Clinical Nutrition Midterm Review

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Clinical Nutrition Midterm Review
2012-10-25 09:59:28

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  1. 1. The label shows a food with ____ calories in the entire container.
    2. (T/F) A serving of this food has 13 grams of total fat plus 5 grams of saturated fat and 2 grams of trans fat for a total of 20 grams.
    3. At 28% DV from sodium, would you recommend this food to a person on a low sodium diet? (Yes/No)
    4. The recommendation for these two nutrients stays the same no matter what you calorie intake.
    5. How many grams of carbohydrates does this food have per serving?
    6. How many grams of protein are in the entire container?
    7. How many calories in one serving are supplied from protein?
    • 1. 280 calories per serving x 2 servings = 560 calories
    • 2. False - saturated and trans fats are included in Total Fats
    • 3. No
    • 4. Cholesterol and Sodium
    • 5. 31 grams
    • 6. 5 grams per serving x 2 servings = 10 grams
    • 7. 5 grams per serving x 4 calories per gram from protein = 20 calories
  2. If the Nutrition Facts, indicates that there is zero trans fats, does that mean there really is zero?
    No, if there is 0.4 grams or less it can be considered zero on the labels, instead check for hydrogenated / partially hydrogenated in the ingredients section
  3. How do you determine how much poly / mono unsaturated fats there are in food through the Nutrition Facts?
    • Poly / Mono = Total Fat - (Saturated Fat + Trans Fat)
    • But can not determine the exact amout of Poly vs Mono
  4. Slows glucose absorption and regulates the passage of food through the GI Tract.
    _____ containing foods and other slowly digested foods prolong the presence of food in the digestive tract, thus providing greater satiety and diminishing the insulin response, which can help with weight control.
    Fiber (has protective effect)
  5. What are the health benefits of eating soluble fiber?
    • Decreased risk of diverticulitis, colon cancer
    • Easily digested by bacteria in the large intestine (fermentable) creating short-chain fatty acids
  6. What are the health benefits of eating insolube fibers?
    • Keeps bulk to the stool
    • Holds on to water (easing elimination)
  7. This hormone moves glucose into the cells.
    After a meal, as blood glucose rises, β-cells of the pancreas respond by secreting _______ into the blood.
    Anabolic, helps get nutrients to different tissues, helps liver produce glycogen, helps fat cells store triglycerides.
  8. This hormone brings glucose out of storage.When blood glucose falls (as occurs between meals), other special cells of the pancreas respond by secreting ________ into the blood.  ________ raises blood glucose by signaling the liver to dismantle its glycogen stores and release glucose into the blood for use by all the other body cells.
    Catabolic, releases triglycerides from fat cells, liver breaks down glycogen to glucose and sent to bloodstream.
  9. Insulin resistance is a central feature of _________ ________, a group of disorders that substantially increase the risk of developing cardiovascular disease (CVD).  _________ ________ is a cluster of at least three of the following:
    -insulin resistance
    -hyper triglyceridemia
    -reduced HDL cholesterol levels
    Metabolic Syndrome
  10. What are the consquences of Metabolic Syndrome?
    • Increased risk of CVD
    • Increased risk of Type II Diabetes
    • Accelerating Atherosclerosis
    • Increased levels of fibrinogen (promotes clotting)
  11. Trunkal fat cells increases _______ __________, causing one to clot more easily which can lead to thrombus.
    Produces cytokines which increase inflammation in the body.
    insulin resistance
  12. This hormone acts quickly to bring glucose out of storage during times of stress.
    Epinephrine (secreted by the adrenal medulla)
  13. Which grade is better "A" or "B"?
    • apoA - HDL
    • apoB - LDL
  14. This transports lipids to all the tissues.
  15. This transports cholesterol from the cells to the liver for use, recycling or disposal.
  16. Having ____ has a protective effect for the body.
    PUFA (Polyunsaturated Fatty Acids)
  17. True / False, All fatty acids are created equal.
  18. This refers to how quickly glucose is absorbed after a person eats, how high blood glucose rises and how quickly it returns to normal.
    Glycemic Response
  19. This is a method of classifying foods according to their potential to raise blood glucose.
    Glycemic Index
  20. Can high levels of glucose and insulin raise triglyceride levels?
  21. Is it alright to eat lots of refined carbohydrates for a person who is highly active?
    Yes, high activity greatly contributes
  22. Eating red meat has increased risk of what?
    Cardiovascular Disease (CVD)
  23. Which would be more unsaturated, nuts or beef?
  24. Which would be more unsaturated, beef or fish?
  25. Which would be more unsaturated, chicken or beef?
  26. ___________ is found in animal foods only (meat, eggs, fish, poultry, dairy products)
  27. This type of diabetes is the less common type, the pancreas fails to make insulin due to destruction of the pancreatic β-cells.
    • Type I Diabetes / IDDM / Juvenile-onset
    • *Some research suggests that in genetically susceptible people, certain viruses activate the immune system to attack and destroy cells in the pancreas as if they were foreign.
  28. This type of diabetes is the more common type where muscle, fat, liver cells fail to respond to insulin and this form of diabetes is frequently asymptomatic. The primary defect in ______ diabetes is insulin resistance, a reduced sensitivity to insulin in muscle, adipose, and liver cells. To compensate, the pancreas secretes larger amounts of insulin, and plasma insulin concentrations can rise to abnormally high levels (hyper insulinemia). Over time, the pancreas becomes less able to compensate for cells' reduced sensitivity to insulin, and hyperglycemia worsens.  The high demand for insulin can eventually exhaust the β-cells of the pancreas and lead to impaired insulin secretion and reduced palsma insulin concentrations. ______ diabetes is therefore associated both with insulin resistance and with relative insulin deficiency.
    Type II Diabetes / NIDDM / Adult-onset
  29. If a person switches out saturated fats with monounsaturated fats, is this good?  Could LDL levels decrease?
    • Yes
    • Might decrease LDL's
  30. The main function of ____________ in the body is to furnish the body with energy.
  31. _______ serves as the essential energy source, is commonly known as blood sugar or dextrose. Most cells depend on _______ for their fuel, and the cells of the brain and the rest of the nervous system depend almost exclusively on _______ for  their energy. The body can obtain _______ from carbohydrates.
  32. What is the carbohydrate found in milk?
  33. Where would you find fiber?
    Vegetables, whole grains, legumes
  34. How do you store excess glucose?
    As glycogen and fat
  35. What defines Diabetes Mellitus?
    high glucose
  36. What are the three P's of diabetes?
    • Polyuria
    • Polydipsia
    • Polyphagia
  37. What are the characteristics of an appropriate diet for diabetics?
    • Adequate amount of fiber
    • not too much Saturated Fatty Acids
    • moderate the amount of protein
    • decrease calories coming from carbohydrates
  38. What are chronic complications associated with Diabetes?
    • Macrovascular (i.e. CVD, peripheral vascular disease)
    • Microvascular (i.e. retinopathy, nephropathy, diabetic neuropathy)
  39. What are the recommendations for patients with Metabolic Syndrome?
    • Dietary Management
    • Physical Exercise
    • *both can improve insulin resistance, blood pressure, and blood lipid levels
  40. α-Linolenic acid and Linoleic acid are both __________.
    essential (something your body can not make, obtained from food)
  41. Where are trans fats founds?
    In products with the term "partially hydrogenated" or "hydrogenated" in ingredents list.
  42. Where are saturated fatty acids found?
    • Animal products, dairy, tropical oils
    • *likely the highest percentage of saturated fatty acids are found in these foods
  43. Polyunsaturated fatty acids from animal meats and grain, are sources ω−3 (Omega-3) or ω−6 (Omega-6)?
  44. Polyunsaturated fatty acids from canola, soy bean, flax seed, walnuts, chia, fish, are sources of ω−3 or ω−6?
  45. Which promote the production of inflammatory prostaglandins / eicosanoids, ω−3 or ω−6?
  46. Which has the greatest effect in decreasing the production of inflammatory prostaglandins, ω−3 or ω−6?
  47. Which fatty acids help raise HDL's, lower triglycerides, protect against arrhythmia, ω−3 or ω−6?
  48. This is a marker of inflammation linked to an incrased risk of CVD.
    • C-reactive protein
    • *The obese often have elevated levels of this
  49. What types of oil are rich in monounsaturated fat?
    Olive oil, avocado oil, peanut oil
  50. If a patient want to increase consumption of fatty acids that promote health, what types should be choosen?
    • ω−3's
    • monounsaturated
    • polyunsaturated
  51. Can an overweight person reduce their blood pressure by losing weight?
  52. Can a person with Metabolic Syndrome benefit from reducing their carbohydrate intake?
  53. Is homocysteine safe or dangerous?
  54. Is plaque related to cancer?
  55. What are risk factors for Coronary Heart Disease?
    • Smoking
    • High LDL's
    • High Blood Pressure
    • Diabetes
  56. Can your body use amino acids are a source of energy?
    Yes, but not recommended
  57. Which are the fats more resistant to oxidation?
  58. Saturated fats are _____ at room temperature.
  59. Polyunsaturated fats are ______ at room temperature.