CH-17-18 Nutrition during the Growing Years – Wardlaw’s Perspectives in Nutrition : Exam Guide

This Document Contains Chapters 17 to 18 Chapter 17 Nutrition during the Growing Years Multiple Choice Questions 1. During the first year of life, the infant increases in length by ________% over what it was at birth. A. 20 B. 33 C. 50 D. 100 2. According to present-day growth charts, an infant will double its birth weight at about ________ months of age and will triple its birth weight at about ________ months. A. 4 to 6; 12 B. 2 to 3; 6 C. 10; 12 to 18 D. 12; 18 3. An infant's birth weight ________ during the first year of life. A. increases very little B. doubles C. triples D. quadruples 4. When adolescence ends, females have ____ as much lean body mass as males. A. one-third B. half C. two-thirds D. four-fifths 5. When adolescence ends, males have ____ as much body fat as females. A. one-third B. half C. two-thirds D. four-fifths 6. Throughout the adolescent years, both males and females gain about ____% of their adult height. A. 5 B. 15 C. 25 D. 35 7. When adolescence ends, both males and females weigh _____% more than when they entered this life stage. A. 10 to 25 B. 25 to 45 C. 45 to 85 D. 75 to 105 8. By the age of _____ years, body water levels are similar to those of adults. A. 2 to 3 B. 5 to 6 C. 8 to 9 D. 11 to 13 9. Changes in height and weight in children are used to indicate ________. A. the effectiveness of the caregiver B. long-term effects of nutrition C. energy intake D. the child's genetic potential for development 10. Over time, measurements of height, weight, and head circumference ________. A. are used to assess an infant's growth and development B. are used to compare an infant's growth to others of the same age and gender C. are used by pediatricians to look for health problems D. All of these choices are accurate. 11. A child is diagnosed as obese when ________. A. BMI-for-age reaches the 85th percentile B. stature-for-age reaches the 95th percentile C. BMI-for-age reaches the 95th percentile D. weight-for-age reaches the 90th percentile 12. A child is considered underweight when ________. A. BMI-for-age drops below the 25th percentile B. weight-for-age drops below the 10th percentile C. BMI-for-age drops below the 5th percentile D. stature-for-age drops below the 25th percentile and weight-for-age drops below the 10th percentile 13. Which is a good indicator of long-term nutritional status? A. Stature-for-age B. BMI-for-age C. Head circumference-for-age D. All of these are good indicators of recent nutritional status. 14. Infants and children who do not grow at the expected rate for several months are more than likely experiencing ________. A. epiphyseal growth B. failure to thrive C. physical depression D. poor socialization 15. Which is true about growth in height? A. It cannot occur after the epiphyses fuse. B. It cannot occur before the epiphyses fuse. C. The epiphyses are not related to growth in height. 16. Growth plates at the end of long bones are called ________. A. calcification B. osteoporosis C. rickets D. epiphyses 17. What are the causes of failure to thrive? A. Physical problems B. Poor infant-parent interactions C. Inborn errors of metabolism D. All of these choices are correct. E. None of these choices are correct. 18. Except for pregnancy and lactation, the total quantities of nutrients and calories needed during ____ are greater than any other stage of the life cycle. A. infancy B. childhood C. adolescence D. All of these responses are correct. 19. Newborns need about ____ calories per pound of body weight each day. A. 10 B. 25 C. 50 D. 100 20. Total calorie needs peak for females at about age ____. A. 3 to 4 years B. 6 to 7 years C. 11 to 13 years D. 15 to 16 years 21. The high metabolic rate of infants results from ________. A. their large surface area of its body B. the calories needed to digest food C. the physical activity of the infant D. All of these choices are accurate. 22. The protein needs of an infant are about ___ as much per pound of body weight as adults'. A. one-fourth B. half C. twice D. three times 23. In developing countries, inadequate intake of ____ is a primary contributor to stunted growth, childhood illness, and death. A. carbohydrate B. protein C. fat D. vitamin A 24. What percent of calories should total fat make up in an infant's diet? A. 20% or less B. 20 to 30% C. 40 to 55% D. 50 to 75% 25. The primary carbohydrate in the diet of most infants is ________. A. sucrose B. glucose C. lactose D. maltose 26. High-protein diets are not good for infants ________. A. unless they are highly digestible proteins B. because they are hypoallergenic C. because the infant's kidneys cannot clear large amounts of urea every day D. All of these choices are accurate. 27. About how much protein should an 18-pound (i.e., 8.2 kg), 10-month-old baby consume each day? A. 8 grams B. 24 grams C. 12 grams D. 32 grams 28. About how much protein should a 24-pound (i.e., 11.0 kg), 2-year-old be consuming each day? A. 12 grams B. 28 grams C. 38 grams D. 50 grams 29. Why do infants have a greater need for water than older humans? A. Infants have a high body surface area. B. Infants have a greater proportion of body water. C. Infants' kidneys are not as efficient. D. All of these responses are correct. E. None of these responses are correct. 30. When is an infant likely to need supplemental water? A. When the infant has a fever B. When the infant has diarrhea C. When the weather is hot D. All of these choices are correct. E. None of these choices are correct; an infant never needs supplemental water. 31. An infant may suffer from water intoxication when ________. A. fed water instead of formula B. the weather is hot C. infant formula powder is underdiluted D. the infant has a fever 32. Infant iron stores are exhausted by _________ of age and need to be replaced by their diet. A. 0 to 2 months B. 4 to 6 months C. 7 to 8 months D. 10 to 12 months 33. Why are adolescents at risk for iron deficiency anemia? A. Blood volume is expanding. B. Menstruation begins in females. C. Lean body mass increases in males. D. All of these choices are accurate. 34. Fluoride supplements should be given to ________. A. breastfed infants beginning at 1 month old B. infants after 6 months of age if the home's water supply is not fluoridated C. all children until they begin using fluoride-containing toothpaste D. None of these choices are accurate. 35. Which infants have special vitamin needs? A. Infants at birth need vitamin K. B. Breastfed infants need iron supplements. C. Breastfed infants whose mothers are vegans need vitamin B-12 supplements. D. All of these choices are accurate. 36. It is best to avoid serving cow's milk until the infant reaches the age of ________. A. 6 months B. 10 months C. 12 months D. 18 months 37. With the possible exception(s) of _____, human milk provides all the nutrients needed during the first 6 months of life. A. vitamin D B. iron C. fluoride D. All of these choices are accurate. E. None of these choices are accurate. 38. Which protein in human milk increases iron absorption? A. Casein B. Lactalbumin C. Lactoferrin D. Bifidus factor 39. Compared to foremilk, hind milk has ________. A. more fat B. more protein C. fewer calories D. All of these choices are correct. 40. Which is NOT true about the fat in human milk? A. The type of fatty acids in human milk depends on the mother's diet. B. The fats in human milk are provided by the mother's diet and are synthesized in the breast. C. Human milk is low in cholesterol and linoleic acid. D. Human milk contains omega-3 fatty acids to support brain and eye development. 41. If human milk or infant formula is not available, ____ can provide a safe, nutritious alternative for infants. A. sweetened condensed milk B. soy drinks C. evaporated milk D. All of these are healthy alternatives to human milk or infant formula. E. None of these are healthy alternatives to human milk or infant formula. 42. Why is cow's milk not recommended for infants? A. Its calcium content is too low. B. Its vitamin E content is too high. C. Its protein content is too high. D. Its vitamin C content is too high. E. All of these responses are accurate. 43. An advantage to infants of being breastfed is ________. A. reduced risk for food allergies B. enhanced visual acuity and learning ability C. reduced risk for crooked teeth D. reduced risk for diarrhea E. All of these are advantages of breastfeeding for the infant. 44. What are signs that an infant has had enough eat? A. Becoming playful B. Falling asleep C. Turning head away or not paying attention D. All of these choices are accurate. 45. How can you tell a breastfed infant is receiving adequate nourishment? A. The infant has 6 or more wet diapers daily. B. Weight gain is normal. C. The infant has 1 to 2 bowel movements daily that look like lumpy mustard. D. All of these answers are correct. 46. A baby should be burped ________. A. every 2 to 3 minutes during feeding B. after giving 1 to 2 ounces of formula C. at the beginning of the feeding D. when the baby begins to spit up a bit of milk 47. The time to introduce solid foods to an infant's diet depends on his or her ________. A. nutritional needs B. physiological capabilities C. physical abilities D. All of these responses are correct. 48. Which is NOT a sign that an infant may be ready for solid foods? A. The infant can sit alone with support. B. The extrusion reflex is strong. C. The infant can make a chewing motion. D. The infant demands to be fed 8 to 10 times daily. 49. Introducing solid foods to an infant's diet before the infant needs them can ________. A. strain the young infant's organs B. help the child sleep through the night C. help the child walk at a younger age D. help the child achieve optimal height 50. By age 1 year, the calories provided from human milk or formula should be ____ the calories provided by solid food. A. twice as high as B. equal to C. half as many as D. one-third as high as 51. The first solid food usually introduced to the infant's diet is ________. A. cow's milk B. strained fruits C. pureed meats D. iron-fortified infant cereals 52. When a new food is introduced, the amount that should be served is ________. A. 1 teaspoon B. 2 tablespoons C. 1/4 cup D. 1/3 cup 53. When serving a food for the first time to an infant, ________. A. the food should be a single-ingredient (not mixed) food item B. wait several days before serving another new food C. expect the baby to eat only a few bites D. All of these responses are correct. 54. Which cereal is least likely to cause allergies in infants? A. rice B. wheat C. barley D. oats 55. When are many babies ready for finger foods? A. 3 months of age B. 6 months of age C. 8 months of age D. 9 months of age 56. What is wrong with giving juice in a bottle or propping up a bottle of formula for the child to drink at bedtime? A. Nothing. The child loves it. B. Sugar bathes the teeth, bacteria grow, acids are produced from sugar, and acids dissolve tooth enamel. C. It is best for an infant to be held when drinking from a bottle for the sense of security that it provides. D. Often, the contents of the bottle spoil, which can lead to gastrointestinal upsets. 57. It is recommended that honey not be given to infants because it ________. A. is high in energy B. may contain Salmonella C. may contain Clostridium botulinum spores D. is too sweet 58. For normal-weight children, reduced-fat milk should be introduced into a child's diet ________. A. after 5 years of age B. after 4 years of age C. after 2 years of age D. after 6 months of age 59. Which food on this list is NOT appropriate for an infant less than one year old? A. egg yolk B. honey C. orange juice D. cooked and strained vegetables 60. Which of these foods pose a choking hazard for infants and children? (Check all the apply) A. popcorn B. peanut butter C. nuts D. grapes E. All of these foods pose choking hazards. 61. A child who exhibits signs of ____ may be suffering from undernutrition. A. fatigue B. increased susceptibility to infection C. underweight D. All of these are signs of undernutrition. 62. An appropriate serving size of carrots for a 3-year-old is ________. A. 3 teaspoons B. 3 tablespoons C. 1/3 cup D. 2/3 cup 63. Which foods are NOT likely to appeal to preschool children? (Check all that apply) A. beef stew B. tuna casserole C. spicy chicken D. All of these choices are correct. 64. To help children develop good nutritional habits, ________. A. limit the number of new foods they are offered B. let children make some choices about the food they eat C. serve new foods at the end of the meal when the child is not hungry D. be certain children finish all the food they are served 65. The preschool years are characterized by ________. A. a slower growth rate B. a decreased appetite C. changes in eating behavior D. All of these choices are accurate. 66. What do preschool children like to eat? A. Familiar foods B. Foods served at comfortable temperatures C. Mild flavors D. Crisp-textured foods E. All of these choices are accurate. 67. To get a child to try a new food, ________. A. offer food rewards, such as a favorite dessert B. add sugar or butter to the food C. employ the "one bite" rule D. All of these choices are accurate. 68. Which is NOT a common mealtime challenge with preschoolers? A. Picky eating B. Food jags C. Refusing to eat D. Pica 69. Which food-related behaviors can negatively affect the quality of adolescents' diets? (Check all that apply) A. meal skipping B. snacking C. eating out D. All of these choices are correct. 70. What is a likely nutritional problem of adolescent girls? A. Not drinking milk B. Iron deficiency anemia C. Frequent dieting D. All of these choices are correct. 71. Children who experience constipation usually ________. A. drink too much water B. drink too much milk C. eat too many snacks D. All of these choices are correct. 72. Typical sign(s) of dehydration in an infant are/is ________. A. no or few tears when crying B. severe drooling C. ear aches D. All of these are signs of dehydration. 73. A baby that sleeps with a bottle filled with formula has an increased risk for ________. A. ear infections B. diarrhea C. allergies D. colic 74. What factor contributes to childhood obesity? A. TV watching or playing video games B. Genetics C. High-fat, high-energy snacks D. Little physical activity E. All of these choices are correct. 75. What is the recommended treatment for childhood obesity? A. Increase physical activity. B. Decrease intake of high-fat, high-energy foods. C. Modify problem behaviors, such as snacking while watching TV. D. All of these choices are correct. 76. Iron deficiency anemia is most likely to occur ________. A. between birth and age 3 months B. between the ages of 12 and 24 months C. between the ages of 3 to 5 years D. after the child starts school 77. Instead of a double cheeseburger from a fast food restaurant for lunch, the hungry adolescent could make a healthier choice by choosing ____ instead. A. french fries B. a hot dog and cola C. a vegetable pizza D. fried chicken E. None of these choices are correct. 78. Menarche is ________. A. cell division B. cell growth C. the onset of menses D. the excretion of lipids, waxes, and triglycerides E. excessive restlessness True / False Questions 79. One-third of all growth in a lifetime occurs during adolescence. TRUE 80. Per pound of body weight, nutrient needs during adolescence are higher than during any other stage of the lifecycle. FALSE 81. The transition from childhood to adulthood is called puberty. FALSE 82. The growth percentile curve a child follows depends ONLY on his/her genetic potential. FALSE 83. "Catch up" growth is possible after the epiphyses have closed. FALSE 84. More amino acids are considered essential for adults than for infants. FALSE 85. Teens in the U.S. tend to consume far more calcium than needed. FALSE 86. In the U.S., infant formula standards are set to match the nutrient composition of human milk as closely as possible. TRUE 87. Breastfed infants have a reduced risk of obesity and ear infections. TRUE 88. Infant formula should be prepared with cold water. TRUE 89. Infant formulas can be heated safely in the microwave oven. FALSE 90. Adding too much water to infant formula can be dangerous to the infant. TRUE 91. An infant's nutrient stores are exhausted by the time the infant has gained 3 pounds. FALSE 92. Bribing children to eat a new food is a good way to help them discover new foods. FALSE 93. To help children keep their weight under control, they should receive no more than 3 meals daily. FALSE 94. Serving new foods in a calm, supportive setting can help children to accept new foods. TRUE 95. The physical changes of adolescence can cause teens to be dissatisfied with their bodies. TRUE 96. Substance use can negatively affect teenagers' diets. TRUE 97. Babies with colic should not be breastfed. FALSE 98. In children, gastroesophageal reflux is most common after age 2 years. FALSE 99. Milk allergies seldom last beyond 3 years of age. TRUE 100. Acne is strongly linked with intake of fatty foods like pizza and chocolate. FALSE 101. A female who becomes pregnant within 2 years of menarche is at a higher nutritional risk than one who becomes pregnant later. TRUE 102. Children should be screened for elevated blood cholesterol if their families have histories of early development of heart disease. TRUE Short Answer Questions 103. Why should leftover formula always be discarded? Answer: Leftover formula should always be discarded for several reasons: 1. Bacterial Contamination: Once formula is prepared and served, it can become contaminated with bacteria from the baby's mouth or surroundings. 2. Nutrient Degradation: Formula left at room temperature can lose its nutritional value and quality over time, impacting its effectiveness in meeting the baby's nutritional needs. 3. Safety Concerns: Reheating or reusing leftover formula can increase the risk of bacterial growth and potential illness, especially in infants with developing immune systems. 4. Hygiene Practices: Discarding leftover formula promotes good hygiene practices, ensuring that babies consume fresh and safe food sources to support their growth and development. 5. Regulatory Guidelines: Health guidelines recommend discarding any remaining formula within one hour after feeding to minimize health risks associated with contamination and nutrient loss. True / False Questions 104. Leftover infant formula should always be discarded because it is contaminated by bacteria and enzymes from the baby. TRUE 105. Children with autism frequently have unusual eating behaviors. TRUE 106. Children with autism often have reduced sensitivity to food taste, smell, color, and/or texture. FALSE Multiple Choice Questions 107. Your friend is concerned that her son is gaining too much weight. Before seeking advice from her son's pediatrician, she wants you to give her your opinion because she knows you are taking a nutrition class. You learn from her that her son is 3' 10" and currently weighs 60 lbs. You also remember that he just had his 6th birthday. How would you classify her son after calculating his BMI? A. Underweight B. Normal weight C. Overweight D. Obese Short Answer Questions 108. Design a 1 day diet for an obese child that is 10 years old. Include recommendations for lifestyle modifications. Answer: 1-Day Diet Plan: Breakfast: • Option 1: • 1 small bowl of whole-grain cereal with low-fat milk • 1 small banana • 1 glass of water • Option 2: • 1 scrambled egg with spinach • 1 slice of whole-grain toast • 1 small apple • 1 glass of water Morning Snack: • Option 1: • 1 small handful of nuts (almonds or walnuts) • 1 glass of water • Option 2: • 1 small serving of low-fat yogurt • 1 glass of water Lunch: • Option 1: • Grilled chicken sandwich with whole-grain bread, lettuce, tomato, and a small amount of mustard • A side of baby carrots • 1 glass of water • Option 2: • Turkey and cheese wrap with whole-grain tortilla, lettuce, and a small amount of hummus • A side of cucumber slices • 1 glass of water Afternoon Snack: • Option 1: • 1 small piece of fruit (like an orange or pear) • 1 glass of water • Option 2: • A small serving of mixed vegetable sticks (like bell peppers and cherry tomatoes) with a small amount of hummus • 1 glass of water Dinner: • Option 1: • Baked salmon fillet with a side of steamed broccoli • Quinoa or brown rice • 1 glass of water • Option 2: • Grilled chicken breast with a side of roasted sweet potatoes • Steamed green beans • 1 glass of water Evening Snack (if needed): • Option 1: • A small serving of low-fat cottage cheese with a few berries • 1 glass of water • Option 2: • 1 small piece of fruit (like an apple or banana) • 1 glass of water Lifestyle Modifications: 1. Regular Physical Activity: • Encourage at least 60 minutes of moderate to vigorous physical activity each day. This can include playing outside, riding a bike, swimming, or participating in sports. 2. Limit Screen Time: • Restrict screen time (TV, video games, and computers) to no more than 1-2 hours per day. Promote more active playtime instead. 3. Healthy Eating Habits: • Teach the child about portion control and the importance of eating a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. • Encourage eating meals as a family to foster healthy eating behaviors and habits. 4. Adequate Sleep: • Ensure the child gets 9-12 hours of sleep per night, as adequate rest is crucial for overall health and weight management. 5. Positive Environment: • Create a supportive home environment where healthy choices are readily available and encouraged. Involve the child in grocery shopping and meal preparation to educate them about nutritious food choices. 109. Describe why young children are at a higher risk for developing iron deficiency anemia. What modifications can be made to help decrease their risk? Answer: Young children are at a higher risk for developing iron deficiency anemia due to several physiological, dietary, and developmental factors. Iron deficiency anemia occurs when there is a lack of adequate iron in the body to produce hemoglobin, the protein in red blood cells responsible for carrying oxygen to the tissues. Here are the key reasons for this increased risk in young children: 1. Rapid Growth and Development: • Young children experience rapid growth and development, particularly in the first two years of life. This rapid growth increases the body's demand for iron to support the production of hemoglobin and the formation of new tissues. If the dietary intake of iron does not meet this increased demand, it can lead to iron deficiency anemia. 2. Inadequate Dietary Intake: • Many young children transition from breast milk or formula to solid foods around the age of six months. During this transition, their diets may lack sufficient iron-rich foods. Additionally, picky eating behaviors are common in toddlers, leading to a limited variety of foods being consumed, further contributing to inadequate iron intake. 3. Exclusive Breastfeeding Beyond Six Months: • While breast milk is an excellent source of nutrition, it contains relatively low levels of iron. After six months of age, infants' iron stores from birth begin to deplete, and breast milk alone may not provide sufficient iron. Without the introduction of iron-rich complementary foods, exclusively breastfed infants are at risk of developing iron deficiency anemia. 4. Cow's Milk Consumption: • Excessive consumption of cow's milk in young children can interfere with iron absorption. Cow's milk is low in iron and can also cause microscopic gastrointestinal bleeding in some children, leading to iron loss. Moreover, children who consume large quantities of cow's milk may have reduced appetite for iron-rich foods. 5. Socioeconomic Factors: • Children from low-income families may have limited access to a variety of nutritious foods, including iron-rich foods. Financial constraints can lead to diets that are low in iron and other essential nutrients, increasing the risk of iron deficiency anemia. To decrease the risk of iron deficiency anemia in young children, several modifications can be made: 1. Iron-Rich Foods: • Introduce iron-rich foods into the child's diet, such as lean meats, poultry, fish, beans, lentils, tofu, fortified cereals, and dark leafy greens. These foods should be included in meals regularly to ensure adequate iron intake. 2. Iron-Fortified Products: • Use iron-fortified infant cereals and formulas, especially during the transition from breast milk or formula to solid foods. Fortified products can help meet the increased iron requirements during periods of rapid growth. 3. Limit Cow's Milk: • Limit the intake of cow's milk to no more than 16-24 ounces (about 2-3 cups) per day for children aged 1-5 years. This helps prevent milk from displacing iron-rich foods in the diet and reduces the risk of gastrointestinal bleeding. 4. Vitamin C-Rich Foods: • Include vitamin C-rich foods in meals, such as citrus fruits, strawberries, tomatoes, and bell peppers. Vitamin C enhances the absorption of non-heme iron (the type of iron found in plant-based foods), improving overall iron status. 5. Regular Check-Ups: • Ensure regular pediatric check-ups to monitor the child's growth and development, as well as to assess their iron status. Early detection of iron deficiency allows for timely intervention and prevention of anemia. By addressing these factors and implementing these modifications, the risk of iron deficiency anemia in young children can be significantly reduced, promoting better overall health and development. 110. Explain why infants need more calories per unit of body weight than adults. Answer: Infants need more calories per unit of body weight than adults due to several key factors related to their rapid growth, development, and higher metabolic rates. 1. Rapid Growth and Development: • Infants experience a tremendous rate of growth and development in their first year of life. Their bodies are constantly developing new tissues, including muscles, organs, and brain cells. This rapid growth requires a significant amount of energy, leading to a higher caloric need per unit of body weight. 2. Higher Basal Metabolic Rate: • Infants have a higher basal metabolic rate (BMR) compared to adults. The BMR is the amount of energy expended while at rest to maintain vital bodily functions such as breathing, circulation, and temperature regulation. Because infants are in a state of continuous development and activity, their BMR is higher, necessitating more calories to support these metabolic processes. 3. Energy Reserves: • Infants have limited energy reserves in the form of fat and glycogen stores. Therefore, they need a constant supply of calories to ensure they have enough energy for their immediate needs, growth, and development. 4. Thermoregulation: • Infants have a higher surface area-to-volume ratio compared to adults, which means they lose heat more quickly. To maintain their body temperature and support thermoregulation, they require additional energy. 5. Increased Activity Levels: • Although infants may not engage in structured physical activity like adults, their daily activities, such as kicking, reaching, and crawling, require substantial energy. These activities contribute to their overall higher caloric needs. 111. Choose 2 nutrients that are of particular concern for children and describe the physiological effect of a deficiency in these nutrients. Answer: 1. Iron: Iron is a crucial nutrient for children, as it plays a vital role in the production of hemoglobin, the protein in red blood cells responsible for transporting oxygen throughout the body. A deficiency in iron can lead to iron deficiency anemia, which has several physiological effects: • Reduced Oxygen Transport: • Iron deficiency anemia results in decreased hemoglobin levels, reducing the oxygen-carrying capacity of the blood. This can lead to fatigue, weakness, and decreased physical endurance in children. • Impaired Cognitive Development: • Iron is essential for proper brain development and function. A deficiency can impair cognitive development, leading to difficulties in learning, attention, and behavior. Children with iron deficiency anemia may experience delays in cognitive and motor development, affecting their academic performance and social interactions. • Compromised Immune Function: • Iron is necessary for a healthy immune system. A deficiency can weaken the immune response, making children more susceptible to infections and illnesses. 2. Vitamin D: Vitamin D is essential for the regulation of calcium and phosphorus in the body, which are critical for healthy bone development. A deficiency in vitamin D can lead to several physiological effects: • Rickets: • Vitamin D deficiency in children can cause rickets, a condition characterized by weak or soft bones, leading to skeletal deformities such as bowed legs, thickened wrists and ankles, and delayed growth. Rickets can cause pain and increase the risk of fractures. • Impaired Bone Mineralization: • Without adequate vitamin D, the body cannot effectively absorb calcium from the diet, leading to poor bone mineralization. This can result in osteomalacia, a condition where bones become soft and brittle. • Weakened Immune Function: • Vitamin D plays a role in modulating the immune system. A deficiency can impair immune function, increasing the risk of infections and autoimmune diseases. Ensuring adequate intake of these essential nutrients is crucial for children's growth, development, and overall health. Chapter 18 Nutrition during the Adult Years Multiple Choice Questions 1. During adulthood, nutrients are used primarily ________. A. to maintain the body B. to support physical growth C. to maintain the body and support physical growth 2. After age ____ or so, the rate of cell breakdown begins to exceed the rate of cell renewal. A. 25 B. 30 C. 35 D. 55 3. Starting around age ___, organ size and efficiency begin to decrease. A. 30 B. 40 C. 50 D. 70 4. Which is NOT a current hypothesis about the cause of aging? A. Blood concentrations of hormones change. B. Cells can divide about 50 times, and then they die. C. The immune system becomes less able to recognize and destroy foreign substances. D. Connective tissue stiffens and reduces flexibility. E. All of these are current hypotheses about the cause of aging. 5. Age-related degenerative changes can be minimized, prevented, or reversed by ________. A. exercising regularly B. getting enough sleep C. avoiding excessive exposure to sunlight D. eating nutritiously E. All of these responses are correct. 6. Which is an example of usual aging? A. Increasing body fatness B. Maintenance of lean body mass C. Maintenance of bone mass D. All of these responses are correct. 7. Compression of morbidity can be defined as ________. A. having the greatest number of healthy years and the fewest number of years with illness B. representing a low death rate from chronic diseases C. having a longer life D. postponing illness until such time as there is an adequate treatment or cure 8. Which determines the rate of aging? A. Genetics B. Lifestyle C. Environment D. All of these choices are accurate. 9. Which aspect(s) of the environment influence(s) the rate of aging? A. Income and education B. Quality of housing and autonomy C. Access to health care and nutritious food D. Psychosocial support and protection from climactic extremes E. All of these responses are correct. 10. According to the Dietary Guidelines for Americans, a goal for adults is to ________. A. limit intake of added sugars and emphasize vegetables in the diet B. keep body weight in a healthy range C. practice safe food handling D. All of these responses are correct. 11. In adulthood, a nutritious diet can help to ________. A. delay onset of disease B. recover more quickly from disease C. increase mental, physical, and social well-being D. A nutritious diet can do all of these things. 12. The diets of adults tend to be high in ________. A. vitamin D B. calcium C. fat D. zinc E. fiber 13. The diets of adults tend to be low in ________. A. vitamin D B. zinc C. magnesium D. folate E. All of these responses are correct. 14. The largest group of adults at risk for nutrient deficiencies is ________. A. women B. pregnant women C. low-income people D. older adults living in long-term care facilities 15. The Dietary Reference Intakes (DRIs) for adults do not take into consideration aging-related changes in ________. A. body composition B. metabolism C. organ function D. DRIs take into account all of these things. 16. Calorie needs decline after age 30 years or so because ________. A. basal metabolism declines B. the body becomes more efficient in using energy C. thrifty metabolism begins D. All of these responses are correct. 17. Who may not receive sufficient protein? A. Adults with limited budgets B. Adults with chewing problems C. Adults who are lactose intolerant D. All of these choices are correct. 18. A diet rich in fiber helps adults to ________. A. reduce risk of osteoporosis B. reduce risk of heart disease C. raise blood cholesterol levels D. avoid diarrhea 19. Low fluid intake in older adults may be caused by ________. A. less intense feelings of thirst B. chronic disease C. certain medications D. reduced ability of the kidneys to concentrate urine E. All of these responses are correct. 20. Why is vitamin D a nutrient of particular concern in older adults? A. Permeability of the intestine to dietary vitamin D increases as the intestine ages, which increases risk for toxicity. B. Vitamin D synthesis in the skin slows. C. The kidneys accelerate the conversion of vitamin D to its active form, which increases the risk for toxicity. D. None of these responses are accurate. 21. A common cause of iron deficiency anemia in adulthood is ________. A. bleeding ulcers B. use of aspirin C. bleeding hemorrhoids D. All of these responses are correct. 22. Insufficient intakes of ___ by adults may contribute to loss of taste sensations and delayed wound healing. A. magnesium B. zinc C. folate D. vitamin B-12 23. Inadequate intake of ____ in adults may contribute to loss of bone strength and mental confusion. A. magnesium B. zinc C. folate D. vitamin B-12 24. Elevated blood concentrations of ____ are associated with increased risk for stroke and neurological decline in some elderly adults. A. zinc B. homocysteine C. vitamin E D. vitamin D 25. Intakes of ______ have been associated with reduced risk for age-related macular degeneration and cataracts. A. vitamin E B. folate C. lutein D. zeaxanthin E. both lutein and zeaxanthin 26. A major problem afflicting the elderly gastrointestinal tract is ________. A. increased lactase synthesis B. constipation C. increased HCl production D. increased synthesis of intrinsic factor 27. A change in muscle that occurs in adulthood is ________. A. increased elasticity B. bloating of muscle cells C. loss of muscle strength D. hypertrophy of muscle cells 28. Physical activity is associated with ________. A. improved sleep B. reduced risk for falling C. positive mental outlook D. better mobility E. All of these responses are correct. 29. To preserve bone mass, adults should ________. A. not smoke B. consume adequate vitamin D C. consume adequate calcium D. All of these recommendations are correct. 30. To protect the cardiovascular system, adults should ________. A. not smoke B. eat low-carbohydrate diets C. avoid vigorous exercise D. All of these choices are correct. 31. To prevent constipation, older adults should ________. A. limit highly sweetened foods B. increase dietary fiber C. take laxatives D. All of these choices are accurate. 32. An age-related change in the nervous system that can adversely affect nutritional status is ________. A. decreased taste perception B. hearing loss C. vision loss D. All of these changes can impact nutritional status. 33. During the adult years, ____ can adversely affect the immune system. A. undernutrition B. overnutrition C. excessive iron intake D. obesity E. All of these choices are correct. 34. Long-term use of aspirin or aspirin-like medications can deplete _________ reserves. A. iron B. calcium C. vitamin K D. thiamin 35. Many elderly people avoid social contact because they ________. A. are experiencing hearing loss B. have trouble seeing, so they avoid going out C. have problems with urinary incontinence D. All of these choices are accurate. 36. Which is true of the Congregate Meal program? A. It is administered by the USDA. B. It is part of the Older Americans Act. C. Anyone age 52 or older can participate. D. All of these responses are accurate. 37. Which U.S. government program distributes surplus agricultural products? A. Commodity Supplemental Food Program B. Supplemental Nutrition Assistance Program (SNAP) C. Child and Adult Care Food Program D. Senior Farmers' Market Nutrition Program 38. Which is true about the Supplemental Nutrition Assistance Program (SNAP)? A. It provides nutrition education. B. It provides a means to purchase food-producing plants. C. It provides a means to buy hot meals in group homes. D. It supplements food budgets of low-income households. E. All of these responses are correct. 39. Warning signs of Alzheimer's disease include ________. A. personality changes B. language problems C. reduced job performance D. faulty judgment E. All of these are signs of Alzheimer's disease. 40. To relieve the symptoms of arthritis, older adults should ________. A. follow a special diet B. restrict certain foods C. take nutrient supplements D. All of these responses are accurate. E. None of these responses are accurate. 41. Which domain of complementary and alternative medicine involves using foods and special diets? A. Energy medicine B. Alternative medical systems C. Biological based practices D. Mind-body interventions 42. Which is an example of a mind-body intervention? A. Hypnosis B. Biofeedback C. Yoga D. All of these are examples of mind-body interventions. 43. Which is NOT an example of energy medicine? A. High-calorie diets B. Pulsed fields C. Magnetic fields D. Electrical currents 44. In complementary and alternative medicine, a manipulative practice is ________. A. massage B. Reiki therapy C. chiropractic manipulation D. All of these examples are correct. E. None of these examples are correct. 45. An alternative medical practice system is ________. A. Ayurveda B. naturopathy C. homeopathy D. acupuncture E. All of these responses are correct. 46. A rational approach for someone wanting to try complementary and alternative medicine is to ________. A. take advice from a trusted friend B. keep a record of symptoms and practices followed C. try at least 2 complementary and alternative medical practices at once D. All of these approaches are rational. 47. Which is true about herbs? A. There is little regulation regarding herbal supplements in the U.S. B. There have been no cases of adverse effects of using herbal supplements. C. Herbal supplements are more effective than medicines. D. Herbal supplements are as rigorously tested as medicines in the U.S. E. All of these responses are true. 48. What food and nutrition service program(s) does the U.S. Department of Agriculture (USDA) and Administration on Aging provide for older adults? A. Commodity Supplemental Food program B. Supplemental Nutrition Assistance program C. Senior Farmers’ Market Nutrition program D. Child and Adult Care Food program E. All of the above. 49. Which strength training recommendation(s), as suggested by the National Institutes on Aging, is/are appropriate for older adults? A. Exercise at least 2 days per week. B. Stretch after completing all exercises. C. Perform exercises that involve major muscle groups. D. All of the choices are appropriate strength training recommendations. 50. An older relative has recently been placed on anticoagulant medications. Her doctor did not make any dietary recommendations. Which of the following foods would you suggest that your relative avoid until further discussing her medication with her doctor? A. Oranges B. Whole grain bread C. Spinach D. Milk 51. Which of the following foods would be recommended for an elderly person who has periodontal disease? A. Carrots B. Chicken breast C. Canned apricots D. Brown rice Short Answer Questions 52. Compare and contrast the benefits of Congregate Meals versus Meals on Wheels for older adults. Answer: Congregate Meals: Benefits: 1. Social Interaction: • Congregate meal programs provide a setting where older adults can dine together, fostering social interaction and reducing feelings of loneliness and isolation. This social engagement can significantly enhance mental and emotional well-being. 2. Community Engagement: • These programs are often held in community centers, churches, or senior centers, which can encourage older adults to participate in other activities and services offered at these locations. This can promote a sense of community and belonging. 3. Nutritional Benefits: • Congregate meals are usually planned by nutritionists to meet the dietary needs of older adults, ensuring they receive balanced and nutritious meals. 4. Opportunities for Physical Activity: • Many congregate meal sites offer opportunities for physical activity, such as exercise classes or walking groups, which can contribute to overall health and well-being. 5. Access to Services: • Congregate meal programs often provide access to additional services such as health screenings, educational workshops, and recreational activities, enhancing the overall quality of life for participants. Drawbacks: 1. Accessibility: • Congregate meal sites may not be accessible to all older adults, particularly those with mobility issues, transportation challenges, or living in rural areas. 2. Fixed Schedule: • These programs usually operate on a fixed schedule, which may not be convenient for all participants. Meals on Wheels: Benefits: 1. Convenience and Accessibility: • Meals on Wheels delivers nutritious meals directly to the homes of older adults, making it accessible to those with mobility issues, transportation challenges, or living in remote areas. 2. Nutritional Support: • The meals are planned by nutritionists to meet the dietary needs of older adults, ensuring they receive balanced and nutritious meals. This can be particularly beneficial for those with dietary restrictions or chronic health conditions. 3. Regular Check-Ins: • Delivery drivers often provide a regular point of contact and can check in on the well-being of recipients. This can help identify any immediate needs or emergencies and provide a sense of security and connection. 4. Flexible Timing: • Meals can be delivered at times convenient for the recipients, allowing for greater flexibility in meal planning. Drawbacks: 1. Limited Social Interaction: • Meals on Wheels primarily focuses on meal delivery and may not provide the same level of social interaction and community engagement as congregate meal programs. This can lead to feelings of isolation if not supplemented with other social activities. 2. Limited Services: • While some programs may offer additional services, Meals on Wheels generally focuses on meal delivery, which might not provide the same range of additional services and activities available through congregate meal programs. Comparison: • Social Interaction: Congregate meals provide greater opportunities for social interaction and community engagement, while Meals on Wheels offers limited social contact primarily through the delivery driver. • Accessibility: Meals on Wheels is more accessible to older adults with mobility issues or transportation challenges, whereas congregate meals may be difficult to attend for those without reliable transportation or who live in remote areas. • Additional Services: Congregate meal programs often offer a range of additional services and activities, whereas Meals on Wheels focuses primarily on meal delivery, with fewer supplementary services. • Flexibility: Meals on Wheels offers greater flexibility in meal timing, catering to the specific needs and schedules of recipients, while congregate meals operate on a fixed schedule. Both programs play a crucial role in supporting the nutritional and social needs of older adults, and the choice between them may depend on individual circumstances, preferences, and specific needs. Multiple Choice Questions 53. A friend was recently prescribed corticosteroids for an inflammatory reaction he is having. He knows that you are taking a nutrition class and has asked you for advice on any drug-nutrient interactions that you may have learned in your class. Which of the following foods would you suggest he increase during the time he is taking this medication? A. Low-fat milk B. Spinach C. Pork D. Salmon 54. You have an older relative that is complaining of fatigue. You learn that she is taking aspirin on a daily basis to prevent a heart attack. What condition do you suspect your relative may have? A. Osteoporosis B. Alzheimer disease C. Iron deficiency anemia D. Gout 55. A friend has recently been diagnosed with hypertension and has been prescribed Lasix to help treat her condition. This doctor did not recommend any dietary changes. Which of the following foods would you suggest that your friend increase until she can discuss her medications with her doctor? A. Any processed foods B. Beans C. Diet soft-drinks D. Oranges 56. A friend has been drinking more than the usual amount of alcohol. You are concerned about the effects alcohol has. Which of the following herbal remedies do you feel comfortable suggesting for your friend to supplement with, based on your knowledge of the harmful effects of alcohol? A. Saw palmetta B. Milk thistle C. Melatonin D. Black cohosh 57. You have been experiencing low back pain for about a week. You do not think that it is necessary to see your medical doctor for this condition, as you have had no injuries to the area. Which of the following CAM practitioners do you feel would be most beneficial to see for relief? A. Aromatherapist B. Chiropractor C. Hypnotist D. Ayurvedic practitioner Test Bank for Wardlaw's Perspectives in Nutrition Carol Byrd-Bredbenner, Gaile Moe, Jacqueline Berning, Danita Kelley 9780078021411, 9781259933844, 9780073522722