compounds found in plants. ⊚ ⊚

83)

true false

A Kilocalorie measures the amount of heat energy.

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⊚ ⊚

true false

84) A clinical sign of a nutrient deficiency is one that is apparent to a health-care provider, such as aches and pains. ⊚ ⊚

85)

true false

Overnutrition can lead to excess stores of nutrients. ⊚ ⊚

true false

86) People in the United States today are generally more at risk for overnutrition than undernutrition. ⊚ ⊚

87)

A poor diet is a risk factor for the major chronic diseases seen today. ⊚ ⊚

88)

true false

In the future, gene therapy may help to treat inherited diseases. ⊚ ⊚

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true false

89)

An animal model is a disease in laboratory animals that closely mimics a human disease. ⊚ ⊚

true false

90) In the U.S., dietary supplements are rigorously regulated by the Food and Drug Administration. ⊚ ⊚

91) U.S.

Supplement manufacturers must prove the supplement is safe before they can sell it in the ⊚ ⊚

92)

true false

Almost all foods that have fat contain both saturated and unsaturated fats. ⊚ ⊚

true false

93) Trans fatty acids are most commonly found in deep-fried foods, cookies, crackers, stick margarine, and shortening. ⊚ ⊚

94)

true false

Cooking is more likely to destroy fat-soluble vitamins than water-soluble vitamins. ⊚ ⊚

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true false

95)

Omega-3 fatty acids are a type of zoochemical provided by fatty fish. ⊚ ⊚

96)

true false

Clinical signs generally occur in the early stage of nutrient deficiency. ⊚ ⊚

true false

97) Family medical history is a major risk factor in the development of many nutritionrelated diseases. ⊚ ⊚

true false

98) A person genetically predisposed to a diet-related disease can do little to delay the onset of the disease. ⊚ ⊚

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true false

Answer Key Test name: Chap 01_3e_Test Bank 1) C 2) A 3) A 4) B 5) C 6) D 7) B 8) A 9) A 10) A 11) C 12) A 13) C 14) C 15) A 16) C 17) B 18) C 19) C 20) C 21) C 22) D 23) D 24) E 25) D 26) A Version 1

27) C 28) C 29) C 30) A 31) C 32) D 33) E 34) A 35) C 36) A 37) A 38) E 39) B 40) D 41) A 42) C 43) A 44) B 45) C 46) D 47) C 48) E 49) B 50) A 51) B 52) B 53) B 54) B 55) C 56) C Version 1

57) D 58) D 59) C 60) D 61) B 62) C 63) B 64) D 65) D 66) B 67) B 68) B 69) D 70) D 71) A 72) E 73) D 74) A 75) C 76) FALSE 77) FALSE 78) TRUE 79) FALSE 80) TRUE 81) FALSE 82) FALSE 83) TRUE 84) TRUE 85) TRUE 86) TRUE Version 1

87) TRUE 88) TRUE 89) TRUE 90) FALSE 91) FALSE 92) TRUE 93) TRUE 94) FALSE 95) TRUE 96) FALSE 97) TRUE 98) FALSE

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CHAPTER 2 MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 1) Which is true about the Dietary Reference Intakes (DRIs)? A) They apply to people in Canada and the U.S. B) They differ by age group. C) They include Recommended Dietary Allowances and Tolerable Upper Intake Levels. D) They were createdby the Food and Nutrition Board. E) All of theseresponses are true.

Dietary Reference Intakes (DRI) values are for people who are ________. A) 1 to 4 years of age B) over 4 years of age C) over 19 years of age D) of all ages

An Adequate Intake (AI) is set for a nutrient when ________. A) too little research is available to establish an RDA B) the needs during pregnancy decline instead of increase C) the set RDA is not adequate enough D) the nutrient has a high potential for being toxic

4) Which Dietary Reference Intake (DRI) is set high enough to meet the needs of 97 to 98% of the population? A) Estimated Energy Requirements B) Estimated Average Requirements C) Recommended Dietary Allowances D) Dietary Reference Intakes

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Tolerable Upper Intake Levels (ULs) are ________. A) the maximum daily intake level not likely to cause harmful effects B) based on intakes from only supplements and highly fortified foods C) nutrient intake goals D) set for all nutrients

Which Dietary Reference Intake (DRI) reflects average daily needs? A) Adequate Intakes B) Estimated Average Requirements C) Recommended Dietary Allowances D) Tolerable UpperIntake Levels

The AMDRs do NOT include estimates for intake of ________. A) essential fatty acids B) essential amino acids C) carbohydrate D) fat

The Recommended Dietary Allowances (RDAs) for nutrients are ________. A) the maximum amounts allowed for an average 70-kg man B) twice as high as almost everyone needs C) average requirements for a population D) designed to meet thenutrient needs of 97 to 98% of individuals in a specific life stage

9) Foods that provide a greater contribution to nutrient needs than calorie needs are said to be ________.

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A) empty calorie B) energy dense C) calorie dense D) nutrient dense

10)

The nutrient standards used on Nutrition Facts panels are called ________. A) Recommended Dietary Allowances B) Daily Values C) Estimated Average Requirements D) Adequate Intakes

11) Daily Values differ from Recommended Dietary Allowances in that Daily Values ________. A) are used on Nutrition Facts panels B) are based on 2 sets of dietary standards C) are not gender-specific D) All of these responses are correct.

12)

Daily Values are based on which sets of dietary standards? A) Reference Daily Intakes and Daily Reference Values B) Recommended Dietary Allowances and Daily Reference Values C) Reference DailyIntakes and Tolerable Upper Intake Levels D) Recommended Dietary Allowances and Reference Daily Intakes

13)

Daily Reference Values are set for ________.

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A) fat and cholesterol B) sodium and potassium C) carbohydrate and protein D) All of these responses are correct.

14) The reference calorie intakefor calculating percent Daily Values on Nutrition Facts labels is ________. A) 1500 kcal B) 2000 kcal C) 2300 kcal D) 3000 kcal

15)

Which dietary standard value varies with calorie intake? A) Fat B) Vitamin C C) Calcium D) Iron

16)

Which is required on all food packages? A) Name and addressof the food manufacturer B) Date and time ofprocessing C) Expirationdate D) Percent DailyValue for protein

17) If a can of soup provides 4 servings and has 100 kcal per serving, how many kcal are in the entire can?

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A) 100 B) 200 C) 400 D) 800

18)

Food components that MUST be listed on the Nutrition Facts panel include ________. A) sugars, dietary fiber, and fluoride B) sugars, dietary fiber, and calcium C) sugars, dietary fiber, and monounsaturated fat D) sugars, calcium, and B-vitamins

19) Which of the following claims are least closely regulated by the Food and Drug Administration (FDA)? A) Health claims B) Structure/functionclaims C) Nutrient contentclaims D) Nutrition Facts Panel

20)

To be defined asa "good" source of calcium, a food must contain ________. A) at least 5% of the Daily Value for calcium in 1 serving of the food B) at least 10% of the Daily Value for calcium in 1 serving of the food C) at least 50% of the Daily Value for calcium in 1 serving of the food D) at least 50% of the Daily Value for calcium in 2 servings of the food

21) When vitamins and/or minerals are added to a food product in amounts in excess of at least 10% above that originally present in the product, the food is designated as ________.

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A) light or lite B) organic C) imitation D) fortified

22)

Which is NOT a permitted health claim?

A) Diets with enoughcalcium may reduce risk of osteoporosis. B) Diets low in sugar may reduce the risk of cancer. C) Diets low insaturated fat and cholesterol may reduce the risk of cardiovasculardisease. D) None of theseresponses are permitted.

23)

What type of claim is "calcium builds strong bones and teeth"? A) Structure/functionclaim B) Health claim C) Nutrient claim D) Preliminary healthclaim

24) For a health claim to be made about a food product, it must NOT contain more than ________. A) 19 g fat B) 70% carbohydrate C) 10% saturated fat D) 120 mg cholesterol E) All of these choices are correct.

25)

Factors that affect the amount of nutrients in foods include ________.

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A) farming conditions B) ripeness of plants when harvested C) cooking processes D) length of time food is stored E) All of these factors affect nutrient content of foods.

26)

By definition, energy-dense foods are ALL ________. A) high in calories B) high in water C) high in fiber D) high in volume

27)

Nutrient databases can be used to determine ________. A) a food's energy density B) a food's nutrient density C) the nutrient content of your diet D) the nutrient content of the foods in a recipe E) All of these responses are appropriate uses of nutrient databases.

28)

The Dietary Guidelines for Americans are designed to reduce the risk of ________. A) cancer B) cardiovascular disease C) obesity D) All of these responses are correct.

29)

The Dietary Guidelines for Americans ________.

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A) provide a scientific basis for USDA's school lunch program B) provide a scientific basis for the Food Stamp Program C) are designed to reduce the risk of "killer" diseases D) All of these choices are correct.

30) According to the Dietary Guidelines for Americans, those who consume alcoholic beverages should do so in moderation. Which of the following statements is true? A) A moderate intake is 1 or fewer servings per day for women. B) Beer is not considered an alcoholic beverage because it is mostly water. C) An average serving of red wine is 1.6 ounces per glass. D) To be considered an alcoholic beverage, distilled spirits must be at least 180 proof.

31)

Which government agency publishes the Dietary Guidelines for Americans? A) USDA B) USDHHS C) FDA D) USDA and USDHHS E) FDA and USDA

32)

MyPlate groups foods into _____ major categories. A) 2 B) 3 C) 4 D) 5

33)

Which of the following is a key behavior emphasized in MyPlate?

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A) Balancingcalories B) Foods toincrease C) Foods to reduce D) All of these responses are correct

34) According to MyPlate, amini bagel would represent _____ ounce(s) from the grains group. A) 0.50 B) 1 C) 2 D) 3 E) 4

35)

Two cups of plain lettuce salad would equal a serving from which MyPlate food group? A) Protein B) Diary C) Vegetable D) Grain

36)

MyPlate includes which food group? A) Dairy B) Vegetables C) Protein D) Fruits E) All of the responses are correct

37)

What eating behavior does MyPlate specifically encourage?

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A) Make half yourplate vegetables. B) Make half yourplate grains. C) Make at least halfyour grains whole grains. D) Add in more empty-calorie foods.

38)

What counts as one serving in the dairy group? A) 1 cup of icecream B) 1 cup ofyogurt C) 1 cup of cottagecheese D) 1 cup gratedcheese

39) According to MyPlate, four ounces of processed cheese equals ____ serving(s) from the Dairy group. A) 1 B) 2 C) 3 D) 4

40)

Which nutrient is contributed by the fruit group of MyPlate? A) Calcium B) Folate C) Zinc D) Protein

41)

Which nutrient is best contributed by the protein foods group of MyPlate?

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A) Iron B) Fibre C) Vitamin C D) Vitamin A

42)

The MyPlate vegetable group is divided into which subgroups?

A) Starchy vegetables, red and orange vegetables, and dark green vegetables B) Dark greenvegetables and other vegetables C) Other vegetables, starchy vegetables, and red and yellow vegetables D) Dark green vegetables, orange vegetables, starchy vegetables, beans and peas, and other vegetables

43)

Reading food labels helps consumers ________. A) identify amounts of salt or sodium in the product B) determine the sugar content of the product C) determine amount and kind of fat in the product D) choose foods with dietary fiber E) All of these responses are correct.

44)

Mandatory labeling of foods is regulated by the ________. A) USDHHS B) FTC C) FDA D) GAO

45) Labeling laws require that ingredients in food products be listed on the container in descending order of their ________.

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A) calories B) nutrient density C) weight D) cost

46) Under the current law on nutrition labeling, the Nutrition Facts panel must include ________. A) grams of total fat B) total calories from trans fat C) total calories from saturated fat D) grams of monounsaturated fat

47) If a group of people consumed an amount of protein equal to the estimated average requirement for their life stage, what percentage would receive insufficient amounts? A) 2 B) 33 C) 50 D) 98

48) What measure best describes the amounts of nutrients that should be consumed by the population? A) The Dietary Reference Intakes because they are a set of nutrient intake values for healthy people B) The Tolerable Upper Intake levels because they are the maximum daily amount of a nutrient needed that is safe for most healthy people C) The Estimated Average Requirements because they reflect the average daily amount of a nutrient that will maintain a specific function in half of the healthy people of a population D) The Recommended Dietary Allowances because they represent the daily amount of a nutrient considered adequate to meet the known nutrient needs of nearly all healthy people

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49) If a person consumed 35% of a diet providing 2500 kcalories from protein, approximately how many grams of protein would be ingested? A) 48 B) 67 C) 165 D) 219

50)

Which of the following meals represents the most nutrient-dense meal? A) Medium apple, fat-free milk, turkey sandwich on whole grain bread, carrot slices B) Graham crackers, fruit punch, salami sandwich on white bread, vegetable soup C) Banana, pretzels with peanut butter, chicken breast wrap sandwich, diet soft drink D) Chocolate chip cookies, low-fat cheese slices on rice cakes, whole milk, peanuts

51)

Which of the following represents the most energy-dense meal?

A) Broiled fish, watermelon, green beans, water B) Whole milk, peanut butter and jelly sandwich on white bread, tortilla chips C) Broccoli, chicken broth, strawberries, fat-free milk D) Light cream cheese on a mini bagel, vegetable soup, kiwi, salad and lemon juice dressing

52) If anticipated results are not seen after implementing various dietary changes, what is likely the recommended next step? A) Add extra meals to the diet. B) Seek the help of a registered dietician/nutritionist or physician. C) Add in supplements. D) Limit nutrient intake.

53)

A food label that advertises the product as a “rich source of fiber” is an example of a(n)

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A) Health claim B) Structure/function claim C) Nutrient claim D) Obesity prevention claim

54)

To put MyPlate into action, what would your first step be? A) Compare your energy needs to servings sizes from food groups B) Cut out food groups you eat too much of C) Estimate how many calories you need

55)

The allotment for maximum sugar per day: A) is the same for all calorie ranges B) increases as calorie load increases C) decreases as calorie load increases D) is not addressed in the most recent Dietary Guidelines for Americans

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Answer Key Test name: Chap 02_3e_Test Bank 1) E All responses correct 2) D DRIs are for people of all ages. 3) A AI is set when too little research is available to establish an RDA. 4) C The RDA is set to meet the needs of 97-98% of the population. 5) A UL is the maximum daily level not likely to cause harmful effects related to toxicity. 6) B EAR reflects average daily needs. 7) B Essential amino acids do not have an established AMDR. 8) D The RDAs are designed to meet the nutrient needs of 97-98% of the population. 9) D Nutrient dense foods provide more nutrient needs relative to calorie needs. 10) B Version 1

Daily Values are used on all Nutrition Facts Panels. 11) D All responses are correct. 12) A DVs are based on RDAs and DRVs. 13) D DRVs are set for all of those nutrients. 14) B Nutrition Facts label values are based on a 2000kcal diet. 15) A Fat recommendations vary with caloric intake. 16) A Name/address of food manufacturer are required on a food package. 17) C 100 kcal/serving x 4 servings/can = 400 kcal/can 18) B Sugars, dietary fiber, and calcium are all required on the current food label. 19) B Health claims, nutrient content claims and Nutrition Facts Panel are more strongly regulated by the FDA. 20) B A “Good” source is defined by “at least 10% of the DV for that nutrient in 1 serving”. 21) D Version 1

Fortified foods have at least 10% more of a nutrient than originally present in that product. 22) B “Diets low in sugar may reduce the risk of cancer” is not a definitively proved statement and not a permitted health claim. 23) A “Calcium builds strong bones and teeth” is a structure/function claim because it explains how a nutrient effects the body. 24) C A product with a health claim cannot contain more than 10% of calories from sat fat. 25) E All of the listed factors affect nutrient content. 26) A Energy 27) E All responses are correct. 28) D All responses are correct. 29) D All responses are correct. 30) A One alcoholic drink per day is the definition of moderation for women. 31) D USDA and DHHS publish the DGAs every 5 years.

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32) D MyPlate has 5 categories: fruit, vegetable, protein, grain, and dairy. 33) D MyPlate emphasizes areas including all responses listed. 34) B A small bagel would be 1 portion/1 ounce. 35) C Lettuce is a vegetable and 1 serving includes 2 cups leafy vegetables. 36) E MyPlate groups include all those listed. 37) C “Make at least half your grains whole grains” is a specific recommendation of MyPlate. 38) B One cup of yogurt or milk is 1 serving of dairy. 39) B Two ounces of cheese is 1 serving from the Dairy group. 40) B Fruit provides a source of folate. Calcium, zinc and protein are not in fruit. 41) A Iron is found in many protein-rich foods. Vitamin C, vitamin A, and folate are generally plant-based. 42) D Vegetables groups is further divided into subgroups as listed.

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43) E All responses are correct. 44) C The FDA regulates mandatory labeling. 45) C Food ingredients must be listed on the label by descending weight. 46) A Grams of total fat is required on the Nutrition Facts Label. 47) C EAR represents average nutrient needs and not meant to use for individuals. 48) D RDAs are meant to be extrapolated to the population. 49) D 2500 kcal x 0.35 = 875 / 4 kcal/gram = 219 grams 50) A All of the items listed in this response have nutrient density. 51) B The items listed in this response are all energy dense and contain the most relative calories. 52) B A health care professional is likely to offer the best advice after initial attempts fail. 53) C A nutrient claim describes the nutrient(s) in the food.

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54) C The first step is to estimate your energy needs. 55) B

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CHAPTER 3 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) According to the Centers for Disease Control, in the U.S., the consumption of beef is a major risk factor for developing variant Creutzfeldt-Jakob disease. ⊚ ⊚

Public water supplies in the U.S. are a major source of infection and disease. ⊚ ⊚

true false

All food additives in the U.S. food supply have been thoroughly tested for safety. ⊚ ⊚

true false

Most foodborne illnesses are typically immediately diagnosed and treated. ⊚ ⊚

true false

5) In the U.S., food labels must indicate the presence of irradiated ingredients, except for dried seasonings. ⊚ true ⊚ false

Bottled water is generally safer than tap water in the U.S. ⊚ ⊚

true false

7) Thawing foods, such as chicken, on the counter overnight is a safe food handling practice. Version 1

⊚ ⊚

true false

8) Although synthetic pesticides cannot be applied to organic foods, synthetic pesticide residues may still occasionally be found on these foods. ⊚ ⊚

true false

9) Antibiotics to promote growth or prevent diseases are allowed in organically produced animals. ⊚ ⊚

10)

true false

The majority of antibiotics used in the U.S. are for food animals. ⊚ ⊚

true false

11) Compared to conventionally grown fruits and vegetables, those grown with organic farming methods contain significantly higher amounts of vitamins and minerals. ⊚ ⊚

true false

12) Fully meeting vitamin and mineral requirements is best done by consuming only organic foods. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 13) Food insecurity is ________.

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A) the inability to meet food needs all of the time B) more common in developing countries than in developed countries C) associated with impaired physical and mental health in children in the U.S. D) All of these choices are accurate.

14)

The percentage of U.S. households considered food insecure is ________. A) 3 B) 12.5 C) 23 D) 73

15) The U.S. government assistance program that provides vouchers for food purchases to low-income pregnant women, infants, and children is ________. A) the Food Stamp Program B) the WIC program C) the food distribution program D) America's Second Harvest

16)

The Supplemental Nutrition Assistance Program (SNAP) benefits ________. A) only low-income women, infants, and children B) poor households that meet eligibility guidelines C) food banks and pantries in communities across the country D) seniors in adult day-care settings

17) The U.S. government agency that administers most food and nutrition assistance programs is the ________.

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A) Food and Drug Administration B) United States Department of Agriculture C) Department of Health and Human Services D) Environmental Protection Agency

18)

The most common micronutrient deficiencies seen in developing countries are ________. A) vitamin C, vitamin A, and iron B) iron, vitamin D, and calcium C) vitamin C, calcium, and iron D) vitamin A, iron, and iodine

19) The proportion of underweight children worldwide _________ over the past 20 years, while malnutrition has had a pronounced impact on young children and women: A) has increased B) has decreased C) has remained the same D) none of the above

20) Populations disproportionately affected by food insecurity, hunger, and malnutrition include ________. A) young children and women B) working adults C) teenagers D) All of the responses are correct.

21)

Which of the following food production methods is not allowed with organic foods?

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A) Use of synthetic fertilizers B) Use of hormones for animals C) Use of genetic engineering D) All of these choices are accurate.

22)

A breakfast cereal labeled as organic must ________. A) have at least 70% of its ingredients meet organic standards B) have at least 95% of its ingredients meet organic standards C) be made from all natural ingredients D) contain no food additives

23)

Common genetically engineered crops in the U.S. include ________. A) soybeans, corn, and cotton B) green beans, peas, and tomatoes C) rice, wheat, and carrots D) legumes, wheat, and corn

24)

Recombinant bovine somatotropin is used by some farmers to ________. A) prevent skin infections in cattle B) increase milk production in dairy cows C) prevent mastitis (inflammation of cow udders) D) increase the amount of protein found in milk

25)

Bt corn contains a protein produced by a bacterial gene. This protein ________.

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A) increases the vitamin A content of the corn B) increases the protein content of the corn C) is a pesticide that kills caterpillars, a major threat to corn D) allows the corn to be tolerant to weed killers

26)

The most commonapplication of genetic engineering of foods is to ________. A) produce meat with a lower fat content B) confer resistance to pesticides applied to kill weeds and insects C) improve vitamin Acontent of foods D) reduce the need for irrigation of crops

27)

Which of the following statements about food irradiation is true? A) Irradiated food is radioactive. B) Irradiation can be used to destroy pathogens in foods. C) All foods in the U.S. can be legally irradiated. D) Labels that identify a food as irradiated are not required.

28) The food additives that inhibit the growth of the pathogen Clostridium botulinum are ________. A) sodium nitrate and sodium nitrite B) monosodium glutamate and guanosine monophosphate C) pectin and guar gum D) calcium silicate and magnesium stearate

29)

An example of an incidental food additive in our food supply is ________.

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A) any additive that is a synthetic additive B) any color additive because their use is not for purposes of food safety C) bisphenol A (BPA), used to increase durability of some food and beverage containers D) monosodium glutamate, because it can also be found naturally in foods

30)

Food additives are regulated by the ________. A) United States Department of Agriculture B) Food and Drug Administration C) Environmental Protection Agency D) All of these choices are accurate.

31) Food additives, such as calcium propionate, sodium nitrate, and acetic acid, act to ________. A) inhibit the growth of molds, fungi, and bacteria in foods B) keep foods, especially powdered mixes, free flowing C) contribute leavening gases to improve texture in baked products D) add savory flavor to foods such as soup, rice, and noodle mixes

32) FDA has limited the use of sulfites on raw vegetables and in salad bars because they ________. A) impart an unpleasant taste to the food B) cause adverse reactions such as shortness of breath or gastrointestinal symptoms in some individuals C) are known to promote cancer D) are used to mask the flavor of spoiled produce

33)

Cross-contamination of food occurs when ________.

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A) two or more microorganisms grow in the same food B) two or more food handlers work on the same food C) a utensil contaminated with a microorganism from a previously handled food contacts a second food D) perishable foods are kept at room temperature for more than 2 hours

34)

__________ and _________ are among the most common bacterial pathogens in the U.S. A) Shigella species, Staphylococcus aureus B) Campylobacter jejuni, Salmonella species C) Clostridium botulinum, Escherichia coli D) Vibrio vulnificus, Vibrio cholerae

35)

Perishable foods should be held either below _______ °F or above ______ °F. A) 32, 98 B) 51, 75 C) 181, 212 D) 41, 135

36)

The temperature danger zone for growth of pathogenic bacteria is ________. A) 32-165°F B) 60-165°F C) 41-135°F D) 135-212°F

37)

Coughing and sneezing on foods can allow __________ to contaminate the food.

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A) Staphylococcus aureus B) Vibrio cholerae C) Clostridium botulinum D) hepatitis A

38)

Foods commonly contaminated with Staphylococcus aureus include ________. A) ham and poultry B) cream-filled pastries C) egg and chicken salads D) All of these choices are accurate.

39) Improper canning of foods can result in serious foodborne illness caused by the ___________ bacterium. A) Escherichia coli B) Salmonella C) Clostridium botulinum D) Listeria monocytogenes

40)

The bacterium ___________ grows only in anaerobic environments. A) Escherichia coli B) Vibrio parahemolyticus C) Listeria monocytogenes D) Clostridium botulinum

41)

__________ can grow at refrigeration temperatures.

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A) Escherichia coli B) Salmonella C) Clostridium botulinum D) Listeria monocytogenes

42) Foods that are most likely to be contaminated with Listeria monocytogenes include ________. A) soft cheeses and deli meats B) undercooked shellfish and water C) gravy and beef D) raw produce and eggs

43) This virus, often transmitted by infected food handlers, causes anorexia, diarrhea, fever, and liver damage. A) Norwalk virus B) Salmonella C) Hepatitis A D) Trichinella spiralis

44)

Typical food sources for this parasite are wild game and pork. A) Toxoplasma gondii B) Trichinella spiralis C) Staphylococcus aureus D) Aflatoxin

45) The parasite ___________ can be spread in water supplies, water parks, and community swimming pools.

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A) hepatitis A B) Yersinia enterocolitica C) Toxoplasma gondii D) Cryptosporidium

46)

Prions are ________. A) bacteria that can cause seizures and brain damage B) naturally occurring toxins formed in damaged grains and nuts C) infectious proteins associated with mad cow disease D) toxins produced in a variety of seafood

47)

Mad cow disease ________. A) causes a fatal brain disease in cows B) is very common in the U.S. and Canada C) is caused by a parasite found in animal feed D) is easily transmitted to humans

48)

Ingesting moldy food can cause disease because the mold ________. A) invades the cells lining the gastrointestinal tract, causing diarrhea B) produces toxins that can cause kidney and liver damage C) prevents the food from being properly digested and absorbed D) produces proteins that destroy vitamins before they are absorbed

49)

The dangerous aflatoxin is most likely to be found in ________.

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A) moldy cheese and bread B) spoiled fruits and vegetables C) moldy peanuts and corn D) All of the responses are correct.

50)

Fish and shellfish most likely to be contaminated with toxins include ________. A) salmon and trout B) cod and haddock C) mussels and clams D) prawns and shrimp E) All of the answers are correct.

51) Sources of the ciguatera toxin that can cause gastrointestinal and neurological symptoms include ________. A) nutmeg, sassafras, and mace B) mushrooms and some herbal teas C) shellfish, such as mussels and clams D) tropical and subtropical fish, such as snapper and amberjack

52) In the U.S., the _________ mandates that public water supplies be monitored regularly for microorganisms, chemicals, and various metals. A) local health department B) Environmental Protection Agency C) Food and Drug Administration D) United States Department of Agriculture

53)

The last food(s) to buy when shopping in the supermarket should be ________.

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A) fresh fruits and vegetables B) bread C) frozen foods D) raw poultry and eggs

54)

Which of the following foods is least likely to cause a foodborne illness? A) Eggs, poultry, unpasteurized milk B) Raw sprouts and produce C) Bread, pasteurized milk, butter D) Deli meats, shellfish, and other seafood

55) Wash hands for at least _______ in warm, soapy water before starting any food preparation. A) 60 seconds B) 2 minutes C) 10 seconds D) 20 seconds

56)

Which of the following is a current food safety recommendation? A) Scrub firm produce,such as melons, under running water with a brush before slicing

it. B) Clean all produce with specialized antibacterial washing products. C) Egg dishes should be cooked to a temperature of 140 degrees F. D) Avoid using wooden cutting boards.

57) To prevent foodborne illness, cooked food should be consumed right away or refrigerated or frozen within _____ hour(s).

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A) 1 B) 2 C) 4 D) 5

58) In general, cooking poultry and ground meat to ______ °F is sufficient to kill pathogenic organisms. A) 125 B) 135 C) 165 D) 85

59)

Most traveler's diarrhea is caused by ________. A) ingesting unfamiliar spices B) parasites, especially Cryptosporidium, in the water supply C) viruses, such as hepatitis A, spread by food handlers D) bacterial infections, especially Shigella dysenteriae, from contaminated food and

water

60)

Sources of the heavy metal lead include ________. A) water pipes and paint in older homes B) certain pottery and crystal food containers C) mineral and herbal supplements D) All of the answers are correct.

61)

A healthy diet with plenty of _____ may reduce lead absorption in children.

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A) protein B) vitamin C C) iron D) potassium

62) The food most likely to be contaminated with dioxins, mercury, and/or polychlorinated biphenyls is ________. A) imported candy B) milk and other dairy products C) grain that has been stored for several months D) fish

63)

Fish most likely to contain methylmercury are ________. A) large fish, such as shark and swordfish B) shellfish C) farm-raised fish D) freshwater fish

64) Current guidelines for limiting fish to reduce methylmercury ingestion pertain to ________. A) all persons B) pregnant, breastfeeding women, and young children C) immunosuppressed individuals only D) the elderly

65)

Foods most likely to include pesticide residues are ________.

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A) fruits and vegetables B) meats C) fish and shellfish D) grain products

66)

Individuals who are most susceptible to adverse effects from pesticides are ________. A) the elderly B) those who have chronic diseases C) infants and young children D) adolescents and young adults

67)

A pesticide tolerance is the ________.

A) toxicity of the pesticide in the laboratory B) number of pests that are killed by a selected dose of the pesticide C) amount of a pesticide that can be applied to a food and how much of the pesticide that is permitted to remain on the food in the marketplace D) ability of the liver to detoxify a pesticide

68)

Which of the following is generally not a consumer concern about GM foods? A) Loss of genetic diversity B) Development of Bt-resistant insects C) Hyperactivity in children D) Addition of allergens to GM foods

69)

Cloned animals are ________.

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A) genetically unique B) not genetically modified C) common in our food supply D) approved for use by the USDA

70) Which of the following is a food additive that breaks down macronutrients found in foods? A) Enzyme B) Anticaking agent C) Leavening agent D) Stabilizer

71)

Why is sodium nitrite allowed to be used as a food additive?

A) It is generally recognized as safe. B) It helps to prevent the growth of Clostridium botulinum. C) There is not enough credible research confirming the conversion of sodium nitrite to the carcinogenic agent nitrosamine. D) All choices are correct.

72) When a slice of fresh apple turns a brown color, this is most likely the result of ________. A) oxidation B) dehydration C) microbial contamination D) treatment in the ripening process

73) Which of the following agency would be most appropriate to contact if you felt a local restaurant was not handling their food safely?

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A) Environmental Protection Agency B) State and local government C) Food and Drug Administration D) U.S. Department of Agriculture

74)

Which of the following is true about bisphenol A (BPA): A) BPA is a food additive used to increase shelf life of canned foods. B) Almost all individuals in the U.S. consume BPA and excrete it in their urine. C) BPA is not considered a threat during fetal development. D) The FDA has banned use of BPA.

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 75) List and briefly describe 5 steps consumers can take in their homes to prevent foodborne illness.

76)

List 4 steps that travelers to developing countries can take to prevent traveler's diarrhea.

77) Describe why inadequate food and nutrients can lead to disease and death, particularly in children.

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78)

Compare a food secure household to one with very low food security.

79)

List 3 programs that may help a low-income family with children remain food secure.

80)

Describe 3 physical signs or symptoms of chronic food insecurity in children.

81)

Compare and contrast a genetically modified food and a conventional food.

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82)

Name 3 foods that are likely to be genetically modified in the U.S.

83)

Describe and evaluate 3 objections to the use of genetically modified foods.

84) List 4 approved uses of food additives. For each use, give an example of a common food that contains the additive.

85) How do intentional food additives differ from incidental food additives? Give an example of each.

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Answer Key Test name: Chap 03_3e_Test Bank 1) FALSE Strict guidelines for monitoring cattle and preventing prion contamination of their feed have sharply reduced BSE worldwide. Because of this and other safeguards to the food supply, experts affirm that eating beef in the U.S. is not a risk for contracting vCJD.5 2) FALSE U.S. public water is safe for consumption and health. 3) FALSE Laws require food manufacturers to carefully test and prove the safety of new additives and obtain FDA approval before they can be used in food. Some additives, however, are exempt from this approval and testing process. 4) FALSE Most cases of foodborne illness go undiagnosed because the symptoms are mild enough that the ill persons do not seek medical care. 5) TRUE True statement 6) FALSE Tap water in the US is safe to drink and generally no less safe than bottled water. 7) FALSE It is typically recommended to thaw frozen foods slowly in the refrigerator to keep them from reaching danger zone Version 1

8) TRUE True statement 9) FALSE Synthetic pesticides, fertilizers, and hormones; antibiotics; sewage sludge (used as fertilizer); genetic engineering; and irradiation are not permitted in the production of organic foods 10) TRUE True statement 11) FALSE Recent meta-analyses show few differences between organically and conventionally grown foods for most nutrients. 12) FALSE Recent meta-analyses show few differences between organically and conventionally grown foods for most nutrients. 13) D All responses describe food insecurity. 14) C In 2017, 40 million Americans (1 in 8) experienced food insecurity. 15) B 16) B 17) B 18) D 19) C According to the FAO, undernutrition in developing regions is decreasing. The proportion of underweight children worldwide has declined by almost half in the past 20 years.2 However, malnutrition still disproportionately affects young children and women. Version 1

20) A 21) D 22) B 23) A Worldwide, 70 to 80% of soybeans and cotton and 24 to 32% of canola and corn are grown from genetically modified seeds. 24) B 25) C 26) B Genetic engineering is used primarily to confer herbicide tolerance and/or insect resistance. 27) B Irradiation is a safe method to destroy pathogens in foods. 28) A 29) C Incidental additives (like BPA) are not intentionally added but become part of a food through some aspect of food cultivation, processing, packaging, transport, or storage. They have no function in finished products and their presence is not indicated on food ingredient labels. 30) B 31) A The additives listed are listed in the text as antimicrobial agents. 32) B 33) C 34) B 35) D The range of temperatures is classified as the “danger zone”. 36) C Version 1

37) A Staph aureus is found on skin and in nasal passages of up to 50% of population. 38) D 39) C 40) D 41) D 42) A 43) C 44) B 45) D 46) C 47) A 48) B 49) C 50) C 51) D 52) B 53) D Raw poultry and eggs should be purchased last so that they will be exposed to higher room temperature for the least amount of time until they can be refrigerated at home. 54) C 55) D 56) A 57) B 58) C 59) D 60) D Version 1

61) C 62) D 63) A 64) B 65) A Foods most likely to include pesticide residues are fruits and vegetables. 66) C 67) C 68) C 69) B 70) A 71) D 72) A When a cup apple is exposed to oxygen, it typically browns. 73) B The environmental services division of a local health department or local health agency would be best to deal with food safety issues within a local restaurant. 74) B Almost all individuals in the U.S. consume BPA and excrete it in their urine. 75) To do their part, consumers need to know how to handle food safely at home. In general, foodborne illness prevention focuses on using good personal and kitchen hygiene; handling food safely by using appropriate thawing, cooking, chilling, and storage procedures; and knowing which foods pose extra risk to those more susceptible to foodborne illness.

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76) Wash your hands often, especially after using the bathroom and before eating. ● Eat foods that are freshly cooked and served piping hot. ● Avoid food from street vendors and buffets. ● Avoid salads and raw fruits and vegetables. ● Avoid raw or undercooked meat and seafood. ● Avoid tap water and beverages reconstituted with tap water (including ice and possibly fruit juice and milk). ● Bottled and sealed beverages, including soft drinks, water, beer, and wine, are generally safe. ● Beverages made with boiled water, such as coffee and tea, are generally safe. ● Travelers also can treat tap water by boiling, chemical disinfection, or filtering 77) When energy intake falls below needs, a variety of problems arise—physical and mental activity declines; growth slows or ceases altogether; muscle and fat wasting occurs; the immune system weakens, increasing susceptibility to disease; and death rates rise (Fig. 3-1). The consequences of micronutrient deficiencies can be equally devastating. For example, vitamin A deficiency, found in approximately 30% of children under age 5 in developing countries, damages the eyes and sometimes causes blindness. Vitamin A deficiency also increases vulnerability to common diseases, such as measles, diarrhea, and respiratory infections. Iodine deficiency is the world’s leading cause of preventable mental retardation and brain damage. Vitamin A, iodine, iron, zinc, and folate are the micronutrients most likely to be in short supply in developing countries.

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78) In the U.S., the Department of Agriculture (USDA) monitors food security, defined as “access by all people at all times to enough food for an active, healthy life.” Food insecurity, or lack of this access (Table 31), contributes to serious health and nutritional problems for millions of people. For instance, food-insecure individuals often eat fewer servings of nutrient-dense foods, such as vegetables, milk, and meat, and consume poorer-quality diets in general. These nutrient-poor diets can impair physical and mental health status and ability to learn. Foodinsecure children are more likely to have poorer general health and report more asthma, stomachaches, headaches, and colds, and they may not grow normally. Behavioral problems in school, lower educational achievement, higher rates of depression and suicidal symptoms, and increased levels of psychological distress also have been linked to food insecurity. Parents may compromise their own diets to allow children to have better diets. Food-insecure adults have a higher risk of chronic diseases, such as diabetes, and poorer management of these diseases. 79) SNAP, WIC, NSLP, School breakfast program, Child/Adult food care program, food distribution programs 80) Food-insecure children are more likely to have poorer general health and report more asthma, stomachaches, headaches, and colds, and they may not grow normally. Behavioral problems in school, lower educational achievement, higher rates of depression and suicidal symptoms, and increased levels of psychological distress also have been linked to food insecurity. Parents may compromise their own diets to allow children to have better diets. Food-insecure adults have a higher risk of chronic diseases, such as diabetes, and poorer management of these diseases.

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81) Today, genetic engineering is used primarily to confer herbicide tolerance and/or insect resistance to soy, corn, cotton, sugar beets, canola, and alfalfa. Papaya and some varieties of squash are genetically engineered to be resistant to plant viruses. More recently, scientists have developed nonbrowning apples by silencing the genes that produce the enzyme polyphenol oxidase (commonly known as PPO), which causes cut apples to turn brown. Nonbruising potatoes also have been developed. 82) Today, genetic engineering is used primarily to confer herbicide tolerance and/or insect resistance to soy, corn, cotton, sugar beets, canola, and alfalfa. Papaya and some varieties of squash are genetically engineered to be resistant to plant viruses. More recently, scientists have developed nonbrowning apples by silencing the genes that produce the enzyme polyphenol oxidase (commonly known as PPO), which causes cut apples to turn brown. Nonbruising potatoes also have been developed.

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83) Production of new allergens or toxins in GM foods Can increase in GM plants, just as they can with traditional plant breeding. Again, there is no evidence that this has occurred, but new GM plants should be scrutinized. ● Development of glyphosate-resistant “superweeds.” These superweeds have been found in different areas of the U.S. as well as several other countries. These weeds can reduce crop yields, and killing them requires larger applications of pesticides, raising concerns about environmental damage and higher costs for farmers. ● Crossed species lines, such as inserting a gene from a fish into a grain. Consumers may find it unnatural to introduce the genes from an unrelated species into another, especially the transfer of animal genes into plants. ● “Gene flow” from GM crops to plants not intended to be modified. ● Development of Bt-resistant insects. This is of particular concern to organic farmers who, although they do not grow GM crops, apply Bacillus thuringiensis bacteria to crops as a biological pest management method. Bt resistance also may lead to increased pesticide use by nonorganic farmers. ● Loss of genetic diversity. If GM crops are widely adopted, the use of local, indigenous, conventional seeds may decline and these plants may disappear. ● Loss of cultural heritage with older, native foods. For example, in Mexico, traditional maize (corn) has a spiritual and cultural significance that is not fulfilled with GM corn. ● Insufficient regulation and oversight of GM plants and animals. Some argue that more rigorous regulation, testing, and oversight are needed to assure safety and benefits for consumers. ● Development of trade barriers. Regulations about GM foods vary around the world; thus, limitations of both imports and exports of Version 1

foodstuffs can arise. 84) Type of Food Additive Examples of Additives Improve Freshness and Safety Antimicrobial agents

Antioxidants

Curing agents

Acidic agents

Alter Nutritional Value Vitamins, minerals, protein

Alternative sweeteners Fat replacers

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Examples of Use

Sodium, benzoate, sorbic acid, calcium Inhibit growth of molds, fungi, propionate and bacteria in beverages, baked goods, jams, jellies, salad dressings, processed meats Butylated hydroxyanisole (BHA), Control adverse effects of butylated hydroxytoulene (BHT), oxygen and/or prevent fats from ascorbic acid, erythorbic acid, alphaspoiling; used in breakfast tocopherol, sulfites cereals, chewing gums, nuts, processed meats; prevent lightcolored foods (sliced potatoes, white wine, fruit) from discoloring

Sodium nitrate, sodium nitrite

Prevent growth of Clostridium botulinum in bacon, ham, salami, hot dogs, other cured meats; contribute to pink color of cured meats Acetic acid, ascorbic acid, phosphoric Add tartness and inhibit growth of acid, lactic acid microorganisms in foods such as beverages, salad dressings, candies, frozen desserts, salsas, pickles, processed meats Thiamin, vitamin A, protein Fortification (add nutrients): iodine in salt; enrichment (replace nutrients lost in processing): thiamin, riboflavin, niacin, folic acid, iron in cereal and grain products Aspartame, sucralose Sweeten products such as beverages, baked goods, yogurt Modified food starch, cellulose Reduced-fat ice cream and low-fat 30

Enhance Flavor or Color Flavors and spices

Salts, sugars, herbs, spices, flavors

Flavor enhancers

Monosodium glutamate (MSG)

salad dressings Grape flavor in popsicles

Enhance existing flavor or contribute savory flavor to foods, such as soups, rice, noodle mixes

Guanosine monophosphate (GMP)

Color additives

Certifiable color additives

Enhance Functional Characteristics Emulsifiers Anticaking agents Humectants

Stabilizers, thickeners

Enzymes

Leavening agents

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Beta-carotene, annatto, beet coloring, Natural colors obtained from cochineal, caramel coloring plant, animal, or mineral sources; used in many foods; exempt from FDA certification FD&C Blue #1, FD&C Blue #2, The only human-made dyes FD&C Green #3, FD&C Red #3, currently certified by the FDA for FD&C Red #40, FD&C Yellow #5, use in foods; found in a variety of FD&C Yellow #6, Citrus Red #2, foods Orange B Egg yolks, soy lecithin, mono-and Salad dressings, peanut butter, diglycerides frozen desserts, baking mixes, margarine Calcium silicate, ammonium citrate, Keep foods, especially powdered magnesium stearate mixes, free flowing Glycerol, sorbitol Retain moisture, flavor, and texture in foods, such as marshmallows, soft candies, energy bars Pectin, gums (guar, carrageenan, Add creaminess and thickness to xanthan), gelatin foods, such as frozen desserts, yogurt, dairy products, salad dressings, pudding, gelatin mixes Lactase, rennet, chymosin, pectinase Act on proteins, fats, or carbohydrates in foods; lactase makes milk more Yeast, baking soda, baking powder Contribute leavening gases (mainly CO2) to improve texture of baked products, such as breads, cookies, cakes, baking mixes

85) Food additives can be classified as either intentional or incidental. Intentional food additives are purposely added to achieve a goal, such as a longer shelf life (preservative), greater nutritional value, or more appealing color or flavor. Flavors and flavor enhancers are the most commonly used group of food additives—over 2600 are in use. Examples of common food additives and their functions are given in Table 3-3. Incidental additives, also called indirect additives, are not intentionally added but become part of a food through some aspect of food cultivation, processing, packaging, transport, or storage. They have no function in finished products and their presence is not indicated on food ingredient labels. There are safety concerns about some of these incidental additives. The presence of pesticide residue and arsenic in some foods is an example (both of these environmental contaminants are discussed in Section 3.5). Another incidental additive of concern is bisphenol A (BPA).

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CHAPTER 4 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Most of the water in the gastrointestinal tract is absorbed in the small intestine. ⊚ ⊚

Removal of the gallbladder prevents normal digestion and absorption of dietary fat. ⊚ ⊚

true false

Irritable bowel syndrome (IBS) is caused by bacterial pathogens. ⊚ ⊚

true false

Fat-soluble vitamins are absorbed directly into the cardiovascular system. ⊚ ⊚

true false

Diarrhea is most often caused by bacterial or viral infection of the GI tract. ⊚ ⊚

true false

A good way to treat mild constipation is to consume 25 to 35 grams of fiber each day. ⊚ ⊚

true false

7) Not eating or drinking anything at all is the best way to treat diarrhea in adults and children.

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⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 8) The smallest functional unit of the human body is the ________. A) organ B) organ system C) cell D) epithelial tissue

Tissues are defined as ________. A) functional systems B) complex organs that perform one task C) a diverse collection of cells D) a collection of cells that perform a specific function

10)

The 4 primary types of tissue are ________. A) epithelial, connective, muscle, and nervous B) gastrointestinal, cardiovascular, muscle, and immune C) gastrointestinal, endocrine, nervous, and cardiovascular D) skeletal, muscle, endocrine, and cardiovascular

11)

Which of the following organs is NOT part of the digestive organ system?

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A) Pancreas B) Small intestine C) Kidneys D) Liver

12) The ______ layer of the GI tract wall contains glands, blood vessels, and nerves, whereas the ________ layer is the outermost layer that protects the GI tract. A) mucosa; muscle B) serosa;submucosa C) submucosa;muscle D) submucosa;serosa

13)

The breakdown of dietary starch to glucose in the small intestine is considered ________. A) metabolism B) hormonal action C) digestion D) absorption

14)

Bicarbonate ions (HCO

3-) from the pancreas ________.

A) neutralize the acid contents in the stomach B) are synthesized in the pyloric sphincter C) neutralize the bile in the duodenum D) neutralize the acid contents in the duodenum

15) The sphincter that allows chyme to pass into the small intestine is known as the ________.

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A) lower esophageal sphincter B) sphincter of Oddi C) pyloric sphincter D) ileocecal sphincter

16)

Segmentation as a function of the GI tract involves ________. A) peristalsis to move the food along the GI tract B) back and forth contractions that break apart the food mass C) conscious effort D) enzyme input to break apart the food mass

17) The chemical reaction sucrose + H ___________ reaction.

2O → fructose + glucose is an example of a

A) hydrolysis B) synthetic C) hormonal D) carboxylase

18) A circular muscle that can open and close and acts to regulate the flow of materials in one direction is referred to as ________. A) enterohepatic circulation B) a sphincter C) a pump D) peristalsis

19) A coordinated muscular contraction that propels food along the GI tract is called ________.

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A) a sphincter B) enterohepatic circulation C) a pump D) peristalsis

20)

The lower esophageal sphincter is located between the ________. A) stomach and esophagus B) stomach and duodenum C) ileum and cecum D) sigmoid colon and anus

21) The bacteria that usually inhabit the large intestine are prevented from backing up into the ileum by the action of the ________. A) sphincter of Oddi B) ileocecal sphincter C) pyloric sphincter D) rectal sphincter

22)

Which of the following is NOT an enzyme? A) Sucrase B) Bile C) Pepsin D) Lipase

23)

Most digestive enzymes are synthesized by the ________.

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A) liver and large intestine B) bile and gallbladder C) kidneys and esophagus D) pancreas and small intestine

24)

Gastrin, secretin, CCK, and gastric inhibitory peptide are examples of ________. A) enzymes B) hormones C) active absorption D) None of these choices are accurate.

25) Human digestion of food begins in the _______, where the enzyme _____ breaks down a small amount of starch. A) mouth; amylase B) stomach;pepsin C) small intestine;amylase D) mouth; lipase

26)

The taste sensation umami can best be described as ________. A) a somewhat salty flavor derived from metal ions B) the combination of salt and sweet tastes together C) a savory or meaty taste derived from the amino acid glutamate D) the taste that arises from compounds such as caffeine and quinine

27) In the process of swallowing, food cannot normally enter the trachea because the ________.

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A) tongue directs the flow of food down the esophagus and away from the trachea B) esophageal sphincter shuts off the passage to the larynx C) epiglottis covers the larynx D) trachea does not connect to the esophagus

28)

Saliva contains ________. A) an amylase B) mucus C) intrinsic factor D) an amylase and mucus

29) The salivary glands produce about ___ cup(s) of saliva each day. Saliva is a watery fluid that contains ________, ___________, and ___________. A) 1; mucus; digestiveenzymes; antibacterial substances B) 1; mucus; bile;hormones C) 4; mucus; digestiveenzymes; antibacterial substances D) 4; mucus; bile;hormones

30) At the beginning of a meal, the hormone _______ is secreted from the stomach; this hormone controls the release of _______. A) pepsinogen;pepsin B) gastrin; HCl C) bile; lipase D) cholecystokinin;pancreatic enzymes

31)

The major function(s) of the stomach is/are ________.

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A) the digestion and absorption of carbohydrates, especially starch B) the digestion and absorption of alcohol C) to mix ingested foods with gastric juices to form chyme D) All of these responses are correct.

32)

The fluid mixture that moves from the stomach to the duodenum is called ________. A) bolus B) chyme C) food D) None of these choices are accurate.

33)

Muscular waves in the stomach mix and churn the contents of a meal with ________. A) bile B) gastric juices C) pancreatic juices D) sodium bicarbonate

34)

Heartburn is caused by ________. A) acid surrounding the heart muscle B) acid and other digestive enzymes within the heart muscle C) the backflow of acidic stomach contents into the esophagus D) None of these choices are accurate.

35)

The stomach is protected from digesting itself by producing ________.

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A) bicarbonate only when food is in the stomach B) a thick layer of mucus to coat the lining of the stomach C) hydroxyl ions to neutralize the acid D) antipepsin that destroys digestive substances

36)

The gastric secretion pepsin is necessary for ________. A) preventing peptic ulcer formation B) protein digestion C) vitamin B-12 absorption D) destruction of harmful bacteria and viruses

37)

Actions of hydrochloric acid produced by the stomach include ________. A) promoting digestion of protein B) destroying bacteria and viruses found in foods C) dissolving dietary minerals for improved absorption D) All of the responses are correct.

38)

The stomach can absorb ________. A) proteins or amino acids B) sugars, such as lactose C) alcohol D) no nutrients

39)

The small intestine is divided into three segments. List them in descending order.

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A) Ileum, Jejunum, Duodenum B) Jejunum, Ileum, Duodenum C) Duodenum, Ileum, Jejunum D) Duodenum, Jejunum, Ileum

40)

Most of the digestive processes occur in the ________. A) mouth B) stomach C) small intestine D) large intestine

41)

Which substances can be absorbed in the small intestine? A) Glucose, Minerals, Amino acids, Vitamins, Alcohol B) Sucrose, Lactose, Fats, Alcohol, Protein C) Starch, Fats, Glucose, Protein, Alcohol D) Glucose, Fructose, Sucrose, Alcohol, Protein

42)

Villi are found mainly in the ________. A) large intestine B) small intestine C) esophagus D) stomach

43)

The villi found in the gastrointestinal tract ________.

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A) are finger-like projections into the lumen of the small intestine B) are covered with the brush border (microvilli) C) contain cells that produce mucus, hormones, and enzymes D) produce a large surface area for nutrient absorption E) All of these choices are correct.

44)

The life span of absorptive cells in the villi is approximately ________. A) 24 hours B) 2 to 5 days C) 8 to 10 days D) 4 to 6 weeks

45)

Amino acidsand glucose enter cells by ________. A) active transport B) passive diffusion C) facilitated diffusion D) endocytosis

46)

The absorptive process that requires energy in the form of ATP is ________. A) facilitated diffusion B) active absorption C) enterohepatic circulation D) the lymphatic system

47)

The secretions of the gallbladder, liver, and pancreas enter the ________.

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A) ileum, by way of a common duct B) duodenum, by way of the sphincter of Oddi C) stomach, by way of a common duct D) jejunum, by way of the sphincter of Oddi

48)

Bile is formed in the ___________ and stored in the ___________. A) stomach; pancreas B) duodenum; kidney C) liver; gallbladder D) gallbladder; liver

49)

Insufficient production of bile is mostly likely to impair absorption of ________. A) starch B) fat C) protein D) sugars

50)

__________ increases the available surface area of fats for digestion and later absorption. A) Pancreatic lipase B) Lingual lipase C) Gastric lipase D) Bile

51)

The main function of the liver in the digestive system is ________.

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A) producing enzymes for digestion of protein, fat, and carbohydrate B) producing the hormones that regulate digestion and absorption C) producing bile for fat digestion and absorption D) distributing nutrients to the gastrointestinal tract

52)

Secretions from the pancreas include ________. A) HCl and digestive enzymes B) sodium bicarbonate and digestive enzymes C) cholecystokinin and sodium bicarbonate D) All of these responses are correct.

53)

An example of a brush border enzyme is ________. A) sucrase B) lipase C) amylase D) bile

54)

Water-soluble nutrients enter into the body by way of ________. A) the blood B) the lymph system C) both the blood and the lymph system D) neither the blood nor the lymph system

55)

Most dietary fats will ________.

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A) be converted to short-chain fatty acids for absorption with other water-soluble nutrients B) enter the lymphatic system C) enter the colon and become "food" for bacteria D) be converted to bile in the lumen of the intestine

56)

The hepatic portal system delivers nutrients from the digestive tract to the ________. A) heart B) liver C) kidneys D) lungs

57)

Lymph ________. A) is like blood, since it contains mostly red blood cells B) is a fluid containing blood proteins C) recycles nutrients between the liver and the small intestine D) transports fat-soluble particles from the intestinal tract to the general circulation

58)

Which of the following nutrients may be absorbed by the colon? A) Minerals, such as sodium and potassium B) Some vitamins synthesized by bacteria C) Short-chain fatty acids D) Water E) All of these answers are correct.

59)

An example of a probiotic is ________.

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A) bacteria in yogurt B) fiber in whole wheat bread C) calcium in milk D) digestible carbohydrates in bananas

60)

Probiotics may be most useful in treating ________. A) constipation B) diarrhea C) celiac disease D) food intolerance

61)

Much of the digestion that occurs in the large intestine is caused by ________. A) lipase B) pepsin C) saliva D) bacteria

62) Fiber and starches not digested in the small intestine may be fermented by bacteria in the large intestine to form ________. A) short-chain fatty acids and flatus B) long-chain fatty acids and bile C) short- and long-chain fatty acids D) simple sugars and flatus

63)

An example of a prebiotic is ________.

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A) a food that contains a naturally occurring antibiotic B) cheese, because of its short-chain fatty acid content C) any food that contains organic acids and short-chain fatty acids D) inulin, a poorly digested carbohydrate found in foods such as onions, garlic, and asparagus

64)

Functions of the large intestine include ________. A) housing bacterial flora that keep the GI tract healthy B) absorption of water and electrolytes, especially sodium and potassium C) the defecation of feces D) All of these responses are correct.

65) Which of the following dietary or nutritional factors may worsen gastroesophageal reflux disease? A) Being overweight B) Consuming a high-fat diet C) Alcohol and caffeine consumption D) Consumption of large meals E) All of these responses are correct.

66)

The leading cause of peptic ulcer disease is ________. A) consumption of spicy foods B) stress C) Helicobacter pylori infection D) alcohol consumption

67) Which of the following is NOT an appropriate recommendation for treatment of peptic ulcer disease? Version 1

A) Limit heavy use of aspirin and other NSAID medications. B) Consume pepper and other strong spices to help move foods through the GI tract. C) Treat withanantibiotic under the care of a physician. D) Stop smoking and limit alcohol intake.

68)

Gallstones are formed mainly from ________. A) pancreatic secretions B) cholesterol C) phospholipids D) minerals

69)

Factors associated with gallstone formation include ________. A) rapid weight loss B) high fiber intake C) being underweight D) None of these answers are correct.

70)

A main cause of intestinal gas formation is ________. A) a lack of bacteria in the large intestine B) the breakdown of undigested carbohydrates by bacteria in the large intestine C) insufficient bile production for fat digestion and absorption D) All of these choices are correct.

71)

Carbohydrates that may contribute to intestinal gas formation include ________.

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A) lactose, fructose, and raffinose B) amylose, glucose, and starch C) sucrose, starch, and glucose D) amylose, glucose, and sucrose

72)

A sensible idea for preventing constipation is to ________. A) use a laxative when needed B) decrease fluid intake C) include more white bread, white rice, and ice cream in the diet D) include more whole grain breads, beans, and apples in the diet

73)

Celiac disease is best treated by ________. A) medication prescribed by a physician B) a high-fiber diet C) a gluten-free diet D) an allergen-free diet

74)

Gluten is best described as ________. A) a protein found in wheat and related grains B) a carbohydrate found in wheat and related grains C) a substance found in wheat and related grains that causes irritable bowel disease D) a medication used to treat celiac disease

75)

Swollen veins in the rectum or anus are called ________.

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A) hemorrhoids B) peptic ulcers C) heartburn D) irritable bowel syndrome

76)

Using mineral oil as a laxative can cause ________. A) colon cancer B) loss of water-soluble vitamins C) loss of fat-soluble vitamins D) diverticulosis

77) Which of the following digestive disorders is caused by thebacterium Helicobacter pylori? A) Flatulence B) Constipation C) Diarrhea D) Peptic ulcer

78)

Which of the following is NOT true about inflammatory bowel disease (IBD)?

A) The most commontypes are ulcerative colitis and Crohn's disease. B) It can causeinflammation and ulceration throughout the gastrointestinal tract. C) IBD is caused by areaction to proteins in foods. D) Nutritional problems related to IBD include anemia, osteoporosis, and poor growth (in children)

79)

The hormone gastrin is made in the _____ and controls the release of _____.

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A) stomach; HCl B) pancreas; insulin C) small intestine; CCK D) mouth; saliva

80)

Which structure prevents food and liquid from entering the airway? A) Tongue B) Epiglottis C) Salivary glands D) Lower esophageal sphincter

81)

In what order does food pass through the organs of the GI tract? A) Duodenum, Stomach, Colon, Ileum, Rectum B) Ileum, Jejunum, Duodenum, Colon, Rectum C) Stomach, Duodenum, Jejunum, Ileum, Colon D) Stomach, Jejunum, Duodenum, Colon, Ileum

82)

What would happen to the lining of the stomach if mucus were not produced? A) The production of intrinsic factor would decrease. B) Carbohydrates could not be digested. C) Pepsinogen would not become activated. D) Cells in the stomach would not be protected from gastric juices.

83)

Which of the following nutrients is NOT acted on by pancreatic juices? A) Protein B) Fat C) Carbohydrates D) Fiber

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84)

Which of the following foods promotes the colonization of microflora in the GI tract? A) Fish B) Yogurt C) Poultry D) Iron-rich foods

85)

What will happen to fat digestion if a gallbladder is removed? A) Fats will no longer be able to be digested because of lack of bile from gallbladder. B) The pancreas will no longer produce lipase, resulting in incomplete fat digestion. C) The liver will stop producing bile and fat digestion will cease. D) Bile will be directly secreted to the small intestine, continuing fat digestion.

86) Which of the following grains should be consumed by an individual with gluten sensitivity or celiac disease? A) Rye B) Barley C) Quinoa D) Spelt

87)

Diarrhea in young children is most typically caused by ____. A) excessive fruit juices B) pathogenic microorganisms C) food poisoning D) food allergies

88)

Low-FODMAP diets may be a good option for individuals with IBS because

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A) low-FODMAP diets reduce acid production in the stomach. B) low-FODMAP diets reduce intake of carbohydrates that are poorly digested and absorbed, and thus are fermented by bacteria in the large intestine. C) low-FODMAP diets are easy to follow and include a wide variety of foods to easily support nutrient needs. D) low-FODMAP diets focus on reducing sugar intake to control blood sugar metabolism.

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 89) Describe the major function of each organ used in the digestive process.

90) A person with a bad cold reports not being able to "taste" anything. Explain what has happened.

91)

Describe the functions of 4 major hormones specific to the digestive process.

92)

Explain the 3 major functions of the large intestine.

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93)

List the major substances absorbed in the stomach, small intestine, and large intestine.

94)

Provide four suggestions for someone who commonly develops constipation.

95) In celiac disease, the protein gluten damages the intestinal villi. Describe why this damage often results in significant malabsorption and malnutrition.

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Answer Key Test name: Chap 04_3e_Test Bank 1) TRUE 2) FALSE Bile is still produced by the liver (and helps to digest fats) when the gallbladder is removed. 3) TRUE 4) FALSE The lymphatic system provides an alternative route into the bloodstream for large molecules that cannot be absorbed by the capillary beds. Fatsoluble nutrients (most fats and the fat-soluble vitamins A, D, E, and K) and other substances, such as some proteins, are transported in lymph. 5) FALSE Multiple related factors are thought to contribute to the development of IBS, including abnormal intestinal motility (leading to constipation or diarrhea), abnormal pain sensation, psychosocial distress, altered gut immunity, increased intestinal permeability, and intestinal dysbiosis. 6) TRUE 7) FALSE When suffering from diarrhea, one needs to consume fluids to avoid dehydration and replace electrolytes. 8) C 9) D 10) A 11) C Kidneys are part of the urinary tract. Version 1

12) D 13) C 14) D 15) C 16) B 17) A 18) B 19) D 20) A 21) B 22) B 23) D 24) B 25) A 26) C 27) C 28) D 29) C 30) B 31) C 32) B 33) B 34) C 35) B 36) B 37) D 38) C 39) D 40) C 41) A Version 1

42) B 43) E 44) B 45) A 46) B 47) B 48) C 49) B Since bile is used as an emulsifying agent to aid in the absorption of fat, bile production would impair fat absorption. 50) D 51) C 52) B 53) A Sucrase breaks down sucrose. 54) A 55) B 56) B 57) D 58) E 59) A Yogurt contains “live active cultures” of bacteria. 60) B Probiotics would allow healthy gut bacteria to re-inhabit the gut after being upset by an episode of diarrhea. 61) D 62) A 63) D Version 1

Prebiotics “feed” the probiotic bacteria. 64) D 65) E 66) C 67) B Recommendations listed in Table 4-5. 68) B 69) A 70) B 71) A 72) D Whole grains, beans, and fruit add more dietary fiber to the diet. 73) C Celiac disease is affected by the protein gluten, which causes an allergic reaction/response. 74) A 75) A 76) C 77) D 78) C 79) A 80) B 81) C 82) D Mucus protects the stomach from being damaged by HCl acid. 83) D Fiber is not able to be fully digested by the body.

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84) B Yogurt is a probiotic food, promoting healthy GI flora. 85) D Bile is still created by the liver after gallbladder removal, so therefore is directly excreted and not stored. This can cause problems if too much fat is eaten at once. 86) C Quinoa does not contain gluten. 87) B 88) B In some individuals, FODMAP carbohydrates are poorly digested and absorbed. This means that they are carried to the large intestine, where bacteria ferment them, also producing intestinal gas. This fermentation process can contribute to intestinal pain and bloating. Low-FODMAP diets may be a good option for individuals with IBS. 89) Answers will vary. Secretion

Sites of Production

Functions

Saliva

Mouth

Dissolves taste-forming compounds; contains many compounds that aid swallowing, digestion, and protection of teeth

Mucus

Mouth, stomach, small and large intestines

Protects GI tract cells, lubricates digesting food

Enzymes (amylases, lipases, proteases)

Mouth, stomach, small intestine, pancreas

Break down carbohydrates, fats, and protein into forms small enough for absorption

Acid (HCl)

Stomach

Promotes digestion of protein, destroys microorganisms, increases solubility of minerals

Bile

Liver (stored in gallbladder)

Aids in fat digestion (emulsifies fat)

Bicarbonate

Pancreas, small intestine

Neutralizes stomach acid when it reaches small intestine

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Hormones

Stomach, small intestine, pancreas Regulate food intake, digestion, and absorption

90) Answers will vary. The sense of taste is enhanced by input from approximately 6 million olfactory cells in the nose, which are stimulated when we chew. Thus, it makes perfect sense that, with nasal congestion, even strong-tasting foods may have little flavor. A variety of diseases and drugs, as well as the effects of aging, can alter taste and smell sensations. 91) Answers will vary. Five hormones, part of the endocrine system, play key roles in this regulation: gastrin, secretin, cholecystokinin (CCK), somatostatin, and glucose-dependent insulinotropic peptide (Table 4-4). 92) Answers will vary. The large intestine performs 3 main functions. It houses gut microbiota that keep the GI tract healthy; it absorbs water and electrolytes, such as sodium and potassium; and it forms and expels feces. 93) Answers will vary. Organ

Primary Nutrients Absorbed

Stomach

Alcohol (20% of total) Water (minor amount)

Small intestine

Calcium, magnesium, iron, and other minerals Glucose Amino acids Fats Vitamins Water (70% to 90% of total) Alcohol (80% of total) Bile acids

Large intestine

Sodium Potassium Some fatty acids Vitamin K and biotin (synthesized by microorganisms in the large intestine) Gases Water (10% to 30% of total)

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94) Answers will vary. Eating foods with plenty of fiber, such as whole-grain breads and cereals, beans, fruits, and vegetables, and drinking more fluid help treat typical cases of mild constipation. The recommended fiber intake for most adults is 25 to 38 grams per day. Fiber stimulates peristalsis by drawing water into the large intestine and helping form bulky, soft feces. The bulky fecal material stretches the peristaltic muscles; the muscles respond by constricting, causing the feces to be propelled forward. 95) Most nutrients are absorbed through the villi. If this is damaged, nutrients will not be absorbed and malnutrition can result. Answers will vary. more info in “Expert Perspective from the Field”

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CHAPTER 5 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The focus on low-glycemic load foods can aid in the control of diabetes. ⊚ ⊚

true false

Soluble dietary fibers have been shown to reduce serum cholesterol. ⊚ ⊚

true false

3) Carbohydrate counting and the food lists for diabetes are effective ways for diabetics to monitor daily carbohydrate intake. ⊚ ⊚

true false

Persons with diabetes can never eat sugar. ⊚ ⊚

true false

The adequate intake for dietary fiber is set at 14 g/1000 kcal. ⊚ true ⊚ false

High-fiber diets can impair the absorption of trace minerals. ⊚ ⊚

true false

7) The glycemic index is a ratio of the blood glucose response of a given food compared with a standard.

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⊚ ⊚

true false

8) Metabolic syndrome is characterized by insulin resistance, obesity, hypertension, and hyperlipidemia. ⊚ ⊚

The RDA for carbohydrate intake is 300 g/day. ⊚ ⊚

10)

true false

Sucralose is a nutritive sweetener that is approximately the same sweetness as honey. ⊚ ⊚

true false

11)

The Atkins diet promotes a high-carbohydrate, low-fat diet pattern. ⊚ true ⊚ false

12)

Sucrose is made up of glucose + glucose. ⊚ ⊚

13)

true false

Raffinose and stachyose are examples of polysaccharides. ⊚ ⊚

true false

14) Maintaining one's ideal body weight is a good means of decreasing risk of type 2 diabetes. Version 1

⊚ ⊚

true false

15)

Type 1 diabetes is caused by a high-sugar dietary pattern. ⊚ true ⊚ false

16)

Glycogen is made of glucose units linked by beta bonds. ⊚ ⊚

true false

17) Sorbitol, mannitol, and xylitol are nutritive sweeteners used in sugarless gum and candies. ⊚ ⊚

true false

18) An adequate carbohydrate intake is important in preventing ketosis and sparing protein from use as an energy source. ⊚ ⊚

19)

Indigestible carbohydrates play a role in promoting bowel health and preventing obesity. ⊚ ⊚

20)

true false

Indigestible carbohydrates play a role in enhancing blood glucose control. ⊚ ⊚

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true false

21) Saliva contains an enzyme called maltase that aids in the breakdown of maltose in the mouth. ⊚ ⊚

22)

true false

Monosaccharides are absorbed by an active absorption process. ⊚ ⊚

true false

23) Insoluble fiber is readily metabolized into acids and gases by bacteria in the large intestine. ⊚ ⊚

24)

true false

Fructose is taken up by the absorptive cells of the small intestine via facilitated diffusion. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 25) Glucose, galactose, and fructose ________. A) are disaccharides B) are soluble fibers C) are monosaccharides D) are polysaccharides

26)

Another name for glucose is ________.

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A) sorbitol B) dextrose C) levulose D) maltose

27)

Three important disaccharides are ________. A) lactose, fructose, and maltose B) fructose, glucose, and galactose C) maltose, sucrose, and lactose D) sucrose, fructose, and glycogen

28)

Which of the following is a noncarbohydrate component of dietary fibers? A) Glycogen B) Pectin C) Cellulose D) Lignin

29)

The three elements in simple sugar are ________. A) carbon, hydrogen, and oxygen B) carbon, hydrogen, and nitrogen C) carbon, hydrogen, and sulfur D) carbon, nitrogen, and oxygen

30)

The enzyme sucrase breaks down sucrose into ________.

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A) glucose + glucose B) lactic acid C) glucose + fructose D) glucose + maltose

31) A sugar not commonly found free in nature that combines with glucose to form the disaccharide lactose is ________. A) sucrose B) maltose C) fructose D) galactose

32)

Humans can digest a carbohydrate if the glucose bond is ________. A) an alpha bond B) a beta bond C) a gamma bond D) a peptide

33)

Sorbitol is ________. A) a sugar alcohol B) absorbed and metabolized more slowly than glucose and other sugars C) used in candies and gums D) All of these choices are correct.

34)

The sugar alcohol commonly used to sweeten chewing gum and candy is ________.

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A) corn syrup B) dextrin C) invert sugar D) sorbitol

35)

The principal sugar found in milk is ________. A) sucrose B) lactose C) dextrose D) maltose

36) In the production of alcoholic beverages, maltose is formed from cereal grains because of the ________. A) germination of grains B) condensation of sugars C) fermentation of stachyose D) hydrolysis of simple sugars

37)

Once absorbed, the majority of glucose is transported to________. A) muscle tissue B) the liver C) the pancreas D) brain cells

38)

The principal function of dietary carbohydrate is to provide ________.

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A) bulk in the diet B) structural material C) sweetness in foods D) energy

39) If no glucose is available from dietary carbohydrate, glucose in the blood may first be derived from ________. A) muscle glycogen and liver glycogen B) triglyceride breakdown C) muscle glycogen and fatty acids D) sugar alcohols

40)

Dietary sugars and starches are called "protein sparing," which means ________.

A) sugars and starches can substitute for dietary protein when it comes to body protein synthesis B) dietary protein can be used for protein synthesis and other vital processes, rather than being used as a source of energy C) sugars and starches are converted to fat, and then converted to glucose for use as blood sugar D) sugars and starches are converted by the liver to ketone bodies

41) The body is capable of making glucose from non-carbohydrate nutrients, such as the amino acids of protein, by a process referred to as ________. A) glycogenesis B) glycolysis C) gluconeogenesis D) ketosis

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42)

The human brain and other nerve tissues use mostly _________________ as fuel. A) fructose B) protein C) ethanol D) glucose

43)

After digestion and absorption, dietary carbohydrates may be ________. A) used for energy B) converted to glycogen and stored in liver and muscle tissue C) synthesized into fat D) All of these choices are correct.

44)

The energy value of dietary carbohydrates is _____ kcal per gram. A) 4 B) 7 C) 9 D) 15

45)

Individuals with lactose intolerance can usually tolerate small amounts of ________. A) yogurt B) nonfat milk C) cheddar cheese D) All of these are often tolerated in small amounts.

46)

Primary lactose intolerance results from ________.

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A) lactase insufficiency B) drinking lactose-fortified milks C) bacteria inhabiting the small intestine D) living in such locations as Mexico, China, Africa, or the Mediterranean

47)

An example of an oligosaccharide is ________. A) maltose B) raffinose C) galactose D) glycogen

48)

Much of the galactose in our diet is found in ________. A) high-fiber foods B) dairy products C) dark green leafy vegetables D) honey and table sugar

49)

Ketosis may result from ________. A) starvation B) a diet of less than 50-100 grams of carbohydrate per day C) untreated diabetes mellitus D) All of these choices are correct.

50)

Insulin is made in the ________.

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A) gallbladder B) pancreas C) liver D) small intestine

51) While _________ suppresses gluconeogenesis, ____________ increases glycogen breakdown. A) glucagon; insulin B) insulin; glucagon C) insulin;glucose D) cortisol; glucagon

52)

Normalfasting blood glucose levels range between ________. A) 40 and 70 mg/dL B) 70 and 100 mg/dL C) 125 and 140 mg per 100 ml D) 200 and 300 mg/dL

53) Low blood glucose is called____________, whereas high blood glucose is called ____________. A) hypoglycemia;hyperglycemia B) metabolic syndrome;hyperglycemia C) hypoglycemia;polydipsia D) hyperglycemia; hypoglycemia

54)

Which combination of foods would be highest in complex carbohydrates?

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A) Cola, Potato chips, Chicken-salad sandwich B) Spaghetti with marinara sauce, Broccoli, Dinner roll, Milk C) Coffee, Crisp bacon, Fried egg, Orange drink D) Chipped beef and Gravy

55) Food processors and manufacturers use amylopectins primarily to produce sauces and gravies for frozen foods because they ________. A) are easily digested B) are resistant to spoilage C) form a stable starch gel D) are sweet tasting

56) Raffinose and stachyose are indigestible oligosaccharides found in foods such as ________. A) milk and dairy products B) cereals and grains C) fruits and vegetables D) beans and other legumes

57)

The storage form of carbohydrates in plants is ________. A) maltose B) starch C) glycogen D) ribose

58) Amylose and amylopectin contain ___________ bonds, which are responsible for the digestibility of these starches.

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A) alpha B) beta C) alpha and beta D) gamma

59)

The best type of fiber to eat for reducing constipation is ________. A) glycogen B) crude fiber C) soluble fiber D) insoluble fiber

60)

Which of the following is classified as an insoluble fiber? A) Pectin B) Mucilage C) Cellulose D) Gums

61)

Which of the following dietary fibers are classified as soluble fibers? A) Pectins and mucilages B) Pectins and lignins C) Hemicelluloses, cellulose, and lignins D) Mucilages and cellulose

62)

_______ is defined as fiber that is added to foods and provides health benefits.

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A) Dietary fiber B) Functional fiber C) Bulk D) Crude fiber

63)

When increasing fiber intake, always ________. A) take a fiber supplement B) increase fluids C) use simple carbohydrates D) increase protein intake also

64) Pouches that form in the walls of the large intestine due to excessive exertion during defecation are called ________. A) hemorrhoids B) ulcers C) diverticula D) phytobezoars

65) During the inflammatory phase of diverticulitis, treatment includes antibiotics and a diet that is ________. A) lower in fiber B) higher in fiber C) lower in sugar D) higher in sugar

66)

The AI for fiber for women is ________.

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A) 15 g/day B) 25 g/day C) 38 g/day D) 45 g/day

67)

An increased fiber intake within recommended guidelines may ________. A) decrease risk of diabetes B) lower blood lipid levels C) decrease risk of certain cancers D) All of these choices are correct.

68)

Which of the following combinations of foods would provide the most dietary fiber?

A) Kidney bean salad, turkey sandwich on whole wheat bread, fresh apple, milk B) Ham sandwich on white bread, potato chips, iced tea C) Roast beef, mashed potatoes, coffee with sugar D) Cheeseburger (white bun, lettuce, mustard, catsup, slice of tomato, 3 oz ground beef, processed cheese slice), french fries, soft drink

69) Of the total day's energy intake, most dietary guidelines recommend that carbohydrates provide _____________ of energy. A) 10%-15% B) 20%-35% C) 45%-65% D) 70%-75%

70)

Why is excess sugar consumption discouraged?

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A) It may cause dentalcaries. B) It may cause weightgain. C) It generally lacks dietary fiber. D) All of these choices are correct.

71) According to the Dietary Guidelines for Americans, consumers should limit their intake of added sugars to ____________ percent of total energy. A) 0 B) 6 C) 10 D) 25

72) Consuming more than 60 grams of fiber per day poses some health risks, such as ________. A) decreased mineral absorption due to chemical binding by the fiber B) blockage of the intestinal tract C) decreased appetite in some individuals D) All of these choices are accurate.

73)

A trade name for aspartame is ________. A) naturlose B) equal C) splenda D) sunette

74) A person diagnosed with phenylketonuria (PKU) should avoid products containing ________.

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A) saccharin B) aspartame C) lactose D) sucrose

75)

All persons with diabetes ________. A) receive insulin injections daily B) need to eat a diet that will control their blood sugar C) can skip meals if they don't feel hungry D) should drink 4 glasses of milk daily to control their blood sugar

76)

Which of the following is the best source of starch? A) Fresh blueberries B) Whole-grain oats C) Low-fat yogurt D) Dark leafy greens

77)

Which of the following is classified as a non-nutritive sweetener? A) Sorbitol B) Honey C) Aspartame D) Mannitol

78)

Which of the following population groups is at lowest risk of type 2 diabetes?

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A) College students B) Obese adults C) Individuals of Hispanic heritage D) Adults over 45 years of age

79)

Usual symptoms of diabetes mellitus include ________. A) weight change B) excessive thirst and urination C) blurred vision D) All of these choices are correct.

80)

Which condition is NOT usually associated with type 2 diabetes? A) Autoimmune destruction of beta cells of the pancreas B) Metabolic syndrome C) Age of onset usually over 40 D) Obesity

81)

The most common type of diabetes mellitus is ________. A) type 1 diabetes B) type 2 diabetes C) gestational diabetes

82)

Which of the following foods has the highest glycemic index?

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A) Bananas B) Apple C) Baked potato D) White bread

83)

Treatment for reactive hypoglycemia includes ________.

A) administering insulin before a meal B) eating regular meals and snacks of protein and complex carbohydrates and avoiding excess simple sugar C) following a high-protein, high-fat diet D) taking supplements of vitamins and minerals

84) After carbohydrates are absorbed from the intestine, which of the following organs receives the absorbed carbohydrates first? A) Kidneys B) Liver C) Pancreas D) Brain

85)

Which of the following foods contains the least amount of lactose per serving? A) Frozen yogurt B) Ice cream C) Bagel D) Swiss cheese

86)

Which of the following organs is the first to respond to a rise in blood glucose levels?

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A) Heart B) Liver C) Gallbladder D) Pancreas

87)

Changes in blood glucose levels will typically result in the following scenario: A) Blood glucose levels that fall too low signal the release of insulin. B) Blood glucose levels that fall too low signal the release of glucagon. C) Blood glucose levels that rise too high signal the release of glycogen. D) Blood glucose levels that rise too high signal the release of epinephrine.

88)

What is stevia? A) A naturally derived sweetener from a plant B) A sugar alcohol C) Apolysaccharide D) A naturally derived sweetener from a fruit

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 89) Name 3 health benefits derived from increased dietary fiber intake.

90)

What foods do individuals with phenylketonuria (PKU) need to avoid?

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91)

Name 3 typical symptoms of type 1 diabetes.

92)

List 3 monosaccharides.

93)

List 3 disaccharides.

94)

What does the term "functional fiber" mean?

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95) List and explain which two primary hormones are regularly involved in maintaining normal blood glucose levels.

96)

List 3 ways to decrease the risk of developing type 2 diabetes.

97)

List 3 examples of non-nutritive sweeteners.

98)

List 3 primary functions of carbohydrates.

99)

List 3 health concerns associated with a low-fiber diet.

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Answer Key Test name: Chap 05_3e_Test Bank 1) TRUE TRUE statement 2) TRUE TRUE statement 3) TRUE TRUE statement 4) FALSE An individual with diabetes CAN consume sugar; however, it should be in controlled amounts, and planned in accordance with other meals and medication. Choices should also ideally be mainly from lower glycemic index foods. 5) TRUE TRUE statement 6) TRUE TRUE statement 7) TRUE TRUE statement 8) TRUE TRUE statement 9) FALSE The RDA for carbohydrates is 130g/day. 10) FALSE Version 1

Sucralose is an alternative sweetener that is approximately 600 times sweeter than sucroses. 11) FALSE The Atkin’s diet promotes low-carbohydrate, high-fat/protein pattern. 12) FALSE Sucrose is made up of glucose + fructose. 13) FALSE Raffinose and stachyose are oligosaccharides. 14) TRUE TRUE statement 15) FALSE A high-sugar dietary pattern has not been proved to CAUSE either type 1 or type 2 diabetes. Type 1 diabetes is an autoimmune disease. A highsugar dietary pattern may contribute to type 2 diabetes by promoting weight gain and fatty liver, which may worsen insulin sensitivity. 16) FALSE Glycogen is made of glucose units linked by ALPHA bonds. 17) TRUE TRUE statement 18) TRUE TRUE statement 19) TRUE TRUE statement 20) TRUE TRUE statement

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21) FALSE Saliva contains salivary amylase. 22) TRUE TRUE statement 23) FALSE Insoluble fibers do not dissolve in water and are not metabolized by bacteria in the large intestine. 24) TRUE TRUE statement 25) C 26) B 27) C 28) D 29) A 30) C 31) D 32) A 33) D 34) D 35) B 36) A 37) B 38) D 39) A If blood glucose is low and dietary carbohydrate is not available, glycogen breakdown is the short-term storage form of carbohydrates and is broken down to increase blood glucose. 40) B Version 1

41) C 42) D 43) D 44) A 45) D 46) A 47) B 48) B 49) D 50) B 51) B 52) B 53) A 54) B The foods in this answer all contain complex carbohydrates. The other responses either have more refined, simple sugars and/or fats and proteins. 55) C 56) D 57) B 58) A 59) D Insoluble fiber provides bulk to feces and reduces transit time in intestines. 60) C 61) A 62) B 63) B 64) C Version 1

65) A 66) B 67) D 68) A Kidney beans, whole wheat bread, and apple all contain good sources of dietary fiber. 69) C 70) D 71) C 72) D 73) B 74) B Individuals with PKU cannot breakdown phenylalanine, which is contained in aspartame. 75) B As diabetes is a disorder where blood sugar is not regulated correctly, all individuals with diabetes must eat a diet that controls the amount of blood sugar released into their bloodstream. This is done through controlled/consistent carbohydrate intake. 76) B Oats contain carbohydrate in the form of starch. 77) C 78) A All other options are higher-risk groups for type 2 diabetes. 79) D 80) A 81) B 82) C Version 1

See GI list. Potatoes have a higher number than other options listed. 83) B In reactive hypoglycaemia, where the blood sugar is low, an individual should consume consistent, controlled carbohydrates throughout the day in order to better regulate blood sugar levels. 84) B 85) C Bagel is not a dairy product and has no galactose or lactose. 86) D Pancreas creates and releases INSULIN, which allows blood glucose to enter the cells, and therefore lowers blood glucose levels. 87) B This is the correct sequence of event and hormone response. 88) A 89) When consumed in adequate quantities, these fibers have been shown to lower blood cholesterol levels and blood glucose levels, thereby reducing risks of cardiovascular disease and diabetes. In addition, fiber can decrease intestinal transit time, thus reducing risks of constipation and diverticular disease. Also, increases feeling of fullness and reduces obesity risk, as well as potentially other cancers and chronic diseases related to digestive tract. 90) Individuals with the genetic disease phenylketonuria (PKU), which interferes with the metabolism of the amino acid phenylalanine, also should avoid aspartame because of its high phenylalanine content.

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91) In type 1 diabetes, individuals develop the classic symptoms of hyperglycemia (increased hunger, thirst, urination, and weight loss). No one symptom is diagnostic of diabetes. Other symptoms—such as unexplained weight loss, exhaustion, and blurred vision—may accompany these symptoms. 92) glucose, fructose, galactose 93) Answer: sucrose, maltose, lactose 94) Fiber added to foods that has shown to provide health benefit 95) Insulin is a hormone produced by beta cells of the pancreas. Among other processes, insulin increases the synthesis of glycogen in the liver and the movement of glucose from the bloodstream into muscle and adipose cells. Another pancreatic hormone, called glucagon, is secreted in response to a decrease in blood glucose. It prompts the breakdown of glycogen in the liver and promotes gluconeogenesis, resulting in the release of glucose to the bloodstream and the normalization of blood glucose levels. 96) Regular exercise, consuming lower glycemic index foods, weight control/maintain healthy weight, following the DGAs, regular screening if at risk 97) Non-nutritive (alternative or artificial) sweeteners provide very-lowcalorie or non-caloric sugar substitutes for people with diabetes and those trying to lose (or control) body weight. Alternative sweeteners include saccharin, cyclamate, aspartame, neotame, sucralose, acesulfame-K, tagatose, stevia, and monk fruit. 98) Providing energy, sparing protein as an energy source, preventing ketosis

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99) constipation/GI irregularity, GI health problems, overweight/obesity, high sugar intake, excess calorie intake, insufficient micronutrient intake.

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CHAPTER 6 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Since monounsaturated fats are healthier, consuming them in excessive amounts is always considered good. ⊚ true ⊚ false

All fat-free foods are generally healthy for you. ⊚ ⊚

true false

3) The decrease in HDL due to the decrease of estrogen in postmenopausal women plays a part in the increased risk of heart disease that occurs in older women. ⊚ ⊚

High blood levels of HDL are protective against heart disease. ⊚ ⊚

true false

Trans fatty acids raise HDL and lower LDL. ⊚ ⊚

true false

Americanstypically eat more omega-3 fatty acids than omega-6 fatty acids. ⊚ ⊚

true false

Plants contain cholesterol.

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⊚ ⊚

Generally dietary cholesterol is recommended not to exceed 300 milligrams per day. ⊚ ⊚

true false

Lecithin and bile are examples of emulsifiers. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 10) Alpha-linolenic acid and linoleic acid are classified as _________ fatty acids. A) essential B) nonessential C) saturated D) trans

11)

Which is correct regarding trans fatty acids? A) They raise HDL and LDL cholesterol. B) They lower LDL cholesterol. C) They raise blood cholesterol and lower HDL cholesterol. D) They raise blood glucose.

12)

Which of the following correctly characterizes lipids?

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A) They do not dissolve in water. B) They containcarbon, hydrogen, and nitrogen. C) They dissolve in water. D) They are all classified as sterols.

13)

In what form is most body fat stored? A) Cholesterol B) Phospholipids C) Triglycerides D) None of these responses are correct.

14)

The functions of fat include all of the following EXCEPT ________. A) build and repair tissue B) cushion and protect vital organs C) insulate the body D) transport fat-soluble vitamins

15) All of the following are ways in which fatty acids can differ from one another EXCEPT ________. A) number of double bonds B) degree of saturation C) chain length D) average number of calories per gram

16)

Phospholipids consist of ________.

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A) glycerol and three fatty acids B) glycerol, two fatty acids, and phosphate C) multiple chemical rings D) chylomicrons

17) Lipids with high saturated fatty acid content aregenerally ____________ at room temperature. A) solid B) liquid C) warm D) gaseous

18)

Arachidonic acid is associated with ________. A) glucose metabolism B) omega-3 fatty acid metabolism C) omega-6 fatty acid metabolism D) cholesterol metabolism

19)

Which of the following lipids is a precursor for estrogen and bile? A) Cholesterol B) Alpha-linoleic acid C) Eicosinoids D) Saturated fat

20) Recommendations suggest that we consume approximately 20% of our fat as monounsaturated fats. All of the following would be appropriate to use to achieve this goal EXCEPT ________.

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A) peanut oil B) canola oil C) coconut oil D) olive oil

21)

Lard, butter, and cream are rich sources of ________. A) saturated fatty acids B) monounsaturated fatty acids C) polyunsaturated fatty acids D) trans fatty acids

22)

The chief contributors of saturated fatty acids in the U.S. diet include ________. A) whole grains B) sunflower, soybean, and safflower oils C) lecithins D) animal products

23)

Saturated fatty acids predominate in which of the following lipids? A) Canola oil B) Safflower oil C) Butter D) Olive oil

24) Which of the following groups of foods would contribute a substantial amount of monounsaturated fatty acids to the diet?

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A) Olive oil, peanuts, and almonds B) Beef franks, bologna, and ham C) Carrots, beets, and peppers D) Bacon, eggs, and butter

25)

Monounsaturated fatty acids ________. A) are liquid at room temperature B) have one double bond in the fatty acid chain C) lower cholesterol D) All of these responses are correct.

26) Fats that are liquid at room temperature can be made more solid by the process of ________. A) saponification B) hydrogenation C) emulsification D) calcification

27)

Which of the following fats and oils provides the most polyunsaturated fatty acids? A) Olive oil B) Butter C) Soybean oil D) Lard

28)

Which essential fatty acid is responsible for lowering the risk of coronary heart disease?

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A) Alpha-linolenic B) Linoleic C) Omega-6 fatty acids D) Omega-9 fatty acids E) None of thesechoices are correct.

29)

Lecithin is classified as a ________. A) triglyceride B) phospholipid C) sterol D) fatty acid

30)

Ergosterol is a type of sterol found in ________. A) eggs B) meat C) plants D) None of the above are correct.

31)

Cholesterol is ________. A) not essential in the diet; the human body can synthesize it B) not found in foods of plant origin C) an important part of human cell membranes and is necessary to make some hormones D) All of these choices are correct.

32) Mike has been told to reduce his fat intake to less than 30% of his total calories. It has been recommended to him that he consume an average of 2000 calories per day. How many grams of fat should he consume per day?

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A) 76 grams B) 67 grams C) 80 grams D) 93 grams

33) TheDietary Guidelines for Americans recommend that total fat intake should not exceed __________ of total calories and saturated fat intake be limited to _______ of total calories. A) 20%; 1% B) 20%; 5% C) 35%; 10% D) 50%; 10%

34)

In the Mediterranean Diet, the majority of fat in the diet is supplied by ________. A) olive oil and olives B) red meat C) eggs D) dairy E) cheese

35) According to guidelines from the American Heart Association for the general population, saturated fats ________. A) should constitute no more than 7% of total energy in the diet B) are quite visible in foods, so they should be eliminated from the diet to reduce risk of heart disease C) are only a health risk if they come from a food that has been fried D) are only a health risk if they come from gravies, desserts, and dairy products

36) Individuals with bleeding disorders taking anticoagulants or scheduling surgery should be cautious about which supplement? Version 1

A) Omega-6 fatty acids B) Omega-9 fatty acids C) Omega-3 fatty acids D) None of these responses are correct.

37)

All the following are good sources of omega-3 fatty acids EXCEPT ________. A) walnuts B) salmon C) avocados D) flaxseed oil

38) Most experts agree thattotal dietary cholesterol intake should be limited to _______ mg per day. A) 200 B) 300 C) 400 D) 500

39)

Fat digestion begins in the ________. A) intestines B) stomach C) mouth D) liver

40)

Lingual lipase breaks down ________.

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A) triglycerides B) proteins C) carbohydrates D) None of these choices are correct.

41)

Which lipoprotein is responsible for transporting cholesterol from the liver to tissues? A) Chylomicron B) Low-density lipoprotein (LDL) C) High-density lipoprotein (HDL) D) Chylomicron remnant

42)

A fatty acid with 10 carbons will be absorbed via the ________. A) lymphatic system B) portal system C) kidney system D) None of the above are correct.

43) High levels of ______ in the blood are associated with lower risk of cardiovascular disease. A) LDL B) HDL C) total cholesterol D) triglycerides

44)

Lipoproteins are important for ________.

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A) transport of fats in the blood and lymphatic system B) synthesis of triglycerides C) synthesis of adipose tissue D) None of these choices are correct.

45)

Which of the following lipoproteins contains the highest proportion of protein? A) LDL B) VLDL C) HDL D) Chylomicrons

46) Low-density lipoproteins (LDL) are the principal transport vehicle for _______ in the blood. A) glucose B) triglycerides C) phospholipids D) cholesterol E) free fatty acids

47)

LDL clearance in the plasma is mediated via the ______ receptor. A) B-48 B) B-100 C) CII D) A

48)

Oxidized LDL in the blood is picked up by the ________.

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A) B100 receptor B) scavenger pathway C) B48 receptor D) no cell can pick up oxidized LDL.

49)

Lipoprotein lipase functions to ________. A) absorb fatty acids and glycerol into the lymph B) reassemble chylomicrons into lipoproteins C) break down triglycerides from lipoproteins for transfer into cells D) break down diglycerides into cholesterol for transfer into cells

50) The ____ pathway for LDL uptake is a means by which LDL contributes to plaque formation in blood vessels. A) receptor B) atherosclerotic C) intermediate D) scavenger

51)

High-density lipoproteins function in lipid transport by ________.

A) delivering cholesterol to target cells throughout the body B) picking up cholesterol from dying cells and other sources for delivery to other lipoproteins and the liver for disposal C) slowly carrying newly synthesized fats from the liver to various body cells D) moving newly absorbed dietary fat through the intestinal wall

52) Immediately after a meal, newly digested and absorbed dietary fats appear in the lymph, and then the blood, as a part of which of the following?

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A) LDL B) HDL C) Chylomicrons D) Cholesterol

53)

Which apolipoprotein is responsible for activating lipoprotein lipase? A) Apo B-48 B) Apo C-II C) Apo C D) Apo B-100

54)

Excessive intakes of saturated fattyacids tend to ________. A) increase cholesterol deposited in arteries B) decrease cholesterol levels in the veins C) be of no concern to heart disease D) increase HDL levels in the blood

55)

Excessive amounts of omega-3 fatty acids can ________. A) impair the immune system B) causeexcessive bleeding C) cause hemorrhagic stroke D) All of these choices are correct. E) None of these choices are correct.

56) Blockage of a major artery is caused by a blood clot. These clots may form when ________.

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A) cholesterol plaques build up in artery walls B) HDL invades artery walls C) the dietary intake of cholesterol is less than 200 mg per day D) LDL fails to remove cholesterol from artery walls

57)

Which of the following is considered a desirable blood level for totalcholesterol? A) 200 mg/dl orless B) 300 mg/dl orless C) 400 mg/dl orless D) 500 mg/dl orless

58) Which of the following blood levels of LDL cholesterol would increase risk for cardiovascular disease for an otherwise healthy adult? A) 100 mg/dl or less B) 130 mg/dl or less C) 130-159 mg/dl D) over 160 mg/dl

59)

Which of the following is a risk factor for heart disease? A) Total bloodcholesterol level greater than 200 mg/dl B) LDL level lowerthan 100 mg/dl C) Vigorous physicalactivity D) HDL level greater than 60 mg/dl

60) All of the following are uncontrollable risk factors for heart disease EXCEPT ________.

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A) gender B) age C) genetics D) hypertension

61)

A stroke ________. A) blocks blood flow in the brain B) reduces blood flow in the heart C) reduces blood flow to the gut D) is not associated with fats or lipids

62)

A diet designed to reduce elevated serum LDL cholesterol levels ________. A) is low in saturated fats B) is reduced in dietary cholesterol C) provides adequate amounts of soluble fiber D) All of these choices are correct.

63) Trans fatty acids are now considered more atherogenic than saturated fatty acids because they ________. A) are unnatural and only form during fat processing B) cause excessive blood clotting C) elevate LDL levels, while decreasing HDL D) cause sudden cardiac arrest in post-menopausal women

64) Margarine is usually made by a process called ________, in which hydrogen atoms are added to double covalent bonds in the polyunsaturated fatty acids found in vegetable oils.

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A) saturation B) isomerization C) esterification D) hydrogenation

65) Lipids with high polyunsaturatd fatty acid content aregenerally ____________ at room temperature. A) solid B) liquid C) warm D) gaseous

66)

Eicosapentaenoic acid (EPA) is associated with A) glucose metabolism. B) omega-3 fatty acid metabolism. C) omega-6 fatty acid metabolism. D) cholesterol metabolism.

67)

Eicosanoids are A) responsible for fat transport in the bloodstream. B) proteins that actlike fat. C) part of an omega-9 fatty acid. D) substances that produce diverse hormone-like effects on the body.

68)

Saturated fatty acids predominate in which of the following lipids?

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A) Canola oil B) Safflower oil C) Butter D) Olive oil

69)

How many hydrogen atoms are attached to each carbon participating in a double bond? A) 1 B) 2 C) 3 D) 4

70)

Which of the following food sources would have the softest fats at room temperature? A) Lard B) Butter C) Chicken D) Safflower

71)

At room temperature, which of the following dietary lipids would turn rancid the fastest? A) Lard B) Peanut oil C) Soybean oil D) Coconut oil

72)

What is a common function of plant sterols? A) Raise LDL and lower HDL B) Inhibit absorption of dietary cholesterol C) Inhibit absorption of “bad” cholesterol D) Enhance absorption of omega-3 fatty acids

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73) Which of the following would be seen on a blood lipid profile of a patient who was recommended to make dietary changes to reduce his or her risk for cardiovascular disease? A) Low LDL and high HDL B) Low HDL and high LDL C) Low VLDL and high HDL D) Low LDL and low HDL

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 74) Compare and contrast the typical American diet to the Mediterranean diet.

75)

How do antioxidants reduce the risk of cardiovascular disease?

76)

How do the plant stanols found in some margarines lower cholesterol?

77) Why are premenopausal women at lower risk for heart disease when compared to men of the same age?

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78) What is atherosclerosis and what key blood cholesterol factors are most associated with this disease?

79)

What is the role of bile acids in the digestion of lipids?

80)

Evaluate the following statement: "Heart disease is more likely due to genetics than diet."

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Answer Key Test name: Chap 06_3e_Test Bank 1) FALSE The recommendation for TOTAL fat is still 20%-35% of total kcals, including monounsaturated sources. 2) FALSE Fat-free foods may contain no fat, but can be high in sugar, kcals, and processed ingredients. 3) TRUE 4) TRUE 5) FALSE Americans generally consume a higher proportion of omega-6 fatty acids, as compared to omega-3s. 6) FALSE Trans fats tend to LOWER HDL and RAISE LDL. 7) FALSE ONLY animal foods contain dietary cholesterol. 8) TRUE 9) TRUE 10) A 11) C 12) A 13) C 14) A 15) D 16) B Version 1

17) A 18) C 19) A 20) C Coconut oil is proportionately higher in saturated fat. 21) A 22) D 23) C 24) A 25) D 26) B 27) C 28) A Alpha-linolenic acid is an omega-3 fatty acid, which help lower the chances of having a heart attack. 29) B 30) C 31) D 32) B 2000 kcal x 0.30 = 600 kcal from fat 600 kcal / 9 kcal/g = 67 g fat 33) C 34) A 35) A 36) C Omega-3’s have anti-inflammatory properties that could potentially thin blood and interact with anticoagulant medicines. 37) C Version 1

38) B 39) C 40) A 41) B 42) B 43) B HDL collects cholesterol from the periphery and carries it to the liver for excretion. 44) A 45) C 46) D 47) B 48) B 49) C 50) D 51) B 52) C 53) B 54) A 55) B 56) A 57) A 58) D 59) A 60) D 61) A 62) D 63) C 64) D 65) B Version 1

66) B 67) D 68) C 69) A 70) D Of the answers listed, safflower oil has the highest unsaturated percentage, lending to more liquid in consistency. 71) C Typically, polyunsaturated fats turn rancid most quickly. Soybean oil is high in polyunsaturated fats. 72) B 73) B Typically, those at higher risk for heart disease would have a high LDL value and low HDL.

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74) Answers will vary. The traditional Mediterranean Diet features the following: ● Olive oil as the main fat (American high in sat fat) ● Abundant daily intake of fruits, vegetables (especially leafy greens like purslane, which is high in omega-3 fatty acids), whole grains, beans, nuts, and seeds (American low in fruits and vegs) ● An emphasis on minimally processed and, wherever possible, seasonally fresh and locally grown foods (American high in processed foods) ● Daily intake of small amounts of cheese and yogurt (American high in cheese and dairy) ● Weekly intake of low to moderate amounts of fish (American low in fish) ● Limited use of eggs and red meat (American high in red meat and eggs) ● Regular exercise (American low in activity) ● Moderate drinking of wine at mealtime 75) Answers will vary. Some of the LDL that remains in the blood be-comes damaged (oxidized) by free radicals, although a diet rich in an-tioxidants can help reduce LDL oxidation. Oxidized LDL increases the risk of cardiovascular disease and metabolic syndrome. 76) Answers will vary. Plant stanols/sterols in the daily diet help reduce cholesterol absorption in the small intestine and lower its return to the liver.

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77) Answers will vary. Many studies have demonstrated that the amount of HDL in the blood can closely predict the risk of cardiovascular disease. Risk increases with low HDL levels because little blood cholesterol is transported back to the liver and excreted. Women tend to have high amounts of HDL, especially before menopause, whereas low amounts are more common in men. 78) Answers will vary. Atherosclerosis, also referred to as hardening of the arteries, develops as plaque thickens in the vessel. This thickening eventually chokes off the blood supply to organs, setting the stage for a heart attack and other problems, or it breaks apart and causes a clot to form in an artery. Typically, high LDL and low HDL values are associated with higher risk. 79) Answers will vary. Bile emulsifies fats. That is, it breaks fat into many tiny droplets, called micelles, and forms a shell around the micelles that keeps the fat droplets suspended in the water-based intestinal contents. Emulsification increases the surface area of lipids and allows pancreatic lipase to efficiently break triglycerides into monoglycerides and free fatty acids. 80) Answers will vary. Having a close relative who died prematurely from CVD, especially before age 50, may increase the risk. Those with the highest risk of premature CVD have genetic defects that block the removal of chylomicrons and triglycerides from the blood, reduce the liver’s ability to remove LDL-cholesterol from the blood, limit the synthesis of HDLcholesterol, or increase blood clotting. However, a genetic link does not ENSURE an individual will suffer from a similar fate. Diet and lifestyle practices that are preventative in nature are important regardless of genetic history. Version 1

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CHAPTER 7 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The body needs 18 different amino acids to function properly. ⊚ ⊚

true false

The 9 amino acids that the body cannot make are known as nonessential amino acids. ⊚ ⊚

true false

3) An individual with the genetic disease PKU has a limited ability to metabolize the essential amino acid phenylalanine. ⊚ ⊚

true false

Nonessential amino acids can be synthesized through a process called transamination. ⊚ ⊚

true false

5) Each strand of DNA is composed of the nucleotides adenine, guanine, cytosine, and thymine. ⊚ ⊚

true false

6) Vegans need to plan their diets carefully to include adequate complementary proteins that provide the needed essential amino acids. ⊚ ⊚

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true false

7) Individuals who are attempting to build up their muscles need 3 times as much protein as those who are not building muscles. ⊚ ⊚

true false

Legumes are an excellent source of vegetable protein. ⊚ ⊚

true false

9) The Protein Digestibility Corrected Amino Acid Score (PDCAAS) is the score derived by multiplying a food's chemical score by its digestibility. ⊚ true ⊚ false

10) For the average North American, protein needs can be easily met through our typical diets without the need for supplementation. ⊚ ⊚

true false

11) During times of recovery from illness or injury, protein needs may range from 0.8 to 2.0 g/kg body weight. ⊚ ⊚

true false

12) Proteins in cow's milk and egg white are not recommended to be given to high risk infants (infants with a family history of allergies) until consulting a pediatrician, as they may predispose the infant to allergies. ⊚ ⊚

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true false

13) High-protein diets are often associated with increased intake of saturated fat and cholesterol in the diet. ⊚ ⊚

14)

true false

Marasmus in infants commonly occurs in poverty-stricken countries. ⊚ ⊚

true false

15) An excess intake of protein, especially from protein supplements, can increase the risk of amino acid toxicity. ⊚ ⊚

16)

Peanuts, cow's milk, and shellfish are among foods considered to be highly allergenic. ⊚ ⊚

17)

true false

Once a food allergy has developed, it persists throughout life. ⊚ ⊚

true false

18) Compared to the typical American diet, vegetarian diets are generally lower in dietary fiber. ⊚ ⊚

19)

true false

Lacto-ovo-vegetarians exclude meat, poultry, fish, and eggs from their diet. ⊚ ⊚

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true false 3

20) The enzymatic digestion of protein begins in the stomach, where proteins are broken down into shorter polypeptide chains of amino acids. ⊚ ⊚

true false

21) Protein intakes above 35% of energy intake may be associated with dehydration, amino acid imbalance, and increased risk of certain cancers. ⊚ ⊚

22)

true false

Vegetarian diets are most often low in calcium, vitamin D, vitamin B-12, iron, and zinc. ⊚ ⊚

true false

23) Most animal proteins have a high biological value as their tissue amino acid pattern is similar to that of human tissues. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 24) The basic building blocks of protein are ________. A) amino acids B) polypeptides C) enzymes D) hormones

25) fat.

The presence of ___________ chemically distinguishes protein from carbohydrate and

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A) carbon B) choline C) nitrogen D) hydrogen

26)

Dietary proteins supply ______ kcal per gram. A) 4 B) 7 C) 9 D) 15

27)

Which bodily function is not associated with protein? A) Blood clotting B) Fluid balance C) Cell growth and repair D) Sparing glucose for energy use as the primary source of energy

28) Over time, if protein intake does not meet the body's protein needs for building and repair of tissues, ________. A) skeletal muscle, heart muscle, and the liver decrease in size B) excessive body fluid begins to accumulate in the extracellular spaces C) the immune system fails to function properly D) All of these choices are accurate.

29)

Which of the following foods provides all of the essential amino acids?

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A) Wheat B) Peanut butter C) Navy beans D) Milk

30)

The side chain, or R portion, of an amino acid ________. A) can be synthesized if there is a source of nitrogen B) can be synthesized if caloric intake is adequate C) cannot be synthesized in sufficient quantities to meet body needs D) determines the name of the amino acid

31) Which of the following amino acids is classified as a "conditionally essential" amino acid? A) Methionine B) Phenylalanine C) Tyrosine D) Lysine

32) Foods containing all essential amino acids in the proportion needed by the body are designated as ________. A) incomplete proteins B) high-quantity proteins C) dispensable proteins D) complete proteins

33) Good sources of high-quality (complete) protein include all of the following EXCEPT ________.

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A) soybeans B) eggs C) whole wheat D) fish

34) When over 10 amino acids are chemically linked by peptide bonds, the resulting product is known as ________. A) a dipeptide B) a tripeptide C) an oligopeptide D) a polypeptide

35)

Cooking an egg destroys its physiological property by ________. A) denaturation B) emulsification C) esterification D) detoxification

36) When 2 or more plant proteins are combined to compensate for deficiencies in essential amino acid content in each protein, the proteins are called ________. A) nonessential proteins B) complementary proteins C) conditional proteins D) corrected proteins

37) DNA-coded instructions for protein synthesis consist of a sequence of ___ nucleotides per unit.

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A) 2 B) 3 C) 5 D) 10

38) The nucleotide units that represent a specific amino acid in protein synthesis are called ________. A) blocks B) bonds C) peptides D) codons

39) The genetic disorder sickle-cell anemia produces a profound change in ___________ structure. A) hemoglobin B) albumin C) phenylalanine D) lysine

40)

The sequential order of the amino acids in the polypeptide chain is called the ________. A) primary structure B) secondary structure C) tertiary structure D) quaternary structure

41)

Worldwide, approximately _______ of protein comes from animal sources.

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A) 10% B) 35% C) 50% D) 75%

42)

Protein quality is determined by all of the following EXCEPT ________. A) the food's digestibility B) the food's cost C) the food's amino acid composition D) the food's ability to support body growth

43)

Which of the following conditions would result in negative nitrogen balance? A) Recovery from injury B) Weight training C) Pregnancy D) Kwashiorkor

44)

Nitrogen makes up approximately _____ of the weight of an amino acid. A) 8% B) 16% C) 24% D) 32%

45)

The RDA for protein for most healthy adults is ________.

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A) 0.5 g/kg of body weight B) 0.8 g/kg of body weight C) 1.2 g/kg of body weight D) 2.0 g/kg of body weight

46)

When food proteins reach the stomach, HCl ________ the protein. A) esterifies B) emulsifies C) transaminates D) denatures

47) Which of the following enzymes aids in digesting polypeptides into shorter peptides and amino acids? A) Lipase B) Trypsin C) HCL D) Lactase

48)

The functions of protein include ________. A) providing structural support to body cells B) producing antibodies to fight infection C) contributing to acid-base balance D) All of these are functions of protein.

49) Edema in the lower extremities may appear when there is a severe lack of dietary protein because ________.

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A) sodium is retained in the body B) blood protein levels drop and fluid shifts into interstitial spaces C) blood protein levels increase and force fluid into the cells D) the kidneys cannot efficiently excrete excess fluid

50)

Amino acids are required for the synthesis of ________. A) enzymes B) neurotransmitters C) some hormones D) All of the responsesare accurate.

51) A diet that is deficient in carbohydrate will ultimately force the liver and, to a lesser extent, the kidneys to ________. A) produce glucose from amino acids B) use fat stores to synthesize glucose C) convert glucose to glycogen in the liver D) All of the above will occur.

52)

Proteins help regulate blood pH by ________. A) accepting and releasing hydrogen ions B) keeping the blood more acidic C) releasing ketone-forming amino acids into the blood D) pumping potassium out of the cells

53)

_________ are compounds that help to maintain acid-base balance within a narrow range.

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A) Antibodies B) Buffers C) Sterols D) Enzymes

54) The proteins that inactivate foreign bacteria and viruses to help prevent infections are called ________. A) enzymes B) hormones C) collagen D) antibodies

55) The lack of an immune response to foreign compounds entering the body is called ________. A) allergy B) anergy C) anorexia D) allopathy

56) A high-quality protein used as a reference protein, for measuring the protein quality of other proteins is ________. A) milk B) beef C) egg white D) soybean

57)

The biological value of a food protein is a measure of ________.

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A) how much of the food one eats B) the total amount of nitrogen in the blood C) how closely the food’s amino acid pattern matches the amino acid pattern of body protein D) the weight gained by a growing rat after eating the food protein for 10 days

58) A growing childwho is consuming adequate protein but only 50% of his or herenergy needs will likely be in ________. A) nitrogen equilibrium B) positive nitrogen balance C) negative nitrogen balance

59)

What would be the recommended amount of protein for a 121-pound female? A) 21 g/day B) 36 g/day C) 44 g/day D) 55 g/day

60) Judy's dietary intake provides 90 grams of protein. Her total energy intake is 2000 kcal. Approximately what percentage of her energy comes from protein? A) 8% B) 11% C) 18% D) 28%

61)

Most Americans consume ________ dietary protein compared tothe RDA.

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A) the correct amount of B) excessive amounts of C) inadequate amounts of D) poor quality

62)

A high-protein diet is discouraged for patients with ________. A) infection B) marasmus C) kidney disease D) kwashiorkor

63)

A vegan diet may be low in ________. A) vitamin B-12 B) iron C) calcium D) All of these responses are correct.

64)

When plant proteins are compared to animal proteins, they ________. A) usually have equal quantities of essential amino acids B) are usually superior in their array of essential amino acids C) are usually deficient in one or more essential amino acids D) are equal in quality so long as they are not overcooked

65)

The recommended amount of protein as a percentage of total energy intake is ________.

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A) 15% to 20% B) 20% to 30% C) 10% to 35% D) 40% to 50%

66)

The major symptoms of kwashiorkor in children are ________. A) edema and growth failure B) nausea, vomiting, and diarrhea C) increased appetite and hyperactivity D) overweight and an excess accumulation of fat

67)

Kwashiorkor ________. A) is a disease of severely deficient protein intake B) is a childhood allergy to human breast milk C) is caused by excessive consumption of cow's milk D) develops in infants who consume contaminated, high proteininfant formulas

68)

Signs of protein deficiency may include ________. A) edema B) mild to moderate weight loss C) poor resistance to infection D) All of these choices are accurate.

69)

After major surgery, hospital patients may be at risk of PEM due to ________.

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A) poor prior health B) low dietary intakes C) increased needs for recovery D) All of these choicesare correct.

70) An example of two incomplete protein foods eaten together to produce a complete protein meal is ________. A) bread and butter B) red beans and rice C) cereal and milk D) hamburger with a bun

71)

A vegan will eat ________. A) milk chocolate and quiche dishes B) dairy products, eggs, and fish C) dairy products and plant foods D) only foods from plant sources

72)

A process involved in the synthesis of nonessential amino acids is called ________. A) ketogenesis B) gluconeogenesis C) transamination D) supplementation

73)

Which of the following is not a means of determining the protein quality of a food?

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A) Biological value B) Chemical score C) Protein efficiency ratio D) Complementary score

74)

Marasmus is characterized by ________. A) edema B) extreme weight loss and fat loss C) excess energy intakes D) allergy to cow's milk

75)

An antibody is ________. A) a protein that breaks down polypeptides for digestion B) a substance that adjusts hydrogen ion concentration C) a substance that inactivates foreign proteins in the body D) the lack of an immune response to foreign substances entering the body

76)

Anergy is ________. A) the space between body cells B) a substance that adjusts hydrogen ion concentration C) a substance that inactivates foreign proteins in the body D) the lack of an immune response to foreign substances entering the body

77)

Excess protein intake can result in ________.

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A) diabetes B) iron deficiency C) loss of calcium D) excess fiber intake

78) The weaker chemical bonds that form between amino acids that stabilize the structure create the ____________ structure. A) primary B) secondary C) tertiary D) quaternary

79) What would happen to dietary protein if HCl were not being produced in sufficient quantities? A) Protein digestion would occur at a faster rate. B) Protein digestion could not fully occur because proteins could not be denatured and pepsinogen could not be converted to pepsin. C) Proteins would be digested by gastric lipase in the stomach. D) None of the choices are correct.

80) If you were cut and needed to heal the wound, which type of protein would the body produce? A) Ferritin B) Albumin C) Collagen D) Hemoglobin

81) What is the state of nitrogen balance when a person ingests 13g of food nitrogen and loses 21 g of nitrogen?

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A) Equilibrium B) Positive balance C) Negative balance D) Exogenous balance

82) What would be the effect on protein digestion if insufficient amounts of gastrin were being produced? A) Too much HCL would be produced, resulting in rapid protein digestion. B) Too little HCL would be produced, resulting in insufficient protein digestion. C) Too much amylase would be produced, inhibiting the digestion of protein. D) No effect; gastrin does not play a role in the secretion of enzymes or substances related to protein digestion.

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 83) Explain the difference between essential and nonessential amino acids.

84)

Why do individuals with PKU need the nonessential amino acid tyrosine in their diets?

85)

Suggest 3 meals that make use of the concept of complementary proteins.

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86)

What is a limiting amino acid?

87)

Define the four levels of protein organization.

88)

Explain why denaturation of a protein destroys its biological function.

89)

Define and explain the importance of"protein turnover."

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90)

List 3 ways of evaluating food protein quality.

91)

Calculate the protein needs of a healthy, 140-lb woman.

92) If Krista consumes 65 grams of protein as part of a 1900-kcal diet, what percent of her total caloriesare from protein?

93)

List 2 circumstances in whichan individual might be in positive nitrogen balance.

94)

List 2 circumstances in whichan individual might be in negative nitrogen balance.

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95)

Explain 3 functions of protein in the body.

96)

Compare and contrastkwashiorkor and marasmus.

97)

List 3 nutrients that are likely to be low in a vegan diet.

98)

List 3 foods that are often allergenic.

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99) What suggestions would you give to a mother who would like her 5-year-old child to follow a vegetarian diet?

100)

Why are high-protein diets potentially harmful?

101)

What suggestions would you give to athletes taking multiple amino acid supplements?

102)

List 3 situations in whicha North American college student might be at risk of PEM.

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Answer Key Test name: Chap 07_3e_Test Bank 1) FALSE 2) FALSE There are 9 ESSENTIAL amino acids, which the body cannot make. 3) TRUE 4) TRUE 5) TRUE 6) TRUE 7) FALSE This recommendation is too high. Individuals wanting to gain muscle mass may need more than the RDA (depending on goals), but not 3 times. 8) TRUE 9) TRUE 10) TRUE 11) TRUE 12) TRUE

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These guidelines are especially important for families with a history of any type of allergy. Feed babies only breast milk or infant formula until they are at least 4 to 6 months old. Consult a pediatrician before giving infants and children highly allergenic foods (e.g., thinned peanut butter, eggs, milk). If an allergy is diagnosed, children must avoid the problematic foods. For children not at high risk for food allergies, when they are able to tolerate some solid foods (between 4 and 6 months of age), introducing small amounts of potentially allergenic foods may help prevent allergies.23 13) TRUE 14) TRUE 15) TRUE 16) TRUE 17) FALSE Individuals can “grow out” of food allergies. Certain allergies are also more prominent in children versus adults. 18) FALSE Vegetarian diets are typically higher in foods with larger amounts of dietary fiber as compared to the typical American diet. These foods include higher amounts of fruits and vegetables, whole grains and legumes. 19) FALSE Lacto-ovo-vegetarians allow dairy and eggs in their diets. 20) TRUE 21) TRUE 22) TRUE 23) TRUE 24) A Version 1

25) C 26) A 27) D 28) D 29) D Animal products, such as milk, contain all 9 essential amino acids; whereas most plant proteins do not. 30) D 31) C Tyrosine becomes conditionally essential when an individual cannot process phenylalanine. 32) D 33) C Animal products contain all 9 essential amino acids (and therefore are complete proteins); whereas most plant proteins, including whole wheat products, do not. 34) D 35) A 36) B 37) B 38) D 39) A 40) A 41) B 42) B 43) D Kwashiorkor is a form of protein malnutrition whereby the body is in negative nitrogen balance.

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44) B 45) B 46) D 47) B 48) D 49) B 50) D 51) A 52) A 53) B 54) D 55) B 56) C 57) C 58) C 59) C 121 lbs / 2.2 lbs/kg = 55 kg 55 kg x 0.8 g/kg/day = 44 g/day 60) C 90 g protein x 4 kcal/g = 360 kcal from protein 360 kcal from protein / 2000 total kcal= 0.18 = 18% of kcal from protein 61) B 62) C The organ that processes excessive protein in the form of toxic urea is the kidney. 63) D 64) C 65) C 66) A Version 1

67) A 68) D 69) D 70) B Red beans and rice are complementary proteins, making a complete protein (with all 9 essential amino acids) together. 71) D 72) C 73) D 74) B 75) C 76) D 77) C 78) B 79) B Stomach acid acts to denature proteins and initiate the process of digestion into absorption. 80) C The key structural proteins (collagen, actin, and myosin) make up more than a third of body protein and provide a matrix for muscle, connective tissue, and bone. 81) C In this instance, the individual would be losing more nitrogen than they ingested, therefore leading to negative balance. 82) B Gastrin also strongly stimulates the stomach’s parietal cells to produce acid, which aids in digestion and the activation of pepsin.

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83) Answers will vary. The body needs 20 different amino acids to function. Although all amino acids are needed for life, 11 of them do not need to be obtained from the diet. They are classified as nonessential (or dispensable) amino acids because our bodies make them, using other amino acids we consume (Table 7-1). The 9 amino acids the body cannot make are known as nutritionally essential (or indispensable) amino acids because they must be obtained from foods. Essential amino acids cannot be synthesized in the body because body cells cannot make the carbon skeleton of the amino acid, cannot attach an amino group to the carbon skeleton, or cannot do the whole process fast enough to meet the body’s needs. 84) Answers will vary. Several nonessential amino acids may be classified as “conditionally essential” amino acids during infancy, disease, or trauma. For example, a person with the genetic disease phenylketonuria (PKU) has a limited ability to metabolize the essential amino acid phenylalanine due to a deficiency of the enzyme phenylalanine hydroxylase. This enzyme is needed to convert phenylalanine to the nonessential amino acid tyrosine. As a result, individuals with PKU cannot produce sufficient tyrosine, thereby making tyrosine a “conditionally” essential amino acid because it must be obtained from the diet. 85) Answers will vary. Food

Primary Limiting Amino Acid

Legumes (peanuts Methionine and dry beans, such as navy, black, and kidney beans)

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Create a Complete Protein Complementary Food By Combining It With Protein Combinations Grains, nuts, or seeds

Hummus and pita bread Bean burrito White beans and pasta Bean and barley stew Pinto beans and polenta Black-eyed pea croquettes

Nuts and seeds Lysine (cashews, walnuts, almonds, sunflower seeds)

Legumes

Vegetarian chili with kidney beans and cashews Sesame, buckwheat, and bean bread Walnut and baked bean casserole

Grains (wheat, rice, oats, corn)

Legumes

Red beans and rice Lentil soup and cornbread Barley and black beans

Lysine

86) Answers will vary. The essential amino acid in smallest supply in a food or diet in relation to body needs is called the limiting amino acid because it limits the amount of protein the body can synthesize. For example, assume the letters of the alphabet represent the 20 different amino acids we need 87) Answers will vary. Four different levels of structure are found in proteins. The primary structure of a protein is the linear sequence of amino acids in the polypeptide chain. Secondary structure consists of areas in the polypeptide chain that have a specific shape stabilized by hydrogen and sulfur bonds. The 3-dimensional shape of proteins is called tertiary structure. It determines the function of the protein. Some proteins also show quaternary structure where 2 or more protein units join together to form a larger protein, such as hemoglobin, depicted in the figure 88) Answers will vary. Protein is partly uncoiled during a denatured state. This uncoiling typically reduces or eliminates biological activity and is usually caused by treatment by heat, enzymes, acid or alkaline solutions, or agitation.

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89) Answers will vary. Most vital body proteins are in a constant state of breakdown, rebuilding, and repair. This process, called protein turnover, allows cells to adapt to changing circumstances. For example, when we eat more protein than necessary for health, the liver makes more enzymes to process the waste product from the resulting amino acid metabolism— namely, ammonia— into urea. Overall, protein turnover is a process by which a cell can respond to its changing environment by increasing the production of needed proteins while reducing the production of proteins not currently needed. 90) Answers will vary. Biologic Value, Protein Efficiency Ratio, Chemical Score, Protein Digestibility Corrected Amino Acid Score 91) 140 lbs / 2.2 lbs/kg = 63.6 = 64 kg 64 kg x 0.8 g/kg/day = 51.2 = 51 g/day 92) 65 g protein x 4 kcal/g = 260 kcal from protein 260 kcal from protein / 1900 totalkcal = 0.14 = 14% of kcal from protein 93) Answers will vary. ● Growth Pregnancy Recovery stage after illness/injury ● Athletic training resulting in increased lean body mass ● Increased secretion of certain hormones, such as insulin, growth hormone, and testosterone

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94) Answers will vary. ● Inadequate intake of protein Inadequate energy intake ● Conditions such as fevers, burns, and infections ● Bed rest (for several days) ● Deficiency of essential amino acids (e.g., poor quality protein consumed) ● Increased protein loss (as in some forms of disease) Increased secretion of certain hormones, such as thyroid hormone and cortisol. 95) Answers will vary. producing vital body structures, maintaining fluid balance, contributing to acid-base balance, forming hormones/enzymes/neurotransmitters, contributing to immune function, transporting nutrients, forming glucose, providing a source of energy. 96) Answers will vary. PEM usually occurs as either marasmus or kwashiorkor. These conditions differ in the severity of the overall energy and protein deficit and the related clinical characteristics (Fig. 7-15). Marasmus develops slowly from a severe deficiency of energy (and, in turn, protein and micronutrients). Over time, this leads to extreme weight loss, muscle and fat loss, and growth impairment. Kwashiorkor occurs more rapidly in response to a severe protein deficit, typically accompanied by underlying infections or disease. Kwashiorkor is characterized by edema, mild to moderate weight loss, growth impairment, and the development of a fatty liver (excess accumulation of fat in the liver).

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97) Answers will vary. The eating patterns of vegetarians can vary considerably, depending on the extent to which animal products are excluded. Vegans follow the most restrictive diet, as they eat only plant foods. Because they do not eat any animal foods, their diets may be low in high biological value protein, riboflavin, vitamin D, vitamin B-12, calcium, and zinc unless carefully planned. 98) Answers will vary. The protein in any food can trigger an allergic reaction. However, 8 foods account for 90% of all food allergies: peanuts, tree nuts (e.g., walnuts and cashews), milk, eggs, fish, shellfish, soy, and wheat (Fig. 716). Other foods frequently identified as causing allergic reactions are meat and meat products, fruits, and cheese.

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99) Answers will vary. At the forefront of nutritional concerns for vegetarians are riboflavin, vitamins D and B-12, calcium, iron, and zinc.A major source of riboflavin, vitamin D, and calcium in the typical North American diet is milk, which is omitted from the vegan diet. However, riboflavin can be obtained from green leafy vegetables, whole-grain breads and cereals, yeast, and legumes—components of most vegan diets. Alternate sourcesof vitamin D include fortified foods (e.g., soy milk) and dietary supplements, as well as regular sun exposure. Calcium-fortified foods are the vegan’s best option for obtaining calcium. These include fortified soy milk, fortified orange juice, calcium rich tofu (check the label), and certain ready-to-eat breakfast cereals, breads, and snacks. Green leafy vegetables also contain calcium, but it is not well absorbed. Dietary supplements provide another option for meeting calcium needs (see Part 4). It is important to read supplement labels and to plan supplement use carefully because a typical multivitamin and mineral supplement supplies only 25 to 45% of daily calcium needs. Vitamin B-12 occurs naturally only in animal foods. Plants can contain soil or microbial contaminants that provide trace amounts of vitamin B-12, but these are negligible sources of the vitamin. Therefore, vegans need to eat food fortified with vitamin B-12 or take supplements to protect against deficiency. Infants and children are at highest risk of nutrient deficiencies as a result of poorly planned vegetarian diets. However, with the use of complementary proteins and good sources of the problem nutrients discussed earlier, the energy, protein, vitamin, and mineral needs of vegetarian and vegan infants and children can be met. The most common nutritional concerns for infants and children following vegetarian and vegan diets are deficiencies of iron, vitamin B-12, vitamin D, zinc, and calcium. Version 1

Vegetarian and vegan diets tend to be high in bulky, high fiber, low calorie foods that cause fullness. Although this side effect can be a welcome advantage for adults, children have a small stomach volume and relatively high nutrient needs for their size and may feel full before their energy needs are met. For this reason, the fiber content of a child’s diet may need to be decreased by replacing high fiber sources with some refined grain products, fruit juices, and peeled fruit. Including concentrated sources of energy, such as fortified soy milk, nuts, dried fruits, and avocados, can help meet calorie and nutrient needs. Overall, vegetarian and vegan diets can be appropriate during infancy and childhood. However, to achieve normal growth and ensure adequate intake of all nutrients, these diets must be implemented with knowledge and, ideally, professional guidance 100) Answers will vary. High protein diets may overburden the kidneys’ capacity to excrete nitrogen wastes. Additionally, because water is needed to dilute and excrete urea, inadequate fluid intake can increase the risk of dehydration as the kidneys use body water to dispose of the urea. These concerns are greatest for people who already have impaired kidney function. A lower protein diet with adequate fluid intake is recommended for these individuals to help preserve kidney health. When excess protein is primarily from a high intake of animal proteins, the overall diet is likely to be low in plant-based foods and consequently low in fiber, some vitamins (vitamins C and E and folate), minerals (magnesium and potassium), and beneficial phyto-chemicals. Animal proteins are often rich in saturated fat and cholesterol and may be cured to create hot dogs, ham, salami, and luncheon meats. As a result, these diets can increase the risk of cardiovascular disease and cancer.

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101) Answers will vary. Our bodies are designed to obtain amino acids from dietary sources of whole proteins. This assures a supply of amino acids in proportions needed for body functions and prevents amino acid toxicity, especially for methionine, cysteine, and histidine—the most toxic amino acids. When individual amino acid supplements are taken, chemically similar amino acids can compete for absorption, resulting in amino acid imbalances and toxicity risk. 102) Answers will vary. Those at greatest risk are individuals living in poverty and/or isolation and those with substance abuse problems, anorexia nervosa, or debilitating diseases (e.g., AIDS or cancer). Some hospitalized patients also are at increased risk of PEM because of poor prior health, low dietary intakes, and increased protein needs for recovery from surgery, trauma, and/or disease. Malnourished patients face a much greater risk of complications and even death.

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CHAPTER 8 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) When the rate of alcohol consumption exceeds the liver's metabolic capacity, blood alcohol levels increase and symptoms of intoxication develop. ⊚ ⊚

true false

2) Guidelines for safe drinking recommend that women should have no more than 2-3 drinks per day. ⊚ ⊚

Alcohol requires no digestion. ⊚ ⊚

4) zinc.

true false

Excess consumption of some alcoholic beverages can lead to deficiencies of iron and ⊚ ⊚

true false

Moderate alcohol intake has been associated with increased HDL cholesterol levels. ⊚ ⊚

true false

6) Excessive alcohol intake can lead to deficiencies of niacin, thiamin, vitamin B-6, vitamin B-12, and folate. ⊚ ⊚

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true false

7) Compared with men, women produce more alcohol dehydrogenase enzyme in the stomach. ⊚ ⊚

true false

8) Compared to men, women absorb approximately 30%-35% more unaltered alcohol from the stomach into the bloodstream. ⊚ ⊚

Extremely high blood alcohol levels can lead to respiratory failure. ⊚ ⊚

10)

true false

Binge drinking is associated with vandalism and suicide. ⊚ ⊚

12)

true false

Signs of alcohol poisoning include hypoglycemia and severe dehydration. ⊚ ⊚

11)

true false

An 80-proof vodka or gin is 80% alcohol. ⊚ ⊚

true false

13) Because alcohol cannot be stored in the body, it has priority in metabolism over other energy sources.

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⊚ ⊚

14)

true false

The small intestine is the primary site for alcohol metabolism. ⊚ ⊚

true false

15) Moderate alcohol consumption is most accurately defined as no more than 7 or 14 drinks per week for women and men, respectively. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 16) The highest concentration of ethanol is found in ________. A) beer B) wine C) distilled spirits D) wine coolers

17)

The alcohol content of an 80-proof tequila is ________. A) 80% B) 40% C) 20% D) 100%

18)

Wine generally contains ________ alcohol.

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A) ≤5% B) 5%-14% C) 15%-22% D) >22%

19)

The process of fermentation involves all of the following EXCEPT ________. A) simple sugars, such as maltose B) yeast C) carbon dioxide D) bacteria

20)

A standard serving of an alcoholic drink is defined as ________. A) 16 oz beer B) 12 oz wine cooler C) 5 oz wine D) 3 oz hard liquor

21)

A standard drink contains _____ grams of alcohol. A) 5 B) 10 C) 14 D) 25

22)

Alcohol is absorbed in the small intestine by ________.

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A) passive diffusion B) facilitated diffusion C) simple diffusion D) active transport

23)

Alcohol absorption occurs in the ________. A) stomach B) small intestine C) esophagus D) stomach and small intestine

24)

The ADH pathway of alcohol metabolism converts ethanol into ________. A) citric acid B) NADH C) acetyl-CoA D) pyruvate

25)

The main organ responsible for ethanol metabolism is the ________. A) liver B) pancreas C) small intestine D) stomach

26) When consumed in low to moderate amounts, alcohol is primarily metabolized by the ________________ pathway.

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A) catalase B) MEOS C) alcoholdehydrogenase D) peroxidase

27) When the MEOS pathway is induced, alcohol tolerance _______ because the rate of alcohol metabolism __________. A) increases;decreases B) decreases;increases C) decreases;decreases D) increases;increases

28)

The symptoms of acetaldehyde buildup during alcohol metabolism include ________. A) flushing B) rapid heartbeat C) hyperventilation D) All of these symptoms can occur.

29) Women absorb 30%-35% more ethanol directly from the stomach than men because women ________. A) have slower rates of gastric emptying B) tend to eat more food when consuming alcoholic beverages C) have lower amounts of alcohol dehydrogenase in the cells lining the stomach D) absorb all substances, including ethanol, more efficiently

30) Binge drinking for a male is defined as having _______ or more drinks on a single occasion.

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A) 2 B) 4 C) 5 D) 10

31)

A blood alcohol level of _____ is defined as legal intoxication in the U.S. and Canada. A) 0.05 B) 0.08 C) 0.10 D) 0.50

32)

What percent of North American adults consume alcohol? A) 10% B) 33% C) 70% D) 84%

33)

Binge drinking on college campuses is associated with ________. A) academic problems B) auto accidents C) sexual abuse D) All of these responses are correct.

34)

The population group with the highest rate of alcohol consumption is ________.

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A) elderly adults B) teenagers C) college students D) middle-aged adults

35)

Moderate drinking is most accurately defined as ________. A) up to 1 drink per day for women and 2 drinks per day for men B) up to 7 drinks per week for women and 14 drinks per week for men C) up to 2 drinks per day for women and 3 drinks per day for men D) less than 2 drink per day for women and 4 drinks per day for men

36)

Benefits of moderate alcohol consumption include lower rates of ________. A) Alzheimer's disease B) many types of cancer C) cardiovascular disease D) All of these responses are correct.

37)

Detrimental effects of excessive alcohol consumption include higher rates of ________. A) high blood pressure and stroke B) cancers of the mouth and throat C) liver disease and liver failure D) All of these responses are correct.

38)

An early sign of alcohol-induced liver damage is ________.

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A) liver cirrhosis B) ascites C) jaundice D) steatosis

39)

Liver cirrhosis is characterized by ________. A) decreased synthesis of proteins made in the liver B) abnormal retention of fluid in the abdomen C) poor nutritional status D) All of these answers are correct.

40)

Alcoholism is associated with all of the following EXCEPT ________. A) cirrhosis of the liver B) jaundice C) type I diabetes D) alcoholic hepatitis

41) Wernicke-Korsakoff Syndrome is a _______ deficiency disease that results from severe alcohol abuse. A) vitamin A B) thiamin C) niacin D) vitamin B-12

42) Individuals who abuse alcohol-often have trouble with night blindness. This can result directly from ________.

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A) impaired absorption of several B-vitamins B) fluid accumulation in the eye C) damage to brain cells D) impaired absorption and transport of vitamin A

43)

The recommendation for alcohol consumption during pregnancy is ________. A) no alcohol at all B) limit to one drink per week C) to follow current guidelines for moderate drinking D) to avoid binge drinking

44)

The problems of alcohol abuse and alcohol dependency ________.

A) are very infrequent in the United States B) affect nearly 1 in 3 Americans over a lifetime C) are untreatable problems D) affect only those with other serious problems, such as poverty, unemployment, or mental health disorders

45)

Which of the following is not a common nutritional concern in alcoholics? A) Vitamin B-12 deficiency B) Protein-energy malnutrition C) Vitamin A toxicity D) Iron deficiency

46)

Medications used to treat alcohol dependence act on ________.

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A) exclusively the brain to reduce alcohol cravings B) exclusively the liver to block complete metabolism of alcohol C) the stomach to prevent alcohol absorption D) both the brain to reduce alcohol cravings and the liver to block complete metabolism of alcohol

47)

The risk of developing a problem with alcohol is higher in those ________. A) with a biological parent with alcohol problems B) who are women C) who begin drinking heavily in middle-age D) who are of Asian descent

48)

Which of the following meals would slow the rate of absorption of alcohol the most? A) Two pancakes with syrup B) Bacon cheeseburger and french fries C) One cup of plain spaghetti D) Baked chicken breast and baked potato

49)

Which of the following individuals would show signs of alcohol intoxication the fastest?

A) 25-year-old male with a normal BMI who has not eaten today B) 35-year-old female with a normal BMI who has eaten a high fat meal 1/2 hour before starting to drink C) 22-year-old female with a high BMI who has eaten a high carbohydrate meal just before ordering her first drink D) 28-year-old male with ahigh BMI who has had a protein shake before ordering his first drink

50) How would moderate alcohol consumption potentially benefit a 70-year-old widow who has no previous history of heart disease?

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A) Alcohol could stimulate her appetite to get more needed nutrients and calories. B) Alcohol could improve her production of estrogen. C) Alcohol could decrease her chances of developing type II diabetes. D) Alcohol could help her absorb more nutrients.

51) What would happen to the liver of an individual who was diagnosed with steatosis if he or she abstained from alcohol? A) He or she would progress to alcoholic hepatitis. B) He or she would progress to cirrhosis. C) He or she would progress to liver cancer. D) They would reverse his or her condition.

52) A person with an alcohol use disorder presents with muscle twitching and cramping. He is also complaining of spasms in his muscles that he cannot seem to control. What nutrient is he likely deficient in? A) Iron B) Folate C) Magnesium D) Niacin

53)

If a nursing mother consumes 1 to 2 drinks of alcohol, when is it safe to breastfeed? A) 2 hours after last drink B) 30 minutes after last drink C) 1 hour after last drink D) She should not breastfeed at all if she chooses to drink.

54) Moderate consumption of wine has been shown to have positive heart health benefits including?

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A) Heart disease preventative effects of resveratrol, a phytochemical B) Lower serum LDL levels C) Increased serum HDL levels D) All of the answers are correct

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 55) List 3 of the leading causes of death in North Americathat are associated with excessive consumption of alcohol.

56) Define what is considered excess alcohol consumption for an average man and for an average woman.

57)

List 3 reasons why women are less tolerant of alcohol than men.

58) .

Describe 2 methods used to treat alcohol use disorders.

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59)

What are 4 symptoms that might indicate that someone has a problem with alcohol?

60)

How does an alcohol use disorder impair nutritional status?

61)

Describe the health consequences to the fetus of drinking alcohol during pregnancy.

62) Describe 3 of the factors that increase the risk of developing alcohol dependency or an alcohol use disorder.

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63)

List 3 signs of an alcohol use disorder.

64)

How does the body absorb and digest low to moderate amounts of alcohol?

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Answer Key Test name: Chap 08_3e_Test Bank 1) TRUE 2) FALSE Drinking alcohol should be done sensibly and in moderation—defined as the consump-tion of up to 1 drink per day for women and up to 2 drinks per day for men. 3) TRUE 4) TRUE 5) TRUE 6) TRUE 7) FALSE Men produce more alcohol dehydrogenase than women. 8) TRUE 9) TRUE 10) TRUE 11) TRUE 12) FALSE For hard liquor (distilled spirits), alcohol content is listed by “proof” rather than by percentage. The proof is twice the percentage of alcohol content. Thus, an 80-proof vodka or gin is 40% alcohol by volume. 13) TRUE 14) FALSE The liver is the main site of alcohol metabolism. 15) FALSE

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Drinking alcohol should be done sensibly and in moderation—defined as the consump-tion of up to 1 drink per day for women and up to 2 drinks per day for men. 16) C 17) B 18) B 19) D 20) C 21) C 22) C 23) D 24) C 25) A 26) C 27) D 28) D 29) C 30) C 31) B 32) C 33) D 34) C 35) A 36) C 37) D 38) D 39) D 40) C 41) B 42) D Version 1

43) A 44) B 45) C 46) D 47) A 48) B A bacon cheeseburger and french fries contain the most calories and fat of all listed options. This would comparatively slow the absorption of the alcohol the most. 49) A Having an empty stomach would cause the alcohol to be absorbed the fastest, and potentially lead to alcohol intoxication. 50) A Drinking small amounts of alcohol at a meal or in a social setting may help stimulate the appetite. However, drinking larger amounts of alcohol can dull the appetite, and healthy foods may be displaced by alcoholic beverages. Heavy drinkers often have poor diets and nutritional status. 51) D Steatosis is reversible. 52) C One of the classic symptoms of magnesium deficiency is tetany, a condition characterized by muscle twitches, cramps, spasms, and sei-zures. 53) A 54) A

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55) Answers will vary. The excessive consumption of alcohol contributes significantly to 4 of the 10 leading causes of death in North America—heart failure, certain forms of cancer, motor vehicle and other accidents, and suicides. 56) Answers will vary. In general, research shows that excess alcohol consumption, as measured by more than 1 drink per day for women and 2 drinks per day for men or as binge drinking, is on the rise. Men use alcohol at higher rates than women. 57) Answers will vary. Compared with men, women produce less of the alcohol dehydroge-nase enzyme in the cells that line their stomachs—as a result, women absorb about 30% to 35% more unmetabolized alcohol from the stomach directly into the bloodstream. Another gender-related factor is that, in comparison with men, women are generally smaller in body size, have more body fat, and have less total body water. As a result, alcohol becomes more concentrated in the blood and body tissues of a woman than in a similar-size man because alcohol can be diluted by water, but not by adipose tissue. For these reasons, a woman becomes intoxicated on less alcohol than a similar-size man. Other factors that can affect alcohol metabolism include the alcohol content of the beverage, the amount of alcohol consumed, and the individual’s usual alcohol intake. As described earlier, individuals who drink large amounts of alcohol regularly are able to me-tabolize alcohol more rapidly and have a greater tolerance to alcohol.

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58) Answers will vary. The treatment of an alcohol use disorders (AUD) typically involves behavioral therapy, along with medication. Behavioral therapy is usually facilitated by a psychologist, social worker, or counselor. Important goals of counseling are to identify triggers for alcohol consumption and ways to compensate for the loss of pleasure from drinking. Total abstinence must be the ultimate objective because, for most alcoholics, there is no such thing as safe and controlled social drinking. Because other mental health disorders often go hand in hand with AUDs, these conditions must be treated as well for successful outcomes. Three medications are approved in the U.S. to treat AUDs. 59) Answers will vary. Alcohol use disorders (formerly known by the terms alcohol abuse and alcohol dependence) are common mental health disorders that pose serious risks for many individuals. In addition to the multiple health problems previously described, persons with an alcohol use disorder (AUD) may experience deteriorating personal relationships, financial burdens, and frequent absences or poor performance in the workplace, school, or other settings. The criteria for diagnosing an AUD are shown in Table 8-5.

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60) Answers will vary. Individuals who abuse alcohol often have poor nutritional status and are at risk of developing nutrient deficiencies for a variety of reasons. Alcohol, a poor source of nutrients, may replace food in the diet. For instance, if a person were to use beer as a nutrient source, he or she would need to consume daily 40 to 55 bottles (12 oz each) to meet protein needs and 65 bottles for thiamin needs. When an individual relies on alcohol for the majority of his or her energy needs, protein-energy malnutrition develops. The symptoms of protein-energy malnutrition with alcoholism are similar to those seen in individuals with kwashiorkor (see Chapter 7). In addition to protein deficiencies, deficiencies of vitamins and minerals can result in further complications. These deficiencies are usually the result of decreased intake, impaired absorption, altered metabo-lism, and alcohol-related tissue damage in the GI tract, liver, and pancreas.

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61) Answers will vary. If a woman chooses to drink during pregnancy, she may cause serious harm to her developing offspring. Alcohol slows nutrient and oxygen delivery to the fetus, thereby retard-ing growth and development. Alcohol also may displace nutrient dense foods in the mother’s diet. Although the most severe dam-age occurs during the first 12 to 16 weeks of pregnancy, when organs are undergoing major developmental steps, consuming alcohol at any time during pregnancy can cause lifelong damage. The alcohol-related health consequences are known collec-tively as fetal alcohol spectrum disorders (FASD). An individual with an FASD may experience a range of effects, including facial malformation (Fig. 88), growth retardation (including a smaller than normal brain), birth defects, lifelong learning disabilities, a short attention span, and hyperactivity. The most serious FASD is known as fetal alcohol syndrome (FAS). Individuals with FAS have facial malformations, growth deficits, and central nervous system problems. 62) Answers will vary. Genetic tendency, male (higher than rates for females), age of onset of drinking habit, ethnicity, mental health status. 63) Answers will vary. Alcohol use disorders (formerly known by the terms alcohol abuse and alcohol dependence) are common mental health disorders that pose serious risks for many individuals. In addition to the multiple health problems previously described, persons with an alcohol use disorder (AUD) may experience deteriorating personal relationships, financial burdens, and frequent absences or poor performance in the workplace, school, or other settings. The criteria for diagnosing an AUD are shown in Table 8-5.

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64) Answers will vary. Alcohol, unlike most carbohydrate, protein, and fat molecules, requires no digestion. It also does not need specific transport mechanisms or receptors to enter cells. Therefore, it is absorbed rapidly throughout the digestive tract by simple diffusion. The stomach absorbs about 20% of ingested alcohol, with the remainder being absorbed in the duodenum and jejunum. When food is consumed with alcohol, absorption is slowed. Larger meals with a high fat content leave the stomach more slowly, thereby slowing the absorption of any alco-hol consumed. In contrast, alcohol consumed on an empty stomach is absorbed quickly from the stomach and small intestine into the bloodstream. Alcohol is readily dispersed throughout the body because alcohol is found wherever water is distributed in the body. Alcohol moves easily through the cell membranes; however, as it does, it damages proteins in the membranes.

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CHAPTER 9 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Anabolic metabolism refers to pathways that build larger, more complex compounds. ⊚ true ⊚ false

2) Catabolic metabolism refers to pathways that break down compounds to smaller, simpler units. ⊚ true ⊚ false

The conversion of pyruvate to acetyl-CoA is irreversible. ⊚ ⊚

Gluconeogenesis takes place in both the cytosol and the mitochondria. ⊚ ⊚

true false

The kidney is the major organ that regulates metabolism. ⊚ ⊚

true false

Beta oxidation takes place in the mitochondria. ⊚ ⊚

true false

Diabetic ketoacidosis is a result of a lack of the actions associated with insulin. ⊚ ⊚

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true false 1

Ketone bodies are products of incomplete oxidation of fatty acids. ⊚ ⊚

true false

The body can make glucose from all fatty acids. ⊚ ⊚

true false

10) During an overnight fast, the primary fuel for the brain and central nervous system is amino acids. ⊚ ⊚

11)

High amounts of ketones in the blood show that the body is using protein as a fuel source. ⊚ ⊚

12)

true false

The electron transport chain takes place in the cytosol. ⊚ ⊚

true false

13) A very low carbohydrate diet that produces ketones is a healthy and effective way to lose body fat. ⊚ ⊚

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true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 14) All the chemical and physical processes involved in maintaining life are referred to as ________. A) anabolism B) catabolism C) homeostasis D) metabolism

15)

Nicotinamide adenine dinucleotide (NAD) ________. A) transports oxygen in various metabolic pathways B) picks up and delivers hydrogens to acceptor molecules C) is another form of ATP D) is a form of lactic acid

16)

The energy currency the body uses is ________. A) NAD B) FAD C) TCA D) ATP

17)

Flavin adenine dinucleotideis a coenzyme form of the vitamin ________. A) pantothenic acid B) niacin C) thiamin D) riboflavin

18)

Photosynthesis occurs in plants and usesenergy from the sun to ________.

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A) produce organic compounds from carbon, hydrogen, and oxygen B) synthesize ATP C) heat the environment D) make plants turn yellow

19)

All the energy available to humans has its origins in ________. A) carbon dioxide and water B) the oxygen we breathe C) foods and beverages D) the sun's solar energy

20)

When a compound is oxidized it ______ one or more electrons. A) loses B) gains C) transforms D) creates

21)

When a compound is reduced it _____ one or more electrons. A) loses B) gains C) transforms D) creates

22)

Oxidation-reduction reactions in the body are controlled by ________.

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A) light and dark cycles B) enzymes C) fluid balance D) protein consumption

23)

If oxygen is present, metabolism is considered to be ________. A) active B) anaerobic C) aerobic D) inactive

24)

In the absence of oxygen, ______ respiration will occur. A) active B) anaerobic C) aerobic D) inactive

25)

Glycolysis is a process involving ________. A) synthesis of fatty acids B) reactions that convert glucose to glycogen C) reactions that convert glucose to pyruvate D) reactions that convert glycogen to protein

26)

Glycolysis begins with _________ and ends with __________.

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A) pyruvate; water B) pyruvate;glucose C) glucose;pyruvate D) pyruvate;acetyl-CoA

27) When muscle tissue is exercising under anaerobic conditions, the production of ______ is important because it ensures a continuous supply of NAD +. A) glucose-6-phosphate B) pyruvate C) lactate D) glycogen

28) In metabolism, glucose is degraded to CO in ________.

2 and water. The carbon dioxide is produced

A) the red blood cells B) the citric acid cycle C) glycolysis D) the electron transport chain

29) Red blood cells undergo anaerobic metabolism, which means that they produce ________. A) plasma B) iron C) lactate D) clots

30) Under anaerobic conditions, how many net ATP are synthesized from one glucose molecule? Version 1

A) 1 ATP B) 2 ATP C) 4 ATP D) 2 GTP E) None of these choices are correct.

31) How many molecules of lactate are produced from one molecule of glucose during metabolism? A) 2 B) 4 C) 6 D) 8

32)

The citric acid cycle is also known as the ________. A) urea cycle B) Krebs cycle C) menstrual cycle D) aerobic pathway

33)

The conversion of pyruvate to acetyl-CoA ________. A) requires the addition of CO 2 B) occurs in the mitochondria of the cell and is irreversible C) occurs in the nucleus of the cell D) is needed for red blood cell production

34)

The common pathway for the oxidation of glucose and fatty acids is ________.

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A) glycolysis B) the Cori cycle C) the citric acid cycle D) ketosis

35)

During the end reaction of the electron transport chain, oxygen becomes ________. A) reduced to water (H 2O) B) oxidized to carbon dioxide C) NADH D) FADH 2

36)

The major end products of the electron transport chain are ________. A) water and ATP B) glucose and amino acids C) dietary fiber and ammonia D) carbon, nitrogen, and hydrogen

37)

Cytochromes ________. A) are produced by photosynthesis B) transport electrons in the electron transport chain C) appear in the citric acid cycle D) are responsible for beta-oxidation of fatty acids

38)

Carnitine ________.

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A) is a dietary essential, especially for athletes B) shuttles NADH across the mitochondrial membrane C) shuttles oxaloacetate from the mitochondria to the cytosol D) shuttles fatty acids from the cytosol into the mitochondria

39) The synthesis of fatty acids occurs in the _________ of the cell and the breakdown of fatty acids occurs in the _______ of the cell. A) mitochondria; cytosol B) nucleus; cytosol C) cytosol; mitochondria D) cytosol; lysosome

40) In which compartment of the cell does the Krebs cycle and fatty acid oxidation take place? A) Cell membrane B) Mitochondria C) Nucleus D) Cytosol

41)

In fatty acid synthesis, the "starting" molecule is ________. A) glycerol B) acetyl-CoA C) ATP D) pyruvate

42) After a person has fasted for more than a few days, the brain adapts to using _______ for some of its fuel needs.

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A) glycerol B) ketones C) fatty acids D) amino acids

43)

Ketones are produced from ________. A) cholesterol B) hormones C) amino acids D) acetyl-CoA

44)

Ketosis increases with ________. A) fasting B) a low-carbohydrate diet C) uncontrolled type 1 diabetes mellitus D) All of these choices are correct.

45) When there is excess glucose and amino acids in the liver, and no more ATP needs to be synthesized, these energy-rich nutrients are converted to ________. A) triglycerides B) pyruvate C) NAD + D) FAD

46) Before protein becomes an energy source, the _________ must be removed from the molecule.

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A) COOH B) CH 3 C) NH 2 D) CO 2

47)

In most cases thestarting material for gluconeogenesis is ________. A) oxaloacetate B) phosphoenolpyruvate C) carnitine D) All of these choices are correct

48)

Gluconeogenesis is the process whereby the body ________. A) converts glucose to its storage form B) retrieves stored glucose from the liver C) lowers the glucose level of the blood D) produces glucose from amino acid and glycerol molecules

49) When the carbon skeleton of an amino acid is oxidized for energy, the amino group is removed and sent to the liver to produce ________. A) ammonia B) protein C) urea D) albumin

50) Amino acids (or parts of their carbon skeletons) that can be converted to pyruvate or enter the citric acid cycle directly are called ________.

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A) glucogenic amino acids B) ketogenic amino acids C) essential amino acids D) non-essential amino acids

51) Amino acids that become acetyl-CoA as a result of deamination are designated ketogenic amino acids because ________. A) they can become parts of the glucose molecule B) they cannot become part of the glucose molecule C) they interfere with metabolism of fatty acids D) all amino acids are interchangeable through the citric acid cycle

52)

Which of the following pathways is the major way in which alcohol is metabolized? A) Pyruvate dehydrogenase pathway B) Ethanol dehydrogenase pathway C) Lactate dehydrogenase pathway D) Alcohol dehydrogenase pathway

53)

Where does alcohol metabolism predominantly occur in the body? A) Intestines B) Liver C) Kidney D) Lungs

54) When excessive amounts of alcohol are consumed, which system oxidizes the excess alcohol?

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A) Beta oxidizing system B) Mitochondrial oxidizing system C) Alcohol oxidizing system D) Microsomal ethanol oxidizing system

55) After a period of prolonged fasting (starving), the brain changes its fuel requirements ________. A) and uses amino acids directly B) and starts to use glycerol as the primary source of energy C) and starts to use ketones and spares protein D) and glycogen becomes the primary source of energy

56)

Fasting or starvation accelerates ________. A) gluconeogenesis B) ketone production C) body protein breakdown D) body fat breakdown E) All of these choices are correct.

57)

In the body, excess amino acids are ________. A) burned as fuel or stored as fat B) stored by the body in the form that they were consumed C) of no concern to health status D) directly converted into lean muscle mass

58)

In the metabolism of amino acids for energy, the amine group is ________.

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A) stored in the liver B) converted to glucose C) excreted as urea D) burned for energy

59)

Typical fatty acids cannot be converted to glucose because ________. A) they lack sufficient energy B) they enter the citric acid cycle at acetyl-CoA and can never reform pyruvate C) they can only be synthesized from amino acid skeletons, not fatty acid skeletons D) they enter the citric acid cycle as propionyl-CoA

60)

Metabolism is regulated by ________. A) hormones such as insulin B) the presence and activity of enzymes C) ATP levels in the individual cells D) All of these choices are correct.

61)

Glycolysis is the process by which ________.

A) fatty acids break apart to form acetyl-CoA B) glucose breaks apart to form pyruvate C) amino groups move from a donor to an acceptor D) NADH + H + and FADH 2 are converted to NAD + and FAD, donating electrons and hydrogen ions to oxygen E) energy derived from NADH + H + and FADH 2 is used to generate ATP

62)

Transamination is the process by which ________.

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A) fatty acids break apart to form acetyl-CoA B) glucose breaks apart to form pyruvate C) amino groups are transferred from a donor to an acceptor D) NADH + H + and FADH 2 are converted to NAD + and FAD, donating electrons and hydrogen ions to oxygen E) energy derived from NADH + H + and FADH 2 is used to generate ATP

63)

Beta-oxidation is the process by which ________.

64)

Electron transport is the process by which ________.

65)

Oxidative phosphorylation is the process by which ________.

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66)

Which portion of cellular respiration benefits from the Cori cycle? A) Citric acid cycle B) Anaerobic glycolysis C) Transition reaction D) Aerobic glycolysis

67)

A patient presents with low copper. Which portion of cellular respiration would suffer? A) Glycolysis B) Citric acid cycle C) Transition reaction D) Electron transport chain

68)

How would metabolism be affected if a patient's liver is were not working efficiently? A) He or she could not effectively absorb nutrients B) Nutrient interconversions and storage would not efficiently occur C) Digestive enzymes could not be produced D) There would be no effect on metabolism

69)

During which phase of cellular respiration is the majority of ATP produced?

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A) Glycolysis B) Transition reaction C) Citric acid cycle D) Electron transport chain

70) Which of the following molecules would be used to produce 2 additional molecules of ATP if needed? A) NADH B) FADH2 C) Oxaloacetate D) GTP

71)

What would be the effect of high concentrations of ATP? A) Catabolic reactions to produce more energy B) Anabolic reactions to synthesize more products C) Catabolic reactions to synthesize more products D) Anabolic reactions to produce more energy

72)

Adaptations to fasting include all of the following except A) reducing energy requirements B) slowing the metabolic rate C) the nervous system uses more glucose D) the nervous system uses more ketone bodies

73)

Fasting encourages all of the following except

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A) glycogen breakdown B) protein synthesis C) fat breakdown D) synthesis of ketone bodies

74)

Feasting encourages all of the following except A) glycogen synthesis B) protein synthesis C) fat synthesis D) gluconeogensis

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 75) Explain why typical fatty acids cannot participate in gluconeogenesis?

76) Explain the meaning of the phrase "fat burns in the flame of carbohydrates." in regards to how carbohydrates help in fat metabolism.

77) Differentiate between aerobic and anaerobic metabolism and state how many ATP are produced from glucose in each process.

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78)

Why do fats yield more energy per gram than proteins or carbohydrates?

79) Explain why some people think that consuming carnitine pills will help them lose weight, and why it may be helpful for others.

80)

Name and briefly describe the 4 stages of aerobic respiration of glucose.

81)

Explain what happens to ketone levels in the body after prolonged starvation.

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82) Explain why individuals with type 1 diabetes can suffer serious complications during ketosis.

83)

Why is the mitochondrion called the powerhouse of the cell?

84) Describe one inborn error of metabolism, discussing the metabolic process it affects, the consequences of the disease, and its treatment.

85) Using metabolic terms, explain how the MEOS system is different from the alcohol dehydrogenase pathway for metabolism of alcohol.

86)

Name two characteristics of inborn errors of metabolism.

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Answer Key Test name: Chap 09_3e_Test Bank 1) TRUE 2) TRUE 3) TRUE 4) TRUE 5) TRUE 6) FALSE The liver is the major organ that regulates metabolism. 7) TRUE 8) TRUE 9) FALSE Typical fatty acids cannot be turned into glucose because those with an even number of carbons—the typical form in the body—break down into acetyl- CoA molecules. Acetyl-CoA can never re-form into pyruvate; the step between pyruvate and acetyl-CoA is irreversible. The options for acetyl-CoA are forming ketones and/or combining with oxaloacetate in the citric acid cycle. At the end of 1 cycle, no carbons from acetyl-CoA are left to turn into glucose; it is impossible to convert typical fatty acids into glucose. The glycerol portion of a triglyceride is the part that can become glucose. Glycerol enters the glycolysis pathway and can follow the gluconeogenesis pathway from glyceraldehyde 3-phosphate to glucose. Glucose yield from glycerol is insignificant. 10) TRUE 11) FALSE High amounts of ketones in the blood show that the body is using fat as a fuel source. Version 1

12) FALSE The ETC takes place in the mitochondria. 13) FALSE A very low carbohydrate diet that produces ketones is not the best way to lose body fat. Although body weight may decline, the large production of ketones means that the body is not capable of oxidizing fatty acids; therefore, the ketones are excreted in the urine. The body is using protein (amino acids) as a fuel source for the brain and nervous system. This loss of amino acids, especially from muscle, is part of the loss of body mass. 14) D 15) B 16) D 17) D 18) A 19) D 20) A 21) B 22) B 23) C 24) B 25) C 26) C 27) C 28) B 29) C 30) B 31) A 32) B 33) B Version 1

34) C 35) A 36) A 37) B 38) D 39) C 40) B 41) B 42) B 43) D 44) D 45) A 46) C 47) A 48) D 49) C 50) A 51) B 52) D 53) B 54) D 55) C 56) E 57) A 58) C 59) B

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Typical fatty acids cannot be turned into glucose because those with an even number of carbons—the typical form in the body—break down into acetyl-CoA molecules. Acetyl-CoA can never re-form into pyruvate; the step be-tween pyruvate and acetyl-CoA is irreversible. The options for acetyl-CoA are forming ketones and/or combining with oxaloacetate in the citric acid cycle. 60) D 61) B 62) C 63) A 64) D 65) E 66) B Even though muscle cells have mito-chondria, during high intensity exercise they rely heavily on anaerobic glycoly-sis to quickly produce ATP. Anaerobic glycolysis causes lactate accumulations and NAD+ regeneration, both of which allow anaerobic glycolysis to continue in the muscle. The lactate generated is transported from the muscles to the liver, where it is converted to glucose, which can then be returned to the muscles. This process is known as the Cori cycle. 67) D Copper plays a role in the electron transport chain, during glycolysis in aerobic respiration. 68) B Liver is the major organ of metabolism, involved in converting nutrients to energy, among other processes.Nutrient absorption occurs in the small intestine.Digestive enzymes are produced in the stomach, pancreas, and small intestine. 69) D Version 1

70) D 71) B High amounts of ATP would yield building reactions in the body. 72) C 73) B 74) B 75) Answers will vary. Typical fatty acids cannot be turned into glucose because those with an even number of carbons—the typical form in the body—break down into acetyl- CoA molecules. Acetyl-CoA can never re-form into pyruvate; the step be-tween pyruvate and acetyl-CoA is irreversible. The options for acetyl-CoA are forming ketones and/or combining with oxaloacetate in the citric acid cycle. At the end of 1 cycle, no carbons from acetyl-CoA are left to turn into glucose; it is impossible to convert typical fatty acids into glucose. The glycerol portion of a triglyceride is the part that can become glucose. Glycerol enters the glycolysis pathway and can follow the gluco-neogenesis pathway from glyceraldehyde 3-phosphate to glucose. Glucose yield from glycerol is insignificant. 76) Answers will vary. In addition to its role in energy production, the citric acid cycle provides compounds that leave the cycle and are used for other pathways. This results in a slowing of the cycle, as eventually not enough oxaloacetate is formed to combine with the acetyl-CoA entering the cycle. Cells are able to compensate for this by synthesizing additional oxaloacetate. One potential source of this additional oxaloacetate is pyruvate (Fig. 9-14). Thus, as fatty acids create acetyl-CoA, carbohydrates (e.g., glucose) are needed to keep the concentration of pyruvate high enough to resupply oxaloacetate to the citric acid cycle. Overall, the entire pathway for fatty acid oxidation works better when carbohydrate is available. Version 1

77) Answers will vary. When oxygen is readily available, cellular respiration may be aerobic. When oxygen is not present, anaerobic pathways are used. Aerobic respiration is far more efficient than anaerobic metabolism at producing ATP. As an example, the aerobic respiration of a single molecule of glucose will result in a net gain of 30 to 32 ATP. In contrast, the anaerobic metabolism of a single molecule of glucose is limited to a net gain of 2 ATP. 78) Answers will vary. Glucose carbons exist in a more oxidized state than fat; as a result, fats yield more energy than carbohydrates (9 kcal/g versus 4 kcal/g). 79) Answers will vary. Carnitine helps shuttle free fatty acids in the cytosol into mitochondria. Carnitine is a popular nutritional supplement. In healthy people, cells produce the carnitine needed, and carnitine supplements provide no benefit. In patients hospitalized with acute illnesses, however, carnitine synthesis may be inadequate. These patients may need to have carnitine added to their intravenous feeding (total parenteral nutrition) solutions.

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80) Answers will vary. Stage 1: Glycolysis. In this pathway, glucose (a 6-carbon compound) is oxidized and forms 2 molecules of the 3-carbon compound pyruvate, produces NADH + H+, and generates a net of 2 molecules of ATP. Glycolysis occurs in the cytosol of cells. Stage 2: Transition reaction. The transition reaction converts 2 molecules of the 3-carbon pyruvate from glycolysis into 2 molecules of the 2-carbon molecule acetyl-CoA (Fig. 9-6). The transition reaction also produces NADH + H+ and releases carbon dioxide (CO2) as a waste product. The transition reaction is given this name because these molecules are transitioning from the cytosol into the mitochondria of cells where this reaction occurs. Stage 3: Citric acid cycle. In this pathway, acetyl-CoA enters the citric acid cycle, result-ing in the production of NADH + H+, FADH2, and ATP. Carbon dioxide is released as a waste product. Like the transition reaction, the citric acid cycle takes place within the mitochondria of cells. Stage 4: Electron transport chain. The NADH + H+ produced by stages 1 through 3 of cellular respiration and FADH2 produced in stage 3 enter the electron transport chain, where NADH + H+ is oxidized to NAD+ and FADH2 is oxidized to FAD. At the end of the electron transport chain, oxygen is combined with hydrogen ions (H+) and electrons to form water. The electron transport chain takes place within the mitochondria of cells. Most ATP is produced in the electron transport chain; thus, the mitochondria are the cell’s major energyproducing organelles.

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81) Answers will vary. When a person is in a state of semistarvation or fasting, the amount of glucose in the body falls, so insulin production falls. This fall in blood insulin then causes fatty acids to flood into the bloodstream and eventually form ketone bodies in the liver. The heart, muscles, and some parts of the kidneys then use ketone bodies for fuel. After a few days of ketosis, the brain also begins to metabolize ketone bodies for energy.Therefore, ketone levels rise during this period of time. 82) Answers will vary. In type 1 diabetes, little to no insulin is produced. This lack of insulin does not allow for normal carbohydrate and fat metabolism. Without sufficient insulin, cells cannot readily uti-lize glucose, resulting in rapid lipolysis and the excess production of ketone bodies. If the concentration of ketone bodies rises too high in the blood, they spill into the urine, pulling the electrolytes sodium and potassium with them. Eventually, severe ion imbalances occur in the body. The blood also becomes more acidic because 2 of the 3 forms of ketone bodies contain acid groups. The resulting condition, known as diabetic ketoacidosis, can induce coma or death if not treated immediately, such as with insulin, electrolytes, and fluids (see Chapter 5). Ketoacidosis usually occurs only in ketosis caused by uncontrolled type 1 dia-betes; in fasting, blood concentrations of ketone bodies typically do not rise high enough to cause the problem. 83) Answers will vary. Many cellular processes that create energy and other functions, including gluconeogenesis, fatty acid oxidation, and glycolysis/the electric transport chain in aerobic respiration, all occur in the mitochondria.

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84) Answers will vary. Inborn errors of metabolism occur when a person inherits a defective gene coding for a specific enzyme from both parents. Both parents are likely to be carriers of the defective gene—that is, they have 1 healthy gene and 1 defective gene for the enzyme in their chromosomes. When each parent donates the defective form of the gene to the offspring, the offspring has 2 defective copies of the gene and therefore little or no activity of the enzyme that the gene normally would produce. If a person has a defective gene, he or she produces a defective protein based on the instructions contained in that defective gene. See “CLINICAL PERSPECTIVE” in Section 09.07 for possible answers to this question specifically. 85) Answers will vary. The MEOS differs in several ways from the ADH pathway. First, the MEOS uses potential energy (in the form of NADPH + H+, another niacin coenzyme), rather than yielding potential energy (as NADH + H+ in the ADH pathway) in the conversion of alcohol to acetaldehyde. This use of energy may, in part, explain why individuals who consume large amounts of alcohol do not gain as much weight as might be expected from the amount of alcohol-derived energy they consume.

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86) Answers will vary. They appear soon after birth. Such a disorder is suspected when otherwise physically well children develop a loss of appetite, vomiting, dehydration, physical weakness, or developmental delays soon after birth. For some of these conditions, infants are screened for the potential to have a specific inborn error of metabolism. ••They are very specific, involving only 1 or a few enzymes. These enzymes usually participate in catabolic pathways (in which compounds are degraded). ••No cure is possible, but typically the disorders can be controlled. The type of control depends on the inborn error—control might include reducing intake of the substance the individual is unable to metabolize normally, taking pharmacological doses of vitamins, and replacing a compound that cannot be synthesized.

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CHAPTER 10 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Negative energy balance results from an energy deficit and the result is weight loss. ⊚ ⊚

true false

2) The part of our energy expenditure that we have the most direct control over is voluntary physical activity. ⊚ ⊚

As cholecystokinin secretion increases, appetite increases. ⊚ ⊚

true false

Hunger signals change even while we eat. ⊚ ⊚

true false

Chewing contributes to satiety. ⊚ ⊚

true false

Stomach distention contributes to satiety. ⊚ ⊚

true false

7) Metabolism of protein may promote satiety by decreasing the secretion of a hormone called ghrelin.

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⊚ ⊚

true false

8) Being classifiedas overweight according to BMI does not necessarilyequate to excess health risks if a person makes wise food choices and exercises. ⊚ ⊚

true false

Women carry more body fat than men for reproductive purposes. ⊚ ⊚

true false

10) According to studies, identical twins raised in different environments tend to have different weight gain patterns. ⊚ ⊚

11)

Genes account for up to 20% of weight differences between people. ⊚ ⊚

12)

true false

Environmental factors are important influences on what we eat. ⊚ ⊚

13)

true false

Eating breakfast has been shown to be a good strategy for losing weight. ⊚ ⊚

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true false

14) Setting a weight-loss goal of 10 pounds in six weeks is reasonable and attainable if the individual is fully committed to such efforts. ⊚ ⊚

15)

true false

Exercise leads to development of more lean tissue, which reduces basal metabolism. ⊚ ⊚

true false

16) In treating morbid obesity with gastroplasty, the volume of the stomach is reduced to approximately 30 milliliters. ⊚ ⊚

17)

true false

A VLCD may only supply 400 to 800 kcal per day. ⊚ ⊚

true false

18) Fad diets rarely lead to lasting weight loss or positive changes in eating and exercise habits. ⊚ ⊚

19)

Treating physical and emotional problems early could help prevent eating disorders. ⊚ ⊚

20)

true false

Ghrelin is a protein that increases appetite. ⊚ true ⊚ false

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MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 21) When the diet contains more energy than is expended, the excess energy ________. A) is stored as fat in adipose tissue B) is stored in muscle tissue C) decreases nitrogen balance D) is excreted in the urine

22)

When energy intake is greater than energy output, body weight generally ________. A) remains the same B) increases C) decreases D) None of these choices are correct.

23)

For most adults, the greatest portion of their energy expenditure is for ________. A) physical activity B) basal metabolism C) thermic effect of food D) None of these choices are correct.

24)

The body's total daily energy expenditure includes ________. A) basal metabolic rate, thermal effect of food, and effects of physical activity B) basal metabolic rate, height, and weight C) body mass index, food intake, and number of hours a person sleeps D) None of these choices are correct.

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25)

All the following are true statements about basal metabolism except ________.

A) it supports the work that goes on in the body all the time B) it is the amount of calories you need to sustain life C) it includes involuntary activities necessary to sustain life D) it accounts for the smallest component of the average person's daily energy expenditure

26)

Compared to men, the basal metabolic rate of women is typically ________. A) lower B) higher C) no different

27) The energy spent in maintaining all involuntary processes in the body at rest, awake, and in a non-absorptive state is called ________. A) resting metabolism B) thermogenesis C) thermic effect D) basal metabolism

28)

A factor that can decrease BMR is ________. A) consuming a very low-energy diet B) having a high fever C) long endurance exercise D) being pregnant

29)

The best predictor of your basal metabolic rate is ________.

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A) the rate of nutrient absorption B) what you had for breakfast C) your lean body mass D) environmental temperature

30)

Of the following males, who would most likely have the lowest BMR? A) 60-year-old B) 16-year-old C) 46-year-old D) 76-year-old

31) day.

The thermic effect of food accounts for approximately ______ of energy consumed each

A) 5% to 10% B) 11% to 15% C) 16% to 20% D) 50%

32)

Consumption of a very-low-calorie diet ________. A) increases BMR by about 10% to 20% B) increases BMR by about 40% to 50% C) decreases BMR by about 10% to 20% D) decreases BMR by about 40% to 50%

33) To calculate estimated energy needs using the equations developed by the Food and Nutrition Board, one needs information about the individual's ________.

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A) age B) weight C) height D) gender E) All of these choices are accurate.

34) A young man weighs 150 pounds. A rough estimate of his basal metabolic rate would be ________. A) 1469 kcal per day B) 68 kcal per hour C) 2500 kcal per day D) 61 kcal per hour

35)

The ratio ofbody weight to height is represented as ________. A) body composition B) basal metabolic rate C) bioelectrical impedance D) body mass index

36)

Hunger can be defined as ________. A) starvation B) a physiological drive to find and eat food C) a sensation caused by distension of the stomach and small intestine D) a psychological drive to eat

37)

Satiety is largely regulated by the ________.

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A) pituitary gland B) cerebral cortex C) hypothalamus D) liver

38)

A man weighs 154 pounds and is 70 inches tall. His BMI is ________. A) 15 B) 20 C) 22 D) 25

39)

A body mass index of 40 represents ________. A) no health risk B) possible health risk C) a high risk for health problems D) a value that is not on the nomogram

40)

Underwater weighing assesses body composition based on the principle that ________. A) lean body tissue is more dense than adipose tissue B) adipose tissue is more dense than lean body tissue C) adipose tissue is composed of mostly water D) body fluids are not being weighed using this method

41)

Bioelectrical impedance assesses body composition based on the principle that ________.

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A) atomic nuclei behave like magnets when an external magnetic field is applied across the body B) adipose tissue is more dense than lean body tissue C) electrical conductivity is greater in lean tissue than in adipose tissue D) fat-free mass is proportional to total body potassium

42) Which of the following techniques for measuring body composition makes use of small exposures to radiation? A) MRI B) DEXA C) TOBEC D) BIA

43) Lee Brown is a 23-year-old college student. Which of these would indicate that he is at greater risk for chronic diseases associated with obesity? A) BMI of 22 B) BMI of 27 C) 41-inch waist D) 38-inch waist

44)

A "thrifty metabolism" is a genetic predisposition that ________. A) causes a person to expend higher-than-average energy at rest B) enables a person to store fat readily C) enables a person to expend fat readily D) None of these choices are accurate.

45)

The set-point theory proposes that ________.

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A) body temperature determines how many calories are burned B) humans have a genetically predetermined body weight or body fat C) metabolism can be reset at different stages of life D) None of these choices are accurate.

46)

Before recommending treatment for obesity, the health professional should ________. A) assess current health status B) take a family history of obesity-related disease C) determine fat distribution in the patient D) All of these choices are accurate.

47) A healthy weight for an individual should not be based exclusively on weight, but on ________. A) total amount of body fat B) location of body fat C) presence or absence of weight-related medical problems D) All of these responses are correct

48) The success (attain and maintain reduced weight for 3 to 5 years) of non-surgical commercial weight reduction programs has been reported to be approximately ________ for adults. A) 40% B) 5% C) 25% D) 0%

49) Based on results of long-term studies, people on weight-reduction diets should limit ________. Version 1

A) high-fat foods B) high-fiber foods C) high-protein foods D) high-mineral foods

50)

Approximately how many calories are calculated to be in one pound of fat? A) 2500 B) 3500 C) 4500 D) 5500

51)

The major goal for weight reduction in the treatment of obesity is the loss of ________. A) weight B) body fat C) body water D) body protein

52) A daily deficit of 400 to 500 kcal should theoretically result in a loss of approximately ________ of body fat per week. A) 0.25 pound B) 1 pound C) 3 pounds D) 4 pounds

53) A weight-reduction program should be considered successful only when the weight loss ________.

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A) exceeds 10% of starting weight B) is maintained C) results in a BMI of below 25 D) All of these choices are correct.

54)

A sound program for weight reduction should include ________. A) control of total energy intake B) increased physical activity C) modification of food habits D) All of these choices are correct.

55)

An example of an appropriate weight-loss strategy would be a ________. A) food plan that meets the nutritional needs of the patient B) diet based on readily obtainable foods C) plan that encourages increased physical activity D) All of these choices are accurate.

56)

Physical activity is MOST likely to lead to successful weight loss if it ________. A) is performed at high intensity B) is performed regularly C) leads to significant loss of body water D) causes muscle soreness

57) Keeping tempting snack foods stashed in the cupboards or freezer instead of leaving them in plain view, which may trigger unnecessary eating, is an example of ________.

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A) cognitive restructuring B) chain-breaking C) self-monitoring D) stimulus control

58) Kevin wants to treat himself to a hot fudge sundae whenever he has a stressful day. He decides that a more appropriate response to a stressful day would be a brisk walk. Which of the following behavior modification techniques has he used? A) Cognitive restructuring B) Self-monitoring C) Contingency management D) Stimulus control

59) By keeping a detailed food diary, the individual who is trying to lose weight can discover ________. A) emotions that lead to poor eating habits B) social influences affecting eating and food choices C) external cues that lead to overeating D) All of these choices are accurate.

60) All of the following are useful behavior modification principles for weight control EXCEPT ________. A) eliminating a reward system for weight loss B) working out with a friend C) recording eating behaviors to identify situations that contribute to overeating D) shopping from a grocery list

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61) The best way to handle a situation in which you "go off" your meal plan for weight loss is to ________. A) go ahead and eat anything you want B) skip eating tomorrow C) assume lapses will occur and re-establish the program but feel guilty D) learn from the experience by identifying triggers so that a repeat can be avoided

62)

Maintenance of weight loss can be fostered by ________. A) eating breakfast B) having a regular exercise plan C) self-monitoring D) All of these responses are correct.

63) The highest rate of weight-loss success and maintenance among people with morbid obesity is seen with ________. A) very-low-calorie diets (VLCDs) B) jaw wiring C) gastroplasty D) commercial weight-loss programs

64)

The primary intent of gastroplasty is to ________. A) speed transit time B) limit stomach volume C) prevent snacking D) alter the absorption of the small intestine

65)

A fad diet for weight loss ________.

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A) can result in quick weight loss B) usually fails because habits are not changed C) may be nutritionally inadequate D) All of these choices are correct.

66)

A weight-loss program is likely a fad diet if it ________. A) recommends expensive, unproven nutrient supplements B) promotes quick weight loss C) guarantees weight-loss success for everyone D) All of these choices are accurate.

67) Eating disorders frequently co-occur with which of the following psychological disorders? A) Depression B) Substance abuse C) Anxiety disorders D) All of these choices are accurate.

68)

Anorexia nervosa can be defined as ________. A) compulsive eating B) purging C) hyperactivity D) psychological denial of appetite

69)

A condition of self-induced semi-starvation is called ________.

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A) bulimia B) anorexia nervosa C) kwashiorkor D) baryophobia

70) The semi-starvation of anorexia nervosa results in many physiological changes, such as ________. A) decreased basal metabolism B) lanugo C) iron-deficiency anemia D) dry, scaly, cold skin E) All of these choices are accurate.

71) Individuals with anorexia have trouble maintaining normal body temperature because of ________. A) loss of body fat as insulation B) lack of appropriate clothing as the person tries to show off his/her extreme thinness C) increased synthesis of the thyroid hormone D) wearing baggy clothes

72)

Lanugo is ________.

A) a consequence of iron deficiency B) the body’s response to increased synthesis of thyroid hormones to compensate for less kcals C) fine, downy hair covering the body to compensate for lack of adequate body fat insulation D) cessation of the menstrual cycle

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73)

The most successful treatment for anorexia nervosa involves ________. A) isolation from the family and forced tube feeding B) dietary counseling on an outpatient basis by a registered dietitian C) inpatient psychological, nutritional, and medical therapy, often involving the whole

family D) use of diuretics

74)

Bulimic patients often have a problem with ________. A) recognizing nutritious food choices B) eating enough food to maintain a healthy body weight C) experiencing no feelings of guilt after bingeing D) an inability to control responses to impulse and desire

75)

One essential difference between anorexia and bulimia ________.

A) is age of onset. Bulimia begins in early childhood B) is gender. Men are far more likely to suffer from anorexia nervosa when they enter their teens C) is that those with anorexia are much more secretive, while those with bulimia are much more open about their eating disorder D) is that the person with bulimia turns to food during a crisis or problem, whereas the person with anorexia turns away from food

76)

To counteract the binge, the bulimic patient may ________. A) induce vomiting B) take laxatives C) over-exercise D) All of these choices are accurate.

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77)

Repeated self-induced vomiting may cause ________. A) tears in the esophagus B) stomach ulcers C) electrolyte imbalances D) tooth demineralization E) All of these choices are correct.

78)

The greatest health risk from frequent vomiting due to bulimia nervosa is ________. A) potassium imbalance B) constipation C) lanugo D) swollen glands

79)

Other Specified Feeding and Eating Disorders (OSFED) ________.

A) are not really an eating disorder but more of a perception of having one B) occur when a person can't decide whether to engage in behaviors that are characteristic of anorexia or behaviors characteristic of bulimia C) refers to a broad category that can include symptoms from both anorexia and bulimia D) None of the answers are correct.

80) Which of the following represents a BMI range considered to be healthy for most adult men and women? A) 10-14 B) 15-18 C) 19-24 D) 25-30

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81)

The thermic effect of food represents A) the BMR minus theenergy used in physical activity B) the decrease infood energy due to cooking C) the increase inenergy expenditure associated with the body's digestion of food D) the body's storageof food as fat for insulation

82)

Which of the following genetic disorders would cause a person to have limited fat stores? A) Marfan syndrome B) Hypothyroidism C) Ovarian cysts D) Prader-Willi syndrome

83) Sally has had a rough day at work. Before she decided to lose weight, she would have normally gone straight to the freezer and eaten a large bowl of ice cream. Now, she recognizes that stress is a trigger for her to overeat so she deals with her stressors in other manners. What strategy is Sally using to control her problem behavior? A) Chain-breaking B) Cognitive restructuring C) Contingency management D) Self-monitoring

84) What would be the best food option for underweight individuals to add to their diet to increase their weight in a healthy manner? A) Cheeseburger B) Pizza C) Whole grain bread with turkey D) Salad with ranch dressing

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85) Eating a large amount of food in the late evening or eating food in order to fall asleep again once awakened in the night is termed A) orthorexia. B) pregorexia. C) night eating syndrome. D) bulimia nervosa.

86) A condition characterized by an excessive concern that one has underdeveloped muscles is termed

A) orthorexia. B) pregorexia. C) anorexia nervosa. D) muscle dysmorphia.

87) ___________ is a condition sometimes called the “health food eating disorder.” Healthy eating is taken to an extreme. A) Orthorexia B) Pregorexia C) Anorexia nervosa D) Muscle dysmorphia

88) ___________ can describe a women who decreases calories and exercises excessively to control weight gain during pregnancy. A) Orthorexia B) Pregorexia C) Night eating syndrome D) Binge-eating disorder

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SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 89) Why is BMI not the best indicator of overfat?

90)

Describe the differences between disordered eating and an eating disorder.

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 91) How does leptin affect appetite and is it involved in the development of obesity?

92)

Explain how hunger signals change several hours after eating.

93) Explain the difference between hunger and appetite and discuss if a craving for chocolate is a sign of hunger?

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94)

What everyday physical activities can help increase energy output?

95) What are the advantages and disadvantages of skinfold measurements as a technique for assessing body composition?

96)

Which body fat measurements are considered the most accurate and why?

97)

Describe two genetic disorders/diseases that can cause weight disturbances.

98)

Name the three important components of a successful weight-management program.

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99) What usually happens when someone resumes their normal lifestyle after having followed a fad diet?

100) Compare and contrast anorexia nervosa and bulimia. In what ways are they similar? In what ways are they different?

101) Explain how psychological therapy can help in the treatment of a patient with an eating disorder?

102) Someone you know is suspected of having an eating disorder. What are some of the steps you can take to help this person?

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Answer Key Test name: Chap 10_3e_Test Bank 1) TRUE 2) TRUE 3) FALSE Endorphins, the body’s natural painkillers, and hormones, such as cortisol and ghrelin, stimulate appetite and increase food intake. 4) TRUE 5) TRUE 6) TRUE 7) TRUE 8) TRUE 9) TRUE 10) FALSE Studies of identical twins provide some insight into the contribution of nature (genetics) to body weight. Even when identical twins are raised apart, they tend to show similar weight gain patterns, both in overall weight and in body fat distribution. 11) FALSE Research suggests that genes account for up to 40% to 70% of weight differences be-tween people. 12) TRUE 13) TRUE 14) TRUE 15) FALSE More lean tissue would increase basal metabolism.

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16) TRUE 17) TRUE 18) TRUE 19) TRUE 20) TRUE 21) A 22) B 23) B 24) A 25) D 26) A 27) D 28) A 29) C 30) D 31) A 32) C 33) E 34) B 150 lbs / 2.2 lbs/kg = 68 kg x 1.0 kcal/kg/hr = 68 kcal/hr 68 kcal/hr x 24 hr/day = 1632 kcal/day 35) D 36) B 37) C 38) C (154 lb x 703) / (70 in)

= 108,262 / 4900 = 22

39) C 40) A 41) C Version 1

42) B 43) C A waist circumference of over 40 inches for a male is considered at risk. 44) B 45) B 46) D 47) D 48) B 49) A 50) B 51) B 52) B 53) B 54) D 55) D 56) B 57) D 58) A Kevin restructured his way of dealing with stress to walk instead of eating high-calorie foods. 59) D 60) A 61) D 62) D 63) C 64) B 65) D 66) D 67) D Version 1

68) D 69) B 70) E 71) A 72) C 73) C 74) D 75) D 76) D 77) E 78) A 79) C 80) C 81) C 82) A 83) B 84) C 85) C 86) D 87) A 88) B 89) Many men (especially athletes) have a BMI greater than 25 because of extra muscle tissue. Adults less than 5 feet tall may have a high BMI but are not overweight or overfat. For this reason, BMI alone should not be used to diagnose overweight or obesity. Still, overfat and overweight conditions generally appear together.

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90) Answers will vary. Disordered eating can be defined as mild and short-term changes in eating patterns that occur in response to a stressful event, an illness, or a desire to modify the diet for health and/or personal appearance reasons. The problem may be no more than a bad habit, a style of eating adapted from friends or family members, or an aspect of preparing for athletic compe-tition. Although disordered eating can lead to changes in body weight and certain nutritional problems, it rarely requires in-depth professional attention. However, in today’s world, given the common practice of dieting, skipping meals, eating at odd times, and having hectic jobs and schedules, it may not be obvious when disordered eating stops and an eating disorder begins. Disordered eating can escalate into physiological changes associated with sustained food restriction, binge eating, purging, and fluctuations in weight that interfere with everyday activities. It also involves emotional and cognitive changes that affect how peo-ple perceive and experience their bodies, such as feelings of distress or extreme concern about body shape or weight. Eating dis-orders frequently co-occur with other psychological disor-ders, such as depression, substance abuse, and anxiety disorders. Eating disorders are not due to a failure of will power or behavior; rather, they are real, treatable medical illnesses that require complex professional intervention that must go beyond nutritional ther-apy. Without treatment, eating disorders can cause serious physical health complications, including heart conditions and kidney failure, which may even lead to death.

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91) Answers will vary. Leptin is a pro-tein made by adipose tissue; it functions as a hormone to reduce food intake, thus decreasing body fat. The obesity gene (ob gene) codes for the synthesis of leptin. When the ob gene is functioning normally, leptin is made and signals satiety. However, when there is a mutation in the ob gene and leptin is not made in sufficient quantities, the desire to eat is increased dramatically, metabolic rate declines (which reduces energy output), and weight gain oc-curs. Because treating people with leptin doesn’t cause significant weight loss, experts sug-gest that, instead of protecting against obesity, leptin may be more important for signaling low body fat stores and setting in motion adaptations that promote energy conservation, delaying the effects of starvation. 92) Answers will vary. Several hours after eating, concentrations of macronutrients in the blood begin to fall and the body starts using energy from body stores. This change causes feelings of satiety to diminish, and feeding signals begin to dominate again. Endorphins, the body’s natural painkillers, and hormones, such as cortisol and ghrelin, stimulate appetite and increase food intake. As you can see, the regulation of food intake and satiety is complex and involves body cells (brain, adipose tissue, stomach, intestines, liver, and other organs), hormones (e.g., cholecystokinin and ghrelin), neurotransmitters (e.g., serotonin), dietary components, and social customs. This system is not perfect, however; your body weight can increase (or decrease) over time if you are not careful to balance your energy intake with your energy output.

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93) Answers will vary. Hunger, the physiologi-cal drive to find and eat food, is controlled primarily by internal body mechanisms, such as organs, hormones, hormonelike factors, and the nervous system. Appetite, the psychologi-cal drive to eat, is affected mostly by external factors that encourage us to eat, such as social custom, time of day, mood (e.g., feeling sad or happy), memories of pleasant tastes, and the sight of a tempting dessert. Internal and external signals that drive hunger and appetite generally operate simulta-neously and lead us to decide whether to reject or eat a food. For example, external signals can cause cephalic phase responses by the body—that is, saliva flows and digestive hor-mones and insulin are released in response to seeing, smelling, and initially tasting food. These physiological responses encourage eating and prepare the body for the meal. Al-though hunger and appetite are closely intertwined, they don’t always coincide. Almost everyone has encountered a mouthwatering dessert and devoured it, even on a full stomach. Alternately, there are times when we are hungry but have no appetite for the food being served. Where food is ample, appetite—not hunger— mostly triggers eating. 94) Answers will vary. Table 10-5 Approximate Energy Costs of Various Activities

kcal/kg

kcaUkg

Activity

per Hour Activity

per Hour

Aerobics-heavy

8.0

Dressing/showering

1.6

Running or jogging 13.2 (10 mph)

Aerobics-medium

5.0

Driving

1.7

Downhill skiing (10 8.8 mph)

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Aerobics-light

3.0

Eating (sitting)

1.4

Sleeping

1.2

Backpacking

9.0

Food shopping

3.6

Swimming (.25 mph)

4.4

Basketball-vigorous 10.0

Football-touch

7.0

Tennis

6.1

Cycling (5.5 mph)

3.0

Golf

3.6

Volleyball

5.1

Bowling

3.9

Horseback riding

5.1

Walking (2.5 mph) 3.0

Calisthenics-heavy 8.0

Jogging-medium

9.0

Walking (3.75 mph) 4.4

Calisthenics-light

Jogging-slow

7.0

Water skiing

7.0

Canoeing (2.5 mph) 3.3

Ice skating (10 mph)

5.8

Weight liftingheavy

9.0

Cleaning

3.6

Lying down

1.3

Weight lifting-light 4.0

Cooking

2.8

Racquetball-social

8.0

Window cleaning

3.5

Cycling (13 mph)

9.7

Roller skating

5.1

Writing (sitting)

1.7

4.0

The values refer to total energy expenditure, including that needed to perform the physical activity plus that needed for basal metabolism. The thermic effect of food, and thennogenesis. Example: For a 150 lb person who played tennis for 1.5 hours 15016/2.2= 68 kg 68 kg x 6.1 kcalthr x 1.5 hr = 622 kcal expenditure

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95) Answers will vary. Skinfold thickness is a common anthropometric method to estimate total body fat content. Technicians use calipers to measure the fat layer directly under the skin at multiple sites and then enter those values into a mathematical formula (Fig. 10-11). The accuracy of this method is good (3 to 4% error margin) when performed by a trained technician. Advantages are that it can be fairly non-invasive way to measure body fat, but a disadvantage is that an unskilled technician can perform a bad measure. 96) Answers will vary. To measure body fat content accurately using typical methods, both body weight and body volume must be measured. Body weight is easy to measure. Of the typical methods used to estimate body volume, underwater weighing is 1 of the most accurate (2 to 3% error margin). This technique determines body volume by measuring body weight when under water and body weight in air and entering these values into a mathematical formula that accounts for the differences in the relative densities of fat tissue and lean tissue (Fig. 10-9). Air displacement, an-other method for determining body volume, measures the space a person takes up inside a small chamber, such as the BodPod® (Fig. 1010). This method also has a 2% to 3% error margin and is an accurate alternative to underwater weighing. Dual energy X-ray absorptiometry (DXA) is considered the most accu-rate way to determine body fat (1% to 4% error margin), but the equipment is very expensive and not widely available. The usual wholebody scan requires about 5 to 20 minutes and the dose of radiation is less than a chest X-ray. This method can estimate body fat, fat-free soft tissue, and bone minerals. Thus, obesity, osteoporo-sis, and other health conditions can be investigated using DXA.

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97) Answers will vary. Body weight and fatness can be affected by certain diseases, hormonal abnormalities, rare genetic disorders, and psychological disturbances. For instance, cancer, AIDS, hyperthy-roidism, Marfan syndrome, and anorexia nervosa tend to cause a person to have limited fat stores. A very small percentage of obesity cases are caused by brain tumors, ovarian cysts, hypothyroidism, and congenital syndromes, such as Prader-Willi syndrome. 98) Answers will vary. The key to weight loss and maintenance can be thought of as a triangle, in which the 3 corners consist of 1 controlling energy intake, 2 performing regular physical activity, and 3 controlling problem behaviors. The 3 corners of the triangle support each other—without 1 corner, the triangle becomes incomplete. 99) Answers will vary. Weight gain typically results after an individual ends a fad diet. 100) Answers will vary. Table 10-8 Typical Characteristics of Those with Eating Disorders

Anorexia Nervosa

Bulimia Nervosa

• Rigid dieting, causing dramatic weight loss, generally to less than 85% of what would be expected for one's age (or BMI of 17.5 or less)

• Secretive binge eating; generally not overeating in front of others

• False body perception—thinking "I'm too fat;' even when extremely underweight; relentless pursuit of control

• Eating when depressed or under stress

• Rituals involving food, excessive exercise, and other aspects of life

• Bingeing on a large amount of food, followed by fasting, laxative or diuretic abuse, self-induced vomiting, or excessive exercise (at least weekly for 3

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months)

• Maintenance of rigid control in lifestyle; security found in control and order

• Shame, embarrassment, deceit, and depression; low self-esteem and guilt (especially after a binge)

• Feeling of panic after a small weight gain; intense fear of gaining weight

• Fluctuating weight (+10 lb or 5 kg) resulting from alternate bingeing and fasting

• Feelings of purity, power, and superiority through maintenance of strict discipline and selfdenial

• Loss of control; fear of not being able to stop eating

• Preoccupation with food, its preparation, and observing another person eat

• Perfectionism, "people please?'; food as the only comfort/escape in an otherwise carefully controlled and regulated life

• Helplessness in the presence of food

• Erosion of teeth; swollen glands from vomiting

• Typically lack of menstrual periods after what should be the age of puberty

• Purchase of syrup of ipecac, a compound sold in pharmacies that induces vomiting

• Some binge eat and purge

Binge Eating Disorder • Same characteristics as bulimia nervosa without purging • Eats faster than normal • Eats even when full or not hungry • Feels unpleasantly full after binge eating • Eats alone to hide binge eating from others

People who exhibit only a few of these characteristics may be at risk but probably do not have a disorder. They should, however, reflect on their eating habits and related concerns and take appropriate action, such

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as seeking a careful evaluation by a physician.

101) Answers will vary. Once the physical problems of anorexic patients are ad-dressed, the treatment focus shifts to the underlying emotional problems of the disorder. To heal, these patients must reject the sense of accomplishment they associate with an emaci-ated body and begin to accept themselves at a healthy body weight. Establishing a strong relationship with either a therapist or another supportive person is especially important to recovery. A key aspect of psychological treatment is showing affected individuals how to regain control of other facets of their lives and cope with tough situations. As eating evolves into a normal routine, they can return to previously neglected activities.

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102) Answers will vary. The following are some ways that caregivers and health professionals can help growing children and adolescents avoid eating disorders: Discourage restrictive dieting, meal skipping, and fasting (except for religious reasons). Encourage children to eat only when hungry. Promote good nutrition and regular physical activity in school and at home. Promote regularly eating meals as a family unit. Provide information about normal changes that occur during puberty. Correct misconceptions about nutrition, healthy body weight, and approaches to weight loss. Carefully phrase any weight-related recommendations and comments. Don’t overemphasize numbers on a scale. Instead, primarily promote healthful eating ir-respective of body weight. Increase self-acceptance and appreciation of the power and pleasure emerging from one’s body. Encourage coaches to be sensitive to weight and body image issues among athletes. Emphasize that thinness is not necessarily associated with better athletic performance. Enhance tolerance for diversity in body weight and shape. Encourage normal expression of emotions. Build respectful environments and supportive relationships. Provide adolescents with an appropriate, but not unlimited, degree of independence, choice, responsibility, and self-accountability for their actions.

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CHAPTER 11 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The best exercise can be considered one that an individual wants to continue to do. ⊚ ⊚

true false

Exercise should be fun in order to promote continuity. ⊚ ⊚

true false

3) A good way to determine the intensity of exercise is to measure the amount of oxygen a person consumes. ⊚ ⊚

true false

Warm-up and cool-down should be parts of your exercise routine. ⊚ ⊚

true false

5) Glycogen is the primary source of glucose for ATP production in muscles during intense activity that lasts for less than 2 minutes. ⊚ ⊚

true false

6) Carbohydrate is more efficient than fat or protein in the amount of ATP produced per unit of oxygen consumed. ⊚ ⊚

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true false

Slow, steady aerobic activity uses mostly fat as a mainenergy source. ⊚ ⊚

Amino acids can be used as a primary fuel for muscles. ⊚ ⊚

true false

Thirst is an excellent indicator of fluid needs during exercise. ⊚ ⊚

13)

true false

During exercise, athletes should always be consuming massive amounts of water. ⊚ ⊚

12)

true false

Carbohydrate loading should be exclusively used by strength-trained athletes. ⊚ ⊚

11)

true false

Athletes need to consume over 500 grams of protein supplements a day to build muscle. ⊚ ⊚

10)

true false

College wrestlers can best enhance their strength by dehydration. ⊚ ⊚

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true false

14) According to the Physical Activity Guidelines for Americans, additional health benefits can be gained by participating in physical activity beyond the equivalent of 300 minutes of moderate-intensity physical activity a week. ⊚ true ⊚ false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 15) Which of the following are benefits of regular and consistent exercise? A) Enhanced heart function B) Improved balance C) Better sleep habits D) Reduced stress E) All of these responses are correct.

16) In order for an individual to maintain a regular exercise regimen it helps most if ________. A) the exercise works only the lower legs B) the exercise is built into a daily routine C) you sweat profusely D) you have a membership to a gym

17) According to the Physical Activity Guidelines for Americans substantial health benefits occur when adults engage ________. A) in occasional physical activity B) in 150-300 minutes of moderate intensity exercise each week C) in 75-150 minutes of moderate intensity exercise each week D) None of these responses are correct.

18)

The benefit(s) of participating in different types of exercise is/are ________.

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A) strengthening a variety of muscle groups B) reducing the chances of injury C) promoting activities that are more interesting and thus more likely to be continued D) All of these responses are correct.

19)

The Borg Scale of Perceived Exertion is used to determine ________. A) flexibility B) muscle strength C) exercise intensity D) All of these responses are correct.

20)

Energy for muscle contraction is most directly supplied by ________. A) amino acids B) creatine C) phosphocreatine D) ATP

21)

The amount of ATP stored in a muscle cell can keep a muscle active for about ________. A) 1-2 seconds B) 10-30 seconds C) 1-3 minutes D) 1-3 hours

22)

Phosphocreatine (PCr) is an energy-rich compound found in ______ tissue.

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A) adipose B) liver C) kidney D) muscle

23) At very high intensities of exercise, most of the energy the body uses is supplied by ________. A) muscle glycogen B) intramuscular fat C) blood glucose D) muscle protein

24) When plenty of oxygen is available in the muscles, the condition is referred to as ________. A) anaerobic B) aerobic C) VO 2max D) glycolytic

25) When conditions in the exercising muscle are anaerobic, metabolism of glucose results in ________. A) the formation of lactate B) production of 28 to 30 ATP C) transfer of electrons and hydrogen ions to oxygen D) None of these responses are correct.

26) When glucose is broken down in an atmosphere where oxygen supply is limited, a 3carbon compound known as ________ accumulates in the muscle. Version 1

A) phosphocreatine B) lactate C) glycogen D) protein

27) The lactate that is made during high intensity exercise is eventually released in the bloodstream and taken up by the ______ and used as an energy source. A) heart B) liver C) muscles D) All of the choices are correct.

28) When an athlete's maximal performance is desired, carbohydrates are a more efficient fuel than fat because ________. A) more ATP is produced per unit of oxygen consumed B) we consume more carbohydrate than fat or protein C) carbohydrate is oxidized more rapidly than fatty acids D) muscles get used to using carbohydrate as a fuel

29)

Anaerobic glycolysis can supply energy to muscle tissue for ________. A) 10 to 30 seconds B) 30 seconds to 2 minutes C) 2 to 5 minutes D) up to 30 minutes

30) The main disadvantage of anaerobic glycolysis in high-intensity muscle contractions is that ________.

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A) the heart muscle "soaks up" most of the lactic acid for its energy needs B) ATP production cannot be sustained for long events C) the production of excessive amounts of CO 2 and H 2O interferes with exercise D) ATP is needed for digestion

31) Lactate from anaerobic glycolysis is transported by the blood to the liver, where it will be ________. A) resynthesized to glucose B) converted to sucrose or maltose C) converted to cholesterol for disposal from the body D) converted to urea for disposal by the kidneys

32)

The site of greatest energy production in a muscle cell is the ________. A) nucleus B) ribosomes C) mitochondria D) cytoplasm

33)

The only fuel that can be used in anaerobic glycolysis is ________. A) fatty acids B) amino acids C) alcohol D) glucose

34) Other than phosphocreatine breakdown, the fastest way to supply ATP to exercising muscle is ________.

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A) aerobic glycolysis B) anaerobic glycolysis C) to consume an energy gel D) to break down fat stores in muscle and convert fatty acids to glucose

35)

In low-intensity exercise, aerobic metabolism of glucosewill result in ________. A) lactic acid B) lipogenesis C) carbon dioxide and water D) glucose, fatty acids, and amino acid skeletons

36) In high-intensity exercise, such as sprinting, the predominant fuel for exercise is ________. A) fat B) protein C) carbohydrates D) vitamins

37)

During the aerobic pathway of carbohydrate metabolism, _______. A) glucose is metabolized with the aid of CO 2 B) fatty acids become the predominant fuel C) ATP is formed slowly, but muscular activity can be sustained for many hours D) ATP is formed quickly, for use in very short bursts

38)

Glucose is stored in muscle tissue as ________.

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A) triglycerides B) glycogen C) protein D) phosphocreatine (PCr)

39) In order to build up maximum stores of muscle glycogen for long-distance marathons, one should consume a ________ diet. A) high-carbohydrate B) high-protein C) high-fat D) high-energy

40)

The majority of stored energy in the body is in the form of ________. A) glucose B) ATP C) amino acids D) triglycerides

41)

_____ can supply as much as 15% of energy needs for endurance events. A) Proteins B) Carbohydrates C) Fats D) Vitamins

42)

_______ of one's general energy needs is supplied by amino acid metabolism.

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A) Five percent B) Fifteen percent C) Fifty percent D) Seventy percent

43)

An adaptation that occurs with exercise, besides improvement in fitness is ________. A) increased bone density B) better eyesight C) increased constipation D) increased morbidity

44)

Prolonged, low intensity exercise uses mainly ______ muscle fibers. A) white B) Type IIX C) Type IIA D) Type I

45)

A response called hypertrophy occurs when ________. A) more ATP is released from the cell B) a person exercises for half an hour per week C) muscles enlarge after being made to work repeatedly D) All of these choices are correct.

46)

Variables that determine an athlete's energy needs include ________.

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A) body composition B) training or competition C) body size D) All of these responses are correct. E) None of these responses are correct.

47) When exercise duration approaches several hours per day, recommended carbohydrate needs for athletes increase up to ________. A) 3 grams carbohydrate per kg body weight B) 5 grams carbohydrate per kg body weight C) 10 grams carbohydrate per kg body weight D) 20 grams carbohydrate per kg body weight

48) The dietary regimen to maximize muscle glycogen stores for later energy usage is called ________. A) carbohydrate synthesis B) glycogen synthesis C) carbohydrate loading D) energy loading

49) For athletes who compete in continuous, intense aerobic events lasting for 90 to 120 minutes (or shorter events repeated in 24 hours), ________. A) carbohydrate-loading may benefit performance B) carnitine supplements have proven to improve the use of fatty acids as muscle fuel C) large doses of bicarbonate counter the acid production in the stomach D) all caffeine-containing foods and beverages should be avoided for at least 2 to 4 days before the competition

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50) Which of the foods below constitutes the best choice when attempting carbohydrate loading before endurance events? A) Orange juice B) French fries C) Spaghetti D) Sausage

51)

"Hitting the wall" is a term to describe ________.

A) someone is training for a marathon B) someone has essentially run out of available carbohydrates for energy C) someone is so tired that he or she must stop to and rest for 10 to 15 minutes before continuing the sport D) None of these responses are correct.

52) During muscle-building regimens, how much protein is generally recommended for athletes consume? A) 0.8 g/kg B) 1.0 - 1.2g/kg C) 1.2 - 1.7 g/kg D) 2.0 - 2.4g/kg

53) Many athletes, particularly female and young athletes, may need to increase their intake of ________ to help increase red blood cell production. A) vitamin C B) vitamin A C) calcium D) iron

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54)

Taking iron supplements has been found to benefit athletes ________. A) only if they are anemic B) in rare cases when they have experienced a cessation of the menstrual cycle C) who are experiencing early symptoms of osteoporosis D) by increasing the bulk of muscle

55)

Which of the following is NOT a part of Relative Energy Deficiency in Sport, or REDS? A) Delayed menses B) Poor bone growth and stress fractures C) Type 2 diabetes D) Energy deficit/disordered eating

56) A weight loss of 2% or more of body weight by dehydration carries some risk of ________. A) increased body temperature B) reduced blood volume C) decreased performance D) All of these choices are correct.

57) For every pound of weight lost during an athletic event, ________ of water should be consumed immediately thereafter. A) ½ cup B) 1 cup C) 1½ cups D) 3 cups

58)

Fluids should be consumed _________ an athletic event.

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A) before B) during C) after D) All of these choices are correct.

59)

One advantage of sports drinks is taste. In addition, they ________. A) are quick replacements for carbohydrates B) increase fluid consumption C) replace important minerals such as sodium, potassium, and chloride D) All of these choices are correct.

60)

Hyponatremia can be a condition that is caused by ________. A) overconsumption of water B) overconsumption of sodium C) underconsumption of water D) underconsumption of potassium

61)

A pre-event meal eaten 1 to 2 hours before competition should be ________. A) low in fat B) low in fluid C) high in dietary fiber D) All of these choices are accurate.

62)

An example of a food to avoid in a pre-game meal is ________.

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A) hot dogs B) spaghetti C) low-fat milk D) All of these foods should be avoided.

63) Recommendations for restoration of muscle glycogen include _____ grams of carbohydrates per kilogram of body weight are consumed 30 minutes after exercise and again 2 hours after exercise. A) 0.5 - 0.75 B) 1.0 - 1.5 C) 3.0 - 4.0 D) None of these responses are correct.

64)

Anabolic steroids are ________. A) synthetic versions of growth hormone B) synthetic forms of cortisol, which increases glucose production C) synthetic versions of male sex hormones D) synthetic versions of thyroxine

65) Which substance is considered to be a proven ergogenic aid that increases athletic performance? A) Salt tablets B) Bee pollen C) Carnitine D) Coenzyme Q-10 E) None of these substances have been proven to increase athletic performance.

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66) Lance Armstrong, who was a triathlete and road racing cyclist, likely has more __________ muscle fibers. A) Type I B) Type IIA C) Type IIX D) He would have equal amounts of all muscle fiber types.

67) Your roommate tells you he wants to put on more muscle mass. He plans to do this by addingstrength-training exercises and protein shakes to his diet. What advice could you offer him? A) Higher amounts of protein will add muscle mass faster, so add in as much as you possibly can. B) Going over 0.8 g/kg will have no benefit for muscle building during the training period. C) Intakes of up to 1.7 g/kg are acceptable during muscle mass gain, but going over this amount can lead to dehydration and insufficient carbohydrate intake. D) Try to stay as low as possible in your intake as proteins have no benefit for muscle mass gain or energy usage.

68)

Which of the following athletes would have the highest requirements for proteins? A) 120 lb female triathelete B) 120 lb female trying to increase her muscle mass C) 180 lb sedentary male D) 180 lb male football player

69) You are at an athletic event and you notice that one of the participants is not feeling well. He is starting to not be able to walk and appears to be confused and irritated. What heat-related condition is he likely suffering from?

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A) Heat exhaustion B) Heat cramps C) Heat stroke D) None of the answers are correct.

70) Sarah has designed a fitness program that includes aerobic exercise, resistance exercise, and flexibility exercise. What characteristic of a well-designed fitness program was Sarah most concerned about when she designed her program? A) Duration B) Intensity C) Progression D) Mode

71)

Athletes in high intensity sports who follow a ketogenic diet

A) have lower glycogen stores. B) may show impaired performance in high intensity activity such as sprinting. C) may need to include come carbohydrate from lower carbohydrate sources for optimal performance. D) All of these are correct.

ESSAY. Write your answer in the space provided or on a separate sheet of paper. 72) What are the basic components of an exercise program?

73) Before initiating a new fitness program, what are two important considerations for the beginner?

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74)

Describe how the intensity of exercise affects glycogen utilization.

75) Contrast the protein requirements for an endurance athlete to requirements for a strengthtrained athlete.

76)

Why is a high intake of protein for athletes discouraged?

77)

Design a diet for an endurance athlete who wants to carbohydrate load.

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78)

Compare the traditional carbohydrate loading diet to the modified method.

79)

What athletes can benefit from carbohydrate loading? Why?

80)

How would your diet plan for a football player differ from that of a marathon runner?

81) How would you convince a football coach that a sports drink would be better than water for his high school athletes during two-a-day practices?

82)

List 5 symptoms of heatstroke, and explain how it can occur.

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Answer Key Test name: Chap 11_3e_Test Bank 1) TRUE TRUE statement 2) TRUE TRUE statement 3) TRUE TRUE statement 4) TRUE TRUE statement 5) TRUE TRUE statement 6) TRUE TRUE statement 7) TRUE TRUE statement 8) FALSE Carbohydrates are used as a primary fuel for muscles. 9) FALSE This recommendation is much too high for daily protein consumption. 10) FALSE Carbohydrate loading is typically utilized by endurance athletes. 11) FALSE Version 1

Too much water consumed during exercise can actually be problematic and cause immediate distention/discomfort and possibly overhydration if over-consumed. 12) FALSE Thirst is not a reliable indicator of hydration needs for very active individuals. 13) FALSE Dehydration can cause loss of endurance, focus, and strength and should never be recommended. 14) TRUE 15) E 16) B 17) B 18) D 19) C 20) D 21) A 22) D 23) A 24) B 25) A 26) B 27) D 28) C 29) B 30) B 31) A 32) C 33) D Version 1

34) B 35) C 36) C 37) C 38) B 39) A 40) D 41) A As a rough guide, only about 5% of the body’s general energy needs, as well as the typical energy needs of exercising muscles, is supplied by amino acid metabolism. However, proteins can contribute to energy needs in endurance exercise, perhaps as much as 15%, especially as glycogen stores in the muscle are exhausted. 42) A As a rough guide, only about 5% of the body’s general energy needs, as well as the typical energy needs of exercising muscles, is supplied by amino acid metabolism. However, proteins can contribute to energy needs in endurance exercise, perhaps as much as 15%, especially as glycogen stores in the muscle are exhausted. 43) A 44) D 45) C 46) D 47) C 48) C 49) A 50) C 51) B 52) C 53) D Version 1

54) A 55) C 56) D 57) D 58) D 59) D 60) A 61) A A high-fat, high fiber meal should not be consumed close to competition time due to potential digestive delay and related problems. 62) A Hot dogs contain no carbohydrates (needed for energy) and are also high in fat (not recommended pre-game). 63) B 64) C 65) E 66) A Prolonged exercise requires type I muscle fibers, and an endurance athlete would benefit from high numbers of type I. 67) C Up to 1.7 g/kg is recommended for those attempting to gain muscle mass. 68) D Of the individuals listed, a 180 lb male football player likely has the most muscle mass and goals of strength building. 69) C The symptoms listed are those related to heat stroke.

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70) D Mode is defined by type of exercise, of which this program has diverse types included. 71) A 72) A good fitness program meets a person’s needs—the ideal program for an individual may not be right for another. The first step in designing a fitness program is to define goals. Some may want a program that trains them for athletic competition; others may want to lose weight or just increase their stamina or improve their balance. Different goals mean different fitness programs. To reach goals, fitness program planning should consider the mode, duration, frequency, intensity, and progression of exercise, as well as consistency and variety. Also, a good fitness program must help individuals achieve and maintain fitness. 73) To stick with an exercise program, experts recommend the following: Start slowly. Vary activities; make exercise fun. Include friends and others. Set specific attainable goals and monitor progress. Set aside a specific time each day for exercise; build it into daily routines, but make it convenient. Reward yourself for being successful in keeping up with your goals. Don’t worry about occasional setbacks; focus on long-term benefits to your health

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74) Glycogen is broken down to glucose, which can be metabolized by both the anaerobic and aerobic pathways. Liver glycogen is used to maintain blood glucose levels, whereas muscle glycogen supplies the glucose to the working muscle. Glycogen is, in fact, the primary source of glucose for ATP production in muscle cells during fairly intense activities that last for less than about 2 hours. In short events (e.g., less than 30 minutes or so), muscles rely primarily on muscle glycogen stores for carbohydrate fuel. Muscles do not take up much blood glucose during short-term exercise because the action of insulin, which increases glucose uptake by mus-cles, is blunted by other hormones, such as epinephrine and glucagon during exercise. As exercise time increases, muscle glycogen stores decline and the muscles begin to take up blood glucose to use as an energy source. The depletion of glycogen in the muscles contributes to fatigue, whereas the depletion of glycogen in the liver leads to a fall in blood glucose. 75) Although amino acids derived from protein can fuel muscles, their contribution is relatively small compared with that of carbohydrate and fat. As a rough guide, only about 5% of the body’s general energy needs, as well as the typical energy needs of exercising muscles, is supplied by amino acid metabolism. However, proteins can contribute to energy needs in endurance exercise, perhaps as much as 15%, especially as glycogen stores in the muscle are exhausted. Endurance exercise is when protein is most likely to make its most significant contribution as a fuel source—but, even then, it provides limited energy, with estimates ranging from 3 to 15%. In contrast, protein is used least in resistance exercise (e.g., weight lifting)

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76) Consuming more protein than the body needs or can use will not lead to greater muscle mass. Eating high carbohy-drate, moderate protein foods immediately after a weight training workout can enhance the anabolic effect of the activity. This most likely increases blood concentrations of insulin and growth hormone and contributes to protein synthesis. Remember, it is impossible to increase muscle mass simply by eating protein; putting physical strain on muscle through strength training or other physical activity is needed, as is adequate protein intake to support growth and recovery. Protein intakes above recommendations result in an increased use of amino acids for energy needs and has disadvantages, such as insufficient carbohydrate intake and increased urine production, which may interfere with body hydration. No advan-tages, such as an increase in muscle protein synthesis, are seen. Despite marketing claims, protein supplements are an expensive and unnecessary part of a fitness plan. 77) WILL VARY depending on chosen athlete… The classic method of carbohydrate loading depleted muscle glycogen stores with 3 days of heavy training and a very low carbohydrate diet. This was followed by 3 days of high carbohy-drate intake and rest to promote muscle glycogen synthesis. This classic method often left athletes exhausted and prone to injuries during the first 3 days. A modified method tapers off training intensity and duration on consecutive days after a bout of glycogen-depleting exercise 6 days before competition. During the first 3 days of tapering, the ath-lete consumes a normal mixed diet, followed by a high carbohydrate diet 3 days before competition.

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78) The classic method of carbohydrate loading depleted muscle glycogen stores with 3 days of heavy training and a very low carbohydrate diet. This was followed by 3 days of high carbohy-drate intake and rest to promote muscle glycogen synthesis. This classic method often left athletes exhausted and prone to injuries during the first 3 days. A modified method tapers off training intensity and duration on consecutive days after a bout of glycogen-depleting exercise 6 days before competition. During the first 3 days of tapering, the ath-lete consumes a normal mixed diet, followed by a high carbohydrate diet 3 days before competition. 79) Appropriate Activities for Carbohydrate Loading Marathons Long-distance swimming Cross-country skiing 30-kilometer runs Triathlons Tournament-play basketball Soccer Cycling time trials Long-distance canoe racing

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80) Athletes need varying amounts of food energy, depending on their body size, their body composition, and the type of training or competition. A petite gymnast may need only 1800 kcal/day to sustain normal daily activities without losing body weight; a tall, muscular swimmer may need 4000 kcal/day. If an athlete experiences daily fatigue and/or weight loss, the first consideration should be whether that person is consuming enough food. Up to 6 meals per day may be needed, including 1 before each workout. Monitoring body weight is an easy way to assess the adequacy of calorie intake. Ath-letes should strive to maintain weight during competition and training. Generally, if athletes are losing weight, then energy intake is inadequate; however, if athletes are gaining weight, then energy intake is too high. If an athlete needs to lose weight, his or her food intake should be lowered by 200 to 500 kcal per day. This slight reduction will allow the athlete to continue to train and compete yet will create a calorie deficit so that weight loss can be achieved. Reducing fat intake is the best way to cut calories and not affect performance. On the other hand, if an athlete needs to gain weight, increasing food intake by 500 to 700 kcal/ day will eventually achieve that goal. The extra calories should come from a healthy balance of carbohydrate, protein, and fat; exercise needs to be maintained to make sure this gain is mostly in the form of lean muscle mass. In general, both athletes should focus on clean unprocessed foods. The calorie levels would depend on weight goals and current status. The football player (focusing on strength), would require a high calorie load, with focus on 1-1.7g/kg protein, while the marathoner would focus on 1.7g/kg protein with a very high carbohydrate intake as well.

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81) When exercise extends beyond 1 hour, sports drinks can offer several advantages over water alone—even more so in hot weather (Fig. 11-14): Carbohydrates in sports drinks supply glucose to muscles as they become depleted of glycogen, thus enhancing performance. Electrolytes in sports drinks help maintain blood volume, enhance the absorption of water and carbohydrates from the intestines, and stimulate thirst. 82) Left unchecked, heat exhaustion can rapidly progress to heatstroke. Heatstroke can occur when the internal body temperature reaches 104°F or higher. Exertional heatstroke results from high blood flow to exercising muscles, which overloads the body’s cooling capacity. Symptoms include nausea, confusion, irritability, poor coordination, seizures, hot and dry skin, rapid heart rate, vomiting, diarrhea, and coma. If heatstroke is left untreated, circulatory collapse, nervous system damage, and death are likely. The death rate from heatstroke is approximately 10%.

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CHAPTER 12 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) People who smoke likely need more vitamin C than nonsmokers. ⊚ ⊚

true false

2) Dietary supplements are tightly regulated by the Dietary Supplement Health and Education Act (DSHEA). ⊚ ⊚

true false

3) Vegans may require supplements of calcium, zinc, iron, and vitamin B-12 to prevent deficiencies. ⊚ ⊚

true false

4) Individuals with lactose intolerance or milk allergies may need calcium and vitamin D supplements. ⊚ ⊚

true false

5) Supplements of bee pollen, lecithin, and inositol are often recommended by dietitians for weight loss. ⊚ ⊚

true false

6) Supplement manufacturers can make unproven claims with regard to conditions that are not diseases. ⊚ ⊚

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true false

Dietary supplements can fully compensate for nutritionally poor diets. ⊚ ⊚

true false

8) Megadoses of vitamins are useful in preventing nutritional deficiencies and decreasing disease risk. ⊚ ⊚

true false

9) People who remain almost fully covered during the day are at increased risk of vitamin K deficiency. ⊚ ⊚

10)

The fat-soluble vitamins all have hormone-like activity. ⊚ ⊚

11)

true false

Plant foods are generally good sources of the minerals potassium and magnesium. ⊚ ⊚

true false

12) Cancers can metastasize to distant parts of the body via the blood or lymph to form invasive tumors. ⊚ ⊚

13)

true false

The ultratrace mineral boron does not yet have an established UL.

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⊚ ⊚

true false

14) Iodine deficiency and iron deficiency are the most common mineral deficiencies worldwide. ⊚ ⊚

15)

When taken in megadoses, some vitamins may act like drugs. ⊚ ⊚

16)

true false

Some minerals can be synthesized in the human body. ⊚ ⊚

19)

true false

Adding baking soda to vegetables during cooking helps preserve the nutrient content. ⊚ ⊚

18)

true false

Some vitamins can be produced by the body. ⊚ ⊚

17)

true false

Trace minerals are present in the body in smaller quantities than are major minerals. ⊚ ⊚

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true false

20) The quantity of minerals in the soil can influence the amount of minerals in the plant grown in that soil. ⊚ ⊚

true false

21) Toxicities from micronutrients usually occur from consuming large amounts of a specific food. ⊚ ⊚

true false

22) Vitamin A supplements have actually resulted in a decrease in vitamin A-related deaths in developing countries. ⊚ ⊚

23)

Vitamin and mineral supplements are closely regulated by the FDA. ⊚ ⊚

24)

true false

Excessive intake of minerals is likely to cause toxic effects. ⊚ ⊚

26)

true false

Oysters, clams, and other shellfish are generally good sources of the fat-soluble vitamins. ⊚ ⊚

25)

true false

Supplements are regulated in a similar way to the regulation of drugs by the FDA. ⊚ ⊚

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true false 4

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 27) Which of the following can contribute to increased risk of cancer? A) Viruses B) Radiation C) Dietary fat D) All of these factors may increase cancer risk.

28) Which of the following is the leading type of cancer in males and females in North America? A) Brain B) Liver C) Lung D) Colon

29)

Which of the following has been associated with a decreased risk of cancer? A) Low intakes of calcium B) High intakes of nitrates C) Adequate intake of vitamin D D) Low intakes of lycopene

30)

Which of the following is NOT classified as an ultratrace mineral? A) Arsenic B) Boron C) Selenium D) Vanadium

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31)

The most nutrient-dense food source of calcium with high bioavailability is ________. A) leafy green vegetables B) soybeans C) milk and dairy products D) cereal grains E) meats

32)

The mineral found in the body in the most abundance is ________. A) phosphorus B) iron C) calcium D) sodium

33) In the U.S., dietary intakes of the major minerals ______ and _______ often fall short of recommendations. A) sodium; phosphorus B) calcium; phosphorus C) sodium; potassium D) potassium; calcium

34)

Chloride is ________. A) the main anion in extracellular fluid B) an intracellular fluid ion C) a positively charged ion D) converted to chlorine in the intestinal tract

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35) Oxalic acid binds some minerals so they cannot be absorbed. Oxalic acid is found in ________. A) some leafy, green vegetables, such as spinach B) milk and dairy products C) wheat grain fibers D) liver and other organ meats

36) Phytic acid binds some minerals so that they cannot be absorbed. Phytic acid is found in ________. A) leafy, green vegetables, such as spinach B) milk and dairy products C) wheat grain fibers D) liver and other organ meats

37)

Which group of foods provides substantial amounts of vitamin C? A) Citrus fruits and vegetables B) Milk and dairy products C) Beef, poultry, seafood D) Breads and cereals

38) Supplements of the water-soluble vitamins ______ and _______ are most likely to cause toxicity symptoms. A) thiamin; riboflavin B) vitamin B-12; pantothenic acid C) vitamin B-6; vitamin C D) biotin; vitamin B-12

39)

Vitamin B-12 is found in which of the following foods?

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A) Orange juice B) Dark green leafy vegetables C) Seed oils D) Chicken

40)

The B-vitamin that has significant liver stores is ________. A) niacin B) folate C) biotin D) vitamin B-12

41)

People who smoke have an increased need for ________. A) vitamin B-12 B) vitamin C C) folate D) biotin

42)

The best food sources of vitamin B-6 are ________. A) meats, fish, and poultry B) milk and dairy products C) carrots, celery, and squash D) enriched breads and cereals

43) Which of the following B-vitamins is found in the widest variety of foods (i.e., different food groups such as vegetables, grains, meat)?

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A) Vitamin C B) Vitamin B-12 C) Pantothenic acid D) All of these choices are accurate.

44)

Flushing of the face and skin can result from pharmacological doses of ________. A) vitamin B-6 B) thiamin C) folate D) niacin

45)

The vitamin that prevents beriberi is ________. A) vitamin B-12 B) riboflavin C) niacin D) thiamin

46)

The nutrients added to enriched grains typically include ________. A) all of the B vitamins B) vitamin C, pantothenic acid, folic acid, and zinc C) thiamin, riboflavin, niacin, folic acid, and iron D) vitamin B-6, folic acid, vitamin B-12, and iron

47)

Nutritionally, the difference between brown rice and white rice is ________.

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A) the presence of bran and germ layers in the brown rice, which have most of the nutrients B) there is more thiamin and fiber in white rice C) fiber content. White rice has more fiber D) negligible

48) In general, excess amounts of water-soluble vitamins are excreted via the ________. A) kidneys B) intestine C) lungs D) skin

49)

Excess intake of zinc supplements can reduce absorption of ________. A) selenium B) calcium C) copper D) iodine

50)

Which of the following does NOT describe a vitamin? A) They are essential organic substances. B) They are fat- or water-soluble. C) They are needed in relatively small amounts. D) They provide a rich source of energy.

51)

Excess amounts of most water-soluble vitamins are ________.

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A) stored in the adipose tissue B) readily excreted C) stored in the liver D) often toxic

52)

Excess amounts of most fat-soluble vitamins are ________. A) stored in the liver or adipose tissue B) excreted via the kidneys C) stored in the pancreas D) All of these choices are accurate.

53)

The vitamin most likely to cause toxicity if consumed in excessive amounts is _____. A) vitamin K B) riboflavin C) vitamin A D) vitamin E

54)

Beta-carotene ________. A) can be converted to vitamin A in the body B) can be converted to vitamin E in the body C) is classified as a retinoid D) is toxic when consumed in excess amounts

55)

A severe deficiency of vitamin A often results in ________.

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A) scurvy B) night blindness C) insufficient blood clotting D) microcytic anemia

56)

After absorption, the fat-soluble vitamins are distributed to body cells by ________. A) free fatty acids B) lipases C) mucopolysaccharides D) lipoproteins

57) When consumed in recommended amounts, approximately ________ of fat-soluble vitamins are absorbed. A) 1%-5% B) 5%-20% C) 10%-35% D) 40%-90%

58) A leading cause of blindness in the world today (excluding accidents) is a dietary deficiency of ________. A) vitamin A B) vitamin D C) vitamin E D) vitamin K

59) This group of vitamins was originally thought to have only one chemical form; the different vitamins became distinguished by each having a number added to the name.

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A) Fat-soluble vitamins B) Water-soluble vitamins C) B-vitamins D) All vitamins

60)

Water-soluble vitamins are absorbed in the ________. A) mouth B) stomach C) small intestine D) large intestine

61) People with diseases that result in decreased fat absorption may run the risk of deficiencies of ________. A) trace minerals B) major minerals C) water-soluble vitamins D) fat-soluble vitamins

62)

The following nutrients exist in foods in the nutrient forms and in the coenzyme forms. A) All trace minerals B) All B-vitamins C) All fat-soluble vitamins D) All ultra-trace minerals

63)

Dairy foods are generally good sources of which of the following vitamins?

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A) Riboflavin and thiamine B) Vitamin B-12 and riboflavin C) Vitamin D and vitamin E D) Vitamin D and folic acid

64)

Enriched grains are generally good sources of which of the following vitamins? A) Riboflavin, niacin, and vitamin D B) Vitamin A, thiamin, and folic acid C) Riboflavin, niacin, and folic acid D) Vitamin B-6, thiamin, and folic acid

65) People with Crohn's disease may have difficulty absorbing which of the following vitamins in particular? A) Thiamin B) Vitamin E C) Vitamin C D) Niacin

66) To help best maintain the vitamin C and B-vitamin content of foods, which of the following food preparation methods should be used? A) Boiling B) Frying C) Long, slow simmer D) Stir-frying

67)

Nutrient content is best preserved by storing many fruits and vegetables ________.

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A) at room temperature B) at refrigeration temperature C) in the sunlight D) in a brown paper bag

68)

Peeling and cutting apples just before eating, rather than too early, helps ________. A) preserve the alkalinity B) increase the acidity reaction C) minimize oxygen exposure D) increase enzyme action

69) To help assure preservation of vitamin content before eating, canned and frozen vegetables should generally be consumed within ________. A) 3 months B) 6 months C) 12 months D) 24 months

70) Golden rice was developed as a fortified food for many areas of the developing world to help prevent deficiencies of this vitamin. A) Vitamin C B) Vitamin A C) Folic acid D) Calcium

71)

Typically, major minerals are needed in amounts of ________ mg or more daily.

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A) 10 B) 100 C) 200 D) 2000

72) The fruit, vegetable, and protein food groups of MyPlate are particularly good sources of the mineral ______. A) calcium B) phosphorus C) magnesium D) potassium

73)

Preparing and cooking vegetables can result in ________. A) the loss of minerals from the vegetable into the boiling water B) the loss of the mineral iron from the vegetable into the cooking equipment C) the destruction of minerals in the vegetable by sanitizing solutions D) the loss of minerals due to added flavor enhancers

74)

The fat-soluble vitamins include: A) vitamin C, vitamin A, vitamin D, and niacin B) vitamin A, vitamin D, niacin, and folic acid C) vitamin A, vitamin K, folic acid, and vitamin B 12 D) vitamin A, vitamin D, vitamin K, and vitamin E

75) Micronutrients that are important in helping the body produce energy are ________.

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A) thiamin, niacin, biotin, panthothenic acid, and magnesium B) thiamin, niacin, vitamin K, vitamin E, and magnesium C) biotin, riboflavin, vitamin C, vitamin E, and iron D) biotin, riboflavin, vitamin C, vitamin K, and iron

76) Minerals with functions related to muscle contraction, nerve impulses, and blood pressure regulation include ________. A) iron, sodium, and potassium B) calcium, sodium, and iodide C) sodium, zinc, and iron D) sodium, potassium, and calcium

77)

Vitamin A, vitamin D, calcium, and fluoride are micronutrients important in ________. A) blood heath B) antioxidant defenses C) fluid balance D) bone health

78)

Fortified dairy products are generally good sources of ________. A) vitamin A, vitamin D, and calcium B) vitamin C, riboflavin, and calcium C) vitamin D, calcium, and iron D) vitamin C, vitamin D, and riboflavin

79) Mineral intake must be especially closely monitored when there is poor functioning of which body organ?

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A) Kidneys B) Pancreas C) Gall bladder D) Small intestine

80)

Lipoproteins help transport which micronutrients? A) Water-soluble vitamins B) Fat-soluble vitamins C) Trace minerals D) Major minerals

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 81) What suggestions would you provide to a client to decrease cancer risk?

82)

List 3 differences between fat-soluble and water-soluble vitamins.

83)

List 2 characteristics of trace minerals.

84)

Why are paper and opaque plastic containers used for milk, milk products, and cereals?

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85)

How does the USP label on a nutrient supplement help the consumer?

86)

List 3 symptoms noted in persons with vitamin A deficiency.

87)

What supplements might you recommend for a 23-year-old, female vegan?

88)

Why is it difficult for researchers to study trace minerals?

89)

Explain how the body adjusts its absorption of minerals based on the body's needs.

90) Why is there no specific advantage from taking vitamin B supplements in the coenzyme forms?

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91) Why are large doses of fat-soluble vitamins more likely to cause toxic effects than large intakes of water-soluble vitamins?

92) How does the absorption of water-soluble vitamins differ from the absorption of fatsoluble vitamins?

93)

Provide an example of a food that has been enriched with micronutrients.

94)

Identify factors that increase and decrease the absorption of minerals.

95)

Identify different reasons that people may choose to take supplements.

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96)

Identify potential benefits of adding minerals to food products.

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Answer Key Test name: Chap 12_3e_Test Bank 1) TRUE 2) FALSE The FDA does not closely monitor dietary supplements, except folic acid, unless there is evidence that a supplement is dangerous or is marketed with an illegal claim. 3) TRUE 4) TRUE 5) FALSE There are no proven supplements that are universally recommended for weight loss by dietitians. 6) TRUE 7) FALSE Although dietary supplements can replace specific nutrients lacking in a diet, they cannot fully correct a nutritionally poor diet. 8) FALSE Megadosing of vitamins has not been proven to be universally useful in preventing or decreasing disease risk. 9) FALSE Vitamin D is the vitamin that is created in the skin with sun exposure. 10) FALSE Only vitamin D has hormone-like activity in the body. 11) TRUE 12) TRUE Version 1

13) FALSE The UL of boron is 20 mg. 14) TRUE 15) TRUE 16) TRUE 17) FALSE Do not add baking soda to vegetables to enhance the green color. Alkalinity destroys vitamin D, thiamin, and other vitamins. 18) FALSE No minerals can be synthesized by the body, only some vitamins. 19) TRUE 20) TRUE 21) FALSE Toxicities generally occur from supplemental doses of vitamins and/or minerals. 22) TRUE 23) FALSE The FDA does not closely monitor dietary supplements, except folic acid, unless there is evidence that a supplement is dangerous or is marketed with an illegal claim. 24) FALSE Oysters, clams, and other shellfish are bioavailable sources of many trace minerals. 25) TRUE 26) FALSE

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Dietary supplements are regulated differently than drugs and food additives, which the FDA tests extensively and regulates for safety, effectiveness, dose size, concerns about interactions with other substances, and health-related claims. In contrast, the FDA does not closely monitor dietary supplements, except folic acid, unless there is evidence that a supplement is dangerous or is marketed with an illegal claim. 27) D 28) C 29) C 30) C 31) C 32) C 33) D 34) A 35) A 36) C 37) A 38) C 39) D 40) D 41) B 42) A 43) C 44) D 45) D 46) C 47) A 48) A 49) C Version 1

50) D 51) B 52) A 53) C 54) A 55) B 56) D 57) D 58) A 59) C 60) C 61) D 62) B 63) B 64) C 65) B 66) D 67) B 68) C 69) C 70) B 71) B 72) D 73) A 74) D 75) A 76) D 77) D 78) A 79) A Version 1

80) B 81) Answers will vary. 1. Choose a diet rich in a variety of plant-based foods, eating plenty of vegetables, fruits, and whole grains. 2. Do not rely on supplements to decrease cancer risk. 3. Maintain a healthy weight and be physically active. 4. Drink alcohol only in moderation, if at all. 5. Select foods low in salt. 6. Avoid sugary drinks and processed meat. 7. Limit the intake of red meats. 8. Exclusively breastfeed for 6 months. And always remember . . . do not use tobacco in any form.

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82) Answers will vary. Fat-soluble vitamins are absorbed along with dietary fat. Thus, adequate absorption of fat-soluble vitamins depends on efficient use of bile and pancreatic lipase in the small intestine to digest dietary fat and adequate intestinal absorption (Fig. 12-1). Under optimal conditions, about 40% to 90% of the fat-soluble vitamins are absorbed when they’re consumed in recommended amounts. In contrast, absorption of Bvitamins and vitamin C typically ranges from 90% to 100% and occurs in the small intestine independent of dietary fat. In contrast to the fat-soluble vitamins, water-soluble vitamins are delivered directly to the bloodstream and distributed throughout the body. With the exception of vitamin K, fat-soluble vitamins are not readily excreted from the body. Instead, they are often stored in the liver and/or adipose tissue. In contrast, most water-soluble vitamins are excreted from the body quite rapidly, resulting in limited stores. Although the toxic effects of an excessive intake of any vitamin is theoretically possible, toxicity from the fat-soluble vitamins A and D is the most likely to occur. 83) Trace minerals are essential for normal development, function, and overall health. For example, we need iron to build red blood cells; zinc, copper, selenium, and manganese help protect us from the damaging effects of free radicals; and iodine is essential for maintaining the body’s normal metabolism. Other trace minerals include fluoride, which assists with bone mineralization, and chromium, which is linked to insulin action. Trace minerals the body requires in extremely small amounts, such as molybdenum, are called ultratrace minerals. For example, although needed in “ultratrace” amounts, molybdenum is essential for the activity of several enzymes. Version 1

84) Answers will vary. Careful storage and cooking of food can help maintain its vitamin content. Compared with fat-soluble vitamins, water-soluble vitamins are more easily destroyed. A food’s vitamin content can be decreased by exposure to heat, light, air, and alkaline substances. 85) The USP-approved brands are tested to ensure that contaminants are not present in harmful amounts, that the ingredients listed on the label are actually in the supplements and will dissolve in the body, and that the supplements were made under safe, sanitary conditions. 86) Answers will vary. Vitamin A deficiency can lead to serious consequences, such as night blindness, total blindness, impaired growth, and an increased incidence of infections. 87) Vegans may require calcium, iron, zinc, vitamin D, and vitamin B12 supplements to prevent deficiencies. 88) Because there are such small quantities in the body, measuring the amount in the body and changes in trace mineral concentrations is often difficult. Therefore, it is often hard to accurately assess trace mineral status in the body and set recommended intake levels. Evaluating the amount of trace minerals in foods also can be difficult. Many agricultural factors and food characteristics affect the amount of trace minerals in food, especially in plant-based foods. Thus, nutrient databases may not provide an accurate indication of the total amount and/or bioavailability of a trace mineral in a specific food.

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89) Foods offer a plentiful supply of many minerals, but the body varies in its capacity to absorb and use them. The ability to absorb minerals from the diet depends on many factors. One significant factor is the physiological need for a mineral at the time of consumption. In general, when the need for a mineral is high, such as the need for iron in growing children, the absorption of that mineral increases. In contrast, absorption tends to decline when the body has adequate stores of the mineral. 90) In foods, B-vitamins are present as vitamins or as coenzymes (see Chapters 9 and 13), both of which are sometimes bound to protein. Digestion frees B-vitamins from coenzymes or protein. Unbound (free) B-vitamins are the main form absorbed in the small intestine . Once inside cells, the coenzyme forms of the B-vitamins are resynthesized. Vitamin supplements sold in the coenzyme form have no specific benefits to consumers because vitamins must be released from their coenzyme before they can be absorbed. 91) Fat-soluble vitamins are excreted less readily from the body than water-soluble vitamins and thus pose a potential threat for toxicity, especially of vitamins A and D. Toxicities of these fat-soluble vitamins generally occur with high doses of supplements, rather than from foods. 92) Vitamins A, D, E, and K are fat soluble, whereas the B-vitamins and vitamin C are water soluble. Fat-soluble vitamins are absorbed along with dietary fat. They travel by way of the lymphatic system into the general circulation, carried by chylomicrons. In contrast, absorption of water-soluble vitamins occurs in the small intestine independent of dietary fat. 93) In the U.S. nearly all bread and cereal products made from milled grains are enriched with 4 B-vitamins—thiamin, riboflavin, niacin, and folic acid—and with the mineral iron. Version 1

94) Table 12-7 Factors That Affect Mineral Bioavailability Factors That Increase Bioavailability Normal gastric acidity Vitamin C intake Good vitamin D status Polyphenols in tea, coffee, and red wine High-dose supplements of single minerals

Factors That Decrease Bioavailability

Reduced gastric acidity Phytic acid in whole grains and legumes Oxalic acid in leafy vegetables

95) Because most Americans fail to meet dietary guidelines for the consumption of fruits, vegetables, and whole grains, they may have inadequate intakes of several micronutrients. Although current evidence is insufficient to support the recommendation of multivitamin and mineral supplementation for the general population, many people take them to enhance or maintain overall well-being and/or for health of specific sites, such as bones, heart, or eyes. Among adults, more women than men use multivitamin and mineral supplements. 96) More and more foods are being fortified with minerals. Iron has been added to milled grains since the enrichment program began in the 1940s. In the U.S., table salt fortified with iodine has been available for nearly 90 years. Many products, such as orange juice, are enriched with calcium, and most breakfast cereals are fortified with a wide array of minerals. These additions can benefit individuals by increasing their daily intake of minerals they would otherwise not consume, and decreasing risks of deficiency.

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CHAPTER 13 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Large doses of riboflavin are nontoxic. ⊚ ⊚

true false

2) Supplemental vitamin B-6, vitamin B-12, and folate can reduce blood levels of homocysteine, but have not been proven to reduce the risk of cardiovascular disease. ⊚ ⊚

true false

3) A good way to reduce risk of cardiovascular disease is to take supplements of vitamin B6, vitamin B-12, folate, and vitamin C. ⊚ ⊚

true false

In the United States, salt can be purchased either with or without added iodide. ⊚ ⊚

true false

5) Manganese plays a role in antioxidant defense as a part of the superoxide dismutase enzyme system. ⊚ ⊚

true false

6) Whole grains, nuts, legumes, and tea are the best dietary sources of manganese. ⊚ ⊚

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true false

7) Approximately 90% of dietary manganese is absorbed and then transported by transferrin to the liver. ⊚ ⊚

true false

8) Molybdenum functions as a cofactor for several enzymes in human metabolism. ⊚ ⊚

true false

Manganese deficiency and toxicity rarely have been reported in humans. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 10) Most B-vitamins function as __________. A) fat-soluble vitamins B) coenzymes C) antibodies D) sources of energy

11)

In which of the following metabolic pathways are coenzymes required? A) Glycolysis B) Citric acid cycle C) Beta-oxidation D) Electron transport chain E) All of these choices are accurate.

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12)

Thiamin pyrophosphate (TPP), the coenzyme form of thiamin, is __________. A) essential for the various oxidation-reduction reactions of the electron transport

system B) essential for the addition of two carbon fragments to fatty acids C) essential for the oxidative decarboxylation of pyruvate D) not really needed because our contemporary diets are low in carbohydrate

13)

Thiamin should be given to an alcoholic patient who has ________. A) pellagra B) Wernicke-Korsakoff syndrome C) pernicious anemia D) scurvy

14)

A nutrient-dense source of thiamin is ________. A) citrus fruits B) milk and milk products C) pork and pork products D) leafy green vegetables

15)

The best sources of thiamin in the average diet are ________. A) pork products, whole or enriched grains and cereals, and legumes B) root vegetables and cheddar-type cheese C) whole grains and fresh fruit D) ham and vegetables of the cabbage family

16) A deficiency of thiamin that affects the cardiovascular, muscular, nervous, and gastrointestinal systems is called ________. Version 1

A) megaloblastic anemia B) pellagra C) scurvy D) beriberi

17)

The coenzyme form of riboflavin is ________. A) TPP B) ATP C) FAD D) NAD

18)

Riboflavin coenzymes function in a variety of metabolic pathways, such as __________. A) beta-oxidation of fatty acids B) the citric acid cycle C) the electron transport chain D) All of these choices are accurate.

19)

Which of the following foods represents the most nutrient-dense source of riboflavin? A) Low-fat milk B) Applesauce C) Whole wheat bread D) Green leafy vegetables

20)

The B-vitamin most easily destroyed by exposure to light is ________.

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A) biotin B) niacin C) riboflavin D) thiamin

21) A painful, red, inflamed tongue, which is sometimes symptomatic of deficiency, is called ________. A) glossitis B) cheilosis C) stomatitis D) anemia

22)

In the average U.S. diet, 1/4 of the riboflavin comes from the ________ group. A) fruit B) vegetable C) milk D) grains E) meat & beans

23) To protect riboflavin from destruction by sunlight, milk and milk products are often packaged in ________. A) clear glass bottles B) paper and opaque plastic cartons C) clear plastic bottles and cartons D) any kind of container

24) Adolescent girls with low dairy product intake often present with fatigue and anemia due to a deficiency of ________. Version 1

A) vitamin C B) calcium C) lactose D) riboflavin

25)

The riboflavin coenzymes have _______ functions in cellular metabolism. A) antioxidant B) chelating C) oxidation and reduction D) single carbon group transfer

26)

An excess intake of riboflavin either from diet or supplements is mainly ________. A) excreted in the urine B) excreted in bile and feces C) stored in all body cells D) stored in the liver

27) Niacin can be obtained from foods as the vitamin itself (preformed niacin) or be synthesized ________. A) from the B vitamin riboflavin B) from the essential amino acid tryptophan C) by bacteria in the large intestine D) All of the above are correct.

28)

A characteristic symptom of niacin deficiency is ________.

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A) cracks at the corners of the mouth B) a purple-red tongue C) severe edema D) inflammation of the skin after exposure to the sun

29)

The coenzyme forms of niacin include ________. A) nicotinic acid and nicotinamide B) FAD and FMN C) NAD and NADP D) ATP and FAD

30)

Niacin is necessary in the diet to prevent the disease called ________. A) pernicious anemia B) beriberi C) scurvy D) pellagra

31) The fact that the amino acid tryptophan can be converted to niacin by the body explains why ________. A) diets high in protein could prevent or cure pellagra B) corn-based diets prevent pellagra C) gelatin cures pellagra D) alcoholics sometimes develop Wernicke-Korsakoff syndrome

32)

Bright yellow urine usually is indicative that someone is supplementing with ________.

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A) niacin B) vitamin A C) vitamin K D) riboflavin

33) The nutrient sometimes prescribed by physicians to increase HDL-cholesterol and lower triglyceride levels is ________. A) thiamin B) folic acid C) niacin D) None of these choices are accurate.

34)

Important contributors to niacin intake in the American diet are ________. A) poultry, meat, and fish B) citrus fruits, kiwi, and bananas C) milk, cheese, and yogurt D) spinach, kale, and broccoli

35) Thiamin, niacin, and riboflavin work together in important biochemical pathways that ________. A) synthesize collagen B) control the visual process C) promote absorption of calcium D) release energy from carbohydrate, fat, and protein

36) A diet that provides 75 g protein per day can contribute __________ mg niacin from tryptophan.

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A) 25 B) 7.5 C) 12.5 D) <5

37)

The niacin coenzyme is reduced (NAD

→ NADH + H

) during ________.

A) glycolysis B) the pyruvate decarboxylation reaction C) the citric acid cycle D) All of these choices are accurate.

38)

Which of the foods listed below has the lowest niacin bioavailability? A) Wheat B) Corn C) Almonds D) Spinach

39)

An essential component of coenzyme A is ________. A) biotin B) pantothenic acid C) thiamin D) vitamin C

40)

Pantothenic acid is a part of _________, an important biochemical compound.

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A) pyruvate B) citric acid C) acetyl-CoA D) homocysteine

41)

Biotin is needed for ________. A) gluconeogenesis B) glutathione reductase C) nicotinamide adenine dinucleotide D) None of these answers are correct.

42)

Biochemical reactions that add CO

2 to compounds often require ________.

A) folic acid B) thiamin C) biotin D) vitamin B-12

43)

The protein in raw egg whites that can bind biotin is called ________. A) avidin B) salmonella C) casein D) keratin

44)

A high intake of raw egg whites (>12 per day) can inhibit absorption of ________.

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A) folate B) vitamin B-12 C) pantothenic acid D) biotin

45)

Those most likely to experience a biotin deficiency are ________. A) adolescents with low energy and, thus, low biotin intake B) alcoholics with impaired biotin absorption C) infants lacking an enzyme required for biotin absorption D) pregnant women who are vegans

46)

Pyridoxal, pyridoxine, and pyridoxamine are three forms of ________. A) vitamin B-12 B) vitamin P C) folic acid D) vitamin B-6

47)

Pyridoxal phosphate ________. A) participates in reactions that synthesize non-essential amino acids B) participates in reactions that synthesize essential amino acids C) prevents premenstrual syndrome D) is a natural oral contraceptive

48) Neurotransmitter synthesis requires the vitamin B-6 coenzyme. Which of the following is classified as a neurotransmitter?

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A) Norepinephrine B) Gamma-aminobutyric acid (GABA) C) Serotonin D) All of these choices are accurate.

49)

Symptoms of vitamin B-6 deficiency include ________. A) depression, confusion, and convulsions B) microcytic anemia C) dermatitis D) All of these choices are accurate.

50)

Irreversible nerve damage may be caused by excessive intake of _______ supplements. A) vitamin B-12 B) vitamin B-6 C) tryptophan D) vitamin C

51) In addition to its role in amino acid metabolism, vitamin B-6 is also required for ________. A) fatty acid metabolism B) the release of glucose from glycogen C) the electron transport chain D) glycolysis

52) Research shows that supplemental vitamin B-6 may help women who are experiencing ________.

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A) nausea associated with pregnancy B) pellagra C) premenstrual syndrome D) depression

53) To calculate the DFE for the diet, multiply total synthetic folic acid intake by ____; add that value to the total food folate. A) 1.7 B) 2.5 C) 4.0 D) None of these choices are accurate.

54) In a dietary deficiency of folate, there are decreasing numbers of mature red blood cells to carry the oxygen from the lungs to the tissues. This condition is known as ________. A) achlorhydria B) megaloblastic anemia C) ariboflavinosis D) hemorrhagic disease

55)

A biochemical function of THFA (tetrahydrofolate) is ________. A) transfer of NH 2 groups from amino acids to CO 2 to form urea B) transfer of hydrogens and electrons through the various energy-yielding pathways C) removal of CO 2 from various intermediates in the citric acid cycle D) accepting or donating single-carbon molecules in various metabolic pathways

56)

A major role of folate in cellular metabolism is the ________.

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A) synthesis of steroid hormones B) conversion of polyunsaturated fatty acids to saturated fatty acids C) formation of glucose from galactose and fructose D) synthesis of purine and pyrimidine bases in RNA and DNA

57)

The cells most sensitive to a deficiency of dietary folate are cells that ________. A) have a short life span and rapid turnover rate B) have to last a lifetime C) function in the immune system D) are classified as phagocytes

58) ________ are very large immature red blood cells, which are formed as a result of folate deficiency. A) Erythrocytes B) Megaloblasts C) Lymphocytes D) Platelets

59) A defect in the formation of the neural tube during early fetal development can occur from a lack of ________. A) biotin B) folate C) vitamin B-6 D) choline

60)

About 50% to 90% of folate in foods can be destroyed by ________.

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A) food processing and preparation B) ultraviolet light C) oxidation D) All of these choices are accurate.

61)

Good sources of folate include ________. A) enriched cereals and grains B) leafy green vegetables C) oranges D) dried beans E) All of these choices are accurate.

62)

The form of folate that is best absorbed is the ________. A) monoglutamate form found in supplements and fortified foods B) polyglutamate form found naturally in foods C) reduced form found mainly in animal foods D) oxidized form found mainly in plant foods E) None of these answers are correct, as all forms are absorbed equally well.

63) It is very difficult to consume excess folic acid from nonprescription vitamin supplements because ________. A) folic acid is never included in over-the-counter nutrient supplements B) the FDA limits the amount of folic acid in supplements to 400 micrograms per capsule C) folic acid in pill form imparts an unpleasant taste so that no one would ever attempt to take extra amounts D) absorption of the vitamin is age-related. As we get older we automatically adjust the amount we absorb to more than the maximum level

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64)

Which group of individuals has the highest requirement for folate? A) Infants B) Adolescent males C) Pregnant women D) The elderly

65) Which group of individuals is advised to consume 400 micrograms of folic acid daily from supplements and/or fortified foods? A) Infants B) The elderly C) Athletes D) Women capable of becoming pregnant

66)

Vitamin B-12 is supplied mostly in ________. A) fruits and vegetables B) cereal grains C) foods of animal origin D) None of these answers are correct.

67)

Intrinsic factor is produced by the ________. A) beta-cells of the pancreas B) salivary glands C) parietal cells of the stomach D) enterocytes of the small intestine

68)

Vitamin B-12 is absorbed in the ________.

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A) stomach B) duodenum C) jejunum D) ileum

69)

For vitamin B-12 to be absorbed, it must be attached to ________. A) an incomplete protein B) intrinsic factor C) bile D) the protein portion of its final coenzyme form

70)

Individuals most likely to experience poor vitamin B-12 status are ________. A) elderly adults, due to atrophic gastritis B) infants, due to low vitamin B-12 content in breast milk C) athletes, due to high vitamin B-12 requirements D) pregnant women, due to high vitamin B-12 requirements

71)

Pernicious anemia is treated most often successfully by ________. A) a diet high in milk and dairy products B) regular intramuscular injection of vitamin B-12 C) oral supplementation of iron D) eating liver three times a week

72)

A major role of vitamin B-12 in cellular metabolism is ________.

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A) the transfer of a methyl group to the amino acid homocysteine, forming the amino acid methionine B) the transfer of a methyl group to the pyrimidine uracil, forming the pyrimidine thymine C) in transamination reactions, allowing the synthesis of nonessential amino acids D) as an electron acceptor, allowing function of the electron transport chain

73) Megaloblastic anemia develops as a result of deficiencies of __________ and __________. A) thiamin; riboflavin B) vitamin B-6; folate C) folate; vitamin B-12 D) vitamin K; folate E) All of these choices are accurate.

74)

Which of the following factors can interfere with the absorption of vitamin B-12? A) Surgical removal of the stomach B) Defective R-protein synthesis C) Infections of the ileum or surgical removal of the ileum D) All of these choices are accurate.

75)

A strict vegan diet may lack ________. A) vitamin B-12 B) vitamin C C) vitamin A D) niacin

76)

Choline is required for the synthesis of ________.

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A) glycogen and many proteins B) phospholipids and lipoproteins C) homocysteine and methionine D) collagen and connective tissue

77)

Rich dietary sources of choline are ________. A) enriched cereals and grains B) fats and oils C) meats, eggs, and dairy products D) fruits and vegetables

78)

The compound carnitine is required for ________. A) fatty acid synthesis B) glycogen breakdown C) active transport of compounds into cells D) transport of fatty acids into mitochondria

79)

Most of our dietary sulfur is supplied by ________. A) protein-rich foods B) carbohydrates C) vitamins D) lipids

80)

Which of the following major minerals does NOT have a DRI?

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A) Sulfur B) Calcium C) Phosphorus D) Magnesium

81) Some athletes commonly believe that the trace mineral ________ helps improve muscle mass and strength despite lack of research evidence. A) chromium B) zinc C) manganese D) selenium

82)

A deficiency of dietary iodide is characterized by ________. A) osteoporosis B) goiter C) dental caries D) decreased glucose tolerance

83)

Cretinism may form as a consequence of a severe maternal deficiency of ________. A) chromium B) selenium C) copper D) iodine

84) In a situation where there is an insufficient intake of dietary iodide, the thyroidstimulating hormone promotes the enlargement of the thyroid gland. This condition is called ________.

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A) Graves' disease B) goiter C) hyperparathyroidism D) Wilson's disease

85)

Iodide in the blood is trapped by the ________. A) pancreas and incorporated into insulin B) adrenal glands and incorporated into aldosterone C) pituitary gland and incorporated into calcitonin D) thyroid gland and incorporated into thyroxine

86)

The most dependable and abundant source of iodide in the American diet is ________. A) saltwater fish B) dark leafy greens C) enriched cereal grains D) fortified salt

87)

Goitrogenic foods that can inhibit iodide metabolism include ________. A) cabbage, broccoli, and cauliflower B) yogurt, buttermilk, and cheese C) oranges and grapefruit D) beef, poultry, and fish

88) In humans, impaired glucose tolerance, nerve damage, and weight loss have been observed in patients with a deficiency of ________.

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A) selenium B) manganese C) molybdenum D) chromium

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 89) Describe the symptoms of thiamin deficiency.

90) Name the 4 Ds of pellagra. What causes pellegra? How is the consumption of corn related to pellagra?

91)

Describe why good folate status is especially important for young women.

92) Discuss the roles of thiamin, riboflavin, niacin, and pantothenic acid in energy metabolism.

93)

List 2 food sources for manganese.

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94)

Describe the symptoms of iodine deficiency.

95)

Explain why a deficiency of selenium can impair iodine metabolism.

96)

What population areas are at increased risk of iodine deficiency?

97)

What is the importance of the Micronutrient Initiative?

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Answer Key Test name: Chap 13_3e_Test Bank 1) TRUE 2) TRUE 3) FALSE These vitamins have not been found to reduce the risk of heart disease. Some individuals take supplemental niacin for these purposes. 4) TRUE 5) TRUE 6) TRUE 7) FALSE Following absorption, most manganese is bound to alpha-2macroglobulin for transport to the liver and then transported via transferrin, alpha-2-macroglobulin, or albumin to other tissues, such as the pancreas, kidneys, and bone. Approximately 6% to 16% of the manganese in food is absorbed. Absorption is affected by the amount of manganese in the diet and by iron status. 8) TRUE 9) TRUE 10) B 11) E 12) C 13) B 14) C 15) A 16) D

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17) C 18) D 19) A 20) C 21) A 22) C 23) B 24) D 25) C 26) A 27) B 28) D 29) C 30) D 31) A 32) D 33) C 34) A 35) D 36) C 75 g protein x 10 mg tryptophan/g protein = 750 mg tryptophan 750 mg tryptophan / 60 mg tryptophan/mg niacin = 12.5 mg niacin 37) D 38) B The bioavailability of niacin is low in some grains, especially corn. This is because niacin is tightly bound to protein, so less than 30% can be absorbed. 39) B 40) C 41) A Version 1

42) C 43) A 44) D 45) C 46) D 47) A 48) D 49) D 50) B 51) B 52) A 53) A 54) B 55) D 56) D 57) A 58) B 59) B 60) D 61) E 62) A 63) B 64) C 65) D 66) C 67) C 68) D 69) B 70) A 71) B Version 1

72) A 73) C 74) D 75) A 76) B 77) C 78) D 79) A 80) A 81) A 82) B 83) D 84) B 85) D 86) D 87) A 88) D

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89) Answers will vary. Beriberi is a deficiency of thiamin. Those with beriberi are very weak because a deficiency of thiamin impairs the nervous, muscular, gastrointestinal, and cardiovascular systems and hinders energy metabolism. The symptoms of beriberi include peripheral neuropathy and weakness; muscle wasting, pain, and ten-derness; enlargement of the heart; difficulty breathing; edema; anorexia; weight loss; poor memory; and confusion. The brain and nerves are especially affected because of their reli-ance on glucose for energy. Beriberi often is described as dry, wet, or infantile beriberi. In dry beriberi, the main symptoms are related to the nervous and muscular systems. In wet beriberi, in addition to the neurological symptoms, the cardiovascular system is affected. The heart is enlarged, breathing may be difficult, and congestive heart failure may occur. Infants develop beriberi when breast milk contains insufficient thiamin. Infantile beriberi causes heart problems, convulsions, and death if not treated. Like most water-soluble vitamins, only small amounts of thiamin are stored in the body; thus, some signs of beriberi can develop after only 14 days on a thiamin-free diet.

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90) Answers will vary. Pellagra is iden-tified by the 3 Ds: dermatitis, diarrhea, and dementia. Death, a 4th D, can result if the disease is not treated. Pellagra has long been associated with corn-based diets. Although there is no evi-dence of pellagra in Central and South America, where corn (maize) has been the staple food in the diet for thousands of years, pellagra outbreaks followed the introduction of corn into Europe and Africa. As mentioned previously, the main reason for this was that in Latin America the traditional culinary practice was to treat corn with alkali (from lime water or wood ashes), which liberates niacin from protein. Un-fortunately, this practice was not adopted in Europe, Africa, or the U.S. When maize (often prepared as a porridge or grits) became a staple food for poor people with limited diets, the result was a very low niacin intake and pellagra. Nutrition scientists have since discovered another reason that corn-based diets can lead to pellagra-corn con-tains little of the amino acid tryptophan. 91) Answers will vary. Adequate folate is necessary for DNA synthesis. For women of childbearing age, pregnancy is a concern. Pregnancy greatly increases the need for this vitamin (the RDA is 600 μg DFE/day) because of the increased rate of cell division, and thus of DNA synthesis, in the mother’s body and that of her developing offspring. Prenatal care often includes prenatal multivitamin and mineral supplements fortified with folate to compensate for the extra needs associated with pregnancy. Folate status is important for women who can become pregnant because supplemental folic acid protects again the development of neural tube birth defects that occur early in pregnancy. Because of the fortification of the U.S. food supply, average daily folate intake exceeds the RDA.

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92) Answers will vary. Thiamin acts as a coenzyme in carbohydrate metabolism and energy release. The riboflavin coenzymes are involved in many reactions in various metabolic path-ways. They are critical for energy metabolism and are involved in the formation of other compounds, including other Bvitamins and antioxidants. Niacin acts as a coenzyme in numerous oxidation-reduction reactions in energy metabolism, synthesis and breakdown of fatty acids. Pan-tothenic acid is part of acyl carrier protein (ACP), a compound used in many biosynthetic reactions, and coenzyme A (CoA), which is used throughout the body in energy metabolism. 93) Answers will vary. Whole-grain cereals, nuts, legumes, leafy greens, coffee, and tea are the best sources of manganese.

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94) Answers will vary. Iodine deficiency disorders, the collective name for endemic goiter and endemic cretinism, oc-cur when dietary iodine intake is insufficient. When iodine availability decreases and plasma levels of T4 hormone drop, the pituitary gland secretes thyroid-stimulating hormone (TSH). In response to increased TSH levels, the thyroid gland enlarges in an attempt to increase its effi-ciency at trapping iodine. The characteristic enlargement of the thyroid gland that occurs is called a goiter. This early adaptive response allows the thyroid gland to temporarily maintain thyroid hormone synthesis. Although a goiter is a painless condition, it can cause pressure on the esopha-gus and trachea, impairing their function. If the underlying iodine deficiency is not corrected, decreased T4 synthesis, slowed metabolism, and more serious complications can develop. Iodine deficiency is of particular concern during pregnancy because of the adverse effects it can have on the developing offspring. These include congenital abnormalities, low birth weight, neurological disorders, impaired mental function, poor physical develop-ment, and death. The resulting restriction of brain development and growth, called cretinism (Fig. 13-21), is characterized by severe mental retardation, loss of hearing and speech abili-ties, short stature, and muscle spasticity. 95) Answers will vary. Iodine is an essential component of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). Most of the circulating thyroid hor-mone in the body is in the form of T4. Within body cells, T4 loses an iodine molecule and is converted to T3, the active form of the hormone. The enzymes involved in this conversion (called deiodinase enzymes) require the trace mineral selenium. Thus, a selenium deficiency can limit the activity of deiodinase enzymes, resulting in decreased T3 levels.

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96) Answers will vary. Descriptions of goiter have been documented for many centuries in China and other parts of the world. Prior to World War I, goiter was very common in the Great Lakes re-gion of the U.S., where the soil and lake waters are very low in iodine. Cretinism also was common in parts of the U.S. Today, approximately one-third of the world’s population remains at risk of iodine deficiency. Almost every country in the world still has iodine-deficient areas (Fig. 13-23). The highest incidence of iodine deficiency disorders occurs in Asia, Africa, the Middle East, and Europe. The discovery in the early 1920s, by scientists in the U.S. and Switzerland, that iodine can prevent the development of goiter resulted in the fortification of table salt in the U.S. and many other countries.

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97) Answers will vary. In an effort to decrease the number of deaths and morbidities associated with malnutrition, the World Health Organization (WHO) launched the e-Library of Evidence for Nutrition Actions (eLENA). The online eLENA project provides case studies and easily accessed, evidence-informed information to help countries launch successful nutrition interventions. One project partner is the Cochrane Collaboration, an international network of people who prepare systematic reviews of health-care research. The Micronutrient Initiative, an international organization with a focus on solutions to end vitamin and mineral malnutrition, is a supporter of eLENA. These are some of the interventions presented on eLENA: Promotion of breastfeeding Fortification of staple foods, such as wheat and maize flours, with iron, zinc, vitamin A, folic acid, and/ or vitamin B-12 Iron and folic acid supplementation for pregnant women Iodine fortification of salt Vitamin A supplementation for infants and children 6 to 59 months of age in settings where vitamin A deficiency is a public health problem Reduction of the impact of the marketing of foods and beverages that are high in fat, sugar, and/or salt.

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CHAPTER 14 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Thirst is a reliable signal to prevent dehydration in older adults. ⊚ ⊚

true false

2) A person cannot drink too much water; the kidneys and sweat glands make water excretion quick and efficient, protecting the body from over hydration. ⊚ ⊚

true false

Too much dietary sodium, is a major nutritional problem today in the U.S.. ⊚ ⊚

true false

4) An individual who consumes one cup of coffee in the morning should drink an additional 2 cups of fluid to compensate for caffeine-induced fluid loss. ⊚ ⊚

Beverages contribute only marginally to calorie intake in the U.S. ⊚ ⊚

true false

The main cause of high blood potassium and potassium toxicity is kidney failure. ⊚ ⊚

true false

Dietary heme iron is obtained mainly from plant-based foods.

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⊚ ⊚

true false

8) Ferritin is a key iron-binding protein in the intestinal mucosa that prevents it from entering the bloodstream. ⊚ ⊚

true false

9) In the U.S., accidental iron overdose is the leading cause of poisoning in young children less than 6 years of age. ⊚ ⊚

true false

10) High intakes of polyphenols, meat protein factor, and manganese aid in the absorption of non-heme iron. ⊚ ⊚

11)

Copper plays a role in connective tissue formation as a component of lysyl oxidase. ⊚ ⊚

12)

true false

Copper absorption is the primary means of regulating copper balance. ⊚ ⊚

13)

true false

All community water systems in the United States are currently fluoridated. ⊚ ⊚

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true false

14)

Zinc supplementation is a scientifically proven means of preventing the common cold. ⊚ ⊚

true false

15) Marginal deficiencies of zinc and copper may be of concern in some population groups in the U.S. even if they do not result in physical symptoms. ⊚ ⊚

true false

16) Zinc is transported in the blood to tissues by the proteins albumin and alpha-2 macroglobulin. ⊚ ⊚

true false

17) An Upper Level has been set for vitamin K to protect against the significant risk of toxicity. ⊚ ⊚

true false

18) One means of detecting a vitamin K deficiency is to measure how quickly prothrombin in the blood can form a clot. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 19) Which of the following about water is NOT true?

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A) Each water molecule forms a maximum of 2 hydrogen bonds. B) Water is incompressible so it functions well as a lubricant. C) Water is formed in the body when protein, carbohydrate, and fat are oxidized. D) Water in the body helps resist body temperature change.

20)

The human body has more of this substance (by weight) than any other substance. A) Protein B) Glycogen C) Fat D) Water

21) In an adult of normal body composition weighing 165 lb, approximately ________ lbs are water. A) 91 B) 55 C) 37 D) 116

22)

When a semipermeable membrane separates two bodies of fluid, ________. A) water can pass through the membrane B) dissolved particles can pass through the membrane C) water cannot pass through the membrane D) None of these choices are accurate.

23)

Which of the following fluids is classified as extracellular fluid?

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A) Tears B) Gastrointestinal fluid C) Blood plasma D) Lymph E) All of these choices are accurate.

24)

Which compartment contains the greatest amount of body fluid? A) Intracellular compartment B) Extracellular compartment C) Both compartments contain the same amount of water.

25)

About 73% of lean muscle tissue is ________. A) protein B) water C) calcium D) sodium

26) The force that develops when two solutions, each with a different concentration of solutes, are separated by a semipermeable membrane is ________. A) systolic pressure B) diastolic pressure C) osmotic pressure D) atmospheric pressure

27) The major cation in the intracellular fluid is ________, whereas the major anion in the extracellular fluid is ________.

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A) sodium; chloride B) potassium; chloride C) sodium; phosphate D) potassium; phosphate

28)

Minerals most involved in fluid balance are ________. A) calcium and magnesium B) copper and iron C) calcium and phosphorus D) sodium and potassium

29)

The sodium-potassium pump uses energy to move ________. A) potassium ions out of the cell B) sodium ions out of the cell C) water out of the cell D) water into the cell

30)

The body's temperature regulation mechanism depends on ________.

A) drinking enough water to remove heat by way of the urine B) water within the body absorbing heat energy, and on the evaporation of perspiration removing heat energy C) water being delivered to the lungs, where the heat energy will be exhaled as water vapor D) excretion of body wastes

31) Compared to dry environments, evaporation of sweat is ________ in humid environments, resulting in _______ body cooling.

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A) decreased; more B) decreased; less C) increased; more D) increased; less

32) The consumption of a high-protein, high-sodium diet will tend to ________ ion concentration of the urine. A) have no effect on B) increase C) decrease

33)

Urea is a major body waste from ________. A) the catabolism of amino acids B) the action of the sodium-potassium pump C) intracellular fluid D) the excretion of minerals by the kidney

34)

The AI recommendation for total water intake is ________. A) 1 liter per kcal expended B) 12.4 liters per day C) 8 cups per day for adult males and females D) 15 cups per day for adult males and 11 cups per day for adult females

35)

Extra water losses from heavy sweating or diarrhea will typically result in ________.

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A) increased urine output B) decreased urine output C) no change in urine output D) decreased water loss from the lungs

36)

Typical daily urine output in a healthy individual is within the range of ________. A) 400 - 600 milliliters B) 1 - 2 liters C) 2 - 4 liters D) 3 - 5 liters E) 600 - 1000 milliliters

37)

Which of the following foods has the highest percent of total weight as water? A) Lettuce B) Bread C) Cottage cheese D) Steak

38)

Who should be concerned about dehydration? A) The child who is ill with fever or diarrhea B) The athlete participating in a vigorous sport C) The traveler on a long airplane flight D) The elderly man hospitalized for a broken hip E) All of these choices are accurate.

39) When blood osmolality increases, ___________ is released by the anterior pituitary and acts on the kidney to increase water retention.

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A) antidiuretic hormone B) renin C) angiotensin II D) insulin

40) Consumption of ______ inhibits the action of antidiuretic hormone causing increased urinary output. A) one cup of coffee B) alcoholic beverages C) high-sodium foods D) high-sugar beverages

41) Renin, released from the kidney as a result of a decrease in blood pressure, acts on ________ produced in the liver. This triggers a series of reactions that culminate in the production of _______ in the adrenal glands. A) angiotensin II, renin B) aldosterone, angiotensin C) angiotensinogen, aldosterone D) antidiuretic hormone, osmosis

42)

A loss of 1%-2% of body weight in fluids will generally cause a person to ________. A) experience thirst B) experience a dramatic decrease in blood volume C) experience decreased heat tolerance and weakness D) lapse into coma and die

43) As dehydration progresses and blood volume decreases, blood pressure will ______ and heart rate will _______. Version 1

A) increase; increase B) remain the same; decrease C) decrease; decrease D) decrease; increase

44) Drinking too much water can result in dilution of sodium in the blood, a condition known as ________. A) hypernatremia B) hyperkalemia C) hyponatremia D) ADH syndrome

45)

Water intoxication is associated with ________. A) headache and blurred vision B) muscle cramps and convulsions C) hyponatremia D) All of these answers are correct.

46)

Most of the world's water consumption is for __________. A) personal consumption for drinking, cooking, and bathing B) industrial consumption C) agriculture and irrigation D) None of these responses are correct.

47)

ADH is ________.

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A) a pituitary hormone that decreases water excretion B) minerals deposited into bone that give strength and rigidity C) an adrenal hormone that causes sodium reabsorption D) a protein-calcium complex that influences enzyme activity in cells E) an enzyme in kidneys formed in response to low blood pressure

48)

Aldosterone is ________. A) a pituitary hormone that decreases water excretion B) minerals deposited into bone that give strength and rigidity C) an adrenal hormone that increases sodium reabsorption in the kidney D) a protein-calcium complex that influences enzyme activity in cells E) an enzyme in kidneys formed in response to low blood pressure

49)

Aldosterone increases ________. A) potassium retention by the kidneys B) water excretion by the kidneys C) sodium retention by the kidneys D) sodium absorption by the intestinal villi

50)

Renin is ________. A) a pituitary hormone that decreases water excretion B) minerals deposited into bone that give strength and rigidity C) an adrenal hormone that causes sodium reabsorption D) a protein-calcium complex that influences enzyme activity in cells E) an enzyme in kidneys formed in response to low blood pressure

51) Which of the following individuals is least likely to benefit from a diet containing less than 1500 mg sodium per day? Version 1

A) A 65-year-old Hispanic male in good health B) A 35-year-old African American female C) A 40-year-old white male with diabetes and chronic kidney disease D) A 20-year-old Asian female college student

52)

Sodium ________. A) acts as the principal positively charged ion in the intracellular fluid B) transmits electrical impulses through nerve cells C) promotes glycolysis D) releases energy from ATP

53)

Most sodium consumed is from ________. A) table salt added at home B) naturally occurring sodium in foods C) tap water and medications D) processed foods and those purchased at restaurants

54) Some North Americans are called "sodium sensitive." For these people, high sodium intake contributes to ________. A) stomach cancer B) hypertension C) gastrointestinal upsets D) serious fluid imbalances

55)

Table salt is _____ sodium.

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A) 20% B) 30% C) 40% D) 60%

56)

One teaspoon of salt contains about ________ of sodium. A) 3400 mg B) 1000 mg C) 2400 mg D) 6000 mg

57)

According to FDA labeling rules, the Daily Value for sodium is listed as ________. A) 7 grams per day B) 4 grams per day C) 2.3 grams per day D) 200 mg per day

58)

Which of the following dairy products has the highest sodium content? A) cottage cheese, 1 cup B) cheddar cheese, 2 oz C) lowfat milk, 1 cup D) The sodium content does not differ among these 3 foods.

59)

In a healthy person, sodium consumed in excess of body needs is ________.

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A) stored in the liver B) excreted by the kidneys C) metabolized in cells D) excreted in the feces

60)

A positively charged ion located in the intracellular fluid is ________. A) sodium B) potassium C) phosphate D) chloride

61)

Which of the following situations is/are life threatening? A) Hypokalemia B) Hyperkalemia C) Hypokalemia and hyperkalemia D) Neither hypokalemia nor hyperkalemia

62) A meal of dried apricots, whole grain cereals, legumes, and liver provides an abundance of ________. A) potassium B) fiber C) beta carotene D) vitamin A E) All of these choices are accurate.

63)

Which of the following groups would be most at risk for potassium deficiency?

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A) Infants and young children B) Pregnant women C) Patients taking diuretics D) Breastfeeding mothers

64)

An ample intake of potassium-rich foods may help protect against ________. A) hypertension B) osteoporosis C) gastric ulcers D) diabetes

65)

Salt substitutes often contain ________. A) sodium bicarbonate B) potassium chloride C) calcium carbonate D) magnesium sulfate

66)

The body regulates its potassium content by ________. A) absorbing more or less potassium from the gastrointestinal tract B) excreting more or less potassium in the urine C) storing more or less potassium in the liver D) storing more or less potassium in the bone

67)

Most of our dietary chloride comes from ________.

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A) fresh fruits B) vegetables C) meat D) seed oils E) table salt

68)

Chloride is ________. A) the main anion in extracellular fluid B) an intracellular fluid ion C) a positively charged ion D) converted to chlorine in the intestinal tract

69) Joe Smith, age 52, has a blood pressure of 145 mm Hg over 95 mm Hg. This is considered ________. A) normal blood pressure B) low blood pressure C) hypertension or high blood pressure D) None of these choices are accurate.

70)

Which of the following blood pressures is considered prehypertensive ? A) 130 mm Hg over 85 mm Hg B) 118 mm Hg over 79 mg Hg C) 142 mm Hg over 95 mm Hg D) 145 mm Hg over 105 mm Hg

71)

Factors that can contribute to an increased risk of high blood pressure include ________.

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A) advanced age B) African-American race C) BMI over 30 D) type 2 diabetes E) All of these choices are accurate.

72)

The organs that are most likely to be damaged because of hypertension are the ________. A) liver, pancreas, gastrointestinal tract, and lungs B) heart, brain, kidney, and eye C) liver, heart, pancreas, and kidney D) brain, eye, heart, lungs

73) A diet that contains an average of 4,000 mg sodium and 1,500 mg potassium daily is likely to ________. A) decrease the risk of hypertension B) decrease the risk of stroke C) increase the risk of hypertension D) have no effect on blood pressure

74)

A lifestyle modification to reduce high blood pressure in women is to ________. A) consume a daily calcium supplement of 1,000 mg B) consume a multi-vitamin mineral supplement C) eliminate all caffeine-containing beverages from the diet D) limit alcohol consumption to no more than 1 drink per day

75)

Which of the following is NOT a characteristic of the DASH diet?

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A) It is rich in the minerals magnesium, potassium, and calcium. B) It is high in fiber. C) It contains 8-10 servings of fruits and vegetables per day. D) It is low in protein.

76)

The richest sources of iron in the diet are ________. A) fruits and vegetables B) nuts and seeds C) meats and seafood D) breads and pastries

77)

Most of the iron in the body is found as a part of ________. A) ferritin B) albumin C) hemosiderin D) hemoglobin

78)

Which type of dietary iron is most efficiently absorbed? A) Non-heme iron B) Elemental iron C) Heme iron D) All these forms of iron are absorbed equally.

79) Which nutrient increases the absorption of non-heme iron by reducing ferric iron (Fe to ferrous iron (Fe 2+)?

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)

A) Vitamin A B) Vitamin C C) Vitamin E D) Vitamin D

80)

Phytic acid and oxalic acid ________ the absorption of dietary iron. A) increase B) decrease C) do not have any effect on

81)

Which of the following factors increases iron absorption? A) High intakes of zinc B) High stores of iron C) Low gastric acidity D) Increased need for iron

82)

Which of the following foods is a good source of non-heme iron? A) Eggs B) Spinach C) Grilled chicken D) Clams

83)

Approximately ____ of dietary iron is absorbed each day from typical Westernized diets.

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A) 3% B) 18% C) 65% D) 99%

84) The proteins ____________ oxidize ferrous iron to ferric iron to allow iron to be transported to body cells. A) hemosiderin and ferritin B) heme and non-heme C) hephaestin and ceruloplasmin D) ferritin and albumin

85)

Iron is stored in the liver as ________. A) hephaestin B) heparin C) ceruloplasmin D) ferritin

86)

Hemoglobin, cytochromes, and myoglobin all contain ________. A) selenium B) zinc C) iron D) iodine

87)

Ceruloplasmin is ________.

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A) a zinc-containing enzyme in the intestinal wall B) a copper-containing enzyme that oxidizes Fe 2+ to Fe 3+ C) the storage form of iron in the liver D) a component of the electron transport system

88)

The hemoglobin molecule ________. A) contains 4 heme compounds B) carries oxygen from the lungs to the tissues C) decreases during iron deficiency anemia D) All of these choices are accurate.

89) When body cells need more iron, the number of transferrin receptors on the cell surface ________. A) increases B) decreases C) remains unchanged

90)

Approximately _______ of iron used each day is recovered and recycled. A) 10% B) 25% C) 75% D) 90%

91)

Ferritin and hemosiderin are ________.

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A) storage forms of iron B) zinc-containing proteins C) protein carriers of selenium in the blood D) iodine-containing enzymes

92) A low serum concentration of hemoglobin is most often associated with a deficiency of ________. A) zinc B) iodine C) copper D) iron

93) The transport of iron out of the intestinal cell for incorporation into serum transferrin is aided by the protein ________. A) insulin B) myoglobin C) ferroportin D) thyroxine

94)

Iron-deficiency anemia often causes symptoms of ________. A) fatigue B) night blindness C) dental decay D) dermatitis

95)

Which of the following population groups is at highest risk of iron-deficiency anemia?

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A) Post-menopausal women B) Weight-training athletes C) Premature infants D) Male college students

96)

In iron-deficiency anemia, the red blood cells are usually classified as ________. A) macrocytic and normochromic B) microcytic and hypochromic C) normocytic and hyperchromic D) megaloblastic

97) A major factor contributing to the decline in iron deficiency anemia among poor preschool children in the U.S. is ________. A) better nutrition education of parents, so that foods children need are actually being served B) the federal Food Stamp Program (now called SNAP) C) the nationwide system of food pantries and soup kitchens D) the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) that distributes iron-fortified formulas and cereals

98) Which of the following population groups is considered at low risk for iron-deficiency anemia? A) Pregnant women B) Infants and preschool children C) Vegans D) Middle-aged businessmen

99)

Hemochromatosis is ________.

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A) a form of anemia common in female athletes B) a genetic condition causing excess absorption of dietary iron C) a type of erythrocyte that carries extra iron D) a genetic form of iron deficiency

100) The "mucosal block" theory is one explanation of how the body protects itself from excess absorption of dietary ________. A) iron and zinc B) iodide and chromium C) fluoride and chloride D) manganese and selenium

101)

Iron plays a role in all of the following functions EXCEPT ________. A) immune function B) oxygen transport C) cognitive development D) synthesis of thyroid hormones

102)

Dietary zinc absorption is increased by ________. A) phytic acid B) zinc deficiency C) ferritin status D) the amount of vitamin C in the diet

103)

When large doses of zinc are consumed, the excess is excreted primarily via ________.

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A) the sweat B) the urine C) the feces D) expired air

104) A dietary deficiency of ______ is associated with retarded growth and inadequate sexual development in humans. A) copper B) iodine C) selenium D) zinc

105)

Zinc can induce the synthesis of metallothionein, which ________. A) is the primary protein carrier of zinc in the blood B) can hinder the absorption of zinc from the intestinal cell C) is the storage form of zinc in the liver D) is a zinc-containing enzyme in the antioxidant defense network

106)

The RDA for zinc for adults is ________. A) 11 grams for men and 8 grams for women B) 15 grams for both men and women C) 11 mg for men and 8 mg for women D) 15 mg for both men and women

107)

Which group of foods would provide the most bioavailable zinc?

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A) Refined breads and cereals B) Oysters and other seafood C) Spinach and leafy greens D) Black-eyed peas and lentils

108)

Which of the following is a symptom of zinc deficiency? A) Megaloblastic anemia B) Increased taste sensitivity C) Poor wound healing D) Cretenism

109)

Zinc functions as a part of ________. A) immune function B) antioxidant defense C) DNA and RNA synthesis D) Zinc is involved in all of these functions.

110) The enzyme superoxide dismutase contains both copper and zinc. The function of this enzyme is ________. A) to decrease serum cholesterol levels B) to protect an individual from developing night blindness C) to act as a scavenger of free radicals, thus protecting the lipid components of the cell D) to prevent GI reflux and symptoms of heartburn

111) The symptoms of copper deficiency in humans include all of the following EXCEPT ________.

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A) anemia B) thyroid disorders C) decreased white blood cell counts D) bone loss (osteopenia)

112)

Individuals with Wilson's disease over-accumulate ________ in the liver and brain. A) iodine B) selenium C) copper D) manganese

113)

The richest dietary sources of copper are ________. A) oranges and melons B) refined grains and pastries C) nuts and dark chocolate D) dark leafy greens

114) Individuals taking daily aspirin or anticoagulation medications should avoid excess intakes of ________. A) beta-carotene B) vitamin K C) vitamin D D) lycopene

115)

The nutrient essential for the synthesis of blood clotting factors is vitamin ________.

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A) A B) D C) E D) K

116)

Vitamin K adds carbon dioxide to glutamic acid to promote ________. A) muscle contraction B) blood clotting C) glucose homeostasis D) red blood cell formation

117)

An important role of vitamin K is the synthesis of ________. A) alpha-tocopherol B) rhodopsin C) calcitriol D) prothrombin

118)

A nutrient synthesized by bacteria in the large intestine is vitamin ________. A) E B) D C) A D) K

119)

The family of compounds known as vitamin K include ________.

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A) phylloquinones and menaquinones B) tocopherols and tocotrienols C) retinol, retinal, and retinoic acid D) cholecalciferol and calcitriol

120)

Vitamin K deficiency is most likely to result from ________. A) insufficient sunlight B) kidney disease C) insufficient intake of dairy products D) antibiotic therapy

121)

Antibiotics and intestinal diseases can interfere with absorption of vitamin ________. A) A B) C C) E D) K

122)

The most nutrient-dense food sources of vitamin K are ________. A) green leafy vegetables B) whole grain breads and cereals C) nuts and seeds D) oysters and shellfish

123) Newborns usually receive an injection of vitamin _________ to protect them against deficiency until the gastrointestinal tract has matured.

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A) A B) D C) B D) K

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 124) List at least five symptoms of dehydration.

125)

Describe 3 ways you can reduce your sodium intake when eating out.

126)

List 6 foods to limit and 6 foods to encourage on a low-sodium diet.

127) Compare and contrast the characteristics of a high-sodium diet to that of a highpotassium diet.

128)

Describe two of the physiologic processes that contribute to primary hypertension.

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129)

Describe several actions an individual can take to prevent hypertension.

130) Describe the nutritional characteristics of the DASH diet. Which food groups are emphasized?

131)

How does vitamin C increase the absorption of iron?

132)

List 2 food sources for zinc.

133)

Describe 2 functions of iron.

134)

List 3 population groups at risk for iron deficiency.

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135)

List 3 factors that can increase iron absorption.

136)

Why are children at risk of iron toxicity?

137)

List 2 transport proteins for iron.

138)

What dietary suggestions would you provide to a vegan to prevent iron deficiency?

139)

Why does vitamin K not have an established UL?

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Answer Key Test name: Chap 14_3e_Test Bank 1) FALSE Thirst is not a reliable indicator of dehydration in older individuals. Thirst sensation reduces as individuals age. 2) FALSE Drinking too much water too rapidly can be as dangerous as drinking too little. In rare instances, it can cause a condition called water intoxication. Water intoxication develops when the kidneys cannot remove water fast enough to keep pace with water intake. As a result, water accumulates in the blood and dilutes the sodium in the serum. 3) TRUE 4) FALSE Although caffeine is a mild diuretic, intakes up to 500 mg per day (the amount in about 4.5 cups of brewed coffee) do not cause dehydration or water imbalance in most people. 5) FALSE In addition to supplying water, many beverages also contribute substantially to sugar and calorie intake. In the U.S., soft drinks, fruit drinks, energy drinks, tea, coffee, and other sweetened beverages are so popular that they provide over 40% of the added sugars. However, sugar-sweetened beverage intake is gradually decreasing, perhaps in response to recommendations to decrease sugar intake. 6) TRUE 7) FALSE Heme iron is derived from animal-based foods. Version 1

8) TRUE 9) TRUE 10) FALSE Factors That Increase Absorption

Factors That Decrease Absorption

High body demand for red blood cells (blood loss, high altitude, physical training, pregnancy, anemia) Low body stores of iron

Low need for iron (high level of storage iron)

Heme iron in food

Oxalic acid in leafy vegetables

Meat protein factor (MPF)

Polyphenols in tea, coffee, red wine, and oregano Reduced gastric acidity

Vitamin C intake Gastric acidity

Phytic acid in whole grains and legumes

Excessive intake of other minerals (zinc, manganese, calcium)

11) TRUE 12) TRUE 13) FALSE Today, about 66% of Americans have access to fluoridated water. For those receiving community water, 75% have a fluoridated supply. 14) FALSE Zinc also may play a role in shortening the duration of common colds in healthy people, when used within the first 24 hours of the onset of symptoms. However, more research is needed, particularly considering the side effects of nausea and bad taste reported with the use of zinc lozenges. 15) TRUE 16) TRUE 17) FALSE To date, no Upper Level has been set for vitamin K. 18) TRUE Version 1

19) A 20) D 21) A 165 lb x 0.55 (percentage of adult body weight that is water) = 90.75 lb 22) A 23) E 24) A 25) B 26) C 27) B 28) D 29) B 30) B 31) B 32) B 33) A 34) D 35) B 36) B 37) A 38) E 39) A 40) B 41) C 42) A 43) D 44) C 45) D 46) C 47) A Version 1

48) C 49) C 50) E 51) D 52) B 53) D 54) B 55) C 56) C 57) C 58) A 59) B 60) B 61) C 62) E 63) C 64) A 65) B 66) B 67) E 68) A 69) C Hypertension is defined as over 140/90. 70) A Hypertension is defined as over 140/90. Normal is less than 120/80. Prehypertensive is 120-139 SBP or 80-89 DBP. 71) E 72) B 73) C Version 1

These values classify as excessive sodium intake and low potassium intake, which could both promote hypertension. 74) D 75) D 76) C 77) D 78) C 79) B 80) B 81) D 82) B 83) B 84) C 85) D 86) C 87) B 88) D 89) A 90) D 91) A 92) D 93) C 94) A 95) C 96) B 97) D 98) D 99) B 100) A 101) D Version 1

102) B 103) C 104) D 105) B 106) C 107) B 108) C 109) D 110) C 111) B 112) C 113) C 114) B 115) D 116) B 117) D 118) D 119) A 120) D 121) D 122) A 123) D 124) Answers will vary. The signs of mild to moderate dehydration include dry mouth and skin, fatigue and muscle weakness, decreased urine output, deep yellow (concentrated) urine, headache, and dizziness. As dehydration progresses, solute concentrations in the blood rise, blood pressure decreases, and heart rate increases due to low blood volume. If fluid losses continue, kidney failure, seizures, delirium, and coma can occur.

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125) Answers will vary. Choose fresh vegetables Ask for low-sodium items Choose unprocessed foods Choose These Foods More Often Grains: whole grains or enriched breads and cereals, plain rice, pasta Vegetables: fresh and frozen plain (no sauce) vegetables Fruits: fresh, canned, and frozen fruits Dairy: low-fat milk, yogurt Meats and substitutes: fresh or frozen lean meats, poultry, fish, shellfish, unsalted lean pork, eggs, tuna or salmon canned without added salt, canned and drained meat and poultry, unsalted nuts or seeds, dried peas, beans, lentils Entrées: prepared from fresh ingredients or those labeled reduced sodium Snack items: unsalted crackers, popcorn, pretzels, breadsticks Seasonings and condiments: fresh and dried herbs, lemon juice, low sodium seasoning products 126) Answers will vary. Choose These Foods More Often

Choose These Foods Less Often

Grains: whole grains or enriched breads and cereals, plain rice, pasta Vegetables: fresh and frozen plain (no sauce) vegetables Fruits: fresh, canned, and frozen fruits

Packaged rice and pasta mixes

Dairy: low-fat milk, yogurt

Cheeses, especially processed

Meats and substitutes: fresh or frozen lean meats, poultry, fish, shellfish, unsalted lean pork, eggs, tuna or salmon canned without added salt, canned and drained meat and poultry, unsalted nuts or seeds, dried peas, beans, lentils Entrées: prepared from fresh ingredients or those

Salted nuts; frozen breaded meat, fish, and poultry; processed meats, such as luncheon meats, bologna, salami, hot dogs, bacon, ham, beef jerky

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Canned vegetables (read the labels), tomato and pasta sauces, frozen vegetables with sauce Commercial fruit pies, turnovers

Instant and canned soups, frozen entrées and

labeled reduced sodium Snack items: unsalted crackers, popcorn, pretzels, breadsticks Seasonings and condiments: fresh and dried herbs, lemon juice, low sodium seasoning products

dinners, pizza, many fast food items Salted crackers, popcorn, chips Salt added during cooking, bouillon cubes, seasoning salts, soy sauce, teriyaki sauce, barbeque sauces, pickles, olives, bottled salad dressings

127) Answers will vary. Diets high in potassium and low in sodium offer the most protection against high blood pressure. Such diets are consistent with the DASH Diet and recommendations from the Dietary Guidelines for Americans 2015-2020. Many individuals can approximate the AI for potassium (2600 mg for adult females or 3400 mg for adult males) by adding an additional 1500 mg of potassium to their daily diets. One banana, 1/2 cup of beans, and 1 sweet or white baked potato easily provide this added potassium. On the other hand, low potassium and high sodium diets, which many people eat today, are more likely to result in high blood pressure. 128) Answers will vary. Primary hypertension develops over a period of years in response to changes in the arteries, kidneys, and sodium/ potassium balance. As we age, our arteries tend to narrow and become more rigid through a process called arteriosclerosis. Additionally, endothelial cells that line the arteries often release vasoconstrictors, substances that cause the arteries to constrict, in response to arterial damage, poor blood flow, stress, and other factors. Although these events alone can result in increased blood pressure, their additive effects on kidney function increase arterial pressure. In response to this, the kidney releases more renin, causing the formation of additional angiotensin II enzyme (see Fig. 14-9). Angiotensin II is a powerful vasoconstrictor that triggers the kidney’s retention of sodium and water. Diets high in sodium and low in potassium worsen these physiological changes. Over time, the result is elevation of blood pressure. Version 1

129) Answers will vary. A healthy lifestyle is the cornerstone for prevention and treatment of high blood pressure and its complications. Maintaining a healthy weight and healthy eating patterns, engaging in regular physical activity, and limiting alcohol intake can help keep blood pressure normal throughout life. 130) Answers will vary. The DASH (Dietary Approaches to Stop Hypertension) Diet was designed to test the effect of a diet low in saturated fat, total fat, and cholesterol and high in fruits, vegetables, and low-fat dairy products on blood pressure. The diet is rich in magnesium, potassium, calcium, protein, and fiber (see Table 14-9). In fact, the amounts of magnesium, potassium, calcium, and fiber greatly exceed typical intakes, but without using nutritional supplements. Food Group Grains* Vegetables Fruits Fat free or low-fat milk and milk products Lean meats, poultry, and fish Nuts, seeds, and legumes Fats and oils Sweets and added sugars

Daily Servings 6–8 4–5 4–5 2–3 6 or less 4–5 per week 2–3 5 or less per week

131) Answers will vary. Vitamin C provides an electron to Fe3+ (ferric iron) to yield Fe2+ (ferrous iron), which then forms a soluble complex with vitamin C. Ferrous iron is better absorbed than ferric iron because it more readily crosses the mu-cosal layer of the small intestine and reaches the brush border of the intestinal absorptive cells. Heme iron does not need to undergo this reduction reaction because the iron in heme is already in the more soluble ferrous form.

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132) Answers will vary. Protein rich meat and seafood are usually good sources of zinc (Fig. 14-20). North Americans obtain about 70% of their dietary zinc from animal-based foods, such as beef, lamb, and pork. Plant-based foods, such as nuts, beans, wheat germ, and whole grains, also contribute. 133) Answers will vary. Functional component of hemoglobin and other key compounds used in respiration; immune function; cognitive development; energy metabolism 134) Answers will vary. Infants; preschool children; women in childbearing years 135) Answers will vary. Factors That Increase Absorption High body demand for red blood cells (blood loss, high altitude, physical training, pregnancy, anemia) Low body stores of iron Heme iron in food Meat protein factor (MPF) Vitamin C intake Gastric acidity 136) Answers will vary. Children are more vulnerable to iron poisoning than adults because their absorptive mechanisms cannot respond as rapidly as those of an adult. The primary cause of iron overload in children is the consumption of excess chewable iron-containing supplements. 137) Answers will vary. Iron in Transport Proteins Transferrin Ferroportin

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138) Answers will vary. Polyphenols, such as the tannins found in tea, and related substances in coffee are known to reduce nonheme iron absorption. Therefore, indi-viduals trying to rebuild iron stores are advised to reduce coffee and tea consumption, particularly at mealtimes. Excessive intakes of other minerals, such as zinc, manganese, and calcium, may interfere with nonheme iron absorption. Because of these potential mineral-mineral interactions, individuals with high iron needs should avoid taking iron supplements with foods or supplements containing significant amounts of these minerals. Vitamin C, or other organic acids, in the diet also increases nonheme iron absorption. Vitamin C provides an electron to Fe3+ (ferric iron) to yield Fe2+ (ferrous iron), which then forms a soluble complex with vitamin C. Ferrous iron is better absorbed than ferric iron because it more readily crosses the mu-cosal layer of the small intestine and reaches the brush border of the intestinal absorptive cells. 139) Answers will vary. To date, no Upper Level has been set for vitamin K. Although vitamin K can be stored in the liver and bone, storage is limited. Vitamin K also is more readily excreted than other fat-soluble vitamins. When used in its natural forms of phylloquinones or menaquinones, increased amounts of vitamin K have not caused harmful effects.

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CHAPTER 15 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) The more dense a bone is, the more brittle it will be. ⊚ ⊚

Bone health is easily determined by a measurement of blood calcium level. ⊚ ⊚

true false

Retinoids play a role in embryonic development and cell differentiation. ⊚ ⊚

true false

4) Carotenoid supplementation has been effective in decreasing the risk of lung cancer in smokers. ⊚ ⊚

5) eye.

Vitamin A deficiency can result in development of xerophthalmia in membranes of the ⊚ ⊚

true false

Vitamin D must be hydroxylated in the liver and kidney to become biologically active. ⊚ ⊚

true false

Kidney disease and liver disease increase the risk of vitamin D deficiency.

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⊚ ⊚

true false

8) The RDA for vitamin E was established to prevent hemolysis of red blood cell membranes. ⊚ ⊚

Adequate selenium intake may lower risk of prostate, lung, and other cancers. ⊚ ⊚

10)

true false

The RDA for vitamin C is 60 mg/day or 4 ounces of orange juice a day. ⊚ true ⊚ false

11) Large doses of vitamin C in supplement form are known to prevent, cure, or diminish the symptoms of the common cold. ⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 12) The 250 mg of calcium found in a cup of spinach ________. A) is the only source of calcium for a vegan B) has low bioavailability because the calcium is bound to oxalic acid C) is poorly absorbed unless the spinach is cooked D) has low bioavailability because the calcium is bound to phytic acid

13)

Individuals advised to consume calcium supplements should consume ________.

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A) about 2,000 mg in a single dose each day B) only calcium citrate as other calcium salts are poorly absorbed C) an amount of no more than 500 mg D) the calcium supplement at the same time as other mineral supplements

14)

Absorption of dietary calcium in the duodenum is aided by ________. A) consumption of lactose B) acidic environment C) 1, 25 (OH) 2 vitamin D D) All of these choices are accurate.

15) Which of the following population groups generally has the highest rate of calcium absorption? A) Postmenopausal women B) Pregnant women C) Premenopausal women (not pregnant or lactating) D) Athletes in training

16) Measuring blood calcium levels is not an accurate indicator of total body calcium because ________. A) calcium in the blood reflects only the most recent dietary intake of calcium B) there are no reliable tests for measuring blood calcium C) blood calcium levels vary according to the intake of other positive ions (e.g., sodium, potassium, and magnesium) D) blood calcium levels are strictly controlled by hormones and do not reflect total body stores

17)

Which factor(s) limits absorption of dietary calcium?

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A) Phytic acid B) Chronic diarrhea C) Tannins in tea D) Vitamin D deficiency E) All of these choices are accurate.

18)

Parathyroid hormone elevates blood calcium levels by ________. A) increasing the synthesis of 1,25 (OH) 2 vitamin D B) reducing calcium excretion by the kidneys C) increasing bone resorption by osteoclast activity D) All of the choices are accurate.

19)

Which of the following foods provides the greatest amount of calcium per serving? A) 1 cup of yogurt B) 2 oz. cheddar cheese C) 3 oz. canned salmon with bones D) 1 cup cooked spinach

20) Assuming that milk is an adolescent’s only source of dietary calcium, how much milk must he/she drink every day to meet the RDA for calcium? A) 1-2 cups B) 2-3 cups C) 3-4 cups D) 4-5 cups

21) The two life stage groups with the highest RDAs for calcium are _________ and _________.

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A) children; adolescents B) infants; children C) adolescents; adults over age 50 D) infants; adolescents

22)

The very dense outer surface of bone is called ________. A) osteoclastic bone B) osteoblastic bone C) trabecular bone D) cortical bone

23) At the end of long bones, inside the spinal vertebrae, and inside the flat bones of the pelvis, is a spongy type of bone known as ________. A) osteoclastic bone B) osteoblastic bone C) trabecular bone D) compact bone

24)

________ replacement after menopause greatly reduces bone loss in women. A) Calcium B) Calcitriol C) Estrogen D) Calcitonin

25) In addition to its role in bone development and maintenance, calcium is also required for ________.

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A) blood clotting, transmitting nerve impulses, and muscle contraction B) regulating potassium excretion, normal kidney function, and regulating intracellular water content C) phospholipid synthesis, muscle contraction, and formation of DNA and RNA D) blood clotting, magnesium absorption, and insulin release from the pancreas

26)

The bones most likely to be affected by the disease osteoporosis include the ________. A) ankle, shoulder, and neck B) hip, thigh, and ankle C) hip, wrist, and vertebrae in the spine D) wrist, forearm, and neck E) All of these are correct as all bones are affected equally by osteoporosis.

27)

Risk factors for osteoporosis include ________. A) overweight and obesity B) amenorrhea C) African-American race D) high levels of physical activity

28)

Phosphorus absorption is promoted by the hormone ________. A) calcitonin B) 1, 25 (OH)2 vitamin D C) cholecalciferol D) aldosterone

29)

The RDA for adults for phosphorus is ________.

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A) the same as calcium B) twice the amount of calcium C) 700 mg/d D) 200 mg/d

30)

Good food sources of phosphorus include ________. A) fruits and vegetables B) nuts and oils C) dairy products, meats, and cereals D) dairy products and leafy green vegetables

31)

The richest dietary sources of magnesium generally are ________. A) animal products, e.g., beef and milk B) plant products, e.g., green vegetables, beans, whole grains C) fats and oils D) bottled waters

32)

Magnesium deficiency is most often caused by ________. A) excessive intakes of sodium and potassium B) low dietary intake of magnesium C) GI disorders that cause prolonged diarrhea or vomiting D) osteopenia or osteoporosis

33)

Over half of the body's magnesium is found in the ________.

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A) heart B) liver C) bones D) brain

34)

High amounts of _____, especially from supplements, can cause diarrhea. A) magnesium B) sodium C) calcium D) potassium

35) Some scientists believe that vitamin D recommendation should be much higher than currently set. A) True B) False

36)

Beta-carotene is also called ________. A) provitamin A B) retinal or retinol C) calcitriol D) rhodopsin

37)

In the intestinal cells, ________.

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A) vitamin A, as retinal, is converted to beta-carotene B) carotenes are split by an intestinal enzyme to form vitamin A C) excess vitamin A is carried to the kidney for excretion D) All of these choices are correct.

38)

Retinal, retinol, and retinoic acid are all forms of ________. A) vitamin A B) vitamin K C) vitamin D D) vitamin E

39) Rhodopsin, the visual pigment in the retina of the eye, is regenerated when opsin combines with ________. A) retinoic acid B) 11-cis retinal C) 13-cis-retinol D) beta-carotene

40)

Of the following, the best source of preformed vitamin A is ________. A) fried liver B) sautéed spinach C) fresh mango D) cheddar cheese

41)

Of the following, the best source of provitamin A is ________.

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A) fried liver B) baked sweet potato C) fresh bananas D) soybeans

42) The yellow-orange coloring of carotenoid-rich dark green vegetables is masked by the pigment ________. A) lycopene B) chlorophyll C) beta-carotene D) alpha-carotene

43) Mucus-forming cells in the body deteriorate and can no longer produce mucus when there is a deficiency of ________. A) vitamin D B) beta-carotene C) vitamin K D) vitamin A

44) When viewing items at night or in very dim light, light strikes the retina of the eyes ________. A) and causes the retinal to change from its cis form to its trans form B) and splits the rhodopsin into opsin and all- trans-retinal C) to trigger an electrical signal along the optic nerve D) All of these choices are accurate.

45)

A deficiency of vitamin A can lead to development of a condition called ________.

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A) xerophthalmia B) osteomalacia C) jaundice D) scurvy

46)

Vitamin A deficiency is characterized by the ________. A) inability of the pancreas to produce insulin B) failure to form blood clots C) inability of the eyes to adapt quickly to changes in light intensity D) production of excessive amounts of collagen by the skin

47)

The maintenance of mucus-forming cells depends on adequate amounts of ________. A) vitamin D B) vitamin C C) vitamin A D) vitamin K

48)

The biochemical functions of vitamin A include all of the following except: ________. A) controlling vision in dim and bright light B) development and maintenance of mucus-forming cells C) cell differentiation D) coenzyme synthesis

49)

Which statement correctly describes vitamin A?

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A) Vitamin A is carried from the liver by retinol-binding protein and transthyretin in the blood. B) Nearly all cells have vitamin-A binding retinoid receptors. C) Within a cell, vitamin A is involved in gene expression and cell differentiation. D) All of the above statements are correct.

50) Vitamin A supplements are not necessary for most adult Americans, as they have significant reserves in ________. A) the eye B) the skin C) the kidney D) the liver

51)

The current RDA for vitamin A is expressed in ________. A) Beta Carotene International Units (BCIU) B) Retinol Activity Equivalents (RAE) C) Alpha-Tocopherol Equivalents (ATE) D) None of these answers are correct.

52) In North America, population groups at increased risk of vitamin A deficiency include all of the following EXCEPT ________. A) college-aged diabetics B) alcoholics with liver disease C) those with GI diseases that prevent fat absorption D) low birth weight, premature infants

53)

The most likely cause of a vitamin A toxicity would be ________.

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A) consuming large amounts of dark green and yellow vegetables B) eating sautéed liver and onions twice a week C) consuming high levels of vitamin A supplements D) drinking carrot juice twice a day

54)

Vitamin A toxicity is known to cause all of the following EXCEPT ________. A) birth defects B) permanent damage to the liver C) kidney disease D) death

55)

What vitamin would most likely lead to death in both deficient and toxic levels? A) Vitamin A B) Vitamin C C) Vitamin E D) Vitamin B-12

56)

A potential danger of using oral Accutane for acne is that it ________. A) can cause spontaneous abortion and birth defects B) can cause blindness if used for over a year C) may lead to atherosclerosis D) can lead to osteomalacia

57)

Children eating large amounts of carrots can develop ________.

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A) hyperactivity B) hypercarotenemia C) hyperglycemia D) vitamin A toxicity

58)

A derivative of vitamin A, 13- cis-retinoic acid (Accutane), is used to ________. A) prevent xerophthalmia B) treat serious cases of acne C) treat hypercarotenemia D) prevent skin cancer

59) Vitamin D deficiency can result in poorly mineralized bone. The resulting disease is called ________. A) osteoporosis B) osteomalacia C) osteoarthritis D) osteopenia

60) Healthy, light-skinned individuals can make sufficient vitamin D to meet the body's needs with a minimum of about ________ of sun exposure on their face, arms, and hands 2 or 3 times per week. A) 15 minutes B) 60 minutes C) 90 minutes D) 120 minutes

61)

The nutrient that can be considered both a vitamin and a hormone is vitamin ________.

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A) E B) K C) D D) A

62)

Vitamin D is sometimes called the sunshine vitamin because ________. A) it is available in fresh orange juice B) exposure to sunlight converts a precursor form to vitamin D C) it can be destroyed by exposure to sunlight D) it is the yellow-orange color of the sun

63)

The main active form of vitamin D in the body is ________. A) calcitriol B) retinal C) cholecalciferol D) calcitonin

64)

Vitamin D is involved in the regulation of body levels of ________. A) cholesterol B) calcium C) prothrombin D) potassium

65)

Functions of vitamin D include ________.

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A) prevention of scurvy B) antioxidant activity C) glucose regulation D) absorption of calcium

66)

As calcitriol, vitamin D functions in calcium and bone metabolism by ________. A) reducing calcium excretion by the kidney B) regulating calcium and phosphorus absorption through the intestinal wall C) regulating the levels of calcium and phosphorus in bones D) All of these choices are accurate.

67)

Calcitriol is the ________. A) precursor to vitamin D that is activated by sunlight B) plant source of vitamin D C) animal food source of vitamin D D) biologically active form of vitamin D

68)

Vitamin D deficiency in adults is called ________. A) osteoporosis B) osteomalacia C) rickets D) hypocalcemia

69) In children, bowed legs, an enlarged head, rib cage, and knee joints, and a deformed pelvis are symptoms of ________.

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A) rickets B) xerophthalmia C) osteopenia D) None of the above are correct.

70)

A reliable food source of vitamin D is ________. A) yellow-orange colored fruits B) dark green leafy vegetables C) whole grain breads D) fortified milk

71) As calcium levels in the blood drop below normal, ____________ is released to increase the synthesis of calcitriol. A) calcitonin B) thyroid hormone C) parathyroid hormone D) secretin

72)

Vitamin D synthesis in the skin is affected by all of the following EXCEPT ________. A) use of sunscreen B) skin color C) geographic location D) All of these factors can affect vitamin D synthesis.

73) Individuals at increased risk of vitamin D deficiency include all of the following EXCEPT ________.

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A) elderly adults living in nursing homes B) dark-skinned children with limited outdoor activity C) young adults who eat high amounts of fatty fish and fish oils D) individuals with diseases of fat-malabsorption

74)

Which of the following is NOT a function of vitamin D? A) Maintaining phosphorus homeostasis B) Regulating cell cycle activity C) Promoting antioxidant activity D) Increasing immunity against infections

75)

Excess intake of vitamin D ________. A) is readily excreted B) can cause hypercalcemia C) can cause rickets D) can cause osteomalacia

76)

Vitamin E is a family of compounds comprised of the ________. A) 4 tocopherols B) 4 tocotrienols C) 4 triglycerides D) 4 tocopherols and 4 tocotrienols

77)

Vitamin E functions to ________.

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A) turn visual light into nerve signals to the brain. B) protect phospholipids in cell membranes from damage by free radicals. C) enhance the absorption of calcium from the small intestine. D) All of these choices are accurate.

78)

A primary function of vitamin E is to serve as ________. A) a coenzyme B) an antioxidant C) a hormone D) a peroxide

79)

Which of the following is NOT involved in antioxidant defense? A) Glutathione peroxidase B) Superoxide dismutase C) Catalase D) Hydrogen peroxide

80)

The most nutrient-dense sources of vitamin E are ________. A) refined grains and cereal products B) orange-colored fruits C) vegetable oils D) animal fats

81)

Vitamin E is carried to the liver and other tissues by ________.

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A) albumin B) hemoglobin C) lipoproteins D) retinol-binding proteins

82) Of the following population groups, those at lowest risk for vitamin E deficiency are ________. A) premature infants B) the elderly C) athletes D) smokers

83)

A high intake of vitamin E can ________. A) interfere with vitamin K's blood-clotting activity B) result in lead poisoning C) inhibit copper absorption D) cause atherosclerosis

84)

Which vitamin deficiency leads to hemolytic anemia? A) Vitamin A B) Vitamin D C) Vitamin E D) Vitamin K

85)

The mineral that partly "spares" the antioxidant vitamin E is ________.

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A) copper B) selenium C) chromium D) iodide

86)

The amount of selenium in foods ________. A) is consistently high in plant-based foods B) will depend on the total amount of other minerals in the food C) depends on the type of water used to irrigate crops D) depends on the amount of selenium in the soil where crops are grown

87)

Excessive fluoride exposure during tooth development can cause ________. A) glucose intolerance B) mottling of the teeth C) dermatitis D) bleeding of the gums

88)

The fluoridation of public drinking water is A) responsible for reduction in dental caries in children. B) an effective means of providing dietary selenium. C) potentially toxic if an individual drinks 64 oz or more of municipal water per day. D) mandatory in all states in the U.S.

89)

The fluoride level in fluoridated water typically is about ________.

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A) 0.2 mg/L B) 0.7 mg/L C) 1.2 mg/L D) 1.7 mg/L

90)

The role of hydroxyl-fluorapatite is to ________. A) enhance insulin sensitivity and prevent diabetes B) prevent dental caries C) improve the rate of growth in children D) prevent the development of anemia

91)

Fluoride is typically provided by sources such as ________. A) toothpaste B) fluoride treatments by the dentist C) municipal drinking water D) All of these choices are accurate.

92)

Which of the following is associated with selenium deficiency? A) Wilson's disease B) Keshan disease C) Grave's disease D) Lou Gehrig's disease

93)

Which of the following enzymes contains selenium?

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A) Glutathione peroxidase B) Superoxide dismutase C) Lysyl oxidase D) Pancreas

94)

Formation and maintenance of collagen requires ________. A) thiamin B) vitamin C C) riboflavin D) folate

95)

Ingestion of vitamin C during meals can modestly improve absorption of ________. A) beta-carotene B) nonheme iron C) vitamin B-12 D) folate

96)

The primary function of vitamin C in cellular metabolism is to ________. A) synthesize collagen B) add hydroxyl groups to the amino acid proline C) act as nonspecific reducing agent (electron donor) D) maintain iron in its reduced form in the formation of collagen

97)

Which meal contains the highest amount of vitamin C?

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A) Hamburger sandwich, french fries, and cola B) Meat loaf, mashed potatoes and gravy, and diet cola C) Baked fish with lemon, broccoli, cole slaw, and strawberries D) Roast beef, carrots, noodles, and coffee

98)

The first symptom of scurvy is ________. A) iron-deficiency anemia B) sudden hair loss C) pinpoint hemorrhages around hair follicles D) nerve degeneration

99) Physiological changes associated with scurvy (hemorrhages, joint pain, fractures) are caused by ________. A) defective collagen synthesis B) inadequate production of the hormone thyroxine C) failure to synthesize neurotransmitters D) impaired function of the citric acid cycle

100)

Which group of foods provides substantial amounts of vitamin C? A) Citrus fruits and vegetables B) Milk and dairy products C) Beef, poultry, seafood D) Breads and cereals

101)

Factors such as heat, iron, copper, and oxygen ________.

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A) enhance the stability of vitamin C in foods B) destroy vitamin C in foods C) have no effect on vitamin C D) convert vitamin C from its inactive to active form

102)

Scurvy is due to a deficiency of ________. A) vitamin C B) thiamin C) folate D) vitamin B-12

103)

The RDA for vitamin C is increased by ________ mg/day for smokers. A) 10 B) 60 C) 35 D) 1000

104) The amino acids _______ and ________ are hydroxylated with the aid of vitamin C to form strong connective tissue. A) proline; lysine B) glutamic acid; alanine C) threonine; methionine D) methionine; homocysteine

105) At intakes of supplemental vitamin C greater than 2 g/day, adverse effects, including _________, may occur.

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A) blood in the urine and muscle weakness B) masking of a vitamin B-12 deficiency C) gastrointestinal bloating and diarrhea D) All of these choices are accurate.

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 106) Describe how to test a calcium supplement for digestibility.

107)

List and briefly describe five risk factors leading to osteoporosis.

108)

List 3 functions of vitamin A.

109)

Why do some scientists suggest that the DRI and UL for vitamin D be increased?

110)

List 3 symptoms of vitamin A toxicity.

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111)

Why should individuals on anticoagulation medication avoid excess vitamin E?

112)

List three food sources rich in vitamin D.

113)

What trace mineral aids in vitamin E function?

114)

What trace mineral toxicity causes tooth mottling and how?

115)

Describe how fluoride works to prevent dental caries.

116)

Why is fluoride not always classified as an essential trace mineral?

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117) Should individuals with a family history of cancer take selenium supplements? Explain your answer.

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Answer Key Test name: Chap 15_3e_Test Bank 1) FALSE The more dense a bone is, the stronger it will be. 2) FALSE Measuring blood calcium levels is not an accurate indicator of total body calcium because blood calcium levels vary according to the intake of other positive ions (e.g., sodium, potassium, and magnesium). 3) TRUE 4) FALSE There is evidence that lycopene may reduce CVD risk by decreasing LDL oxidation and cholesterol synthesis, as well as by increasing LDL receptor activity in cells. Some studies have suggested a beneficial effect of blood lutein levels on coronary heart disease, stroke, and metabolic syndrome. However, the evidence for cardioprotective benefits is not consistent in all studies. Until these complex relationships are more clearly understood, nutritionists do not recommend carotenoid supplements. Instead, they advocate increased intakes of carotenoid-rich fruits and vegetables. 5) TRUE 6) TRUE 7) TRUE 8) TRUE 9) TRUE 10) FALSE

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The RDA for vitamin C for adult men is 90 mg/day; for adult women, it is 75 mg/day; and the Daily Value on food and supplement labels is 90 mg. 11) FALSE One aspect of high vitamin C intake (up to 1000 mg/day) that has drawn a lot of attention is its possible use in preventing or treating the common cold. Almost 40 studies suggest that any beneficial effect of vitamin C supplementation is very modest, perhaps reducing cold duration by 1 day per year in adults. For individuals exposed to extreme physical stress, such as marathon runners and cross-country skiers, vitamin C supplementation reduced the risk of contracting a cold after the physical stress. Despite its popularity, supplemental vitamin C cannot be recommended to prevent or treat common colds in most individuals. 12) B 13) C The body cannot absorb more than about 500 mg of calcium at once. 14) D 15) B 16) D 17) E 18) D 19) A Fig 15-5 20) D If the RDA for adolescents is 1300 mg, and a cup of milk contains approximately 300 mg of calcium, an individual would need approximately 4 to 5 cups. 21) C Version 1

22) D 23) C 24) C 25) A 26) C 27) B 28) B 29) C 30) C 31) B 32) C 33) C 34) A 35) A 36) A 37) B 38) A 39) B 40) A 41) B 42) B 43) D 44) D 45) A 46) C 47) C 48) D 49) D 50) D 51) B Version 1

52) A 53) C 54) C 55) A 56) A 57) B 58) B 59) B 60) A 61) C 62) B 63) A 64) B 65) D 66) D 67) D 68) B 69) A 70) D 71) C 72) D 73) C 74) C 75) B 76) D 77) B 78) B 79) D 80) C 81) C Version 1

82) C 83) A 84) C 85) B 86) D 87) B 88) A 89) B 90) B 91) D 92) B 93) A 94) B 95) B 96) C 97) C Citrus fruits, vegetables, and berries are all high in vitamin C. 98) C 99) A 100) A 101) B 102) A 103) C 104) A 105) C 106) Answers will vary. Some calcium supplements are poorly digested because they do not readily dissolve. To test for solubility, put a supplement in 6 oz of vinegar. Stir every 5 minutes. It should dissolve within 30 minutes.

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107) Answers will vary. History of osteoporotic fracture in a 1st-degree relative (i.e., parent or sibling) Small, thin skeletal frame Advancing age Too little estrogen in women, caused by Menopause, especially in Caucasian and Asian women Amenorrhea (cessation of normal menstrual periods), indicating low estrogen Oophorectomy (removal of ovaries), resulting in low estrogen Smoking, which can have direct toxic effects on bone and impair absorption and metabolism of bone-forming nutrients; smokers also are likely to be less physically active Low intake of calcium, vitamin D, and other nutrients Excessive intake of coffee, cola, or other caffeinated beverages Low physical activity Three or more drinks (alcohol) per day Presence of other diseases (e.g., cystic fibrosis, anorexia nervosa, type 1 diabetes mellitus, inflammatory bowel disease, rheumatoid arthritis, celiac disease, multiple sclerosis, or epilepsy) that can impair absorption, metabolism, and utilization of bone-forming nutrients; in some cases, nutrient excretion may be increased Chronic use of some medications, including corticosteroids (used to treat many inflammatory and autoimmune diseases), anticonvulsants, and proton pump inhibitors

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108) Answers will vary. ● Normal growth and development ● Black/white and color vision ● Cell differentiation and gene expression ● Immunity 109) Answers will vary. To support the diverse functions of vitamin D, some researchers estimate that the body requires approximately 3000 to 4000 IU (75–100 μg) of vitamin D daily to maintain optimal blood levels of 25–OH vitamin D3. However, typical inputs from UV exposure (2000 IU), food sources (150–200 IU), and dietary supplements (200 IU) often provide 2400 IU daily or less for the average individual. Thus, an oral intake of approximately 1000 to 4000 IU daily might be necessary to maintain optimal vitamin D status in people who have limited sun exposure.

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110) Answers will vary. Toxicity symptoms Teratogenic ● Fetal malformation Spontaneous abortion Acute ● Gastrointestinal upsets/nausea ● Headaches ● Dizziness Muscle uncoordination Chronic ● Liver damage ● Hair loss ● Bone/muscle pain ● Loss of appetite ● Dry skin and mucous membranes ● Hemorrhages ● Coma ● Fractures 111) Answers will vary. Although vitamin E is relatively nontoxic, excessive amounts can interfere with the role of vitamin K in blood clotting. This causes insufficient clotting and a risk of hemorrhaging. These risks are of particular concern in individuals taking daily aspirin or anticoagulation medications, such as warfarin (Coumadin®), to prevent blood clots. Megadoses of vitamin E can result in severe hemorrhaging in these individuals. 112) Answers will vary. The best food sources of vitamin D are fatty fish (e.g., sardines, mackerel, herring, and salmon), cod liver oil, fortified milk, and some fortified breakfast cereals.

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113) Vitamin E, vitamin C, selenium, and beta-carotene (which can be converted to vitamin A) are important parts of the body’s antioxidant network. 114) In the early 1930s, it was observed that individuals living in the southwestern U.S., where the water naturally contained high concentrations of fluoride, had fewer dental caries (cavities). Many people in these areas also had small spots on their teeth (known as mottling or fluorosis) due to excess fluoride (Fig. 15-19). Although discolored, the mottled teeth were virtually free of dental caries. This discovery led to research studies confirming this mineral’s ability to reduce cavities and the start of controlled water fluoridation in parts of the U.S. 115) Answers will vary. Fluoride works in several ways to prevent caries. During the development of teeth and bones, fluoride forms hydroxyfluorapatite crystals. These crystals provide greater resistance (than typical hydroxyapatite crystals) to bacteria and acids in the mouth that can erode tooth enamel. Fluoride in the blood contributes to fluoride in the saliva, which promotes the remineralization of enamel lesions and reduces the net loss of minerals from tooth enamel. 116) Answers will vary. Fluoride, the ionic form of fluorine, may not be an essential nutrient because all basic body functions can occur without it.

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117) Answers will vary. Diets low in fruits and vegetables (rich sources of phytochemicals and antioxidant nutrients, such as selenium, vitamin C, and vitamin E) have been associated with an increased incidence of certain cancers. Selenium acts as a cofactor for glutathione peroxidase, which prevents the oxidative destruction of cell membranes by hydrogen peroxide and free radicals. Selenium also aids in the conversion of the thyroid hormone T4 to T3. The selenium content of the soil in an area greatly affects the amount of selenium in the foods from that area. In general meat, eggs, seafood, grains, and seeds are the best sources of selenium. In areas where the soil lacks selenium, deficiencies are more prevalent. Selenium deficiency increases the risk of Keshan disease and possibly certain cancers. Because selenium has a narrower range of safety for intake than most other trace minerals, selenium supplementation can cause symptoms of toxicity at lower levels of intake. However, research evidence does not suggest selenium, alone, PREVENTS cancer.Therefore, in advising an individual about supplements, it is important to understand that selenium supplements alone will not likely prevent cancer.An individual should assess his/her overall diet and determine needs for supplementation if selenium is deficient.

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CHAPTER 16 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) Preterm infants are born before 37 weeks of gestation. ⊚ ⊚

true false

Poor maternal nutrient intakes are linked with low birth weights. ⊚ ⊚

true false

3) A developing offspring's cells have separated into a stack of 3 layers (mesoderm, endoderm, and ectoderm) when the zygote stage ends. ⊚ ⊚

true false

4) Most critical period for fetal/embryonic development occur during the second trimester of pregnancy. ⊚ ⊚

true false

5) The placenta's size and ability to support fetal growth depend on the mother's nutritional status. ⊚ ⊚

true false

Low birth weightinfants have a greater risk for chronic diseasein adultlife. ⊚ ⊚

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true false

Insufficient intake of protein during pregnancy is very common in the U.S. ⊚ ⊚

true false

8) Compared to a nonpregnant woman, a pregnant woman needs additional calories and additional amounts of a few critical micronutrients. ⊚ ⊚

true false

9) Megadoses of prenatal vitamin and mineral supplements are dangerous for the mother, but not the fetus. ⊚ ⊚

10)

true false

Regular exercise can help control gestational diabetes. ⊚ ⊚

true false

11) Pregnant women should generally gain the most proportional weight during the first trimester. . ⊚ ⊚

true false

12) Insufficient weight gain in the last trimester of pregnancy increases the risk for fetal growth retardation. ⊚ ⊚

13)

true false

Insufficient prenatal care increases the risk of delivering a low birth weight baby.

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⊚ ⊚

14)

Eclampsia can cause maternal and fetal death. ⊚ ⊚

15)

true false

Smokers secrete nicotine in their breast milk. ⊚ ⊚

19)

true false

Herbal products offer a safe way to treat disease in pregnant women. ⊚ ⊚

18)

true false

Uncontrolled gestational diabetes can cause the fetus to be born with a low birth weight. ⊚ ⊚

17)

true false

Hormones synthesized by the placenta decrease the efficiency of insulin. ⊚ ⊚

16)

true false

Breast size is an indicator of successful breastfeeding. ⊚ ⊚

true false

20) A proposed goal of Healthy People 2030 is to increase the proportion of infants who are breastfed exclusively through age 6 months.

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⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 21) A characteristic of a favorable pregnancy outcome is ________. A) a gestation period longer than 37 weeks B) a live, healthy infant C) an infant who weighs at least 5.5 pounds D) All of these are characteristics of a successful pregnancy.

22)

A low birth weight infant weighs ________. A) less than 7.5 pounds B) less than 7 pounds C) less than 6 pounds D) less than 5.5 pounds

23) The most appropriate time to focus on nutrition in regards to a healthy pregnancy is ________. A) throughout childbearing years B) immediately after conception C) during the first trimester D) during the second trimester

24) Infants born after 37 weeks' gestation and weighing less than 5.5 pounds are labeled ________.

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A) healthy birth weight B) premature C) large for gestational age D) small for gestational age

25)

A small-for-gestational-age (SGA) infant ________. A) weighs less than 5.5 pounds B) is likely to have nutritional complications C) is likely to have medical complications D) All of these choices are correct.

26) During the first two weeks after conception, the developing offspring is known as ________. A) a zygote B) an embryo C) a fetus D) an ovum

27)

After the eighth week of pregnancy, the developing offspring is known as ________. A) a zygote B) an embryo C) a fetus D) an ovum

28)

On average, a full-term infant at birth ________.

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A) weighs 5 to 6 pounds and is about 18 inches long B) weighs 7 to 8 pounds and is about 20 inches long C) weighs 8 to 9 pounds and is about 26 inches long D) weighs 9 to 10 pounds and is about 22 inches long

29) About 1 in _____ pregnancies results in a spontaneous abortion, often before a woman even realizes she is pregnant. A) 2 B) 3 C) 4 D) 5

30)

Maternal nutrient deficiencies or exposure to toxins can cause _____ in the fetus. A) toxic levels of nutrient stores B) high birth weight C) abnormal organ function D) longer than normal gestation period

31)

Excessive calorie intake during pregnancy can result in a fetus that ________. A) has a high birth weight B) suffers from cretinism C) has decreased bone density D) has thyroid disorders

32) Serious fetal malformations may occur when pregnant women consume very large doses of vitamin ________.

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A) K B) C C) B-12 D) A

33) Neural tube defects may occur when women consume too little ____ before becoming pregnant. A) iron B) calcium C) folate D) zinc

34)

The fetus receives most nourishment through ________. A) the placenta B) amniotic fluid C) antibodies D) meconium

35)

Which of the following is NOT true about the placenta? A) It provides nourishment to the zygote. B) It synthesizes fatty acids, cholesterol, and glycogen. C) It produces hormones that affect the mother and fetus. D) It grows throughout pregnancy.

36)

The fetus accumulates most of itsbody fat and mineral stores ________.

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A) during the first trimester B) during the second trimester C) during the third trimester D) at any time during development

37) During the second trimester, a pregnant woman needs an average of an additional _______ kcal per day. A) 100 B) 350 C) 450 D) 500

38)

For pregnant woman, the RDA for protein increases by ___ over pre-pregnancy needs. A) 10% B) 15% C) 20% D) 50%

39)

Severe zinc deficiencies during pregnancy can cause ________. A) premature birth B) fetal growth retardation C) birth defects D) All of these are effects of zinc deficiencies during pregnancy.

40) An increased requirement for _________ during pregnancy is partly due to its role in the synthesis of red blood cells.

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A) vitamin E B) vitamin K C) folate D) calcium

41)

Maternal iron deficiency anemia can cause ________. A) premature birth B) infant death C) labor complications D) All of these are effects of iron deficiency.

42)

Physiological anemia that occurs during pregnancy ________. A) is the same as iron deficiency anemia B) is caused by insufficient intake of vitamin B-12 C) occurs because the plasma expands more than the number of red blood cells D) signals grave danger for the mother

43) The practice of eating non-food substances, such as clay or laundry starch, during pregnancy is called ________. A) hyperemesis B) pica C) pregnancy-induced hunger D) diuresis

44)

Daily during pregnancy, women should try to ________.

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A) drink 3 cups of milk or milk products B) restrict nuts and dairy to prevent allergies for the newborn C) minimize intake of strong-tasting vegetables to 1 serving D) restrict their protein intake

45)

Under what condition(s) is/are the use of nutrient supplements advisable? A) Adolescent pregnancy B) Multiple fetuses C) Poverty D) Inadequate maternal diet E) All of these choices are accurate.

46)

A pregnant woman who is a vegan likely needs to take ______ nutrient supplements. A) vitamin E andriboflavin B) calcium andiron C) protein and vitaminA D) thiamin andvitamin C

47) The RDA for iron during pregnancy increases greatly. To reach this level the pregnant woman may ________. A) need to take a prenatal iron supplement B) need to double or triple the number of multivitamin-mineral tablets taken every day C) need to avoid cooking in iron cookware D) need to decrease her intake of vitamin C-rich fruits and vegetables which would lower the bioavailability of iron

48)

Which condition increases the risk of a poor pregnancy outcome?

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A) Young maternal age B) Fasting during pregnancy C) Food contaminants D) Eating disorders E) All of theseresponses are correct.

49)

An infant's birth weight is closely related to ________. A) the length of gestation B) the mother's pre-pregnancy weight C) the weight the mother gains during pregnancy D) All of these choices are correct.

50)

Obese pregnant women have an increased risk for ________. A) low blood pressure B) gestational diabetes C) ketosis D) inadequate placenta development

51)

Women who begin pregnancy underweight have an increased risk for ________. A) high blood pressure B) gestational diabetes C) ketosis D) poor nutrient stores

52) Adolescents often have smaller babies than mature women. They are advised to gain more weight during pregnancy to ________.

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A) provide calories needed for the infant to be larger than normal at birth B) avoid ketosis C) meet both the fetal and mother's growth needs D) All of these choices are accurate.

53)

For the best pregnancy outcome, overweight women (BMI > 26 to 29) should ________. A) not gain any weight during pregnancy B) gain slightly more weight than women who begin pregnancy at a healthy weight C) gain about 15 to 25 pounds during pregnancy D) lose at least 4 or 5 pounds during pregnancy

54) Which component of weight gain accounts for the greatest amount of increased weight during pregnancy? A) Infant B) Placenta C) Amniotic fluid D) Breast tissue E) Maternal bloodsupply

55) Women who begin pregnancy at a normal BMI should gain about ____ pounds during pregnancy. A) 15 B) 15 to 25 C) 25 to 35 D) 28 to 40

56) Women who begin pregnancy at a low BMI should gain about ___ pounds during pregnancy. Version 1

A) 15 to 25 B) 25 to 35 C) 28 to 40 D) 45 to 55

57) Which of these conditions indicates thata woman needs to pay particular attention to the quality of her diet during pregnancy? A) Eating disorders B) Phenylketonuria C) Diabetes D) All of thesechoices are correct.

58)

Which of the following factors may deplete a woman's nutrient stores? A) Numerous previous pregnancies B) Preterm births C) Pregnancies after age 35 D) Pregnancies more than 3 years apart

59)

Pregnancy-induced hypertension ________. A) is a normal and expected condition seen during pregnancy B) occurs because of the increase in maternal plasma that occurs during pregnancy C) can develop into a deadly condition called eclampsia D) is also called hemodilution E) None of these choices are correct.

60)

A characteristic of preeclampsia is ________.

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A) intense hunger B) low blood pressure C) strong feelings of thirst D) blurred vision and headaches

61)

Gestational diabetes ________. A) is a normal and expected condition seen during pregnancy. B) can develop into a deadly condition called eclampsia. C) is most common in women with a family history of diabetes. D) All of these choices are correct.

62) To keep gestational diabetes under control, recommendations for pregnant women include ________. A) regular exercise B) eating high glycemic load carbohydrates through the day C) taking chromium supplements D) All of these choices are correct.

63)

A maternal practice that can be harmful to the fetus is ________. A) a low-carbohydrate diet B) fasting C) smoking D) All of these choices are accurate.

64)

WIC serves low-income ________.

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A) children up to the age of 5 B) newborns and infants C) pregnant & breastfeeding mothers D) All of these choices are accurate.

65)

WIC aims to provide ________. A) nutrition education B) nutritional care C) nutritious food D) All of these choices are accurate.

66)

Participation in WIC is associated with ________. A) fewer infant deaths B) lower birth weights C) higher medical costs after birth D) All of these choices are accurate.

67) The bacterium Listeria monocytogenes can be fatal to the developing fetus. What foods are possible sources of this bacterium and should be avoided by pregnant women? A) Pasteurizedmilk B) Yogurt C) Brie andblue-veined cheeses D) All of these choices are accurate.

68)

Heavy caffeine intake during pregnancy may ________.

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A) decrease iron absorption B) increase risk for spontaneous abortion C) increase risk for low birth weight D) All of these choices are accurate.

69)

Exposure to alcohol during fetal life may cause ________. A) inadequate prenatal and infant growth B) physical deformities C) mental retardation D) All of these choices are correct.

70) Decreased learning capacity in childhood has been linked to exposure to ____ during fetal life. A) excessive calcium B) alcohol C) inadequate vitamin C D) inadequate vitamin D

71)

To avoid constipation, pregnant women should increase intake of ________. A) milk and dairy products B) whole-grain bread, bran, and fruits C) sugars and starches D) lean meat, poultry, and fish

72)

Edema during late pregnancy is a problem if ________.

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A) hypertension is detected B) excess protein is found in the urine C) extreme fluid retention occurs D) All of these choices are correct. E) None of these choices are correct.

73)

To reduce heartburn symptoms, pregnant women should ________. A) exercise right after meals B) eat larger meals in the morning C) limit caffeine and chocolate intake D) All of these choices are correct.

74)

To minimize nausea during pregnancy, pregnant women should ________. A) wear strong perfume B) drink a large glass of cool water before getting out of bed in the morning C) breathe warm, moist air D) None of these responses are accurate.

75)

The ability to produce milk is affected by the hormone ________. A) prolactin B) estrogen C) progesterone D) insulin E) thyroxine

76)

The let-down reflex in breastfeeding is controlled by the hormone ________.

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A) oxytocin B) prolactin C) estrogen D) progesterone E) secretin

77)

The let-down reflex is inhibited by ________. A) feeling confident and relaxed B) nervous tension and fatigue C) a sleepy baby D) All of these responses are correct.

78)

The first fluid secreted by the mother's breast after giving birth is called ________. A) colostrum B) prolactin C) lactalbumin D) mature milk

79) A factor in human milk that helps prevent the growth of some harmful bacteria in an infant's intestinal tract is ________. A) lactase B) albumin C) intrinsic factor D) Lactobacillus bifidus factor

80)

Compared to pregnancy, the RDA for nutrients changes during lactation ________.

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A) only for energy B) only for protein and energy C) for many nutrients, but not proportionately for all nutrients D) None of these responses are correct; nutrient needs during lactation are the same as during pregnancy.

81) Average additional dietary energy requirements for lactation are approximately _______ kcal per day. A) 100 - 200 B) 250 - 350 C) 400 - 500 D) 550 - 650

82)

To produce human milk, a lactating woman needs ________. A) 100 - 200 extra kcal per day above pre-pregnancy needs B) twice as much dietary protein as needed during pregnancy C) additional fluid daily D) twice as much dietary iron as needed during pregnancy E) All of these choices are accurate.

83)

A benefit of breastfeeding for mothers is ________. A) reduced risk for ovarian cancer B) less postpartum bleeding C) postpartum weight loss D) All of these responses are correct.

84)

Women are more likely to choose to breastfeed their infants if they ________.

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A) know the advantages of breastfeeding B) have a supportive partner C) deliver babies in a hospital that supports breastfeeding D) All of these choices are correct.

85)

Consuming alcohol while breastfeeding ________. A) is recommended to help mothers relax B) increases milk output C) may cause babies to have disrupted sleep patterns D) may cause babies to drink more milk

86) Which of the following would you recommend to a friend that is having difficulties breastfeeding her baby? A) Drink alcohol. This will have a relaxing effect. B) Find a relaxing environment to breastfeed your baby. C) Consume more milk. The excess milk will be converted into breastmilk. D) Decrease calorie intake. This will help with the production of more milk.

87) Your sister is pregnant and is very uncomfortable. She is experiencing heartburn daily and is looking for some relief. In your nutrition class, you just learned about heartburn during pregnancy. What advice can you offer her? A) Eat smaller meals more frequently to decrease the volume of food in the stomach. B) Do not lie down after eating to avoid the effects of gravity. C) Talk to her doctor about using antacids for relief. D) All of these choices could give her some relief.

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88) Your friend just told you she is pregnant. She is concerned about the amount of weight she will gain during her pregnancy and is looking for some advice so that she and her baby can be healthy. Her pre-pregnancy weight was 155 pounds and she is 5'5" tall. Based on her prepregnancy weight, how much weight should your friend gain during her pregnancy? A) 11 to 20 lbs B) 15 to 25 lbs C) 25 to 35 lbs D) 28 to 40 lbs

89) Which of the following exercises would be most appropriate to continue to perform during a healthy pregnancy? A) Kickboxing B) Zumba C) Swimming D) Jogging

90)

Beginning a pregnancy with hypertension may lead to all of the following EXCEPT A) Intrauterine growth retardation B) Preterm birth C) Insomnia D) Stillbirth

91)

All of the following are goals of Healthy People 2030 EXCEPT

A) To eliminate caffeine use during pregnancy and lactation. B) To reduce the number of preterm births. C) To increase the proportion of infants who are breastfed exclusively through age 6 months. D) Abstinence from alcohol, cigarettes, and illicit drugs by pregnant women.

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SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 92) Design an appropriate exercise program for a healthy, pregnant female. Explain the benefits of this program and why this program is associated with the least possible risks.

93)

Explain why breastfeeding is beneficial to the mother.

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Answer Key Test name: Chap 16_3e_Test Bank 1) TRUE TRUE statement 2) TRUE TRUE statement 3) TRUE TRUE statement 4) FALSE 5) TRUE TRUE statement 6) TRUE TRUE statement 7) FALSE Protein intake is sufficient before and during pregnancy in the U.S., since most Americans regularly consume above the RDA. 8) FALSE In just 9 months or so, a mother’s body provides all the calories and nutrients needed to produce an infant 5000 times larger than the fertilized egg. To accomplish this, a pregnant woman needs additional calories and more of almost every nutrient than a nonpregnant woman. The extra calories and nutrients support the growth and development of the fetus, placenta, and mother’s body, as well as increased maternal metabolism. 9) FALSE Version 1

It is important not to exceed the recommended dose because megadoses of vitamin and mineral supplements can be dangerous for both the pregnant woman and the fetus. For example, iron, zinc, selenium, and vitamins A, B-6, C, and D can exert toxic effects when taken in large doses. 10) TRUE TRUE statement 11) FALSE Few, if any, of these extra calories are needed during the 1st trimester of pregnancy, when the developing offspring gains little weight. During the 2nd trimester, a daily increase of about 350 calories is recommended. And in the 3rd trimester, a daily increase of approximately 450 calories is recommended. 12) TRUE TRUE statement 13) TRUE TRUE statement 14) TRUE TRUE statement 15) TRUE TRUE statement 16) FALSE

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Untreated gestational diabetes can severely deplete fetal iron stores. In addition, uncontrolled diabetes can cause the fetus to grow quite large. The oversupply of glucose from maternal circulation signals the fetus to increase insulin production, which causes fetal tissues to readily use glucose for growth. Another threat is that the infant may have low blood glucose at birth because of the tendency to produce extra insulin, which began during gestation. Other concerns are the potential for preterm delivery and increased risk of birth trauma and malformations. 17) FALSE Alcohol, drugs, herbal and botanical products, and smoking are lifestyle choices that increase the risk of a poor pregnancy outcome. A woman should avoid substances that can harm the developing offspring, especially during the 1st trimester. 18) TRUE TRUE statement 19) FALSE Women with small breasts can produce all the milk their babies need; there is no relationship between breast size and quantity of milk produced. 20) TRUE 21) D 22) D 23) A 24) D 25) D 26) A 27) C 28) B 29) A Version 1

30) C 31) A 32) D 33) C 34) A 35) A 36) C 37) B 38) D 39) D 40) C 41) D 42) C 43) B 44) A 45) E 46) B 47) A 48) E 49) D 50) B 51) D 52) C 53) C 54) A 55) C 56) C 57) D 58) A 59) C Version 1

60) D 61) C 62) A 63) D 64) D 65) D 66) A 67) C 68) D 69) D 70) B 71) B 72) D 73) C 74) D 75) A 76) A 77) B 78) A 79) D 80) C 81) C 82) C 83) D 84) D 85) C 86) B Tension and anxiety can prevent oxytocin from controlling the letdown reflex to release milk from the breast. 87) D Version 1

These are all recommendations to alleviate heartburn. 88) B This woman’s BMI is 26 (70.45kg/2.7m); therefore her recommended weight gain would be for an overweight individual, which is 15-25 lbs. 89) C Swimming would be the likely least intense and aerobically jarring exercise of those listed. 90) C The offspring of women who begin pregnancy with hypertension have a greater risk of experiencing intrauterine growth retardation and preterm birth. High blood pressure may cause the placenta to separate from the uterus before birth, which can lead to stillbirth. Controlling hypertension before and during pregnancy reduces the risk of complications. 91) A

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92) A low or moderate intensity exercise program can offer physical and psychological benefits to a woman experiencing a normal, healthy pregnancy. Benefits include improved cardiovascular function, an easier and less complicated labor, and an improved attitude and mental state. Exercise also can help prevent or treat gestational diabetes. Infants born to women who exercise tend to be leaner and more neurologically mature than babies born to nonexercisers. Women with high risk pregnancies, such as those experiencing premature labor contractions, may need to restrict their physical activity. Exercise moderately for about 30 minutes daily on most days of the week. ● Drink plenty of liquids to maintain normal fluid and electrolyte balance and avoid dehydration. ● Keep heart rate below 140 beats per minute to maintain adequate blood (and oxygen) flow to the fetus. ● Include a cool-down period at the end of exercise sessions so that heart rate can gradually return to normal. After about the 4th month, avoid exercises that are done while lying down because the enlarged uterus compresses blood vessels and cuts down blood flow to the fetus. ● Avoid deep flexing (e.g., deep knee bends), joint extensions (e.g., leg stretches), and activities that jar the joints (e.g., jumping) because connective tissue that has become more elastic to facilitate normal childbirth can be damaged if overstressed in exercise. ● Prevent increases in body temperature by not exercising in hot, humid weather or engaging in strenuous activities for more than 15 minutes. High body temperatures can damage enzymes that regulate fetal development. ● Stop exercising immediately if discomfort occurs—aches and pains are a warning that something may be wrong. ● Avoid strenuous or endurance activities because they can cause Version 1

lower than normal birth weights. ● Avoid activities that could cause abdominal trauma (e.g., horseback riding, martial arts), that involve rapid shifts in balance or body position that may cause accidental falls (e.g., basketball, skiing, hockey), or that compress the uterus (e.g., scuba diving). ● Avoid becoming overly tired. 93) Earlier recovery from pregnancy due to the action of hormones that promote a quicker return of the uterus to its prepregnancy state Decreased risk of ovarian and premenopausal breast cancer Potential for quicker return to prepregnancy weight Potential for delayed ovulation and therefore reduced chances of pregnancy (a short-term benefit, however) Potential bone remineralization to levels exceeding those before lactation Less postpartum bleeding Reduced risk of type 2 diabetes among women with no history of gestational diabetes Reduced risk of Metabolic Syndrome later in life Reduced risk of rheumatoid arthritis if the mother breastfeeds for more than 12 months during her lifetime Decreased feelings of depression in postpartum period after childbirth Lower household food costs (extra food for a breastfeeding mother is less expensive than infant formula)

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CHAPTER 17 TRUE/FALSE - Write 'T' if the statement is true and 'F' if the statement is false. 1) One-third of all growth in a lifetime occurs during adolescence. ⊚ ⊚

true false

2) Per pound of body weight, nutrient needs during adolescence are higher than duringany other stage of the lifecycle. ⊚ ⊚

true false

Adolescence begins with the onset of puberty. ⊚ ⊚

true false

The growth percentile curve a child follows depends ONLY on his/her genetic potential. ⊚ true ⊚ false

"Catch up" growth is possible after the epiphyses have closed. ⊚ ⊚

More amino acids are considered essential for adults than for infants. ⊚ ⊚

true false

Teens in the U.S. tend to consume far more calcium than needed.

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⊚ ⊚

true false

8) In the U.S., infant formula standards are set to match the nutrient composition of human milk as closely as possible. ⊚ ⊚

true false

9) Breastfed infants have a reduced risk of obesity and ear infections, as compared to formula-fed infants. ⊚ ⊚

10)

Infant formula should be prepared with cold water. ⊚ ⊚

11)

true false

Adding too much water to infant formula can be dangerous to the infant. ⊚ ⊚

13)

true false

Infant formulas can be heated safely in the microwave oven. ⊚ ⊚

12)

true false

An infant's nutrient stores are exhausted by the time the infant has gained 3 pounds. ⊚ ⊚

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true false

14)

Bribing children to eat a new food is a good way to help them discover new foods. ⊚ ⊚

true false

15) To help children keep their weight under control, they should receive no more than 3 meals daily. ⊚ ⊚

16)

Serving new foods in a calm, supportive setting can help children to accept new foods. ⊚ ⊚

17)

true false

Babies with colic should not be breastfed. ⊚ ⊚

20)

true false

Substance use can negatively affect teenagers' diets. ⊚ ⊚

19)

true false

The physical changes of adolescence can cause teens to be dissatisfied with their bodies. ⊚ ⊚

18)

true false

In children, gastroesophageal reflux is most common after age 2 years. ⊚ ⊚

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true false

21)

Milk allergies seldom last beyond 3 years of age. ⊚ ⊚

22)

true false

Acne is strongly linked with intake of fatty foods like pizza and chocolate. ⊚ ⊚

true false

23) A female who becomes pregnant within 2 years of menarche is at a higher nutritional risk than one who becomes pregnant later. ⊚ ⊚

true false

24) Children should be screened for elevated blood cholesterol if their families have histories of early development of heart disease. ⊚ ⊚

true false

25) Leftover infant formula should always be discarded because it is contaminated by bacteria and enzymes from the baby. ⊚ ⊚

26)

true false

Children with autism frequently have unusual eating behaviors. ⊚ ⊚

true false

27) Children with autism often have reduced sensitivity to food taste, smell, color, and/or texture.

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⊚ ⊚

true false

MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 28) During the first year of life, the infant increases in length by ________% over what it was at birth. A) 20 B) 33 C) 50 D) 100

29) According to present-day growth charts, the average infant will double its birth weight at about ________ months of age and will triple its birth weight at about ________ months. A) 4 to 6; 12 B) 2 to 3; 6 C) 10; 12 to 18 D) 12; 18

30)

An infant's birth weight generally ________ during the first year of life. A) increases very little B) doubles C) triples D) quadruples

31)

When adolescence ends, females generally have ____ as much lean body mass as males.

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A) one-third B) half C) two-thirds D) four-fifths

32)

When adolescence ends, males generally have ____ as much body fat as females. A) one-third B) half C) two-thirds D) four-fifths

33) Throughout the adolescent years, both males and females gain about____% of their adult height. A) 5 B) 15 C) 25 D) 35

34) When adolescence ends, on average both males and females weigh _____% more than when they entered this life stage. A) 10 to 25 B) 25 to 45 C) 45 to 85 D) 75 to 105

35)

By the age of about _____ years, body water levels are similar to those of adults.

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A) 2 to 3 B) 5 to 6 C) 8 to 9 D) 11 to 13

36)

Changes in height and weight in children are used to indicate ________. A) the effectiveness of the caregiver B) long-term effects of nutrition C) energy intake D) the child's genetic potential for development

37)

Over time, measurements of height, weight, and head circumference ________. A) are used to assess an infant's growth and development B) are used to compare an infant's growth to others of the same age and gender C) are used by pediatricians to look for health problems D) All of these choices are accurate.

38)

A child is diagnosed as obese when ________. A) BMI-for-age reaches the 85th percentile B) stature-for-age reaches the 95th percentile C) BMI-for-age reaches the 95th percentile D) weight-for-age reaches the 90th percentile

39)

A child is considered underweight when ________.

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A) BMI-for-age drops below the 25th percentile B) weight-for-age drops below the 10th percentile C) BMI-for-age drops below the 5th percentile D) stature-for-age drops below the 25th percentile and weight-for-age drops below the 10th percentile

40)

Which is a good indicator of long-term (versus recent) nutritional status? A) Stature-for-age B) BMI-for-age C) Headcircumference-for-age D) All of these are good indicators of recent nutritional status.

41) Infants and children who do not grow at the expected rate for several months are more than likely experiencing ________. A) epiphyseal growth B) failure to thrive C) physical depression D) poor socialization

42)

Which is true about growth in height? A) It cannot occurafter the epiphyses fuse. B) It cannot occurbefore the epiphyses fuse. C) The epiphyses arenot related to growth in height.

43)

Growth plates at the end of long bones are called ________.

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A) calcification B) osteoporosis C) rickets D) epiphyses

44)

What could cause failure to thrive in an infant? A) Physical problems B) Poor infant-parent interactions C) Inborn errors of metabolism D) All of these choices are correct. E) None of these choices are correct.

45) Except for pregnancy and lactation, the total quantities of nutrients and calories needed during ____ are greater than any other stage of the life cycle. A) infancy B) childhood C) adolescence D) All of these responses are correct.

46)

Newborns need about ____ calories per pound of body weight each day. A) 10 B) 25 C) 50 D) 100

47)

Total calorie needs peak for females at about age ____.

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A) 3 to 4 years B) 6 to 7 years C) 11 to 13 years D) 15 to 16 years

48)

The high metabolic rate of infants results from ________. A) the large surface area of the infant’s body B) the calories needed to digest food C) the physical activity of the infant D) All of these choices are accurate.

49) The protein needs of an infant are about ___ as much per pound of body weight as adults'. A) one-fourth B) half C) twice D) three times

50) In developing countries, inadequate intake of ____ is a primary contributor to stunted growth, childhood illness, and death. A) carbohydrate B) protein C) fat D) vitamin A

51)

What percent of calories should total fat make up in an infant's diet?

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A) 20% or less B) 20% to 30% C) 40% to 55% D) 50% to 75%

52)

The primary carbohydrate in the diet of most infants is ________. A) sucrose B) glucose C) lactose D) maltose

53)

High-protein diets are not good for infants ________. A) unless they are highly digestible proteins B) because they are hypoallergenic C) because the infant's kidneys cannot clear large amounts of urea every day D) All of these choices are accurate.

54) About how much protein should an 18-pound (i.e., 8.2 kg), 10-month-old baby consume each day? A) 8 grams B) 24 grams C) 12 grams D) 32 grams

55) day?

About how much protein should a 24-pound (i.e., 11.0 kg), 2-year-old be consuming each

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A) 12 grams B) 28 grams C) 38 grams D) 50 grams

56)

Why do infants have a greater need for water than older humans? A) Infants have a high body surface area. B) Infants have a greater proportion of body water. C) Infants' kidneys are not as efficient. D) All of these responses are correct. E) None of these responses are correct.

57)

When is an infant likely to need supplemental water? A) When the infant has a fever B) When the infant has diarrhea C) When the weather is hot D) All of these choices are correct. E) None of these choices are correct; an infant never needs supplemental water.

58)

An infant may suffer from water intoxication when ________. A) overfed water instead of formula B) the weather is hot C) infant formula powderis underdiluted D) the infant has a fever

59) Infant iron stores are typically exhausted by _________ of age and need to be replaced by their diet.

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A) 0 to 2 months B) 4 to 6 months C) 7 to 8 months D) 10 to 12 months

60)

Why are adolescents at risk for iron deficiency anemia? A) Blood volume is expanding. B) Menstruation begins in females. C) Lean body mass increases in males. D) All of these choices are accurate.

61)

Fluoride supplements should generally be given to ________. A) breastfed infants beginning at 1 month old B) infants after 6 months of age if the home's water supply is not fluoridated C) all children until they begin using fluoride-containing toothpaste D) None of these choices are accurate.

62)

Which infants have special vitamin needs?

A) Infants at birth need vitamin K. B) Breastfed infants may need iron supplements. C) Breastfed infants whose mothers are vegans generally need vitamin B-12 supplements. D) All of these choices are accurate.

63)

It is best to avoid serving cow's milk until the infant reaches the age of ________.

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A) 6 months B) 10 months C) 12 months D) 18 months

64) With the possible exception(s) of _____, human milk provides sufficient amounts of all the nutrients needed during the first 6 months of life. A) vitamin D B) iron C) fluoride D) All of these choices are accurate. E) None of these choices are accurate.

65)

Which protein in human milk increases iron absorption? A) Casein B) Lactalbumin C) Lactoferrin D) Bifidus factor

66)

Compared to foremilk, hind milk has ________. A) more fat B) more protein C) fewer calories D) All of these choices are correct.

67)

Which is NOT true about the fat in human milk?

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A) The type of fattyacids in human milk depends on the mother's diet. B) The fats in humanmilk are provided by the mother's diet and are synthesized in the breast. C) Human milk is lowin cholesterol and linoleic acid. D) Human milkcontains omega-3 fatty acids to support brain and eye development.

68) If human milk or infant formula is not available, ____ can provide a safe, nutritious alternative for infants. A) sweetened condensed milk B) soy drinks C) evaporated milk D) All of these are healthy alternatives to human milk or infant formula. E) None of these are healthy alternatives to human milk or infant formula.

69)

Why is cow's milk not recommended for infants? A) Its calcium content is too low. B) Its vitamin E content is too high. C) Its protein content is too high. D) Its vitamin C content is too high. E) All of these responses are accurate.

70)

An advantage to infants of being breastfed is ________. A) reduced risk for food allergies B) enhanced visual acuity and learning ability C) reduced risk for crooked teeth D) reduced risk for diarrhea E) All of these are advantages of breastfeeding for the infant.

71)

What are signs that an infant has had enough to eat?

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A) Becoming playful B) Falling asleep C) Turning head away or not paying attention D) All of these choices are accurate.

72)

How can you tell a breastfed infant is receiving adequate nourishment? A) The infant has 6or more wet diapers daily. B) Weight gain is normal according to growth charts. C) The infant has 1to 2 bowel movements daily that look like lumpy mustard. D) All of theseanswers are correct.

73)

A baby should generally be burped ________. A) every 2 to 3 minutes during feeding B) after giving 1 to 2 ounces of formula C) at the beginning of the feeding D) when the baby begins to spit up a bit of milk

74)

The time to introduce solid foods to an infant's diet depends on his or her ________. A) nutritional needs B) physiological capabilities C) physical abilities D) All of these responses are correct.

75)

Which is NOT a sign that an infantmay be ready for solid foods?

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A) The infantcansit alone with support. B) The extrusionreflex is strong. C) Theinfantcan make a chewing motion. D) Theinfantdemands to be fed 8 to 10 times daily.

76)

Introducing solid foods to an infant's diet before the infant needs them can ________. A) potentially strain the young infant's organs B) help the child sleep through the night C) help the child walk at a younger age D) help the child achieve optimal height

77) By age 1 year, the calories provided from human milk or formula should be ____ the calories provided by solid food. A) twice as high as B) equal to C) half as many as D) one-third as high as

78)

The first solid food usually introduced to the infant's diet is ________. A) cow's milk B) strained fruits C) pureed meats D) iron-fortified infant cereals

79)

When a new food is introduced, the amount that should be served is about ________.

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A) 1 teaspoon B) 2 tablespoons C) 1/4 cup D) 1/3 cup

80)

When serving a food for the first time to an infant, ________. A) the food should be a single-ingredient (not mixed) food item B) wait several days before serving another new food C) expect the baby to eat only a few bites D) All of these responses are correct.

81)

Which cereal is least likely to cause allergies in infants? A) Rice B) Wheat C) Barley D) Oats

82)

When are many babies ready for finger foods? A) 1 month of age B) 3 months of age C) 6 months of age D) 9 months of age

83) What is wrong with giving juice in a bottle or propping up a bottle of formula for the child to drink at bedtime?

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A) There is nothing wrong with this practice. It helps the child grow developmentally. B) Sugar bathes theteeth, bacteria grow, acids are produced from sugar, and acids dissolve toothenamel. C) It is best for aninfant to be held when drinking from a bottle for the sense of security that itprovides. D) Often, thecontents of the bottle spoil, which can lead to gastrointestinal upsets.

84)

It is recommended that honey not be given to infants because it ________. A) is high in energy B) may contain Salmonella C) may contain Clostridium botulinum spores D) is too sweet

85) For normal-weight children, reduced-fat milk is recommended to be introduced into a child's diet ________. A) after 5 years of age B) after 4 years of age C) after 2 years of age D) after 6 months of age

86)

Which food on this list is NOT appropriate for an infant less than one year old? A) Egg yolk B) Honey C) Orange juice D) Cooked and strained vegetables

87)

Which of these foods pose a choking hazard for infants and children?

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A) Popcorn B) Peanut butter C) Nuts D) Grapes E) All of these foods pose choking hazards.

88)

A child who exhibits signs of ____ may be suffering from undernutrition. A) fatigue B) increased susceptibility to infection C) underweight D) All of these are signs of undernutrition.

89)

An appropriate serving size of carrots for a 3-year-old is approximately ________. A) 3 teaspoons B) 3 tablespoons C) 1/3 cup D) 2/3 cup

90)

Which foods are typically NOT likely to appeal to preschool children? A) Thick beef stew B) Creamy tuna casserole C) Spicy chicken D) All of these choices are correct.

91)

To help children develop good nutritional habits, ________.

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A) limit the number of new foods they are offered B) let children make some choices about the food they eat C) serve new foods at the end of the meal when the child is not hungry D) be certain children finish all the food they are served

92)

The preschool years are typically characterized by ________. A) a slower growth rate B) a decreased appetite C) changes in eating behavior D) All of these choices are accurate.

93)

What do preschool typically children like to eat? A) Familiar foods B) Foods served at comfortable temperatures C) Mild flavors D) Crisp-textured foods E) All of these choices are accurate.

94)

To get a child to try a new food, ________. A) offer food rewards, such as a favorite dessert B) add sugar or butter to the food C) employ the "one bite" rule D) All of these choices are accurate.

95)

Which is NOT a common mealtime challenge with preschoolers?

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A) Picky eating B) Food jags C) Refusing to eat D) Pica

96)

Which food-related behaviors can negatively affect the quality of adolescents' diets? A) Meal skipping B) Snacking C) Eating out D) All of these choices are correct.

97)

What is a typical nutritional problem of adolescent girls? A) Not drinkingmilk B) Iron deficiencyanemia C) Frequent dieting D) All of these choices are correct.

98)

Constipation in many children is often caused by: A) drinking too much water B) drinking too much milk C) eating too many snacks D) All of these choices are correct.

99)

A typical sign of dehydration in an infant is ________.

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A) no or few tears when crying B) severe drooling C) ear aches D) All of these are signs of dehydration.

100)

A baby that sleeps with a bottle filled with formula has an increased risk for ________. A) ear infections B) diarrhea C) allergies D) colic

101)

What factor(s) contributes to childhood obesity? A) Increased levels of “screen time” B) Genetics C) High-fat, high-energy snacks D) Little physical activity E) All of these choices are correct.

102)

What is the recommended treatment for childhood obesity? A) Increase physicalactivity. B) Decrease intake ofhigh-fat, high-energy foods. C) Modify problem behaviors, such as snacking while watching TV. D) All of these choices are correct.

103)

Iron deficiency anemia is most likely to occur ________.

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A) between birth and age 3 months B) between the ages of 12 and 24 months C) between the ages of 3 to 5 years D) after the child starts school

104) Instead of a double cheeseburger from a fast food restaurant for lunch, the hungry adolescent could make a healthier choice by choosing ____ instead. A) french fries and fruit juice B) a hot dog andcola C) a grilled chicken sandwich with lettuce and tomato D) fried chicken and creamy potato salad E) None of these choices are correct.

105)

Menarche is ________. A) cell division B) cell growth C) the onset of menses D) the excretion of lipids, waxes, and triglycerides E) excessive restlessness

106) Your friend is concerned that her son is gaining too much weight. Before seeking advice from her son's pediatrician, she wants you to give her your opinion because she knows you are taking a nutrition class. You learn from her that her son is 3' 10" and currently weighs 60 lbs. You also remember that he just had his 6th birthday. How would you classify her son after calculating his BMI? A) Underweight B) Normal weight C) Overweight D) Obese

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107) Common nutrition related challenges during adolescents include all of the following EXCEPT: A) Teenage pregnancy B) Obesity C) Inadequate nutrition knowledge D) Decreased caloric requirements E) Acne

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 108) Why should leftover formula always be discarded?

109) List suggested recommendations for lifestyle modifications for an obese 10-year-old child.

110) Describe why young children are at a higher risk for developing iron deficiency anemia. What modifications can be made to help decrease their risk?

111)

Explain why infants need more calories per unit of body weight than adults.

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112)

Discuss specific recommendations for supplements in children, if any.

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Answer Key Test name: Chap 17_3e_Test Bank 1) TRUE 2) FALSE Nutrient needs are highest proportionately per pound of body weight during infancy. 3) TRUE 4) FALSE The percentile curve a specific child follows depends on dietary intake and genetic potential. 5) FALSE Growth in height ceases when the growth plates at the ends of the bones, called epiphyses, fuse. 6) FALSE Young infants need all the essential amino acids that adults do, as well as some others that are also considered essential for infants. 7) FALSE Drinking soft drinks in place of milk causes many teenagers to have inadequate calcium intake. This practice is linked to decreased bone mass and increased bone fractures in this age group. Figure 2-3 in Chapter 2 shows the stark contrast between milk and soft drinks with respect to calcium and other nutrients. If dairy products are not consumed, alternative calcium sources need to be included in the diet. 8) TRUE 9) TRUE 10) TRUE Version 1

11) FALSE Infant formula and human milk fed from a bottle should not be heated in a microwave oven because hot spots may develop, which can burn the infant’s mouth and esophagus. 12) TRUE It is important to prepare formula by exactly following instructions on the label of powdered and concentrated formulas—adding too much or too little water can be very dangerous for infants. 13) FALSE The nutrient stores a baby had at birth are exhausted by the time an infant has doubled his or her birth weight and weighs at least 13 pounds. 14) FALSE Bribing children with food, like dessert, also teaches them that food is an appropriate reward. At the other end of the spectrum lie parents who are so excessively concerned that their children will become obese that they restrict their children’s food intake. In some cases, caregivers restrict food intake so severely that the children become underweight and fail to thrive. Pressuring a child to eat more or less than is desired tells the child not to trust his or her own hunger and satiety signals—this can lead to a lifetime battle with weight problems. 15) FALSE

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Children have small stomachs. Offering them 6 or so small meals succeeds better than limiting them to 3 meals each day. Sticking to 3 meals a day offers no special nutritional advantages; it’s just a social custom. When we eat isn’t nearly as important as what we eat. Frequent meals and snacks help children meet their nutrient and calorie needs, as well as keep their blood glucose levels high enough to support the activity of their rapidly developing brain and nervous system. Breakfast and snacks are especially important. 16) TRUE 17) TRUE 18) TRUE 19) FALSE Breastfeeding of colicky infants should continue. Mothers can try decreasing or stopping their consumption of milk and milk products, caffeine, chocolate, and strongly flavored vegetables to see if it helps reduce colic. 20) FALSE GERD typically develops before age 2 to 3 months and usually resolves on its own by the time an infant is 12 months old. 21) TRUE 22) FALSE Although it’s popularly believed that eating nuts, chocolate, and pizza can make acne worse, scientific studies have failed to show a strong link between any dietary factor and acne. Actually, acne develops when excess oily secretions block glands in the skin. 23) TRUE 24) TRUE 25) TRUE Version 1

26) TRUE 27) FALSE Food taste, smell, color, and/or texture may cause hypersensitive children to restrict or avoid certain foods or groups of foods and be unwilling to try new foods. 28) C — 29) A 30) C 31) C 32) B 33) B 34) C 35) A 36) B 37) D 38) C 39) C 40) A 41) B 42) A 43) D 44) D 45) C 46) C 47) D 48) A 49) C 50) B Version 1

51) C 52) C 53) C 54) C 8.2 kg x 1.5g/kg = 12.75 g. Recommendations for infancy are 1.5 g protein/kg body weight 55) A 11kg x 1.1g/kg = 12.1 g. Recommendations for 1-3 year-olds are 1.1 g protein/ kg body weight. 56) D 57) D 58) A 59) B 60) D 61) B 62) D 63) C 64) D 65) C 66) A 67) C 68) E 69) C 70) E 71) D 72) D 73) B 74) D 75) B Version 1

76) A 77) B 78) D 79) A 80) D 81) A 82) D 83) B 84) C 85) C 86) B 87) E 88) D 89) B 90) D Children tend to like foods with crisp textures and mild flavors, as well as familiar foods. Because their taste buds are more sensitive than those of adults, preschool children often refuse to eat strongly flavored foods. In addition, young children are especially sensitive to hot-temperature foods and tend to reject them. Children also may object to having foods mixed, as in stews and casseroles, even if they like the ingredients separately. 91) B 92) D 93) E

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Children tend to like foods with crisp textures and mild flavors, as well as familiar foods. Because their taste buds are more sensitive than those of adults, preschool children often refuse to eat strongly flavored foods. In addition, young children are especially sensitive to hot-temperature foods and tend to reject them. Children also may object to having foods mixed, as in stews and casseroles, even if they like the ingredients separately. 94) C 95) D 96) D 97) D 98) B 99) A 100) A 101) E 102) D 103) B 104) C A grilled chicken sandwich with vegetables provides more nutrient density. 105) C 106) D On the BMI growth chart, he is falling above 95

percentile.

107) D During adolescence, common nutrition-related challenges are teenage pregnancy, acne, obesity, and inadequate nutrition knowledge. Adolescents have increased caloric needs to support growth and development, compared to children.

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108) Answers will vary. Discard any leftovers in the bottle—they are contaminated by bacteria and enzymes from the infant’s saliva.

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109) Answers will vary. The 1st step is to assess how much physical activity he or she engages in. If a child spends much free time in sedentary activities, more physical activities should be encouraged. Both the U.S. government and health professionals recommend 60 minutes or more of moderate to intense physical activity per day for children and adolescents. An overall active lifestyle will help children not only attain a healthy body weight but also keep a healthy body weight later in life and reduce the risk of obesity-related diseases. An increase in physical activity won’t just happen; parents and other caregivers need to plan for it. Two good ideas are getting the family together for a brisk walk after dinner and finding an after-school sport the child enjoys. Foods should include a focus on vegetables, fruits, lean proteins, and whole grains, with less refined sugars and processed foods. Obese children often need to find a new way to relate to foods, especially snack foods. An important family rule might be that children are allowed to eat only while sitting at the dining table or in the kitchen. This rule can stop mindless snacking in front of the television and make all family members more conscious of when they are eating. It also might be helpful to put portions of snack foods on plates rather than to allow unlimited amounts of snacks, as often happens when children eat directly from a full box of crackers or cookies. Obese children also need support, admiration, and encouragement to bring their weight under control. A child’s self-esteem is extremely fragile. Obesity itself often affects the child’s psyche and mental outlook (e.g., depression). Humiliation doesn’t work; it only makes the child feel worse. Resorting to a weight loss diet is usually not necessary. Children have an advantage over adults in dealing with obesity; their bodies can use stored energy for growth. Thus, if weight gain can be moderated, their normal increases in height can help bring weight under control. Version 1

110) Answers will vary. Children 1 to 2 years old are particularly vulnerable to iron deficiency anemia because their diets often are dominated by milk, a low-iron food, and most are no longer receiving iron-fortified formula. In addition, they typically do not like meat or have difficulty chewing it. In some cases, intestinal parasites contribute to iron deficiency. Iron-fortified cereal and easily chewed meats (e.g., ground beef) can help children boost iron intake; serving iron-rich food with vitamin C-rich food increases the absorption of this mineral. 111) Answers will vary. All of the changes that occur during the growing years influence energy and nutrient intakes and needs, but growth rate has the greatest effect. The faster the growth rate, the greater the nutrient and calorie needs per pound of body weight. Thus, the greatest needs, pound for pound, occur during infancy, when growth is at its peak velocity. Although calorie and nutrient needs per pound of body weight steadily decline after infancy, the total quantity of calories and nutrients needed rises throughout childhood because the body grows larger.

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112) Answers will vary. With the exception of a vitamin K supplement for newborns, an iron supplement for breastfed infants, a vitamin B-12 supplement for breastfed infants of vegan mothers, a vitamin D supplement for some infants, and a fluoride supplement for infants, children, and teens with an unfluoridated water supply, routine nutrient supplementation is not needed by healthy children and teens. However, supplements may be recommended for children and teens who are poor eaters, vegans, pregnant, on programs to manage obesity, and/or deprived, neglected, or abused. The American Academy of Pediatrics suggests that these children and teens may benefit from a children’s multivitamin and mineral supplement not exceeding 100% of the RDA or Adequate Intakes. Still, supplements are not a substitute for a healthy diet.

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CHAPTER 18 MULTIPLE CHOICE - Choose the one alternative that best completes the statement or answers the question. 1) During adulthood, nutrients are used primarily ________. A) to maintain the body B) to support physical growth C) for anabolic conditioning D) for storage purposes

After age ____ or so, the rate of cell breakdown begins to exceed the rate of cell renewal. A) 25 B) 30 C) 35 D) 55

Starting around age ___, organ size and efficiency begin to decrease. A) 30 B) 40 C) 50 D) 70

Which is NOT a current hypothesis about the cause of aging? A) Bloodconcentrations of hormones change. B) Cells can divideabout 50 times, andthen they die. C) The immune systembecomes less able to recognize and destroy foreign substances. D) Connective tissuestiffens and reduces flexibility. E) All of these arecurrent hypotheses about the cause of aging.

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5) Age-related degenerative changes can be minimized, prevented, or reversed by ________. A) exercising regularly B) getting enough sleep C) avoiding excessive exposure to sunlight D) eating nutritiously E) All of these responses are correct.

Which is a typical example of usual aging? A) Increasing body fatness B) Maintenance of lean body mass C) Maintenance of bone mass D) All of these responses are correct.

Compression of morbidity can be defined as ________. A) having the greatest number of healthy years and the fewest number of years with

illness B) representing a low death rate from chronic diseases C) having a longer life D) postponing illness until such time as there is an adequate treatment or cure

Which determines the rate of aging? A) Genetics B) Lifestyle C) Environment D) All of these choices are accurate.

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Which aspect(s) of the environment influence(s) the rate of aging? A) Income and education B) Quality of housing and autonomy C) Access to health care and nutritious food D) Psychosocial support and protection from climactic extremes E) All of these responses are correct.

10)

According to the Dietary Guidelines for Americans, a goal for adults is to ________. A) limit intake of added sugars and emphasize vegetables in the diet B) keep body weight in a healthy range C) follow a healthy eating pattern across the lifespan D) All of these responses are correct.

11)

In adulthood, a nutritious diet can help to ________. A) delay onset of disease B) recover more quickly from disease C) increase mental, physical, and social well-being D) A nutritious diet can do all of these things.

12)

The diets of adults tend to be higher than recommended for _____. A) vitamin D B) calcium C) fat D) zinc E) fiber

13)

The diets of adults tend to be lower than recommended for _____.

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A) vitamin D B) zinc C) magnesium D) folate E) All of these responses are correct.

14)

The largest group of adults at risk for nutrient deficiencies is ________. A) women B) pregnant women C) individuals with a low-income D) older adults living in long-term care facilities

15) The Dietary Reference Intakes (DRIs) for adults take into consideration all of the following aging-related changes, EXCEPT ____. A) body composition B) metabolism C) organ function D) DRIs take into account all of these things.

16)

Calorie needs decline after age 30 years or so because ________. A) basal metabolism declines B) the body becomes more efficient in using energy C) thrifty metabolism begins D) All of these responses are correct.

17)

Which of the following groups may not receive sufficient protein?

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A) Adults with limited budgets B) Adults with chewing problems C) Adults who are lactose intolerant D) All of these choices are correct.

18)

A diet rich in dietary fiber may help adults to ________. A) reduce risk of osteoporosis B) reduce risk of heart disease C) raise blood cholesterol levels D) reduce the risk of dementia

19)

Low fluid intake in older adults may be caused by ________. A) less intense feelings of thirst B) chronic disease C) certain medications D) reduced ability of the kidneys to concentrate urine E) All of these responses are correct.

20)

Why is vitamin D a nutrient of particular concern in older adults?

A) Permeability of theintestine to dietary vitamin Dincreases as the intestine ages, whichincreases risk for toxicity. B) Vitamin D synthesis in the skin slows with age. C) The kidneysaccelerate the conversion of vitamin D to its active form, which increases therisk for toxicity. D) None of theseresponses are accurate.

21)

A common cause of iron deficiency anemia in adulthood is ________.

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A) bleeding ulcers B) use of aspirin C) bleeding hemorrhoids D) All of these responses are correct.

22) Insufficient intakes of ___ by adults may contribute to loss of taste sensations and delayed wound healing. A) magnesium B) zinc C) folate D) vitamin B-12

23) Inadequate intake of ____ in adults may contribute to loss of bone strength and mental confusion. A) magnesium B) zinc C) folate D) vitamin B-12

24) Elevated blood concentrations of ____ are associated with increased risk for stroke and neurological decline in some elderly adults. A) zinc B) homocysteine C) vitamin E D) vitamin D

25) Intakes of ______ havebeen associated with reduced risk for age-related macular degeneration and cataracts. Version 1

A) vitamin E B) folate C) niacin D) both lutein and zeaxanthin

26)

A major problem afflicting the elderly gastrointestinal tract is ________. A) increased lactase synthesis B) constipation C) increased HCl production D) increased synthesis of intrinsic factor

27)

A change in muscle that typically occurs in adulthood is ________. A) increased elasticity B) bloating of muscle cells C) loss of muscle strength D) hypertrophyof muscle cells

28)

Physical activity is associated with ________. A) improved sleep B) reduced risk for falling C) positive mental outlook D) better mobility E) All of these responses are correct.

29)

To preserve bone mass, adults should ________.

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A) not smoke B) consume adequate vitamin D C) consume adequate calcium D) All of these recommendations are correct.

30)

To protect the cardiovascular system, adults should ________. A) not smoke B) eat low-carbohydrate diets C) avoid vigorous exercise D) All of these choices are correct.

31)

To prevent constipation, older adults should ________. A) limit highly sweetened foods B) increase dietary fiber and fluids C) regularly take laxatives D) All of these choices are accurate.

32) An age-related change in the nervous system that can adversely affect nutritional status is ________. A) decreased taste perception B) hearing loss C) vision loss D) All of these changes can impact nutritional status.

33)

During the adult years, ____ can adversely affect the immune system.

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A) undernutrition B) overnutrition C) excessive iron intake D) obesity E) All of these choices are correct.

34)

Long-term use of aspirin or aspirin-like medications can deplete _________ reserves. A) iron B) calcium C) vitamin K D) thiamin

35)

Many elderly people avoid social contact because they ________. A) are experiencing hearing loss B) have trouble seeing, so they avoid going out C) have problems with urinary incontinence D) All of these choices are accurate.

36)

Which is true of the Congregate Meal program? A) It isadministered by the USDA. B) It is part of theOlder Americans Act. C) Anyone age 52 orolder can participate. D) All of theseresponses are accurate.

37)

Which U.S. government program distributes surplus agricultural products?

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A) Commodity Supplemental Food Program B) Supplemental Nutrition Assistance Program (SNAP) C) Child and Adult Care Food Program D) Senior Farmers' Market Nutrition Program

38)

Which is true about the Supplemental Nutrition Assistance Program (SNAP)? A) It providesnutrition education. B) It provides ameans to purchase food-producing plants. C) It provides ameans to buy hot meals in group homes. D) It supplementsfood budgets of low-income households. E) All of theseresponses are correct.

39)

Warning signs of Alzheimer's disease include ________. A) personality changes B) language problems C) reduced job performance D) faulty judgment E) All of these are signs of Alzheimer's disease.

40)

To relieve the symptoms of arthritis, older adults with the condition are all advised to: A) follow a special restrictive diet B) restrict certain inflammatory foods C) take megadoses of certain nutrient supplements D) All of these responses are accurate. E) None of these responses are accurate.

41) Which domain of complementary and alternative medicine involves using foods and special diets? Version 1

A) Energy medicine B) Alternative medical systems C) Biological based practices D) Mind-body interventions

42)

Which is an example of a mind-body intervention? A) Hypnosis B) Biofeedback C) Yoga D) All of these are examples of mind-body interventions.

43)

Which is NOT an example of energy medicine? A) High-caloriediets B) Pulsed fields C) Magneticfields D) Electricalcurrents

44)

In complementary and alternative medicine, a manipulative practice is ________. A) massage B) Reiki therapy C) chiropractic manipulation D) All of these examples are correct. E) None of these examples are correct.

45)

An alternative medical practice system is ________.

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A) Ayurveda B) naturopathy C) homeopathy D) acupuncture E) All of these responses are correct.

46) A rational approach for someone wanting to try complementary and alternative medicine is to ________. A) take advice from a trusted friend B) keep a record of symptoms and practices followed C) try at least 2 complementary and alternative medical practices at once D) All of these approaches are rational.

47)

Which is true about herbs? A) There is little regulation regarding herbal supplements in the U.S. B) There have beenno cases of adverse effects ofusing herbal supplements. C) Herbalsupplements are more effective than medicines. D) Herbal supplements are as rigorously tested as prescription medications in the U.S. E) All of these responses are true.

48) What food and nutrition service program(s) does the U.S. Department of Agriculture (USDA) and Administration on Aging provide for older adults? A) CommoditySupplemental Food program B) SupplementalNutrition Assistance program C) Senior Farmers’Market Nutrition program D) Child and AdultCare Food program E) All of the above.

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49) Which strength training recommendation(s), as suggested by the National Institutes on Aging, is/are appropriate for older adults? A) Exercise at least2 days per week. B) Stretch aftercompleting all exercises. C) Perform exercisesthat involve major muscle groups. D) All of the choices are appropriate strength training recommendations.

50) An older relative has recently been placed on anticoagulant medications. Her doctor did not make any dietary recommendations. Which of the following foods would you suggest that your relative avoid until further discussing her medication with her doctor? A) Oranges B) Whole grain bread C) Spinach D) Milk

51) Which of the following foods would be recommended for an elderly person who has periodontal disease? A) Carrots B) Chicken breast C) Canned apricots D) Brown rice

52) A friend was recently prescribed corticosteroids for an inflammatory reaction he is having. He knows that you are taking a nutrition class and has asked you for advice on any drugnutrient interactions that you may have learned in your class. Which of the following foods would you suggest he increase during the time he is taking this medication? A) Low-fat milk B) Spinach C) Pork D) Salmon

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53) You have an older relative who is complaining of fatigue.You learn that she is taking aspirin on a daily basis to prevent a heart attack. What condition do you suspect your relative may have? A) Osteoporosis B) Alzheimer disease C) Iron deficiency anemia D) Gout

54) A friend has recently been diagnosed with hypertension and has been prescribed Lasix to help treat her condition. This doctor did not recommend any dietary changes. Which of the following foods would you suggest that your friend increase until she can discuss her medications with her doctor? A) Any processed foods B) Beans C) Diet soft-drinks D) Oranges

55) A friend has been drinking more than the usual amount of alcohol. You are concerned about the effects alcohol has. Which of the following herbal remedies do you feel comfortable suggesting for your friend to supplement with, based on your knowledge of the harmful effects of alcohol? A) Saw palmetta B) Milk thistle C) Melatonin D) Black cohosh

56) You have been experiencing low back pain for about a week. You do not think that it is necessary to see your medical doctor for this condition, as you have had no injuries to the area. Which of the following CAM practitioners do you feel would be most beneficial to see for relief?

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A) Aromatherapist B) Chiropractor C) Hypnotist D) Ayurvedic practitioner

57)

Insufficient Vitamin D intake and levels in the blood can lead to A) increased risk of osteoporosis B) increased risk of Alzheimer’s disease and other types of dementia C) both of these are correct. D) None of these are correct.

58)

__________ is the loss of muscle mass due to aging. A) Anabolism B) Catabolism C) Sarcopenia D) None of these are correct

59)

Strength training recommendations for older adults include all of the following EXCEPT

A) Exercise different muscle groups in each session. B) Exercise at least 3 days per week in 60 -minute sessions. C) Perform exercises that involve the major muscle groups (e.g., arms, shoulders, chest, abdomen, back, hips, and legs) and exercises that build grip strength. D) Avoid locking the joints in the arms and legs.

SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 60) Compare and contrast the benefits of Congregate Meals versus Meals on Wheels for older adults.

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Answer Key Test name: Chap 18_3e_Test Bank 1) A 2) B 3) A 4) E 5) E 6) A 7) A 8) D 9) E 10) D 11) D 12) C 13) E 14) D 15) D 16) A 17) D 18) B 19) E 20) B 21) D 22) B 23) A 24) B 25) D 26) B Version 1

27) C 28) E 29) D 30) A 31) B 32) D 33) E 34) A 35) D 36) B 37) A 38) E 39) E 40) E 41) C 42) D 43) A 44) D 45) E 46) B 47) A 48) E 49) D 50) C Spinach is high in vitamin K, which may interact with the anticoagulant. 51) C This choice would allow the least amount of chewing. 52) A Corticosteroids can lead to poor utilization of calcium, found in low-fat milk…so higher intake would be a good practice. Version 1

53) C Aspirin therapy can potentially lead to anemia from blood loss due to affect on iron. 54) B Lasix is a medication that is a potassium-wasting diuretic. Beans are high in potassium. 55) B Milk thistle: May have a protective effect on the liver, thought to be due in part to its ability to prevent toxins from contaminating liver cell membranes. 56) B A chiropractor may be able to alleviate some spinal pain. 57) C 58) C 59) A

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60) Answers will vary. The Elderly Nutrition Program, an important aspect of the Older Americans Act, provides nutrition services through the Congregate Meal Program and Home Delivered Meal Program (often referred to as Meals on Wheels). Anyone age 60 or older can participate; however, priority usually is given to those with the greatest economic, social, and health needs. Both meal programs can help older people obtain some of the food needed for good health. Each meal meets at least one-third of the daily recommendations. The social aspect of the Congregate Meal Program provides opportunities for socialization that often improve appetite and general outlook on life. These programs also may provide shopping assistance, counseling, nutrition education, and referral to other social, rehabilitative, and transportation services.

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