The Dental Hygienists Guide to Nutritional Care 5th Edition by Cynthia A. Stegeman - Test Bank

Chapter 03: The Alimentary Canal: Digestion and Absorption Stegeman: The Dental Hygienist’s Guide to Nutritional Care, 5th Edition MULTIPLE CHOICE 1. Each is a portion of the alimentary canal, except one. Which is the exception? a. Oral cavity b. Pharynx c. Larynx d. Esophagus e. Small intestine ANS: C The larynx is not a portion of the alimentary canal. This tubular structure is approximately 30-ft long and comprises all the body parts through which food passes. DIF: Recall REF: p. 50 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 2. The small intestine is comprised of the cecum, colon, and rectum. The large intestine includes the duodenum, jejunum, and ileum. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: B Both statements are false. The statements are reversed. The small intestine is comprised of the duodenum, jejunum, and ileum. The large intestine includes the cecum, colon, and rectum. DIF: Recall REF: p. 50 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 3. Mechanical aspects of digestion include chewing and hypergeusia. Mechanical actions involve peristalsis, voluntary waves of contraction traveling the whole length of the alimentary tract. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: B Both statements are false. Mechanical aspects of digestion include chewing and peristalsis. Peristalsis is a series of involuntary, not voluntary, rhythmic waves of contraction traveling the whole length of the alimentary tract. Note that hypergeusia is a condition where the sense of taste is heightened. DIF: Recall REF: p. 50 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 4. Each is true of enzymes, except one. Which is the exception? a. Enzymes are complex proteins that are very specific. b. Enzymes regulate metabolic reactions so that they proceed slowly and thoroughly. c. Enzymatic reactions require a substrate. d. Only small amounts of an enzyme is needed to complete a reaction. ANS: B Enzymes enable metabolic reactions to proceed at a faster rate without being exhausted. Enzymes function similar to keys: they are highly specific and function on only one substrate, similar to a key fitting a particular lock. When the reaction is completed, the complex separates, releasing new chemical compounds and the enzyme. DIF: Comprehension REF: p. 50 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 5. Loss of smell results in a condition that limits capacity to detect flavor of food and beverages called: a. hypergeusia. b. dysgeusia. c. anosmia. d. phantom taste. e. peristalsis. ANS: C Anosmia, or loss of smell, results in limited capacity to detect flavor of food and beverage. Upper respiratory infections, nasal or sinus problems, and neurological disorders can cause anosmia. Hypergeusia is heightened taste acuity. Dysgeusia is persistent, abnormal distortion of taste. Phantom taste is dysgeusia without identifiable taste stimuli. Peristalsis is a mechanical action involved in digestion. It involves involuntary rhythmic waves of contraction in the alimentary tract. DIF: Recall REF: p. 52 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 6. Gluten sensitivity, an allergic condition, is an example of a systemic condition. Gluten-sensitive patients develop impairment of the small intestine. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: B Gluten sensitivity is an example of a systemic condition because it qualifies as a disease or disorder that affects the whole body, but it is not an allergic condition. Gluten-sensitive patients can develop gastrointestinal symptoms, but the small intestine is not impaired. Gluten is a protein composite found in foods processed from wheat. DIF: Recall REF: p. 61 OBJ: 5 TOP: NBDHE, 3.0 Biochemistry and Nutrition 7. During peristalsis, doorlike mechanisms called valves or sphincter muscles perform all of the following functions, except one. Which is the exception? a. Retain food in each segment until mechanical actions is complete. b. Allow measured amount of food to pass to next segment. c. Synthesize dietary enzymes necessary for chemical digestion. d. Prevent food from “backing up” into the preceding area. ANS: C Valves or sphincter muscles within the alimentary tract are strictly involved in mechanical aspects of digestion and do not synthesize dietary enzymes. An example of valvular peristaltic action is the small amounts of chyme that are released from the stomach through the pyloric sphincter to allow for adequate digestion and absorption in the small intestine. Regulation of these valves is complex, involving muscular function and different pressures on each side of the valve. DIF: Comprehension REF: p. 50 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 8. Food-drug interactions have the potential to cause nutritional problems. For example, consuming milk or milk products while taking amoxicillin decreases the amount of antibiotic and calcium available to the body. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: C The first statement is true; the second is false. Amoxicillin undoubtedly has other food-drug interactions, but it is tetracycline that interacts with milk and milk products. The result of this interaction is that lowered amounts of tetracycline and calcium are available to the body. DIF: Recall REF: p. 50 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 9. The use of over-the-counter enzyme tablets might not be beneficial to patients because the enzymes within the product are digested before they can be used. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: A Both the statement and the reason are correct and related. Prescription enzymes are more likely to have protective features which prevent the active ingredient from being digested prior to the point at which it can be used. For example, prescription pancreatic enzymes have a special enteric coating preventing the enzyme from exposure to gastric juices. An example of an OTC product that has such a protective feature is lactase which is effective for lactose intolerant because it is either added to or taken with lactose-containing foods. DIF: Comprehension REF: p. 50 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 10. Taste buds, receptors of taste located in the oral cavity, play an important role in the digestive system. Visual sensory perceptions associated with the presentation and color of food are known as gustatory sensations. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: C The first statement is true; the second is false. Gustatory refers to taste, which is one of the three sensory perceptions that influence food choices. The remaining two are sight and smell. As food is chewed, gustatory receptors are exposed to chemicals dissolved in saliva. DIF: Recall REF: p. 51 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 11. Each descriptions of taste papillae is true, except one. Which is the exception? a. A taste bud consists of 30 to 100 papillae. b. Taste papillae appear on the tongue as large red spots or small bumps. c. Taste papillae are most numerous on the dorsal epithelium of the tongue. d. Taste papillae replace themselves every 3 to 10 days. ANS: B Taste papillae appear on the tongue as little, not large, red dots, or raised bumps. They are most numerous on the dorsal surface of the tongue, which is the top surface. Disease, drugs, nutritional status, radiation, and age can affect taste papillae. DIF: Recall REF: p. 51 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 12. It is not uncommon for an elderly patient to state that food “just doesn’t taste good,” because the impairment of the olfactory nerves is prevalent in older adults. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: A Both the statement and the reason are correct and related. Aromas stimulate olfactory nerves, which are receptors for smell. Prevalence of impairment of olfactory nerves is high in older adults, with the problem increasing with age. DIF: Comprehension REF: p. 52 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 13. Gustatory and olfactory disorders can result in the deterioration of a patient’s general condition or nutritional status. Potentially adverse compensatory habits can contribute to dental caries and systemic conditions. a. Both the statement and the reason are correct and related. b. The statement is correct, but the reason is not correct. c. The statement is not correct, but the reason is correct. d. Neither the statement nor the reason is correct. ANS: A Both the statement and the reason are correct and related. It is not unusual for patients with impaired taste (gustatory) and smell (olfactory) senses to decline in health. In an effort to enjoy meals, many patients make compensatory changes such as adding of sugar and other sweeteners. These substances have detrimental health consequences, including dental caries and blood glucose disturbances. The addition of salt, another compensatory measure to improve the eating experience, negatively affects cardiovascular health. DIF: Comprehension REF: p. 52 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 14. Each is a function of saliva, except one. Which is the exception? a. Saliva is essential to gustatory sensations. b. Saliva lubricates oral tissues. c. Saliva provides antibacterial action. d. Saliva buffers bacterial acids. e. Saliva extracts calcium and phosphate from demineralized tooth surfaces. ANS: E Saliva restores or returns calcium, phosphates, and other minerals into surfaces of teeth that have been damaged by caries, erosion, or abrasion. Saliva is supersaturated with calcium phosphates. DIF: Recall REF: p. 52 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 15. Saliva is supersaturated with bacterial by-products that allow demineralized areas of hydroxyapatite in enamel to be remineralized. Demineralization occurs when calcium, phosphate, and other minerals migrate from the enamel surface into the dentin. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: B Both statements are false. Saliva is supersaturated with calcium phosphates that allow demineralized areas of hydroxyapatite in enamel to be remineralized. Remineralization is defined as the restoration or return of calcium phosphates and other minerals into damaged tooth surfaces. Demineralization occurs when calcium, phosphate, and other minerals are lost from tooth enamel, causing tooth enamel to dissolve. DIF: Recall REF: p. 52 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 16. Demineralization is a result of acids produced by fermentable carbohydrates combining with proteins to form prebiotics. Demineralization is caused by a lack of calcium intake or a calcium deficiency. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: B Both statements are false. Demineralization is a result of acids produced by fermentable carbohydrates combining with acidogenic bacteria. It is not caused by lack of calcium intake or a calcium deficiency. Note that prebiotics are nondigestible food ingredients that have beneficial effects within the large intestine and colon. DIF: Recall REF: p. 52 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 17. Hydrolysis of a starch begins with which enzyme? a. Salivary amylase b. Pepsin c. Pancreatic amylase d. Sucrase ANS: A Some chemical action or hydrolysis of nutrients begins in the mouth. Salivary amylase initiates starch digestion. If a carbohydrate, such as a cracker, is chewed and held in the mouth for a few seconds, it will begin to taste sweet. This denotes that some of the starch is being hydrolyzed to dextrin and maltose. Note that the name for many enzymes is derived from the name of its substrate, with the suffix -ase. Sucrase is the enzyme that hydrolyzes sucrose. DIF: Recall REF: p. 52 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 18. Digestion is accomplished solely through chemical activities on food because peristalsis permits blending of foodstuffs with digestive secretions. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: D The statement is not correct, but the reason is correct. Digestion involves two basic types of action on food: mechanical and chemical. Mechanical actions include chewing and peristalsis, both of which break up and mix foods. The mechanical actions permit better blending of foodstuffs with digestion secretions. DIF: Comprehension REF: p. 50 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 19. The accessory organs include the large and small intestines. The role of accessory organs is to store foodstuffs during the digestive process. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: B Both statements are false. The accessory organs are the salivary gland, liver, gallbladder, and pancreas. They provide secretions essential for digestion and absorption. DIF: Recall REF: p. 50 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 20. The maxilla and mandible need the forces of chewing to prevent calcium absorption. Chewing firm food helps to maintain a proper balance between bone breakdown and new bone formation within the alveolar process. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: D The first statement is false; the second is true. The maxilla and mandible need chewing forces to prevent the resorption, not absorption, of calcium. Resorption breaks down a substance; absorption integrates a substance into the body. Calcium absorption is a desired process, whereas calcium resorption is not. The alveolar process is the crest of the maxilla and mandible that serves as the bony investment for the teeth. DIF: Recall REF: p. 54 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 21. Missing teeth increase the potential for food obstruction in the airway because an inability to masticate food can result in larger chunks of food being swallowed. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: A Both the statement and the reason are correct and related. The act of chewing reduces food particle size. An inability to masticate food adequately can result in large chunks of food being swallowed, which increases the potential for food obstruction in the airway. Loss of even one permanent molar can decrease masticatory efficiency, which is defined as how well a patient prepares food for swallowing. DIF: Comprehension REF: p. 54 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 22. Masticatory efficiency refers to enhancement of gustatory effects. Even after a patient becomes fully adjusted to well-fitted dentures, masticatory efficiency is reduced compared with that of patients with their natural teeth. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: D The first statement is false; the second is true. Masticatory efficiency refers to how well a patient prepares food for swallowing. Gustatory sensations, more commonly known as the sense of smell, are intricately involved with appetite, but this is not definitive of masticatory efficiency. When masticatory efficiency declines, people frequently choose foods that require less chewing or they use techniques to soften foods, such as stewing meats, steaming vegetables, or dunking cookies in fluids. DIF: Recall REF: p. 54 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 23. Each is true of swallowing and processing food, except one. Which is the exception? a. The swallowing reflex moves a bolus into the esophagus. b. A bolus is a mass of food. c. The bolus is transported to the stomach by osmosis and gravity. d. The bolus penetrates the diaphragm through the esophageal hiatus. e. The lower esophageal sphincter relaxes to permit food into the stomach. ANS: C The bolus is transported to the stomach by peristalsis, not osmosis, and gravity. Peristalsis is a series of contractile waves that mechanically move the bolus through the alimentary tract. Note that osmosis is the passage of water through a semipermeable membrane to equalize osmotic pressure. This process involves ionic control of movement of water (fluids) across membranes. DIF: Recall REF: p. 54 OBJ: 2 | 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 24. The lower esophageal sphincter is a bony structure located within the stomach. It relaxes to permit food to move within the stomach on its way to the intestines. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: B The lower esophageal sphincter comprises a group of strong circular muscle fibers located just above the stomach. The lower esophageal sphincter relaxes to permit food into the stomach. DIF: Recall REF: p. 54 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 25. In a well-functioning alimentary tract, stomach contents do not “back wash” into the esophagus because the pyloric sphincter prevents foodstuff from seeping back into the esophagus. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: C The first statement is true; the second is false. When all components are functioning correctly, the lower esophageal, not pyloric, sphincter prevents backwash of foodstuff (chyme). The pyloric sphincter performs a similar task in a different location. It releases small amounts of chyme from the stomach into the small intestine for digestion and absorption. DIF: Recall REF: p. 54 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 26. A patient who reports stomach ulcers should avoid all the following foods, except one. Which is the exception? a. Proteins b. Caffeine c. Calcium d. Wheat ANS: D Patients with ulcers of certain gastrointestinal tract disorders should avoid dietary constituents that increase hydrochloric acid and pepsin secretion. Foods to avoid include proteins, calcium, caffeine, coffee, and alcohol. Conversely, wheat (a whole grain), brown rice, and pastas are usually well tolerated because they do not typically stimulate gastric secretions. Note that although wheat is problematic in patients with gluten sensitivity, it is not contraindicated in patients with ulcers. DIF: Comprehension REF: p. 55 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 27. An adult stomach functions as a reservoir to hold an average meal for 6 to 8 hours. The rate of passage through the stomach (fastest to slowest) is liquids, proteins, carbohydrates, and fats. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: D The first statement is false; the second is true. An adult stomach functions as a reservoir to hold an average meal for 3 to 4 hours. The stomach empties at different rates depending on its size and the composition of the chyme. The rate of passage, fastest to slowest, is liquids, carbohydrates, proteins, and fats. Note that fats remain in the stomach longer, increasing satiety for a longer time than proteins or carbohydrates. DIF: Recall REF: p. 55 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 28. Most absorption occurs in the stomach because the gastric juices secreted by the stomach effectively hydrolyze and prepare nutrients for absorption. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: E Neither the statement nor the reason is correct. Very little absorption occurs in the stomach because few foods are completely hydrolyzed to nutrients that the body can use at this stage. Nutrients that can be absorbed from the stomach include some water, alcohol, and a few water-soluble substances such as amino acids and glucose. Most of the energy-providing nutrients are completely hydrolyzed and absorbed within the small intestine. DIF: Comprehension REF: p. 55 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 29. Which is most likely to be absorbed within the stomach? a. Carbohydrates b. Fats c. Amino acids d. Fat-soluble vitamins ANS: C Most of the energy-providing nutrients are completely hydrolyzed and absorbed within the small intestine. The only nutrients completely absorbed within the stomach are water, alcohol, and a few water-soluble substances such as amino acids and glucose. Note that little absorption occurs in the stomach because few foods are completely hydrolyzed to nutrients that the body can use at this point. DIF: Recall REF: p. 55 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 30. Each accurately describes aspects of the villi, except one. Which is the exception? a. Fingerlike projections called villi rise from the intestinal lumen. b. Villi decrease the surface area of the alimentary tract by contraction and compression. c. Each villus is covered with a layer of epithelial cells called microvilli. d. The brush border of cells is formed by microvilli. ANS: B Villi increase, rather than decrease, the surface area of the alimentary tract to approximately 3000 square feet. Note that microvilli are minute cylindrical processes located on the surface of intestinal cells, greatly increasing their absorptive surface area. DIF: Recall REF: p. 56 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 31. Intestinal digestion of fats and insoluble molecules is enhanced because emulsification by bile salts facilitates breakdown of such substances into smaller particles. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: A Both the statement and the reason are correct and related. This question accurately describes emulsification, or breakdown of fats and soluble substances within the intestine. Importantly, emulsification allows greater exposure of fats to intestinal and pancreatic lipases. Peristalsis facilitates mixing and emulsification processes. DIF: Comprehension REF: p. 56 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 32. Pancreatic enzymes enter the colon through the pancreatic duct. Produced and stored in the pancreas, these enzymes hydrolyze carbohydrates, proteins, and fats. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: D The first statement is false; the second is true. Pancreatic enzymes enter the duodenum, not the colon, through the pancreatic duct. The duodenum is the first section of the small intestine. DIF: Recall REF: p. 56 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 33. Proteolytic enzymes are most likely to break down which food type? a. Carbohydrates b. Proteins c. Fats d. Lipids ANS: B Proteolytic enzymes target and break down proteins. Notice that the names of most enzymes begin with the type of food it targets and end in -ase. For example, lipase breaks down fats, also known as lipids. Other enzymes, such as pancreatic enzymes, contain the full name of the organ from which it originates. DIF: Recall REF: p. 56 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 34. Passage of a permeable substance from a more concentrated solution to an area of lower concentration is called osmosis. Transport requiring a carrier and cellular energy is active transport. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: D The first statement is false; the second is true. Osmosis, active transport, and passive diffusion are three mechanisms that aid in transporting materials during absorption of nutrients. Passage of a permeable substance from a more to a less concentrated solution is called passive diffusion. Osmosis is the passage of water through a semipermeable membrane to equalize osmotic pressure exerted by ions in solutions. Active transport is accurately described in the question. DIF: Recall REF: p. 57 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 35. Nutrients are absorbed from the small intestine through the mucosa into the portal circulation. Nutrients are transported through the portal vein to the liver where metabolism is initiated. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: A Both statements are true. The portal circulation enables passage of nutrients from the gastrointestinal tract and spleen through the portal vein to the liver. Most nutrients are absorbed from the small intestine through the mucosa into the portal circulation. The portal circulation delivers the nutrients to the liver where metabolism is initiated. DIF: Recall REF: p. 57 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 36. Most nutrients are absorbed from the small to the large intestine, where the majority of digestion occurs. As the large intestine reabsorbs water and electrolytes, it forms the residue, also called feces. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: D The first statement is false; the second is true. Almost no absorption occurs in the large intestine; most absorption occurs in the small intestine. The large intestine forms and stores the residue, or feces, until defecation. Residue in the intestinal tract is defined as the total amount of fecal solids. DIF: Recall REF: p. 58 OBJ: 5 TOP: NBDHE, 3.0 Biochemistry and Nutrition 37. Each is true of microflora within the colon, except one. Which is the exception? a. Approximately 50 different species of microorganisms compose the microflora. b. Microflora break down substances that human enzymes are unable to digest. c. Vitamin K and numerous B vitamins are synthesized by the microflora. d. Microflora inhibit pathogenic bacteria. ANS: A More than 1 trillion harmless bacteria thrive in the colon. Approximately 400 different species or microorganisms compose the microflora within the colon. Proliferation of pathogenic, or harmful, bacteria is inhibited by the protective features of the microflora. Types of food and medications ingested influence the type, activity, and relative numbers of bacteria. When intestinal flora is unbalanced, overall health can be affected. DIF: Recall REF: p. 58 OBJ: 5 TOP: NBDHE, 3.0 Biochemistry and Nutrition 38. Each is true of protective elements within the microflora, except one. Which is the exception? a. Prebiotics are food ingredients that must be digested to stimulate growth and activity of microorganisms. b. Probiotics are living microorganisms that are considered food or dietary supplements in the United States. c. Symbiotics are a combination of prebiotics that support growth of probiotics. d. Probiotics are helpful in managing and treating constipation. ANS: A Prebiotics are nondigestible food ingredients that have beneficial effects on the host by selectively stimulating the growth or activity, or both, of beneficial colonic microorganisms. Stated succinctly, prebiotics are food for probiotics. Probiotics together with prebiotics that support their growth are called symbiotics because they work together to promote probiotic benefits more efficiently. Although probiotics can help to regulate bowel habits and relieve constipation, they are frequently used to treat diarrhea and to prevent irritable bowel syndrome. Constipation means having a bowel movement fewer than three times per week with hard, dry, difficult-to-pass stools. DIF: Recall REF: p. 60 OBJ: 5 TOP: NBDHE, 3.0 Biochemistry and Nutrition 39. Each is true of wheat sensitivity, except one. Which is the exception? a. Celiac disease is an autoimmune disorder caused by permanent gluten sensitivity. b. If not treated, celiac disease damages the microvilli in the small intestine. c. Gluten sensitivity is both an allergic reaction and an autoimmune disorder. d. Celiac disease is more common in people of European origin. ANS: C Celiac disease and gluten sensitivity are two different conditions related to ingestion of gluten. Gluten is the structural protein component of the grains wheat, rye, barley, and triticale (a cross between wheat and rye). Whereas celiac disease is an autoimmune disorder, gluten sensitivity is neither allergic nor immunologic. Gluten-sensitive individuals are unable to tolerate gluten and can develop gastrointestinal symptoms, but the small intestine is not impaired (as is the case with celiac disease). A third category exists in which the patient develops an allergy to wheat. DIF: Comprehension REF: p. 61 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 40. Alveolar bone is primarily composed of bony spikes forming a meshwork of spaces within cancellous bone. This spikelike formation is called interdental bone. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: C The first statement is true; the second is false. The spikelike formation of bone that forms a meshwork of spaces within cancellous bone is called trabecular bone. Cancellous bone is internal bone that appears spongy with little hollows that contain bone marrow. DIF: Recall REF: p. 54 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 41. Lactose-intolerant individuals have a deficiency of both lactase and sucrase because breakdown of lactose involves conversion into two monosaccharides. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: E Neither the statement nor the reason is correct. Lactose intolerance is associated with a deficiency of lactase only. Although lactose is converted into two monosaccharides before exposure to gastric juices, the enzyme sucrose is not crucial. Note that sucrase is an enzyme necessary for proper metabolism of sucrose (sugar). DIF: Comprehension REF: p. 50 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 42. Each statement describes functions of the small intestine, except one. Which is the exception? a. Complete hydrolysis of most energy-providing nutrients b. Absorption of most vitamins and minerals c. Enzymatic breakdown of cellulose d. Secretion of digestive juices from its luminal wall ANS: C Cellulose, a carbohydrate found in plants, cannot be completely digested because the human body lacks enzymes that can hydrolyze and break it down. DIF: Comprehension REF: p. 57 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 43. Bile is produced and secreted by the liver and stored in the small intestine. Production of bile is stimulated by salivary amylase. a. Both statements are false. b. Both statements are true. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: A Both statements are false. Bile is produced and secreted by the liver and stored in the gallbladder, not small intestine. Production of bile is stimulated by cholecystokinin, not salivary amylase, a hormone released in response to fat in chyme. Note that acidic chyme entering the intestine stimulates hormones to release pancreatic juices. DIF: Recall REF: p. 56 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 44. The basic hydrolysis reactions necessary for food digestion depend upon sugars because these complex carbohydrate-based substances enable completion of metabolic reactions at an efficient rate. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: E Neither the statement nor the reason is correct. The basic hydrolysis reactions depend on enzymes because these complex proteins are responsible for enabling completion of metabolic reactions at a fast rate without exhausting themselves. DIF: Comprehension REF: p. 50 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 45. Each is true of carbohydrate digestion, except one. Which is the exception? a. Digestion begins with salivary amylase. b. Hydrolysis begins within the mouth. c. Ptyalin is an enzyme involved in carbohydrate digestion. d. Xerostomia increases digestive function. ANS: D Xerostomia, dry mouth from inadequate salivary section, leads to diminished digestive function. Much digestion, including that of carbohydrates, begins in the mouth with the action of salivary amylase. Note that this digestive enzyme, also called ptyalin, initiates starch digestion. DIF: Comprehension REF: p. 52 OBJ: 2 | 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 46. Which substance is most essential for hydrolyzing large protein molecules? a. Gastric lipase b. Pepsin c. Mucus d. Intrinsic factor ANS: B Although many enzymes are involved in hydrolysis and digestion, pepsin is essential for hydrolysis large protein molecules. Mucus forms an alkaline coating that protects the stomach lining from digestion by pepsin. Gastric lipase is involved in digestion of short-and medium-chain triglycerides. Intrinsic factor is secreted by the stomach and is essential for absorption of vitamin B12. DIF: Recall REF: p. 55 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 47. Which enzyme is most essential for digestion of triglycerides found in butterfat? a. Gastric lipase b. Pepsin c. Mucus d. Intrinsic factor ANS: A Gastric lipase is essential for digestion of short- and medium-chain triglycerides, such as those found in butter fat. Pepsin is essential for hydrolysis of large protein molecules. Mucus forms an alkaline coating that protects the stomach lining from digestion by pepsin. Intrinsic factor is secreted by the stomach and is essential for absorption of vitamin B12. DIF: Recall REF: p. 55 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition Chapter 01: Overview of Healthy Eating Habits Stegeman: The Dental Hygienist’s Guide to Nutritional Care, 5th Edition MULTIPLE CHOICE 1. Each is true regarding designations for professionals in the field of nutrition, except one. Which is the exception? a. A nutritionist usually works in a public health setting. b. A registered dietitian (RD) must pass a national registration examination. c. An RD who works in public health can call herself a registered dietitian nutritionist (RDN). d. A dietetic technician, registered (DTR) works under supervision of a registered nurse. ANS: D A dietetic technician, registered (DTR) normally works under the supervision of a registered dietitian. Like the registered dietitian, the DTR must pass a national registration examination and receive continuing education. Although the DTR can complete a 4-year curriculum, there also is a 2-year option. Regarding the distinction between the registered dietitian and the nutritionist, all registered dietitians are nutritionists, but not all nutritionists are registered dietitians. DIF: Comprehension REF: p. 2 OBJ: 1 TOP: NBDHE, 3.0 Biochemistry and Nutrition 2. Nutrition is the process by which living things use food to obtain nutrients for energy, growth and development. Energy is the measure of heat equivalent to 1000 cal needed to do work. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: C The first statement is true; the second is false. The process by which living things use food to obtain nutrients for energy is nutrition. Energy is the ability or power to do work, whereas a kilocalorie (kcal) is a measure of heat equivalent to 1000 cal. The second statement confuses energy with the definition of a kilocalorie. DIF: Comprehension REF: p. 2 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 3. Increase in consumption of which of the following has the greatest effect on an increase in body weight? a. Carbohydrate intake b. Protein intake c. Fat intake d. Kilocalorie intake ANS: D There is little evidence that any individual calorie food group (carbohydrate, protein, and fat) has a unique effect on body weight. Kilocalories are the key factor to controlling body weight—not the proportions of fat, carbohydrates, and protein, but balancing caloric intake with energy expenditure. DIF: Recall REF: pp. 8-9 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 4. Each is true regarding weight maintenance, except one. Which is the exception? a. 1600 to 2400 kcal are recommended for adult women. b. 2000 to 3000 kcal are recommended for adult men. c. Kilocalories from alcohol do not count because they are expended rapidly. d. A patient needing 2000 kcal/day should limit saturated fat intake to 20 g or less. ANS: C Like energy-producing nutrients (carbohydrates, proteins, and fats), kilocalories from alcohol must be balanced with energy expenditure. In short, kilocalories from alcohol contribute to weight gain in the same manner as any other substance consumed. DIF: Comprehension REF: p. 14 OBJ: 7 TOP: NBDHE, 3.0 Biochemistry and Nutrition 5. Dietary guidelines recommend lowering caloric requirements for older adults because metabolic rate increases with age. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: C The statement is correct, but the reason is not correct. Metabolic rate decreases, not increases, with age. For this reason, the caloric requirements are lowered. Failure to lower the caloric intake without an accompanying increase in expenditure of energy will result in weight gain. For older individuals, this can be very serious because joint and cardiac function can be further stressed. DIF: Comprehension REF: p. 9 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 6. A kilocalorie is the heat equivalent of how many calories? a. 10 b. 100 c. 1000 d. 10000 ANS: C 1000 cal are equivalent to 1 kilocalorie (kcal). DIF: Recall REF: p. 3 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 7. Each nutrient provides energy, except one. Which is the exception? a. Proteins b. Carbohydrates c. Fats d. Vitamins e. Alcohol ANS: D Vitamins do not provide energy, nor do minerals. Although proteins, carbohydrates, fats, and alcohol provide energy, the body cannot use energy from the energy-containing components of food without adequate amounts of vitamins and minerals. DIF: Recall REF: p. 3 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 8. Increasing the variety of foods often causes nutrient excesses and toxicities. A dietary change to eliminate or increase intake of one specific food or nutrient usually alters the intake of other nutrients. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: D The first statement is false; the second is true. Increasing the variety of foods is recommended to reduce the probability of developing isolated nutrient deficiencies, nutrient excesses, and toxicities resulting from nonnutritive components or contaminants in any particular food. For example, because red meats are an excellent source of iron and zinc, decreasing cholesterol intake by limiting these meats can reduce dietary iron and zinc intake. DIF: Comprehension REF: p. 3 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 9. Precursors are substances from which an active substance is formed. Nonessential nutrients cannot be synthesized from other substances. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: C The first statement is true; the second is false. Nonessential nutrients can be used by the body; they either are not required or can be synthesized from dietary precursors. Carotene is a precursor to vitamin A. It is found in fruits and vegetables and is converted to an active form of vitamin A by the liver. DIF: Recall REF: p. 3 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 10. Which nutrient is the most important? a. Protein b. Carbohydrate c. Minerals d. Water ANS: D Water is the most important nutrient. After water, nutrients in highest priority are those that provide energy, which must be provided from foods or can be supplied from quantities stored in the body. DIF: Recall REF: p. 3 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 11. The human body has adaptive mechanisms that tolerate modest ranges in nutrient intakes. The metabolic rate usually increases to compensate for decreased caloric intake. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: C The first statement is true; the second is false. The human body adapts to tolerate a modest range of nutrient intake. However, the metabolic rate usually decreases to compensate for decreased caloric intake. This is an adaptive mechanism that “saves” energy for future needs in situations of decreased nutritional intake. DIF: Recall REF: p. 3 OBJ: 2 TOP: NBDHE, 3.0 Biochemistry and Nutrition 12. Healthy People 2020, issued by the U.S. Department of Health and Human Services, has influenced a remarkable reduction in childhood obesity. Since the programs’s initiation, the number of children participating in annual dental visits has increased. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: B Both statements are false. A midcourse progress report for Healthy People 2020 indicates little to no detectable change in rates of childhood obesity. The number of children who had an annual dental visit actually declined, since the instigation of the program. DIF: Recall REF: p. 4 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 13. Dietary reference intakes (DRIs) do NOT: a. replace the older recommended daily allowances. b. attempt to estimate required nutrients to improve long-term health. c. specifically address individuals whose requirements are affected by a disease state. d. attempt to establish maximum safe levels of tolerance for nutrients. ANS: C Dietary reference intakes (DRIs) are inappropriate for malnourished individuals or patients whose requirements are affected by a disease state. DRIs were intended for planning and assessing diets of healthy Americans and Canadians. DRIs replace an earlier publication, the recommended daily allowances (RDAs). Note that there is also a new RDA which is intended as a goal for achieving adequate intakes. DIF: Recall REF: p. 4 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 14. Which set of guidelines is intended to assess population groups, not individuals? a. Old recommended dietary allowances (RDAs) b. Estimated average requirement (EAR) c. New recommended dietary allowances (RDAs) d. Tolerable upper intake level (UL) ANS: B The estimated average requirement (EAR) is the amount of a nutrient that is estimated to meet the needs of half of the healthy individuals in a specific age and gender group. This set of values is useful in assessing nutrient adequacy or planning intakes of population groups, not individuals. DIF: Recall REF: p. 4 OBJ: 3 TOP: NBDHE, 3.0 Biochemistry and Nutrition 15. The average amount of a nutrient that seems to maintain a defined nutritional state is measured by the: a. recommended daily allowance (RDA). b. estimated average requirement (EAR). c. adequate intake (AI). d. acceptable macronutrient distribution ranges (AMDRs). ANS: C To overcome shortcomings in both the EAR and the RDA, an AI was established. Derived from mean nutrient intakes by groups of healthy people and based upon scientific judgments, an AI is the average amount of a nutrient that seems to maintain a defined nutritional state. Values were established for various life stages for several nutrients, including fluoride. AMDRs were established for the macronutrients, fat, carbohydrate, protein, and two polyunsaturated fatty acids, to ensure sufficient intakes of essential nutrients. DIF: Recall REF: p. 4 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 16. Which is NOT true of the acceptable macronutrient distribution ranges (AMDRs)? a. AMDRs were established to ensure sufficient intakes of the micronutrients. b. One focus of the AMDRs is reduction of chronic disease. c. Macronutrients are fat, carbohydrate, protein, and two polyunsaturated fatty acids. d. Consuming amounts outside the AMDRs increases risk of insufficient intake of essential nutrients. ANS: A AMDRs were established for the macronutrients, fat carbohydrate, protein, and two polyunsaturated fatty acids, rather than the micronutrients, like vitamins and minerals. The goal of the guideline is to ensure sufficient intakes of essential nutrients, while reducing risk of chronic disease. DIF: Recall REF: p. 4 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 17. Acceptable macronutrient distribution ranges (AMDRs) are expressed as a percentage of total energy intake because an intake of each depends on intake of the others or of the total energy requirement of the individual. Increasing or decreasing one energy source while consuming a set amount of kilocalories affects the intake of the other sources of energy. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: A Both the statement and the reason are correct and related. For example, if an individual who routinely consumes 2000 kcal decides to reduce the amount of fat ingested, either the protein or carbohydrate intake would need to increase proportionately. DIF: Comprehension REF: p. 4 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 18. The nutrient-based reference value that is defined as dietary energy intake predicted to maintain energy balance in healthy individuals of a defined age, gender, and weight is the: a. acceptable macronutrient distribution ranges (AMDRs). b. estimated energy requirement (EER). c. recommended daily allowance (RDA). d. estimated average requirement (EAR). ANS: B The estimated energy requirement (EER) is similar to the EAR. The major difference is that the EAR is the amount of a nutrient that is estimated to meet the needs of half of the healthy individuals in specific groups, whereas the EER addresses all healthy individuals in terms of age, sex, weight, height, and physical activity. Because energy requirement depends on activity level, four different activity levels are provided. DIF: Recall REF: p. 5 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 19. Each, except one, is a valid consideration for a dental hygienist when making dietary recommendations. Which is the exception? a. The dietary reference intakes (DRIs) can be used as an assessment guide for all patients. b. An individual’s exact requirement for a specific nutrient is not known. c. The upper limits (ULs) can be used to warn patients of adverse effects of excessive intake of nutrients. d. The DRIs are general guidelines and do not provide specific requirements. e. Specific foods or groups of foods should be discussed rather than nutrients. ANS: A DRIs are designed as an assessment guide for healthy patients only. These guidelines apply to average daily intakes, and they should be met by consuming a variety of foods whenever possible. Patients with specific illnesses or dietary imbalances should be referred to as registered dietitian. DIF: Recall REF: p. 5 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 20. The MyPlate food guidance icon is divided into sextants, each of which is a different color to represent a different food type. MyPyramid replaced the well-known MyPlate icon in 2011. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: B Both statements are false. In 2011, the well-known food guide MyPyramid was replaced with MyPlate. This new food guidance system is divided into four quadrants, not six sextants, to represent a different food type—protein, grain, fruit, and vegetables. DIF: Recall REF: p. 16 OBJ: 9 TOP: NBDHE, 3.0 Biochemistry and Nutrition 21. Each accurately describes features of MyPlate, except one. Which is the exception? a. MyPlate replaces the well-known food guide, MyPyramid. b. The interactive website is intended to help consumers apply personalized dietary guidance. c. MyPlate materials on the website can be printed in English or French. d. Foods providing similar types of nutrients are grouped together and emphasizes proportionality of food selections. e. MyPlate is designed as a food guidance tool for the general public. ANS: C MyPlate brochures, tip sheets, graphics, and archived material can be printed from the website in English or Spanish, not French. DIF: Recall REF: p. 17 OBJ: 9 TOP: NBDHE, 3.0 Biochemistry and Nutrition 22. Which message is NOT synonymous with MyPlate? a. Fruits and vegetables should fill half the plate. b. Fruit juices should be consumed frequently. c. Lean proteins foods should be chosen in moderation. d. Whole grains should occupy about one fourth of the plate. e. Physical activity is encouraged through the activity tab that has links to MyJournal. ANS: B Although any fruit or 100% fruit juice counts as part of the fruit group, MyPlate suggests that people minimize fruit juice. Because of their fiber content, fresh, frozen, canned, or dried fruits are recommended. Note that the physical activity tab has links that discuss methods for incorporating an individualized exercise plan. The “Super Tracker” and MyJournal can help to plan, analyze, and track food intake and physical activity. Note that milk products, especially fat-free or low-fat, should be incorporated. DIF: Comprehension REF: p. 9 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 23. Most vegetables are low in calories, but high in water and fiber content. This high water and fiber composition counteracts the low levels of cholesterol present in many dark-green vegetables. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: C The first statement is true; the second is false. Due to their high water and fiber content, most vegetables are relatively low in calories. Vegetables do not contain cholesterol. DIF: Comprehension REF: p. 9 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 24. Which food provides the most protein? a. Beans b. Red peppers c. Asparagus d. Celery ANS: A Beans are an unusual vegetable because they are in both the vegetable and protein groups. Beans contain protein, fiber, calcium, folic acid, and potassium. DIF: Recall REF: p. 9 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 25. It is difficult for consumers to identify whole grain products because labeling is inconsistent and color is a poor indicator. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: A The difficulty in identifying whole grains is a major barrier to consuming adequate amounts of whole grains. Descriptive labels such as “100% wheat,” “stone ground,” and “multigrain” do not guarantee whole grain. In addition, color is a poor indicator because molasses or caramel food coloring may be added. DIF: Application REF: p. 10 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 26. Each is true of dietary considerations from the milk and milk product groups, except one. Which is the exception? a. Fortified milk products are important sources of vitamin D. b. Many mild substitutes are not fortified with vitamin D. c. Children 2 to 3 years of age need 2 cups of milk daily. d. Whole milk and many cheeses are high in unsaturated fat. ANS: D Whole milk and many cheeses are high in saturated fat and can have negative health consequences. Low-fat or fat-free milk products provide little or no fat and should be chosen most often to avoid consuming more kilocalories than needed. DIF: Recall REF: p. 11 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 27. The dairy group includes butter and cream because they are high in calcium, riboflavin, and protein. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: E High-fat products such as butter and cream are not included in the dairy products group because they are not high in calcium, riboflavin, and protein. DIF: Comprehension REF: p. 11 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 28. Consumption of milk and milk products can promote the achievement of peak bone mass in children and adolescents. Studies indicate that higher dairy consumption is associated with decreased dental caries but has no effect on periodontal disease. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: C The first statement is true; the second is false. Studies indicate that higher dairy consumption correlates with decreased prevalence and severity of both dental caries and periodontal health. DIF: Recall REF: p. 11 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 29. Current scientific evidence shows that most people consume only half the required amount of protein. Protein supplements promoted to increase muscle mass contain several amino acids not easily absorbed from foods. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: B Both statements are false. Most individuals consume adequate amounts (or more) of protein foods. Protein supplements do not contain nutrients important for health other than what foods provide. These should be used only after consulting a health care provider or registered dietitian. DIF: Recall REF: p. 11 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 30. Which is NOT a macronutrient? a. Fat b. Polyunsaturated fatty acids c. Carbohydrate d. Protein e. Vitamins ANS: E Vitamins and minerals are considered micronutrients, not macronutrients. Macronutrients are defined as being the classes of chemical compounds, humans consume in the largest quantities and which provide bulk energy. Conversely, micronutrients are needed by the body in small amounts. DIF: Recall REF: p. 4 OBJ: 4 TOP: NBDHE, 3.0 Biochemistry and Nutrition 31. Magnesium is NOT a principal nutrient in which food group? a. Vegetable b. Fruit c. Grain d. Dairy ANS: B Magnesium is not a principal nutrient in fruit and meat food groups. Vegetables, whole grains, and dairy are dietary sources of magnesium. DIF: Comprehension REF: p. 7, Table 1.2 OBJ: 5 TOP: NBDHE, 3.0 Biochemistry and Nutrition 32. Each daily reference value (DRV) is correct, except one. Which is the exception? a. Protein: 50 g b. Carbohydrate: 300g c. Total fat: <65 g d. Sodium: <2400 mg e. Fiber: 50 g ANS: E The daily reference value for fiber is 25 g. Note that the daily reference values (DRVs) do not appear on the nutrient label. Instead the term daily value appears on the label for ease of understanding and reflects the DRV and the DRI standards to encourage a healthy diet. In addition, the DRI for protein has been established for certain groups. The 50 g of protein in the DRV is for adults and children older than 4 years of age only. DIF: Recall REF: p. 21, Box 1.3 OBJ: 10 TOP: NBDHE, 3.0 Biochemistry and Nutrition 33. The process of restoring iron, thiamin, riboflavin, folic acid, and niacin removed during processing to approximately their original levels is called: a. fortification. b. enrichment. c. satiety. d. ghrelin. ANS: B The process of restoring nutrients removed during processing is called enrichment. This process is controlled by the U.S. Food and Drug Administration (USDA), which establishes the quantity of nutrients that can be added. White bread is an example of a highly enriched product. Fortification is the process of adding nutrients not present in the natural product or increasing the amount above that in the original product. Satiety is the feeling of fullness provided by food. Fats provide more satiety than do lean proteins. Ghrelin is an appetite-stimulating hormone that is suppressed by proteins better than by carbohydrates and lipids. DIF: Recall REF: p. 10 OBJ: 6 TOP: NBDHE, 3.0 Biochemistry and Nutrition 34. The nutrient facts label was established by the USDA and the FDA to improve health and well-being by enhancing nutritional knowledge. Nutrient content claims describe a relationship between a food or food component and reduced risk of a disease or health-related condition. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true. ANS: C The first statement is true; the second is false. Two categories of claims currently can be used on food labels: nutrient content claims and health claims. Nutrient content claims describe the percentage of a nutrient in a product relative to the daily value. Health claims describe a relationship between a food or food component and reduced risk of a disease or health-related condition. DIF: Comprehension REF: p. 21 OBJ: 10 TOP: NBDHE, 3.0 Biochemistry and Nutrition 35. Each is true of terminology on food nutrition labels, except one. Which is the exception? a. Daily reference values (DRVs) are the levels of nutrients considerable desirable for health. b. A product’s nutrient profile is based on the percentage of DRVs, but the term daily value (DV) is used on the label. c. For ease of standardizing the label, 2000 kcal is the reference amount for calculating the percentage of the DV in a serving. d. The amounts for the nutrients are based on the daily value (DV). ANS: D For ease of labeling, although nutrient label information uses the term daily value, the amounts for the nutrients are based on the reference daily intake (RDI). Recall that the RDI is usually larger than the RDA for a specific age/gender group. DIF: Comprehension REF: p. 21 OBJ: 10 TOP: NBDHE, 3.0 Biochemistry and Nutrition 36. Qualified health claims must be supported by qualified experts because although they are supported by some evidence, they do not meet the scientific standard. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct, but they are not related. c. The statement is correct, but the reason is not correct. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: D Health claims on foods are limited and regulated in an effort to protect consumers. Although qualified health claims are supported by some evidence, they do not meet scientific standards. For this reason, qualified claims must be accompanied by a disclaimer as specified by the U.S. Food and Drug Administration (FDA). Such a health claim must use the exact wording specified by the FDA. The other type of health claim, unqualified, must be supported by qualified experts agreeing that a relationship exists between the nutrient and product and a specific disease. DIF: Comprehension REF: p. 21 OBJ: 10 TOP: NBDHE, 3.0 Biochemistry and Nutrition 37. The Nutrition Facts Panel on brownie mix shows the following: 1 serving is one twentieth of the mix. Each serving contains 120 cal, 20 cal from fat, 17 g of sugar, and 10 g of protein. What is the approximate percentage of sugar in the brownie mix? a. 17% b. 27% c. 57% d. 73% ANS: C Approximately 57% of the brownie mix is sugar. This is calculated by (1) multiplying the number of grams of sugar in a product by 4 kcal/g, (2) dividing this number by the total number of kilocalories per