03a: Nutrition

Question 1

Dietary Guidelines for Americans (DGA) have been published every (X) years with the objective to:

Answer 1

X = 5

Promote population health (via support of health professionals and informing policy)

Question 2

In line with key recommendations of DGA, a diet that’s consistently associated with positive health outcomes is one (low/high) in (X).

Answer 2

High;

X = fruits and veggies

Question 3

Less than (X)% of calories per day should come from added sugars.

Answer 3

X = 10

Question 4

Less than (X)% of calories per day should come from saturated fats.

Answer 4

X = 10

Question 5

EtOH limit per day for men is (X) and women is (Y).

Answer 5

X = 2 drinks
Y = 1 drink

Question 6

Consume less than (X) per day of Na.

Answer 6

X = 2300 mg

Question 7

Healthy Mediterranean-Style Pattern is similar to US-Style but increases recommended (X) and decreases recommended (Y).

Answer 7

X = seafood and fruit
Y = dairy

Question 8

In Healthy Vegetarian Pattern, which food groups are increased with elimination of meat/poultry/seafood?

Answer 8

1. Soy/legumes
2. Whole grains
3. Nuts/seeds

Question 9

Amount of nutrient intake that meets the needs of 50% of population.

Answer 9

Estimated Average Requirement (EAR)

Question 10

Amount of nutrient intake that meets the needs of 98% of population.

Answer 10

Recommended Dietary Allowance (RDA)

Question 11

When there’s not enough data on a nutrient, (X) is used for intake recommendations. This value is based on (Y).

Answer 11

X = AI (Adequate intake)
Y = intake of healthy individuals

Question 12

Maximum intake of nutrient that’s unlikely to pose risk.

Answer 12

UL (tolerable upper intake level)

Question 13

Why might vitamin deficiency occur during pregnancy?

Answer 13

Increased requirement is not met with adequate intake

Question 14

Vitamin deficiency may occur in patient with fever or after major surgery due to (increase/decrease) (X).

Answer 14

Increase

X = metabolic demand of body

Question 15

List the key fat soluble vitamins of concern in US population.

Answer 15

Vit A, D, E

Question 16

List the key water soluble vitamins of concern in US population.

Answer 16

Vit B9 (folate), B12, C

Question 17

List the key minerals of concern in US population.

Answer 17

Fe, K, Ca, Mg

Question 18

List the key vitamins/minerals of concern in vegetarian/vegan diet.

Answer 18

Vit B12, D;

Fe, Ca, Zn

Question 19

List the key vitamins/minerals of concern in elderly.

Answer 19

Vit B12

Question 20

List the key vitamins/minerals of concern in women of childbearing age.

Answer 20

Vit B9 (folate), B12;
Fe

Question 21

Intestinal microorganisms can give us which key nutrients?

Answer 21

Vit K and Biotin

Question 22

Malabsorption causing fatty stools would cause one to worry about vitamin (X) deficiency.

Answer 22

X = ADEK (fat-soluble vitamins) and B9, B12

Question 23

Pt with Crohn’s disease is at risk for (X) vitamin deficiency, which are associated with the inflammation of terminal ileum.

Answer 23

X = B9 (folate) and B12

Question 24

Pt with Crohn’s disease is at risk for (X) mineral deficiency due to (Y) symptom.

Answer 24

X = Fe
Y = blood loss in stools

Question 25

Key vitamins of concern in alcoholism.

Answer 25

Thiamine (B1) and folate (B9)

Question 26

Key minerals of concern in alcoholism, specifically associated with re-feeding syndrome.

Answer 26

P, K, Ca, Mg

Question 27

Koilonychias, aka (X), is related to (Y) micronutrient deficiency.

Answer 27

``` X = spooning nails Y = Fe ```

Question 28

Pt presenting with fatigue, pallor, tachycardia, and changes in nails/hair likely has (X) deficiency. List some dietary sources you'd recommend.

Answer 28

X = Fe (anemia) Green veggies, legumes, fortified flour/cereal, nuts/seeds, meat

Question 29

Which micronutrient deficiency might lead to bowing of the legs, aka (X)?

Answer 29

X = rickets | Vit D

Question 30

Which micronutrient deficiency might lead to osteopenia or osteoporosis? Which dietary sources would you recommend?

Answer 30

Vit D; Fortified food (juice, milk, cereal), fatty fish, sun

Question 31

Which micronutrient deficiency might lead to xeropthalmia/bitot spots on eyes?

Answer 31

Vit A

Question 32

Which micronutrient deficiency might lead to night blindness? Which dietary sources would you recommend?

Answer 32

Vit A; Sweet potato, carrot, pumpkin, dark leafy greens, meat

Question 33

T/F: Malnutrition in hospitalized patients is common regardless of the country’s income level.

Answer 33

True

Question 34

T/F: Prevalence of undernutrition among hospitalized patients is higher among children.

Answer 34

False - lower

Question 35

When malnutrition, aka (under/over)-nutrition is taken into account, as many as (X)% of hospitalized children and (Y)% of hospitalized adults are malnourished.

Answer 35

Both; X = 50 Y = 76

Question 36

In the starved-fed cycle, body metabolism favors homeostasis of (X) via which signaling molecules?

Answer 36

X = glucose Insulin (fed state) and glucagon (starved state)

Question 37

List the three stages of the starved-fed cycle.

Answer 37

1. Post-absorptive (after meal) 2. Early fasting (night) 3. Re-fed (breakfast)

Question 38

Hormonal responses to starvation: (X) levels decrease to (increase/decrease) protein synthesis.

Answer 38

X = IGF-1 (insulin-like GF) | Decrease

Question 39

During starvation, hormones such as glucocorticoids, catecholamines, and growth hormone (increase/decrease), promoting (X) processes.

Answer 39

Increase; | X = lipolysis and proteolysis

Question 40

Starvation adaptation: (glycogen/gluconeogenesis) usage kicks in first for energy.

Answer 40

Glycogen

Question 41

At around day 2 of starvation, plasma level of (X) E source shoots up drastically. Why does this happen?

Answer 41

X = ketone bodies High FA degradation results in accumulation of acetyl CoA; TCA can't process them all due to low oxaloacetate (used in gluconeogenesis)

Question 42

(X) growth charts should be used for children under (Y) age. For older children, (Z) growth charts should be used.

Answer 42

``` X = WHO Y = 2 Z = CDC (2-18 y.o.) ```

Question 43

List the indicators used to monitor growth/nutritional status in kids. Star the one only used for children under 2 y.o.

Answer 43

1. Head circumference* 2. Height/length 3. Weight 4. WL (weight-for-length) or WH (height)* 5. BMI

Question 44

"Corrected age" used for premature infants. What's the formula? And the units?

Answer 44

CA = (current age) - (40 weeks - gestational age at birth) All in weeks

Question 45

T/F: Growth charts are only age-specific.

Answer 45

False - age and sex; also, preterm and disease-specific charts exist

Question 46

New efforts to improve assessment of pediatric nutritional status. For example, (X) used instead of percentiles.

Answer 46

X = Z-scores (standard deviations from mean)

Question 47

Adult malnutrition: following identification of nutritional risk, you should look for (X) symptom. Based on its presence/absence, you can conclude:

Answer 47

X = inflammation Presence: injury or disease-related Absence: starvation-related

Question 48

Milk to moderate inflammation in malnourished adult likely stems from (X)-related malnutrition.

Answer 48

X = chronic disease

Question 49

A rise in metabolic demand is seen in malnutrition due to (starvation/stress).

Answer 49

Stress

Question 50

A GF Diet is one that eliminates gluten, a(n) (X), found in a number of grains including (Y).

Answer 50

``` X = intact storage protein Y = wheat, barley, rye ```

Question 51

T/F: GF Diet is essentially always nutritionally | sufficient for all micro- and macronutrients.

Answer 51

False

Question 52

T/F: Inclusion of oats in GF diet is controversial.

Answer 52

True

Question 53

Diabetes Prevention Program (DPP) was an efficacy trial of (X) effect on diabetes prevention in (Y) population.

Answer 53

``` X = intense lifestyle modification Y = pre-diabetic ```

Question 54

Symptoms of "Gluten sensitivity" may in fact be due to (X), from the CHOs of wheat, not gluten.

Answer 54

X = fructan (oligosaccharide)

Question 55

The (X) diet in 3-diet study had no calorie restriction.

Answer 55

X = low CHO

Question 56

Main things to limit via Mediterranean diet

Answer 56

1. Meat/poultry 2. Dairy 3. Refined grains/sweets

Question 57

In the 3-diet study, which two had the best, nearly identical, outcomes?

Answer 57

Mediterranean and low-CHO

Question 58

In 3-diet study, which diet had the greatest percent fat intake?

Answer 58

Low-CHO (39%)

Question 59

Paleo diet cuts out healthy sources of:

Answer 59

1. Fiber via whole grains 2. Calcium via dairy 3. Protein via legumes

Question 60

In 3-diet study, which diet had best fasting glucose among diabetics?

Answer 60

Mediterranean

Question 61

In 3-diet study, which diet improved LDL levels? And HDL?

Answer 61

None; All improved HDL levels