Understanding Nutrition 14th edition Chapter 16, 17, 18, 19, 20 Test Guide

Chapter 16 – Life Cycle Nutrition: Infancy, Childhood, and Adolescence

1. What would be a normal body weight after one year for a healthy infant with a birthweight of 8 lbs?

answer: 24 lbs

2. What is the typical weight gain (lbs) of an infant between the first and second year of life?

answer: 10

3. What organ in the infant uses more than half of the day’s total energy intake?

answer: Brain

4. What is the relative weight of an infant brain compared to an adult’s brain?

answer: Six times as much

5. The recommended amounts of vitamins and minerals for infants are based on the

answer: average amounts ingested by thriving infants breastfed by well-nourished mothers.

6. For optimal breast-feeding benefits, it is recommended that the infant be encouraged to suckle on the first breast offered

answer: until he stops actively suckling.

7. What is the chief protein in human breast milk?

answer: Alpha-lactalbumin

8. What is thought to be the primary function of the oligosaccharides in breast milk?

answer: Protection from infections in the infant

9. What is colostrum?

answer: A milk-like substance secreted right after delivery

10. Which of the following is a feature of infant development and nutrition?

answer: Breast-fed infants obtain iron-binding proteins that inhibit bacterial infections.

11. Which of the following is associated with bifidus factors?

answer: Increased bacterial growth

12. What factor in breast milk binds iron and prevents it from supporting the growth of the infant’s intestinal bacteria?

answer: Lactoferrin

13. What is lactadherin?
answer: A breast milk protein that inactivates a GI virus that causes diarrhea

14. Compared with cow’s milk, breast milk contains
answer: less protein and calcium.

15. To gradually replace breast milk with infant formula or other foods appropriate to an infant’s diet is to

answer: wean

16. Which of the following formulas is available for infants with lactose intolerance?
a. Egg
b. Soy
c. Barley
d. Powdered cow’s milk
e. Goat’s milk

ANS: B

17. Which of the following is a common source of lead poisoning in infants?
a. Maternal passage of lead to fetus
b. Baby bottles made from lead crystal
c. Contaminated water used to make infant formula
d. Preparation of infant formula in galvanized containers
e. Environmental contamination from leaded gasoline

ANS: C

18. What is the most realistic advice for reducing lead exposure from the tap water used to prepare infant formula?
a. Because the lead in hot water pipes settles out overnight, draw the water from this source first.
b. Whenever possible, boil the water to vaporize the lead and thus decrease the amount remaining in the water.
c. Because the first water drawn from the tap each day is highest in lead, let the water run a few minutes before using it.
d. To inhibit lead absorption, add a small amount of citrus juice to the water to provide citric acid to complex with the lead.
e. Filtering the water through a clean coffee filter will typically remove the majority of lead contamination.

ANS: C

19. Goat’s milk is inappropriate for infants due to its low content of
a. iron.
b. folate.
c. protein.
d. calcium.
e. vitamin D.

ANS: B

20. Which of the following defines nursing bottle tooth decay?
a. Caries development resulting from frequent use of non-sterile bottles and nipples.
b. Bacterial attack of teeth due to severe tooth misalignment from sucking on oversized bottle nipples.
c. Marked tooth decay of an infant due to prolonged exposure to carbohydrate-rich fluids from a bottle.
d. Tooth decay resulting from constant exposure to food due to inability of the infant to swallow normally.
e. Tooth decay resulting from the rubbing of the nipple against the teeth and consequent thinning of enamel.

ANS: C

21. Which of the following feeding practices is recommended for preterm infants?
a. They should be fed exclusively on breast milk.
b. They should be fed on breast milk enriched in a 1 to 1 ratio with cow’s milk.
c. They should be fed preterm breast milk, occasionally fortified with specific nutrients.
d. They should be fed only on special formulas because the nutrient content of breast milk is too low.
e. They should be fed raw cow’s milk fortified with infant vitamins.

ANS: C

22. Of the following cereals, which is most likely to result in an allergic reaction upon first feeding?
a. Oat
b. Rice
c. Corn
d. Wheat
e. Barley

ANS: D

23. Which of the following represents a good age to introduce solid foods to infants?
a. Two weeks
b. Two months
c. Five months
d. Nine months
e. One year

ANS: C

24. At what age does the normal infant first develop the ability to swallow nonliquid food?
a. 1 to 2 months
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 9 months
e. 9 to 12 months

ANS: C

25. Why should new foods be introduced to an infant one at a time?
a. It prevents overfeeding.
b. Any allergic reactions can be detected.
c. Immunological protection hasn’t been developed.
d. The swallowing reflex is not under voluntary control.
e. It reduces risk of upset stomach.

ANS: B

26. What should be the first cereal introduced to the infant?
a. Oat
b. Corn
c. Rice
d. Wheat
e. Barley

ANS: C

27. Which of the following nutrients need to be supplied first by solid foods in a baby’s diet?
a. Vitamin C and iron
b. Vitamin A and zinc
c. Vitamin B12 and fluoride
d. Vitamin E and magnesium
e. Sodium and manganese

ANS: A

28. Infants fed honey or corn syrup are at increased risk for
a. protein malnutrition.
b. botulism.
c. osteopenia.
d. type 1 diabetes.
e. lead poisoning.

ANS: B

29. Young children who drink more than 2 to 3 1/2 cups of milk a day are most likely at increased risk for deficiency of
a. iron.
b. folate.
c. vitamin A.
d. vitamin C.
e. vitamin D.

ANS: A

30. Which of the following is true regarding energy metabolism of the preschool child?
a. Food intake is remarkably similar from meal to meal.
b. Overweight individuals have appetites similar to normal-weight individuals.
c. Energy needs per kg body weight increase from 1 year of age to 5 years of age.
d. A 1 year old who needs 800 kcal/day would require only about 1600 kcal at 6 years of age.
e. An active 10 year-old requires about 3200 kcal/day.

ANS: D

31. Approximately how many kcal per day does an average 6 year old need to obtain?
a. 400
b. 800
c. 1600
d. 2400
e. 3200

ANS: C

32. Children should spend no more than ____ hours per day watching television, playing electronic games, and using the computer (except for homework)
a. 1 to 2
b. 2 to 3
c. 3 to 4
d. 4 to 5
e. 5 to 6

ANS: A

33. Which of the following is a characteristic of fat in the diet of children?
a. The recommended daily fat intake up to age 12 is age plus 20 g.
b. There is an RDA for total fat for children beginning at 3 years of age.
c. Low-fat diets usually provide sufficient amounts of the micronutrients.
d. Fat intakes below 30% of total energy do not impair growth provided that total energy intake is adequate.
e. Children between 4 and 18 years of age should get at least 50% of their energy from fat.

ANS: D

34. Which of the following is the most prevalent nutrient deficiency among U.S. and Canadian children?
a. Iron
b. Protein
c. Calcium
d. Vitamin C
e. Vitamin A

ANS: A

35. Which of the following is a feature of nutrition in childhood?
a. Very few children take nutrient supplements of any kind.
b. Total energy requirements are higher for a typical 3 year old than a 12 year old.
c. Iron-deficiency anemia in children is prevalent in Canada but not the United States due to fortification.
d. Children who fail to consume vitamin D-fortified foods should receive a daily supplement of 10 micrograms.
e. Vegetarian and vegan diets are unsafe for children.

ANS: D

36. Which of the following was a finding of the Feeding Infants and Toddlers Study?
a. Most toddlers but not infants consumed insufficient intakes of sodium.
b. The most popular food among these population groups was baked potatoes.
c. Most infants but not toddlers demonstrated food intake patterns consistent with MyPlate recommendations.
d. About one-fourth of the infants and toddlers failed to consume even one serving of fruits or vegetables daily.
e. Less than 10% of young preschoolers consumed nutrient-poor, energy-dense beverages, desserts, and snack foods each day.

ANS: D

37. Which of the following is a characteristic of hunger and behavior in children?
a. Children who fail to eat breakfast typically become hyperactive after eating lunch.
b. The nutrient deficit arising from skipping a breakfast is usually made up over the following 2 days.
c. Children who eat nutritious breakfasts are absent from school less often than their friends who do not.
d. Although breakfast-skippers show reduced attention spans, their scores on intelligence tests remain unaffected.
e. While hunger can have short-term effects, there is little evidence for long-term effects.

ANS: C

38. Which of the following is characteristic of children who regularly eat breakfast or skip breakfast?
a. Breakfast-skippers actually show lower scores on IQ tests than those who eat breakfast.
b. Attention spans are similar but a significant number of breakfast-skippers show hyperglycemia.
c. Breakfast-skippers initially show decreased mental performance but with time they adapt and show almost identical achievements.
d. Breakfast-skippers who change to eating breakfast show a temporary improvement in mental concentration but also a moderate degree of hypoglycemia.
e. Children who skip breakfast and often quite thin and malnourished.

ANS: A

39. Which of the following is a characteristic of iron deficiency in children?
a. It affects brain function before anemia sets in.
b. It rarely develops in those with high intakes of milk.
c. It is the primary factor in tension-fatigue syndrome.
d. Mild deficiency enhances mental performance by lowering physical activity level, thereby leading to increased attention span.
e. Children who had iron deficiency as infants recover completely when iron levels are normalized.

ANS: A

40. Which of the following is a characteristic of lead exposure and health?
a. Absorption of lead is higher on an empty stomach.
b. Lead toxicity is most prevalent in children around the time of puberty.
c. Lead-induced anemia is similar to the anemia of vitamin B12 deficiency.
d. The symptoms of lead toxicity can be reversed by adding iron to the diet.
e. Lead exposure is extremely rare in the U.S..

ANS: A

41. What percentage of young school aged children exhibit hyperactivity?
a. 5%
b. 7%
c. 9%
d. 11%
e. 13%

ANS: D

42. What is thought to account, in part, for the rise in the prevalence of peanut allergy?
a. Excess sodium consumed as part of the peanuts.
b. Roasting peanuts at very high temperatures makes them more allergenic.
c. Impaired digestion/absorption resulting from elevated leptin and adiponectin levels.
d. Increased inflammation of the immune system due to altered ratio of omega-6 to omega-3 fatty acids.
e. Hyperstimulation of the immune system by multiple vaccines.

ANS: B

43. A child who develops antibodies to a certain food is said to have a
a. food allergy.
b. food intolerance.
c. specific inducible episode.
d. transient immune suppression.
e. histamine inhibition response.

ANS: A

44. Which of the following is a characteristic of a food allergy?
a. It always elicits symptoms in the person.
b. It always involves the production of antibodies.
c. It always shows up immediately after exposure to the allergic food.
d. It is elicited from very small, simple molecules as well as large, complex molecules.
e. It is less severe than an intolerance.

ANS: B

45. Which of the following foods are most often the cause of anaphylactic shock?
a. Eggs, peanuts, and milk
b. Bananas, juice, and cola
c. Apples, noodles, and rice
d. Pears, oatmeal, and chocolate
e. Barley, corn, and quinoa

ANS: A

46. What food is responsible for the most life-threatening allergic reactions in people?
a. Eggs
b. Peanuts
c. Shellfish
d. Cow’s milk
e. Soy

ANS: B
.

47. A life-threatening whole-body allergic reaction is known as
a. anaphylactic shock.
b. hyperhistamine response.
c. hyporespiratory syndrome.
d. wheezing food intolerance.
e. immunoresponsive allergy.

ANS: A

48. A child known to be allergic to peanuts who begins to show signs such as difficulty breathing, swelling of the tongue, and severe abdominal discomfort is most likely in immediate need of a life-saving injection of
a. cortisone.
b. serotonin.
c. epinephrine.
d. acetylcholine.
e. histamine.

ANS: C

49. A child with a true allergy to milk is actually allergic to the milk’s
a. casein.
b. lactose.
c. medium-chain fats.
d. bovine growth hormone.
e. contamination with antibiotics.

ANS: A

50. If a child is allergic to soy, which of the following should be avoided?
a. Milk
b. Diglycerides
c. Peanut butter
d. Textured vegetable protein
e. Seitan

ANS: D

51. Approximately what percentage of U.S. children between 2 and 19 years of age are overweight?
a. 4
b. 8
c. 16
d. 32
e. 48

ANS: D

52. Which of the following is a characteristic of obesity in childhood?
a. The typical obese child does not learn food behaviors from his family.
b. A nonobese child of nonobese parents has a less than 10% chance of becoming obese in adulthood.
c. An obese adolescent with one obese parent has virtually a 100% chance of becoming obese in adulthood.
d. The typical obese child today has approximately the same energy intake as did children 30 years ago.
e. Obese children should be put on restrictive diets to reduce their weight as quickly as possible.

ANS: B

53. According to the American Academy of Pediatrics, what is the recommended maximum number of hours/day of television viewing for a child under 2 years of age?
a. 0
b. 1
c. 2
d. 3
e. 5

ANS: A

54. What population group consumes the most soft drinks each day at school?
a. Teenage boys
b. Teenage girls
c. 10 to 12 year-old boys
d. 10 to 12 year-old girls
e. 8 to 10 year-old boys and girls

ANS: A

55. The typical can of soft drink contains the equivalent of how many teaspoons of sugar?
a. 1
b. 3
c. 7
d. 10
e. 16

ANS: D

56. To help improve a child’s BMI, the American Academy of Pediatrics recommends limiting television and video time for children older than 2 years to how many hours per day?
a. 1
b. 2
c. 3
d. 4
e. 5

ANS: B

57. What is the leading cause of high blood pressure in children?
a. Obesity
b. High sodium intake
c. Insufficient calcium intake
d. Insufficient potassium intake
e. Excess vitamin E intake

ANS: A

58. Which of the following is a feature of nutrition and behavior in children?
a. Hyperactivity responds favorably to a low-sugar diet.
b. The adverse effects from caffeine first appear only after drinking 6 cans of cola in one day.
c. Television commercials featuring snack foods have been found to affect children’s food preferences.
d. Because most children are sensitive to the stimulating effects of caffeine, they are able to control their intake of cola beverages.
e. Research indicates a strong relationship between food dyes and attention deficit hyperactivity disorder.

ANS: C

59. Which of the following is an effective strategy for dealing with obesity in a child?
a. Encourage the individual to eat quickly and then leave the table.
b. Institute new eating habits such as teaching the individual to clean the food plate.
c. Engage the individual in at least 1 hour per day of moderate to vigorous physical activity.
d. Take control and strongly encourage the individual to lose weight by limiting food intake and exercising vigorously.
e. Behavior modification programs that reward healthy choices and punish unhealthy choices.

ANS: C

60. Who is best able to manage the growth and weight gain of overweight children?
a. School nurse
b. Parents/caregivers
c. Health-care professional
d. School physical education instructor
e. Peers

ANS: C

61. Even in preschoolers whose habits are being established, existing dietary attitudes are relatively resistant to change. How should wise parents react?
a. Be patient and persistent.
b. Impose their own eating habits on the children.
c. Wait until the children start school to initiate changes.
d. Exert continuous pressure to initiate good food habits.
e. Punish inappropriate eating behavior.

ANS: A

62. If a child is reluctant to try a new food, it is best to
a. send the child to his/her room.
b. withhold dessert until all food on the plate is eaten.
c. quietly remove it and present it again at another time.
d. encourage other family members to coax the child to eat it.
e. ignore the child until he or she eats it.

ANS: C

63. When children are allowed to eat freely from a variety of foods, they usually select foods that are high in
a. iron.
b. fiber.
c. sugar.
d. protein.
e. fat.

ANS: C

64. What minimum fraction of the RDA for key nutrients for children 10-12 years of age should be provided by public school lunches?
a. 1/8
b. 1/4
c. 1/3
d. 1/2
e. 2/3

ANS: C

65. One factor that has limited the success of the School Breakfast Program is that
a. the cost is prohibitive.
b. the meals are not nutritious.
c. children simply do not participate in it.
d. fewer than 10% of the nation’s schools participate in it.
e. many pediatricians oppose it.

ANS: C

66. Which of the following is a characteristic of the adolescent period?
a. Obesity occurs more often in African-American females.
b. Appetite for red meat increases in females to meet iron needs.
c. More nutrient-dense foods are needed by males because of their faster development.
d. The risk for calcium insufficiency is greatest in males due to their high intake of soft drinks.
e. The adolescent growth spurt begins around age 12 for females and 10 for males.

ANS: A

67. Girls younger than the age of 14 who have started to menstruate, need additional ____ milligrams of iron per day.
a. 1
b. 1.5
c. 2
d. 2.5
e. 3

ANS: D

68. Which of the following is a feature of beverage intake in adolescents?
a. Juice intake is spread throughout the day.
b. Milk intake occurs primarily between meals.
c. Males typically drink less milk than females.
d. Four standard colas a day provides enough caffeine to alter behavior.
e. Soft drinks are typically consumed in addition to milk, not instead of it.

ANS: D

69. Approximately what fraction of an average teenager’s daily energy intake is derived from snacks?
a. 1/4
b. 1/3
c. 1/2
d. 2/3
e. 3/4

ANS: A

70. About how many meals each week are eaten outside the home by adolescents?
a. 3
b. 7
c. 10
d. 14
e. 18

ANS: B

COMPLETION

1. After the age of ____________________ years, children can be transitioned to fat-free milk if care is taken to avoid excessive restriction of dietary fat.

ANS: 2; two

2. No single nutrient is more essential to growth than ____________________.

ANS: protein

3. The component of breast milk that inhibits the development of inflammatory bowel disease and supports a healthy epithelial barrier is ____________________.

ANS: transforming growth factor-beta

4. ____________________ in breast milk help to establish and maintain growth of desired bacteria in gastrointestinal tract and inhibit pathogen attachment to the intestinal mucosa.

ANS: Oligosaccharides

5. Honey should never be fed to infants because of the risk of ____________________.

ANS: botulism

6. Limited research suggests that food additives such as ____________________ preservative may exacerbate hyperactive symptoms such as inattention and impulsivity in some children.

ANS: sodium benzoate

7. A true ____________________ occurs when fractions of a food protein or other large molecule are absorbed into the blood and elicit an immunologic response.

ANS: food allergy

8. Adverse reactions to foods that do not involve the immune system are called ___________________.

ANS: food intolerances

9. ____________________, the over-the-counter version of orlistat, should not be given to anyone younger than age 18.

ANS: Alli

10. ____________________ is a craving to consume nonfood items.

ANS: Pica

Chapter 17 – Life Cycle Nutrition: Adulthood and the Later Years
1. Approximately what fraction of the U.S. population is at least 65 years old?
a. 1/100
b. 1/30
c. 1/10
d. 1/8
e. 1/3ANS: D

2. What is the fastest-growing age group in the United States?
a. 21-34 years
b. 35-49 years
c. 50-64
d. 65-84 years
e. Over 85 years

ANS: D

3. What is the life expectancy of black males and females in the United States?
a. 72 (males), 78 years (females)
b. 78 (males), 85 years (females)
c. 81 (males), 86 years (females)
d. 85 (males), 89 years (females)
e. 90 (males), 93 years (females)

ANS: A

4. What was the average life expectancy of a person born in the year 1900?
a. 47 years
b. 55 years
c. 61 years
d. 68 years
e. 71 years

ANS: A

5. What is the life expectancy of white males and females in the United States?
a. 62 (males), 68 years (females)
b. 77 (males), 81 years (females)
c. 82 (males), 86 years (females)
d. 87 (males), 90 years (females)
e. 89 (males), 93 years (females)

ANS: B

6. Approximately how many years is the maximum human life span?
a. 75
b. 100
c. 115
d. 130
e. 145

ANS: D

7. Once a woman reaches the age of 75 years, about how many more years of survival would be expected?
a. 9
b. 11
c. 13
d. 15
e. 17

ANS: C

8. Longevity is defined as
a. long duration of life.
b. a person’s age in years from date of birth.
c. maximum number of years of life attainable by a species.
d. average number of years lived by people in a given society.
e. the years of life left for someone who has attained a given age.

ANS: A

9. Which of the following is a characteristic of the response to stress?
a. Men often follow a pattern of “tend-and-befriend”
b. Women usually engage in the “fight-or-flight” response
c. Older men and women tend to lose their ability to adapt to stress
d. Common psychological stressors in older people include alcohol abuse and smoking
e. The physiologic responses triggered by stress decrease the likelihood of physical responses to the stressors

ANS: C

10. By 2030, what proportion of the U.S. population is expected to be 65 years of age or older?
a. 1 in 7
b. 1 in 6
c. 1 in 5
d. 1 in 4
e. 1 in 3

ANS: C

11. The CDC recommends older adults engage in strength training at least two (non-consecutive) days a week, at a moderate to high intensity for ____ repetitions.
a. 5-10
b. 10-15
c. 15-20
d. 20-25
e. 25-30

ANS: B

12. What would be the physiological age of a 75-year-old woman whose physical health is equivalent to that of her 50-year-old daughter, whose physical health is average for her age?
a. 25 years c. 70 years
b. 50 years d. 125 years

ANS: B

13. What is the most important predictor of a person’s mobility in the later years?
a. BMI
b. Alcohol use
c. Chronological age
d. Regular physical activity
e. Good genes

ANS: D

14. Which of the following is a finding from studies of diet restriction in rats?
a. Restriction of specific nutrients exerted antiaging effects
b. Energy-restricted diets led to life extension in 90% of the rats
c. Energy-restricted diets led to lowering of the metabolic rate and body temperature
d. Restriction of food intake only after rats reached maturity, but not before, resulted in extension of the life span
e. Although early research was encouraging, more recent research has found that the effects are much smaller than hoped

ANS: C

15. Which of the following is a feature of energy intake and longevity?
a. Improvements in longevity with energy restriction depend on reducing energy intake but not on the amount of body fat
b. Restriction of energy intake in genetically obese animals does not seem to improve longevity
c. Biochemical markers for longevity in humans are improved only when energy intake is reduced by at least one-third
d. The activities of the genes of older mice on energy-restricted diets are similar to those of mice on standard diets
e. Research with humans has found a substantial increase in longevity with a 5% reduction in energy intake

ANS: A

16. What minimum reduction from the usual intake of energy in people brings about measurable improvements in body fat, blood pressure, insulin response, and blood lipids?
a. 10%
b. 15%
c. 20%
d. 25%
e. 30%

ANS: A

17. People who persistently restrict energy intake by 30% for 30 years can expect to increase longevity by up to how many years?
a. 3
b. 6
c. 9
d. 12
e. 15

ANS: A

18. In people who practice energy restriction to prolong life, hunger becomes persistent when kcal intake first drops by what percentage?
a. 10
b. 20
c. 30
d. 40
e. 50

ANS: C

19. Which of the following is a proposed mechanism for energy restriction and improved longevity in animals?
a. Reduced oxidative stress
b. Increased metabolic rate
c. Enhanced lipid oxidation
d. Accelerated growth and development
e. Decreased physiologic arousal to stress

ANS: A

20. Which of the following is a feature of the stress response in men and women?
a. Women’s general reactions to stress are different than those of men.
b. The ability to respond is weaker in older women compared with older men.
c. The secretion of epinephrine is suppressed in elderly women compared with elderly men.
d. Psychological stressors such as divorce or death of a loved one are handled much less well by elderly men compared with elderly women.
e. There are no clinically important differences in men’s and women’s responses to stress.

ANS: A

21. For adults older than ____, mortality is lowest among individuals who are moderately overweight (BMI 23.5-27.5)
a. 45
b. 55
c. 65
d. 75
e. 85

ANS: C

22. What is sarcopenia?
a. Loss of central visual activity
b. Loss of muscle mass and strength
c. Aging-induced chronic inflammation of the stomach
d. Intestinal dysmotility from excessive use of laxatives
e. Paralysis of GI tract muscles

ANS: B

23. Which of the following is a characteristic of aging and the immune system?
a. Immunity in older people does not seem to be affected by regular exercise.
b. In the United States, infectious diseases are a minor cause of deaths in the elderly.
c. Immune function does not decline with age in people who maintain good nutrition.
d. Antibiotics are often ineffective in treating infections in older people who have deficient immune systems.
e. In elderly persons, nutritional status rarely influences immune functioning.

ANS: D

24. Which of the following terms describes an immune system that is inefficient and overactive in the aged?
a. Inflammaging
b. Dysphagic cell mass
c. Sarcopenic undermining
d. Endentulous-induced wasting
e. Cachexia of aging

ANS: A

25. A person with dysphagia has
a. no teeth.
b. low immunity.
c. difficulty swallowing.
d. diminished muscle mass.
e. impaired cognitive function.

ANS: C

26. A person who is edentulous has
a. no teeth.
b. low immunity.
c. difficulty swallowing.
d. diminished muscle mass.
e. limited lower body mobility.

ANS: A

27. What fraction of eligible seniors participate in the SNAP?
a. 1/4
b. 1/3
c. 1/2
d. 2/3
e. 3/4

ANS: B

28. The evidence from studies to date shows that nutritional interventions designed to relieve depression
a. may or may not be effective.
b. are mildly effective.
c. are moderately effective.
d. are greatly effective.
e. may worsen depression in very old individuals.

ANS: A

29. The calcium Dietary Reference Intake for women 50 and older is
a. 800 mg.
b. 1000 mg.
c. 1200 mg.
d. 1400 mg.
e. 1600 mg.

ANS: C

30. A person with a pressure ulcer has damage to her
a. skin.
b. colon.
c. mouth.
d. stomach.
e. small intestine.

ANS: A

31. Approximately what percentage decline in basal metabolism is seen in an 80-year-old person compared with a 40-year-old?
a. 1-2
b. 2-4
c. 4-8
d. 8-16
e. 16-24

ANS: C

32. Approximately what percentage decline in total energy expenditure is seen in a 70 year old versus a 30 year old?
a. 2
b. 10
c. 20
d. 30
e. 40

ANS: C

33. Which of the following describes the nutrient needs of older people?
a. They vary according to individual histories.
b. They remain the same as in young adult life.
c. They increase; therefore, supplementation is required.
d. They decrease for vitamins and minerals due to changes in body composition.
e. They rarely change from middle-age onward.

ANS: A

34. Which of the following is a feature of elderly people and water metabolism?
a. They may not feel thirsty or recognize dryness of the mouth.
b. They have a higher total body water content compared with younger adults.
c. They show increased frequency of urination, which results in higher requirements.
d. They frequently show symptoms of overhydration such as mental lapses and disorientation.
e. Overhydration increases risk of pressure ulcers and urinary tract infections.

ANS: A

35. What is the minimum number of glasses of water per day recommended for older adults?
a. 4
b. 6
c. 8
d. 10
e. 12

ANS: B

36. What percentage of older adults live in poverty?
a. 7
b. 9
c. 11
d. 13
e. 15

ANS: B
.
37. Adults aged 71 and older who engage in minimal outdoor activity need ____ micrograms of vitamin D daily.
a. 15
b. 20
c. 25
d. 30
e. 35

ANS: B

38. Which of the following is a research finding on vitamin D nutrition in the elderly?
a. Self-synthesis capacity is high.
b. The skin’s capacity to synthesize the vitamin is reduced.
c. The presence of atrophic gastritis reduces bioavailability of the vitamin.
d. Symptoms of deficiency include dermatitis and diminished taste acuity.
e. Deficiency is rarely a problem.

ANS: B

39. Which of the following is a feature of vitamin D nutrition in the elderly?
a. Most elderly receive near-RDA amounts of the vitamin.
b. Aging reduces the kidneys’ ability to convert vitamin D to its active form.
c. The RDA for vitamin D in the elderly is lower due to less excretion by the kidneys.
d. Most elderly rely primarily on self-synthesis of the vitamin due to their greater time spent outdoors.
e. Elderly individuals need at least 40 micrograms per day.

ANS: B

40. Which of the following is a feature of calcium nutrition in the elderly?
a. The DRI is 800-1000 mg.
b. Calcium intakes are well below recommendations.
c. Calcium supplements are not effective sources of calcium due to poor digestibility.
d. Calcium from food is not well absorbed due to the intake of calcium-binding laxatives.
e. An elderly individual who lacks sufficient calcium stores can rarely be helped by supplementation.

ANS: B

41. Which of the following statements describes one aspect of mineral nutrition of older adults?
a. Zinc intake is adequate for about 95% of this group.
b. Iron absorption is reduced due to low stomach acidity.
c. Calcium intakes of females are near the RDA for this group.
d. Calcium allowances for this group have recently been increased by the Committee on Dietary Reference Intakes.
e. Folate excesses are fairly common.

ANS: B

42. A condition that increases the likelihood of iron deficiency in older people is
a. lack of intrinsic factor.
b. loss of iron due to menopause.
c. blood loss from yearly physical testing procedures.
d. poor iron absorption due to reduced stomach acid secretion and/or use of antacids.
e. the body’s need for iron increases well into old age.

ANS: D

43. Which of the following is a feature of zinc nutrition in the elderly?
a. Zinc intake is insufficient in older people.
b. Excess zinc from supplements blunts the taste buds.
c. Zinc deficiency stimulates the appetite for high-fat foods.
d. Most medications affect zinc excretion but not absorption.
e. Excess zinc increases the risk of pneumonia.

ANS: A

44. Which of the following is a characteristic of nutrition and cataract formation?
a. Obese and lean people have the same risk for cataracts.
b. Adequate intakes of biotin and inositol seem to delay the onset of cataract formation.
c. Nutrition seems to play little, if any, role in the onset of cataracts.
d. Vitamin C supplements in doses of 1,000 mg for several years appear to raise the risk for cataracts.
e. Antioxidant supplements appear to slow the progression of cataracts.

ANS: D

45. What are the thickenings that occur to the lenses of the eye, thereby affecting vision, especially in the elderly?
a. Retinitis
b. Keratoids
c. Cataracts
d. Rhodolipids
e. Glaucoma

ANS: C
.

46. What proportion of persons in the U.S., age 65 and older, have a cataract?
a. About 1 in 50
b. About 1 in 20
c. About 1 in 10
d. About 1 in 5
e. More than half

ANS: E

47. What organ is affected by macular degeneration?
a. Bone
b. Eyes
c. Liver
d. Kidneys
e. Spinal cord

ANS: B

48. Which of the following foods seems to relieve rheumatoid arthritis in some people?
a. Milk
b. Olive oil
c. Iodized salt
d. Refined cereals
e. Beef and pork

ANS: B

49. Which of the following types of diets has been shown to prevent or reduce arthritis inflammation?
a. High in simple sugars, low in canned fruit
b. High in animal protein, low in canned fruit
c. Low in polyunsaturated fat, high in oleic acid
d. Low in saturated fat, high in omega-3 fatty acids
e. High in animal protein and both omega-3 fatty acids and oleic acid

ANS: D

50. What disorder is associated with the body’s breakdown of purines?
a. Gout
b. Dysphagia
c. Sarcopenia
d. Senile dementia
e. Macular degeneration

ANS: A

51. What is thought to be the most important nutrition concern for people with Alzheimer’s disease?
a. Maintenance of appropriate body weight
b. Ensuring adequate intakes of antioxidant nutrients and DHA
c. Monitoring intake of medications that may interfere with nutrient bioavailability
d. Treatment for iron overload to prevent formation of new neurofibrillary tangles
e. Taking vitamin and mineral supplements appropriate for dementia treatment

ANS: A

52. Which of the following is a characteristic of alcohol use in the elderly?
a. Binge drinking is more frequent in the elderly than in younger persons.
b. The proportion of binge drinkers in greater in the elderly than any other age group.
c. In elderly individuals, unlike in younger individuals, alcohol use is not associated with other risky behavior such as illicit drug use.
d. Alcohol withdrawal is much more difficult for older persons than for younger persons.
e. Elderly individuals are rarely successfully treated for alcohol abuse and dependence.

ANS: A

53. Which of the following is thought to promote the development of brain senile plaques and neurofibrillary tangles?
a. Oxidative stress
b. Excess acetylcholine
c. Dietary deficiency of choline
d. Low blood levels of homocysteine
e. Inability to adequately metabolize protein

ANS: A

54. Approximately what percentage of U.S. adults are affected by Alzheimer’s disease after age 65?
a. 1
b. 5
c. 12
d. 33
e. 50

ANS: C

55. What is the main reason for dieting in the elderly?
a. To economize when food prices increase
b. To improve appearance among their peers
c. To pursue a medical goal such as reducing blood glucose
d. To reduce risks for development of atrophic gastritis and pernicious anemia
e. Unintentionally, as a result of depression or dementia

ANS: C

56. Which of the following is a feature of food choices and eating habits of older people?
a. The quality of life among older people has not improved since 1995.
b. Older people spend less money on foods to eat at home than younger people.
c. People over 65 are less likely to diet to lose weight than are younger people.
d. Most older people think of themselves as generally unhappy and in poor health.
e. Older people tend to be adventuresome eaters who enjoy breaking away from traditional foods.

ANS: C

57. What is a congregate meal?
a. A meal provided for the elderly in a place such as a community center
b. A meal prepared for the elderly that meets one-third of the Dietary Recommended Intakes
c. A meal prepared for disadvantaged people of all ages to encourage communal gathering of diverse population groups
d. A meal provided through the Nutrition Screening Initiative for the elderly and served primarily to church congregations
e. A meal prepared by a community organization and delivered to home-bound individuals where they live

ANS: A

58. Which of the following is true of food assistance programs for older Americans?
a. Persons aged 70 and older are eligible.
b. There are no income limits for eligibility.
c. Meals on Wheels is generally preferred to congregate meals.
d. Meals on Wheels requires that individuals be permanently disabled in order to receive meals.
e. Congregate meals and Meals on Wheels are funded by the Social Security Administration.

ANS: B

59. Which of the following is a program that provides low-income older adults with coupons that are exchangeable for fresh vegetables and fruits at community-supported farmers’ markets and roadside stands?
a. Senior Farmers Market Nutrition Program
b. Food Security for the Disadvantaged Elderly
c. Old Age and Survivors Health Benefits Program
d. Elderly Nutrition and Maintenance Food Co-Op
e. Eldercare Food Assistance

ANS: A

60. Which of the following would be the most effective substitute for fresh milk for the elderly person living alone?
a. UHT milk
b. Low-cost expired milk
c. Calcium carbonate tablets
d. Greens with highly bioavailable calcium
e. Sweetened condensed milk

ANS: A

61. What percentage of all prescription drugs sold in the United States is taken by people over 65 years of age?
a. 10
b. 20
c. 30
d. 40
e. 50

ANS: D

62. How does aspirin reduce inflammation and pain?
a. It acts as a sedative and barbiturate.
b. It promotes wound healing and blood clotting.
c. It interferes with the synthesis of prostaglandins.
d. It binds to nerve receptors involved in pain perception.
e. It stimulates endorphin release.

ANS: C

63. What are the known consequences of taking a single two-tablet dose of aspirin?
a. It inhibits monoamine oxidase activity.
b. It doubles the bleeding time of wounds.
c. It increases production of prostaglandins that enhance fever.
d. It is excreted very rapidly in people taking vitamin C supplements.
e. In it insufficient to reduce risk of heart attack in at-risk individuals.

ANS: B

64. What is the primary action of the medication megestrol acetate?
a. It relieves depression.
b. It promotes weight loss.
c. It promotes weight gain.
d. It lowers blood pressure.
e. It is used to treat moderate dementia.

ANS: C

65. What nutrient is known to interfere significantly with the utilization of the antibiotic tetracycline?
a. EPA
b. Zinc
c. Calcium
d. Vitamin B12
e. Sodium

ANS: C

66. What is a common side effect from taking certain prescription drugs and consuming grapefruit juice?
a. A metallic taste in the mouth appears.
b. Blood concentrations of the drugs increase.
c. The bioavailability of the drugs falls substantially.
d. The bioflavonoids in the juice bind to the drugs and promote formation of uric acid crystals.
e. Absorption is greatly reduced.

ANS: B

67. Which of the following is a feature of warfarin use and vitamin K utilization?
a. Warfarin blocks vitamin K absorption.
b. Orange juice intake interferes with warfarin’s effects on vitamin K.
c. Dietary vitamin K intake determines the amount of warfarin prescribed.
d. The tyramine content of aged meats interferes with binding of vitamin K to warfarin.
e. Vitamin K can dangerously potentiate warfarin’s anticlotting actions.

ANS: C

68. Your father was recently prescribed an anticoagulant medicine and was surprised that the doctor advised him to maintain consumption of consistent amounts of green leafy vegetables every day. You inform your father that
a. these vegetables significantly reduce absorption of the drug.
b. these vegetables significantly increase absorption of the drug.
c. variable intake of green leafy vegetables will affect activity of monoamine oxidase inhibitors.
d. inconsistent intakes of green leafy vegetables will interfere with the regular action of the drug.
e. he is confused – green leafy vegetable intake is unrelated to anticoagulant action.

ANS: D

69. Which of the following foods in particular must be restricted in the diet of a person taking a monoamine oxidase inhibitor drug?
a. Red meat
b. Aged cheeses
c. Fresh fish
d. Cruciferous vegetables
e. Chocolate

ANS: B

70. What ingredient commonly used as an additive in liquid medicines often causes diarrhea?
a. Sorbitol
b. Maltose
c. Saccharin
d. Aspartame
e. Lactulose

ANS: A

COMPLETION

1. ____________________ is the average number of years lived by people in a given society.

ANS: Life expectancy

2. ____________________ is the maximum number of years of life attainable by a member of a species.

ANS: Life span

3. ____________________ is a person’s perceived physical and mental well-being.

ANS: Quality of life

4. ____________________ is a person’s age as estimated from her or his body’s health and probable life expectancy.

ANS: Physiological age

5. ____________________ are damage to the skin and underlying tissues as a result of compression and poor circulation.

ANS: Pressure ulcers

6. Any threat to a person’s well-being or a demand placed on the body to adapt is referred to as ____________________.

ANS: stress

7. The medical term for loss of skeletal muscle mass, strength, and quality is ____________________.

ANS: sarcopenia

8. The combination of an inefficient and overactive response in aging—known as
“____________________”—results in a chronic inflammation that accompanies frailty, illness, and death .

ANS: inflammaging

9. Difficulty swallowing is called ____________________.

ANS: dysphagia

10. The medical term for a person who lacks teeth is ____________________.

ANS: edentulous

Chapter 18 – Diet and Health
1. What are cytokines?
a. Scavengers of the immune system
b. Specialized antibodies that retain B-cell memory
c. Specialized proteins that activate responses to infection
d. Highly specific cells that attack only one type of antigen
e. Lymphocytes that produce antibodiesANS: C

2. Immunoglobulins are produced primarily by
a. T-cells.
b. B-cells.
c. antigens.
d. phagocytes.
e. NK-cells.

ANS: B

3. The process by which immune cells engulf and then destroy bacteria is known as
a. bactocytosis.
b. phagocytosis.
c. cytotoxicosis.
d. immunoglobinemia.
e. immunocytosis.

ANS: B

4. The immune system treats foreign substances such as bacteria and toxins as
a. antigens.
b. antibodies.
c. antitoxins.
d. immunoglobulins.
e. symbionts.

ANS: A

5. Which of the following is a feature of AIDS?
a. It has no cure.
b. Its prevention depends on good nutrition.
c. It cannot pass from mother to infant during breastfeeding.
d. It is among the 10 leading causes of death in the United States.
e. There has been very limited progress made in finding effective treatments.

ANS: A

6. What is the role of omega-3 fatty acids in immune functioning?
a. Maintain healthy skin and other epithelial tissues as barriers to infection.
b. Regulate T-cell responses.
c. Help to resolve inflammation when it is no longer needed for the immune response.
d. Participate in antibody production.
e. Helps maintain an effective immune response.

ANS: C

7. Of the ten leading causes of illness and death, how many are associated directly with nutrition?
a. one
b. two
c. four
d. five
e. eight

ANS: C

8. Which of the following risk factors for disease may be modified by diet?
a. Age
b. Gender
c. Heredity
d. Low HDL level
e. Race

ANS: D

9. What is the term given to the accumulation of lipid material mixed with smooth muscle cells and calcium that develops in the artery walls?
a. Plaques
b. Angina streaks
c. Arterial thickening
d. Pre-thromboemboli
e. Lipid tangles

ANS: A

10. The most common form of cardiovascular disease is
a. stroke.
b. atheromatous disease.
c. coronary heart disease.
d. hypertensive aneurysm.
e. congestive heart failure.

ANS: C

11. By what age do most people first have well-developed arterial plaque?
a. 20
b. 30
c. 40
d. 50
e. 60

ANS: B

12. Which of the following is a feature of atherosclerosis?
a. It is characterized by inflammation in all stages.
b. It is improved by high blood homocysteine levels.
c. It is characterized by infiltration of platelets in the arterial wall.
d. It is worsened by elevated blood high-density lipoproteins.
e. It is the second most common cause of coronary heart disease.

ANS: A

13. The ballooning out of an artery wall at a point where it has been weakened by deterioration is called a(n)
a. aorta.
b. plaque.
c. aneurysm.
d. diverticula.
e. pouch.

ANS: C

14. A person’s level of C-reactive protein appears to be a strong predictor for
a. cancer.
b. diabetes.
c. a heart attack.
d. HIV progression.
e. rheumatoid arthritis progression.

ANS: C

15. Which of the following may be classified as a risk factor for coronary heart disease?
a. BMI of 26
b. Low LDL-cholesterol levels
c. High HDL-cholesterol levels
d. High C-reactive protein levels
e. Low blood triglyceride (VLDL) levels

ANS: D

16. In the development of plaque, what is thought to be responsible for oxidation of LDL cholesterol during the inflammatory phase?
a. Free radicals
b. Beta-blockers
c. P-reactive protein (PRP)
d. Lipoprotein-associated phospholipase A
e. Cytokines

ANS: A

17. The obstruction of a blood vessel by a clot that broke away from arterial plaque is termed
a. an anginism.
b. an embolism.
c. circulatory hypoxia.
d. a de-plaquing event.
e. plaque rupture.

ANS: B

18. A significant reduction in blood flow to the brain is termed
a. angina.
b. a stroke.
c. a vascular event.
d. metabolic syndrome.
e. Chiari event.

ANS: B

19. Which of the following blood pressure readings first signifies a diagnosis of hypertension?
a. 110 over 50
b. 120 over 70
c. 130 over 80
d. 140 over 90
e. 150 over 100

ANS: D

20. What disease accounts for the majority of deaths in U.S. women?
a. Diabetes
b. Lung cancer
c. Breast cancer
d. Coronary heart disease
e. Stroke

ANS: D

21. Which of the following is true of coronary heart disease (CHD)?
a. By age 20, half of the adults in the United States have at least one major risk factor for CHD.
b. Women who take estrogen to reduce the risk for osteoporosis are at significantly higher risk for CHD.
c. Aging becomes a significant risk factor for women who are 75 and older.
d. Women younger than 45 years of age tend to have higher LDL cholesterol than do men of that age, but this difference disappears after menopause.
e. Levels of the amino acid homocysteine, which protects artery walls, are typically higher in women than in men.

ANS: A

22. What proportion of adults in the U.S. have high blood triglycerides?
a. 1/10
b. 1/4
c. 1/3
d. 1/2
e. 2/3

ANS: C

23. What is prehypertension?
a. A predictor of stroke risk
b. Slightly high blood pressure
c. A precursor for Syndrome X
d. A component of the metabolic syndrome
e. A cluster of risk factors that predict the likelihood of hypertension

ANS: B

24. What blood cholesterol carrier is of greatest concern in atherosclerosis?
a. HDL
b. LDL
c. HDK
d. VLDK
e. NK

ANS: B

25. Which of the following is considered a desirable blood level for triglycerides?
a. < 150 b. 150-200 c. 200-250 d. 250-300 e. 300-350 ANS: A 26. A person who produces a normal amount of insulin but whose cells show suboptimal response is said to be a. polydipsic. b. insulin resistant. c. hyperglucagonemic. d. pancreatic beta-cell deficient. e. glucophillic. ANS: B 27. A desirable HDL cholesterol is a. 20-30 mg/dl. b. 30-40 mg/dl. c. 40-50 mg/dl. d. 50-60 mg/dl. e. >60 mg/dl.

ANS: E

28. Which of the following is true of progress in the treatment and prevention of CHD in the United States?
a. Mortality rates have increased among men.
b. CHD is no longer the number 1 cause of death in women.
c. Blood cholesterol levels have been declining since 1960.
d. By age 45, about 1/3 of adults have at least one major risk factor for CHD, down from 1/2 20 years ago.
e. Efforts to reduce CHD incidence by reducing cigarette smoking have largely failed.

ANS: C

29. What should be the next course of action for a person who was unsuccessful in lowering LDL or blood pressure by lifestyle changes?
a. Obtain prescription medications.
b. Consider coronary bypass surgery.
c. Obtain regular nutrition counseling.
d. Consider gastric surgery to reduce body weight.
e. Try again with a more stringent diet and exercise program.

ANS: A

30. Among the following, which should be the first action taken to lower blood cholesterol?
a. Begin drug treatment.
b. Consume a high-protein diet.
c. Consume large amounts of fish and fish oils.
d. Achieve and maintain appropriate body weight.
e. Increase alcohol intake and/or use an antianxiety medication.

ANS: D

31. Approximately what proportion of people in the United States are believed to have hypertension?
a. 1/10
b. 1/5
c. 1/4
d. 1/3
e. 1/2

ANS: D

32. What is the best predictor for risk of a stroke?
a. Blood pressure
b. LDL-cholesterol
c. HDL-cholesterol
d. Trans-fatty acid intake
e. Family history

ANS: A

33. Which of the following is a characteristic of factors associated with hypertension?
a. Most people with hypertension have BMIs <25.
b. Most people with hypertension are extremely salt sensitive.
c. Three to four alcohol drinks per day lowers risk for hypertension.
d. African Americans develop high blood pressure earlier in life and their average blood pressure is higher than others.
e. About 1/3 of people 65 and older have hypertension.

ANS: D

34. Hypertension contributes to an estimated ____ strokes in the U.S. each year.
a. 400,000
b. 600,000
c. 800,000
d. 1,000,000
e. 1,200,000

ANS: C DIF: Bloom’s: Remember REF: 18.4 Hypertension
OBJ: UNUT.WHRO.16.18.4 Present strategies to lower blood pressure.

35. Which of the following is the most likely reason that a blood pressure reading should be repeated before confirming a diagnosis of hypertension?
a. The person reacted emotionally to the procedure.
b. Blood pressure measuring devices often give inaccurate readings.
c. The cuff of the blood pressure measuring device was wrapped too tightly on the arm.
d. The cuff of the blood pressure measuring device was wrapped too loosely on the arm.
e. The person failed to fast before the test was performed.

ANS: A

36. How does obesity increase the risk for developing hypertension?
a. Obesity is associated with altered kidney function and fluid retention leading to higher blood pressure.
b. The excess fat pads surrounding the kidneys impair blood flow to these organs and lead to a higher output of renin.
c. Sodium intake in obese people significantly exceeds the recommended intake, thereby predisposing them to higher blood pressure.
d. Higher lipoprotein lipase activity in obese people triggers the angiotensin cascade, leading to increased peripheral resistance to blood flow.
e. Obesity alters inflammatory responses, which in turn alters the elasticity of arterial walls.

ANS: A

37. The lifetime percent risk of developing hypertension later in life when the blood pressure is normal at age 55 is
a. 10.
b. 25.
c. 50.
d. 75.
e. 90.

ANS: E

38. Peripheral resistance is the resistance blood encounters in the
a. veins.
b. arteries.
c. venules.
d. arterioles.
e. heart.

ANS: D

39. Which of the following statements describes lifestyle modifications suggested to treat high blood pressure?
a. Three alcohol drinks per day decreases the risk for developing high blood pressure.
b. Optimal body mass in from 25.0 to 29.9.
c. Sodium intake should be reduced to 1500 mg among persons who are 51 and older.
d. Perform aerobic physical activity for at least 90 minutes per day, most days of the week.
e. Recommended sodium intakes are higher for African Americans than for other groups.

ANS: C

40. Among the following lifestyle changes, which is least effective at reducing blood pressure?
a. Adopting the DASH eating plan
b. Limiting daily alcohol intake to 1-2 drinks
c. Reducing body weight to achieve a BMI of less than 25
d. Performing physical exercise for 30 minutes per day, 5 days a week
e. Restricting sodium to less than 2500 mg per day

ANS: B

41. Which of the following describes a relationship between sodium/salt and high blood pressure?
a. People with chronic kidney disease are less likely to be salt-sensitive.
b. Lowering sodium intakes reduces blood pressure only in certain ethnic groups.
c. People less 30 years of age are most likely to be salt-sensitive.
d. Weight loss is often as effective as sodium restriction in lowering blood pressure.
e. Of all racial groups, whites tend to be most salt sensitive.

ANS: D

42. People who use diuretics are most at risk of developing imbalances of
a. sodium.
b. calcium.
c. potassium.
d. phosphate.
e. manganese.

ANS: C

43. Diuretics act to lower blood pressure by
a. increasing fluid loss.
b. decreasing potassium loss.
c. reducing arterial plaque formation.
d. increasing retention of calcium and potassium.
e. increasing stroke volume.

ANS: A

44. Which of the following is a characteristic of drug therapy for hypertension?
a. Antihypertensive drugs called diuretics work by lowering blood volume.
b. The most frequently prescribed drug therapies are DASH inhibitors.
c. Most people with hypertension need only one medicine to reduce blood pressure..
d. Major side effects of antihypertensive drugs are depletion of body sodium and phosphorus.
e. Unless weight is also reduced, antihypertensive drugs are unlikely to reduce blood pressure.

ANS: A

45. Which of the following is a difference between DASH and USDA recommendations?
a. USDA has a higher intake recommendation for grains.
b. DASH has a higher recommendation for milk.
c. DASH has a separate recommendation for seeds, nuts and legumes.
d. USDA has a higher intake recommendation for lean meats, poultry, and fish
e. USDA has a higher intake recommendation for fruits.

ANS: C

46. A person who hasn’t consumed anything except water for the past 8 hours has a blood glucose concentration of 101 mg/dL. This person would be classified as
a. normal.
b. diabetic.
c. prediabetic.
d. impaired glucose tolerant.
e. hypoglycemic.

ANS: C

47. Among the leading causes of death in the United States diabetes ranks number
a. 1.
b. 3.
c. 5.
d. 7.
e. 9.

ANS: D

48. What is believed to be the primary cause of type 1 diabetes?
a. Defect in insulin sensitivity
b. Excessive body weight gain
c. Defect of the immune system
d. Excessive intake of simple carbohydrates
e. Environmental toxins

ANS: C

49. In which of the following conditions would the pancreas be unable to synthesize insulin?
a. Hyperglycemia
b. Type 1 diabetes mellitus
c. Type 2 diabetes mellitus
d. Adult-onset diabetes mellitus
e. Hypoglycemia

ANS: B

50. Type 2 diabetes usually develops after people reach the age of
a. 21.
b. 30.
c. 40.
d. 55.
e. 65.

ANS: C

51. What percentage of people with diabetes have type 1?
a. 5-10
b. 10-15
c. 15-20
d. 20-25
e. 25-30

ANS: A

52. Which of the following is a characteristic of type 1 diabetes?
a. It is an autoimmune disorder.
b. It occurs exclusively in people under 40 years of age.
c. It must be treated by daily oral intake of insulin pills.
d. It accounts for approximately 50% of all cases of diabetes.
e. It is typically preceded by metabolic syndrome.

ANS: A

53. Most people with type 2 diabetes have
a. sarcopenia.
b. osteoporosis.
c. excess body fat.
d. insulin dependency.
e. relative insulin excess.

ANS: C

54. Which of the following conditions is characterized by insulin resistance of fat cells?
a. Hypoglycemia
b. Atherosclerosis
c. Type 1 diabetes
d. Type 2 diabetes
e. Juvenile diabetes

ANS: D

55. Insulin resistance is defined as
a. reduced sensitivity of cells to blood insulin.
b. impaired secretion of insulin by the pancreas.
c. increased destruction of insulin-producing cells.
d. increased persistence of insulin molecules in the blood.
e. relative excess of insulin-binding proteins in muscle tissue.

ANS: A

56. A complication of diabetes is blurry vision, which results from swelling of the lenses of the eye caused by conversion of excess glucose to
a. sugar alcohols.
b. glycated fructose.
c. long-chain ketones.
d. glycated corneal membranes.
e. glycoproteins.

ANS: A

57. The frequent urination common in diabetes is known as
a. polyuria.
b. polyphagia.
c. polyuresis.
d. pseudodiuresis.
e. enuresis.

ANS: A

58. The excessive thirst common in diabetes is known as
a. hydration.
b. polyuresis.
c. polydipsia.
d. hyperhydration.
e. paradoxical thirst.

ANS: C

59. Microangiopathies are disorders of the
a. kidneys.
b. pancreas.
c. capillaries.
d. coronary vessels.
e. eyes.

ANS: C

60. Which of the following is a leading cause of both blindness and kidney failure?
a. Cancer
b. Diabetes
c. HIV/AIDS
d. Atherosclerosis
e. Stroke

ANS: B

61. In the otherwise stable person with type 1 diabetes, a potential problem associated with physical activity is
a. hypoglycemia.
b. hyperglycemia.
c. nausea and vomiting.
d. temporary kidney shutdown.
e. sudden-onset blindness.

ANS: A

62. Which of the following describes the actions of a carcinogen?
a. Initiates cancer
b. Inhibits cancer
c. Treats cancer
d. Acts as an antipromoter
e. Stimulates tumor necrosis

ANS: A

63. A tumor that releases cells, leading to the spread of cancer to other regions of the body, is said to
a. promote.
b. augment.
c. metastasize.
d. infiltrate downstream.
e. become necrotic.

ANS: C

64. A substance that causes cancer is best termed a(n)
a. carcinogen.
b. antipromoter.
c. DNA-modifier.
d. RNA-modifier.
e. mutagen

ANS: A

65. The higher risk for breast cancer in obese women after menopause is thought to result mainly from chronic exposure to
a. estrogen.
b. aflatoxin.
c. high-fat diets.
d. sedentary lifestyles.
e. progesterone.

ANS: A

66. Which of the following cooking techniques for meats results in formation of the highest amounts of carcinogens?
a. Broiling
b. Roasting
c. Marinating before cooking
d. Wrapping the food in foil when cooking
e. Steaming

ANS: A

67. Which of the following dietary components is thought to be protective against certain types of cancer?
a. Fiber
b. Inositol and biotin
c. Certain saturated fats
d. Protein from animal sources
e. Certain sugars

ANS: A

68. Which of the following foods is known to be a protective factor for esophageal cancer?
a. Alcoholic beverages
b. Nonstarchy vegetables
c. Mate tea
d. Broiled meats
e. Salted fish

ANS: B

69. What is ayurveda?
a. A system that combines biofeedback with hypnosis
b. An oriental plant that suppresses colon and breast tumor growth
c. A Hindu system for enhancing the body’s ability to prevent illness and to heal itself
d. A variation of standard acupuncture technique that applies electromagnetic impulses to the needles
e. A manual healing method that directs a healing force from an outside source

ANS: C

70. What is the name of the cancer-treatment substance first extracted from the bark of old Pacific yew trees (and now synthesized in the laboratory)?
a. Ephedra
b. Paclitaxel
c. Kombucha
d. Germanium
e. Echinacea purpurea

ANS: B

COMPLETION

1. ____________________ are large proteins of the blood and body fluids, produced by the immune system in response to the invasion of the body by foreign molecules.

ANS: Antibodies

2. ____________________ are special proteins that direct immune and inflammatory responses.

ANS: Cytokines

3. ____________________ are white blood cells, including B-cells and T-cells, which participate in acquired immunity.

ANS: Lymphocytes

4. ____________________ are large phagocytic cells that serve as scavengers of the blood, clearing it of old or abnormal cells, cellular debris, and antigens.

ANS: Macrophages

5. AIDS develops from infection by ____________________.

ANS:
human immunodeficiency virus (HIV)
HIV

human immunodeficiency virus

6. The most common form of cardiovascular disease is ____________________.

ANS: coronary heart disease (CHD)

7. The abnormal bulging of a blood vessel wall is called a(n) ____________________ .

ANS: aneurysm

8. High levels of ____________________ have proved to more accurately predict future heart attack than high LDL cholesterol.

ANS:
C-reactive protein (CRP)
C-reactive protei
CRP

9. A clot that breaks free from an artery wall and travels through the circulatory system until it lodges in a small artery and suddenly shuts off blood flow to the tissues is called a(n) ____________________.

ANS: embolism

10. Pain and pressure in the area around the heart is called ____________________.

ANS: angina

Chapter 19 – Consumer Concerns about Foods and Water
1. The potential of a substance to harm someone is known as
a. a hazard.
b. toxicity.
c. risk level.
d. safety level.
e. liability.ANS: B

2. What term defines the measure of the probability and severity of harm?
a. Risk
b. Safety
c. Hazard
d. Toxicity
e. Danger

ANS: A

3. What term describes the possibility of harm from normal use of a substance?
a. Hazard
b. Toxicity
c. Bioinsecurity
d. Food insecurity
e. Riskiness

ANS: A

4. What is the international agency that has adopted standards to regulate the use of pesticides?
a. FAO
b. FDA
c. CDC
d. USDA
e. WHO

ANS: A

5. According to the Centers for Disease Control and Prevention, how many people in the United States experience foodborne illnesses every year?
a. 24 million
b. 36 million
c. 48 million
d. 60 million
e. 72 million

ANS: C

6. What is the leading cause of food contamination in the United States?
a. Naturally occurring toxicants
b. Food poisoning from microbes
c. Pesticide residues from farmers
d. Food additives from the food industry
e. Deliberate contamination

ANS: B

7. Approximately how many people in the United States are killed by foodborne illness each year?
a. 1,000
b. 3,000
c. 5,000
d. 7,000
e. 9,000

ANS: B

8. What organism is responsible for producing the most common food toxin?
a. Escherichia coli
b. Vibrio vulnificus
c. Staphylococcus aureus
d. Lactobacillis acidophilus
e. Clostridium perfringens

ANS: C

9. Which of the following is an example of food intoxication?
a. Addition of alkaline and acidic agents to foods
b. Illness produced by acute overconsumption of high-fat foods
c. Addition of alcohol-containing beverages in the cooking of foods
d. Illness produced from ingestion of food contaminated with natural toxins
e. The drowsiness that occurs after a high protein meal is consumed

ANS: D

10. Which of the following is a characteristic of botulism?
a. A chief symptom is diarrhea
b. A full recovery may take years
c. It is caused by the organism Staphylococcus aureus
d. It is a toxicant produced in foods stored under aerobic conditions
e. Symptoms may take several weeks to appear.

ANS: B

11. What fraction of reported foodborne illnesses can be attributed to the food industry?
a. 1/10
b. 1/3
c. 1/2
d. 2/3
e. 4/5

ANS: E

12. The industrial application of heat to inactivate most but not all bacteria in a food is commonly known as
a. sanitization.
b. sterilization.
c. pasteurization.
d. depathogenation.
e. irradiation.

ANS: C

13. What system was developed by government regulatory agencies and the food industry to help identify and/or control food contamination and foodborne disease?
a. The Two-Forty-One-Forty rule
b. Safe Handling Certification Program
c. Hazard Analysis Critical Control Points
d. North American Residue Monitoring Program
e. Precautionary Principle

ANS: C

14. A patient with a high temperature complains of headache, stomachache, fever, and vomiting. Upon questioning, he admits to eating several raw eggs the day before. The most likely organism causing these symptoms is
a. E. coli.
b. Salmonella.
c. Perfringens.
d. Campylobacter jejuni.
e. Staphylococcus aureus

ANS: B

15. Clostridium botulinum poisoning is a hazard associated with
a. nitrosamines.
b. rotting vegetables.
c. unpasteurized milk.
d. improperly canned vegetables.
e. unwashed fruits.

ANS: D

16. Which of the following is the major food source for transmission of Campylobacter jejuni?
a. Raw poultry
b. Contaminated grains
c. Imported soft cheeses
d. Undercooked beef hot dogs
e. Raw fruits and vegetables

ANS: A

17. Which of the following foods are associated with illness from Salmonella?
a. Raw vegetables
b. Pickled vegetables
c. Home-canned vegetables
d. Raw meats, poultry, and eggs
e. Raw fruits

ANS: D

18. What is the recommended minimum amount of time for washing hands with warm water and soap before preparing or eating food?
a. 10-15 seconds
b. 20 seconds
c. 1/2-1 minute
d. 1-2 minutes
e. 2-3 minutes

ANS: B

19. A few years ago a foodborne illness outbreak was reported by a national restaurant chain. After dozens of people were infected, authorities determined that employees of the restaurant had used the same knife to cut raw meat products as they did for produce items such as lettuce. Which of the following terms most likely describes the employees’ neglect that led to the patrons of the restaurant becoming ill?
a. Contamination
b. Cross-contamination
c. Hazard Analysis Critical Control Points
d. Inappropriate monitoring of food temperatures
e. Improper cooking procedures

ANS: B

20. The seal “Graded by USDA” that appears on packaged meat and poultry means that the product is
a. uncooked.
b. not hazardous.
c. free of bacteria.
d. assessed for tenderness.
e. humanely slaughtered.

ANS: D

21. In cows infected with mad cow disease, which of the following tissues is generally free of the infectious agents?
a. Brain
b. Muscle
c. Spinal cord
d. Nerves
e. Eyes

ANS: B

22. What unintended benefit is derived from the freezing of fish by the food industry?
a. The fish becomes tenderized.
b. Mature parasitic worms are killed.
c. Botulinum toxin becomes inactivated.
d. The toxins from hepatitis A and B are destroyed.
e. It will cook more rapidly when thawed.

ANS: B

23. To minimize the possibility of foodborne illness, hamburger should be cooked to an internal temperature (°F) of at least
a. 125.
b. 140.
c. 160.
d. 195.
e. 212.

ANS: C

24. Which of the following foods is best known to transmit hepatitis?
a. Poultry
b. Seafood
c. Legumes
d. Raw vegetables
e. Grains

ANS: B

25. What is the minimum recommended safe temperature (°F) to heat leftovers?
a. 140
b. 152
c. 165
d. 180
e. 212

ANS: C

26. What is the safe refrigerator storage time for uncooked steaks, cooked chicken, opened packages of lunch meats, and tuna salad?
a. 1-2 days
b. 3-5 days
c. 1 week
d. 2-4 weeks
e. 4-6 weeks

ANS: B

27. What nutrients in foods are most vulnerable to losses during food handling and preparation?
a. Trace minerals
b. Fat-soluble vitamins
c. Polyunsaturated fats
d. Water-soluble vitamins
e. Simple carbohydrates

ANS: D

28. The extent to which an environmental contaminant lingers in the environment or body is referred to as
a. persistence.
b. degradation rate.
c. binding capacity.
d. constancy.
e. perseverance.

ANS: A

29. Which of the following are examples of heavy metals?
a. Mercury and lead
b. Iron and chromium
c. Carbon and nitrogen
d. Molybdenum and fluoride
e. Manganese and magnesium

ANS: A

30. The increase in the concentration of contaminants in the tissues of animals high on the food chain is termed
a. bioaccumulation.
b. hyperconcentration.
c. evolutionary containment.
d. functional high-level accumulation.
e. biomassing.

ANS: A

31. What is the primary source of dietary mercury?
a. Seafood
b. Legumes
c. Unfiltered water
d. Undercooked poultry
e. Unwashed fruits and vegetables

ANS: A

32. What was the toxic substance that accidentally found its way into the food chain in the early 1970s and to which almost all of Michigan’s residents became exposed?
a. Lead acetate
b. Methylmercury
c. Listeria monocytogenes
d. Polybrominated biphenyl
e. Perfluorooctanoic acid

ANS: D

33. Which of the following is a characteristic of heavy metals in the U.S. food supply?
a. Virtually all fish contain trace amounts of mercury.
b. Mercury contamination of fish is most severe in tuna.
c. Toxicity is most severe in the elderly population group.
d. Contamination is usually greater in farm-raised fish than in ocean fish.
e. Older fish are generally safer than younger fish, since they have had more time to excrete the mercury.

ANS: A

34. What is the principal factor related to solanine concentration in potatoes?
a. Contamination
b. Irradiation malfunction
c. Soil heavy metal content
d. Improper storage conditions
e. Cooking at very high temperatures in oil

ANS: D

35. Which of the following is a feature of naturally occurring food toxicants?
a. Lima beans contain deadly cyanide compounds.
b. The toxic solanine in potatoes is inactivated by cooking.
c. The toxic laetrile in certain fruit seeds is a moderately effective cancer treatment.
d. Mustard greens and radishes contain compounds that are known to worsen a cholesterol problem.
e. Even small amounts of goitrogen-containing vegetables can cause thyroid problems.

ANS: A

36. Many countries restrict the varieties of commercially-grown lima beans due to the seed’s content of
a. cyanide.
b. solanine.
c. goitrogens.
d. hallucinogens.
e. narcotic-like substances.

ANS: A

37. Government agencies that set tolerance levels for pesticides first identify those foods commonly eaten in large quantities by
a. children.
b. adolescents.
c. adults.
d. elderly.
e. animals used for food.

ANS: A

38. What term is used to describe the highest level of a pesticide that is allowed in a food when the pesticide is used according to label directions?
a. Toxicity level
b. Tolerance level
c. Risk concentration
d. Optimum concentration
e. Adverse concentration

ANS: B

39. How many varieties of fruits and vegetables are imported from other countries into the U.S.?
a. 200
b. 400
c. 600
d. 800
e. 1000

ANS: B

40. What percentage of foods imported from other countries are tested?
a. 1
b. 5
c. 10
d. 15
e. 20

ANS: A

41. Food producers are allowed to label a food product as organic if it
a. has been irradiated.
b. contains genetically engineered ingredients.
c. was made with at least 95% organic ingredients.
d. was grown with fertilizer made from sewer sludge.
e. was grown in the U.S.

ANS: C

42. What is the name of the rule that modifies the original meaning of the Delaney Clause?
a. GRAS list
b. Bonnie Clause
c. De minimis rule
d. No-risk standard
e. Precautionary Principle

ANS: C

43. What level of lifetime cancer risk to human beings from a food additive is accepted by the FDA?
a. 1 in 100
b. 1 in 1,000
c. 1 in 1,000,000
d. 1 in 100,000,000
e. 1 in 1,000,000,000,000

ANS: C

44. What defines the FDA’s de minimis rule?
a. A requirement that the least toxic food additive be used on foods
b. The minimum amount of a food particle that can be detected
c. The minimum amount of nitrite that can be added to foods to prevent spoilage over a certain time frame
d. The amount of a food additive that causes no more than a one-in-a-million lifetime risk of cancer to human beings
e. The amount of a food additive that causes no more than a one-in-a-million risk of birth defects in human beings

ANS: D

45. What is the term that describes the allowance of most additives in foods at levels 100 times below the lowest level known to cause any harmful effects?
a. Toxicity range
b. Zone of hazard
c. Acceptable area
d. Margin of safety
e. Risk acceptability

ANS: D

46. Sugar and salt are used as antimicrobial agents in foods because they prevent microbial use of the food’s
a. fat.
b. water.
c. protein.
d. carbohydrate.
e. micronutrients.

ANS: B

47. Of the following, which is used most widely as an antimicrobial agent?
a. Sugar
b. Saccharin
c. Sodium nitrite
d. Sodium propionate
e. Alcohol

ANS: A

48. When a slice of fresh apple turns a brown color, this is most likely the result of
a. oxidation.
b. dehydration.
c. microbial contamination.
d. ethylene oxide treatment in the ripening process.
e. lack of nutrients in the apple itself.

ANS: A

49. What vitamin undergoes the most destruction in foods preserved with sulfites?
a. Folate
b. Thiamin
c. Vitamin D
d. Ascorbic acid
e. Vitamin K

ANS: B

50. A feature of sulfite food additives is that they
a. are frequently used in wines.
b. inhibit growth of most microbes.
c. interact with folate to inhibit its absorption.
d. are one of the few substances to have virtually no side effects.
e. are one of the most expensive additives.

ANS: A

51. What is the only food intended to be consumed raw in which the FDA allows the use of sulfite additives?
a. Grapes
b. Lettuce
c. Carrots
d. Strawberries
e. Apples

ANS: A

52. Which of the following is a feature of the substance BHT?
a. It is a food antimicrobial.
b. It is a common food colorant.
c. It contributes significantly to the total additive intake from the diet.
d. It decreases cancer formation when given in large amounts to animals exposed to carcinogens.
e. It shortens the lives of animals when it is fed in very large amounts.

ANS: D

53. The flavor enhancer MSG represents a dietary source of
a. sulfite.
b. sodium.
c. acrylamide.
d. bicarbonate.
e. manganese.

ANS: B

54. What are bacteriophages in the food supply?
a. Intentional food additives
b. Unusually deadly foodborne bacteria
c. Two or more pathogenic organisms on the same food
d. Bacteria that are resistant to common cooking methods
e. Bacteria used to test food for potentially dangerous contaminants

ANS: A

55. The upper safe level of intake for aspartame-sweetened soft drinks (cans/day) for a normal 70 kg adult is approximately
a. 1.
b. 5.
c. 10.
d. 20.
e. 50.

ANS: D

56. What sweetener should be avoided by people with PKU?
a. Neotame
b. Sucralose
c. Aspartame
d. Acesulfame-K
e. Invert sugar

ANS: C

57. Which of the following is a feature of aspartame?
a. Its sweetness increases with heat.
b. It is made up of three amino acids.
c. It is recommended for people with PKU.
d. Two of its breakdown products include methanol and formaldehyde.
e. It has been removed from the market by the FDA.

ANS: D

58. Which of the following foods represents a common source of acrylamide intake in the United States?
a. Raw fruits
b. French fries
c. Raw vegetables
d. Grilled seafood
e. White rice

ANS: B

59. Which of the following toxic substances are formed from production of paper products used in food packaging?
a. PBBs
b. URPs
c. Dioxins
d. BHT and BHA
e. PFOA

ANS: C

60. What is the standard chemical used to remove caffeine from coffee beans?
a. Nitric acid
b. Sodium propionate
c. Methylene chloride
d. Polybrominated biphenyl
e. Hydrochloric acid

ANS: C

61. Which of the following is a characteristic of antibiotic use in animals raised for human consumption?
a. Meat from animals fed antibiotics contains resistant bacteria.
b. Antibiotic use in dairy cows often gives the milk off-flavors.
c. The antibiotic levels are essentially zero by the time the food reaches consumers.
d. Although some antibiotics may be present in the food, the level is too low to induce adverse side effects even in sensitive people.
e. The FDA lacks legal authority to investigate the impact of this antibiotic use on human health.

ANS: A

62. Which of the following is a feature of bovine growth hormone use in the United States?
a. It decreases udder infections in cows.
b. It cannot be detected in meat or milk of cows receiving it.
c. If consumed from foods, it is denatured by enzymes in the GI tract.
d. If consumed from foods, it could potentially stimulate receptors for human growth hormone.
e. Testing of BGH has indicated that its risks to human health are, at most, minor.

ANS: C

63. Which of the following is a characteristic of antibiotic use in livestock?
a. Development of antibiotic-resistant organisms is very rare.
b. Proper cooking of the meat destroys any traces of antibiotics.
c. Farmers use more than 5 times more antibiotic in livestock than physicians use in people.
d. Because the antibiotics have a short half-life, the FDA permits slaughter of the animals at any time.
e. There is no evidence of harm to the environment or human health from the use of antibiotics in livestock.

ANS: C

64. What is meant by potable water?
a. Water fit for drinking
b. Water that must be boiled before drinking
c. Water that must be chlorinated before drinking
d. Water suitable only for use on lawns and gardens
e. Water to which fluoride has been added

ANS: A

65. Water that has the odor of “rotten eggs” is most likely contaminated with
a. sulfur.
b. dioxins.
c. Giardia.
d. Cryptosporidium.
e. chloramines.

ANS: A

66. What is the chief purpose of using ozone as a commercial water treatment?
a. It kills microorganisms.
b. It complexes with heavy metals.
c. It stabilizes the carbon filtration process.
d. It promotes chlorine dissipation and thus enhances taste.
e. It “softens” the water.

ANS: A

67. What is the average yearly intake (gallons) per person of bottled water in the United States?
a. 15
b. 30
c. 45
d. 60
e. 75

ANS: B

68. What is the process by which water is purified by pressurizing it and forcing it across a membrane?
a. Ozonation
b. Distillation
c. Reverse osmosis
d. Activated carbon filtration
e. Pasteurization

ANS: C

69. Improvements in nutrient composition, such as when corn is genetically modified to contain higher amounts of its limiting amino acids, is a strategy known as
a. biofortification.
b. reverse DNA enrichment.
c. USDA approved enrichment.
d. nutritional transdevelopment.
e. artificial fortification.

ANS: A

70. Genetic engineering of broccoli to increase the selenium content has inadvertently lowered the content of
a. fiber, an indigestible carbohydrate.
b. vitamin C, a water-soluble antioxidant.
c. sulforaphane, an anticancer phytochemical.
d. chlorophyll, a magnesium-containing substance.
e. vitamin E, a fat-soluble antioxidant.

ANS: C

COMPLETION

1. The toxin produced in improperly refrigerated meats that can cause diarrhea, nausea, vomiting, abdominal cramps and fever in 1 to 6 hours is ____________________.

ANS: staphylococcal toxin

2. The organism spread by person-to-person contact as well as raw foods, salads and sandwiches, causing vomiting in 1 to 2 days that can last 1 to 2 days, is ____________________.

ANS: norovirus

3. ____________________ is found in undercooked ground beef and can cause severe bloody diarrhea, abdominal cramps, and vomiting lasting 5 to 10 days.

ANS: E.coli: O157:H7

4. In the United States, all food producers use a(n) ____________________ plan to help prevent foodborne illnesses at their source.

ANS:
Hazard Analysis Critical Control Point (HACCP)
Hazard Analysis Critical Control Point
HACCP

5. ____________________ refers to sterilizing a food by exposure to energy waves, similar to ultraviolet light and microwaves

ANS: Irradiation; Ionizing radiation

6. ____________________ refers to the accumulation of contaminants in the flesh of animals high on the food chain.

ANS: Bioaccumulation

7. The Minamata, Japan incident, in which more than 100 individuals, including infants, became ill, many died, and survivors suffered blindness, deafness, lack of coordination, and intellectual deterioration, was caused through the contamination of fish by ____________________.

ANS: methylmercury

8. In the late 1970s, women in Taiwan Women who had eaten the rice oil tainted with ____________________ gave birth to children with developmental problems.

ANS:
PCB (polychlorinated biphenyls)
PCB

polychlorinated biphenyls

9. The FDA has found that the vast majority of apple juice tested contains trace amounts of ___________________.

ANS: arsenic

10. An estimated 97% of Michigan residents were exposed when ____________________ were accidentally mixed in livestock feed that was distributed throughout the state.

ANS:
PBB (polybrominated biphenyls)

Chapter 20 – Hunger and the Global Environment
1. Approximately what percentage of the world’s population experiences persistent hunger?
a. 4
b. 8
c. 12
d. 16
e. 20ANS: C

2. Limited or doubtful availability of nutritionally adequate and safe foods is termed food
a. insecurity.
b. insufficiency.
c. vulnerability.
d. precariousness.
e. inadequacy.

ANS: A

3. Melissa works two jobs to support her three children. Her financial priorities are to pay the rent and utilities and provide food and medical necessities for the children. Melissa rarely eats three meals a day and worries about how and where she will get the next meal for herself and her children. Melissa is experiencing which of the following?
a. Food insufficiency
b. Food mismanagement
c. Non-sustainable lifestyle
d. Misallocation of resources
e. Very low food security

ANS: E

4. Which of the following is the primary cause for hunger in the United States and in less developed countries?
a. Poverty
b. High cost of food
c. Excessive food waste
d. Lack of nutrition education
e. Lack of physical access to food

ANS: A

5. How many people in the United States live in poverty?
a. 19 million
b. 29 million
c. 39 million
d. 49 million
e. 59 million

ANS: D

6. Which of the following is true of the relationship between poverty and hunger?
a. Hunger and obesity may exist in the same household.
b. The highest rates of obesity occur among the wealthiest.
c. The provision of food to the poor increases obesity.
d. Even people below the poverty line have enough money for food.

ANS: A

7. Approximately what proportion of the world’s food supply is wasted along the way from farm to final consumption?
a. 1/10
b. 1/5
c. 1/4
d. 1/3
e. 1/2

ANS: D

8. What fraction of the U.S. population receives food assistance of some kind?
a. 1/25
b. 1/15
c. 1/5
d. 1/3
e. 1/2

ANS: C

9. What is the largest federal food assistance program in the United States?
a. WIC
b. EAT
c. National Food Resource Program
d. Supplemental Nutrition Assistance Program
e. Senior Farmer’s Market Program

ANS: D

10. What is the average monthly benefit for a recipient of SNAP, per person?
a. $85
b. $105
c. $135
d. $185
e. $215

ANS: C

11. SNAP debit cards may be used to purchase which of the following?
a. laundry detergent
b. seeds to produce food
c. cigarettes
d. vitamins
e. diapers

ANS: B

12. What is a food desert?
a. Worldwide crop failures due to drought and pestilence
b. Absence of fresh fruits and vegetables at certain times of the year
c. A neighborhood having limited access to nutritious and affordable food
d. A low-cost energy-dense snack sold primarily in poor neighborhoods
e. An area in which poverty has made families unable to purchase necessary food

ANS: C

13. Approximately how many people, in millions, are served by the U.S. Supplemental Nutrition Assistance Program?
a. 15
b. 25
c. 35
d. 45
e. 55

ANS: D

14. What is the name of the largest U.S. national food recovery program?
a. Feeding America
b. Goodwill Food Assistance
c. Salvation Army Ready-to-Eat Meals
d. Food Salvage and Rescue Organization
e. We CAN

ANS: A

15. Which of the following is true of malnutrition in children?
a. Children with kwashiorkor typically have edema.
b. Children with marasmus often have fatty livers.
c. Kwashiorkor results mainly from energy inadequacy.
d. Marasmus results mainly from protein inadequacy.
e. Children with marasmus often have changes in the color of their hair and skin.

ANS: A

16. As you sit in the waiting room of a doctor’s office leafing through a magazine, you see a letter to the editor about world hunger. In it, the author takes issue with a statement made in a previous issue that stated, “…and thus, hunger worsens poverty….” The letter writer claims that this statement is completely unfounded and has no reasoning behind it. Does hunger worsen poverty?
a. Yes, but it can be corrected with appropriate access to reproductive health care.
b. No; if hungry people work hard enough they can work to get themselves out of poverty.
c. Yes, it propagates poverty by increasing the death rate and leaving many families as single-parent households.
d. Yes, hunger makes poverty worse by robbing a person of the good health and the physical and mental energy needed to be active and productive.
e. Sometimes, but only when unemployment is high and jobs are scarce.

ANS: D

17. A period of extreme food shortage resulting in widespread starvation and death is best termed
a. a plague.
b. a famine.
c. food poverty.
d. food insecurity.
e. epidemic starvation.

ANS: B

18. Cutting world hunger and malnutrition in half by 2015 would generate a value of more than ____ in longer, healthier, and more productive lives.
a. $40 billion
b. $80 billion
c. $120 billion
d. $160 billion
e. $200 billion

ANS: C

19. The worst famine in the 20th century occurred in
a. India.
b. China.
c. Ethiopia
d. Ireland.

ANS: B

20. Which of the following is a feature of world poverty?
a. Poverty causes hunger in the developing but not the developed world.
b. The poorest do not bear children due to poor health.
c. Poverty affects about 10% of the world’s population.
d. The poorest poor are typically female.
e. Urbanization typically decreases poverty-associated hunger.

ANS: D

21. As the newly appointed director of International Supplementation for the World Health Organization (WHO), you propose supplementing the diets of malnourished populations worldwide with nutrients that would markedly improve health and well-being. Which of the following nutrients is most likely to be deficient?
a. Iron
b. Iodine
c. Vitamin A
d. Vitamin D
e. Zinc

ANS: A

22. Deficiency in which of the following is associated with irreversible intellectual disability?
a. iron
b. iodine
c. protein
d. vitamin A
e. zinc.

ANS: B

23. In an effort to reduce morbidity and mortality, which of the following would be a first course of action for a Peace Corps volunteer to reduce the prevalence of diarrhea in a small village where she is working?
a. Implementing oral rehydration therapy for those who are dehydrated
b. Implementing oral refeeding therapy for those who are malnourished
c. Ensuring there is enough fortified rice for all the women and children
d. Distributing as many medications to the village people as she can obtain
e. Distributing meals-ready-to-eat (MREs) to restore nutrition.

ANS: A

24. Worldwide, approximately what number of children under 5 die each year of malnutrition and malnutrition-related causes?
a. 1.6 million
b. 3.6 million
c. 5.6 million
d. 7.6 million
e. 9.6 million

ANS: D

25. Worldwide, how many children younger than 5 have symptoms of vitamin A deficiency?
a. 70 million
b. 80 million
c. 90 million
d. 100 million
e. 110 million

ANS: D

26. What is administered by health care workers to help treat the diarrhea and dehydration common to children suffering from diseases of poverty?
a. Oral rehydration therapy
b. Ozone purified waste water
c. Protein-energy repletion formula
d. Charcoal-filtered water and corn starch
e. RUTF

ANS: A

27. What is meant by carrying capacity of the earth?
a. The number of tons of edible food that can be produced by all of the earth’s cultivable land
b. The maximum number of living organisms that can be supported in an environment over time
c. The amount of oxygen consumed by all living organisms in relation to the amount of oxygen produced by all living plants
d. The total weight of all living organisms in relation to the weight of all non-living material including the earth’s water mass
e. The maximum number of people who can exist on earth without causing environmental damage.

ANS: B

28. What is the approximate yearly increase in the world’s population?
a. 50 million
b. 60 million
c. 70 million
d. 80 million
e. 90 million

ANS: D

29. What is the chief reason why people living in poverty and hunger in the developing world bear numerous children?
a. Birth control expenses are prohibitive.
b. The children are less likely to survive to adulthood.
c. The low educational level of adults limits their understanding of family planning.
d. The parents seek greater fulfillment through having more children.
e. It is a cultural custom in those areas to have many children.

ANS: B

30. The famine Somalia is currently experiencing has left an estimated ____ people starving.
a. 6 million
b. 8 million
c. 10 million
d. 12 million
e. 14 million

ANS: D

31. Worldwide, the poorest poor subsist on less than ____ per day.
a. $1
b. $3
c. $5
d. $7
e. $9

ANS: A

32. Which of the following describes a known long-term relationship among poverty and population growth?
a. As economic status improves, population growth rises.
b. As economic status improves, population growth diminishes.
c. Lack of natural resources, not poverty, is the most important contributor to overpopulation.
d. Extreme poverty tends to greatly suppress population growth.
e. Economic status and population growth are unrelated in the developing world.

ANS: B

33. What percentage of the world’s population is at risk of zinc deficiency?
a. 5
b. 10
c. 15
d. 20
e. 25

ANS: D

34. What proportion of children in the developing world are severely underweight by age 5?
a. 1 in 20
b. 1 in 10
c. 1 in 4
d. 1 in 3
e. 1 in 2

ANS: C

35. Acute malnutrition in children is characterized by
a. hyperactivity.
b. shrunken liver.
c. low weight for height.
d. short height for weight.
e. stunting

ANS: C

36. Chronic malnutrition in children is characterized by
a. hyperactivity.
b. shrunken liver.
c. short height for age.
d. low weight for height.
e. rapid weight loss

ANS: C

37. You are reading a case study from a researcher at World University. The researcher has traveled to the largest city in India and is reporting on an illness present in a 15-month-old boy. The researcher describes the child as extremely thin and bony, with wrinkled skin and enlarged fatty liver. For the past year, this child has subsisted almost entirely on diluted cereal drink. Your first thought is that most of these observations are characteristic of marasmus, but then you realize that ____ is more consistent with kawashikor.
a. wrinkled skin
b. food intake pattern
c. enlarged fatty liver
d. extremely thin
e. bony appearance

ANS: C

38. Which of the following would you expect to see in a person with kwashiorkor?
a. Edema
b. Low levels of ADH
c. Muscle wasting
d. Baggy-appearing skin
e. “Match stick” arms and legs

ANS: A

39. Which of the following is associated with the presence of tissue edema in kwashiorkor?
a. Inadequate intake of water
b. Excessive intake of dietary protein
c. Low concentration of blood protein
d. High concentration of blood protein
e. Low levels of ADH

ANS: C

40. Which of the following is a characteristic of marasmus?
a. Increased body temperature
b. Affects brain development only minimally
c. Rapid metabolism
d. Inability to tolerate cold
e. Decreased albumin

ANS: D

41. Which of the following is a feature of malnutrition?
a. Dysentery is common and leads to diarrhea and nutrient depletion.
b. Intestinal villi grow slightly larger to provide additional absorptive surfaces for nutrients.
c. Digestive enzyme production increases in order to extract as much of the ingested nutrients as possible.
d. Infections are uncommon due to insufficient availability of nutrients in the body to support growth of bacteria and viruses.
e. Children typically recover well from marasmus if adequate food is provided.

ANS: A

42. At the end of your class presentation on “Acute Malnutrition,” a student asks you to clarify how the rapid onset of malnutrition occurs in kwashiorkor. How should you respond?
a. It is the result of an inborn error of metabolism.
b. It is usually synchronized with the drought season in each respective country.
c. It is typically seen in patients who are 2-5 years old due to the sudden change in diet arising from their dislike for breast milk as they grow older.
d. It is typically seen in patients after weaning due to the sudden change in diet arising from their being weaned from breast milk after the birth of a sibling.
e. It occurs when the family’s finances are no longer able to afford food for all family members.

ANS: D

43. What term describes the malnutrition syndrome a child develops when the next child is born and the first child no longer receives breast milk?
a. Marasmus
b. Kwashiorkor
c. Psychomalnutrition
d. Postbirth malnutrition
e. Sibling-associated anorexia

ANS: B

44. The word “marasmus” means
a. terribly thin.
b. without muscle.
c. dying away.
d. empty stomach.
e. lacking food.

ANS: C

45. In kwashiorkor, the loss of hair color is indirectly related to
a. lack of tyrosine.
b. elevated levels of blood homocysteine.
c. excessive exposure to the sun’s UV rays.
d. being nursed by a poorly-nourished mother.
e. increased blood lead levels.

ANS: A

46. In kwashiorkor, what mineral is often present in an unbound form that promotes bacterial growth?
a. Iron
b. Iodine
c. Arsenic
d. Calcium
e. Sodium

ANS: A

47. What is the most likely explanation for the fatty liver that develops from protein deficiency?
a. Increased uptake of circulating fats
b. Increased absorption of dietary fats
c. Inability of adipose tissue to remove circulating fats
d. Inability of the liver to synthesize lipoproteins for fat export
e. Paradoxical storage of fats

ANS: D

48. Which of the following is a feature of kwashiorkor?
a. It makes the child appear grossly dehydrated.
b. It usually occurs prior to the onset of marasmus.
c. It is usually found in communities where marasmus is present.
d. Children typically have a grossly swollen belly.
e. Children have a “skin and bones” appearance.

ANS: D

49. Which of the following is true of RUTF?
a. It restores fluids.
b. It is powdered and must be rehydrated for use.
c. It is administered IV.
d. It is a paste made from local commodities.
e. Children dislike the taste and often must be forced to eat it.

ANS: D

50. What type of diet is advised to rehabilitate a severely malnourished child?
a. RUTF
b. Large amounts of the local diet
c. Liberal quantities of lactose-free powdered milk until growth rate is restored
d. High energy until normal body mass index is achieved, then moderate energy thereafter
e. BRAT

ANS: A

51. Which of the following is a characteristic of marasmus in children?
a. It leads to inability to maintain body temperature.
b. It promotes hyperactivity and excessive crying for food.
c. It impairs brain development mainly from ages 2-5 years old.
d. It leads to severe edema of the abdomen but insufficient water retention by the brain.
e. It is rare even in very impoverished nations due to UN programs combating hunger.

ANS: A

52. What is RUTF?
a. An advanced stage of kwashiorkor
b. An advanced stage of protein-energy malnutrition
c. A paste of peanut butter and powdered milk plus micronutrients
d. A sustainable agricultural practice that integrates farm-raised animals with aquaculture
e. A fluid used to restore electrolytes in children with diarrhea

ANS: C

53. What percentage of the world’s children under the age of 5 have short stature for their age?
a. 5
b. 10
c. 15
d. 20
e. 25

ANS: E

54. What percentage of the world’s children under the age of 5 have low weight for their height?
a. 5
b. 10
c. 15
d. 20
e. 25

ANS: B

55. The famine in Somalia has left ____ children under the age of 5 dead.
a. 10,000
b. 20,000
c. 30,000
d. 40,000
e. 50,000

ANS: C

56. Which of the following is among the ingredients of a common oral rehydration formula?
a. Iron
b. Sugar
c. Milk
d. Zinc
e. Powdered peanuts

ANS: B

57. Which of the following is a feature of common agricultural practices in the developed world?
a. They promote protection of soil and water.
b. They frequently lead to higher crop prices.
c. They are designed to benefit mostly small family farms.
d. They tend to support the use of pesticides and fertilizers.
e. They emphasize “green” practices.

ANS: D

58. A sharp rise in the rates of hunger and malnutrition, usually set off by a shock to either the supply of, or demand for, food and a sudden spike in food prices is called a
a. food crisis.
b. famine.
c. food inflation.
d. food imbalance.
e. cost imbalance.

ANS: A

59. Which of the following is a characteristic of farm irrigation?
a. It makes the soil more porous.
b. It helps preserve the water supply.
c. It contributes to soil preservation.
d. It increases the salt content in the soil.
e. It raises water tables.

ANS: D

60. What is aquaculture?
a. A seaweed growth system
b. The practice of fish farming
c. Replenishment of fish in the wild
d. The raising of plants in a water environment
e. Raising food crops in fluid rather than soil

ANS: B

61. Which of the following is a feature of aquaculture?
a. All farmed fish must be fed to sustain the practice.
b. It provides about 10% of the world’s fish for consumption.
c. It is successful in freshwater lakes but not in ocean waters.
d. Currently available technologies cannot yet make it sustainable.
e. It provides nearly all of the world’s shellfish for consumption.

ANS: A

62. Approximately what percentage of all energy use in the U.S. is devoted to the food industry?
a. 5
b. 10
c. 20
d. 30
e. 40

ANS: C

63. Which of the following is a major contributor to the world’s supply of food energy?
a. Barley
b. Maize
c. Rye
d. Sorghum
e. Adzuki beans

ANS: B

64. What term describes agricultural practices that are designed to minimize use of energy and chemicals?
a. Integrated production
b. Progressive agriculture
c. Sustainable agriculture
d. Resource management production
e. Balanced farming

ANS: C

65. About how many kcalories of fuel are used to produce 1 kcalories of grains?
a. <1
b. 2
c. 5
d. 10
e. 15

ANS: A

66. What is the nutritional advantage of eating range-fed buffalo?
a. The iron content is higher.
b. The nutrients are more stable and less prone to oxidation.
c. The fat content includes more omega-3 fatty acids.
d. There is a greater variety of phytonutrients, especially those that reduce risk of heart disease and cancer.
e. Range-fed buffalo has lower levels of polyunsaturated fats.

ANS: C

67. Compared to vegetarian diets, meat based diets use ____ times as much energy.
a. 1.5
b. 2.0
c. 2.5
d. 3.0
e. 3.5

ANS: C

68. Compared to vegetarian diets, meat based diets use ____ times as much water.
a. 1.9
b. 2.9
c. 3.9
d. 4.9
e. 5.9

ANS: B

69. How much more grain is consumed by livestock than by people?
a. Twice as much
b. Three times as much
c. Five times as much
d. Ten times as much
e. Twenty times as much

ANS: D

70. On average, how many miles is a food item transported before a consumer eats it?
a. 25
b. 100
c. 750
d. 1500
e. 3000

ANS: D

COMPLETION

1. Collecting crops from fields that either have already been harvested or are not profitable to harvest is called ____________________.

ANS: gleaning, food gleaning

2. Individuals who have limited or uncertain access to foods of sufficient quality or quantity to sustain a healthy and active life with reduced quality of life with little or no indication of reduced food intake have ____________________.

ANS: low food security

3. Individuals who have access to enough food to sustain a healthy and active life with one or two indications of food-access problems but with little or no change in food intake have ____________________.

ANS: marginal food security

4. In the United States, the largest federal food assistance program is ____________________.

ANS:
Supplemental Nutrition Assistance Program (SNAP)
SNAP

Supplemental Nutrition Assistance Program

5. Neighborhoods and communities characterized by limited access to nutritious and affordable foods are known as ____________________.

ANS:
food deserts

6. Of the world’s 7 billion people, ____________________ percent have no land and no possessions at all.

ANS: 25; twenty-five; twenty five

7. Malnutrition caused by recent severe food restriction; characterized in children by underweight for height (wasting) is called ____________________ malnutrition.

ANS: acute

8. Severe malnutrition characterized by failure to grow and develop, edema, changes in the pigmentation of hair and skin, fatty liver, anemia, and apathy is called ____________________

ANS: kwashiorkor

9. Severe malnutrition characterized by poor growth, dramatic weight loss, loss of body fat and muscle, and apathy is called ____________________.

ANS: marasmus

10. ____________________ is a paste made of local commodities such as peanut butter and powdered milk and fortified with vitamins and minerals and used to rehabilitate children with uncomplicated, severe acute malnutrition.

ANS:
Ready-to-use therapeutic food (RUTF)
Ready-to-use therapeutic food
RUTF

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