This Document Contains Chapters 13 to 14 Chapter 13 The Water-Soluble Vitamins Multiple Choice Questions 1. Most B-vitamins function as A. fat-soluble vitamins. B. coenzymes. C. antibodies. D. sources of energy. 2. In which of the following metabolic pathways are coenzymes required? A. glycolysis B. citric acid cycle C. beta-oxidation D. electron transport chain E. All of these answers are correct. 3. In general, excess amounts of water-soluble vitamins are excreted via the A. kidneys. B. intestine. C. lungs. D. skin. 4. Nutritionally, the difference between brown rice and white rice is A. the presence of bran and germ layers in the brown rice, which have most of the nutrients. B. negligible. There is a little more thiamin in white rice than brown rice. C. fiber content. White rice has more fiber. D. there is more thiamin and fiber in white rice. 5. The nutrients added to enriched grains typically include A. all of the B vitamins. B. vitamin C, pantothenic acid, folic acid, and zinc. C. thiamin, riboflavin, niacin, folic acid, and iron. D. vitamin B-6, folic acid, vitamin B-12, and iron. 6. The vitamin that prevents beriberi is A. vitamin B-12. B. riboflavin. C. niacin. D. thiamin. 7. Thiamin pyrophosphate (TPP), the coenzyme form of thiamin, is A. essential for the various oxidation-reduction reactions of the electron transport system. B. essential for the addition of two carbon fragments to fatty acids. C. essential for the oxidative decarboxylation of pyruvate. D. not really needed because our contemporary diets are low in carbohydrate. 8. Thiamin should be given to an alcoholic patient who has A. pellagra. B. Wernicke-Korsakoff syndrome. C. pernicious anemia. D. scurvy. 9. A nutrient-dense source of thiamin is A. citrus fruits. B. milk and milk products. C. pork and pork products. D. leafy green vegetables. 10. The best sources of thiamin in the average diet are A. pork products, whole or enriched grains and cereals, and legumes. B. root vegetables and cheddar-type cheese. C. whole grains and fresh fruit. D. ham and vegetables of the cabbage family. 11. A deficiency of thiamin that affects the cardiovascular, muscular, nervous, and gastrointestinal systems is called A. megaloblastic anemia. B. pellagra. C. scurvy. D. beriberi. 12. The coenzyme form of riboflavin is A. TPP. B. ATP. C. FAD. D. NAD. 13. Riboflavin coenzymes function in a variety of metabolic pathways, such as A. beta-oxidation of fatty acids. B. the citric acid cycle. C. the electron transport chain. D. All of these choices are accurate. 14. Which of the following foods represents the most nutrient-dense source of riboflavin? A. low-fat milk B. applesauce C. whole wheat bread D. green leafy vegetables 15. The B-vitamin most easily destroyed by exposure to light is A. biotin. B. niacin. C. riboflavin. D. thiamin. 16. A painful, red, inflamed tongue is called A. glossitis. B. cheilosis. C. stomatitis. D. anemia. 17. In the average U.S. diet, a quarter of the riboflavin comes from one food group, the A. fruit group. B. vegetable group. C. milk group. D. grains group. E. meat & beans group. 18. To protect riboflavin from destruction by sunlight, milk and milk products are packaged in A. clear glass bottles. B. paper and opaque plastic cartons. C. clear plastic bottles and cartons. D. any kind of container. 19. One cause of fatigue and anemia in adolescent girls with low dairy product intake is deficiency of _________. A. vitamin C B. calcium C. lactose D. riboflavin 20. The riboflavin coenzymes have _______ functions in cellular metabolism. A. antioxidant B. chelating C. oxidation and reduction D. single carbon group transfer 21. An excess intake of riboflavin either from diet or supplements is mainly A. excreted in the urine. B. excreted in bile and feces. C. stored in all body cells. D. stored in the liver. 22. Niacin can be obtained from foods as the vitamin itself (preformed niacin) or be synthesized A. from the B vitamin riboflavin. B. from the essential amino acid tryptophan. C. by bacteria in the large intestine. D. All of the choices are correct. 23. A characteristic symptom of niacin deficiency is A. cracks at the corners of the mouth. B. a purple-red tongue. C. severe edema. D. inflammation of the skin after exposure to the sun. 24. The coenzyme forms of niacin include A. nicotinic acid and nicotinamide. B. FAD and FMN. C. NAD and NADP. D. ATP and FAD. 25. Niacin is necessary in the diet to prevent the disease called A. pernicious anemia. B. beriberi. C. scurvy. D. pellagra. 26. The fact that the amino acid tryptophan can be converted to niacin by the body explains why A. diets high in protein could prevent or cure pellagra. B. corn-based diets prevent pellagra. C. gelatin cures pellagra. D. alcoholics sometimes develop Wernicke-Korsakoff syndrome. 27. Bright yellow urine usually is indicative that someone is supplementing with A. niacin. B. vitamin A. C. vitamin K. D. riboflavin. 28. Flushing of the face and skin can result from pharmacological doses of A. vitamin B-6. B. thiamin. C. folate. D. niacin. 29. The nutrient sometimes prescribed by physicians to increase HDL-cholesterol and lower triglyceride levels is A. thiamin. B. folic acid. C. niacin. D. None of these choices are accurate. 30. Important contributors to niacin intake in the American diet are A. poultry, meat, and fish. B. citrus fruits, kiwi, and bananas. C. milk, cheese, and yogurt. D. spinach, kale, and broccoli. 31. Thiamin, niacin, and riboflavin work together in important biochemical pathways that A. synthesize collagen. B. control the visual process. C. promote absorption of calcium. D. release energy from carbohydrate, fat, and protein. 32. A diet that provides 75 g protein per day can contribute __________ mg niacin from tryptophan. A. 25 B. 7.5 C. 12.5 D. 12 per day) can inhibit absorption of A. folate. B. vitamin B-12. C. pantothenic acid. D. biotin. 41. Those most likely to experience a biotin deficiency are A. adolescents with low energy and, thus, low biotin intake. B. alcoholics with impaired biotin absorption. C. infants lacking an enzyme required for biotin absorption. D. All of these choices are accurate. 42. Pyridoxal, pyridoxine, and pyridoxamine are three forms of A. vitamin B-12. B. vitamin P. C. folic acid. D. vitamin B-6. 43. Pyridoxal phosphate A. participates in reactions that synthesize dispensable amino acids. B. participates in reactions that synthesize indispensable amino acids. C. prevents premenstrual syndrome. D. is a natural oral contraceptive. 44. Neurotransmitter synthesis requires the vitamin B-6 coenzyme. Which of the following is classified as a neurotransmitter? A. norepinephrine B. gamma-aminobutyric acid (GABA) C. serotonin D. All of these choices are accurate. 45. The best food sources of vitamin B-6 are A. meats, fish, and poultry. B. milk and dairy products. C. carrots, celery, and squash. D. enriched breads and cereals. 46. Symptoms of vitamin B-6 deficiency include A. depression, confusion, and convulsions. B. microcytic anemia. C. dermatitis. D. All of these choices are accurate. 47. Irreversible nerve damage may be caused by excessive intake of _______ supplements. A. vitamin B-12 B. vitamin B-6 C. tryptophan D. vitamin C 48. In addition to its role in amino acid metabolism, vitamin B-6 is also required for A. fatty acid metabolism. B. the release of glucose from glycogen. C. the electron transport chain. D. glycolysis. 49. Research shows that supplemental vitamin B-6 is most likely to aid those experiencing A. nausea associated with pregnancy. B. pellagra. C. premenstrual syndrome. D. depression. 50. Red blood cells turn over every A. 20 minutes. B. 20 hours. C. 2 months. D. 120 days. 51. To calculate the DFE for the diet, multiply total synthetic folic acid intake by ____; add that value to the total food folate. A. 1.7 B. 2.5 C. 4.0 D. None of these choices are accurate. 52. In a dietary deficiency of folate, there are decreasing numbers of mature red blood cells to carry the oxygen from the lungs to the tissues. This condition is known as A. achlorhydria. B. megaloblastic anemia. C. ariboflavinosis. D. hemorrhagic disease. 53. A biochemical function of THFA (tetrahydrofolate) is A. transfer of NH2 groups from amino acids to CO2 to form urea. B. transfer of hydrogens and electrons through the various energy-yielding pathways. C. removal of CO2 from various intermediates in the citric acid cycle. D. accepting or donating single-carbon molecules in various metabolic pathways. 54. A major role of folate in cellular metabolism is the A. synthesis of steroid hormones. B. conversion of polyunsaturated fatty acids to saturated fatty acids. C. formation of glucose from galactose and fructose. D. synthesis of purine and pyrimidine bases in RNA and DNA. 55. The cells most sensitive to a deficiency of dietary folate are cells that A. have a short life span and rapid turnover rate. B. have to last a lifetime. C. function in the immune system. D. are classified as phagocytes. 56. ________ are very large immature red blood cells, which are formed as a result of folate deficiency. A. Erythrocytes B. Megaloblasts C. Lymphocytes D. Platelets 57. A defect in the formation of the neural tube during early fetal development can occur from a lack of A. biotin. B. folate. C. vitamin B-6. D. choline. 58. Folate in foods can be destroyed by A. food processing and preparation. B. ultraviolet light. C. oxidation. D. All of these choices are accurate. 59. Good sources of folate include A. enriched cereals and grains. B. leafy green vegetables. C. oranges. D. dried beans. E. All of these choices are accurate. 60. It is very difficult to consume excess folic acid from nonprescription vitamin supplements because A. folic acid is never included in over-the-counter nutrient supplements. B. the FDA limits the amount of folic acid in supplements to 400 micrograms per capsule. C. folic acid in pill form imparts an unpleasant taste so that no one would ever attempt to take extra amounts. D. absorption of the vitamin is age-related. As we get older we automatically adjust the amount we absorb to more than the maximum level. 61. Which group of individuals has the highest requirement for folate? A. infants B. adolescent males C. pregnant women D. the elderly 62. Which group of individuals is advised to consume 400 micrograms of folic acid daily from supplements and/or fortified foods? A. infants B. the elderly C. athletes D. women capable of becoming pregnant 63. Vitamin B-12 is supplied mostly in A. fruits and vegetables. B. cereal grains. C. foods of animal origin. D. None of these answers are correct. 64. Persons who smoke have an increased need for A. vitamin B-12. B. vitamin C. C. folate. D. biotin. 65. Intrinsic factor is produced by the A. beta-cells of the pancreas. B. salivary glands. C. parietal cells of the stomach. D. enterocytes of the small intestine. 66. Vitamin B-12 is absorbed in the A. stomach. B. duodenum. C. jejunum. D. ileum. 67. For vitamin B-12 to be absorbed, it must be attached to A. an incomplete protein. B. intrinsic factor. C. bile. D. the protein portion of its final coenzyme form. 68. The B-vitamin that has significant liver stores is A. niacin. B. folate. C. biotin. D. vitamin B-12. 69. Individuals most likely to experience poor vitamin B-12 status are A. elderly adults, due to atrophic gastritis. B. infants, due to low vitamin B-12 content in breast milk. C. athletes, due to high vitamin B-12 requirements. D. pregnant women, due to high vitamin B-12 requirements. 70. Pernicious anemia is treated most often by A. a diet high in milk and dairy products. B. regular intramuscular injection of vitamin B-12. C. oral supplementation of iron. D. eating liver three times a week. 71. A major role of vitamin B-12 in cellular metabolism is A. transfer of a methyl group to the amino acid homocysteine, forming the amino acid methionine. B. transfer of a methyl group to the pyrimidine uracil, forming the pyrimidine thymine. C. in transamination reactions, allowing the synthesis of nonessential amino acids. D. as an electron acceptor, allowing function of the electron transport chain. 72. Megaloblastic anemia develops as a result of deficiencies of ________ and _____. A. thiamin; riboflavin. B. vitamin B-6; folate. C. folate; vitamin B-12. D. vitamin K; folate. E. All of these choices are accurate. 73. Which of the following factors can interfere with the absorption of vitamin B-12? A. Surgical removal of the stomach B. Defective R-protein synthesis C. Infections of the ileum or surgical removal of the ileum D. All of these choices are accurate. 74. A strict vegan diet may lack A. vitamin B-12. B. vitamin C. C. vitamin A. D. niacin. 75. Vitamin B-12 is found in which of the following foods? A. orange juice B. dark green leafy vegetables C. seed oils D. chicken 76. Supplements of the water-soluble vitamins ______ and _______ are most likely to cause toxicity symptoms. A. thiamin; riboflavin B. vitamin B-12; pantothenic acid C. vitamin B-6; vitamin C D. biotin; vitamin B-12 77. Formation and maintenance of collagen require A. thiamin. B. vitamin C. C. riboflavin. D. folate. 78. Ingestion of vitamin C during meals can modestly improve absorption of __________. A. beta-carotene B. nonheme iron C. vitamin B-12 D. folate 79. The primary function of vitamin C in cellular metabolism is to A. synthesize collagen. B. add hydroxyl groups to the amino acid proline. C. act as nonspecific reducing agent (electron donor). D. maintain iron in its reduced form in the formation of collagen. 80. Which meal contains the highest amount of vitamin C? A. Hamburger sandwich, french fries, and cola B. Meat loaf, mashed potatoes and gravy, and diet cola C. Baked fish with lemon, broccoli, cole slaw, and strawberries D. Roast beef, carrots, noodles, and coffee 81. The first symptom of scurvy is A. iron-deficiency anemia. B. sudden hair loss. C. pinpoint hemorrhages around hair follicles. D. nerve degeneration. 82. Physiological changes associated with scurvy (hemorrhages, joint pain, fractures) are caused by A. defective collagen synthesis. B. inadequate production of the hormone thyroxine. C. failure to synthesize neurotransmitters. D. impaired function of the citric acid cycle. 83. Which group of foods provides substantial amounts of vitamin C? A. Citrus fruits and vegetables B. Milk and dairy products C. Beef, poultry, seafood D. Breads and cereals 84. Factors such as heat, iron, copper, and oxygen A. enhance the stability of vitamin C in foods. B. destroy vitamin C in foods. C. have no effect on vitamin C. D. convert vitamin C from its inactive to active form. 85. The RDA for vitamin C is increased by ________ mg/day for smokers. A. 10 B. 60 C. 35 D. 1000 86. The amino acids _______ and ________ are hydroxylated with the aid of vitamin C to form strong connective tissue. A. proline; lysine B. glutamic acid; alanine C. threonine; methionine D. methionine; homocysteine 87. At intakes of supplemental vitamin C greater than 2 g/day, adverse effects, including _________, may occur. A. blood in the urine and muscle weakness B. masking of a vitamin B-12 deficiency C. gastrointestinal bloating and diarrhea D. All of these choices are accurate. 88. Rich sources of choline are A. enriched cereals and grains. B. fats and oils. C. meats, eggs, and dairy products. D. fruits and vegetables. True / False Questions 89. Large doses of riboflavin are nontoxic. TRUE 90. Large doses of vitamin C in supplement form are known to prevent, cure, or diminish the symptoms of the common cold. FALSE 91. Supplemental vitamin B-6, vitamin B-12, and folic acid can reduce blood levels of homocysteine but have not been proven to reduce the risk of cardiovascular disease. TRUE 92. A good way to reduce risk of cardiovascular disease is to take supplements of vitamin B-6, vitamin B-12, folic acid, and vitamin C. FALSE 93. Although not classified as vitamins, ingestion of the substances taurine and carnitine is required for good health. FALSE Matching Questions 94. Match the water-soluble vitamin with its deficiency disease or disorder.
1. Scurvy Niacin
2. Pernicious anemia Vitamin B-12
3. Pellagra Folate
4. Neural tube defect Vitamin C
5. Beriberi Thiamin
1. Scurvy Niacin 3
2. Pernicious anemia Vitamin B-12 2
3. Pellagra Folate 4
4. Neural tube defect Vitamin C 1
5. Beriberi Thiamin 5
95. Match the water-soluble vitamin with its function in cellular metabolism.
1. Participates in oxidation and reduction reactions in energy metabolism Folate
2. Is a part of the molecule acetyl CoA Pantothenic acid
3. Removes carbon dioxide from compounds such as pyruvate Thiamin
4. Functions in the exchange of single carbon groups Riboflavin
5. Donates electrons to iron and copper metal ions Biotin
6. Adds carbon dioxide to compounds such as pyruvate Vitamin C
1. Participates in oxidation and reduction reactions in energy metabolism Folate 4
2. Is a part of the molecule acetyl CoA Pantothenic acid 2
3. Removes carbon dioxide from compounds such as pyruvate Thiamin 3
4. Functions in the exchange of single carbon groups Riboflavin 1
5. Donates electrons to iron and copper metal ions Biotin 6
6. Adds carbon dioxide to compounds such as pyruvate Vitamin C 5
96. Match the water-soluble vitamin with its coenzyme form(s).
1. Riboflavin THFA
2. Niacin FAD, FMN
3. Vitamin B-6 TPP
4. Folic Acid CoA
5. Thiamin PLP
6. Pantothenic Acid NAD, NADP
1. Riboflavin THFA 4
2. Niacin FAD, FMN 1
3. Vitamin B-6 TPP 5
4. Folic Acid CoA 6
5. Thiamin PLP 3
6. Pantothenic Acid NAD, NADP 2
Essay Questions 97. Describe the symptoms of thiamin deficiency. Answer: Thiamin (vitamin B1) deficiency can lead to several health issues, primarily affecting the nervous system, heart, and muscles. The symptoms of thiamin deficiency include: 1. Beriberi: This condition manifests in two forms: • Wet Beriberi: Characterized by cardiovascular symptoms such as edema, shortness of breath, and increased heart rate. It can lead to heart failure. • Dry Beriberi: Involves neurological symptoms like muscle weakness, tingling, and numbness in the hands and feet, difficulty walking, and paralysis. 2. Wernicke-Korsakoff Syndrome: This severe neurological disorder is often associated with chronic alcoholism and includes: • Wernicke's Encephalopathy: Symptoms include confusion, ataxia (loss of muscle coordination), and ophthalmoplegia (eye movement disorders). • Korsakoff's Psychosis: Characterized by memory loss, difficulty forming new memories, hallucinations, and confabulation (making up stories). 3. Other Symptoms: Fatigue, irritability, poor appetite, and weight loss are also common in thiamin deficiency. 98. Name the 4 Ds of pellagra. What causes pellagra? How is the consumption of corn related to pellagra? Answer: The 4 Ds of pellagra are: 1. Dermatitis: Skin lesions, often symmetrical, that worsen with sun exposure. 2. Diarrhea: Gastrointestinal issues, including severe diarrhea. 3. Dementia: Cognitive impairments, including confusion, memory loss, and psychosis. 4. Death: If untreated, pellagra can be fatal. What causes pellagra? Pellagra is caused by a deficiency in niacin (vitamin B3) or its precursor, tryptophan. It can result from a diet low in niacin or tryptophan, as well as conditions that impair the body's ability to absorb or convert these nutrients. How is the consumption of corn related to pellagra? Corn is a staple food in many cultures, but it is naturally low in niacin and bound to niacytin, making it difficult for the body to absorb. Additionally, corn is low in tryptophan. Traditional preparation methods, such as nixtamalization (soaking and cooking corn in an alkaline solution), release the bound niacin and make it more bioavailable. In cultures where this preparation method is not used, reliance on corn as a primary food source can lead to niacin deficiency and pellagra. 99. Why are paper and opaque plastic containers used for milk, milk products, and cereals? Answer: Paper and opaque plastic containers are used for milk, milk products, and cereals to protect these products from light, particularly ultraviolet (UV) light. Exposure to light can cause several issues: 1. Nutrient Degradation: UV light can degrade sensitive nutrients such as riboflavin (vitamin B2) and vitamin A, reducing the nutritional value of the product. 2. Oxidation: Light exposure can accelerate the oxidation of fats and oils, leading to rancidity and off-flavors. 3. Spoilage: Light can promote the growth of certain bacteria and other microorganisms, leading to faster spoilage. Using opaque containers helps to preserve the quality, flavor, and nutritional content of these products, ensuring they remain safe and enjoyable for consumers. 100. Describe why good folate status is especially important for young women. Answer: Good folate status is especially important for young women due to its critical role in reproductive health, cell division, and overall development. Folate, a B-vitamin, is vital for the synthesis of DNA and RNA, the genetic materials essential for cell division and growth. Here are the key reasons why maintaining adequate folate levels is crucial for young women: 1. Prevention of Neural Tube Defects: One of the most significant reasons for ensuring good folate status in young women is to prevent neural tube defects (NTDs) in developing fetuses. NTDs, such as spina bifida and anencephaly, occur when the neural tube does not close properly during early pregnancy. Adequate folate intake before conception and during early pregnancy significantly reduces the risk of these serious birth defects. 2. Support for Rapid Growth Periods: Young women, especially those in their teenage years, experience rapid growth and development. Folate is essential for producing new cells and tissues, supporting healthy development during these critical periods. 3. Red Blood Cell Formation and Anemia Prevention: Folate is crucial for the formation of red blood cells. A deficiency can lead to megaloblastic anemia, characterized by the production of abnormally large and immature red blood cells. This condition can cause fatigue, weakness, and other health issues. Ensuring adequate folate intake helps prevent anemia and supports overall vitality. 4. DNA Synthesis and Repair: Folate plays a fundamental role in DNA synthesis and repair. Young women, particularly those of childbearing age, need sufficient folate to support the ongoing processes of cell division and tissue growth. This is not only important for reproductive health but also for maintaining general health and well-being. 5. Cardiovascular Health: Adequate folate levels are linked to lower homocysteine levels in the blood. Elevated homocysteine is a risk factor for cardiovascular diseases. By maintaining good folate status, young women can help reduce their risk of developing heart disease later in life. In summary, good folate status is essential for young women to support reproductive health, prevent birth defects, promote healthy growth and development, prevent anemia, and maintain overall health. 101. Describe how vitamin C, iron, and copper interact to allow metalloenzyme function to proceed. Answer: Vitamin C, iron, and copper interact in a complex manner to support the proper function of metalloenzymes, which are enzymes that contain metal ions as cofactors. These interactions are critical for various biochemical processes, including the synthesis of connective tissue, energy production, and the regulation of neurotransmitters. Here's a detailed explanation of how these nutrients work together: 1. Vitamin C and Iron Absorption: Vitamin C, also known as ascorbic acid, enhances the absorption of non-heme iron (the form of iron found in plant-based foods) in the intestines. It does this by reducing ferric iron (Fe³⁺) to ferrous iron (Fe²⁺), which is more soluble and easier for the body to absorb. This increased iron absorption is crucial for maintaining adequate iron levels, which are necessary for the function of various metalloenzymes, particularly those involved in oxygen transport and energy production. 2. Iron and Metalloenzyme Function: Iron is a key component of many metalloenzymes, including cytochromes, which are involved in the electron transport chain for energy production, and catalase, which helps decompose hydrogen peroxide into water and oxygen, protecting cells from oxidative damage. Adequate iron levels are essential for the proper functioning of these enzymes and for maintaining overall metabolic health. 3. Copper and Iron Metabolism: Copper is involved in the regulation of iron metabolism through its role in the enzyme ceruloplasmin. Ceruloplasmin oxidizes ferrous iron (Fe²⁺) to ferric iron (Fe³⁺), which can then be bound to transferrin and transported in the blood to various tissues. This process is crucial for iron homeostasis and for ensuring that iron is available for incorporation into metalloenzymes. 4. Copper as a Cofactor: Copper is a cofactor for several important metalloenzymes, including cytochrome c oxidase, which is involved in the final step of the electron transport chain, and lysyl oxidase, which is essential for the cross-linking of collagen and elastin in connective tissues. These enzymes require copper to function properly, highlighting the importance of adequate copper levels for overall health and enzyme activity. 5. Synergistic Effects on Antioxidant Defense: Vitamin C also acts as an antioxidant, protecting cells from oxidative stress by neutralizing free radicals. This antioxidant function supports the activity of copper-containing enzymes such as superoxide dismutase (SOD), which catalyzes the dismutation of superoxide radicals into hydrogen peroxide and oxygen, further protecting cells from damage. In summary, vitamin C, iron, and copper interact in several key ways to support the function of metalloenzymes. Vitamin C enhances iron absorption, iron is essential for the activity of many metalloenzymes, and copper is involved in iron metabolism and serves as a cofactor for critical enzymes. Together, these nutrients ensure the proper functioning of biochemical processes vital for health and well-being. 102. Discuss the roles of thiamin, riboflavin, niacin, and pantothenic acid in energy metabolism. Answer: Thiamin, riboflavin, niacin, and pantothenic acid are B-vitamins that play crucial roles in energy metabolism. These vitamins act as coenzymes in various biochemical pathways that convert nutrients from food into usable energy in the form of adenosine triphosphate (ATP). Here’s a detailed discussion of their roles: Thiamin (Vitamin B1) Thiamin is a vital component of energy metabolism, primarily through its role as a coenzyme in the form of thiamin pyrophosphate (TPP). TPP is essential in several key biochemical processes: 1. Carbohydrate Metabolism: Thiamin is crucial for the decarboxylation of pyruvate to acetyl-CoA, a key step linking glycolysis and the citric acid cycle (Krebs cycle). Without thiamin, this conversion is impaired, leading to a buildup of pyruvate and lactate. 2. Citric Acid Cycle: TPP is also involved in the citric acid cycle, where it acts as a coenzyme for the alpha-ketoglutarate dehydrogenase complex. This complex catalyzes the conversion of alpha-ketoglutarate to succinyl-CoA, a critical step in the cycle that generates ATP. 3. Nerve Function: Beyond its role in energy metabolism, thiamin is necessary for the proper functioning of the nervous system, as it helps in the synthesis of neurotransmitters. Riboflavin (Vitamin B2) Riboflavin is integral to energy production, primarily through its roles in the form of two coenzymes: flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD): 1. Electron Transport Chain: FAD is a critical component of the electron transport chain, where it participates in the transfer of electrons from the citric acid cycle to the chain, ultimately leading to the production of ATP. 2. Citric Acid Cycle: FAD is also a coenzyme for succinate dehydrogenase in the citric acid cycle, catalyzing the conversion of succinate to fumarate. 3. Fatty Acid Oxidation: FMN and FAD are involved in the beta-oxidation of fatty acids, which breaks down fatty acids to produce acetyl-CoA, NADH, and FADH2, all of which are essential for ATP production. Niacin (Vitamin B3) Niacin is crucial for energy metabolism due to its role in the form of two coenzymes: nicotinamide adenine dinucleotide (NAD) and NAD phosphate (NADP): 1. Glycolysis and Citric Acid Cycle: NAD is involved in glycolysis and the citric acid cycle, where it acts as an electron carrier. It accepts electrons during these metabolic processes, becoming NADH, which then donates these electrons to the electron transport chain to produce ATP. 2. Oxidative Phosphorylation: NADH generated from glycolysis, the citric acid cycle, and beta-oxidation enters the electron transport chain, contributing to the production of ATP through oxidative phosphorylation. 3. Biosynthetic Reactions: NADP, in its reduced form (NADPH), provides the reducing power needed for biosynthetic reactions, including fatty acid and cholesterol synthesis. Pantothenic Acid (Vitamin B5) Pantothenic acid is a component of coenzyme A (CoA), which is fundamental to numerous metabolic pathways: 1. Formation of Acetyl-CoA: Pantothenic acid is crucial for the synthesis of CoA, which is required for the formation of acetyl-CoA from pyruvate, fatty acids, and amino acids. Acetyl-CoA enters the citric acid cycle, where it contributes to the production of ATP. 2. Citric Acid Cycle: Acetyl-CoA is a key molecule that combines with oxaloacetate to form citrate, initiating the citric acid cycle, which generates ATP, NADH, and FADH2. 3. Synthesis and Metabolism of Fatty Acids: CoA is also involved in the synthesis and oxidation of fatty acids, which are crucial for producing and storing energy. In summary, thiamin, riboflavin, niacin, and pantothenic acid are essential for energy metabolism. They function as coenzymes in various biochemical pathways that convert carbohydrates, fats, and proteins into ATP, the energy currency of the cell. These B-vitamins ensure the efficient production and utilization of energy, supporting overall cellular function and health. Multiple Choice Questions 103. Which of the following water-soluble vitamins can be a part of lecithin? A. Thiamin B. Niacin C. Choline D. Vitamin C 104. A patient presents with diarrhea. They have no signs and symptoms of a foodborne illness. What is the likely cause of the problem? A. Too high intake of niacin B. Too low intake of riboflavin C. Too high intake of vitamin C D. Too low intake of biotin 105. A relative has been told she has too high triglyceride levels and too low HDL levels. Which of the following may help reverse these values? A. Pantothenic acid B. Nicotinic acid C. Vitamin B-12 D. Vitamin C 106. A friend has been complaining of skin issues: redness, inflammation, and soreness. Which of the following would you NOT suspect is contributing to his condition? A. Niacin deficiency B. Biotin deficiency C. Vitamin B-6 deficiency D. Vitamin B-12 deficiency 107. You have a friend that smokes. Which of the following nutrients would you recommend that she gets more of? A. Vitamin C B. Pantothenic acid C. Taurine D. Thiamin Chapter 14 Water and Major Minerals Multiple Choice Questions 1. Which of the following about water is NOT true? A. Each water molecule forms a maximum of 2 hydrogen bonds. B. Water is incompressible, so it functions well as a lubricant. C. Water is formed in the body when protein, carbohydrate, and fat are oxidized. D. Water in the body helps resist body temperature change. 2. The human body has more of this substance (by weight) than any other substance. A. protein B. glycogen C. fat D. water 3. When a semipermeable membrane separates two bodies of fluid, A. water can pass through the membrane. B. dissolved particles can pass through the membrane. C. water cannot pass through the membrane. D. None of these choices are accurate. 4. In an adult of normal body composition weighing 165 lb, approximately ________ lb is water. A. 91 B. 55 C. 37 D. 16 5. Which of the following fluids is classified as extracellular fluid? A. tears B. gastrointestinal fluid C. blood plasma D. lymph E. All of these choices are accurate. 6. Which compartment contains the greatest amount of body fluid? A. intracellular compartment B. extracellular compartment C. Both compartments contain the same amount of water. 7. About 73% of lean muscle tissue is A. protein. B. water. C. calcium. D. sodium. 8. The force that develops when two solutions, each with a different concentration of solutes, are separated by a semipermeable membrane is A. systolic pressure. B. diastolic pressure. C. osmotic pressure. D. atmospheric pressure. 9. The major cation in the intracellular fluid is ________, whereas the major anion in the extracellular fluid is ________. A. sodium; chloride B. potassium; chloride C. sodium; chloride D. potassium; phosphate 10. Minerals most involved in fluid balance are A. calcium and magnesium. B. copper and iron. C. calcium and phosphorus. D. sodium and potassium. 11. The sodium-potassium pump uses energy to move A. potassium ions out of the cell. B. sodium ions out of the cell. C. water out of the cell. D. water into the cell. 12. The body's temperature regulation mechanism depends on A. drinking enough water to remove heat by way of the urine. B. water within the body absorbing heat energy, and on the evaporation of perspiration removing heat energy. C. water being delivered to the lungs, where the heat energy will be exhaled as water vapor. D. excretion of body wastes. 13. Compared to dry environments, evaporation of sweat is ________ in humid environments, resulting in _______ body cooling. A. reduced; more B. reduced; less C. increased; more D. increased; less 14. The consumption of a high-protein, high-sodium diet will tend to ________ ion concentration of the urine. A. have no effect on B. increase C. decrease 15. Urea is a major body waste from A. the catabolism of amino acids. B. the action of the sodium-potassium pump. C. intracellular fluid. D. the excretion of minerals by the kidney. 16. The AI recommendation for total water intake is A. 1 liter per kcal expended. B. 12.4 liters per day. C. 8 cups per day. D. 15 cups for adult males and 11 cups for adult females. 17. Extra water losses from heavy sweating or diarrhea will typically result in A. increased urine output. B. decreased urine output. C. no change in urine output. D. decreased water loss from the lungs. 18. Typical daily urine output in a healthy individual is within the range of A. 400 - 600 milliliters. B. 1 - 2 liters. C. 2 - 4 liters. D. 3 - 5 liters. E. 600 - 1000 milliliters. 19. Which of the following foods has the highest percent of total weight as water? A. lettuce B. bread C. cheese D. steak 20. Who should be concerned about dehydration? A. The child who is ill with fever or diarrhea B. The athlete participating in a vigorous sport C. The traveler on a long airplane flight D. The elderly man hospitalized for a broken hip E. All of these choices are accurate. 21. When blood osmolality increases, ___________ is released by the posterior pituitary and acts on the kidney to increase water retention. A. antidiuretic hormone B. renin C. angiotensin II D. insulin 22. Consumption of ______ inhibits the action of antidiuretic hormone, causing increased urinary output. A. one or two cups of coffee B. alcoholic beverages C. high-sodium foods D. high-sugar beverages 23. Renin, released from the kidney as a result of a decrease in blood pressure, acts on ________ produced in the liver. This triggers a series of reactions that culminate in the production of _______ in the adrenal glands. A. angiotensin II; renin B. aldosterone; angiotensin C. angiotensinogen; aldosterone D. antidiuretic hormone; osmosis 24. As dehydration progresses and blood volume decreases, blood pressure will ______ and heart rate will _______. A. increase; increase B. remain the same; decrease C. decrease; decrease D. decrease; increase 25. Drinking too much water can result in dilution of sodium in the blood, a condition known as _________. A. hypernatremia B. hyperkalemia C. hyponatremia D. ADH syndrome 26. Water intoxication is associated with A. headache and blurred vision. B. muscle cramps and convulsions. C. hyponatremia. D. All of these answers are correct. 27. ADH A. is a pituitary hormone that decreases water excretion. B. is minerals deposited into bone that give strength and rigidity. C. is an adrenal hormone that causes sodium reabsorption. D. is a protein-calcium complex that influences enzyme activity in cells. E. is an enzyme in kidneys formed in response to low blood pressure. 28. Aldosterone A. is a pituitary hormone that decreases water excretion. B. is minerals deposited into bone that give strength and rigidity. C. is an adrenal hormone that increases sodium reabsorption in the kidney. D. is a protein-calcium complex that influences enzyme activity in cells. E. is an enzyme in kidneys formed in response to low blood pressure. 29. Aldosterone increases A. potassium retention by the kidneys. B. water excretion by the kidneys. C. sodium retention by the kidneys. D. sodium absorption by the intestinal villi. 30. Renin A. is a pituitary hormone that decreases water excretion. B. is minerals deposited into bone that give strength and rigidity. C. is an adrenal hormone that causes sodium reabsorption. D. is a protein-calcium complex that influences enzyme activity in cells. E. is an enzyme in kidneys formed in response to low blood pressure. 31. When we obtain calcium from a dietary supplement, the absorption of magnesium and copper from food may be reduced because A. calcium interferes with the digestion of trace minerals. B. magnesium and copper both have the same valence as the calcium, so there is competition for absorption sites. C. excess calcium can destroy the villi of the intestinal tract. D. excess calcium means the magnesium and copper cannot be solubilized in water. 32. Phytic acid binds minerals so that they cannot be absorbed. Phytic acid is found in A. leafy, green vegetables, such as spinach. B. milk and dairy products. C. cereal grain fibers. D. liver and other organ meats. 33. Oxalic acid binds minerals so they cannot be absorbed. Oxalic acid is found in A. some leafy, green vegetables, such as spinach. B. milk and dairy products. C. cereal grain fibers. D. liver and other organ meats. 34. Which of the following individuals is least likely to benefit from a diet containing less than 1500 mg sodium per day? A. A 65-year-old Hispanic male in good health B. A 35-year-old African American female C. A 40-year-old white male with diabetes and chronic kidney disease D. A healthy Asian female college student 35. Sodium A. acts as the principal positively charged ion in the intracellular fluid. B. transmits electrical impulses through nerve cells. C. promotes glycolysis. D. releases energy from ATP. 36. Most sodium consumed is from A. table salt added at home. B. naturally occurring sodium in foods. C. tap water and medications. D. processed foods and those purchased at restaurants. 37. Some North Americans are called "sodium sensitive." For these people, high sodium intake contributes to A. stomach cancer. B. hypertension. C. gastrointestinal upsets. D. serious fluid imbalances. 38. Table salt is _____ sodium. A. 20% B. 30% C. 40% D. 60% 39. One teaspoon of salt contains about ________ of sodium. A. 3400 mg B. 1000 mg C. 2300 mg D. 6000 mg 40. According to FDA labeling rules, the Daily Value for sodium is listed as A. 7 grams per day. B. 4 grams per day. C. 2.4 grams per day. D. 200 mg per day. 41. Which of the following dairy products has the highest sodium content? A. American cheese, 2 oz B. cheddar cheese, 2 oz C. lowfat milk, 1 cup D. The sodium content does not differ among these 3 foods. 42. In a healthy person, sodium consumed in excess of body needs is A. stored in the liver. B. excreted by the kidneys. C. metabolized in cells. D. excreted in the feces. 43. A positively charged ion located in the intracellular fluid is A. sodium. B. potassium. C. phosphate. D. chloride. 44. Which of the following situations is/are life threatening? A. hypokalemia B. hyperkalemia C. hypokalemia and hyperkalemia D. neither hypokalemia nor hyperkalemia 45. A meal of dried apricots, whole grain cereals, legumes, and liver provides an abundance of A. potassium. B. fiber. C. beta carotene. D. vitamin A. E. All of these choices are accurate. 46. Which of the following groups would be most at risk for potassium deficiency? A. Infants and young children B. Pregnant women C. Patients taking diuretics D. Breastfeeding mothers 47. An ample intake of potassium-rich foods may help protect against A. hypertension. B. osteoporosis. C. gastric ulcers. D. diabetes. 48. Salt substitutes often contain A. sodium bicarbonate. B. potassium chloride. C. calcium carbonate. D. magnesium sulfate. 49. The body regulates its potassium content by A. absorbing more or less potassium from the gastrointestinal tract. B. excreting more or less potassium in the urine. C. storing more or less potassium in the liver. D. storing more or less potassium in the bone. 50. Chloride is A. the main anion in extracellular fluid. B. an intracellular fluid ion. C. a positively charged ion. D. converted to chlorine in the intestinal tract. 51. Most of our dietary chloride comes from A. fresh fruits. B. vegetables. C. meat. D. seed oils. E. table salt. 52. In the U.S., dietary intakes of the major minerals ______ and _______ often fall short of recommendations. A. sodium; phosphorus B. calcium; phosphorus C. sodium; potassium D. potassium; calcium 53. Joe Smith, age 52, has a blood pressure of 145 mm Hg over 95 mm Hg. This is considered A. normal blood pressure. B. low blood pressure. C. hypertension, or high blood pressure. D. None of these choices are accurate. 54. Which of the following blood pressures is considered prehypertension? A. 130 mm Hg over 85 mm Hg B. 118 mm Hg over 82 mg Hg C. 142 mm Hg over 95 mm Hg D. 145 mm Hg over 105 mm Hg 55. Factors that can contribute to an increased risk of high blood pressure include A. advanced age. B. African-American race. C. BMI over 30. D. type 2 diabetes. E. All of these choices are accurate. 56. The organs that are most likely to be damaged because of hypertension are the A. liver, pancreas, gastrointestinal tract, and lungs. B. heart, brain, kidney, and eye. C. liver, heart, pancreas, and kidney. D. brain, eye, heart, lungs. 57. A diet that contains an average of 4,000 mg sodium and 1,500 mg potassium daily is likely to A. decrease the risk of hypertension. B. result from an eating disorder. C. increase the risk of hypertension. D. have no effect on blood pressure. 58. A strategy that can help prevent or reduce high blood pressure in women is to: A. consume a daily calcium supplement of 1,000 mg. B. consume a multi-vitamin mineral supplement. C. eliminate all caffeine-containing beverages from the diet. D. limit alcohol consumption to no more than 1 drink per day. 59. Which of the following is NOT a characteristic of the DASH diet? A. It is rich in the minerals magnesium, potassium, and calcium. B. It is high in fiber. C. It contains 8-10 servings of fruits and vegetables per day. D. It is low in protein. 60. The mineral found in the body in the most abundance is A. phosphorus. B. iron. C. calcium. D. sodium. 61. The 250 mg of calcium found in a cup of spinach A. is the only source of calcium for a vegan. B. has low bioavailability because the calcium is bound to oxalic acid. C. is poorly absorbed unless the spinach is cooked. D. has low bioavailability because the calcium is bound to phytic acid. 62. Individuals advised to consume calcium supplements should consume A. about 2,000 mg in a single dose each day. B. only calcium citrate as other calcium salts are poorly absorbed. C. an amount of no more than 500 mg with or just after a meal. D. the calcium supplement at the same time as other mineral supplements. 63. Absorption of dietary calcium in the duodenum is aided by A. consumption of lactose. B. acidic environment. C. 1, 25 (OH)2 vitamin D. D. All of these choices are accurate. 64. Which of the following population groups has the highest rate of calcium absorption? A. Postmenopausal women B. Pregnant women C. Premenopausal women (not pregnant or lactating) D. Athletes in training 65. Measuring blood calcium levels is not an accurate indicator of total body calcium because A. calcium in the blood reflects only the most recent dietary intake of calcium. B. there are no reliable tests for measuring blood calcium. C. blood calcium levels vary according to the intake of other positive ions (e.g., sodium, potassium, and magnesium). D. blood calcium levels are strictly controlled by hormones and do not reflect total body stores. 66. Which factor(s) limit(s) absorption of dietary calcium? A. Phytic acid B. Chronic diarrhea C. Tannins in tea D. Vitamin D deficiency E. All of these choices are accurate. 67. Parathyroid hormone elevates blood calcium levels by A. increasing the synthesis of 1,25 (OH)2 vitamin D. B. reducing calcium excretion by the kidneys. C. increasing bone resorption by osteoclast activity. D. All of the choices are accurate. 68. The most nutrient-dense food source of calcium with high bioavailability is A. leafy green vegetables. B. fish fillets. C. milk and dairy products. D. cereal grains. E. meats. 69. Which of the following foods provides the greatest amount of calcium per serving? A. 1 cup of yogurt B. 1 slice of American cheese C. 3 oz. canned salmon with bones D. 1 cup cooked spinach 70. Assuming that milk is the only source of dietary calcium, how much milk must an adolescent drink every day to meet the RDA for calcium? A. 2 cups B. 3 cups C. 4 cups D. 5 cups 71. The two life stage groups with the highest RDAs for calcium are _________ and _________. A. children; adolescents B. infants; children C. adolescents; adults over age 50 D. infants; adolescents 72. The very dense outer surface of bone is called A. osteoclastic bone. B. osteoblastic bone. C. trabecular bone. D. cortical bone. 73. At the end of long bones, inside the spinal vertebrae, and inside the flat bones of the pelvis is a spongy type of bone known as A. osteoclastic bone. B. osteoblastic bone. C. trabecular bone. D. compact bone. 74. ________ replacement after menopause greatly reduces bone loss in women. A. Calcium B. Calcitriol C. Estrogen D. Calcitonin 75. In addition to its role in bone development and maintenance, calcium is also required for A. blood clotting, transmitting nerve impulses, and muscle contraction. B. regulating potassium excretion, normal kidney function, and regulating intracellular water content. C. phospholipid synthesis, muscle contraction, and formation of DNA and RNA. D. blood clotting, magnesium absorption, and insulin release from the pancreas. 76. The bones most likely to be affected by the disease osteoporosis include the A. ankle, shoulder, and neck. B. hip, thigh, and ankle. C. hip, wrist, and vertebrae in the spine. D. wrist, forearm, and neck. E. All of these are correct as all bones are affected equally by osteoporosis. 77. Risk factors for osteoporosis include A. overweight and obesity. B. amenorrhea. C. African-American race. D. high levels of physical activity. 78. Phosphorus absorption is promoted by the hormone A. calcitonin. B. 1, 25 (OH)2 vitamin D. C. cholecalciferol. D. aldosterone. 79. The RDA for adults for phosphorus is A. the same as calcium. B. twice the amount of calcium. C. 700 mg/d. D. 200 mg/d. 80. Good food sources of phosphorus include A. fruits and vegetables. B. nuts and oils. C. dairy products, meats, and cereals. D. dairy products and leafy green vegetables. 81. The richest dietary sources of magnesium are A. animal products, e.g., beef and milk. B. plant products, e.g., green vegetables, beans, whole grains. C. fats and oils. D. bottled waters. 82. Magnesium deficiency is most often caused by A. excessive intakes of sodium and potassium. B. low dietary intake of magnesium. C. GI disorders that cause prolonged diarrhea or vomiting. D. osteopenia or osteoporosis. 83. Over half of the body's magnesium is found in the A. heart. B. liver. C. bones. D. brain. 84. High amounts of _____, especially from supplements, can cause diarrhea. A. magnesium B. sodium C. calcium D. potassium 85. Most of our dietary sulfur is supplied by A. protein-rich foods. B. carbohydrates. C. vitamins. D. lipids. 86. Which of the following major minerals does NOT have a DRI? A. sulfur B. calcium C. phosphorus D. magnesium True / False Questions 87. Thirst is a reliable signal to prevent dehydration in older adults. FALSE 88. A person cannot drink too much water; the kidneys and sweat glands make water excretion quick and efficient, protecting the body from overhydration. FALSE 89. The more dense a bone is, the more brittle it will be. FALSE 90. Too much dietary sodium, rather than too little dietary sodium, is a major nutritional problem today. TRUE 91. Bone health is easily determined by a measurement of blood calcium level. FALSE 92. An individual who consumes one cup of coffee in the morning should drink an additional 2 cups of fluid to compensate for caffeine-induced fluid loss. FALSE 93. Plant foods are good sources of the minerals potassium and magnesium. TRUE 94. The main cause of high blood potassium and potassium toxicity is kidney failure. TRUE Matching Questions 95. Match the term with its description.
1.Hyponatremia Hormone secreted by the adrenal glands that acts on the kidneys to increase sodium retention
2.Hyperkalemia Low blood sodium
3.ADH Hormone secreted by the pituitary gland that signals the kidneys to decrease water excretion
4.Renin Enzyme formed in the kidneys in response to low blood pressure
5.Aldosterone High blood potassium
1.Hyponatremia Hormone secreted by the adrenal glands that acts on the kidneys to increase sodium retention 5
2.Hyperkalemia Low blood sodium 1
3.ADH Hormone secreted by the pituitary gland that signals the kidneys to decrease water excretion 3
4.Renin Enzyme formed in the kidneys in response to low blood pressure 4
5.Aldosterone High blood potassium 2
96. Match the term with its description.
1. Osteoblast The surface bone cells that dissolve bone, releasing calcium and phosphorus to the bloodstream
2. Cortical bone Biochemically active bone cells that are the most numerous and that increase in number when bone becomes more dense
3. Osteocyte The bone-building cells that produce collagen and add minerals
4. Osteoclast A compound composed of calcium and phosphate that is deposited into the bone protein matrix to give it strength and rigidity
5.Hydroxyapatite The outer dense shell of bone that makes up most skeletal mass
1. Osteoblast The surface bone cells that dissolve bone, releasing calcium and phosphorus to the bloodstream 4
2. Cortical bone Biochemically active bone cells that are the most numerous and that increase in number when bone becomes more dense 3
3. Osteocyte The bone-building cells that produce collagen and add minerals 1
4. Osteoclast A compound composed of calcium and phosphate that is deposited into the bone protein matrix to give it strength and rigidity 5
5.Hydroxyapatite The outer dense shell of bone that makes up most skeletal mass 2
Essay Questions 97. List at least five symptoms of dehydration. Answer: Dehydration occurs when the body loses more fluids than it takes in, and it can lead to several symptoms that range from mild to severe. Here are at least five symptoms of dehydration: 1. Thirst: The most obvious and early symptom, thirst indicates that the body needs more water. 2. Dry Mouth and Mucous Membranes: A lack of sufficient fluids leads to a dry, sticky feeling in the mouth and throat. 3. Decreased Urine Output: Urine becomes darker in color, and the frequency of urination decreases. 4. Fatigue: Lack of adequate hydration can cause feelings of tiredness and lethargy. 5. Dizziness and Lightheadedness: Insufficient fluid levels can affect blood pressure, leading to dizziness or lightheadedness. 98. Describe 3 ways you can reduce your sodium intake when eating out. Answer: Reducing sodium intake is important for maintaining heart health and preventing hypertension. Here are three strategies to reduce sodium intake when eating out: 1. Choose Fresh Over Processed Foods: Opt for dishes made from fresh ingredients rather than processed or pre-prepared items. Fresh vegetables, fruits, and grilled meats typically contain less sodium compared to processed foods. 2. Request Modifications: Ask for your meal to be prepared without added salt or request that sauces and dressings be served on the side. This allows you to control how much you use. 3. Select Lower-Sodium Options: Many restaurants offer lower-sodium menu items. Look for dishes labeled as "heart-healthy" or "low-sodium" and avoid items that are typically high in sodium, such as soups, sauces, and fried foods. 99. List and briefly describe five risk factors leading to osteoporosis. Answer: Osteoporosis is a condition characterized by weakened bones that are more prone to fractures. Several risk factors can increase the likelihood of developing osteoporosis: 1. Age: As people age, bone density naturally decreases, making bones more susceptible to osteoporosis. The risk significantly increases after the age of 50. 2. Gender: Women are at a higher risk of developing osteoporosis compared to men, particularly after menopause due to the decrease in estrogen levels, which is crucial for maintaining bone density. 3. Family History: A family history of osteoporosis or fractures can increase an individual's risk, as genetics play a significant role in bone health. 4. Low Calcium and Vitamin D Intake: Insufficient intake of calcium and vitamin D, which are essential for bone health, can lead to decreased bone density and a higher risk of osteoporosis. 5. Sedentary Lifestyle: Lack of physical activity, particularly weight-bearing exercises like walking or lifting weights, can contribute to weaker bones. Regular exercise helps maintain bone strength and density. In summary, understanding the symptoms of dehydration, strategies to reduce sodium intake when eating out, and the risk factors for osteoporosis can help individuals make informed decisions about their health and well-being. 100. List 6 foods to limit and 6 foods to encourage on a low-sodium diet. Answer: Maintaining a low-sodium diet is important for managing blood pressure and overall cardiovascular health. Here are six foods to limit and six foods to encourage on a low-sodium diet: Foods to Limit: 1. Processed Meats: Such as bacon, sausage, and deli meats, which are often high in sodium. 2. Canned Soups: Typically contain high levels of sodium for preservation. 3. Fast Food: Burgers, fries, and other fast food items are usually high in sodium. 4. Salted Snacks: Like potato chips, pretzels, and salted nuts. 5. Canned Vegetables: Often packed in salty brines. 6. Condiments: Such as soy sauce, ketchup, and salad dressings, which can be high in sodium. Foods to Encourage: 1. Fresh Fruits and Vegetables: These are naturally low in sodium and high in potassium and other essential nutrients. 2. Whole Grains: Such as brown rice, quinoa, and oats, which are naturally low in sodium. 3. Lean Proteins: Such as skinless poultry, fish, and legumes, prepared without added salt. 4. Low-Sodium Dairy Products: Like yogurt, milk, and cheese, or unsalted butter. 5. Herbs and Spices: Use fresh or dried herbs, spices, and lemon juice to flavor food instead of salt. 6. Nuts and Seeds: Unsalted varieties provide healthy fats and protein without added sodium. 101. Compare and contrast the characteristics of a high-sodium diet to that of a high-potassium diet. Answer: High-Sodium Diet: • Characteristics: • Typically includes processed and fast foods that are high in sodium. • Increases the risk of hypertension (high blood pressure) due to sodium's role in fluid retention. • Can lead to fluid imbalance in the body, causing swelling and bloating. • Often associated with an increased risk of cardiovascular diseases like stroke and heart disease. High-Potassium Diet: • Characteristics: • Includes foods rich in potassium, such as fruits (e.g., bananas, oranges), vegetables (e.g., spinach, potatoes), and legumes (e.g., beans, lentils). • Helps regulate blood pressure by counteracting the effects of sodium and promoting vasodilation. • Supports muscle function, including the heart muscle, and aids in nerve transmission. • Associated with a reduced risk of stroke, osteoporosis, and kidney stones. Comparison: • Both diets can affect blood pressure regulation, but in opposite ways: high sodium tends to elevate blood pressure, while high potassium tends to lower it. • High-sodium diets are linked to increased cardiovascular risk, whereas high-potassium diets are associated with cardiovascular benefits. • High-sodium diets often include processed and unhealthy foods, whereas high-potassium diets emphasize whole, nutrient-rich foods. Contrast: • A high-sodium diet contributes to fluid retention and increases blood pressure, while a high-potassium diet promotes fluid balance and helps lower blood pressure. • High-sodium diets are commonly associated with modern diets heavy in processed foods, whereas high-potassium diets focus on natural, whole foods like fruits and vegetables. 102. Describe two of the physiologic processes that contribute to primary hypertension. Answer: Primary hypertension, also known as essential hypertension, refers to high blood pressure with no identifiable cause. Here are two physiological processes that contribute to primary hypertension: 1. Renin-Angiotensin-Aldosterone System (RAAS) Activation: • Process: When blood pressure drops or blood flow to the kidneys decreases, specialized cells in the kidneys release an enzyme called renin into the bloodstream. • Effect: Renin converts angiotensinogen (produced by the liver) into angiotensin I. Angiotensin I is then converted into angiotensin II by an enzyme called angiotensin-converting enzyme (ACE), primarily in the lungs. • Consequences: Angiotensin II is a potent vasoconstrictor, causing blood vessels to narrow. It also stimulates the release of aldosterone from the adrenal glands, which promotes sodium and water retention by the kidneys, leading to increased blood volume and elevated blood pressure. 2. Sympathetic Nervous System Overactivity: • Process: In response to stress, anxiety, or other triggers, the sympathetic nervous system releases catecholamines (e.g., epinephrine and norepinephrine). • Effect: Catecholamines cause blood vessels to constrict, increasing peripheral vascular resistance. This makes the heart work harder to pump blood through narrowed vessels. • Consequences: Chronic activation of the sympathetic nervous system leads to sustained high blood pressure. Over time, this can contribute to vascular remodeling and damage, further exacerbating hypertension. In summary, primary hypertension involves complex physiological processes such as RAAS activation and sympathetic nervous system overactivity, which together contribute to the chronic elevation of blood pressure. Understanding these mechanisms is crucial for developing effective treatments and interventions to manage hypertension and reduce cardiovascular risk. 103. Describe several actions an individual can take to prevent hypertension. Answer: Hypertension, or high blood pressure, is a significant risk factor for cardiovascular diseases. Here are several actions individuals can take to prevent hypertension: 1. Maintain a Healthy Weight: Being overweight or obese increases the risk of hypertension. Losing even a small amount of weight can lower blood pressure. 2. Adopt a Healthy Diet: Follow a diet rich in fruits, vegetables, whole grains, and lean proteins. Reduce sodium intake and limit processed foods, which are often high in sodium. 3. Reduce Sodium Intake: Aim for less than 2,300 milligrams of sodium per day (and even lower for individuals with hypertension or at risk). Avoid adding salt to meals and read food labels for sodium content. 4. Increase Potassium Intake: Potassium helps balance sodium levels in the body and can lower blood pressure. Eat potassium-rich foods such as bananas, oranges, potatoes, spinach, and beans. 5. Limit Alcohol Consumption: Excessive alcohol intake can raise blood pressure. Limit consumption to moderate levels (up to one drink per day for women and two drinks per day for men). 6. Exercise Regularly: Engage in regular physical activity, aiming for at least 150 minutes of moderate-intensity aerobic exercise per week (e.g., brisk walking, swimming, cycling). 7. Manage Stress: Chronic stress can contribute to hypertension. Practice stress-reducing techniques such as deep breathing, meditation, or yoga. 8. Quit Smoking: Smoking increases blood pressure and damages blood vessels. Quitting smoking can significantly reduce the risk of hypertension and cardiovascular disease. 9. Monitor Blood Pressure: Regularly check blood pressure levels, especially if there is a family history of hypertension or cardiovascular disease. 10. Medication Adherence: If prescribed medication for hypertension, take it as directed by a healthcare provider and attend regular follow-up appointments. By implementing these lifestyle changes and habits, individuals can significantly reduce their risk of developing hypertension and improve overall cardiovascular health. 104. Describe the nutritional characteristics of the DASH diet. Which food groups are emphasized? Answer: The Dietary Approaches to Stop Hypertension (DASH) diet is an eating plan designed to help lower blood pressure and improve overall health. It emphasizes nutrient-rich foods and limits sodium intake. Here are the nutritional characteristics of the DASH diet and the food groups it emphasizes: Emphasized Food Groups in the DASH Diet: 1. Fruits: Including a variety of fruits such as berries, apples, oranges, and bananas. These provide essential vitamins, minerals, and fiber. 2. Vegetables: Emphasizing leafy greens like spinach and kale, as well as colorful vegetables such as carrots, bell peppers, and tomatoes. Vegetables are rich in potassium, magnesium, and fiber. 3. Whole Grains: Including whole wheat, brown rice, oats, and quinoa. These grains are high in fiber, which promotes satiety and helps regulate blood sugar levels. 4. Lean Proteins: Such as poultry (without skin), fish, beans, and legumes. These provide protein without the saturated fats found in red meats. 5. Low-Fat Dairy: Including milk, yogurt, and cheese, preferably low-fat or fat-free options. Dairy products are sources of calcium and vitamin D, important for bone health. 6. Nuts, Seeds, and Legumes: These provide healthy fats, protein, and fiber. Examples include almonds, walnuts, chia seeds, and lentils. Nutritional Characteristics: • Low Sodium: The DASH diet is low in sodium, aiming for less than 2,300 milligrams per day (and ideally closer to 1,500 milligrams per day for those with hypertension). • Rich in Potassium, Magnesium, and Calcium: These minerals help lower blood pressure and support overall cardiovascular health. Foods rich in these nutrients are emphasized in the DASH diet. • High in Fiber: Whole grains, fruits, vegetables, and legumes provide dietary fiber, which aids in digestion, promotes fullness, and helps regulate blood sugar levels. • Balanced Macronutrients: The DASH diet provides a balanced ratio of carbohydrates, proteins, and fats, focusing on healthy fats from sources like nuts and seeds. In summary, the DASH diet promotes a balanced and nutritious eating pattern that supports heart health by emphasizing fruits, vegetables, whole grains, lean proteins, and low-fat dairy while limiting sodium intake. Following the DASH diet can help reduce blood pressure and lower the risk of cardiovascular diseases. Short Answer Questions 105. Explain how the kidneys maintain fluid balance. Answer: The kidneys play a crucial role in maintaining fluid balance in the body through a process known as renal regulation. This mechanism ensures that the body maintains optimal hydration levels and regulates blood pressure. Here’s how the kidneys achieve fluid balance: Filtration: 1. Glomerular Filtration: The process begins in the nephrons, the functional units of the kidneys, where blood enters tiny clusters of blood vessels called glomeruli. Here, blood pressure forces fluid and small molecules (such as ions, glucose, and waste products) out of the blood and into the renal tubules. Reabsorption: 2. Tubular Reabsorption: As the filtered fluid (now called filtrate) passes through the renal tubules, the nephrons selectively reabsorb substances essential for maintaining body functions, such as water, glucose, amino acids, and ions (like sodium, potassium, and chloride). This process occurs across the tubular epithelial cells lining the nephrons and is highly regulated to maintain fluid and electrolyte balance. Secretion: 3. Tubular Secretion: In addition to reabsorption, the kidneys also actively secrete certain substances into the renal tubules. This secretion process helps eliminate waste products, drugs, and excess ions (such as hydrogen and potassium ions) from the bloodstream into the urine. Hormonal Regulation: 4. Renin-Angiotensin-Aldosterone System (RAAS): This hormonal system plays a critical role in regulating fluid balance and blood pressure. When blood pressure drops or blood flow to the kidneys decreases, specialized cells in the kidneys release an enzyme called renin into the bloodstream. Renin converts angiotensinogen (produced by the liver) into angiotensin I, which is then converted to angiotensin II by an enzyme called ACE (angiotensin-converting enzyme), primarily in the lungs. Angiotensin II is a potent vasoconstrictor, causing blood vessels to narrow, and also stimulates the release of aldosterone from the adrenal glands. Aldosterone promotes sodium and water retention by the kidneys, helping to increase blood volume and raise blood pressure. Antidiuretic Hormone (ADH): ADH, also known as vasopressin, is another hormone that plays a crucial role in fluid balance. It is produced by the hypothalamus and released by the pituitary gland in response to changes in blood osmolality (concentration of solutes in the blood) or blood volume. ADH acts on the kidneys to increase water reabsorption from the renal tubules back into the bloodstream, reducing urine output and conserving water to maintain fluid balance. Conclusion: In summary, the kidneys maintain fluid balance through a complex interplay of filtration, reabsorption, secretion, and hormonal regulation. This intricate process ensures that the body retains essential substances while eliminating waste products, thereby maintaining optimal hydration levels and supporting overall health and homeostasis. Understanding the mechanisms by which the kidneys regulate fluid balance is essential for comprehending how the body maintains internal equilibrium and responds to changes in hydration status. Multiple Choice Questions 106. If deficient, which of the following minerals would have the least affect on bone health? A. Phosphorus B. Calcium C. Magnesium D. Chloride 107. If deficient, which of the following minerals would have the least effect on blood pressure? A. Potassium B. Sodium C. Calcium D. Magnesium 108. A friend is complaining of constipation. In addition to lifestyles changes, which mineral could help relieve your friend's constipation? A. Sodium B. Magnesium C. Sulfur D. Chloride 109. What will be the effect of an increase of parathyroid hormone? A. Osteoblast activity increases, resulting in an increase in blood calcium. B. Osteoclast activity increases, resulting in an increase in blood calcium. C. Osteoblast activity increases, resulting in a decrease in blood calcium. D. Osteoclast activity increases, resulting in a decrease in blood calcium. 110. What will be the effect of an increase of calcitonin? A. Osteoblast activity will increase, resulting in an increase in blood calcium. B. Osteoclast activity will increase, resulting in an increase in blood calcium. C. Osteoblast activity will increase, resulting in a decrease in blood calcium. D. Osteoclast activity will increase, resulting in a decrease in blood calcium. Test Bank for Wardlaw's Perspectives in Nutrition Carol Byrd-Bredbenner, Gaile Moe, Jacqueline Berning, Danita Kelley 9780078021411, 9781259933844, 9780073522722
