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Questions and Answers
What heart rate range corresponds to moderate-intensity exercise for a person with a maximum heart rate of 198?
Which of the following assessments does NOT belong to the ABCDEs of nutritional status?
What does the acronym RDA stand for in nutritional guidelines?
Which of the following best describes the concept of Adequate Intake (AI)?
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What is the Estimated Energy Requirement (EER) primarily used for?
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What is the primary difference between hunger and appetite?
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Which of the following macronutrients provides the highest energy density per gram?
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If a meal contains 300 calories from carbohydrates, 600 calories from protein, and 360 calories from fat, what is the percentage of calories from fat?
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Which body mass index (BMI) category corresponds to someone with a BMI of 27?
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What is the recommended limit for added sugars as a percentage of daily calories?
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What is the equivalent of 1 pound in kilograms?
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Which step in evidence-based practice involves evaluating the outcomes after implementation?
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At what intensity level should children accumulate at least 60 minutes of physical activity per day?
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What is the correct formula to calculate Body Mass Index (BMI)?
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Which of the following foods is characterized as energy-dense?
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What is the primary function of mitochondria in the cell?
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Which organ system is primarily responsible for the protection of the body against environmental hazards?
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What is the role of insulin in the body?
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Which hormone is produced by the adrenal glands and increases blood glucose during times of stress?
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Which of the following vitamins regulates blood calcium levels?
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What primarily differentiates soluble fiber from insoluble fiber?
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What distinguishes disaccharides from monosaccharides?
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What is the maximum recommended intake of sodium to reduce the risk of hypertension?
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Which digestive enzyme begins the digestion of carbohydrates in the mouth?
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What defines epigenetics in the context of gene expression?
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Which of the following recommendations is true regarding fiber intake for women?
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What is the function of lysosomes in a cell?
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Which type of bacteria is enhanced by prebiotics?
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What is the primary function of excess acetyl CoA in the body?
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What fasting blood glucose level is indicative of pre-diabetes?
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Which statement about glycemic index and glycemic load is true?
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What is the role of HDL in cholesterol transport?
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Which of the following fatty acids is considered saturated?
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Which lipoprotein is known as 'bad cholesterol'?
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What is the recommended dietary fat intake according to the 2020 Dietary Guidelines for Americans?
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Which amino acid is considered essential for infants?
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What is the classification of omega-3 fatty acids?
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What is one of the modifiable risk factors for cardiovascular disease?
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Which enzyme is responsible for converting trypsinogen to trypsin?
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What characterizes the secondary structure of a protein?
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In the body, which distribution of fat is associated with higher health risks?
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Study Notes
Hunger and Appetite
- Hunger: Physical drive to eat controlled by internal mechanisms.
- Appetite: Psychological drive to eat, influenced by factors like smell and taste.
Energy Density of Macromolecules
- Carbohydrates and Proteins: 4 kcal/g of energy.
- Lipids (Fats): 9 kcal/g of energy.
- Alcohol: 7 kcal/g of energy.
Converting Grams and Kcals
- Grams to Kcals:*
- Multiply grams of each macronutrient by their respective kcal/g value.
- Add the calories from all macronutrients.
- Kcals to Grams:*
- Determine the calorie contribution of each macronutrient percentage.
- Divide these calories by the respective kcal/g value to find grams.
Body Mass Index (BMI)
- Formula: BMI = weight (kg) / height (m)^2
- Weight Conversion: 1 pound = 0.453592 kg
- Height Conversion: 1 inch = 0.0254 meters
BMI Categories
- Underweight: Less than 18.50
- Normal Range: 18.50 - 24.99
- Overweight: Greater than or equal to 25
- Obese: Greater than or equal to 30
Energy Dense vs. Nutrient Dense Foods
- Energy Dense: High calorie content relative to weight (e.g., nuts, oils).
- Nutrient Dense: High nutrient content relative to calorie content (e.g., fruits, vegetables).
Food Components to Limit
- Added Sugars: Less than 10% of daily calories.
- Saturated Fat: Less than 10% of daily calories.
- Sodium: Less than 2300 mg/day.
-
Alcohol: Moderate consumption
- Women: 1 drink per day.
- Men: 2 drinks per day.
Physical Activity Guidelines
- Children:*
- Aerobic: 60+ minutes per day, including vigorous intensity at least 3 days a week.
- Muscle Strengthening: As part of the 60 minutes per day, at least 3 days a week.
- Bone Strengthening: As part of the 60 minutes per day, at least 3 days a week.
- Adults:*
- Moderate-Intensity Aerobic: At least 150 to 300 minutes per week.
- Vigorous-Intensity Aerobic: At least 75 to 150 minutes per week.
Exercise Intensity
- Moderate-Intensity: 64% - 76% of maximum heart rate.
- Vigorous-Intensity: 77% - 95% of maximum heart rate.
Maximum Heart Rate
- Formula: 220 - age
- Use the formula to calculate an individual's maximum heart rate.
Malnutrition
- Overnutrition: Excessive intake of nutrients, leading to health problems.
- Undernutrition: Insufficient intake of nutrients, leading to health problems.
Nutritional Status Assessment (ABCDEs)
- Anthropometric: Measures like height, weight, body fat percentage, and body circumference.
- Biochemical: Nutrient and byproduct levels in blood, urine, and feces.
- Clinical: Physical signs and symptoms related to nutrient deficiencies.
- Dietary: Assessment of dietary intake using methods like food records or 24-hour recalls.
- Environmental: Factors like medical history, social history, education level, and economic status.
Dietary Reference Intakes (DRIs)
- Recommended Daily Allowance (RDA): The amount of a nutrient that meets the needs of 97% of a specific age and gender group (minimum).
- Adequate Intake (AI): Used when there's insufficient data to establish an RDA. Based on amounts maintaining health in healthy people.
- Estimated Energy Requirement (EER): Calculated energy needs based on age, sex, weight, height, and physical activity level.
- Tolerable Upper Intake Level (UL): The maximum daily intake of a nutrient that's unlikely to pose risks for most individuals.
- Chronic Disease Risk Reduction (CDRR): Recommendations for intakes of nutrients linked to chronic disease prevention.
Tolerable Upper Limit
- The Tolerable Upper Limit (UL) is the highest daily intake of a nutrient that is unlikely to cause adverse health effects.
Chronic Disease Risk Reduction Intakes
- Chronic Disease Risk Reduction Intakes (CDRR) values are established through correlations between nutrient intakes and disease.
- The CDRR for sodium is set at 2,300mg per day to decrease the risk of hypertension.
Mitochondria
- The mitochondria are the respiratory center of the cell and contain the TCA cycle and electron transport chain, essential for aerobic metabolism.
- They form part of a network.
- The number of mitochondria in a cell can differ depending on the cell type, with skeletal muscle cells containing many and red blood cells containing none.
Nucleus
- Most cells contain one nucleus, while skeletal muscle cells have many.
- Red blood cells (RBCs) do not have a nucleus.
- The nucleus contains nuclear pores for chemical communication and stores DNA.
- DNA in the nucleus is condensed into chromosomes.
- DNA is the genetic blueprint that is read by the enzyme RNA polymerase to produce messenger RNA (mRNA).
Endoplasmic Reticulum (ER): Smooth ER (SER) & Rough ER (RER)
- SER is involved in synthesizing phospholipids, cholesterol, steroids, triglycerides (TAGs), glycogen, and stores calcium (Ca++).
- RER is responsible for protein synthesis at ribosomes on its surface, releasing the proteins into the ER cisternae.
Golgi Apparatus
- It modifies and packages proteins for secretion.
- It produces lysosomes.
Lysosomes
- Lysosomes are produced by the Golgi apparatus.
- They fuse with damaged organelles to break them down, including unused proteins.
- They also fuse with endosomes to destroy bacteria or other debris entering the cell.
- Lysosomes are involved in autolysis, the internal digestion of the cell.
Peroxisomes
- They are involved in breaking down very long chain fatty acids.
- They detoxify harmful chemicals.
- They produce hydrogen peroxide (H2O2).
Integumentary System
- Major organs: Skin, Hair, Sweat Glands, Nails.
-
Functions:
- Protects against environmental hazards.
- Regulates body temperature.
- Provides sensory information.
- Produces vitamin D.
Skeletal System
- Major organs: Bones, Cartilages, Associated Ligaments, Bone Marrow.
-
Functions:
- Provides support and protection for other tissues.
- Stores calcium and other minerals.
- Forms blood cells.
Muscular System
- Major organs: Skeletal muscles and associated tendons.
-
Functions:
- Provides movement.
- Provides protection and support for other tissues.
- Generates heat maintaining body temperature.
Nervous System
- Major organs: Brain, Spinal Cord, Peripheral Nerves, Sense Organs.
-
Functions:
- Directs immediate responses to stimuli.
- Coordinates or moderates activities of other organ systems.
- Provides and interprets sensory information about external conditions.
Endocrine System
- Major organs: Pituitary gland, Thyroid gland, Pancreas, Adrenal glands, Gonads, Endocrine tissues in other systems.
-
Functions:
- Directs long-term changes in the activities of other organ systems.
- Adjusts metabolic activity and energy use by the body.
- Controls many structural and functional changes during development.
Cardiovascular System
- Major organs: Heart, Blood, Blood vessels.
-
Functions:
- Distributes blood cells, water, and dissolved materials, including nutrients, waste products, oxygen, and carbon dioxide.
- Distributes heat and assists in controlling body temperature.
Lymphatic System
-
Major organs:
- Spleen
- Thymus
- Lymphatic vessels
- Lymph nodes
- Tonsils
-
Functions:
- Defends against infection and disease.
- Returns tissue fluids to the bloodstream.
Respiratory System
-
Major organs:
- Nasal cavities
- Sinuses
- Larynx
- Trachea
- Bronchi
- Lungs
- Alveoli
-
Functions:
- Delivers air to alveoli (sites in lungs where gas exchange occurs).
- Provides oxygen to the bloodstream.
- Removes carbon dioxide from the bloodstream.
- Produces sounds for communication.
Digestive System
-
Major organs:
- Teeth
- Tongue
- Pharynx
- Esophagus
- Stomach
- Small intestine
- Large intestine
- Liver
- Gallbladder
- Pancreas
-
Functions:
- Processes and digests food.
- Absorbs and conserves water.
- Absorbs nutrients.
- Stores energy reserves.
Urinary System
-
Major organs:
- Kidneys
- Ureters
- Urinary bladder
- Urethra
-
Functions:
- Excretes waste products from the blood.
- Controls water balance by regulating the volume of urine produced.
- Stores urine prior to voluntary elimination.
- Regulates blood ion concentrations and pH.
Male Reproductive System
-
Major organs:
- Testes
- Epididymides
- Ductus deferentia
- Seminal vesicles
- Penis
- Scrotum
-
Functions:
- Produces male sex cells (sperm), seminal fluids, and hormones.
- Sexual intercourse.
Female Reproductive System
-
Major organs:
- Ovaries
- Uterine tubes
- Uterus
- Vagina
- Labia
- Clitoris
- Mammary glands
-
Functions:
- Produces female sex cells (oocytes) and hormones.
- Supports developing embryo from conception to delivery.
- Provides milk to nourish newborn infant.
- Sexual intercourse.
Growth Hormone
- Produced by the pituitary gland.
- Promotes protein synthesis and growth.
- Increases the use of fat as fuel.
Thyroid Hormone
- Produced by the thyroid gland.
- Regulates metabolic rate, growth, and development.
Epinephrine and Norepinephrine
- Produced by the adrenal glands.
- Increase blood glucose.
- Increase metabolic rate during times of stress.
Cholecystokinin (CCK)
- Produced by the small intestine and brain.
- Regulates the movement of food through the GI tract and stimulates the release of bile and pancreatic juice into the small intestine.
1,25-Dihydroxyvitamin D3 (Calcitriol)
- Produced by the skin and activated in the liver and kidneys.
- Regulates blood calcium level.
Insulin and Glucagon
- Produced by the pancreas.
- Regulate blood glucose level.
Ghrelin
- Produced by stomach cells.
- Helps to regulate energy intake and body weight by stimulating hunger.
Leptin
- Produced by adipose tissue (fat storage).
- Helps to regulate energy intake and body weight by reducing hunger.
Secretin
- Stimulates bicarbonate release from the pancreas.
Gastrin
- Stimulates gastric motility and stomach enzyme release.
Digestive Enzymes
-
Mouth:
- Salivary amylase: Begins carbohydrate digestion.
- Lingual lipase: Begins lipid digestion.
-
Stomach:
- Parietal cells:
- HCl: Kills pathogens, denatures proteins, breaks down plant cell walls & animal connective tissue, and activates pepsinogen to pepsin.
- Intrinsic factor: Essential for vitamin B12 absorption.
- Chief cells:
- Pepsinogen: Begins protein digestion.
- Gastric lipase: Continues lipid digestion.
- G cells:
- Gastrin: Stimulates product release by chief cells and parietal cells, as well as gastric motility.
- P/D1 cells:
- Ghrelin: Initiates hunger; acts as an antagonist to leptin, which signals satiety.
- Parietal cells:
-
Small Intestine:
- Pancreatic alpha amylase: Continues carbohydrate digestion.
- Pancreatic lipase: Finishes lipid digestion.
- Trypsin, chymotrypsin, elastase, carboxypeptidase A & B: Continue protein digestion (released from the pancreas as proenzymes).
- Brush border enzymes: Finish the digestion of carbs & proteins.
- Sucrase, maltase, isomaltase, and lactase: Finish carbohydrate digestion.
- Aminopeptidase, tripeptidase, dipeptidyl peptidase: Finish amino acid (protein) digestion.
- Enteropeptidase: Cleaves trypsinogen to trypsin (from pancreas).
- Hormones:
- CCK: Pancreatic enzyme release and gallbladder contraction.
- Secretin: Bicarbonate release from the pancreas.
- Gastrin: Gastric motility; stomach enzyme release.
Gut Microbiome
- Probiotics: Foods containing live microorganisms becoming part of the gut microbe population.
- Prebiotics: Substances that increase the growth of probiotic microorganisms.
- Synbiotics: Contain both probiotics and prebiotics.
- Postbiotics: Metabolic products of probiotic microorganisms.
Epigenetics and Nutritional Genomics
- Epigenetics: Changes to gene expression without changing DNA code.
- Nutritional Genomics: Interactions between genetics and nutrition.
Carbohydrate and Fiber Recommendations
- 45-65% of total daily calories should come from carbohydrates.
- Half of these carbohydrates should be whole grains.
- Recommended Daily Allowance (RDA) for carbohydrates is 130 grams per day for everyone.
- Fiber recommendations:
- 25 grams for women.
- 38 grams for men.
Monosaccharides and Disaccharides
-
Monosaccharides (simplest sugars):
- Glucose: Derived from starches and sucrose (e.g., rice, spaghetti).
- Fructose: Found in fruits; most is converted to glucose).
- Galactose: Found in lactose in dairy products; most is converted to glucose.
- Glucose can be converted to galactose to make milk in lactating mothers.
-
Disaccharides:
- Maltose, sucrose, and lactose.
- Sucrose: Natural sweetener found in sugar cane, sugar beets, honey, and maple syrup.
- Lactose: Milk sugar.
- Maltose: Two glucose molecules joined together.
Amylose, Amylopectin, and Glycogen
-
Polysaccharides:
- Amylose:
- 15-20% of cereal grains, potatoes, and other vegetables.
- Amylopectin:
- 80-85% of cereal grains, potatoes, and other vegetables.
- Has branch points broken down by isomaltase, unlike glycogen which has more branches.
- Broken down more readily, leading to a faster rise in blood sugar.
- Glycogen: Storage form of carbohydrates in humans and animals.
- Amylose:
Soluble and Insoluble Fiber
-
Soluble Fiber (viscous):
- Pectins, gums, mucilages.
- Found in beans, oats, oat bran, some fruits, and vegetables.
- Readily fermented by bacteria in the large intestine to form short-chain fatty acids.
- Attracts water to feces, promoting stool soften.
- Reduces blood cholesterol by inhibiting absorption of cholesterol and bile in the large intestine.
- Controls blood glucose.
-
Insoluble Fiber (non-fermentable):
- Found in wheat bran, nuts, fruit skins, and some vegetables.
- Speeds up transit time in the digestive tract, a natural laxative.
- Provides bulk to feces.
- Contributes to satiety.
Carbohydrate Digestion Enzymes
- Salivary amylase: In the mouth, it breaks down polysaccharides.
- Pancreatic alpha amylase: In the small intestine, it continues polysaccharide digestion.
-
Brush border enzymes: In the small intestine, they finish digestion:
- Maltase: Cleaves the bond between two glucose molecules.
- Isomaltase: Cleaves bonds of limit dextrins.
- Sucrase: Cleaves sucrose to produce fructose and glucose.
- Lactase: Cleaves lactose to produce galactose and glucose.
Insulin and Glucagon
-
Insulin: Released from the pancreas after eating when blood glucose rises.
- Stimulates storage pathways:
- Glycogen synthesis (stores glucose)
- Protein synthesis
- Triglyceride (TAG) synthesis (stores fat)
- Stimulates storage pathways:
-
Glucagon: Released from the pancreas between meals when blood glucose drops.
- Stimulates breakdown pathways:
- Glycogenolysis (breaks down glycogen, releasing glucose into the bloodstream).
- Gluconeogenesis (synthesis of glucose from noncarbohydrate sources).
- Lipolysis (breaks down fat for energy).
- Stimulates breakdown pathways:
Diabetes Diagnosis
- Defined by an elevated blood glucose level.
- All forms of diabetes are characterized by a defect in insulin production or inability to use insulin.
-
Type I diabetes: Autoimmune disease.
- Symptoms: Increased thirst, frequent urination, dry mouth, extreme hunger, unexplained weight loss, fatigue, blurry vision, sores that are slow to heal.
- Diabetic ketoacidosis: Cells can't take in glucose, fatty acids become the primary energy source.
- Requires insulin therapy.
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