Healthy Diet The Basics Test Bank Docx Chapter.8

Chapter 8

Healthy Diet: The Basics

Learning Outcomes

Upon successful completion of this chapter, students should be able to:

1. Define and differentiate between reference values for recommended nutrient intake and identify problem areas in the typical American’s diet.
2. Differentiate between carbohydrates, fats, protein, vitamins, and minerals in terms of their dietary sources, recommended need, and uses by the body, including their relationship to obesity and health.
3. Discuss sugar and fat substitutes in current use and their health benefits and detriments.
4. Identify the functions of body water and recommended fluid intake for healthy people as well as people with conditions that increase the need for fluids.

Chapter Outline/Summary

1. Components of a healthy diet
   1. DRIs:

Dietary reference intakes (DRIs) are a broad set of reference values for recommended nutrient intake. They include estimated average requirements (EARs), recommended dietary allowances (RDAs), adequate intakes (AIs), and tolerable upper intake levels (ULs). Individuals should aim to meet the RDA or AI and avoid exceeding the UL.

• 1. Problems in the American diet:

Americans consume more calories than ever before, but most over-consume empty calories and do not meet recommendations for intake of fruits, vegetables, whole grains, and fat-free or low-fat milk.

1. Carbohydrates: primary constituents of the diet
   1. Why we need dietary carbohydrate:

Carbohydrates are an important source of energy and can be stored in limited quantities as glycogen. Carbohydrates can be classified as monosaccharides, disaccharides, and polysaccharides. In addition, fiber is the nondigestible form of carbohydrate that makes up plant cell walls and has significant health benefits.

• 1. Do sugars harm health and cause obesity:

Both monosaccharides and disaccharides are classified as “sugars.” Added sugar in the form of sucrose (table sugar) may be related to an increased risk of obesity and diabetes. High-fructose corn syrup intake has significantly increased in the past 25 years and has been linked to hypertension, elevated blood lipids, and type 2 diabetes. A direct link with human obesity is unproven. Most health agencies recommend limiting added sugars to 5-10% of total calories.

• 1. Sugar replacers in common use:

Sugar replacers/substitutes provide no or minimal calories. Only the sugar alcohols offer any direct health benefits (prevention of dental caries and a lower glycemic response than sugar). The role of sugar replacers in weight management requires more research.

1. Lipids: key players in health and weight management

The family of lipids includes triglycerides (made up of one molecule of glucose bound to 3 fatty acids), phospholipids, and cholesterol.

• 1. Fatty acids:

Fatty acids may be classified by chain length, by degree of saturation with hydrogen atoms (saturated, monounsaturated, polyunsaturated), and by location of double bonds (omega-6 and omega-3).

• 1. Cholesterol:

Cholesterol is only found in animal products, although significant amounts of cholesterol can be produced by most body cells. Lipoproteins transport cholesterol and include chylomicrons (take dietary cholesterol from the gut to the liver and other tissues), very-low-density lipoproteins (move cholesterol from the liver to the tissues), low-density lipoproteins (the so-called “bad” cholesterol, derived from VLDLs), and high-density lipoproteins (the so-called “good” cholesterol).

• 1. Trans fatty acids:

Most trans fatty acids are produced in a manufacturing process called hydrogenation, which lengthens the shelf life of foods by making unsaturated fats behave more like saturated fats. Trans fatty acids are the most blood cholesterol-raising types of fats.

• 1. Does dietary fat make people obese?:

High-fat diets promote fat storage, not only for physiological reasons but because fats taste good and promote overeating. Low-fat diets promote weight loss, but moderation of caloric intake is equally important.

• 1. Fat substitutes in common use:

Fat substitutes/replacers can mimic some of the chemical properties of fats while reducing caloric intake. These are not only valuable for weight management but can also help reduce the risk of cardiovascular disease by cutting saturated fat consumption. Olestra has some unpleasant side effects.

1. Protein: builder and maintainer of body tissues
   1. What proteins do:

Proteins are composed of amino acids, some of which are essential (can only be obtained through the diet). While proteins are energy nutrients, their primary function is to support growth and maintenance of body tissues, as well as synthesis of hormones, enzymes, and neurochemicals. Proteins found in animal products are classified as complete because they contain all of the essential amino acids. Plant proteins are incomplete because they lack one or more essential amino acid.

• 1. Protein modification and health:

High protein diets are not needed for weight loss, although keeping protein intake at least at 15% of kcals can prevent or minimize the drop in energy expenditure seen when calories are reduced. Plant-based diets offer a number of health benefits, including reduced consumption of animal fats, and protection against cancer and cardiovascular disease. The omega-3 fatty acids found in fish also convey health benefits.

1. Vitamins: vital dietary constituents
   1. Fat-soluble vitamins:

Vitamins A, D, E, and K constitute the fat-soluble vitamins; they are absorbed, transported, and stored along with lipids. Vitamin A has antioxidant properties and is involved in immunity, reproduction, bone health, and vision. Vitamin E is also an antioxidant. Vitamin D enhances calcium absorption and thereby plays an important role in bone health. Vitamin K plays a role in calcium uptake and blood clotting. Both vitamin D and K can be synthesized in the body.

• 1. Water-soluble vitamins:

The eight B vitamins and vitamin C are water-soluble and, with the exception of vitamin B₁₂, are stored in only small quantities. Thiamine, riboflavin, niacin, vitamin B₆, pantothenic acid, and biotin are coenzymes in various aspects of energy metabolism. Folate and vitamin B₁₂ maintain healthy blood and a healthy nervous system; deficiencies of either result in anemia and, potentially, nerve damage. Folate deficiency during pregnancy is associated with neural tube disorders. Vitamin C is needed for collagen production, neurotransmitter synthesis, and antioxidant activities.

1. Water and minerals: nutrient teammates
   1. Why water is essential:

Water is the most essential nutrient. The average healthy person needs 2-4 liters of water from food and fluids every day. Dehydration can be life threatening. Minerals dissolve in water as salts, called electrolytes or ions.

• 1. The role of minerals:

Three major minerals – calcium, phosphorus, and magnesium – are primarily stored in bone and share important functions in bone health. Osteoporosis and osteopenia result from loss of bone density, which can occur from mineral undernutrition. Sodium, potassium, chloride, and sulfate are other major minerals. Iron, a trace mineral, is found primarily in the red blood cells; deficiency results in anemia. Zinc is another trace mineral with important functions in cell replication, immunity, wound healing, and metabolism.

Suggested Activities and Applications

Application 8.1 The Challenge of Limiting Sugar

Students will work with a sugar “budget” of about 180 sugar kcal (45 grams) each day. They will use Table 8-2 to see the difficulties involved in this. Students are then asked to calculate their own sugar “budget” depending on their caloric intake (it is suggested that this be between 1,800-2,600 kcal/day). Assuming they were limiting sugar intake to 15% of caloric intake:

• Calculate their sugar budget
• Consider what foods they would need to give up
• What foods would they substitute for those foods?

Application 8.2 Factors That Influence What We Eat

Students will write a list of foods and beverages in the last meal they consumed. (NOTE: some student have erratic eating habits, so, for this assignment, they should choose the last real meal that they ate).

• For each food and beverage, what affected their choice?
• If they were going to modify their diet, how would these factors have to change?

Application 8.3 Water Consumption

Students will keep a record of their beverage consumption for three typical days (1 weekend day and 2 weekdays). If necessary, they might have to use a measuring cup to determine the volume of beverage containers that they typically use. Then, add up the total volume of all beverages and divide by 3 to determine average beverage consumption.

• How does their beverage consumption compare with the DRI (Table 8-10 gives the DRI for water).
• What proportion of their beverage consumption was from water? Soda? Juices?
• Using Table 8-4, they can estimate the amount of sugar replacers in their beverages. How does this compare to the ADIs?
• Were there foods consumed on those 3 days that provided additional fluid? (Foods would include fruits, soups, yogurt, sherbet).
• Given their activity level and other characteristics (pregnancy, lactation, exposure to heat), students will comment on the adequacy of their beverage consumption and, if needed, how they would add more fluid to their diet.

Activity 8-1 Sugar Substitutes and Metabolism

A September 18, 2014 article in the journal Nature reported research with mice and humans that found a relationship between artificial sweetener use and altered microbial metabolism in the gut, which was associated with glucose intolerance and other metabolic abnormalities. The authors note that “NAS [non-caloric artificial sweeteners]may have directly contributed to enhancing the exact epidemic [obesity] that they themselves were intended to fight.”

The article, “Artificial sweeteners induce glucose intolerance by altering the gut microbiota,” by Jotham Suez et al., Nature, September 18, 2014, can be obtained online (doi:10.1038/nature13793) or through your library.

Discuss:

• Which artificial sweeteners were studied in mice? In humans?
• What were the findings with mice?
• How many humans were studied, and what were the major findings?

• Why might artificial sweeteners have these effects?

Activity 8-2 A Snapshot of Vitamins and Minerals

Rather than an instructor led lecture about vitamins and minerals, consider assigning a vitamin or mineral to each student or to pairs of students. Students do some reading and research prior to the class session and report the following to the class:

• What the vitamin/mineral does
• The best food source(s)
• Is there a UL?
• An interesting fact

Chapter 8

Test Questions

True/False

1. For diet planning, healthy individuals should aim to meet the UL of the DRI. (True/ False)

2. Free monosaccharides are abundant in foods. (True/ False)

3. Monosaccharide glucose is the most nutritionally significant carbohydrate; it is the form in which carbohydrate circulates in the bloodstream, and virtually every cell needs it for energy. (True/ False)

4. Because fiber is not digestible, it contributes bulk but not calories to the diet. (True/ False)

5. High fiber foods promote satiety and delay the onset of hunger. (True/ False)

6. Research has proven a direct link between human obesity and high fructose corn syrup (HFCS). (True/ False)

7. Fructose has a lower thermic effect than other carbohydrates, so less heat and energy is released when it is metabolized. (True/ False)

8. If all you want is energy, it doesn’t matter if you eat whole wheat bread or jellybeans, because they have the same caloric value per gram. (True/ False)

9. Unsaturated fatty acids offer many health benefits. (True/ False)

10. Cholesterol is only found in animal products. As such, a diet that contains a lot of plant foods can help control cholesterol intake. (True/ False)

11. Obesity rates are lower among vegetarians. (True/ False)

12. Vitamin deficiencies are common in the U.S. (True/ False)

13. Low vitamin intake is associated with the development of chronic diseases. (True/ False)

14. Water and minerals make up a substantial portion of body weight 60-70% for water and about 4% for minerals. (True/ False)

15. Iron and zinc deficiencies are primarily the result of inadequate dietary intake. (True/ False)

Multiple Choice

16. _______________________ are average amounts of each nutrient needed to prevent inadequacy without causing toxicity in practically all healthy people.

A. Dietary Reference Intakes

B. Recommended Dietary Allowances

C. Energy Nutrients

D. All of the above

17. The starting point to formulate a Recommended Dietary Allowance uses the ________________________________.

A. Lower Tolerable Limit

B. Upper Tolerable Limit

C. Subclinical Deficiency Value

D. Estimated Average Requirement

18. The RDAs (Recommended Dietary Allowances) for nutrients are generally

A. more than twice as high as anyone needs

B. the minimum amounts that average people need

C. designed to be adequate for almost all healthy people

D. designed to prevent deficiency disease in half the population

19. The federal government and national health organizations recommend an adult diet that provides _____% of calories from carbohydrate.

A. 20-35%

B. 45-65%

C. 65-75%

D. >75%

20. The federal government and national health organizations recommend an adult diet that provides ________% of calories from fat.

A. 0-10%

B. 10-20%

C. 20-35%

D. 35-45%

21. The federal government and national health organizations recommend an adult diet that provides ________% of calories from protein.

A. 10-35%

B. 35-50%

C. 50-60%

D. > 60%

22. The most recent HEI score for Americans was ________.

A. 53

B. 65

C. 70

D. 73

23. According to the dietary guidelines, a sedentary 31-50 year old woman should consume no more than __________ calories per day.

A. 1,200

B. 1,500

C. 1,800

D. 2,000

24. According to the dietary guidelines, a sedentary 31-50 year old man should consume no more than __________ calories per day.

A. 1,500

B. 1,800

C. 2,000

D. 2,400

25. Most of the energy in each day’s diet should come from _______________________.

A. Protein

B. Fat

C. Carbohydrate

D. A & B

26. __________________________ is a simple carbohydrate made up of a single unit of sugar (glucose, fructose, and galactose).

A. Monosaccharide

B. Disaccharide

C. Polysaccharide

D. All of the above

27. __________________________ is a carbohydrate made up of two monosaccharides (sucrose lactose and maltose).

A. Monosaccharide

B. Disaccharide

C. Polysaccharide

D. All of the above

28. __________________________ is a complex carbohydrate composed of repeating glucose units (starch, fiber, and glycogen).

A. Monosaccharide

B. Disaccharide

C. Polysaccharide

D. All of the above

29. _____________________ and _____________________ make up most of the carbohydrate in our diets.

A. Monosaccharide and disaccharides

B. Monosaccharide and polysaccharides

C. Disaccharides and polysaccharides

30. _______________________ is the nondigestible carbohydrate and lignin that makes up plant cell walls.

A. Functional fiber

B. Dietary fiber

C. Soluble fiber

D. All of the above

31. ________________________ is abundant in oat bran, barley bran, psyllium, and legumes; it dissolves in water and may form a gel in the digestive tract. It is often linked to reductions in blood cholesterol.

A. Soluble fiber

B. Insoluble fiber

C. Both A & B

32.________________________ is found in wheat bran, fruits, vegetables, and legumes and is associated with the passage of waste materials through the colon.

A. Soluble fiber

B. Insoluble fiber

C. Both A& B

33. Sugars provide _____ kcal of energy per gram of weight.

A. 3 kcal

B. 4 kcal

C. 5 kcal

D. 6 kcal

34. The various health organizations (the Institute of Medicine, the World Health Organization, and the American Heart Association) recommendations range from _____% to _____% of calories from added sugars.

A. 10%-20%

B. 15%-25%

C. 5%-25%

D. 5%-40%

35. ____________________________ are fats (solid at room temperature) and oils (liquid at room temperature) that make up 95% of the lipids in our diet.

A. Fatty acids

B. Saturated fatty acids

C. Triglycerides

D. A & B

36. Lipids differ in their degree of saturation or unsaturation due to their number of

A. amino acids

B. double bonds

C. trans fats

D. peptide linkages

37. __________________________ are any number of organic acids made of carbon chains of varying lengths and degrees of saturation with hydrogen.

A. Triglycerides

B. Fatty acids

C. Lipoproteins

D. All of the Above

38. Long chain fatty acids have more than _____ carbons.

A. 3

B. 6

C. 6-12

D. >12

39. _______________________ are sometimes called “bad cholesterol” because the particles are small enough to be taken up into the lining of damaged arteries and, if oxidized, can form atherosclerotic plaque.

A. Very-low-density lipoproteins (VLDLs)

B. Low-density lipoproteins (LDLs)

C. High-density lipoproteins (HDLs)

D. All of the above

40. ______________________ may counteract “bad cholesterol” by removing excess cholesterol from the cells and transporting it back to the liver for disposal as bile; they are sometimes referred to as “good cholesterol.”

A. Very-low-density lipoproteins (VLDLs)

B. Low-density lipoproteins (LDLs)

C. High-density lipoproteins (HDLs)

D. All of the above

41. When the fat content of the diet is reduced to ________% of calories per day, people tend to lose weight regardless of whether or not they decrease their caloric intake.

A. 10%

B. 10-20%

C. 20-25%

D. 30%

42. There are _____ common amino acids.

A. 5

B. 10

C. 15

D. 20

43. According to most recommendations for a healthy adult, protein consumption should not exceed ______% of total calories per day.

A. 15%

B. 25%

C. 35%

D. 45%

44. Alpha-tocopherol is the most biologically available form of vitamin ______.

A. Vitamin A

B. Vitamin B

C. Vitamin D

D. Vitamin E

45. Without sufficient vitamin _____ children develop rickets and adults develop osteomalacia.

A. Vitamin A

B. Vitamin B

C. Vitamin C

D. Vitamin D

46. Vitamin _____ is the “non-B” water soluble vitamin that is involved in the production of collagen.

A. Vitamin A

B. Vitamin B

C. Vitamin C

D. Vitamin E

47. Scurvy is characterized by the breakdown of connective tissue, especially the skin, blood vessels, and gums. This is caused by a deficiency in vitamin _____.

A. Vitamin A

B. Vitamin B

C. Vitamin C

D. Vitamin D

48. To maintain good health, the average person needs to consume _____ liters of water in food and fluids each day.

A. 1-2 liters

B. 2-4 liters

C. 4-6 liters

D. > 6 liters

49. A similar type of anemia is produced when there is a deficiency of either

A. iron and zinc

B. vitamin B₁₂ or folate

C. vitamin B₆ or vitamin B₁₂

D. vitamin K or vitamin C

50. In what system would the effects of a vitamin D deficiency be most readily observed?

A. nervous

B. skeletal

C. muscular

D. circulatory

51. Which of the following explains why B vitamin deficiencies lead to lack of energy?

A. B vitamins are a source of kcals

B. absorption of carbohydrates and fats is decreased without B vitamins

C. oxygen for energy metabolism cannot be transported to the cells

D. B vitamins are coenzymes needed in energy metabolism

52. Which of the following is not one of the minerals stored in bone?

A. Phosphorus

B. Magnesium

C. Folate

D. Calcium

53. _____________________ is a disease characterized by significant loss of bone density, resulting in bone mass more than 2.5 standard deviations below the average for a specific age.

A. Osteogenesis Imperfecta

B. Scurvy

C. Osteoporosis

D. Rickets

54. Which of the following is a feature of cholesterol?

A. synthesized by the body

B. minor relationship to heart disease

C. recommended intake is zero

D. no known functions in humans

55. In which of the following are ample amounts of carbohydrates almost always found?

A. plant foods

B. health foods

C. animal products

D. protein-rich foods

56. Which of the following is a feature of an essential amino acid?

A. It is not necessary in the diet

B. It must be supplied by the diet

C. It can be made by fat in the body

D. It can be made from glucose in the body

57. All of the following are properties of electrolytes EXCEPT:

A. they attract water

B. they are charged particles

C. they include fat-soluble and water-soluble particles

D. they carry an electrical current

Short Answer/ Fill in the Blank

58. ________________________ are the nutrients (carbohydrates, fat, and protein) that contain calories; they are made up of carbon, hydrogen, oxygen, and (in protein) nitrogen.

59. List two of the four DRI reference values:

1)_______________________________________

2)_______________________________________

60. Describe the Healthy Eating Index. What is the purpose of the Healthy Eating Index?

61. Using the HEI as a guide, what are some of the problems in the American diet?

62. ________________________ is the storage form of a carbohydrate, consisting of one unit of glucose and 3 units of water.

63. Provide two examples of food sources of fiber:

1)______________________________________________

2)______________________________________________

64. Provide two examples of food sources of carbohydrates:

1)______________________________________________

2)______________________________________________

65. What are the benefits and limitations to using sugar replacers to help with weight management?

66. In addition to providing energy, what are two other functions of lipids in overall health?

1)______________________________________________

2)______________________________________________

67. ______________________ are large lipoproteins that transport dietary triglycerides and cholesterol from the intestine to the liver and other tissues.

68. What purpose do trans-fatty acids serve in processed foods?

69.What is the role of dietary fat in weight gain and obesity?

70. _______________________ is the tendency to overeat fat-rich foods, also called passive overconsumption.

71. What is the problem with a low calorie diet in which fat makes up a substantial portion of the calories?

72. What are the benefits and limitations to using fat replacers in the diet? Provide at least one example of a fat replacer in your answer.

73.______________________ is a building block of protein; consists of a central carbon atom with attached hydrogen, amino group (NH₂), acid group (COOH), and a side chain that gives each a unique identity.

74. What is the role of protein in the diet? (What does protein do?)

75. Describe some differences between plant proteins and animal proteins in promoting health.

76. Provide examples of two fat-soluble vitamins:

1)______________________________________________

2)______________________________________________

77. ___________________________ are substances in foods that protect cell membranes from destruction resulting from chemicals, radiation, ozone, cigarette smoke, and smog; they may play a role in the prevention of cancer and cardiovascular disease.

78. Provide examples of two water-soluble vitamins:

1)______________________________________________

2)______________________________________________

79. A reduction in body water is known as _______________________.

80.What is the role of electrolytes in maintaining hydration?