Exam # 1 Nutrition

Exam # 1 Nutrition The client who would benefit most from an increase in dietary fiber intake is one with a. fatigue. b. constipation. c. dehydration. d. coronary heart disease. ANS: B Adequate dietary fiber and fluid intake can help alleviate constipation. It has a small but less significant effect in helping reduce risk of coronary heart disease. Dietary fiber intake does not affect fatigue or hydration status. The best example of the type of concern that is likely to be addressed by the U.S. Department of Health and Human Services when target goals for Healthy People 2030 are updated is a. preference for vegetarian eating patterns among white women. b. low intake of fruits and vegetables by African American children. c. widespread use of bottled water in higher socioeconomic groups. d. common use of protein and vitamin supplements in athletes. ANS: B Healthy People is used to set targets for health promotion to improve the health of all individuals. It addresses environmental and social issues that affect health outcomes. Low intake of fruits and vegetables by African American children is likely to have an adverse effect on their health and so may be addressed when target goals are set. Vegetarian eating patterns, use of bottled water, and use of protein and vitamin supplements do not necessarily have an adverse effect on nutritional health and so are less likely to be addressed. The National Health and Nutrition Examination Survey (NHANES) is able to assess the overall nutritional and health status of Americans because a. the populations surveyed are representative of the total population. b. it focuses on ethnic and socioeconomic groups at greatest risk. c. it collects large volumes of survey data from all over the nation. d. survey methods and standards are consistent from year to year. ANS: A Data from NHANES represent America overall because the survey populations are carefully selected to represent the total population. Their data therefore provide a better indication of the nation’s overall health than do large amounts of data from all over the country. It does not focus specifically on populations at high risk for disease. Standardization over time provides useful data on trends and changes but does not reveal the overall health of the nation. For a mother with two children who works in health care management 60 to 70 hours a week, the biggest barrier to healthy eating is likely to be a. lack of concern for her own or her children’s health. b. inadequate income to purchase healthy foods. c. insufÏcient time to plan and prepare healthful meals. d. lack of knowledge about healthy eating. ANS: C For busy professionals and families, the biggest barrier to healthy eating is usually hectic schedules and lack of time to plan and prepare healthy meals. Most mothers, especially those who work in a health care field, are concerned about their family’s health. Many professional women have at least some understanding of healthy eating. With a professional job, lack of income is not very likely to be a barrier to healthy eating. Increased consumption of fruits and vegetables would be most beneficial to someone with a. arthritis. b. diarrhea. c. constipation. d. osteoporosis. ANS: C Foods with high amounts of dietary fiber, such as fruits and vegetables, can help relieve constipation by increasing fecal bulk. Arthritis is not related to intake of fruits and vegetables. High intake of fruits and vegetables may exacerbate diarrhea. Osteoporosis is related to intake of calcium and vitamin D; fruits and vegetables are not good sources of these nutrients. An example of a daily change that may help decrease constipation is a. drinking tomato juice instead of carbonated beverages with lunch. b. eating oatmeal and raisins instead of a bagel for breakfast. c. snacking on pretzels instead of potato chips. d. eating mashed potatoes instead of pasta with dinner. ANS: B Increasing intake of dietary fiber helps prevent constipation; oatmeal and raisins have significantly higher levels of fiber than does a bagel. In fruit and vegetable juices, most of the fiber is removed during the juicing process; drinking vegetable juice would add nutrients but not fiber. Pretzels have less fat than potato chips, but both have low amounts of fiber. Mashed potatoes contain only slightly more fiber than does pasta. For most Americans, the most significant nutrition concerns are a. lack of interest in making healthy food choices. b. poor availability of fruits and vegetables in many areas. c. excessive intake of saturated fats, cholesterol, sodium, and sugars. d. inadequate intake of key vitamins, minerals, and phytochemicals. ANS: C Most Americans have high intake of saturated fats, cholesterol, sodium, and sugars, which is associated with increased prevalence of chronic disease. Many people have inadequate intake of micronutrients, but this has a lesser overall effect than excessive intakes of fats, sodium, and sugars. Some areas of the country have poor availability of fruits and vegetables, but this is not a widespread problem in the country as a whole. Many Americans express at least some concern about making healthy food choices. The most beneficial function of cholesterol in the body is a. formation of sex hormones, bile, and vitamin D. b. depositing plaques in arteries. c. being part of cell membrane structure. d. solubility in both water and fat. ANS: A The body uses sterols such as cholesterol to make sex hormones, bile, and vitamin D. Cholesterol does contribute to deposition of arterial plaques, but this is not beneficial to the body. Cell membrane structure and solubility in both water and fat are functions of phospholipids; cholesterol is a sterol, not a phospholipid. High levels of low-density lipoprotein cholesterol (LDLc) are associated with an increased risk of a. diabetes mellitus. b. high levels of high-density lipoprotein cholesterol (HDLc). c. coronary artery disease. d. high blood pressure and stroke. ANS: C High levels of low-density lipoprotein cholesterol are associated with increased risk of coronary artery disease. They do not have a direct effect on risk for diabetes mellitus or high blood pressure and stroke. LDLc and HDLc levels are not necessarily related. The primary goal of therapy to reduce risk of cardiovascular disease is to lower serum levels of _____ cholesterol. a. total b. LDL c. HDL d. very low-density lipoprotein (VLDL) ANS: B The primary goal of therapy to reduce risk of cardiovascular disease focuses on lowering blood levels of LDL cholesterol. Lowering serum total cholesterol and VLDL cholesterol levels and increasing HDL cholesterol levels also decreases cardiovascular risk but are not the main focus. In a 55-year-old woman, an LDL cholesterol level of 195 mg/dL would be considered a. normal. b. borderline high. c. high. d. very high. ANS: D A serum LDL cholesterol level in excess of 190 mg/dL is considered very high. LDL cholesterol levels of 160 to 189 mg/dL are considered high; levels of 130 to 159 mg/dL, borderline high; levels of 100 to 129 mg/dL, normal; and levels lower than 100 mg/dL, optimal. patient with high serum LDL cholesterol levels tells you that he usually eats a granola bar and a cup of coffee on the way to work; eats a grilled cheese sandwich and chips for lunch; eats a home-cooked meal for dinner, which is usually a chicken dish with potatoes or pasta and frozen vegetables; and snacks on popcorn and pretzels. The most beneficial change for him to make to lower his LDL cholesterol levels would be to a. use fresh instead of frozen vegetables. b. drink decaffeinated instead of regular coffee. c. eat unsalted pretzels and popcorn. d. eat a turkey sandwich with 100% whole-grain bread instead of grilled cheese. ANS: D Cheese has high levels of saturated fat, and grilled cheese sandwiches are often made with butter (which also has high levels of saturated fat) or margarine (which may have high levels of saturated fat), and so switching to a turkey sandwich would help decrease saturated fat intake and lower LDL cholesterol levels. Using fresh instead of frozen vegetables makes no difference other than taste. Drinking decaffeinated instead of regular coffee will not affect serum lipid levels. Eating unsalted pretzels and popcorn would help decrease blood pressure but not blood lipids. In a 55-year-old woman, an LDL cholesterol level of 195 mg/dL would be considered a. normal. b. borderline high. c. high. d. very high. ANS: D A serum LDL cholesterol level in excess of 190 mg/dL is considered very high. LDL cholesterol levels of 160 to 189 mg/dL are considered high; levels of 130 to 159 mg/dL, borderline high; levels of 100 to 129 mg/dL, normal; and levels lower than 100 mg/dL, optimal. Of the following, the most helpful change to decrease blood LDL cholesterol levels would be to a. eat oatmeal instead of a bagel for breakfast. b. use fresh rather than canned vegetables. c. use margarine instead of butter. d. eat a salad instead of a sandwich for lunch. ANS: A Switching to oatmeal instead of a bagel for breakfast would increase intake of soluble fiber, which can significantly lower the serum LDL cholesterol level. Using fresh instead of canned vegetables would decrease sodium intake, which would help decrease blood pressure but would not affect serum lipid levels. Using margarine instead of butter may or may not be beneficial, depending on the type of oil the margarine is made from, the degree of hydrogenation, and whether it contains added stanols. Eating a salad instead of a sandwich could increase blood LDL cholesterol levels, depending on the amount and type of dressing and cheese. One way to help clients follow the Dietary Guidelines for Americans is to encourage them to use a. Healthy People 2020. b. the MyPlate food guidance system. c. the Supplemental Nutrition Assistance Program (SNAP). d. the Exchange Lists for Meal Planning. ANS: B MyPlate is designed to help clients implement the recommendations of the Dietary Guidelines for Americans. Healthy People 2020 sets national targets for health promotion. SNAP provides funds for individuals and families with low incomes to buy nutritious foods. The Exchange Lists for Meal Planning is intended primarily for patients with diabetes and those who need to lose weight; the system helps patients choose appropriate portion sizes to control their intake of fat, protein, carbohydrate, and energy. The primary reason that many Americans use vitamin supplements on a regular basis is that a. supplements taste better than food. b. this practice is necessary for good health. c. it is cheaper than consuming an adequate diet. d. it is easier than making dietary and behavioral modifications. ANS: D It is often easier to take vitamin supplements than to make dietary and behavioral modifications to ensure that the diet provides adequate nutrients. Supplements do not necessarily taste good, and supplements are not necessary for good health for most people. Supplements are also not necessarily cheaper than foods containing a variety of nutrients. It would be most difÏcult for the body to maintain homeostasis if over several days someone had an inadequate intake of a. calcium. b. sodium. c. iron. d. fluoride. ANS: B Homeostasis is maintenance of physiologic equilibrium within the body. All of these minerals help maintain homeostasis, but inadequate intake of sodium over just a few days would have the most effect. Sodium is an electrolyte and is important for maintaining fluid balance in the body. If calcium intake is inadequate, the body can draw on reserves in bone; if iron intake is inadequate, the body has some reserves in the spleen, and so body homeostasis would not be affected unless the deficiency continued long term. Fluoride deficiency may cause dental caries and may affect bone density, but this is also a long-term effect and would not affect the body over a few days. During acute bacterial infections, patients need extra protein to manufacture a. hormones. b. antibodies. c. antibiotics. d. enzymes. ANS: B During bouts of infection, the immune system uses protein to produce antibodies. Hormones are chemical messengers in the body that are sometimes proteins but are not directly involved in fighting infection. Antibiotics help recover from bacterial infections but are administered to the patient and are not produced by the body. Enzymes are protein catalysts in the body and are also not involved in fighting infection. An individual would be described as having an external locus of control if he or she a. writes out a shopping list each week and generally buys only foods on the list. b. tries to eat mostly foods produced through organic and sustainable farming practices. c. has decided to eat a turkey sandwich but ends up ordering pizza with friends. d. tries to influence friends and family to help them make healthier food choices. ANS: C Individuals with an external locus of control do not feel they are able to control outside forces that have power over their experiences, so they may be easily influenced to eat pizza instead of a sandwich. Individuals who write and buy foods from a shopping list would be described as having an internal locus of control because they have an inner sense of their ability to guide life events. Use of organic foods and a desire to influence other people’s food choices are not related to locus of control. The primary function of carbohydrates in the body is to provide a. sweetness. b. satiety. c. energy. d. dietary fiber. ANS: C The most important function of carbohydrates in the body is to provide energy. Unrefined sources of carbohydrate do provide dietary fiber, but refined carbohydrates do not. Similarly, unrefined carbohydrates may add to satiety, but refined carbohydrates contribute less to satiety than do protein and fat. Simple carbohydrates provide sweetness; this is pleasant but not essential to the body. Fructose, galactose, and glucose are examples of a. disaccharides. b. polysaccharides. c. monosaccharides. d. complex carbohydrates. ANS: C Fructose, galactose, and glucose each consist of a single unit of carbohydrate and are therefore monosaccharides. Disaccharides consist of two carbohydrate units; polysaccharides and complex carbohydrates consist of several carbohydrate units. Someone who follows a strict vegetarian (vegan) diet and eats very few refined foods is likely to have _____ intake of _____ carbohydrates and dietary fiber. a. low; complex b. high; complex c. low; simple d. high; simple ANS: B Strict vegetarian diets contain only plant foods that have high levels of carbohydrates. Refined foods contain more simple sugars and some starch. Unrefined foods contain mostly complex carbohydrates and fiber. Therefore, someone who follows a strict vegetarian diet and eats very few refined foods are likely to have a high intake of complex carbohydrates and dietary fiber. A bottle of beer that contains 13 g of carbohydrates and 16 g of alcohol provides _____ kcal. a. 116 b. 155 c. 164 d. 203 ANS: C Carbohydrate provides 4 kcal/g; alcohol provides 7 kcal/g. Therefore, this bottle of beer would provide 164 kcal ([13 x 4] + [16 x 7] = 52 + 112). If someone goes on a long hike, after 4 hours most of his or her energy will be obtained from a. glucose. b. glycogen. c. fatty acids. d. amino acids. ANS: C In long-term, moderate-intensity exercise, the muscles use more fatty acids and less glucose and glycogen. Amino acids may be used to provide glucose for the brain when glucose and glycogen stores are depleted, but they would not be the major source of energy for working muscles.