Practice quiz

Question 1

Where do temperature increases tend to be greatest? [2]

Answer 1

• Higher latitudes (i.e., closer to the poles)
• In continental interiors

Question 2

When it comes to dealing with climate change, adaptation responses act on the root cause of the issue, by reducing such as greenhouse has (GHG) emissions, whereas mitigation responses take place at a local level to deal with the impacts of climate change in that particular context.
True or False?

Answer 2

False.
The opposite is true.

Question 3

When it comes to dealing with climate change, mitigation responses act on the root cause of the issue, by reducing such as greenhouse has (GHG) emissions, whereas adaptation responses take place at a local level to deal with the impacts of climate change in that particular context.
True or False?

Answer 3

True.

Question 4

Higher temperatures during the growing season are reducing crop yields of staple grains like wheat, rice, and maize. This is happening because higher temperatures have detrimental impacts on biological processes important for plant growth and development. For example, at higher temperatures, […] and […] of plants decrease, and […] of plants increases.

Answer 4

At higher temperatures, pollination and photosynthesis of plants decrease, and dehydration of plants increases.

Question 5

Farmers in Mozambique have started to bake and sell bread as an alternative source of income when crop yields are reduced due to changing climate conditions.

What is this an example of? [2]

Answer 5

1. Adaptation due to climate change
2. Diversification of income sources

Question 6

Food waste in Canada occurs primarily at the […] level.

Answer 6

Food waste in Canada occurs primarily at the household level.

Question 7

What is meant by a sustainable diet?

Answer 7

• Lower environmental impact than typical Western diet
• Contains more plant-based foods and fewer animal-based foods
• Nutritionally adequate
• Safe and healthy
• Culturally acceptable
• Accessible/Affordable

Question 8

Do you think dietary guidelines should advise people to consume sustainable diets? Explain.

Answer 8

• Yes, in richer nations like Canada.
• Sustainable diets are associated with fewer GHG emissions, and this will help reduce the extent of future climate change
• A vegan diet is associated with 45% fewer GHG emissions than a typical Western diet
• A UK study showed that sustainable diets cost ~the same as a typical UK diet
• Consuming a sustainable diet is a “no-regret option” (there is no downside)
• There are “co-benefits” to consuming a sustainable diet (i.e., they benefit personal health as well as planetary health)
• Personal health benefits of consuming a sustainable diet include reductions in risk for chronic disease (e.g., cardiovascular disease, type 2 diabetes, some forms of cancer, obesity, etc.)

Question 9

Golden rice could be a good way to introduce a vitamin A-rich food into the diets of many populations who rely on rice as a staple grain without altering their regular pattern of eating. People unanimously agree that using Golden Rice would be an effective way to prevent vitamin A deficiency.
True or False?

Answer 9

False.

Question 10

Strategies to produce more agricultural output from the same land area while reducing environmental impacts (and considering social, political, economic factors) are called ____________. These strategies allow us to use resources at a rate that does not exceed the Earth’s capacity to replace them.

Answer 10

Strategies to produce more agricultural output from the same land area while reducing environmental impacts (and considering social, political, economic factors) are called sustainable intensification. These strategies allow us to use resources at a rate that does not exceed the Earth’s capacity to replace them.

Question 11

Using a flush toilet or latrine is an example of improved WASH.
True or False?

Answer 11

True.

Question 12

Drinking water from a nearby river is an example of improved WASH.
True or False?

Answer 12

False.

Question 13

Storing food in a refrigerator is an example of improved WASH.
True or False?

Answer 13

False.

Question 14

Plumpy’nut is an example of […]. These foods are often administered at home to treat malnutrition in children because they are easy to use, highly effective, and do not require refrigeration or cooking.

Answer 14

Plumpy’nut is an example of RUTF. These foods are often administered at home to treat malnutrition in children because they are easy to use, highly effective, and do not require refrigeration or cooking.

Question 15

Name 3 benefits of the Green Revolution.

Answer 15

• Yields of staple grains increased
• The need for imported food aid was reduced or eliminated
• Poverty and hunger were reduced in countries most affected

Question 16

Transoceanic delivery of food aid typically takes longer to deliver than food aid that is obtained locally, but the nutritional quality of food transported by transoceanic delivery is much higher than locally procured food.
True or False?

Answer 16

False.

Question 17

Briefly summarize the view of aid as temporary.

Answer 17

“Big push” out of poverty traps, cope with short-term crisis and disasters. A humanitarian response.

Question 18

Briefly summarize the view of aid as permanent.

Answer 18

Global social safety net, redistribution of some wealth and resources.

Question 19

Briefly summarize the view of aid as distortion.

Answer 19

Distorts markets and causes dependency

Question 20

What is the leading cause of preventable blindness in the world?

Answer 20

Vitamin A deficiency

Question 21

Pallor (unexpectedly pale skin) could be a sign of which micronutrient deficiency?

Answer 21

Iron deficiency

Question 22

Name 3 functions of fat.

Answer 22

• It contributes to a sense of satiety (fullness)
• It is a carrier of vitamins A, D, E, and K
• It is a concentrated source of energy, supplying 9 kcal/g

Question 23

How would you increase absorption of dietary iron?

Answer 23

Have a glass of orange juice with your meal

Question 24

Basal metabolism typically accounts for approximately 20% of a person’s total energy (kcal) needs.
True or False?

Answer 24

False.
Basal metabolism typically accounts for approximately 60-75% of a person’s total energy (kcal) needs.

Question 25

Basal metabolism typically accounts for approximately 60-75% of a person’s total energy (kcal) needs.
True or False?

Answer 25

True.

Question 26

Digestion is the process by which nutrients and other substances are transferred from the digestive system into body fluids for transport throughout the body.
True or False?

Answer 26

False.
Absorption is the process by which nutrients and other substances are transferred from the digestive system into body fluids for transport throughout the body.

Question 27

Absorption is the process by which nutrients and other substances are transferred from the digestive system into body fluids for transport throughout the body.
True or False?

Answer 27

True.

Question 28

Describe the top 6 strategies for reducing food waste from most preferable to least preferable.

Answer 28

1. Reduce the amount of waste generated at the source
2. Feed hungry people (e.g., donate surplus to food banks)
3. Feed animals (e.g., divert leftover food to livestock)
4. Industrial uses (e.g., use oil as biofuel)
5. Compost to create a nutrient-rich soil amendment
6. Dispose of waste in landfill or incinerate (burn) it

Question 29

What is a limitation of the 24-hour recall method of assessing dietary intake?

Answer 29

It relies on memory

Question 30

Maternal mortality may result from complications during pregnancy or delivery, high blood pressure, and a variety of other factors. For example, deficiency in the micronutrient […] is estimated to cause approximately 20% of maternal mortality (because women with this deficiency cannot sustain as much blood loss as women with good nutritional status can).

Answer 30

Maternal mortality may result from complications during pregnancy or delivery, high blood pressure, and a variety of other factors. For example, deficiency in the micronutrient iron is estimated to cause approximately 20% of maternal mortality (because women with this deficiency cannot sustain as much blood loss as women with good nutritional status can).

Question 31

Due to the effects of climate change on the environment Oueme Valley, Benin, people there are using agro-fingerponds to increase the amount of food they can reliably grow. This is an example of what type of response to climate change?

Answer 31

Adaptation

Question 32

Grace is a 22-year-old woman who just gave birth to her second child. If she feeds her infant exclusively with her breastmilk for the first 6 months of the infant’s like, Grace is less likely to get pregnant during that time than she would be if she fed the infant her breastmilk and rice porridge.
True or False?

Answer 32

True.
Exclusive breastfeeding (i.e., feeding an infant breastmilk only, no other fluids or foods) reduces the likelihood a woman will ovulate and thus possibly get pregnant again during that time.

Question 33

[…] reflects acute malnutrition and is defined as low weight for height.

Answer 33

Wasting reflects acute malnutrition and is defined as low weight for height.

Question 34

Bilateral pitting edema is a clinical sign of kwashiorkor.
True or False?

Answer 34

True.

Question 35

Healthy adults can regularly consume up to […]% of their total energy (kcal) intake from protein

Answer 35

Healthy adults can regularly consume up to 35% of their total energy (kcal) intake from protein

Question 36

MFP factor decreases iron absorption.
True or False?

Answer 36

False.
MFP factor enhances iron absorption.

Question 37

Phytate decreases iron absorption.
True or False?

Answer 37

True.

Question 38

Where is heme iron found?

Answer 38

Hemoglobin
Myoglobin

Question 39

Famine foods are eaten during extreme food scarcity because they are a good source of energy.
True or False?

Answer 39

False.
Famine foods may not actually provide much energy (kcal), but they do provide satiety (a feeling of fullness).

Question 40

Why are nutrition interventions aiming to reduce undernutrition during the “first 1,000 days” are important? [3]

Answer 40

• Consequences of undernutrition during this time of development are significant and long-lasting.
• Intervening during this time is cost-effective (i.e., a large benefit can be derived from a relatively smaller investment).
• Deaths that result from undernutrition during this time are largely preventable

Question 41

Iron deficiency makes death during childbirth more likely because loss of blood during childbirth can be fatal to a woman with iron deficiency anemia.
True or False?

Answer 41

True.

Question 42

The proportion (%) of iron absorbed is higher when the iron content of the diet is low
True or False?

Answer 42

True.

Question 43

The World Health Organization (WHO) recommends that zinc supplements be given to children experiencing acute diarrhea
True or False?

Answer 43

True.

Question 44

Although food waste is an issue worldwide, fortunately Canadians do not waste very much food.
True or False?

Answer 44

False.
Canadians waste a lot of food; it is estimated that Canadians waste more than $31 Billion dollars of food per year; Canadians waste food valued at more than the GDP of 29 of the world’s poorest countries – or most of the food wasted in Canada is at the household level

Question 45

Colostrum is the first phase of breast milk produced. It is discoloured and of lesser volume than mature breast milk and is thus considered rancid and should be discarded.
True or False?

Answer 45

False.
It is true that colostrum is the first phase of breast milk produced and that it is a different colour from mature breast milk (though that does not mean it is ‘discoloured’ – but it is NOT considered rancid and it should NOT be discarded. Colostrum is very nutritious (and contains growth factors and antibodies) and infants should consume it.

Question 46

Wasting (i.e., marasmus) is more easily treated than nutritional edema (i.e., kwashiorkor).
True or False?

Answer 46

True.

Question 47

Plumpy’nut (a ready-to-use therapeutic food; RUTF) can be administered at home.
True or False?

Answer 47

True.

Question 48

Approximately what proportion of land used for agriculture is used to support livestock production?

Answer 48

70%

Question 49

Evaluate this recipe in terms of the nutrition it would provide and answer the following questions:

Which ingredients would provide macronutrients? (Specify which macronutrients would be provided by specific ingredients) (2 marks) Which ingredients would provide energy (kcal)? (1 mark) Do you think this recipe is appropriate for a child between 6 and 24 months of age? Why or why not? Clearly justify your response, considering both the nutrients provided by this recipe and the nutritional needs of children aged 6 to 24 months. (2 marks)

Answer 49

• Cassava (CHO); fish (protein and fat): oil (fat); sugar (CHO)
• The same ingredients also provide energy.
• Yes, this would be good for children
  
  • Cassava provides energy
  • Fish provides complete protein, essential fatty acids, and is nutrient-dense
  • Palm oil could provide vitamin A (if red palm oil)
  • If salt is iodized, it could provide iodine
  • Little bit of sugar will add sweetness and encourage consumption

Question 50

Briefly describe three views of foreign aid. Which view do you think is most appropriate? Why?

Answer 50

i) Aid as “temporary” - i.e., it would be provided for a short time period only (e.g., short-term humanitarian food aid, a large investment in programs or infrastructure that is expected to help groups get out of poverty)

ii) Aid as “permanent”- i.e., wealthier nations should provide aid to less economically developed nations on an ongoing (indefinite) basis, as part of an overall global safety net

iii) Aid as “distortion” - i.e., aid is not beneficial, it distorts markets and causes dependency and so should not be used

Question 51

Tiru is a 25-year-old widowed mother of five, in Miyo, Oromia Region (a drought-affected area in southern Ethiopia). Tiru is pictured with her two six-month-old twins, Gorore and Tadhala and her 9 year old daughter.

Tiru says: “I lost my husband when I was pregnant with my twins, due to sickness. We used to work together, we had cattle then. We lost our 2 cattle because of the drought. We also watered crops for the rich farmers. I now do this alone. It is very difficult with two babies to work. My income is much less. I can no longer support my children. My father is old. He was able to support me at the start but now cannot.”

Identify and briefly describe one immediate, one underlying, and one basic cause of undernutrition for Tiru’s children. Your description of each cause should indicate how that cause could result in undernutrition for Tiru’s children.

Answer 51

Immediate: inadequate dietary intake (e.g., low energy or insufficient micronutrient intkae); children become malnourished because their energy needs are not being met.

Underlying: relatively large family means many mouths to feed, each child is not able to get enough food; mother is likely not educated and this is associated with poorer nutritional status in her children; the father/husband died which reduces household income, causes household food insecurity, and reduces her capacity to care for her children which ledas to inadequate care; likely inadequate care for 6-month-old twins in particular – unlikely that undernourished/underweight mother could produce enough breast milk to adequately feed both, this would result in inadequate dietary intake for them

Basic causes: drought (poor climate conditions) makes it hard to grow/obtain sufficient food (their 2 cattle died because of the drought) to feed children; social/political/economic context of Ethiopia (e.g., disparity, poverty, lack of infrastructure, landlocked country, fewer opportunities for women) and its impact

Question 52

Northern Cameroon has a harsh climate (with temperatures often above 45 degrees Celsius) and often experiences water scarcity. Food insecurity is increasing in the Far North region of Cameroon and it is estimated that ~180,000 people in the area may experience severe food shortage this year. The “lean season” (the time before the next harvest) is underway, and insecurity caused by Boko Haram (a militant terrorist group) has severely disrupted farming and cross-border trade. Insecurity and attacks by Boko Haram have caused more than 70% of farmers (and their families) in the region to desert their farms, and refugees from neighbouring Nigeria are currently occupying 200 hectares of land that was previously used for farming.

These factors have combined to drastically reduce harvests of key crops such as sorghum, millet, cowpea, and rice (e.g., 132,000 tonnes of cereal grains were produced and it is estimated that the region needs 770,000 tonnes per year). Reduced food production has caused the cost of food to increase to the point that it is very difficult for many people to afford. Malnutrition among children under 5 years of age (especially those who have been displaced from their homes) is at emergency levels. Women are also experiencing malnutrition, many of whom are giving their portions of food to their children in the hope that their children will get enough to eat.

Are you surprised that women and children are experiencing malnutrition in this context? Explain your response.

Answer 52

No, not surprised.
* Women and children are typically the most vulnerable to malnutrition
* Children have relatively high needs relative to their body size because it is a time of rapid growth, and women would have higher nutrition-related needs if pregnant or breastfeeding
* Women often consume less food because other members of the family eat first when food is scarce, so they would be more likely to have inadequate intake and experience malnutrition

Question 53

Northern Cameroon has a harsh climate (with temperatures often above 45 degrees Celsius) and often experiences water scarcity. Food insecurity is increasing in the Far North region of Cameroon and it is estimated that ~180,000 people in the area may experience severe food shortage this year. The “lean season” (the time before the next harvest) is underway, and insecurity caused by Boko Haram (a militant terrorist group) has severely disrupted farming and cross-border trade. Insecurity and attacks by Boko Haram have caused more than 70% of farmers (and their families) in the region to desert their farms, and refugees from neighbouring Nigeria are currently occupying 200 hectares of land that was previously used for farming.

These factors have combined to drastically reduce harvests of key crops such as sorghum, millet, cowpea, and rice (e.g., 132,000 tonnes of cereal grains were produced and it is estimated that the region needs 770,000 tonnes per year). Reduced food production has caused the cost of food to increase to the point that it is very difficult for many people to afford. Malnutrition among children under 5 years of age (especially those who have been displaced from their homes) is at emergency levels. Women are also experiencing malnutrition, many of whom are giving their portions of food to their children in the hope that their children will get enough to eat.

Identify and briefly describe two (2) clinical signs of malnutrition that might be observed among children under 5 years of age experiencing malnutrition in this context. In your description, clearly indicate how one would interpret each sign (e.g., what type of malnutrition does it suggest?)

Answer 53

• Depigmentation of hair (reflects protein deficiency)
• Bitot’s spots, foamy plaque on white part of eye (reflects vitamin A deficiency)
• Night blindness (reflects vitamin A deficiency)
• Swollen, bleeding, red gums (reflects vitamin C deficiency)
• Bilateral pitting edema (indicates kwashiorkor)
• Palor/pale conjunctiva (reflects possible iron deficiency)

Question 54

Northern Cameroon has a harsh climate (with temperatures often above 45 degrees Celsius) and often experiences water scarcity. Food insecurity is increasing in the Far North region of Cameroon and it is estimated that ~180,000 people in the area may experience severe food shortage this year. The “lean season” (the time before the next harvest) is underway, and insecurity caused by Boko Haram (a militant terrorist group) has severely disrupted farming and cross-border trade. Insecurity and attacks by Boko Haram have caused more than 70% of farmers (and their families) in the region to desert their farms, and refugees from neighbouring Nigeria are currently occupying 200 hectares of land that was previously used for farming.

These factors have combined to drastically reduce harvests of key crops such as sorghum, millet, cowpea, and rice (e.g., 132,000 tonnes of cereal grains were produced and it is estimated that the region needs 770,000 tonnes per year). Reduced food production has caused the cost of food to increase to the point that it is very difficult for many people to afford. Malnutrition among children under 5 years of age (especially those who have been displaced from their homes) is at emergency levels. Women are also experiencing malnutrition, many of whom are giving their portions of food to their children in the hope that their children will get enough to eat.

Myriam is a 2-year-old girl in the Far North region of Cameroon. Two months ago, she and her family (mother, father, and five older brothers and sisters) were forced to leave their small homestead farm due to nearby attacks by Boko Haram. Myriam has lost weight during this time and now suffers from moderate acute malnutrition. Based on the information you have, do you think Myriam is experiencing wasting (marasmus) or nutritional edema (kwashiorkor)? Justify your response.

Answer 54

• Marasmus
• Kwashiorkor is always severe acute malnutrition, but marasmus may be moderate or severe - since she has moderate malnutrition, it must be marasmus/wastinig

Question 55

South Sudan is the world’s newest country. After decades of conflict with the north, it became an independent country in July 2011 (following a referendum in which people overwhelmingly voted to separate from Sudan). Since December 2013, what started as a power struggle between political leaders has expanded to become a widespread violent and deadly conflict, affecting millions. An estimated 6 million people in South Sudan are currently experiencing extreme food insecurity and more than one million children have been forced to flee the country as refugees, many of whom are separated from their families.

Thousands of people have fled their homes in Eastern Bieh State in South Sudan in recent months, due to violent clashes between government and opposition military forces. “I left running – there was no time to take anything,” said William, a 41-year-old father of 5 children. William and his family, like many others, are taking shelter in the bush. They are currently living under a tree, surviving on leaves and small amounts of food from aid organizations. “When there is no food, we eat the leaves on the trees.” William’s 5-year-old son died recently, most likely from cholera. (Cholera is a disease characterized by severe watery diarrhea, caused by consuming food or water contaminated with the bacterium V. cholerae; the risk of cholera transmission increases when access to clean water and sanitation facilities is lacking). The international humanitarian organization Doctors Without Borders (MSF) is currently operating three health clinics in the region. They have reported an increase in malnutrition among children under the age of 5 years, with approximately 1 in 10 children having severe acute malnutrition.

Considering what you have learned so far in FNH 355, what do you think needs to be done in this situation, to improve the nutritional status (and overall health and wellbeing) of people living in South Sudan?

Integrate the following terms into your response: UNICEF framework, nutrition assessment, famine foods, priority, limitation, Canada. (6 marks; underline each of those 6 terms where they appear in your response)

Answer 55

Example 1: Using the UNICEF conceptual framework we can determine the immediate, underlying, and basic causes of malnutrition in South Sudan. Immediate causes are inadequate food intake and disease. Underlying are poor living environments, limited access to health care services, inadequate care and food insecurity. The basic causes are the political struggle and deadly conflict. The basic causes are at the root of the malnutrition problem and the priority needs to be addressing these issues. Canada can assist in addressing the malnutrition in South Sudan by providing food aid so that the people there have more access to nutritious foods, rather than being so dependent on famine foods, such as leaves which provide them with little in the way of nutrients and energy because they are so high in fibre. A limitation of sending food aid during a time of political conflict is that so many people are displaced and infrastructure is destroyed, making it difficult to distribute food to all those who need it. Therefore, Canada could instead work toward meeting the UN recommendation of contributing 0.7% of the country’s GNI to international aid. This may provide the UN with sufficient support so they can go in to South Sudan and conduct various nutrition assessments (e.g., anthropometric, dietary, clinical) to determine who needs the most help and in what form.

Example 2: In order to improve nutritional status, the basic or “real” causes according to the UNICEF Conceptual Framework need to be addressed, which in South Sudan is the war and conflict. This is the priority for domestic and international agencies to help decrease the number of people suffering from malnutrition. Specifically, Canada can aid by sending peacekeepers (once situational assessments are made) or increase their spending on foreign aid to 0.7% of gross national income, as recommended by the UN. In addition to addressing the basic causes of undernutrition, the immediate and underlying causes need to be addressed. After conducting nutrition assessments using anthropometric, clinical, and dietary measures, we can start to address the cholera by sending zinc supplements to communities. Furthermore, with more international food aid, we can reduce the number of people eating the famine foods (leaves in South Sudan which are normally not edible). However, until the basic causes (war) are resolved, the giving of food aid and micronutrient supplementation has limited impact on improving the overall nutritional status.