Domain I: Principles of Dietetics

Question 1

Nutritive value of Fruits and Vegetables

Answer 1

1. 75-93% water, carbohydrates (digestible and indigestible)
2. Some minerals (calcium in oranges, greens), vitamins C, A, some B

Question 2

Structure of Fruits and Vegetables

Answer 2

crispness (state of turgor) is due to the osmotic pressure of water-filled vacuoles

Question 3

Fruits- chemical changes due to enzymes during ripening

Answer 3

Starch changed to sugar;
protopectin converted to pectin (ripe fruit) then converted to pectic acid (overripe fruit)

Question 4

What gas accelerates ripening of fruit during storage?

Answer 4

Ethylene

Question 5

At what temperature should frozen fruit be stored?

Answer 5

At or near 0F

Question 6

At what temperature should dried fruit be stored?

Answer 6

Room temperature

Question 7

Which fresh fruits are best stored at room temperature?

Answer 7

Avocados, bananas, pears, and tomatoes

Question 8

What is the method for delaying apples aging through a controlled atmosphere?

Answer 8

Reduced oxygen

Question 9

Climacteric fruits

Answer 9

Ripen post-harvest (peach, pear, banana, apple, tomato)

Question 10

Non-climacteric fruits

Answer 10

Best when ripened before harvest (grapes, melon, citrus)

Question 11

Chlorophyll

Answer 11

1. green
2. insoluble in water

Question 12

What happens to chlorophyll in acid?

Answer 12

Turns olive green; pheophytin

Question 13

What happens to chlorophyll in alkaline?

Answer 13

Turns bright green and mushy; chlorophyllin; hemicellulose broken down

Question 14

Carotenoids

Answer 14

1. yellow, orange
2. insoluble in water
3. little effect in acid or alkaline solution

Question 15

Lycopenes

Answer 15

1. type of carotenoid
2. antioxidant
3. phytochemical

Question 16

Anthocyanins

Answer 16

1. flavonoids
2. red, blue, purple
3. soluble in water

Question 17

What happens to anthocyanins in acid?

Answer 17

turn bright red

Question 18

What happens to anthocyanins in alkaline?

Answer 18

turn bluish

Question 19

Anthoxanthins

Answer 19

1. flavonoids
2. colorless, white to yellow
3. soluble in water

Question 20

What happens to anthoxanthins in acid?

Answer 20

bleaching effect

Question 21

What happens to anthoxanthins in alkalines?

Answer 21

turn yellow

Question 22

What happens to anthoxanthins when cooked in an aluminum pan?

Answer 22

Turn yellow, flavones chelate aluminum

Question 23

Preparation and processing of fruits and vegetables (raw)

Answer 23

1. wash to remove dust and spray residues
2. berries and mushrooms should be washed just before serving

Question 24

How do you prevent the rapid darkening of fruits low in vitamin C when cut due to enzymatic action?

Answer 24

1. dip in citrus juice,
2. add sugar before freezing,
3. heat to boiling

Question 25

How much juice will one dozen oranges yield?

Answer 25

One quart

Question 26

Preparation and processing of fruits and vegetables (cooked)

Answer 26

1. softens cellulose
2. increases keeping quality
3. cooks starch

Question 27

When sweetener is added to liquid of packing juice, what is the density of the syrup expressed as?

Answer 27

1. % weight of sucrose
2. measured in degrees Brix by a Brix hydrometer
3. On label as extra light, light, heavy, extra heavy syrup

Question 28

What is coulis?

Answer 28

Thin puree of fruit and vegetables, sugar, and water; used as a sauce

Question 29

What is a compote?

Answer 29

fruit cooked (stewed) in syrup

Question 30

Potatoes have phenolic compounds which cause color changes in raw, peeled, or bruised potatoes

Answer 30

1. Green color under skin- due to chlorophyll that develops when potato is exposed to light during storage. May be accompanied by solanine, a natural toxicant
2. Starch changes to sugar during storage (changes in taste, color, and texture) Old potatoes taste sweeter, cook to darker brown (Maillard reaction), and are softer in texture

Question 31

Fruits and Vegetables
Cooking methods-boil

Answer 31

1. small amount of a salted water for a short time, covered pan unless otherwise indicated
2. Acidic vegetables that need more time to cook: use more water, no lid

Question 32

Fruits and Vegetables
Cooking methods-steam

Answer 32

perforated container, covered, over boiling water

Question 33

Fruits and Vegetables
Cooking methods-pressure cooking

Answer 33

retains color, flavor; cut small

Question 34

Fruits and Vegetables
Cooking methods-stir-fry

Answer 34

use tender vegetables, high in moisture; don’t drain

Question 35

Fruits and Vegetables
Cooking methods-frozen

Answer 35

shorter cooking time than fresh because blanching and freezing have made them tender

Question 36

Fruits and Vegetables
Cooking methods-blanching

Answer 36

immersion in boiling water for a short time

Question 37

Cauliflower preparation suggestions

Answer 37

cook for a short time, covered

Question 38

Broccoli preparation suggestions in microwave

Answer 38

less time, same flavor, slightly better retention of color, better retention of vitamin C, no large difference in eating quality

Question 39

Cabbage preparation suggestions

Answer 39

minimize the development of a strong flavor: cook for a short time, keep lid off initially to let acids escape, cook in large amount of water

Question 40

Can sizes: #10

Answer 40

6/case
6 lbs 9 oz
13 cups
20-25 servingss

Question 41

Can sizes: #3

Answer 41

12/case
46 ounces
5 3/4 cups
12-15 servings

Question 42

Can sizes: #2 1/2

Answer 42

24/case
1 lb 13 oz
3 1/2 cups
6-8 servings

Question 43

Can sizes: #2

Answer 43

24/case
1 lb 4 oz
2 1/2 cups
4-6 servings

Question 44

Can sizes: 300

Answer 44

24/case
14-16 oz
1 3/4 cups
3-4 servings

Question 45

Flavor of vegetables

Answer 45

1. sugars in peas and corn
2. glutamic acid found in young vegetables- used in form of salt (MSG)
3. sulfur- onion, cabbage; when cut, enzymes and sulfur are mixed; cook Brussel sprouts uncovered with little water for best flavor

Question 46

Flavor of fruits

Answer 46

1. Due to acids, sugars, aromatic compounds
2. tannins cause astringent feeling in mouth (unripe banana)

Question 47

Grades USDA fruits and vegetables- based on

Answer 47

1. quality
2. firmness
3. color
4. maturity
5. freedom from defects
6. uniform size and shape

Question 48

Grades USDA- canned fruits and vegetables

Answer 48

Grade A- desserts, salads (Fancy)
Grade B- processed (Choice)
Grade C- pudding, pie (Standard)

Question 49

Grades USDA- fresh produce

Answer 49

Fancy, Extra #1, #1, Combination, #2

Question 50

Myofibrils

Answer 50

bundles of fibers muscle is composed of

Question 51

Sheet of connective tissue holding muscle fibers in bundles

Answer 51

1. collagen
2. elastin

Question 52

Collagen

Answer 52

structural part of tendon that surrounds muscle; in heat- hydrolyzed to gelatin, becomes tender

Question 53

Elastin

Answer 53

resistant to heat, little change in cooking

Question 54

Sheet of connective tissue holding muscle fibers in bundles

Answer 54

1. collagen
2. elastin

Question 55

Meat, poultry, fish-fat structure

Answer 55

deposited around organs, muscles, in muscles (marbling); finish-amount of fat cover on carcass

Question 56

Meat, poultry, fish-shape of bone

Answer 56

identifies cut: round bone-leg, T-bone- back and ribs

Question 57

Nutritive value of meat, poultry, fish, meat alternative

Answer 57

1. 16-23% protein
2. carbohydrate- glycogen in liver, glucose in blood
3. vitamins, minerals- thiamin, niacin, riboflavin, iron, copper, trace minerals (pork is a good source of thiamin)
4. calcium content is high in fish canned with bones, oysters, shrimp

Question 58

Pigments in meat

Answer 58

Myoglobin + oxygen -> red -> brown -> green
(green colors are due to further myoglobin breakdown)

Question 59

Post-mortem changes and aging

Answer 59

1. hold in cold storage to age and ripen- about 10 days
2. aging increases tenderness
3. change in muscle protein brought about by enzymes which increase the water-holding capacity of the muscle
4. acid (vinegar) and salt also increase tenderness by increasing water-holding capacity of muscle
5. physical activity of animal will NOT increase tenderness

Question 60

Anaerobic (Sous vide)- meat storage

Answer 60

vacuum-packing meat in an oxygen-impermeable film, stored unfrozen at 0C; extends storage life of meat

Question 61

MAP (modified atmosphere packaging) -meat storage

Answer 61

prolongs shelf life; air (oxygen) is removed and replaced with gasses (carbon dioxide, nitrogen); prevents deterioration by slowing respiration

Question 62

Meat inspection- USDA

Answer 62

mandatory; done at slaughter
shown with round purple stamp “USDA Inspected and Passed”

Question 63

Wholesome Meat Act of 1967

Answer 63

assures consumer that the animal was healthy at the time of slaughter and the meat is fit for human consumption (assures wholesomeness)

Question 64

Meat grading- USDA

Answer 64

1. indicates quality
2. appears on shield
3. states federally graded by Agricultural Marketing Service of the USDA
4. Grades: prime, choice, select, standard (determined at slaughter)
5. Based on maturity of animal, marbling of fat, color and texture of lean
6. standard grades have the least marbling; prime the most

Question 65

Meat specifications

Answer 65

1. Uses a numbering system for order wholesale cuts
2. IMPS-Institutional Meat Purchasing Specifications
3. NAMP- National Association of Meat Purveyors

Question 66

Cooking principles (meat)

Answer 66

1. 325F for roasting
2. high temperatures increase shrinkage, toughen
3. a slow-cooked roast yields less waste
4. insert meat thermometer BEFORE cooking

Question 67

Safe minimum internal temperatures

Answer 67

145F pork, beef, veal, steaks, roast, fish
160F ground beef, ground veal, ground lamb
165F turkey, chicken, duck

Question 68

Physical and chemical changes- meat protein

Answer 68

coagulates

Question 69

Physical and chemical changes- meat collagen

Answer 69

hydrolyzed to gelatin and softens; tough cuts need to be cooked well done because they have more collagen which needs more time to soften

Question 70

Physical and chemical changes- meat surface browning

Answer 70

due to breakdown of pigments

Question 71

Physical and chemical changes- meat interior color during cooking

Answer 71

heat changes interior from red to pink to brown to gray; heat denatures globin; iron is oxidized

Question 72

Physical and chemical changes- meat dehydration

Answer 72

heat to 160F before dehydrating (beef jerky)

Question 73

Physical and chemical changes- cured meat

Answer 73

pink from nitrites (inhibit botulism)

Question 74

Tempering meat

Answer 74

allows to cook more evenly

Question 75

Methods of cooking- dry heat

Answer 75

no water involved, for tender cuts near backbone (loin, sirloin)
frying, broiling, roasting, grilling

Question 76

Methods of cooking- frying

Answer 76

desirable for fat used to have high smoke point >400F
Do not fry tough cuts of meat (bottom round)

Question 77

Smoke point

Answer 77

temperature to which fat can be heated before puffs of smoke occur

Question 78

Smoke point-decreasing order

Answer 78

Safflower (513), soybean, canola, corn, palm, peanut, sunflower, sesame, olive (375), lard (375), shortening (365-370), butter (350)
Monoglycerides (shortening) have lower smoke points

Question 79

Rancidity

Answer 79

the uptake of oxygen in an unsaturated fatty acid
healthiest plant oils are all highly unsaturated (olive oil has more MUS; less susceptible to rancidity than soybean oil which has more PUS)

Question 80

Methods of cooking- broiling

Answer 80

form of radiated heat

Question 81

Methods of cooking- roasting

Answer 81

when meat is removed from oven, “carry-over-cooking” occurs for about 10 minutes; internal meat temperature will rise 15-25F
allow roast to stand 30 minutes before carving

Question 82

Methods of cooking- grilling

Answer 82

form of dry heat cooking

Question 83

Methods of cooking- moist heat

Answer 83

water involved, less tender cuts with more connective tissue (bottom round, chuck roast)
braising, simmer, steam, stewing

Question 84

Methods of cooking- braising

Answer 84

flour meat, brown, cover, and simmer in liquid; in oven or range-top

Question 85

Methods of cooking- simmer

Answer 85

heat in water to 170-185F with appearance of bubbles

Question 86

Methods of cooking- steam

Answer 86

heat over, not in, water

Question 87

Methods of cooking- stewing

Answer 87

add water or other liquid during cooking

Question 88

Proteolytic enzyme (papain)

Answer 88

tenderizes meat (blend of papaya and salt)

Question 89

Meat alternative: soybeans

Answer 89

1. methionine is the limiting amino acid
2. protein concentrates: >70% protein; protein isolates >90% protein
3. used in textured protein products (TVP); mixed with ground meats-extends the number of servings, lowering costs; soy protein adds juiciness because of water content
4. edamame (soybean pod), tofu (coagulated soy protein), miso (paste of soy and grains), tempeh (aged soybean and grain), natto (fermented soybeans)

Question 90

Fish cookery

Answer 90

1. use dry or moist heat
2. more perishable than meat so store at lower temperatures
3. fresh fish should have bright red gills and bright, shiny skin

Question 91

Surimi

Answer 91

purified and frozen minced fish with a preservative, used in analogs, may have egg white or starch added to create desired structure

Question 92

histamine toxicity

Answer 92

linked to inadequate refrigeration of tuna, mackerel, mahimahi

Question 93

Eggs-structure

Answer 93

1. porous shell- exchanges moisture and gasses; covered with bloom that prevents excessive loss and protects contents
2. color of shell is unrelated to food value or quality
3. inner membrane contracts leaving air space in large end
4. air space becomes larger with age
5. high proportion of thick white is indicator of good quality
6. yolk is surrounded by vitelline membrane, chalazae are yolk anchors

Question 94

Egg-nutritive value

Answer 94

1. 80 calories, 6 grams protein, 5 grams, fat, vitamins A, D, riboflavin
2. yolk is more concentrated than white (more protein, fat, minerals, and vitamins by weight)
3. fat is present in an emulsified form (egg yolk=naturally occurring oil in water emulsion)
4. color of yolk depends on amount and type of pigment in hen’s diet

Question 95

Egg-grades

Answer 95

AA, A, B
thickness of white, location and condition of yolk
viewed by candling (pass an egg in front of bright light to view contents)

Question 96

Egg-grades do NOT include

Answer 96

color of shell, nor size of egg

Question 97

Egg size

Answer 97

based on weight per dozen

Question 98

Egg freshness

Answer 98

raw eggs can be stored in refrigerator at 40-45F for 3-5 weeks
Grade A eggs can be maintained for 6 months in cold storage
A fresh egg will sink to bottom in pan of cold water and has dull, rough shell

Question 99

Egg coagulation

Answer 99

1. protein coagulates at 62-70C (sets a custard)
2. used to bind, gives firmness, stability, coats food, browns, clarifies liquids

Question 100

Syneresis (weeping)

Answer 100

liquid released from a coagulated product
occurs when cooked at too high a temperature, or too low a temperature for too long a time; creates a tough, watery product

Question 101

Egg-leavening

Answer 101

depends on amount of air beaten in an retained
1. when an egg foam is heated, air expands, egg white stretches and protein coagulates
2. acid stiffens egg white foam by tenderizing protein allowing it to stretch more easily (egg white foams compared by measuring specific gravity)
3. egg whites at room temperature have lower surface tension-whip more easily and yield larger volume
4. Sugar stabilizes egg white foam

Question 102

Egg-emulsification

Answer 102

1. lecithin helps yolk act as an emulsifier
2. lipoproteins stabilize the emulsion by interacting at the surface of the oil droplets to form a layer
3. mayonnaise-food emulsion stabilized by egg yolk

Question 103

Methods of cooking egg-water preparation

Answer 103

1. poaching or coddling-use high quality egg, appearance is important
2. vinegar and salt improve shape by hastening coagulation
3. surfaces of yolks turn green when overcooked or allowed to cool slowly due to iron from yolk and sulfur from whole egg combining to form ferrous sulfide

Question 104

Methods of cooking egg-dried heat

Answer 104

1. overcooking toughens
2. undercooking results in excessive shrinkage when removed from oven

Question 105

Methods of cooking egg- custards

Answer 105

1. larger the % sag, the more tender the gel (objective measure of quality)
2. custards made from dehydrated eggs, may be grayer and less yellow, have an eggy flavor, and be watery

Question 106

Egg processing-frozen

Answer 106

1. remove from shell first; can be frozen whole or in parts
2. 10% salt or sugar (by weight of the yolks) are added as stabilizers

Question 107

Egg processing-dried

Answer 107

1. can be vacuum-packed in nitrogen gas
2. dried fortified: 70% white, 30% yolk
3. baker’s special eggs: sucrose added to improve foaming ability

Question 108

Egg substitutes

Answer 108

1. lower in fat, calories, cholesterol; often higher in sodium than fresh eggs
2. when cooking with egg substitutes, there will be color (added carotenoid) and flavor differences

Question 109

When eggs are held in the refrigerator too long:

Answer 109

1. deterioration affects appearance and use
2. loss of carbon dioxide makes eggs more alkaline
3. whites become watery, yolks flatten
4. odors are absorbed

Question 110

Milk composition and nutritive value

Answer 110

1. 87% water, 3.7% fat, 4.9% carbohydrate (lactose)
2. 3.5% protein (complete, HBV); 80% casein (precipitated at pH 4.6 forms soft curd); whey is liquid that drains from curd (lactose, lactalbumin, lactoglobulin, water soluble vitamins, minerals)
3. good source of calcium, phosphorous, riboflavin, vitamins A, D
4. low in iron and vitamin C

Question 111

Pasteurization

Answer 111

1. destroys pathogenic bacteria
2. 145F for 30 minutes or 160F for 15 seconds
3. UHT (ultra high temperature) aseptically packaged milk can be stored without refrigeration if unopened

Question 112

Types of milk: homogenized

Answer 112

high pressure breaks fat globules to 1/5 regular size; film of protein surrounds each globule

Question 113

Types of milk: vitamin D milk

Answer 113

feed the cow vitamin D, irradiating the milk, or adding vitamin

Question 114

Types of milk: 2%, low fat, skim

Answer 114

2% milk has 1.5-2.25% fat
low fat milk has .5%-2% fat
skim milk <.5% fat

Question 115

Types of milk: concentrated

Answer 115

evaporated milk (60% water removed, at least 7.9% milk-fat, brown color due to caramelization of lactose during canning),
sweetened condensed milk (evaporated milk, add 15-18% sucrose or glucose),
dried whole milk (26% fat, does not keep well),
dried skim milk (<1.5% fat, condense skim milk, dry by spraying into heated vacuum chamber)

Question 116

Types of milk: fermented

Answer 116

cultured buttermilk: add lactic acid bacteria to skimmed or partly skimmed milk, recipe= 1T vinegar or lemon juice, or 1 3/4 tsp cream of tartar + enough milk to make 1 cup, when using buttermilk in place of regular milk increase baking soda
sweet acidophilus milk: skim milk + Lactobacillus acidophilus bacteria to reduce lactose

Question 117

Types of milk: fermented

Answer 117

cultured buttermilk: add lactic acid bacteria to skimmed or partly skimmed milk, recipe= 1T vinegar or lemon juice, or 1 3/4 tsp cream of tartar + enough milk to make 1 cup, when using buttermilk in place of regular milk increase baking soda
sweet acidophilus milk: skim milk + Lactobacillus acidophilus bacteria to reduce lactose
kefir: fermented by Lactobacillus kefir which reduces lactose

Question 118

Types of milk: low lactose-Lactaid

Answer 118

treated with lactase in processing or add enzyme to regular milk and hold in the refrigerator

Question 119

Types of milk: yogurt

Answer 119

coagulated product, fermentation of milk sugars by lactic acid bacteria

Question 120

Types of milk: filled milk

Answer 120

skim milk, vegetable fat (coconut oil), water, illegal in some states

Question 121

Types of milk: imitation milk

Answer 121

resembles milk but contains neither milk fat nore other important dairy ingredients
made from casein derivatives or soybean protein and vegetable oils

Question 122

When milk is heated, whey protein:

Answer 122

precipitates out on bottom of pan or on surface of milk

Question 123

To prevent a film from forming when heating milk

Answer 123

cover or beat the milk to produce foam

Question 124

To prevent milk from coating sides of pan

Answer 124

heat over water

Question 125

To prevent curdling

Answer 125

add acid slowly and agitate, acid precipitates casein

Question 126

Butter vs margarine fat percentage

Answer 126

butter- 80% milk fat; margarine- 80% vegetable oil or animal fat

Question 127

Hydrolytic rancidity

Answer 127

Uptake of water leads to flavor changes in butter (saturated fat)

Question 128

Oxidative rancidity

Answer 128

Uptake of oxygen at a double bond in an unsaturated fat

Question 129

Cream % fat

Answer 129

heavy or thick >36%
medium 30-36%
whipped cream 35%
light or thin 18-30%
sour cream >18%
half and half no less than 10.5%

Question 130

Cheese production

Answer 130

warm milk, add lactic acid bacteria, add enzyme rennet to coagulate casein forming th curd, separate curd from whey

Question 131

Cheese types

Answer 131

1. uncured-refrigerate immediately (cottage cheese, cream cheese)
2. cured- additional whey removed, salt added, ripened
3. % moisture content high to low: cottage (79), cream, mozzarella (45-55), camembert, bleu, Swiss, cheddar, parmesan (31)
4. processed- blend of several natural cheeses + emulsifier, fat will not separate out, high moisture content (41-50%)

Question 132

To prevent stringy, curdled-looking cheese products

Answer 132

cook for short time at moderate temperatures

Question 133

Flour, grains, and cereals: structure

Answer 133

starchy endosperm rich in protein, outer layer of hull, and bran
scutellum in germ has most thiamin

Question 134

Flour, grains, and cereals: nutritional value

Answer 134

75% starch; partially complete protein; 2% fat-found in germ
vitamin E (in germ), thiamin, riboflavin, phosphorous

Question 135

Flour, grains, and cereals: milling

Answer 135

air classification is a separation method that improves baking qualities by separating large flour particles from fine particles

Question 136

Flour, grains, and cereals: processing of hot, ready to cook cereal

Answer 136

1. farina-inner portion of wheat kernel
2. quick-cooking cereals have disodium phosphate added: makes cereal alkaline so particles swell faster, avoid on low sodium diets
3. enzyme treated for quicker cooking means the proteins have been split to lessen cooking time

Question 137

Wheat flours: graham, whole wheat

Answer 137

entire grain, use freshly ground, spoils quickly due to fat in germ

Question 138

Wheat flour: bread (hard wheat)

Answer 138

strong gluten; 11.8% protein

Question 139

Wheat flour: all-purpose

Answer 139

blend of hard and soft, less gluten, 10.5% protein

Question 140

Wheat flour: pastry (soft wheat)

Answer 140

weaker gluten, 7.9% protein

Question 141

Wheat flour: cake (soft wheat)

Answer 141

least and weakest gluten, 7.5% protein

Question 142

Wheat flour: enriched

Answer 142

thiamin, riboflavin, niacin, iron, folic acid

Question 143

Wheat flour: instant blending, agglomerated, instantized

Answer 143

no pre-sifting needed

Question 144

Wheat flour: self-rising

Answer 144

baking powder, flour, and salt

Question 145

Alimentary pastes

Answer 145

1. durum wheat-high in gluten: after bran and germ removed, starch is ground to make semolina flour, products are flexible after cooking
2. noodles- contain egg yolk or egg solids

Question 146

Rice cookery

Answer 146

1. vitamins are lost when cooked in excess water or when water is drained off
2. cook in an amount of water that will be absorbed during cooking (for 1 cup rice-use 2 cups water)

Question 147

Functional properties of gluten (flour) in baked goods

Answer 147

elastic properties, forms framework, holds in leavening agent, made from gliadin and glutenin through process of hydration and mixing
strength of flour refers to capacity to retain leavening

Question 148

Color due to carotenoids in baked flour mixtures

Answer 148

1. natural agents cause oxidation during storage and turn flour from creamy yellow to white
2. if an oxidizing agent is added-labeled “Bleached”

Question 149

What happens to baked goods when you add bran and how do you compensate?

Answer 149

1. decreases volume of end product
2. increase flour and liquid to compensate

Question 150

Functional properties of liquid in baked goods

Answer 150

hydrates gluten and starts its development
starts action of chemical leavening agent
dissolve salt, sugar; gelatinizes starch

Question 151

Functional properties of leavening agent (steam) in baked goods

Answer 151

expand the hollow shell formed by flour and egg
hot oven is required to raise liquid to boiling quickly
popovers, creampuffs

Question 152

Functional properties of leavening agent (air) in baked goods

Answer 152

air expands when heated before proteins coagulate and retain it
to incorporate air: beat, sift, fold, cream
angel cake, sponge cake

Question 153

Functional properties of leavening agent (carbon dioxide) in baked goods

Answer 153

from action of yeast on sugar yielding carbon dioxide and alcohol
from action of acid (sour milk, cream of tartar, molasses) on baking soda (sodium bicarbonate)
baking powder (mixture of baking soda, dry acid, and cornstarch) provides both the acid and alkali needed for reaction; old baking powder is more alkaline causing loss of thiamin in baked goods
deeper brown crust: alkaline solution (baking soda) and solid sugar

Question 154

Functional properties of salt in baked goods

Answer 154

adds lavor, keeps yeast from sticking

Question 155

Functional properties of egg in baked goods

Answer 155

provides stability, retains leavening agent, distributes shortening by emulsification, introduces air, adds color and flavor

Question 156

Functional properties of fat in baked goods

Answer 156

adds tenderness by coating gluten particles

Question 157

Functional properties of sugar in baked goods

Answer 157

hygroscopic-tenderizes; softens gluten and prevents gluten development by absorbing some of the water gluten needs
too much sugar results in coarse cells, thick walls, a shiny crust and a crumbly product
most of sugar in honey is glucose and fructose
when substituting Sweet and Low for sugar in a recipe, use half as much

Question 158

Methods of mixing

Answer 158

1. use bowl with sloping sides and 1/2 full
2. beat: over and over to smooth and incorporate air
3. cream: work one or more foods until soft and creamy (cream fat into sugar)
4. cut-in: distributes fat into dry ingredients
5. fold: use in foams; a down, across, up, across the top motion, rotate bowl
6. knead: used in dough; push, pull, turn
7. stir: circular or figure 8 motion to blend
8. whip: beat rapidly to incorporate air to form a foam

Question 159

Quick breads, examples

Answer 159

muffins, biscuits, popovers

Question 160

Quick breads, basic ingredients

Answer 160

egg and flour

Question 161

Muffin mixing method

Answer 161

1. sift dry ingredients; make well in center
2. blend liquids and add all at once to dry ingredients
3. mix just enough to dampen

Question 162

Excess mixing of muffins results in:

Answer 162

1. loss of carbon dioxide, overdeveloped gluten
2. tunnels from top to bottom, tough, heavy produce

Question 163

Characteristics of a good muffin

Answer 163

round, pebbled top, symmetrical shape, no long, narrow tunnels

Question 164

Cakes-method of mixing

Answer 164

cream fat with sugar, add egg, add sifted dry ingredients in portions, alternating with portions of milk

Question 165

Cakes-types

Answer 165

shortened cake (comparatively large amount of fat; uses chemical leavening)
foam cake (uses air as leavening)

Question 166

Types of shortened cake

Answer 166

1. layer cake (baking powder)
2. pound cake (air and steam)
3. rich cake (increased fat, sugar, egg; increases keeping quality)
4. gold cake (egg yolks)
5. white cake (egg whites)
6. yellow cake (whole egg)

Question 167

Types of foam cake

Answer 167

1. angel cake (egg white foam)
2. sponge cake (yolk foam and white foam)
3. chiffon cake (liquid yolks, egg white foam, baking powder, oil)

Question 168

Crumb structure depends on:

Answer 168

ingredients, procedure used, pan shape and size, baking temperature, time elapsed before baking

Question 169

Cake-alterations in the amount of sugar

Answer 169

the more sugar, the more time is needed to reach the elevated coagulation temperature of the gluten
As sugar increases, the volume of cake increases up to the point where volume is so great, and gluten so weak, that the gluten strands snap and the cake falls in the center
gummy, crystalline appearance

Question 170

What causes a cake to yellow?

Answer 170

alkaline batter (excess soda)

Question 171

What causes a cake to have a fallen center?

Answer 171

excess sugar, excess fat, excess baking powder

Question 172

What causes a cake to have a tough, dry crumb?

Answer 172

too much flour or egg, too much mixing, too little fat or sugar, over-baking

Question 173

What causes a cake to have a coarse texture?

Answer 173

too much baking powder or sugar, oven temp too low

Question 174

What causes a cake to have poor volume?

Answer 174

too little baking powder, improper level of sugar or fat

Question 175

Cookies

Answer 175

modified shortened cake; higher in fat, lower in sugar and liquid

Question 176

Pastry

Answer 176

flour, fat, liquid, salt

Question 177

Substituting butter for lard in pastry

Answer 177

lard and oil are each 100% fat; butter and margarine only 80% fat
when substituting butter for lard, need to use more

Question 178

Pastry, mixing method

Answer 178

cut fat into flour and salt, add liquid
avoid over-handling
bake at 425-250F for 10-15 minutes

Question 179

How do you increase tenderness in pastry?

Answer 179

enhance by using oil, soft fats, or fat cut into very small pieces

Question 180

How do increase flakiness in pastry?

Answer 180

leave fat in coarse particles (fat pieces melt and leave a hole where steam collects)

Question 181

How do you bake meringue on top of lemon pie?

Answer 181

spread meringue on warm to hot filling, bake at 425F 4-5 min

Question 182

Liquid to flour ratios of: pour batter, drop batter, soft dough, stiff dough (and examples)

Answer 182

pour batter 1:1, waffles
drop batter 1:2, muffins
soft dough 1:3, bread
stiff dough 1:4, pie crust

Question 183

What type of batter absorbs the most fat when deep fried?

Answer 183

high fat, high sugar

Question 184

What types of flour absorb less fat during frying?

Answer 184

all-purpose and bread flours absorb less fat than cake flour

Question 185

Yeast dough

Answer 185

1. use high protein flour (low protein flour causes crumbly products)
2. yeast ferments sugar releasing carbon dioxide

Question 186

Straight dough method-yeast dough

Answer 186

all ingredients are added before dough is allowed to rise

Question 187

Sponge method-yeast dough

Answer 187

combine liquid and part of flour and allow to ferment for several hours; add other ingredients and knead
proofing time is shortened

Question 188

Continuous baking method-yeast dough

Answer 188

reduces processing time, not as affected by fermentation time and temperature
commercial process that substitutes intense mechanical energy to a large degree for traditional bulk fermentation

Question 189

Baking at high altitudes

Answer 189

1. steam forms earlier
2. decrease amount of baking powder, increase amount of liquid
3. longer cooking time required (boiling temperature drops 1F for every 500 foot rise)

Question 190

Two types of starch molecules

Answer 190

amylose and amylopectin

Question 191

Amylose

Answer 191

responsible for gelation of cooled, cooked pasta
not branched

Question 192

Amylopectin

Answer 192

branched: 1,4 and 1,6 alpha glucosidic linkages
waxy starches (corn, rice, sorghum)
non-gelling: stable to freezing and thawing, used in frozen foods (corn starch used most often)

Question 193

Thickening ability of starches in order of effectiveness (most to least)

Answer 193

potato, waxy corn, waxy rice, waxy sorghum, tapioca, wheat starch, wheat flour
(wheat flour less effective than wheat starch because of protein content; more protein=less effective)

Question 194

Gelatinization

Answer 194

the swelling that occurs when starch is heated in water close to boiling point.
Heat dissociates bonds, water moves in and swells granules.
Friction is created causing paste to thicken

Question 195

Role of sugar in gelatinization

Answer 195

1. competes with starch for water
2. increase translucency, reduces viscosity and gel strength
3. if too much sugar is used, consistency is thin

Question 196

Acid effect on gelatinization

Answer 196

breaks down starch producing runny product
if necessary, add when cooking is complete

Question 197

Retrogradation

Answer 197

starches revert to insoluble form on freezing or ageing, hydrogen bonds holding gel together break causing gritty texture
stale bread, separation of when gravy thaws
more common with higher proportion of amylose

Question 198

Modified starch

Answer 198

chemical modification: by acids and enzymes to change viscosity and ability to gel
physical modification: pre-gelatinized starch used in instant pudding
used to stabilize frozen gravies, waxy maize, modified cornstarch

Question 199

Starch uses in food preparation-dry heat

Answer 199

starch molecules break into fragments called dextrins-dextrinization
color change occurs (browning of toast)

Question 200

Starch uses in food preparation-moist heat

Answer 200

1. starch granule in cold water don not dissolve, form a suspension
2. to prevent lumps, mix starch with fat, cold water, or sugar
3. heat, acid, and agitation will affect the stability of swollen starch granules in a paste

Question 201

White Sauce

Answer 201

1. melt fat, add flour (roux-half fat, half flour)
2. remove from heat, add liquid at 170-180F; add salt
3. add an acid when cooking is complete
4. to get a clear, shiny, translucent sauce, use cornstarch as thickener
5. if product is starchy tasting and grainy-due to uncooked flour
6. souffle is an example of a thick white sauce

Question 202

Crystallization in food preparation-preparation of crystalline candies

Answer 202

heat sugar and liquid to dissolve. heat further. crystallize under conditions that produce small crystals which have a smooth, creamy feeling

Question 203

How to control crystal size-crystal inhibitors

Answer 203

(keep crystals small and smooth)
1. Acid-cream of tartar, vinegar
-sugar and acid combine to promote inversion (hydrolysis) of sucrose
-end products are equal amount glucose and fructose (invert sugar)
2. fat-chocolate, milk
3. protein-milk, egg whites, gelatin

Question 204

Candies-ingredients

Answer 204

sugar, water, corn syrup or cream of tartar

Question 205

Candies-progression of look and texture

Answer 205

viscous, shiny and smooth at start of process then becomes creamy, dull, lighter in color. With further beating, cools and stiffens rapidly

Question 206

Candies-types

Answer 206

1. crystalline sugar-fixed orderly pattern of molecules or atoms (large crystals-rock candy; small-fondant, fudge)
2. non-crystalline sugar- amorphous, glasslike (crystallization prevented with interfering substances or increased sugar concentration; hard candies, brittles, chewy candy, gummy candies)

Question 207

Ice cream-overrun

Answer 207

increase in volume from freezing and whipping
determined by weight; should be 70-80%

Question 208

Ice cream-homogenization

Answer 208

makes ice cream smooth by making it easier to beat in air during freezing

Question 209

Ice cream-agitation

Answer 209

is essential to keep ice crystals small and to incorporate air

Question 210

Process for making ice cream

Answer 210

hydrate gelatin in cold water then heat

Question 211

Ice cream- crystal inhibitors

Answer 211

1. fat- not adding enough fat produces a grainy texture, increase fat to produce smoother ice cream (heavy cream instead of light cream)
2. egg
3. gelatin
4. nonfat milk solids

Question 212

Mellorine

Answer 212

imitation ice cream; butterfat replaced by hydrogenated vegetable oil

Question 213

Gelatin-nutritive value

Answer 213

4 calories/gram; incomplete protein-no tryptophan, low in methionine and lysine

Question 214

Gelatin-properties and uses

Answer 214

1. changes liquid into elastic solid
2. acts as a foaming agent in marshmallows
3. keeps sugar and ice crystals small in candy and ice cream by interfering with the union of small crystals to make large ones

Question 215

Gelatin-gel formation

Answer 215

1 T gelatin will gel 1 pint liquid, mix with cold water to soften, add hot water to disperse

Question 216

Increase gelatin or decrease liquid when:

Answer 216

1. making a large mold
2. it will stand at room temperature for a long time
3. acid content is high
4. making a whip

Question 217

Enzymes that prevent gelation

Answer 217

bromelain (pineapple) and papain (papaya)

Question 218

What temperature is best for brewing coffee

Answer 218

185-203F; higher temperature-tannin is extracted and coffee is bitter

Question 219

Percolator

Answer 219

single container, covered basket with stem; gives stronger and bitter coffee; water is hotter and repeatedly passes through grounds

Question 220

Dripolator

Answer 220

three separate compartments; add boiling water to top and let drip through; brief contact with ground; free of bitterness

Question 221

Vacuum brewed

Answer 221

higher temps than recommended

Question 222

Decaffeinated coffee

Answer 222

process uses methylene chloride

Question 223

Food additives

Answer 223

FDA controls
emulsifiers, sorbitol, stabilizers/thickeners, anti-caking, nitrites, mold inhibitor, antioxidants, flavor enhancer

Question 224

Examples of emulsifiers

Answer 224

1. monoglycerides
2. diglycerides
3. lecithin
4. disodium phoosphate

Question 225

Reasons for adding sorbitol

Answer 225

humectant (retains moisture)
sweetener
bulking agent
limits mold

Question 226

Examples of stabilizers/thickeners

Answer 226

pectin
cellulose
gelatin
gum
agar
carrageenan-prevents chocolate from sedimenting in fat free milk

Question 227

Examples of anti-caking

Answer 227

Calcium silicate
mannitol

Question 228

Reasons for adding nitrites

Answer 228

fixes color
inhibits spores of clostridium botulinum

Question 229

Examples of mold inhibitors

Answer 229

propionate
sodium benzoate (soda)

Question 230

Examples of antioxidant additives

Answer 230

propyl gallate
BHA
BHT
ascorbic acid
alpha tocopherol (natural)

Question 231

Examples of flavor enhancer additives

Answer 231

MSG-monosodium glutamate (provides umami, savory taste)

Question 232

Qualitative sensory evaluation of food

Answer 232

uses organoleptic measurements (sense organs) to test color, odor, taste, texture

Question 233

Analytical sensory evaluation of food

Answer 233

difference or discrimination tests
-paired comparison test- two samples side by side to compare specific quality
-triangle- three samples, determine which two are identical, tests differences between new and old products
-ranking or scaling- classify differences in color, taste; rank in order of preference

Question 234

Affective sensory evaluation of food

Answer 234

determine preference, acceptance, or opinions of a product
-hedonic rating-scale; facial hedonic-smiling faces
-paired preference-compares two samples for preferences of a specific attribute
-ranking test-extension of paired preference; additional samples

Question 235

Flavor profile method of sensory food evaluation

Answer 235

trained panel
analyze and record aromas and flavor in great detail

Question 236

Pentrometer

Answer 236

tenderness firmness; baked custards (objective measure)

Question 237

Viscosimeter

Answer 237

objective measure of viscosity on an incline plane or rotational basis

Question 238

Line-spread test

Answer 238

objective measure of viscosity on a flat surface

Question 239

Specific gravity

Answer 239

objective comparison of lightness of products (egg white foams); ratio of the density of a food to that of water

Question 240

GMO

Answer 240

scientific techniques used to produce specific desired traits in plants, animals, or microorganisms through the use of genetic knowledge

Question 241

GMO crops

Answer 241

corn, soybeans, canola, papaya

Question 242

GMO results include:

Answer 242

plants more resistant to disease, insects, weeds
plants that require less water
extended shelf life
improved efficiency of food production

Question 243

Food synergy

Answer 243

the additive influence of foods and constituents which, when eaten, have a beneficial effect on health

Question 244

Probiotics

Answer 244

live microbial food ingredients that benefit health (kefir, acidophilus milk, yogurt)
promote healthy microbial balance in intestine, may stimulate activity of immune cells and reduce gut inflammation

Question 245

Prebiotics

Answer 245

nondigestible food ingredients that support growth of probiotics
1. fibers (FOS, soluble dietary fiber, found in onions, garlic, asparagus)
2. inulin (fructose polymer)

Question 246

Functional foods

Answer 246

provide more functions than the basic nutritional benefits
1. conventional (whole) foods
2. modified: fortified, enriched, enhanced
3. medical foods: PKU formulas
4. special dietary use: gluten-free, weight loss foods

Question 247

Phytochemicals

Answer 247

biologically active, naturally occurring chemical components in plant foods, act as natural defense for plants

Question 248

Sources of phytochemicals

Answer 248

fruits, vegetables, legumes, whole grains, nuts, seeds, herbs, and spices

Question 249

Possible benefits of phytochemicals

Answer 249

1. prevention or treatment of chronic diseases
2. may detoxify drugs, toxins, carcinogens, mutagens
3. may act as blocking agents, preventing active carcinogen from reaching target
4. may reduce risk CHD by protecting LDL cholesterol from oxidation, reducing synthesis or absorption of cholesterol

Question 250

Examples of phytochemicals

Answer 250

1. Indoles: cruciferous vegetables (sulfur)-detoxification of carcinogens
2. Isoflavones: anthoxanthin in soybeans- lower elevated cholesterol
3. categories: terpenes, carotenoids, lycopene, phenols, flavonoids, phytoestrogens, thiols, lignans (flaxseed)

Question 251

USDA National Nutrient Database for Standard Reference

Answer 251

major source of food composition

Question 252

FNDDS Food and Nutrient Database for Dietary Studies

Answer 252

use to analyze data from dietary studies

Question 253

FDA Total Diet Study Database

Answer 253

Data on foods, minerals, chemicals

Question 254

Dietary supplements database

Answer 254

NIH

Question 255

Labeling and packaging claims

Answer 255

Nutrition Labeling and Education Act
FDA
label must identify: form, weight, name and address of manufacturer, ingredients in decreasing order of predominance, size of serving

Question 256

Label regulations

Answer 256

low cholesterol= <20 mg of cholesterol/serving
low calories= no more than 40 calories/serving
calorie free= <5 calories/serving
low fat= 3g or less/serving
fat free= <0.5 g/serving
very low sodium= no more than 35 mg/serving
low sodium= no more than 140 mg/serving
low sat fat= 1g or less/serving
lean= <10g fat, <4g sat fat, <95mg cholesterol
extra lean= <5g fat, <2g sat fat, <95mg cholesterol
free= no amount, or trivial amount
lite, light= 1/3 fewer calories or 50% less fat
gluten-free= <20ppm
organic= minimum of 95% organic ingredients

Question 257

Label regulations

Answer 257

low cholesterol= <20 mg of cholesterol/serving
low calories= no more than 40 calories/serving
calorie free= <5 calories/serving
low fat= 3g or less/serving
fat free= <0.5 g/serving
very low sodium= no more than 35 mg/serving
low sodium= no more than 140 mg/serving
low sat fat= 1g or less/serving
lean= <10g fat, <4g sat fat, <95mg cholesterol
extra lean= <5g fat, <2g sat fat, <95mg cholesterol
free= no amount, or trivial amount
lite, light= 1/3 fewer calories or 50% less fat
gluten-free= <20ppm
organic= minimum of 95% organic ingredients

Question 258

%DV

Answer 258

% of the daily value for each nutrient a serving of the food provides, based on a 2000 calorie intake.
Includes DRV (daily reference value) and RDI (reference daily intake)

Question 259

New food labels

Answer 259

DVs for vitamin D, potassium, calcium, iron; total sugar and added sugars; single serving packages reflect values as one serving

Question 260

Food additive that does not have GRAS status

Answer 260

sucralose

Question 261

Packaging claims

Answer 261

Health claims: based on authoritative statements from a scientific body of the US Government or the National Academy of Sciences

Question 262

Qualified health claims

Answer 262

emerging evidence of a relationship, but not conclusive; requires a disclaimer

Question 263

Structure function claims

Answer 263

may be used without FDA permission

Question 264

Ineffective communication can result in incorrect diagnoses and noncompliance with treatment. Consider the following:

Answer 264

1. Assume differences until similarities are proven
   2.Emphasize description rather than interpretation or evaluation. Focus on getting a complete description of what is wanted rather than making judgments on how something was said.
2. Avoid stereotyping

Question 265

How do cultural communication styles differ?

Answer 265

1. Rate, pitch and volume of the voice
2. Eye contact: direct gaze or avert eyes as a sign of respect
3. Expression restrained, emotional, focused
4. Speech: slow and soft, loud and fast
5. Greetings: handshake firm, mild

Question 266

Spatial relationships vary among cultures and among individuals, what are the zones?

Answer 266

1. Intimate zone: <18” very close friends, business handshakes
2. Personal zone: 18”-4’ giving instructions, working closely
3. Social zone: 4-12’ most business interactions
4. Public zone: >12’ very formal interaction

Question 267

When working with clients with limited English:

Answer 267

use common terms
avoid slang, acronyms, and shorthand
use short, simple sentences

Question 268

Pedagogy

Answer 268

art and science of teaching children
teachers are authority figures

Question 269

Andragogy

Answer 269

adults are mutual partners in learning, more problem-centered than subject-centered, motivation is more internal than external, self-directed learner

Question 270

Social Economic status effect on learning style

Answer 270

Middle and upper adults: goal-oriented; consider activities they can’t relate to as a waste of time
Lower income adults: interests focus on costs and traditional food habits; oriented toward present and towards solving current problems
Very Poor: short term planners

Question 271

Age groups learning styles

Answer 271

Adolescents: relate to their interests; consider peer pressure and attitudes toward authority
Elderly: decreased attention span; audience participation to maintain interest; control questions to stay on topic; prefer written material

Question 272

SMART objectives

Answer 272

specific, measurable, attainable, relevant, time bound

Question 273

Consonance

Answer 273

the fit between the program and the expected outcomes based on the objectives

Question 274

Content: community resources, learning activities/methodology, references, handouts, instructional materials

Answer 274

1. evaluate the information available and match it to objectives
2. organize into logical sequence
3. develop a lesson plan
4. evaluate what you have developed

Question 275

Instructional media selected depends on:

Answer 275

teaching goals
size and learning style of the audience
physical facility
equipment and time available

Question 276

Posters, slides, movies

Answer 276

assist in oral instruction

Question 277

Computers, programmed instruction materials

Answer 277

can substitute for instructors in certain aspects of the learning process
used to learn purely cognitive material; leaves instructor more time to develop affective and psychomotor learning

Question 278

Evaluation criteria

Answer 278

1. What is the purpose, timing, and the specific outcomes? What will you valuate, when and how?
2. Evaluation strategies should reflect the objectives of the educational program.
   -norm referencing compares students with the norm of a group
   -criterion referencing measures performance against a standard or defined objective

Question 279

Budget development

Answer 279

1. Budgeting is closely linked to planning. Account for all expenses
2. Consider project funding, expenditures to date, current estimate costs to complete the project, anticipated profit or loss
3. Periodic budget reviews help control resources and help adhere to the planning schedule

Question 280

Tools of program promotion

Answer 280

advertising: purchased print or electronic media. Targeted message to carefully defined audience
sales promotion: short term incentives to encourage purchases (coupons)
personal promotion: formal/informal presentations, health fairs, cooking demonstrations, media interviews. Direct contact provides positive feedback
public relations (publicity): organized effort to promote a favorable image through news coverage or goodwill

Question 281

Types of domains of learning

Answer 281

1. cognitive: acquisition of knowledge or subject matter (factual information)
2. affective: acquisition of attitudes and values, growth in feelings or emotions
3. psychomotor: acquisition of muscular skills (exercises, food preparation)

Question 282

Bloom’s taxonomy

Answer 282

objectives at lower level must be mastered before more complex learning can take place

Question 283

Education readiness assessment: Motivational level

Answer 283

affects attention span

Question 284

Education readiness assessment: Educational level

Answer 284

not always related to amount of formal education

Question 285

Education readiness assessment: situational assessment

Answer 285

Inexperienced: young children, some adults lacking nutrition training, need thorough introduction and background
Moderately experienced: teachers, health educators, patients already instructed. Emphasize review of material, reorganize it for better use, move on to more complicated concepts
Very experienced: limit audience participation at first, establish yourself as the expert, cite credentials, lecture format/AVs
economics, time needed, availability, environmental

Question 286

Behavior modification

Answer 286

techniques are based on a cause-and-effect explanation of behavior
ABC framework: therapy can focus on Antecedents, Behavior, or Consequences

Question 287

Behavior modification methods

Answer 287

1. positive reinforcement: encourages repetition of a given behavior; specific and immediate; meaningful attention from superiors
2. avoidance learning: learn to escape from unpleasant consequences, avoid future criticism by improving future performance
3. extinction: reduce undesired behavior; ignore undesired behavior

Question 288

Transtheoretical Stages of Change model

Answer 288

Precontemplation: unaware/not interested
Contemplation: thinking about change
Preparation: decides/plans to change
Action: tries to make change
Maintenance: Sustains change for >6 months

Question 289

Health Belief Models

Answer 289

developed to explain why people fail to participate in programs designed to detect or prevent disease
person must perceive severity and their susceptibility to the threat for threat to be behavior-motivating

Question 290

Health Belief Model Components

Answer 290

Perceived susceptibility
Perceived impact
Perceived advantage of change
Appraisal barriers
Self-efficacy

Question 291

DIffusion of innovation: categories of people

Answer 291

Innovators: adopt and idea readily without input from others
Early adopters: opinion leaders in community, well respected
Early majority: cautious in adopting new ideas
Late majority: skeptical, adopt an idea only through peer pressure
Laggards: last to adopt the idea

Question 292

Diffusion of innovation: components

Answer 292

knowledge, persuasion, decision, confirmation

Question 293

Communication principles

Answer 293

1. motivation eases transition to new behaviors
2. emphasize human factors; feelings, anxieties, concerns
3. involve learner in an active way; application of the info and active involvement of the learner permits the greatest retention
4. establish rapport
5. discuss problems descriptively rather than evaluatively; don’t be judgmental
6. offer alternatives provisionally rather than dogmatically
7. problem-oriented rather than manipulative
8. empathetic rather than neutral
   message should be clear, complete, concise, concrete, correct
9. listening: clarification, active listening-paraphrase
   10 legitimation statements

Question 294

How to instruct

Answer 294

prepare, present, try, follow-up

Question 295

Environment for instruction

Answer 295

1. psychological-openness, encourage questions, informal, supportive
2. physical-comfortable temperature, lighting, chairs; maintain eye contact; free from outside noise
3. confidentiality must be respected

Question 296

Method of instruction is based on the size of the group and the educational and motivational aspects of the group’s members

Answer 296

1. the discussion method of teaching helps master higher-level cognitive objectives: small group discussion-some lecture plus interaction; beneficial in clinical setting; teacher needs to remain in control; 3-5 people with similar needs; learn from each other
2. large group-lecture: one way flow of information; presents a large amount of material in a short time

Question 297

Group process, group dynamics: skills to develop as a group leader

Answer 297

1. relieve social concerns of the group; all must feel accepted
2. tolerate silence-after introductions, state purpose of gathering, state your intentions not to participate, sit patiently
3. guide and encourage interactions; don’t become focus
4. know when and how to resume control
5. reinforce “multi-sided” nature of conversation; “how do you feel about that?”
6. exercise control over talkative participants; encourage silent members
7. halt side conversations by engaging the distractors; discourage wisecracks
8. help group stay on topic; avoid showing your preferences
9. negotiating techniques- plan strategy in advance-know what you are willing to accept; don’t start with the hard issues; be direct, clear, calm, patient, tolerant
10. synergy: the groups product (decision) is superior to what the most resourceful individual within the group could have produced by working alone

Question 298

Interviewing: steps

Answer 298

1. preparation: collect background information-age, weight, height, diet history; establish objectives for collecting information during the interview
2. build rapport
3. collect data: open-ended, non-judgmental questions
4. closing: summarize for client to check accuracy; tell client what will be done with the information and when he will be contacted for teaching

Question 299

Question types

Answer 299

open-ended: broad, gives freedom in responding; gives you a chance to listen and observe; takes more time but less threatening
closed: more restrictive; limits answers; gives you control; less time
primary: introduces new topics
secondary: obtain more info, follow-up
neutral: preferred-do not reveal your bias
leading: reveals your bias

Question 300

Non-verbal communication

Answer 300

1. kinesics: physical communication
   -direct eye contact-attentiveness
   -lowering eyes, look away-preoccupation
   -arms folded across chest-dislike, avoidance
   -clenched fists-anxiety, anger
   crossing and uncrossing legs-anxiety
2. paralinguistic: how the client’s message is delivered
   -hesitations, stuttering-sensitivity, anxiety
   -whispering-difficulty disclosing
3. proxemics-personal space
   -moves away-discomfort
   -moves closer-seeking more interaction
   -sits behind or next to an object-seeks protection

Question 301

Strategies when delivering culturally diverse nutrition counseling

Answer 301

1. listen first to assess prior knowledge
2. reinforce correct knowledge, clarify misinformation
3. use simple language, use visual media to show what you are teaching
4. talk in slow, clear words, repeat as necessary
5. encourage questions and strive for interaction
6. use the teach-back method-ask client to restate knowledge in own language

Question 302

Counselor’s responses to client: evaluative

Answer 302

make judgment about persons feelings, or imply how he should feel. Leads to offering of advice, not problem-solving, seldom helpful

Question 303

Counselor’s responses to client: hostile

Answer 303

uncontrolled anger or frustration; may antagonize or humiliate client

Question 304

Counselor’s responses to client: reassuring

Answer 304

may make it difficult to solve the client’s problem or discuss it further. suggests the problem does not exist. client is prevented from working through feelings. little attempt is made to understand the needs of the client

Question 305

Counselor’s responses to client: probing

Answer 305

attempt to clarify or gain more information as they recall details. may encourage conversation

Question 306

Counselor’s responses to client: understanding

Answer 306

one of the best ways to respond, try to recreate the persons message in your own frame of reference. may lead to more client cooperation. helps client feel accepted and safe in expressing their feelings

Question 307

Cognitive Behavior Theory

Answer 307

focus on identifying behaviors and thoughts that have a negative impact on desired behaviors and goals and apply strategies to change those thoughts

Question 308

Motivational Interviewing

Answer 308

It is a client-centered method for enhancing intrinsic motivation, guides rather than directss, and does not give advice to the client

Question 309

Motivational Interviewing strategies

Answer 309

1. Express empathy (suggests acceptance), evocation (summons feelings)
2. Develops discrepancy-between where he is and where he wants to be
3. Avoid arguments and confrontation
4. Roll with resistance-acknowledge reluctance to change and ambivalence; offer new information or alternatives to consider
5. Support self-efficacy-reinforce hope and optimism
6. Client autonomy means that decisions are left to the client

Question 310

Methods of communication: written

Answer 310

more formal and authoritative: email, texting, handouts
1. interpreted more accurately-use when record is required
2. keep reading level around 8th grade for general population and 6th grade for low literacy audiences
3. procedure for determining readability: SMOG Index gives grade level of written text by determining average number of polysyllabic words

Question 311

Methods of communication: verbal

Answer 311

more personal, encourages two-way communication
most critical barrier: poor listening skills

Question 312

Methods of communication: media activities

Answer 312

1. develop media partnerships with local television and radio stations: extends reach to audiences that maybe out of reach due to financial reasons
2. introduce campaign to the community with kickoff events (press conference at farmer’s market, grocery store), develop 2-4 key messages
3. sustain ongoing media relationships with a few key reporters who cover food or health issues offer to serve as resource for them

Question 313

Formative evaluation

Answer 313

made early or during course of education, can change direction
1. helps pinpoint parts mastered and parts not mastered
2. allows for revision of plans and methods to improve the process
3. answers “How should we do it?”
4. client must be involved; focus group, pre-test, pilot test
5. frequent feedback of results guides the rest of the educational process
6. often qualitative with data collection by observation, interviews

Question 314

Summative evaluation

Answer 314

designed at planning stage but conducted at end
1. considered final; purpose may be grading, or evaluation of progress
2. Did we achieve what we planned? What was the impact, the outcome?
3. example: post-test
4. have client perform a task using new information
5. purpose is to improve a program’s delivery and effectiveness. Did is result in desired changes?
6. uses quantitative approaches to appraise results, outcomes, or quality

Question 315

Formal vs Informal evaluation

Answer 315

Formal-objective test: not well suited for clinic or community setting
-performance test: client asked to complete task based on learning objectives
Informal-unstructured observation of food selection and behaviors

Question 316

Documentation

Answer 316

1. Documentation of employee education and training is essential for safety issues and the correct use of all equipment
2. Use orientation checklist. Note date and content of training
3. The Joint Commission requires documentation of nutrition services to evaluate MNT and for any legal issues that may arise

Question 317

Nutritional informatics

Answer 317

the intersection between nutrition, information and technology. use of technology in spreading information
Technology drives change in the practice of Dietetics

Question 318

EHR, EMR, PHR

Answer 318

EHR-electronic health records, EMR-electronic medical record: enter, store, retrieve and manage information related to health care
PHR-personal health record: consumer maintains health information

Question 319

HIPAA

Answer 319

maintains privacy of PHI (protected health information).
Patients’ rights to their own health information, privacy and confidentiality.
Patients must be notified if their medical information is to be shared outside of the care process, or if protected information (address, email, income) is to be shared.

Question 320

Telehealth services

Answer 320

use of electronic information and technologies to support long-distance clinical health care, patient and professional education, public health administration, remote patient face-to-face services, via live video conferencing, store and forward telecommunication services (clinical data, images, sound, video) which can then be retrieved by another site for clinical evaluation.

Question 321

Telenutrition

Answer 321

RDN uses electronic information and technologies to implement the NCP with clients at a remote location within provisions of their state license as applicable. Medicare Part B allows some services provided by RDNs to be offered via telehealth including MNT, diabetes self-management training

Question 322

ANDHII

Answer 322

Academy of Nutrition and Dietetics Health Informatics Infrastructure
tracks nutrition care outcomes and advances evidence-based nutrition practice research. On-line data collection uses familiar terminology. (DOR) Dietetics Outcomes Registry aggregates anonymous data available for outcomes research

Question 323

Altmetrics

Answer 323

presentation of amount of activity from Twitter, Facebook, science blogs, mainstream news and other sources over time

Question 324

NCP National Consumer Panel

Answer 324

data helps manufacturers understand consumer preferences on specific brands; enables retailers to stock the right item assortment for their local markets

Question 325

Three branches of government

Answer 325

1. Legislative: introduce and enact a law, override veto by the executive branch
2. Executive: may veto legislation or sign it into law
3. Judiciary: may discard law if it considers it in violation of a person’s basic rights and freedoms

Question 326

Operating and enforcement agencies that carry out the law

Answer 326

1. FTC: Federal Trade Commission, regulates content of food ads, enforces truth-in-labeling, challenges product claims when product crosses state lines
2. FDA-ensures safety of some domestic and imported food products
3. FCC-Federal Communications Commission, licenses radio and TV

Question 327

Stages of Public policy and legislation

Answer 327

1. Legislation enters as a bill or a resolution
2. The bill is sent to committees which schedule public hearing where testimony is taken from bill’s sponsors. Nutritionist can present views here or in earlier planning stages
3. The committee revises bill during a markup session and put into final form. If approved, it is sent to Rules Committee for debate
4. It needs approval from both Houses (House of Representatives and Senate) and the President
5. Differences between the two Houses are worked out in a Joint House-Senate Conference Committee, ultimately passing a reconciliation bill
6. Appropriations bill must be passed to provide funding
7. formulate regulations that interpret and operate the law
   -a federal regulation interprets a law and provides details and rules that put the policy into effect; carries the force of a law but is easier to change
   -regulations are written by staff members of the agencies charged with enforcing the regulations

Question 328

Federal Register

Answer 328

notices of public hearing, proposed and final rules, agency decisions, published weekly; lists changes in USDA food programs

Question 329

Congressional Record

Answer 329

information from floor, NO HEARINGS lists bill with sponsors and action, issued daily when Congress is in session

Question 330

Congressional Index

Answer 330

weekly update; identifies bill with sponsor and committee

Question 331

Advocacy

Answer 331

aggressive form of action; plead cause of a group
1. know facts and arguments for and against the issue
2. be realistic-usually results in compromise
3. lobbying-activities aimed at influencing public officials and legislators

Question 332

Child Nutrition Reauthorization

Answer 332

covers NSLP, SBP, CACFP, SFSP, SMP, WIC

Question 333

The Farm Bill

Answer 333

covers national and international nutrition education, research, funding

Question 334

The Older Americans Act

Answer 334

funds nutrition programs in the community

Question 335

Steps in research

Answer 335

1. identify a relevant and important topic: review published research literature related to the topic
2. Develop well-considered research question
3. Research question leads to a hypothesis
4. Prepare research protocol: methodology to solve the problem
5. Organize methods and materials, collect and analyze data
6. Study results and make decisions
7. Study design and checklists

Question 336

Hypothesis should be:

Answer 336

feasible, interesting, novel, ethical, and relevant

Question 337

Meta analysis

Answer 337

combines the results of numerous small studies to increase the strength of belief in the observed effects
Studies are of similar design, have defined inclusion and exclusion criteria, and are published peer-reviewed studies

Question 338

QUOROM

Answer 338

has proposed quality standards for the review and monitoring of systematic reviews and meta-analysis of randomized trials

Question 339

PRISMA

Answer 339

evidenced-based minimum set of items for reporting in systematic reviews and meta-analyses. focuses on the reporting of reviews evaluating randomized trials, but can also be used as a basis for reporting systematic reviews of other types of research, particularly evaluations of interventions

Question 340

MOOSE

Answer 340

Meta-analysis of Observational Studies in Epidemiology (suggests common evaluation criteria)

Question 341

CONSORT

Answer 341

common criteria for clinical trials

Question 342

Research report

Answer 342

1. abstract
2. general introduction
3. review of existing literature
4. methodology
5. results
6. discussion
7. conclusion
8. implications

Question 343

Descriptive vs analytical research

Answer 343

descriptive-describes state of nature at a point in time, generates hypothesis regarding determinants of a condition or disease, provides baseline data and monitors changes over time, establishes associations among factors, but does not allow causal relationships to be determined
analytical-tests hypotheses concerning the effects of specific factors of interest and allows causal associations to be determined

Question 344

Types of descriptive research

Answer 344

1. qualitative research-generates narrative data collected through interviews, observations, questionnaires; may use focus group-Delphi
2. case report, case study, or case series-report observations on one subject or more than one subject
3. surveys-research designed to describe and quantify characteristics of defined population; defined time frame; pinpoints problems
4. correlation studies or ecological studies-compare frequency of events in different populations with the per capita consumption of certain dietary factors

Question 345

Types of analytical research

Answer 345

1. Experimental model-randomized control trials
2. Quasi-experimental design-series of measurements at periodic intervals before the program begins and after the program ends, shows whether continued pattern or noteworthy change
3. Cohort studies-cohort of healthy people with a behavior and one without a behavior followed through time to see if they develop a specific disease (incidence)
4. Case control studies-those with the disease are compared with a group without the disease, but otherwise similar in characteristics
5. Cross-sectional studies-one time data collection counting all of the cases of a specific disease among a group of people at a particular time (prevalence)

Question 346

Parallel design research

Answer 346

participants are randomly assigned to a particular treatment group and remain on that treatment throughout the study

Question 347

crossover design study

Answer 347

each participant serves as their own control, intervention-wash out period-intervention

Question 348

Institutional Review Board

Answer 348

committee established to review and approve research involving human subjects to ensure it is conducted within all ethical and federal guidelines
AKA Independent Ethics Committee, Ethical Review Board, or Research Review Board

Question 349

To be designated as an author of a manuscript in a biomedical journal

Answer 349

you must have made substantial contributions to the design or analysis and the interpretation of the data

Question 350

Relevance or validity

Answer 350

ability to measure phenomenon it intends to measure

Question 351

Internal validity

Answer 351

tests whether the difference between the two groups is real (has the experimental group really performed differently)

Question 352

External validity

Answer 352

tests whether or not a generalization can be made from the study to a larger population

Question 353

Analysis of variance

Answer 353

ANOVA-tool used to evaluate validity
asks whether the difference between samples is a reliable one that would be repeated
used when several products compete against one another
compares the variance between groups with the variance within groups
answers: are there one or more significant differences anywhere among the the samples

Question 354

Reliability

Answer 354

consistency or reproducibility of test results
1. test then retest later: are the results similar?
2. parallel forms: two separate but similar forms of the same test at the same time, reliable if similar results
3. split halves: divide the test in half, reliable is similar results

Question 355

Precision

Answer 355

amount of variation that occurs randomly
less random variation-> greater precision in the measurement and greater reliability

Question 356

Sensitivity and specificity

Answer 356

sensitivity-proportion of afflicted individuals who test positive
specificity-proportion of non-afflicted identified as non-afflicted

Question 357

Nominal variables

Answer 357

variables that fit into a category with no special order (gender, race, marital status, present or absent)

Question 358

Rank order variables

Answer 358

observations compared with each other and put in order, perhaps best to worst, or state of disease from 1 to 4

Question 359

Numerical discrete variables

Answer 359

data with numbers (number of clinics)

Question 360

Dependent vs Independent variables

Answer 360

dependent-outcomes
independent-what you manipulate in the study

Question 361

Probability sampling

Answer 361

each segment of the population will be represented in the sample
randomization-select sample from whole population

Question 362

Non-probability sampling

Answer 362

no way of forecasting that each element in the population will be represented in the sample
convenience or accidental, quota

Question 363

Arithmetic mean

Answer 363

simple average

Question 364

Median

Answer 364

midpoint

Question 365

Mode

Answer 365

most frequently occurring value; prediction most likely to right

Question 366

Range

Answer 366

measure of dispersion, difference between the lowest and highest values in the distribution

Question 367

Standard deviation

Answer 367

indicates degree of dispersion about the mean value, square root of the sum of the squared deviations of each value from the mean divided by the number of observations
68% of observations within 1 SD
95% within 2 SD

Question 368

Linear correlation coefficient (r)

Answer 368

measures the degree to which the points in a scatter diagram cluster about a straight line
r is between -1 and 1
closer to 1 (or -1) is closer to a straight line
r=0 is no linear relationship

Question 369

Clinical significance

Answer 369

change or difference in outcomes that somebody cares about

Question 370

p-value

Answer 370

less than or equal to .05: significant difference, results are reliable
smaller p value the higher confidence that the effect observed is real

Question 371

Double blind study

Answer 371

removes bias from research; neither the researcher nor the subject knows which group is receiving the treatment and which the placebo

Question 372

Mortality

Answer 372

rate of death

Question 373

Morbidity

Answer 373

state of disease

Question 374

Variable of interest

Answer 374

what researchers are observing

Question 375

Population of interest

Answer 375

describes group about which the observations are made

Question 376

Descriptive statistics

Answer 376

summarizes and describes aspects of a set of data

Question 377

Inferential statistics

Answer 377

techniques that allow conclusions to extend beyond and immediate data set; what is the probability that the results can be applied to a larger group; what can you infer from the results of your study

Question 378

Nonparametric test

Answer 378

does not depend on a normal distribution

Question 379

Dichotomous scores

Answer 379

only two events are possible (heads, tails)

Question 380

Continuous scores

Answer 380

measured on a continuous scale

Question 381

Pilot study

Answer 381

scaled down version of the larger investigation; practice implementation, determine whether clinical trial, as planned, is feasible; are goals realistic and attainable? includes every step in the study, but done on a small test group; formative evaluation

Question 382

Focus group

Answer 382

method of attaining information about a target group; small group who talk about the beliefs, opinions, problems; contributes attitudinal data

Question 383

Chi square

Answer 383

tests whether or not there is a real difference between categories
used with attributes that have more than two categories
compares frequency with which we’d expect certain observations to occur with the frequency they actually occur

Question 384

t test

Answer 384

tests significance between the means of two different populations

Question 385

histogram

Answer 385

block diagram whose blocks are proportional in area to the frequency in each class or group, summarizes data from a process that has been collected over time

Question 386

AND Evidence Analysis Library

Answer 386

Evidence-based guidelines summarized by subject matter experts and trained analysts that assist in answering questions that may arise during provision of nutrition care

Question 387

Energy Sources

Answer 387

Carbohydrates- 4 kcal/g
Protein- 4 kcal/g
Fat- 9 kcal/g

Question 388

Energy Source for the brain

Answer 388

glucose exclusively; ketone bodies during starvation

Question 389

Tissue stores of glucose

Answer 389

1. glycogen from muscle and liver
2. fat from adipose tissue
3. cellular mass (protein stores)

Question 390

Gluconeogenesis

Answer 390

conversion of non-carbohydrate sources into glucose (from glycerol and amino acids)

Question 391

Homeostasis

Answer 391

state of equilibrium of the internal environment of the body

Question 392

Cellular oxidation: enzymes

Answer 392

proteins, organic catalysts that control reaction

Question 393

Cellular oxidation: coenzyme

Answer 393

enzyme activators; includes some vitamins
pantothenic acid (B5), thiamin (B1), riboflavin (B2), niacin (B3) are needed for energy production

Question 394

Cellular oxidation: substrate

Answer 394

substance upon which an enzyme works

Question 395

Cellular oxidation: cofactor

Answer 395

assists enzymes; minerals

Question 396

Cellular oxidation: hormones

Answer 396

secretions from endocrine glands
1. chemical messengers that trigger enzymes
2. thyroxine- regulates metabolism and rate of oxidation
-influences physical and mental growth
-stimulates liver glycogenolysis, gluconeogenesis-raises blood glucose

Question 397

Cellular oxidation: energy reactions

Answer 397

1. anabolism: synthesis of a more complex substance
2. catabolism: breakdown; uses and releases energy; creates a constant energy deficit, which must be supplied by food

Question 398

Total Energy Expenditure (TEE)

Answer 398

BEE + EEPA + TEF
basal energy expenditure + energy expended in physical activity + thermic effect of food

Question 399

Basal Energy Expenditure (BEE)

Answer 399

minimum amount of energy needed at rest in fasting (amount needed to carry out involuntary work of the body, activity of internal organs, internal temperature)
-affected by extremes in environmental temperature (tropical climate 5-20% increase)
-caffeine, alcohol, nicotine stimulate metabolic rate 7-15%

Question 400

Energy Expended in Physical Activity (EEPA)

Answer 400

highly variable; activity thermogenesis

Question 401

Thermic Effect of Food (TEF)

Answer 401

diet-induced thermogenesis (DIT), or calorigenic effect of food (about 10% of total energy expenditure)
-energy needed to digest, absorb and assimilate nutrients
-greater after consumption of CHO and PRO than fat

Question 402

Basal Metabolic Rate (BMR)

Answer 402

measured in the morning when reclining, awake, relaxed, at normal body temperature, at least 12 hours after last meal, and several hours after strenuous activity
-measures oxygen consumed and carbon dioxide produced
-higher during periods of growth, pregnancy, lactation, fever (7% increase for each degree rise in temperature), some diseases which increase cell activity
-increased by exercise

Question 403

BMR is affected primarily by:

Answer 403

1. sex-women 5-10% lower than men
2. age- highest BMR 0-2 years old
   -older adults have less activity, less lean body mass, more body fat resulting in lower BMR
3. body composition, body surface area
4. endocrine glands-thyroid

Question 404

BMR is measured by PBI (protein bound iodine)

Answer 404

measures activity of thyroid gland
1. hormones: thyroxine (T4), triiodothyronine (T3)
2. when PBI is elevated, BMR is elevated
3. measures energy metabolism; measures level of thyroxine produced
4. not a nutritional assessment parameter

Question 405

Resting Metabolic Rate (RMR)

Answer 405

energy expenditure measured under similar conditions, after a short rest and controlled intake of caffeine, alcohol
more frequently measured than the BMR; greater than BMR (10-20%)
Mifflin St Jeor-use with normal weight and obese individuals

Question 406

Measures of energy utilization-weight control

Answer 406

following changes in weight is the most practical way of measuring energy balance

Question 407

Calorimetry

Answer 407

direct- measures heat produced in respiration chamber
indirect- measures oxygen consumed and carbon dioxide excreted using a portable machine, useful with athlete, burns

Question 408

Respiratory Quotient (RQ)

Answer 408

carbon dioxide expired/oxygen consumed
RQ=1 CHO alone
RQ=0.82 PRO alone
RQ=0.7 fat alone
RQ=0.85 mixed intake

Question 409

Monosaccharide

Answer 409

glucose, fructose, galactose (simple sugars)

Question 410

Disaccharides

Answer 410

sucrose (glucose + fructose)
lactose (glucose + galactose)
maltose (glucose +glucose)

Question 411

Polysaccharide

Answer 411

complex sugars
1. starch-glucose chains; 50% of CHO intake
2. cellulose-resistant to digestive enzyme amylase; adds bulk
3. pectin- non-digestible; thickening quality; fruits
4. glycogen-animal starch; from glucose; stored in muscle and liver
5. dextrin-intermediate product of starch break down

Question 412

Sorbitol

Answer 412

alcohol from glucose; absorbed more slowly than glucose by passive diffusion; converted to fructose; excess may cause diarrhea

Question 413

Carbohydrates in order of sweetness

Answer 413

Fructose, invert sugar, sucrose, glucose, sorbitol, mannitol, galactose, maltose, lactose

Question 414

Carbohydrate sources

Answer 414

flour, cereals, fruits, vegetables, dairy products

Question 415

Carbohydrate functions

Answer 415

1. energy
2. protein-sparing action: allows most of protein to be used for tissue synthesis
3. regulation of fat metabolism: a CHO restriction leads to ketosis

Question 416

Composition of protein

Answer 416

carbon, hydrogen, oxygen, nitrogen (16%), sulfur (found in cysteine and methionine)

Question 417

Amino Acids structure

Answer 417

amino group (NH2)-base
carboxyl group (COOH)-acid

Question 418

Essential Amino Acids

Answer 418

PVT TIM HaLL
Phenylalanine
Valine
Threonine
Tryptophan
Isoleucine
Methionine
Histidine
Leucine
Lysine

Question 419

Conditionally essential Amino Acids

Answer 419

during catabolic stress: arginine and glutamine

Question 420

Tryptophan is a precursor to:

Answer 420

serotonin and nicain

Question 421

Phenylalanine converts to

Answer 421

tyrosine

Question 422

Methionine converts to

Answer 422

cysteine

Question 423

Complete proteins

Answer 423

all essential amino acids in sufficient quantity and ratio to maintain body tissues and promote growth; HBV high biological value
Soy protein, quinoa, and animal protein

Question 424

Incomplete proteins

Answer 424

deficient in one or more essential amino acids
legumes- low in methionine, cystine, and tryptophan
gelatin- low in methionine, lysine, no tryptophan

Question 425

Protein classification

Answer 425

1. simple-amino acids
2. conjugated-simple plus non-protein substance (lipoprotein)
3. derived- fragments from simple and conjugated (peptide)

Question 426

Protein sources

Answer 426

meat, poultry, fish, eggs, milk, legumes

Question 427

Protein functions

Answer 427

1. tissue synthesis, maintains growth, regulates body processes
2. inefficient energy source-nitrogen must be removed first (58% of PRO can be converted to glucose)

Question 428

PRO diet requirements

Answer 428

0.8 g/kg (10-15% of total energy intake)

Question 429

Fat (lipid) types

Answer 429

1. simple: triglycerides (3 fatty acids, 1 glycerol)
2. compound: simple fat plus other component (phospholipid -in cell membranes; control passage of compounds in an out of the cell. most are lecithins which contain choline (lipotropic factor). helps prevent fat accumulation in the liver. it functions in the transport and utilization of fatty acids and cholesterol through the enzyme LCAT (lecithin-cholesterol acyltransferase))
3. derived: fat substance derived from a simple or compound fat by hydrolysis or enzymatic breakdown; fatty acid, glycerol, steroid

Question 430

Saturated fatty acids

Answer 430

all available bonds of carbon chain are filled with hydrogen; solid at room temperature

Question 431

Unsaturated fatty acids

Answer 431

one (mono) or more (poly) double bonds
safflower=most polyunsaturated
canola=most unsaturated

Question 432

Essential fatty acid

Answer 432

absence will create a specific deficiency disease
linoleic (omega 6)
a-linolenic acid (omega 3)

Question 433

Linoleic acid (omega 6)

Answer 433

lack creates eczema, poor growth rate, petechiae (red, purple skin spots)
1. if replaces CHO: LDL decreases, HDL increases
2. if replaces saturated fat: total cholesterol decreases, HDL decreases
3. Safflower is the best source

Question 434

A-linolenic acid (omega 3)

Answer 434

retinal function and brain development; deficiency-neurological changes-numbness, blindness
1. comes mainly from fish oils (EPA, DHA), walnuts, flaxseed, canola
2. decreases hepatic production of triglycerides (inhibits VLDL synthesis); little effect on total cholesterol levels

Question 435

Structure of fatty acids

Answer 435

1. straight hydrocarbon chains terminating in a carboxyl group at one end and a methyl group at the other end
2. classified by the number of carbons in the chain, the position of the first double bon, and the number of double bonds
3. the location of the first double bound, counted from the METHYL end of the FA, is designated by the omega sign

Question 436

Hydrogenation

Answer 436

reduction process of adding hydrogen (at the double bond) to unsaturated fatty acids to increase saturation and stability
1. trans-hydrogens across from each other, intake harmful to cell function; found in milk fat, margarines, shortenings, frying fats
2. cis-hydrogens on same side as the double bond; most natural fats and oils

Question 437

most to least saturated fat

Answer 437

coconut oil, palm kernel, cocoa butter, butter, palm oil, canola

Question 438

Medium chain triglycerides

Answer 438

SFAs between 6 and 12 carbons-naturally found in milk fat, coconut oil, and palm kernel oil

Question 439

most to leat monounsaturated fat

Answer 439

olive, canola, peanut, sunflower, coconut (MCT source)

Question 440

most to least polyunsaturated fat

Answer 440

safflower, corn, soybean, cottonseed, palm kernel

Question 441

most to least FA in butter and margarine

Answer 441

butter-SAT, MUFA, PUFA
margarine- PUFA, MUFA, SAT

Question 442

lipid food sources

Answer 442

butter, oils, nuts, bacon

Question 443

lipid functions

Answer 443

1. energy, insulation and padding, depresses gastric secretion so delays emptying
2. has less oxygen, more carbon than CHO so provides more energy (more carbons for oxidation)

Question 444

lipid diet requirements

Answer 444

less than 30% of calories

Question 445

Alcohol

Answer 445

metabolized as fat-7 kcal/g
kcal=proofoz0.8 (proof = %alcohol*2)
requires no digestion, is readily absorbed by simple diffusion through stomach or small intestine lining and transported unaltered in bloodstream
decreases beta oxidation of fatty acids, promotes triglyceride synthesis
established risk factor for head and neck cancer
may increase risk of developing breast cancer

Question 446

Winterized oil

Answer 446

salad dressings, won’t crystallize when cold, clear (not cloudy)
corn, soy, cottonseed oils are winterized

Question 447

Vitamin A: Properties

Answer 447

Fat-soluble, stored in liver; carotene-precursor, provitamin (nutrient changed into vitamin) converted in intestinal mucosal cells

Question 448

Vitamin A: Function

Answer 448

skin, vision

Question 449

Vitamin A: sources

Answer 449

yellow, orange fruits (mango); dark green leafy vegetables
cantaloupe, fish, liver, carrots, fortified skim milk, apricots, sweet potato

Question 450

Vitamin A: needs

Answer 450

M 900mcg RE
F 700 mcg RE
Toxic level 10,000 IU

Question 451

Vitamin A: deficiencies

Answer 451

Night blindness, nyctalopia, is reversible (detected using dark adaptation test)
Xerophthalmia-corneal damage, not reversible Bitot’s spots on conjunctiva
Dry, scaly skin (hyperkeratosis)

Question 452

Vitamin D: Properties

Answer 452

Cholesterol is precursor
UV light, fat soluble
7 dehydrocholesterol->D3 cholecalciferol->D2 ergocalciferol

Question 453

Vitamin D: Function

Answer 453

Ca, P metabolism

Question 454

Vitamin D: Sources

Answer 454

Sunlight, egg yolk, fortified milk

Question 455

Vitamin D: needs

Answer 455

AI 5-15 mcg

Question 456

Vitamin D: deficiencies

Answer 456

Rickets, Osteomalacia

Question 457

Vitamin E: Properties

Answer 457

Tocopherol, fat soluble
One of least toxic vitamins
High doses of vitamin E may antagonize vitamin K

Question 458

Vitamin E: Function

Answer 458

Antioxidant, resists hemolysis of RBC

Question 459

Vitamin E: sources

Answer 459

Vegetable oils (cottonseed), whole grains, green vegetables, almonds

Question 460

Vitamin E: needs

Answer 460

15 mg; UL 1000 mgs

Question 461

Vitamin E: deficiencies

Answer 461

Hemolytic anemia

Question 462

Vitamin K: Properties

Answer 462

Synthesized by bacteria in lower intestinal tract
No toxicity symptoms
Fat-soluble

Question 463

Vitamin K: Function

Answer 463

Forms prothrombin in liver: aids blood clotting
Given pre-surgery
Calcium metabolism

Question 464

Vitamin K: Sources

Answer 464

Spinach, kale, broccoli
Green, leafy vegetables

Question 465

Vitamin K: Needs

Answer 465

M 120 mcg
F 90 mcg

Question 466

Vitamin K: Deficiencies

Answer 466

Hemorrhage
Affected by: mineral oil antibiotics, anticoagulants

Question 467

Vitamin B1 (Thiamin): Properties

Answer 467

water-soluble
Lost as temp or pH rises
Heat stable in acids

Question 468

Vitamin B1 (Thiamin): Function

Answer 468

Oxidation of CHO
More CHO, more need
Metabolism of pyruvate

Question 469

Vitamin B1 (Thiamin): Sources

Answer 469

Grains, wheat germ, pork, liver

Question 470

Vitamin B1 (Thiamin): Needs

Answer 470

M 1.2 mg
F 1.1 mg

Question 471

Vitamin B1 (Thiamin): Deficiencies

Answer 471

Beriberi, muscle weakness, foot drop, memory loss, tachycardia
Lowered erythrocyte transketolase
More plasma pyruvate

Question 472

Vitamin B2 (Riboflavin): Properties

Answer 472

Lost in UV light

Question 473

Vitamin B2 (Riboflavin): Function

Answer 473

Energy release from protein
Red cell production

Question 474

Vitamin B2 (riboflavin): Sources

Answer 474

liver, kidney, meat, milk

Question 475

Vitamin B2 (Riboflavin): Needs

Answer 475

M 1.3 mg
F 1.1 mg

Question 476

Vitamin B2 (Riboflavin): Deficiencies

Answer 476

Growth failure
Cheilosis-cracked lips
Angular stomatitis-mouth corner cracks, sore throat
Magenta tongue

Question 477

Niacin: Properties

Answer 477

Precursor: tryptophan
Essential in all cells for energy production and metabolism

Question 478

Niacin: Function

Answer 478

Metabolism of CHO, Protein, and fat

Question 479

Niacin: Sources

Answer 479

Protein, peanuts, RTE cereal, chicken, rice, yeast, milk

Question 480

Niacin: Needs

Answer 480

M 16 NE
F 14 NE

Question 481

Niacin: Deficiencies

Answer 481

Pellagra
Dermatitis, diarrhea, dementia
Beefy, bright, red tongue
Symmetrical, pigmented rash in sunlight

Question 482

Folate: Properties

Answer 482

water-soluble
PABA is a precursor
zinc-dependent

Question 483

Folate: Functions

Answer 483

DNA synthesis, forms RBC in bone marrow, prevents neural tube defects

Question 484

Folate: Sources

Answer 484

Fortified dry cereal, liver, kidney, green leafy vegetables, citrus fruits, lentils, beans

Question 485

Folate: Needs

Answer 485

400 mcg

Question 486

Folate: Deficiencies

Answer 486

Megaloblastic
Macrocytic anemia
Diarrhea, fatigue
Irritability, dyspnea

Question 487

Vitamin B6 (Pyridoxine): Properties

Answer 487

INH-isoniazid (B6 antagonist)

Question 488

Vitamin B6 (Pyridoxine): Functions

Answer 488

Coenzyme in amino acid metabolism: deamination, transamination
More protein-more pyridoxine

Question 489

Vitamin B6 (Pyridoxine): Sources

Answer 489

Meat, wheat, corn, yeast, pork, liver, RTE cereal

Question 490

Vitamin B6 (Pyridoxine): Needs

Answer 490

M 1.2-1.7 mg
F 1.3-1.5 mg

Question 491

Vitamin B6 (Pyridoxine): Deficiencies

Answer 491

Seizures, anemia
Dermatitis, glossitis, peripheral neuropathy

Question 492

Vitamin B12 (Cyanocobalamin): Properties

Answer 492

Contains cobalt
Bound by intrinsic factor in gastric juice

Question 493

Vitamin B12 (Cyanocobalamin): Functions

Answer 493

Coenzyme in protein synthesis
Forms RBC

Question 494

Vitamin B12 (Cyanocobalamin): Sources

Answer 494

Liver, meat, milk, kidney, eggs, fish, cheese

Question 495

Vitamin B12 (Cyanocobalamin): Needs

Answer 495

2.4 mcg

Question 496

Vitamin B12 (Cyanocobalamin): Deficiencies

Answer 496

Macrocytic, megaloblastic anemia
Pernicious anemia-after gastrectomy or removal of ileum. Due to lack of intrinsic factor

Question 497

Vitamin B5 (Pantothenic acid): Functions

Answer 497

Coenzyme A-energy
Synthesis of fatty acids

Question 498

Vitamin B5 (Pantothenic acid): Sources

Answer 498

Animal foods, grains, legumes

Question 499

Vitamin B5 (Pantothenic acid): Needs

Answer 499

AI 5 mg

Question 500

Vitamin B5 (Pantothenic acid): Deficiencies

Answer 500

Rare
Paresthesia in feet

Question 501

Vitamin C (Ascorbic acid): Properties

Answer 501

Most easily destroyed, structure like glucose
Antioxidant
Needs acid pH
Destroyed by heat, alkaline pH, oxidation

Question 502

Vitamin C (Ascorbic acid): Functions

Answer 502

Changes proline into hydroxyproline into collagen which strengthens intercellular substances
Wound healing
Aids iron absorption

Question 503

Vitamin C (Ascorbic acid): Sources

Answer 503

Citrus fruits, potatoes, papaya, dark green, yellow vegetables

Question 504

Vitamin C (Ascorbic acid): Needs

Answer 504

75-90 mg

Question 505

Vitamin C (Ascorbic acid): Deficiencies

Answer 505

Scurvy, poor wound healing, bleeding gums, petechiae

Question 506

Vitamin B7 (Biotin): Properties

Answer 506

Synthesized by intestinal bacteria, inactivated by avidin (protein in raw egg white)

Question 507

Vitamin B7 (Biotin): Functions

Answer 507

Coenzyme in fatty acid synthesis, converts pyruvate to oxaloacetate in gluconeogenesis

Question 508

Vitamin B7 (Biotin): Sources

Answer 508

Liver, kidney, egg yolk, yeast

Question 509

Vitamin B7 (Biotin): Needs

Answer 509

AI 30 mcg

Question 510

Vitamin B7 (Biotin): Deficiencies

Answer 510

Muscle pain, dermatitis, glossitis

Question 511

Vitamin B8 (Myo-inositol): Properties

Answer 511

In plants as phytic acid related to sugar contains phosphorous vitamin-like factor

Question 512

Vitamin B8 (Myo-inositol): Functions

Answer 512

Binds calcium, zinc, iron membrane structure

Question 513

Vitamin B8 (Myo-inositol): Sources

Answer 513

Outer husks of cereal grains, leafy green vegetables

Question 514

Calcium: Properties

Answer 514

Most abundant mineral
Regulated by parathyroid hormone, Vitamin D, acid, lactose aid absorption.
Calcitonin lowers serum calcium by inhibiting bone resorption

Question 515

Calcium: Functions

Answer 515

Blood clotting, cardiac function, nerve transmission, smooth muscle contractility

Question 516

Calcium: Sources

Answer 516

Dairy products, Leafy vegetables, Legumes

Question 517

Calcium: Needs

Answer 517

1000-1200 mg

Question 518

Calcium: Deficiencies

Answer 518

Hypocalcemia leads to tetany
associated with vitamin D and Mg deficiencies

Question 519

Phosphorous: Properties

Answer 519

Second most abundant mineral
Part of DNA, RNA, and ATP

Question 520

Phosphorous: Functions

Answer 520

Phospholipids transport fat through lymph and blood
Bone, teeth

Question 521

Phosphorous: Sources

Answer 521

Meat, milk, poultry, eggs, fish, cheese

Question 522

Phosphorous: Needs

Answer 522

700 mg

Question 523

Phosphorous: Deficiencies

Answer 523

Rare

Question 524

Iron: Properties

Answer 524

Trace mineral
Part of hemoglobin
Food iron: ferric
Absorbable: ferrous
Stored: ferritin
Iron overload: Hemochromatosis treated with iron chelation therapy

Question 525

Iron: Function

Answer 525

Oxygen transport

Question 526

Iron: Sources

Answer 526

Heme: animal foods, meat, fish, poultry
Non-heme: cereals, vegetables, poorly absorbed; absorption aided by gastric juice, vitamin C, Calcium helps if oxalates are present.
Does not aid absorption: eggs, tea, milk, cheese

Question 527

Iron: Needs

Answer 527

M 8 mg
F 18 mg

Question 528

Iron: Deficiencies

Answer 528

Pale tongue, fatigue
Anemia
Spoon-shaped nails
Pale conjunctivae (mucous membranes lining eyelid)
Higher prevalence in infants and adolescents

Question 529

Magnesium: Properties

Answer 529

Part of chlorophyll
50% in bone, 50% in cells

Question 530

Magnesium: Functions

Answer 530

Protein and fatty acid synthesis
Stabilizes structure of ATP
High protein, calcium, vitamin D increases need

Question 531

Magnesium: Sources

Answer 531

Most foods, milk, bread

Question 532

Magnesium: Needs

Answer 532

M 420 mg
F 320 mg

Question 533

Magnesium: Deficiencies

Answer 533

Rare-tremors

Question 534

Zinc: Properties

Answer 534

Trace mineral
Excess leads to copper or iron deficiency

Question 535

Zinc: Functions

Answer 535

Increases taste acuity
Enhances insulin action
Stabilizes DNA, RNA
Cell division

Question 536

Zinc: Sources

Answer 536

Meat, liver, eggs, fish
Phytates and copper decrease absorption

Question 537

Zinc: Needs

Answer 537

M 11 mg
F 8 mg

Question 538

Zinc: Deficiencies

Answer 538

Reduced immune function, alopecia, poor wound healing, hypogeusia
Growth retardation and sexual immaturity in adolescents

Question 539

Iodine: Properties

Answer 539

Trace mineral
Part of thyroxine

Question 540

Iodine: Sources

Answer 540

Seafoods, iodized salt

Question 541

Iodine: Needs

Answer 541

150 mcg

Question 542

Iodine: Deficiencies

Answer 542

Goiter

Question 543

Fluoride: Properties

Answer 543

Trace mineral

Question 544

Fluoride: Functions

Answer 544

Teeth, bones

Question 545

Fluoride: Sources

Answer 545

Soil, water

Question 546

Fluoride: Needs

Answer 546

M 4 mg
F 3 mg

Question 547

Fluoride: Deficiencies

Answer 547

Dental caries

Question 548

Copper: Properties

Answer 548

Trace mineral
Attached to protein ceruloplasmin

Question 549

Copper: Function

Answer 549

Hemoglobin synthesis
Aids iron absorption

Question 550

Copper: Sources

Answer 550

Beef liver, kidney, oysters, shellfish, seeds and nuts, dark leafy greens

Question 551

Copper: Needs

Answer 551

900 mcg

Question 552

Copper: Deficiencies

Answer 552

Rare: microcytic anemia, neutropenia
Wilson’s disease: low serum copper, genetic absence of liver enzyme

Question 553

Selenium: Properties

Answer 553

Cooperates with vitamin E
Trace mineral

Question 554

Selenium: Function

Answer 554

Antioxidant
Tissue respiration

Question 555

Selenium: Sources

Answer 555

Soil, grains, meat, fish, poultry, dairy

Question 556

Selenium: Needs

Answer 556

M 55 mcg
F 45 mcg

Question 557

Selenium: Deficiencies

Answer 557

Myalgia, cardiac myopathy

Question 558

Manganese: Properties

Answer 558

Trace mineral

Question 559

Manganese: Functions

Answer 559

Central nervous system

Question 560

Manganese: Sources

Answer 560

Whole grains, legumes, nuts

Question 561

Manganese: Needs

Answer 561

1.8-2.3 mg

Question 562

Chromium: Properties

Answer 562

Absorption enhanced by vitamin C, niacin
Ultra-trace mineral

Question 563

Chromium: Functions

Answer 563

Aids insulin action
Glucose metabolism

Question 564

Chromium: Sources

Answer 564

Yeast, oysters, potatoes, liver

Question 565

Chromium: Needs

Answer 565

25-35 mcg

Question 566

Chromium: Deficiencies

Answer 566

Insulin resistance

Question 567

Cobalt: Properties

Answer 567

Exists with B12
Stored in liver

Question 568

Cobalt: Functions

Answer 568

Maturation of red blood cells

Question 569

Cobalt: Deficiencies

Answer 569

Related to B12 deficiency

Question 570

Sulfur: Properties

Answer 570

Part of amino acids
cysteine, methionine

Question 571

Sulfur: Functions

Answer 571

Components of organic molecules

Question 572

Sulfur: Sources

Answer 572

Meat, fish, eggs, poultry

Question 573

Sulfur: Needs

Answer 573

425-550 mg AI

Question 574

Choline: Properties

Answer 574

Component of lecithin

Question 575

Choline: Functions

Answer 575

Transports lipids as acetylcholine

Question 576

Choline: Sources

Answer 576

Fat in eggs, milk, liver, soybeans

Question 577

Intracellular vs Extracellular Water

Answer 577

ICW- water within cells, ECW-plasma, lymph, interstitial, intercellular

Question 578

Electrolytes-concentration in milliequivalents

Answer 578

mEq = (mg/atomic weight) * valence
Na: AW=23, Valence=1
K: AW=39, Valence=1
Ca: AW=40, Valence=2

Question 579

Extracellular Electrolytes

Answer 579

Na, Ca, Cl, HCO3
1. NaCl is 40% sodium
2. 1 tsp=6g NaCl=2.4g Na
3. Na is absorbed by aldosterone and retained by steroids
4. normal saline=0.9% NaCl=154 mEq Na and 154mEq Cl per liter

Question 580

Intracellular Electrolytes

Answer 580

K, Mg, P
1. Aldosterone increases excretion
2. Hyperkalemia causes cardiac irregularites

Question 581

Potassium sources

Answer 581

meat, fruits, vegetables (banana, orange, tomato, potato, cantaloupe)
low=apple, cranberry, blueberry, carrot, corn

Question 582

Osmosis

Answer 582

water moves from less to more concentrated side of membrane

Question 583

Diffusion

Answer 583

particles move from more to less concentrated side

Question 584

Effect of protein

Answer 584

exerts colloidal osmotic pressure

Question 585

Albumin

Answer 585

exerts pressure on blood vessel wall that keeps water within. When albumin drops, the pressure drops, causing fluid to leak out. Water moves to interstitial space. Low serum protein leads to edema and ascites

Question 586

Anasarca

Answer 586

extreme, generalized edema and widespread swelling of skin due to effusion of fluid into extracellular space
associated with heart, liver, renal failure, and extreme protein/calorie malnutrition

Question 587

Dehydration

Answer 587

decreased water intake, excessive water output, heavy solute load
1. nausea, dizziness, sunken eyes, fever, hyperventilation, excessive sweating, concentrated urine, dry inelastic skin, increase in solutes (BUN), tachycardia, headache, fatigue, decreased appetite, rapid weight loss
2. Serum sodium is the BEST assessment parameter for fluid status, hypernatremia: dehydration, hyponatremia: over-hydration

Question 588

Acid-base balance

Answer 588

regulation of hydrogen concentration
acid releases hydrogen ions; base takes up hydrogen ions
buffer- mixture of acid and base components to protect against a strong acid or strong base

Question 589

Major buffer in body

Answer 589

carbonic acid and sodium bicarbonate
a change in one side of the buffer brings about a compensatory change in the other side to maintain balance; maintain pH close to 7.4

Question 590

Role of lungs and kidneys: acid-base

Answer 590

1. lungs control supply of carbonic acid (carbon dioxide and water)
   amount altered by rate and depth of breathing
   -hypoventilation-retention of acid; hyperventilation-loss of acid
2. kidneys control bicarbonate (base)
   regulate hydrogen ion secretion and bicarbonate reabsorption
   if kidneys retain bicarbonate-level of base increases
   if kidney excrete excess bicarbonate-level of base decreases

Question 591

Respiratory acidosis

Answer 591

Increase in H2CO3
Causes: CO2 retention; hypoventilation; emphysema
Compensatory response: kidneys increase absorption of base (bicarbonate)

Question 592

Respiratory alkalosis

Answer 592

Decrease H2CO3
Causes: loss of CO2; hyperventilation; anxiety, severe exercise
Compensatory response: kidneys excrete base (bicarbonate)

Question 593

Metabolic acidosis

Answer 593

Decrease HCO3; Increase H
Causes: kidneys excrete excess base: uremia, diarrhea; increased hydrogen production or retention by kidney; uncontrolled diabetes; starvation; high fat or low CHO diet
Compensatory response: respiration increases to expel CO2; hyperventilation

Question 594

Metabolic alkalosis

Answer 594

Increased HCO3; decrease H
Causes: abnormal retention of base increased ingestion of alkali diuretics, vomiting; loss of acid diuretics, loss of chloride
Compensatory response: respiration decreases to retain CO2, hypoventilation

Question 595

Weight gain guidelines during pregnancy

Answer 595

normal weight: 25-35 lbs
underweight: 28-40 lbs
Overweight: 15-25 lbs
Obese: 11-20 lbs
Target at least lower limit
Black and young women: aim for upper end
+1 lb/month 1st trimester
+1 lb/week thereafter

Question 596

Calories during pregnancy

Answer 596

2nd trimester: +340 kcal
3rd trimester: +452 kcal, 71g PRO

Question 597

Calories during lactation

Answer 597

1st 6 months: +330 kcal
6-12 months: +400 kcal
71g PRO

Question 598

At risk during pregnancy

Answer 598

failure to gain 4 lbs/month in last half of pregnancy
< 16 or >/=35 years old
<12 months between pregnancies
pregnant adolescent: needs extra iron , calcium, zinc

Question 599

Pregnancy supplements

Answer 599

ferrous sulfate: 30mgs during 2nd and 3rd trimester
folic acid: 400 mcg (added to 200 from food)

Question 600

AI calcium for pregnancy and lactation

Answer 600

</= 18 yrs: 1300 mg
>18 yrs: 1000 mg

Question 601

Progesterone

Answer 601

hormone that develops placenta after implantation

Question 602

Linolenic acid in pregnancy and lactation

Answer 602

pregnancy: 1.4 g/day
lactation: 1.3 g/day
Needed for development of fetal nervous system

Question 603

Avoid during pregnancy:

Answer 603

preformed vitamin A (supplements>5000IU)
shark, swordfish, king mackerel
limit albacore, raw fish

Question 604

Birthweight categories

Answer 604

Normal birth weight: 2500-4000g
LBW <2500g
VLBW <1500g
ELBW <1000g

Question 605

SGA vs AGA vs LGA

Answer 605

SGA: <10th percentile BW for GA
AGA: 10th-90th percentile
LGA: >90th percentile

Question 606

Calorie, PRO, water needs for 0-6 months

Answer 606

108 kcal/kg, 1.52 g PRO/kg, 125-155 mL water/kg, minimum 30 g fat/day

Question 607

Calorie, PRO, water needs for 7-12 months

Answer 607

98 kcal/kg, 1.2 g PRO/kg, 1.5 mL water/kcal

Question 608

Neonate

Answer 608

birth to 1 month; can absorb whole, intct protein

Question 609

Human milk

Answer 609

20 kcal/oz
colostrum: yellowish transparent fluid during first few days; meets infant needs during first week; has more PRO, less fat and CHO; has antibodies
recommend exclusive for first 6 mo; up to at least 12 mo
milk supply is adequate if infant gains weight/length, has frequent stools, and 6-8 wet diapers/day

Question 610

Maternal hormones-lactation

Answer 610

from pituitary
prolactin stimulates milk production
oxytocin moves milk through the ducts

Question 611

Human milk composition

Answer 611

PRO: 7%
CHO: 38%
Fat: 55%

Question 612

Breast fed infant supplement needs

Answer 612

400IU vitamin D from birth
.25 mg fluoride after 6 months if not in water

Question 613

infant formula

Answer 613

20 kcal/oz; need 2.5 oz/lb/day
has more PRO and iron than HM but lacks antibodies
vitamin D needs met with 1 quart/day
iron-fortified formula recommended for infants on formula

Question 614

Hyperbilirubinemia

Answer 614

unconjugated bilirubin levels elevated within the first week of life as a result of increased breakdown of RBC or decreased intestinal mobility
Encourage 9-12 feedings per day of human milk or formula to promote hydration and intestinal motility

Question 615

Fetal iron stores

Answer 615

Decrease at 3-4 months; need additional iron, preferably from formula or supplemental foods (cereal starting at 4-6 months)
One serving of vitamin C rich foods around 6 months to enhance iron absorption from non-heme sources

Question 616

Introduce solids to infants

Answer 616

4-6 months
sitting posture can be sustained
extrusion reflex diminishes
Begin with iron fortified cereal then strained vegetables or fruits
6-8 months add large finger foods that can be secured with palmar grasp
9-12 months add small finger foods as pincer grasp develops

Question 617

Cow’s milk for infants

Answer 617

no cow’s milk during 1st year
low and non-fat inappropriate for first 2 years
for those who cannot tolerate cow’s milk-based or soy products use formulas made from casein hydrolysate

Question 618

Sunken fontanel

Answer 618

dehydration or protein malnutrition

Question 619

Childhood nutrient needs

Answer 619

1. 1-3 growth rate slows (food serving sizes 2-4 oz, 2-4T); 4-6 growth in spurts; 7-10 growth slows
2. 2002 RDA PRO: 1-3, 13g; 4-8, 19g; 9-13, 34g
3. iron needs: same for boys and girls through age 10
4. limit fruit juice to 4 oz/day up to 6 years
5. at least 60 min of physical activity each day
6. adolescence-final growth spurt; most dietary deficiencies
7. 2002 RDA Pro; males 14-18, 52 g; females 14-18, 46 g
8. calcium for males and females 9-13: 1300 mg AI

Question 620

Weight for length (birth-24 mon; young children 2-5)

Answer 620

identifies under/over nutrition
detects short term changes in nutritional status
used to distinguish between stunting and wasting
<5th may reflect acute illness or wasting; >95th over-nutrition

Question 621

Stature/length for age (birth-24 month recumbent length, 2-20 years height)

Answer 621

defines shortness/tallness
reflects long term nutritional status; determines extent of stunting
affected by long term nutritional stress or chronic illness
<5th short stature

Question 622

Weight for age (birth-24 month and 2-20 years)

Answer 622

NOT used to classify under/over weight
short term marker of growth; affected by acute nutritional stress or illness
CANNOT distinguish between stunting and wasting because it does not include height
further evaluation needed if below 5th or above 95th percentile

Question 623

BMI for age percentiles starting at age 2: age and sex specific

Answer 623

Underweight <5th%ile
Normal weight: 5th-84th %ile
Overweight: 85th-94th %ile
Obese >/=95th %ile or >30
Best measure to assess weight in children (includes height, weight, age)

Question 624

Failure to Thrive in Infants

Answer 624

weight for age falls below 5th %ile on multiple occasions or weight deceleration that crosses 2 major percentiles on a growth chart
may result from acute or chronic illness, restricted diet, poor appetite, lack of fiber leading to chronic constipation, diminished intake

Question 625

Measurement considerations for infants

Answer 625

measure HC until 3
measure supine length until 2
major reason for large discrepancies in growth patterns is human error in measurement

Question 626

Newborn initial weight loss

Answer 626

6% loss of birth weight, should be regained by 10-14 days

Question 627

Weight changes compared to BW (4-5 mo, 1 yr, 2 yr)

Answer 627

4-5 months: BW should double
1 year: BW should triple, length increase by 50%
2 year: BW should quadruple, length should increase by 75%

Question 628

AAP growth charts to assess children with Down syndrome

Answer 628

no longer reflect population; should not be used
growth charts for other special needs are based on relatively small populations; if used, use along with CDC and WHO growth charts

Question 629

Lead poisoning

Answer 629

irritability, lethargy, anorexia, vomiting, constipation, anemia

Question 630

Adulthood nutrient needs

Answer 630

1. physical activity determines needs
2. RDA PRO; >/=19 males, 56 g; females 46 g
3. 45-65% CHO; 20-35% fat; 10-35% PRO
4. Fiber: <50, M 38, F 25; >50 M 30, F 21
5. Fluid: 35 mL/kg or 1 mL/kcal

Question 631

Elderly nutrient needs

Answer 631

1. young old 65-74; aged 75-84; oldest old 85+
2. calorie needs decrease, PRO remains same
3. often lack calcium and iron (decreased absorption due to decreased HCl)
4. constipation due to decreased gastric motility, decreased HCl secretion in stomach
5. fluids: 25-30 mL/kg
6. encourage folate-rich foods; supplements of B6 and B12 may be needed
7. diet high in antioxidants may delay development of cataracts
8. sarcopenia: loss of muscle mass during aging
9. more vulnerable to toxicity of vitamin A (increased liver storage, lower blood clearance)

Question 632

Nutrition and athletics: fluid

Answer 632

athletes need water during physical activity: 16 oz water for every 1 pound body weight lost
during and after continuous endurance physical activity of 1-4 hours, consume fluids that contain CHO and Na

Question 633

CHO loading, glycogen load

Answer 633

stores 2-3 times normal amount of muscle glycogen
adverse effects: weakness, bloating, dizziness, soreness

Question 634

Exercise physiology

Answer 634

1. at rest and during normal activities, fats are the primary energy source (80-90%); CHO (5-18%); PRO (2-5%)
2. during low to moderate intensity aerobic activity (long duration, steady pace) (endurance training), fat is a significant energy source
3. exercise above 60-65% of maximal oxygen uptake, CHO is needed as a fuel source
4. during prolonged exercise, reliance on CHO to provide PYRUVATE for continued lipid oxidation
5. muscle glycogen depleted 2-3 hours of continuous exercise 60-80%
6. creatine supplements do NOT enhance endurance (not helpful for marathon runner, soccer player)

Question 635

Nonnutritive sweeteners

Answer 635

1. saccharin (sweet N low), aspartame (NutraSweet, Equal), acesulfame-K (sunette, sweetone), sucralose (splenda), stevia (truvia), neotame
2. provide minimal to no energy and must be approved by the FDA

Question 636

Sugar alcohols: sorbitol, mannitol, xylitol

Answer 636

1. 40-100% as sweet as sucrose, resistant to digestion, contribute fewer calories
2. can be labeled “sugar-free” but not “calorie-free”
3. cavity-preventing (cariostatic) cannot be digested by bacteria responsible for dental caries
4. function as humectants (holds water) and emulsifiers, extending shelf life
5. more slowly absorbed than other sugars causing diarrhea, abdominal pain, gas (consuming >30g sorbitol not recommended)

Question 637

Herbals, botanicals, and supplements regulated by the DSHEA: Dietary Supplement Health and Education Act 1994

Answer 637

1. clarifies marketing regulations for botanical and reclassifies them as dietary supplements
2. plant extracts, enzymes, vitamins, minerals, hormonal products available without prescriptions may carry ‘structure/function’ claims
3. the physiological effect can be noted, but no claims about prevention or cure of specific conditions can be made

Question 638

Black cohash

Answer 638

Primary use: ease menopause symptoms
Potential interaction: may act as blood thinner, effects statins

Question 639

Comfrey

Answer 639

Primary use: soothe nerves
Potential interactions: irreversible liver disease

Question 640

Echinacea

Answer 640

Primary use: prevent, moderate cold symptoms
Potential interactions: avoid taking >2 months

Question 641

Ephedra

Answer 641

Primary use: promote weight loss
Potential interactions: rapid heart rate, headaches; very likely hazardous

Question 642

Garlic

Answer 642

Primary use: may lower cholesterol, blood pressure
Potential interactions: reduces clotting time; avoid use with warfarin

Question 643

Ginger

Answer 643

Primary use: antiemetic
Potential interactions: avoid use with drugs that affect bleeding

Question 644

Ginkgo biloba

Answer 644

Primary use: vasodilation
Potential interactions: avoid use with warfarin, caution with diabetes, avoid pre-surgery

Question 645

Ginseng

Answer 645

Primary use: immunity, endurance
Potential interactions: high blood pressure, avoid with warfarin; may decrease blood glucose

Question 646

Kava

Answer 646

Primary use: relieve anxiety
Potential interactions: liver failure, very likely hazardous

Question 647

Milk thistle

Answer 647

Primary use: may help protect liver

Question 648

St John’s Wort

Answer 648

Primary use: antidepressive; serotonin-enhancing
Potential interactions: reduces effect of warfarin, avoid with antihypertensives, oral contraceptives, some statins; avoid combinations with spironolactone, thiazide and loop diuretics, hypertensives

Question 649

Saw palmetto

Answer 649

Primary use: remedy for enlarged prostate
Potential interactions: diuretics

Question 650

Valerian root

Answer 650

Primary use: calms nerves
Potential interactions: avoid with liver disease

Question 651

Yohimbe

Answer 651

Primary use: erectile dysfunction
Potential interactions: elevates blood pressure

Question 652

Digestive Process

Answer 652

1. Food in oral cavity is chewed and mixed with saliva secreted by glands in the mouth (parotid, submaxillary, sublingual)
2. Food passes into the stomach via the esophagus through the cardiac valve into the fundus, the upper portion of the stomach that holds the bulk of the food to be digested. Most digestion in the stomach occurs in the pyloric (lower) region
3. Food is then forced into the small intestine through the pyloric valve of the stomach. Complete digestion and absorption of food takes place in the small intestine (duodenum, jejunum, ileum)
4. The hepatic duct from the liever joins with the cystic duct from the gallbladder
5. Bile, produced in the liver, is stored in the gallbladder. The liver stores glycogen and synthesizes glucose
6. The pancreas lies between the duodenum and the stomach
7. Undigested food and water pass through the ileocecal valve into the large intestine or colon

Question 653

Types of digestion: chemical or enzymatic activity

Answer 653

1. in stomach: start of proteolysis by protease pepsin and HCl; limited continuation of starch hydrolysis by salivary amylase
2. hormone gastrin stimulates gastric secretions and motility
3. hormone CCK cholecystokinin (release from duodenum when fat enters) contracts gallbladder releasing bile, stimulates pancreas
4. hormone secretin (duodenum) stimulates flow of pancreatic juice (bicarbonate) and water into the duodenum, inhibits gastric acid secretion
5. hormone glucagon-like peptide 1 (GLP-1), hormone glucose-dependent insulinotropic polypeptide (GIP), released from intestine in presence of glucose and fat, stimulates insulin synthesis and release

Question 654

types of digestion: mechanical or muscular activity

Answer 654

1. mastication-produces bolus (mass of masticated food)
2. rhythmic contractions of esophagus force food into the stomach where it is mixed with gastric juice and reduced to chyme (acidic)
3. Gastric emptying of a meal usually takes between two and six hours. CHO rich and PRO rich foods empty at about the same rate from the stomach. High fat foods and complex CHo, especially soluble fibers, slow gastric emptying
4. acidic chyme enters duodenum, mixes with fluids and bicarbonate ions (from pancreas) which neutralize the acid
5. most digestion is completed by the middle of the jejunum: nutrients absorbed include amino acids, fatty acids, glycerol, simple sugars, minerals, vitamins
6. peristalsis-rhythmic movements of small intestine

Question 655

types of digestion: bacterial digestion

Answer 655

1. large intestine absorbs water, salts, and the vitamins synthesized by bacteria (vitamin K, B12, thiamin, riboflavin) which are used by GI mucosal cells
2. colonic salvage: anaerobic fermentaion and absorption of end products of CHO, fiber and amino acid breakdown
3. converts malabsorbed CHO and fibers into: SCFA (acetate, butyrate, propionate, lactate) which stimulate water and Na absorption in the colon and provides substrates for energy production; gases (H2, CO2, N, CH4)

Question 656

Carbohydrate absorption

Answer 656

simple sugars: small intestine-> liver-> converted to glucose or glycogen

Question 657

Dietary sources of glucose

Answer 657

1. 100% CHO
2. 58% PRO-glucogenic amino acids (yield glucose following deamination)
   -Alanine is the MOST glucogenic amino acid (alanine-glucose cycle) Catabolized to pyruvate or to Kreb’s cycle intermediates
3. fatty acids and muscle glycogen do not contribute to the body’s supply of glucose

Question 658

Sources of glucose

Answer 658

dietary
liver glycogen
products oof intermediary CHO metabolism (reconversion of lactic and pyruvic acid)

Question 659

Uses of glucose

Answer 659

energy
storage
-glycogenesis-in muscle and liver, lipogenesis
small amount is converted into other CHO compounds
-ribose-needed to form RNA, DNA

Question 660

Hormones control blood glucose level

Answer 660

1. insulin-Beta cells of pancreas
   -increases cell permeability to glucose; fosters glycogenesis, lipogenesis
2. glucagon-Alpha cells of pancreas
   -induces glycogenolysis (glycogen->glucose)
3. glucocorticoids
   -PRO->glucose (gluconeogenesis)
   -requires pyridoxine
4. epinephrine-adrenal medulla
   -stimulates sympathetic nervous system
   -stimulates liver and muscle glycogenolysis (glycogen->glucose)
   -decreases release of insulin from pancreas during catabolic stress
5. growth hormone, ACTH (adrenocorticotropic) -insulin antagonists

Question 661

Energy metabolism

Answer 661

glucose in cell is oxidized to produce energy, carbon diaxide, water (end products of metabolism)

Question 662

Glycolysis

Answer 662

in cytoplasm
Purpose is to produce pyruvate for the Kreb’s cycle by breaking down glucose, with or without oxygen, into pyruvate or lactate
1. aerobic glycolysis-end product pyruvate
2. anaerobic glycolysis-end product lactate

Question 663

Steps of glycolysis

Answer 663

1. glucose enters cells aided by insulin; combines with phosphorous in presence of magnesium to form glucose-6-phosphate
   1a. proceeds to pyruvic acid
   1b. may lead to glycogen synthesis
   -liver glycogen releases glucose to blood (requires glucose-6-phosphatase-muscles do not have-muscle glycogen must be used in muscles)
   1c. proceeds through the pentose shunt (side channeling of glucose)
   -does not require ATP; produces ribose and NADPH
   2a. pyruvic acid converted to lactic acid, used for muscle contractions when anaerobic
   2b. pyruvic acid converted to acetyl COA
   -requires thiamin (TDP), niacin (NAD), riboflavin (FAD), pantothenic acid (CoA), magnesium, lipoic acid

Question 664

TCA, Kreb’s, citric acid cycle

Answer 664

1. acetyl CoA (from CHO, fatty acids, or PRO)
2. cycle produces 90% of body’s energy as ATP
3. CHO is the fuel needed to keep the cycle going
4. Oxaloacetate (main CHO fuel) formed from pyruvate and some amino acids reacts with acetyl CoA to form citric acid which starts the cycle
5. alpha ketoglutaric acid (from amino acids through gluconeogenesis) needs thiamin for deoxycarboxylation

Question 665

Full oxidation of 1 molecule of glucose yields:

Answer 665

38 ATP

Question 666

Protein metabolism

Answer 666

amino acids->intestinal capillaries->portal blood stream->tissues
pyridoxine is needed for the transport of amino acids

Question 667

Branched chain amino acids

Answer 667

valine, leucine, isoleucine

Question 668

Exercise and amino acids

Answer 668

exercise releases alanine from muscle proteins; it is transported to the liver deaminated, and converted to glucose
also during exercise, the oxidation of leucine (a BCAA) increases

Question 669

tyrosine can be synthesized from

Answer 669

phenylalanine

Question 670

cysteine can be synthesized from

Answer 670

methionine

Question 671

Nitrogen balance

Answer 671

measures body’s equilibrium
compares intake to output
0 =maintenance, nitrogen equilibrium
+ =net gain in body protein (infant, teenager, pregnancy, healing)
- = erosion of body protein, inadequate intake
formula: PRO/6.25 - UUN (urinary urea nitrogen) - 4

Question 672

Methods to determine the quality of protein in foods

Answer 672

1. BV (biological value)-fraction of absorbed nitrogen retained (egg is BV=100)
2. NPU (net protein utilization)=(N intake-N output)/N intake
3. Protein Digestibility Corrected Amino Acid Score (PDCAAS)-estimates % PRO actually digested (animal-97%, plant-70-90%)

Question 673

Protein anabolism (synthesis)

Answer 673

DNA forms RNA on ribosomes; RNA is template for protein carried into cytoplasm

Question 674

Protein catabolism (pyridoxine is involved)

Answer 674

1. deamination-splitting off NH2 by hydrolysis in the liver
2. NH2 converted to ammonia which is toxic
3. most of NH3 converted to urea and excreted by kidneys
4. some NH3 converted to purines, some used to make nonessential amino acids by transamination
5. remaining carbon chain is a ketoacid, can be oxidized for energy

Question 675

Hormonal control of protein use

Answer 675

1. pituitary growth hormone, thyroid hormone, insulin, testosterone: anabolism
2. adrenal steroids (glucocorticoids)-protein catabolism-stimulate gluconeogenesis

Question 676

Fat metabolism

Answer 676

1. end products of fat digestion: monoglycerides, diglycerides, glycerol, fatty acids
2. absorbed directly into portal blood: glycerol (water soluble), short chain fatty acids (<12 carbons), some phospholipids
3. monoglycerides, diglycerides, long chained fatty acids combine with bile salts form micelles
   -form lipoproteins (chylomicrons); penetrate intestinal mucosa, travel through lymph, into the thoracic duct into the blood
4. cholesterol: some absorbed with bile salts, most absorbed with cholesterol esterase; converted into cholesterol esters and excreted by the liver as bile

Question 677

Fat metabolic activities

Answer 677

1. lipogenesis (synthesis, deposition), insulin is anabolic hormone
   -adipose-most active site: fatty acid+glycerol->triglycerides
   —needs NADPH from pentose shunt
   -liver-synthesizes fat, but should not store fat
   —to prevent fat accumulation: lipotropic factors (choline) produce lipoproteins which transfer fatty acids out of the liver
2. lipoproteins: chylomicron (diet-derived) largest, mostly triglyceride; VLDL about half TG; LDL smaller, mostly cholesterol; HDL rich in protein
3. lipolysis-oxidation forms acetyl CoA which enters Krebs cycle
   -growth hormone, glucagon (insulin antagonist)
   -glucocorticoids, thyroxine, epinephrine, ACTH-increase rate of fat mobilization

Question 678

Ketosis

Answer 678

1. normal fat metabolism-requires adequate CHO for complete fat oxidation
2. abnormal fat metabolism-inadequate CHO (starvation, uncontrolled diabetes) results in incomplete fat oxidation and build up of ketones (which serve as fuel for muscle and brain, but disturbs acid/base balance)

Question 679

Active transport

Answer 679

mechanism for most nutrients (glucose, amino acids, Na, K, Mg, Ca, Fe)
sodium pump: uphill pumping from lower to higher concentration, across a membrane against energy gradient; requires ATP

Question 680

Simple diffusion

Answer 680

mechanism for some water and electrolytes
higher to lower concntratio: intestine to blood to lymph

Question 681

Carrier-facillitated passive diffusion

Answer 681

water soluble nutrients
higher to lower concentration

Question 682

Factors that aid vitamin and mineral absorption

Answer 682

vitamin A: bile salts, pancreatic lipase, fat
vitamin D: hydroxylated in liver, then kidney; needs bile salts, acidity of chyme; accompanies Ca, P absorption
riboflavin: phosphorous
B12: ileum, stomach secretions (HCl, intrinsic factor)
iron: HCl, calcium interferes (binds oxalates)
folate: zinc dependent, cleaves polyglutamate to monoglutamate (folic acid in fortified foods and supplements is monoglutamate)

Question 683

Hypothalamus

Answer 683

key brain structure involved in the control of food and energy intake
a. Serotonin: neurotransmitter, low levels increase CHO appetite
b. Leptin produced by fat cells in response to food intake, induces satiety
c. Ghrelin: produced in stomach and intestine, stimulates appetite and growth hormone secretion, decreases fat utilization in adipose
d. low leptin and high ghrelin promote excess food intake

Question 684

Social Determinants of Health

Answer 684

Conditions in the places where people live, learn, work and play that affect a wide range of health risks and outcomes
Economic stability
Education
Social and community context
Access to healthy foods and safe neighborhoods
Health care