Probiotics and Weight Loss Supplements

Question 1

What are the potential adverse effects of green tea? (6)

Answer 1

1. Caffeine-related: excessive consumption
   - Insomnia
   - Nervousness and anxiety
   - Irregular or rapid heartbeat
2. Liver toxicity
3. GI problems
4. Reduced iron absorption
5. Drug interactions
   - Increased risk of bleeding when taken with anticoagulants
6. Allergic reaction

Question 2

What are the active ingredients of green tea? (2)

Answer 2

1. Catechins
2. Epigallocatechingallate (EGCG): Max 330mg/day as supplement; 700mg/day as brewed tea

Question 3

What are the adverse effects of Garcinia cambogia? (5)

Answer 3

1. GI issues
2. Liver damage
3. Headaches
4. DIs
   - Serotonergic drugs - increased risk of serotonin syndrome
   - Hepatotoxic drugs - potential for hepatotoxicity
5. Others potentials:
   - BPD
   - Blood sugar and clotting issues
   - Dizziness
   - Dry mouth

Question 4

What are some nonpharmacoloigical recommendations for weight loss? (6)

Answer 4

1. Adequate fluid intake
2. Whole foods
3. Limit processed foods
4. Awareness of portion sizes
5. Regular monitoring
6. Exercise, 150 min/week

Question 5

What are some examples of sports dietary supplements? (8)

Answer 5

1. Creatine monohydrate
2. Beta alanine
3. B vitamins
4. Caffeine
5. Protein
6. BCAAs
7. Ca, Vit D, Mg
8. MSM

Question 6

What are the benefits of beta-alanine?
What is the mechanism?

Answer 6

1. Muscular endurance?
2. Carnosine production

Question 7

What are the ADEs of beta-alanine? (3)

Answer 7

1. Insomnia
2. Tingling
3. Not to be used in pregnancy

Question 8

What are the benefits of BCAAs?
What is the mechanism?

Answer 8

1. Muscle growth, endurance, less sore
2. Fuel (amino acids), build muscle proteins

Question 9

What are the ADEs of BCAAs? (3)

Answer 9

1. Blood glucose?
2. Headache
3. Nausea

Question 10

What are the benefits of B vitamins?
What is the mechanism?

Answer 10

1. Supports metabolism, less fatigue
2. Energy production, B12-RBCs

Question 11

What are the benefits of MSM?
What is the mechanism?

Answer 11

1. Reduce muscle and joint pain
2. Reduction in inflammation. Supports cartilage maintenance

Question 12

What are the ADEs of MSM? (3)

Answer 12

1. Cannot take with alcohol
2. Nausea
3. Diarrhea

Question 13

Define relative risk

Answer 13

• In clinical trials is a measure that cimpares the risk of a certain event occurring in two different groups
• The ratio of the probability of an event occurring in the treatment group to the probability of the same event occurring in the control group

Question 14

What is relative risk reduction?

Answer 14

How much risk is reduced in an experimental group compared to a control group
RRR = (CER-EER)/CER

Question 15

What is absolute risk?

Answer 15

In clinical trials, is the probability of an event occurring in a specific group over a defined period
AR = Number of events in the group/Total number of people in the group

Question 16

Which of the following is/are correct regarding probiotics?
a. all foods and dietary supplements labeled as “probiotics” on the market have proven health benefits
b. live microorganisms that, when administered in adequate amounts, confer a health benefit on the host
c. All of these responses are correct
d. dead microorganisms and those made by microorganisms (such as proteins, polysaccharides, nucleotides, and peptides) are, by definition, also probiotics

Answer 16

b.

Question 17

Which of the following micro-organisms is NOT a typical probiotic organism?
a. Saccharomyces cerevisiae
b. Bifidobacterium longum
c. Lactobacillus rhamnosus
d. Bifidobacterium animalis
e. Shigella sonnei

Answer 17

e.

Question 18

Shelly is interested in weight-loss supplements. She is currently taking metformin 500mg BID. She is allergic to latex, shrimp and penicillin. Which of the following weight loss supplements are NOT a safe choice for her?
a. green tea
b. Garcinia cambogia
c. chromium picolinate
d. chitosan

Answer 18

d.

Question 19

Common adverse reactions to probiotics include:
a. flatulence and diarrhea
b. diarrhea
c. systemic infections
d. bleeding

Answer 19

a.

Question 20

Probiotics have varied mechanisms of action, however, what they have in common is which of the following?
a. Increasing gastrointestinal transit time
b. None of these choices is correct
c. Blocking production of bioactive metabolites such as vitamins or short-chain fatty acids
d. Increasing pH in the intestines

Answer 20

b.

Question 21

Side effects of Garcinia Cambogia include:
a. severe inflammatory rash
b. fast heart rate and trouble sleeping
c. high blood glucose
d. numbness and tingling in the extremities

Answer 21

b.

Question 22

John started using a natural health product for weight loss. Since then, he is complaining of being ‘tired all the time’. When asked about medical conditions, John reported hypothyroidism. He is currently taking levothyroxine. Which of the following weight loss supplements can decrease the effectiveness of the supplemented thyroid hormone?
a. Green Tea
b. Caffeine
c. Chitosan
d. Carnitine

Answer 22

d.

Question 23

Regarding product quality and safety of probiotics:
a. Probiotics that are sold in Canada are all highly pure with regard to the organisms in the product as being identical to those listed on the label
b. Probiotics in food and pill form are of equivalent safety if the CFUs per portion are the same
c. Clinical trial safety data is commonly not well-reported
d. Probiotics are very safe therefore the current safety data reporting is adequate

Answer 23

c.

Question 24

Green tea catechins are associated with the modulation of fat metabolism and consequent weight loss. Which of the following is the most active and most abundant polyphenol that has been correlated with anti-obesogenic properties in green tea?
a. Theaflavins
b. Epigallocatechin gallate (EGCG)
c. Epicatechin (EC)
d. Caffeine

Answer 24

b.

Question 25

Proposed mechanisms of action for green tea as a weight-loss supplement include all of the following EXCEPT: a. decrease of appetite b. fat oxidation c. promotion of lipogenesis d. increase in sympathetic nervous system activity

Answer 25

c.

Question 26

A significant potential adverse effect of konjac is: a. hyperglycemia b. intestinal blockage c. cardiac arrythmia d. syncope (fainting)

Answer 26

b.

Question 27

You have learned that recommendations about probiotics should be as specific as possible for a particular bacterial strain for a given indication. The reason for this is: a. Generalized, pooled data from various research studies can lead to misleading conclusions about efficacy and safety b. All Lactobacilli are immune modulators but Bifidobacteria are not c. Production of bioactive metabolites is highly strain-specific, e.g. most bacterial species do not produce bioactive metabolites d. Activities such as toxin neutralization are shared by multiple species

Answer 27

a.

Question 28

Probiotics must be labeled as to the CFUs (colony-forming units) they contain. Which of the following is correct regarding CFUs? a. The CFU count is not directly related to activity b. A higher CFU count is desireable, particularly in older patients, in order to maximize benefits c. The CFU count is for dosing for specific indications. d. The CFU represents the level of yeast only when it is present in the product

Answer 28

a.

Question 29

Many foods are through to contain probiotics because they are prepared by fermentation: kimchi, kombucha, miso, pickles, sourdough bread, sauerkraut, yogurts, etc. What are the limitations of consuming these foods as a source of probiotics? a. The levels of probiotic bateria are too high to safely consume them in excess regularly. b. These foods are actually sources of prebiotics, not probiotics. c. Few people can tolerate the taste of soured foods. d. Bacteria in these foods may not survive long enough to reach the colon.

Answer 29

d.

Question 30

Regarding clinical trials for probiotics, which of the following is correct? a. Trials have uniformly shown a lack of efficacy of probiotics for antibiotic-associated diarrhea prevention or treatment b. There is a lack of meta-analysis to guide our understanding of clinical trials' outcomes c. There have been many trials for the use of probiotics for gastrointestinal disease d. There are clear mechanisms for applications of probiotics in asthma, allergy and atopic dermatitis

Answer 30

c.

Question 31

This supplement is related to energy metabolism, however, evidence of it improving muscular endurance is not strong in the absence of deficiency a. Hydroxycitric acid b. Beta alanine c. Taurine d. B vitamins

Answer 31

d.

Question 32

Which of the following represent protein supplementation choices? a. whey b. Legumes like chick peas and lentils c. lean meat d. pea protein e. All of the choices are correct

Answer 32

e.

Question 33

Which of the following correctly describes relative risk reduction in clinical trials? a. Risk difference between treatment and control groups b. A proportional measure of the effect size of an intervention group compared to a control group. c. How much the treatment changed the chance of a bad outcome compared to a control group who did not receive the treatment. d. The chance of a bad outcome occurring in the control group, as baseline.

Answer 33

c.

Question 34

This supplement may increase the perception of energy and allow for a greater intensity of exercise, however, at higher doses it can cause tachycardia, anxiety and gastrointestinal adverse effects. a. caffeine b. beta alanine c. amino acids d. SAMe

Answer 34

a.

Question 35

Which of the following is correct regarding creatine supplementation a. It is appropriate for teen athletes to quickly build muscle for sports competition. b. Maintenance dose is 3-5 grams per day. c. Increases muscle power by up to 20% regardless of exercise intensity. d. It is unsafe in the elderly and should be avoided.

Answer 35

b.