This Document Contains Chapters 9 to 10 Chapter 09 Energy Metabolism Multiple Choice Questions 1. All the chemical and physical processes involved in maintaining life are referred to as ________. A. anabolism B. catabolism C. homeostasis D. metabolism 2. Nicotinamide adenine dinucleotide (NAD) ________. A. transports oxygen in various metabolic pathways B. picks up and delivers hydrogens to acceptor molecules C. is another form of ATP D. is a form of lactic acid 3. The energy currency the body uses is ________. A. NAD B. FAD C. TCA D. ATP 4. Flavin adenine dinucleotide is a coenzyme form of the vitamin ________. A. pantothenic acid B. niacin C. thiamin D. riboflavin 5. Photosynthesis occurs in plants and uses energy from the sun to ________. A. produce organic compounds from carbon, hydrogen, and oxygen B. produce energy-yielding compounds C. heat the environment D. make plants turn yellow 6. All the energy available to humans has its origins in ________. A. carbon dioxide and water B. the oxygen we breathe C. foods and beverages D. the sun's solar energy 7. When a compound is oxidized it ______ one or more electrons. A. loses B. gains C. transforms D. creates 8. When a compound is reduced it _____ one or more electrons. A. loses B. gains C. transforms D. creates 9. Oxidation-reduction reactions in the body are controlled by ________. A. light and dark cycles B. enzymes C. fluid balance D. protein consumption 10. If oxygen is present, metabolism is considered to be ________. A. active B. anaerobic C. aerobic D. inactive 11. In the absence of oxygen, ______ respiration will occur. A. active B. anaerobic C. aerobic D. inactive 12. Glycolysis is a process involving ________. A. synthesis of fatty acids B. reactions that convert glucose to glycogen C. reactions that convert glucose to pyruvate D. reactions that convert glycogen to protein 13. Glycolysis begins with _________ and ends with __________. A. pyruvate; water B. pyruvate; glucose C. glucose; pyruvate D. pyruvate; acetyl-CoA 14. When muscle tissue is exercising under anaerobic conditions, the production of ______ is important because it ensures a continuous supply of NAD+. A. glucose-6-phosphate B. pyruvate C. lactate D. glycogen 15. In metabolism, glucose is degraded to CO2 and water. The carbon dioxide is produced in ________. A. the red blood cells B. the citric acid cycle C. glycolysis D. the electron transport chain 16. Red blood cells undergo anaerobic metabolism, which means that they produce ________. A. plasma B. iron C. lactate D. clots 17. Under anaerobic conditions, how many net ATP are synthesized from one glucose molecule? A. 1 ATP B. 2 ATP C. 4 ATP D. 2 GTP E. None of these choices are correct. 18. How many molecules of lactate are produced from one molecule of glucose? A. 2 B. 4 C. 6 D. 8 19. The citric acid cycle is also known as the ________. A. urea cycle B. Krebs cycle C. menstrual cycle D. aerobic pathway 20. The conversion of pyruvate to acetyl-CoA ________. A. requires the addition of CO2 B. occurs in the mitochondria of the cell and is irreversible C. occurs in the nucleus of the cell D. is needed for red blood cell production 21. The common pathway for the oxidation of glucose and fatty acids is ________. A. glycolysis B. the Cori cycle C. the citric acid cycle D. ketosis 22. During the end reaction of the electron transport chain, oxygen becomes ________. A. reduced to water (H2O) B. oxidized to carbon dioxide C. NADH D. FADH2 23. The major end products of the electron transport chain are ________. A. water, carbon dioxide, and ATP B. glucose and amino acids C. dietary fiber and ammonia D. carbon, nitrogen, and hydrogen 24. Cytochromes ________. A. are produced by photosynthesis B. transport electrons in the electron transport chain C. appear in the citric acid cycle D. are responsible for beta-oxidation of fatty acids 25. Carnitine ________. A. is a dietary essential, especially for athletes B. shuttles NADH across the mitochondrial membrane C. shuttles oxaloacetate from the mitochondria to the cytosol D. shuttles fatty acids from the cytosol into the mitochondria 26. The synthesis of fatty acids occurs in the _________ of the cell and the breakdown of fatty acids occurs in the _______ of the cell. A. mitochondria; cytosol B. nucleus; cytosol C. cytosol; mitochondria D. cytosol; lysosome 27. In which compartment of the cell does the Krebs cycle and fatty acid oxidation take place? A. cell membrane B. mitochondria C. nucleus D. cytosol 28. In fatty acid synthesis, the "starting" molecule is ________. A. glycerol B. acetyl-CoA C. ATP D. pyruvate 29. After a person has fasted for about a week, the brain adapts to using _______ for some of its fuel needs. A. glycerol B. ketones C. fatty acids D. amino acids 30. Ketones are produced from ________. A. cholesterol B. hormones C. amino acids D. acetyl-CoA 31. Ketosis increases with ________. A. fasting B. a low-carbohydrate diet C. uncontrolled type 1 diabetes mellitus D. All of these choices are correct. 32. When there is excess glucose and amino acids in the liver, and no more ATP needs to be synthesized, these energy-rich nutrients are converted to ________. A. triglycerides B. pyruvate C. NAD+ D. FAD 33. Before protein becomes an energy source, the _________ must be removed from the molecule. A. COOH B. CH3 C. NH2 D. CO2 34. In most cases the starting material for gluconeogenesis is ________. A. oxaloacetate B. phosphoenolpyruvate C. carnitine D. All of these choices are correct 35. Gluconeogenesis is the process whereby the body ________. A. converts glucose to its storage form B. retrieves stored glucose from the liver C. lowers the glucose level of the blood D. produces glucose from amino acid and glycerol molecules 36. When the carbon skeleton of an amino acid is oxidized for energy, the amino group is removed and sent to the liver to produce ________. A. ammonia B. protein C. urea D. albumin 37. Amino acids (or parts of their carbon skeletons) that can be converted to pyruvate or enter the citric acid cycle directly are called ________. A. glucogenic amino acids B. ketogenic amino acids C. essential amino acids D. non-essential amino acids 38. Amino acids that become acetyl-CoA as a result of deamination are designated ketogenic amino acids because ________. A. they can become parts of the glucose molecule B. they cannot become part of the glucose molecule C. they interfere with metabolism of fatty acids D. all amino acids are interchangeable through the citric acid cycle 39. Which of the following pathways is the major way in which alcohol is metabolized? A. pyruvate dehydrogenase pathway B. ethanol dehydrogenase pathway C. lactate dehydrogenase pathway D. alcohol dehydrogenase pathway 40. Where does alcohol metabolism predominantly occur in the body? A. intestines B. liver C. kidney D. lungs 41. When excessive amounts of alcohol are consumed, which system oxidizes the excess alcohol? A. beta oxidizing system B. mitochondrial oxidizing system C. alcohol oxidizing system D. microsomal ethanol oxidizing system 42. After a period of prolonged fasting (starving), the brain changes its fuel requirements ________. A. and uses amino acids directly B. and starts to use glycerol as the primary source of energy C. and starts to use ketones and spares protein D. and glycogen becomes the primary source of energy 43. Fasting or starvation accelerates ________. A. gluconeogenesis B. ketone production C. body protein breakdown D. body fat breakdown E. All of these choices are correct. 44. In the body, excess amino acids are ________. A. burned as fuel or stored as fat B. stored by the body in the form that they were consumed C. of no concern to health status D. directly converted into lean muscle mass 45. In the metabolism of amino acids for energy, the amine group is ________. A. stored in the liver B. converted to glucose C. excreted as urea D. burned for energy 46. Typical fatty acids cannot be converted to glucose because ________. A. they lack sufficient energy B. they enter the citric acid cycle at acetyl-CoA and can never reform pyruvate C. they can only be synthesized from amino acid skeletons, not fatty acid skeletons D. they enter the citric acid cycle as propionyl-CoA 47. Metabolism is regulated by ________. A. hormones such as insulin B. the presence and activity of enzymes C. ATP levels in the individual cells D. All of these choices are correct. 48. Glycolysis is the process by which ________. A. fatty acids break apart to form acetyl-CoA B. glucose breaks apart to form pyruvate C. amino groups move from a donor to an acceptor D. NADH + H+ and FADH2 are converted to NAD+ and FAD, donating electrons and hydrogen ions to oxygen E. energy derived from NADH + H+ and FADH2 is used to generate ATP 49. Transamination is the process by which ________. A. fatty acids break apart to form acetyl-CoA B. glucose breaks apart to form pyruvate C. amino groups are transferred from a donor to an acceptor D. NADH + H+ and FADH2 are converted to NAD+ and FAD, donating electrons and hydrogen ions to oxygen E. energy derived from NADH + H+ and FADH2 is used to generate ATP 50. Beta-oxidation is the process by which ________. A. fatty acids break apart to form acetyl-CoA B. glucose breaks apart to form pyruvate C. amino groups move from a donor to an acceptor D. NADH + H+ and FADH2 are converted to NAD+ and FAD, donating electrons and hydrogen ions to oxygen E. energy derived from NADH + H+ and FADH2 is used to generate ATP 51. Electron transport is the process by which ________. A. fatty acids break apart to form acetyl-CoA B. glucose breaks apart to form pyruvate C. amino groups move from a donor to an acceptor D. NADH + H+ and FADH2 are converted to NAD+ and FAD, donating electrons and hydrogen ions to oxygen E. energy derived from NADH + H+ and FADH2 is used to generate ATP 52. Oxidative phosphorylation is the process by which ________. A. fatty acids break apart to form acetyl-CoA B. glucose breaks apart to form pyruvate C. amino groups move from a donor to an acceptor D. NADH + H+ and FADH2 are converted to NAD+ and FAD, donating electrons and hydrogen ions to oxygen E. energy derived from NADH + H+ and FADH2 is used to generate ATP True / False Questions 53. Anabolic metabolism refers to pathways that build larger, more complex compounds. TRUE 54. Catabolic metabolism refers to pathways that break down compounds to smaller, simpler units. TRUE 55. The conversion of pyruvate to acetyl-CoA is irreversible. TRUE 56. Gluconeogenesis takes place in both the cytosol and the mitochondria. TRUE 57. Beta oxidation takes place in the mitochondria. TRUE 58. The kidney is the major organ that regulates metabolism. FALSE 59. Diabetic ketoacidosis is a result of a lack of insulin. TRUE 60. Ketone bodies are products of incomplete oxidation of fatty acids. TRUE 61. The body can make glucose from fatty acids. FALSE 62. During an overnight fast, the primary fuel for the brain and central nervous system is amino acids. TRUE 63. High amounts of ketones in the blood show that the body is using protein as a fuel source. FALSE 64. The electron transport chain takes place in the cytosol. FALSE Matching Questions 65. Match the term with its definition.
1. Breakdown of glucose to pyruvate ketosis
2. Breakdown of fat to acetyl-CoA beta-oxidation
3. Formation of excess ketone bodies glycolysis
4. Synthesis of glucose from non-carbohydrate sources gluconeogenesis
5. Electrons are transferred back and forth to make ATP electron transport chain
1. Breakdown of glucose to pyruvate ketosis 3
2. Breakdown of fat to acetyl-CoA beta-oxidation 2
3. Formation of excess ketone bodies glycolysis 1
4. Synthesis of glucose from non-carbohydrate sources gluconeogenesis 4
5. Electrons are transferred back and forth to make ATP electron transport chain 5
66. Match the term with its definition.
1. Carrier of fatty acids across mitochondrial membrane carnitine
2. Synthesis of fat lipolysis
3. Compounds that transfer electrons deamination
4. Breakdown of triglycerides cytochromes
5. Removal of amine group from an amino acid lipogenesis
1. Carrier of fatty acids across mitochondrial membrane carnitine 1
2. Synthesis of fat lipolysis 4
3. Compounds that transfer electrons deamination 5
4. Breakdown of triglycerides cytochromes 3
5. Removal of amine group from an amino acid lipogenesis 2
Essay Questions 67. Why can't typical fatty acids be used as substrates for gluconeogenesis? Answer: Gluconeogenesis is the process of synthesizing glucose from non-carbohydrate precursors, such as amino acids, lactate, and glycerol. While glycerol derived from triglycerides (fats) can contribute to gluconeogenesis, typical fatty acids cannot be directly converted into glucose due to the following reasons: 1. Acetyl-CoA Formation: • Fatty acids undergo beta-oxidation in the mitochondria to produce acetyl-CoA molecules. Acetyl-CoA cannot be converted back into pyruvate, which is a necessary intermediate in gluconeogenesis. Pyruvate is typically derived from glucose or other intermediates that can be converted into oxaloacetate, a key precursor for gluconeogenesis. 2. Energy Yield: • Fatty acid oxidation primarily serves to produce ATP through the citric acid cycle and oxidative phosphorylation, yielding large amounts of energy. This process does not yield intermediates that can be used for gluconeogenesis. 3. Role of Glycerol: • Glycerol, released during the breakdown of triglycerides, can be converted into dihydroxyacetone phosphate (DHAP), an intermediate of glycolysis. DHAP can then be converted into glucose through gluconeogenesis. However, fatty acids themselves do not yield glucose directly. Therefore, while glycerol from fats can contribute to gluconeogenesis indirectly, typical fatty acids cannot serve as direct substrates for glucose synthesis in the body. 68. Explain the meaning of the phrase "fat burns in the flame of carbohydrates." Answer: The phrase "fat burns in the flame of carbohydrates" refers to the metabolic relationship between carbohydrates and fats in energy metabolism: • Glycolysis: Carbohydrates are broken down into glucose, which undergoes glycolysis to produce pyruvate and a small amount of ATP. • Pyruvate Oxidation: Pyruvate is converted into acetyl-CoA, which enters the citric acid cycle (Krebs cycle). • Energy Production: The citric acid cycle generates reducing equivalents (NADH and FADH2) and ATP through oxidative phosphorylation in the electron transport chain. • Fatty Acid Oxidation: Fatty acids are broken down into acetyl-CoA through beta-oxidation, and acetyl-CoA enters the citric acid cycle to produce more reducing equivalents and ATP. In essence, the efficient oxidation (burning) of fats (fatty acids) for energy production in the citric acid cycle and oxidative phosphorylation relies on an adequate supply of carbohydrates. Carbohydrates provide the initial substrate (glucose) and intermediates (pyruvate) necessary for the optimal function of the citric acid cycle and electron transport chain. Without sufficient carbohydrates, fatty acid oxidation cannot proceed efficiently, potentially leading to incomplete oxidation and the production of ketone bodies in conditions like fasting or very low-carbohydrate diets. 69. Differentiate between aerobic and anaerobic metabolism. How does this apply to physical activity? Answer: Aerobic Metabolism: • Definition: Aerobic metabolism refers to the process of producing energy (ATP) with the presence of oxygen. • Pathway: In aerobic metabolism, glucose is fully oxidized to carbon dioxide and water through glycolysis, pyruvate oxidation, citric acid cycle, and oxidative phosphorylation. • Energy Yield: Aerobic metabolism yields a large amount of ATP (36-38 molecules per glucose molecule) and is highly efficient. • Application to Physical Activity: Aerobic metabolism is predominant during low to moderate intensity exercises, such as walking, jogging, and endurance activities. It provides sustained energy production and supports longer durations of exercise. Anaerobic Metabolism: • Definition: Anaerobic metabolism refers to the process of producing energy (ATP) without oxygen or in conditions where oxygen availability is limited. • Pathway: In anaerobic metabolism, glycolysis produces ATP from glucose without oxygen, generating lactate as a byproduct. • Energy Yield: Anaerobic metabolism yields a smaller amount of ATP (2 molecules per glucose molecule) compared to aerobic metabolism. • Application to Physical Activity: Anaerobic metabolism predominates during high-intensity exercises, such as sprinting or weightlifting, where energy demands exceed oxygen availability. It provides rapid energy but is not sustainable for prolonged periods due to lactate accumulation and muscle fatigue. 70. Why do fats yield more energy per gram than proteins or carbohydrates? Answer: Fats yield more energy per gram than proteins or carbohydrates primarily due to their chemical structure and energy density: 1. Energy Density: • Fats have a higher energy density compared to proteins and carbohydrates. Each gram of fat provides approximately 9 calories (kcal) of energy, whereas proteins and carbohydrates provide about 4 calories per gram. This is because fats contain more carbon-hydrogen bonds, which store more energy compared to the oxygen-hydrogen bonds found in carbohydrates and proteins. 2. Efficient Energy Storage: • Fats are highly efficient for energy storage in the body. They are stored in adipose tissue (body fat) and can be broken down into fatty acids and glycerol during periods of energy demand. Fatty acids are then oxidized through beta-oxidation in mitochondria to produce ATP (adenosine triphosphate), the primary energy currency of cells. 3. Role in Energy Production: • During metabolism, fats undergo beta-oxidation to produce acetyl-CoA molecules, which enter the citric acid cycle (Krebs cycle) and electron transport chain in mitochondria. This process generates a substantial amount of ATP through oxidative phosphorylation, making fats a crucial energy source for prolonged activities and endurance. 71. Explain why some people think that consuming carnitine pills will help them lose weight. Answer: Carnitine is a compound synthesized from amino acids lysine and methionine, primarily found in animal products like meat and dairy. It plays a key role in transporting fatty acids into mitochondria for oxidation and energy production. Here's why some people believe consuming carnitine pills can aid in weight loss: • Role in Fat Metabolism: Carnitine is involved in the transport of fatty acids across mitochondrial membranes, where they are oxidized for energy. Supporters of carnitine supplements suggest that increased carnitine levels could enhance fat burning and energy expenditure. • Energy Production: By facilitating fatty acid oxidation, carnitine is believed to promote the use of stored fat for energy, potentially aiding in weight loss when combined with exercise. However, the effectiveness of carnitine supplements for weight loss is debated. While carnitine is essential for fatty acid metabolism, most individuals synthesize adequate amounts through diet and endogenous production. The benefits of carnitine supplements in weight loss may be limited, especially without concurrent lifestyle changes such as regular exercise and a balanced diet. 72. Name 3 basic metabolic processes in the body. Answer: Three fundamental metabolic processes in the body include: 1. Glycolysis: • Definition: Glycolysis is the initial step in the breakdown of glucose, where glucose is converted into pyruvate. • Location: Occurs in the cytoplasm of cells. • Energy Yield: Generates a small amount of ATP and NADH. • Role: Provides energy for cellular processes and serves as a precursor for other metabolic pathways. 2. Citric Acid Cycle (Krebs Cycle): • Definition: The citric acid cycle is a series of chemical reactions that occur in mitochondria, where acetyl-CoA derived from carbohydrates, fats, and proteins is oxidized to produce ATP, NADH, and FADH2. • Energy Yield: Generates ATP through oxidative phosphorylation and produces reducing equivalents (NADH and FADH2) for the electron transport chain. • Role: Provides energy for cellular functions and supplies intermediates for biosynthesis. 3. Oxidative Phosphorylation: • Definition: Oxidative phosphorylation is the process where ATP is synthesized from ADP and inorganic phosphate using energy generated by the electron transport chain. • Location: Occurs in the inner mitochondrial membrane. • Energy Yield: Produces the majority of ATP in cells (about 34 molecules of ATP per molecule of glucose). • Role: Drives cellular activities by providing ATP, the primary energy currency of cells 73. Explain what happens to ketone levels in the body after prolonged starvation. Answer: During prolonged starvation or fasting, when carbohydrate stores (glycogen) are depleted, the body shifts to alternative energy sources to maintain vital functions, especially for the brain and red blood cells which rely on glucose. Here’s what happens to ketone levels in the body: • Increased Ketogenesis: As glycogen stores are depleted, the liver increases the production of ketone bodies through a process called ketogenesis. Ketone bodies, specifically acetoacetate, beta-hydroxybutyrate, and acetone, are synthesized from fatty acids. • Ketosis: Ketone bodies are released into the bloodstream and transported to tissues, including the brain, where they can be used as an alternative fuel source to glucose. This metabolic state is known as ketosis. • Regulation: Ketone production is regulated by the availability of fatty acids, insulin levels, and the demand for energy substrates. In prolonged starvation, ketone levels rise to provide energy for tissues and organs, reducing the reliance on glucose to preserve muscle mass and supporting survival during periods of food scarcity. • Health Implications: While ketosis is a natural response to prolonged fasting or low-carbohydrate diets, excessive ketone production can lead to ketoacidosis, a serious condition characterized by dangerously high levels of ketones and acidification of the blood. This is more common in individuals with untreated type 1 diabetes or severe insulin deficiency. 74. Explain why individuals with undiagnosed diabetes lose weight. Answer: Undiagnosed diabetes, particularly type 1 diabetes or poorly managed type 2 diabetes, can lead to unintended weight loss due to several factors: • Insulin Deficiency: In type 1 diabetes, the pancreas does not produce sufficient insulin, or in type 2 diabetes, the body becomes resistant to insulin's effects. Insulin is crucial for transporting glucose into cells for energy production or storage. Without adequate insulin, cells cannot effectively utilize glucose, leading to high blood sugar levels (hyperglycemia). • Increased Glucose Excretion: High blood sugar levels cause increased glucose excretion through urine (glycosuria). This leads to calorie loss as glucose, along with water, is excreted from the body. • Muscle Wasting: In the absence of insulin or insulin resistance, cells may break down protein (muscle tissue) for energy, further contributing to weight loss and muscle wasting. • Metabolic Changes: High blood sugar levels prompt the body to use alternative fuels for energy, including breaking down fats (lipolysis) and producing ketones. This can lead to ketosis, further exacerbating weight loss. • Polyphagia: Some individuals with untreated diabetes may experience increased hunger (polyphagia) as the body tries to compensate for the lack of energy entering cells. Overall, unintentional weight loss in individuals with undiagnosed or poorly managed diabetes underscores the importance of early diagnosis, appropriate medical management, and lifestyle modifications to control blood sugar levels and prevent complications. 75. Why is the mitochondrion called the powerhouse of the cell? Answer: The mitochondrion is referred to as the powerhouse of the cell due to its pivotal role in energy production through aerobic respiration: • Energy Production: Mitochondria generate adenosine triphosphate (ATP), the primary energy currency of cells, through oxidative phosphorylation. This process occurs in the inner mitochondrial membrane and involves the electron transport chain (ETC) and ATP synthase. • Aerobic Respiration: Mitochondria oxidize nutrients, such as glucose and fatty acids, to produce ATP molecules. During aerobic respiration, glucose is broken down into pyruvate through glycolysis in the cytoplasm, which is then further oxidized into acetyl-CoA in the mitochondrial matrix. Acetyl-CoA enters the citric acid cycle (Krebs cycle), generating reducing equivalents (NADH and FADH2) and carbon dioxide as byproducts. • Electron Transport Chain (ETC): The ETC, located in the inner mitochondrial membrane, transfers electrons from NADH and FADH2 to oxygen, driving the production of ATP through oxidative phosphorylation. This process is highly efficient in generating ATP molecules from the breakdown of nutrients. • Cellular Functions: ATP produced by mitochondria powers various cellular processes, including muscle contraction, cellular signaling, biosynthesis of macromolecules, and maintenance of ion gradients across cell membranes. In summary, the mitochondrion is essential for aerobic metabolism and ATP production, making it the powerhouse of the cell by providing energy for cellular functions and maintaining overall cellular homeostasis. 76. Describe one inborn error of metabolism, discussing the metabolic process it affects, the consequences of the disease, and its treatment. Answer: Metabolic Process Affected: Phenylketonuria (PKU) affects the metabolism of the amino acid phenylalanine. • Normal Metabolism: Phenylalanine is normally metabolized in the liver by the enzyme phenylalanine hydroxylase (PAH), which converts phenylalanine to tyrosine. Tyrosine is further metabolized to produce neurotransmitters and melanin. • Consequences of PKU: In individuals with PKU, there is a deficiency or absence of phenylalanine hydroxylase enzyme activity. As a result, phenylalanine accumulates in the blood and tissues, leading to toxic levels. High phenylalanine levels can cause intellectual disability, developmental delays, seizures, behavioral problems, and other neurological complications if left untreated. • Treatment: Treatment for PKU involves dietary management. Individuals with PKU must follow a strict low-phenylalanine diet, limiting the intake of high-protein foods such as meat, dairy, and certain grains. They often require special medical formulas and supplements that provide essential amino acids without phenylalanine. Early diagnosis through newborn screening programs allows for prompt dietary intervention, which can prevent or minimize the neurological and developmental effects of the condition. 77. Using metabolic terms, explain how the MEOS system is different from the alcohol dehydrogenase pathway for metabolism of alcohol. Answer: Alcohol Metabolism Pathways: • Alcohol Dehydrogenase Pathway: In this pathway, alcohol dehydrogenase enzymes in the liver convert ethanol (alcohol) into acetaldehyde. Acetaldehyde is then converted into acetate by aldehyde dehydrogenase enzymes, which can enter the citric acid cycle for energy production. • Microsomal Ethanol Oxidizing System (MEOS): • Location: The MEOS system is located in the smooth endoplasmic reticulum of liver cells (hepatocytes). • Enzymes: MEOS involves the cytochrome P450 enzyme system, specifically CYP2E1, which can metabolize ethanol at higher concentrations or in chronic alcohol consumption. • Induction: Chronic alcohol consumption can induce the activity of CYP2E1 enzymes in the MEOS system, increasing the capacity of the liver to metabolize alcohol. • Differences: • Substrate Specificity: Alcohol dehydrogenase primarily metabolizes ethanol at low to moderate concentrations. In contrast, MEOS becomes more active and significant at higher concentrations of alcohol or with chronic alcohol consumption. • Regulation: MEOS activity can be induced by chronic alcohol intake, leading to increased ethanol metabolism and potential tolerance to alcohol effects. Alcohol dehydrogenase, on the other hand, maintains a more consistent rate of metabolism. 78. Name two characteristics of inborn errors of metabolism. Answer: 1. Genetic Basis: Inborn errors of metabolism are typically caused by genetic mutations that affect enzymes involved in biochemical pathways. These mutations can result in deficiencies or complete absence of enzyme activity, disrupting normal metabolic processes. 2. Manifestation: Inborn errors of metabolism often manifest early in life, sometimes shortly after birth or during childhood. Symptoms may vary widely depending on the specific metabolic pathway affected, but common features include developmental delays, neurological impairments, metabolic crises, and sometimes organ dysfunction. Multiple Choice Questions 79. Which portion of cellular respiration benefits from the Cori cycle? A. Citric acid cycle B. Anaerobic glycolysis C. Transition reaction D. Aerobic glycolysis 80. A patient presents with low copper. Which portion of cellular respiration would suffer? A. Glycolysis B. Citric acid cycle C. Transition reaction D. Electron transport chain 81. How would metabolism be affected if a patient's liver is were not working efficiently? A. He or she could not effectively absorb nutrients B. Nutrient interconversions and storage would not efficiently occur C. Digestive enzymes could not be produced D. There would be no effect on metabolism 82. During which phase of cellular respiration is the majority of ATP produced? A. Glycolysis B. Transition reaction C. Citric acid cycle D. Electron transport chain 83. Which of the following molecules would be used to produce 2 additional molecules of ATP if needed? A. NADH B. FADH2 C. Oxaloacetate D. GTP 84. What would be the effect of high concentrations of ATP? A. Catabolic reactions to produce more energy B. Anabolic reactions to synthesize more products C. Catabolic reactions to synthesize more products D. Anabolic reactions to produce more energy Chapter 10 Energy Balance, Weight Control, and Eating Disorders Multiple Choice Questions 1. When the diet contains more energy than is expended, the excess energy ________. A. is stored as fat in adipose tissue B. increases the thermic effect of food C. increases the basal metabolic rate D. is excreted in the urine 2. When energy intake is greater than energy output, body weight ________. A. remains the same B. increases C. decreases D. None of these choices are correct. 3. For most adults, the greatest portion of their energy expenditure is for ________. A. physical activity B. basal metabolism C. thermic effect of food D. None of these choices are correct. 4. The body's total daily energy expenditure includes ________. A. basal metabolic rate, thermal effect of food, and effects of physical activity B. basal metabolic rate, height, and weight C. body mass index, food intake, and number of hours a person sleeps D. None of these choices are correct. 5. All the following are true statements about basal metabolism except ________. A. it supports the work that goes on in the body all the time B. it is the amount of calories you need to sustain life C. it is the sum total of all involuntary activities necessary to sustain life D. it accounts for the smallest component of the average person's daily energy expenditure 6. Compared to men, the basal metabolic rate of women is ________. A. lower B. higher C. no different 7. The energy spent in maintaining all involuntary processes in the body at rest, awake, and in a non-absorptive state is called ________. A. resting metabolism B. thermogenesis C. thermic effect D. basal metabolism 8. A factor that can decrease BMR is ________. A. consuming a low-energy diet B. having a high fever C. long endurance exercise D. being pregnant 9. The best predictor of your basal metabolic rate is ________. A. your exercise pattern B. what you had for breakfast C. your lean body mass D. environmental temperature 10. Of the following males, who would have the lowest BMR? A. 6-year-old B. 16-year-old C. 46-year-old D. 76-year-old 11. The thermic effect of food accounts for approximately ______ of energy consumed each day. A. 5% to 10% B. 11% to 15% C. 16% to 20% D. 50% 12. Consumption of a very-low-calorie diet ________. A. increases BMR by about 10% to 20% B. decreases BMR by about 10% to 20% C. has no effect on BMR 13. To calculate estimated energy needs using the equations developed by the Food and Nutrition Board, one needs information about the individual's ________. A. age B. weight C. height D. gender E. All of these choices are accurate. 14. A young man weighs 150 pounds. A rough estimate of his basal metabolic rate would be ________. A. 1469 kcal per day B. 68 kcal per hour C. 2500 kcal per day D. 61 kcal per hour 150 lbs / 2.2 lbs/kg = 68 kg × 1.0 kcal/kg/hr = 68 kcal/hr 68 kcal/hr × 24 hr/day = 1632 kcal/day 15. The ratio of body weight to height is represented as ________. A. body composition B. basal metabolic rate C. bioelectrical impedance D. body mass index 16. Hunger can be defined as ________. A. starvation B. a physiological drive to find and eat food C. a sensation caused by distension of the stomach and small intestine D. a psychological drive to eat 17. Satiety is largely regulated by the ________. A. pituitary gland B. cerebral cortex C. hypothalamus D. liver 18. A man weighs 154 pounds and is 70 inches tall. His BMI is ________. A. 15 B. 20 C. 22 D. 25 (154 lb × 703) / (70 in)2 = 108,262 / 4900 = 22 19. A body mass index of 40 represents ________. A. no health risk B. possible health risk C. a high risk for health problems D. a value that is not on the nomogram 20. Underwater weighing assesses body composition based on the principle that ________. A. lean body tissue is more dense than adipose tissue B. adipose tissue is more dense than lean body tissue C. adipose tissue is composed of mostly water D. body fluids are not being weighed using this method 21. Bioelectrical impedance assesses body composition based on the principle that ________. A. atomic nuclei behave like magnets when an external magnetic field is applied across the body B. adipose tissue is more dense than lean body tissue C. electrical conductivity is greater in lean tissue than in adipose tissue D. fat-free mass is proportional to total body potassium 22. Which of the following techniques for measuring body composition makes use of small exposures to radiation? A. MRI B. DEXA C. TOBEC D. BIA 23. Lee Brown is a 23-year-old college student. Which of these would indicate that he is at risk for chronic diseases associated with obesity? A. BMI of 22 B. BMI of 27 C. 41-inch waist D. 31-inch waist 24. A "thrifty metabolism" is a genetic predisposition that ________. A. causes a person to expend higher-than-average energy at rest B. enables a person to store fat readily C. enables a person to expend fat readily D. None of these choices are accurate. 25. The set-point theory proposes that ________. A. body temperature determines how many calories are burned B. humans have a genetically predetermined body weight or body fat C. metabolism can be reset at different stages of life D. None of these choices are accurate. 26. Before recommending treatment for obesity, the health professional should ________. A. assess current health status B. take a family history of obesity-related disease C. determine fat distribution in the patient D. All of these choices are accurate. 27. A healthy weight for an individual should not be based exclusively on weight, but on ________. A. amount of lean body tissue B. energy intake versus energy expenditure C. body size of family members D. total amount of body fat, location of body fat, and presence or absence of weight-related medical problems 28. The success (attain and maintain reduced weight for 3 to 5 years) of non-surgical weight reduction programs has been reported to be approximately ________ for adults. A. 40% B. 5% C. 25% D. 0% 29. Based on results of long-term studies, people on weight-reduction diets should limit ________. A. high-fat foods B. breads and rolls C. potatoes D. meat 30. How many calories are in one pound of fat? A. 2500 B. 3500 C. 4500 D. 5500 31. The major goal for weight reduction in the treatment of obesity is the loss of ________. A. weight B. body fat C. body water D. body protein 32. A daily deficit of 400 to 500 kcal should result in a loss of approximately ________ of body fat per week. A. 0.25 pound B. 1 pound C. 3 pounds D. 4 pounds 33. A weight-reduction program can be considered successful only when the weight loss ________. A. exceeds 10% of starting weight B. is maintained C. results in a BMI of below 25 D. All of these choices are correct. 34. A sound program for weight reduction should include ________. A. control of total energy intake B. increased physical activity C. modification of food habits D. All of these choices are correct. 35. An example of an appropriate weight-loss strategy would be a ________. A. food plan that meets the nutritional needs of the patient B. diet based on readily obtainable foods C. plan that encourages increased physical activity D. plan that helps the patient relinquish obesity-promoting beliefs E. All of these choices are accurate. 36. Physical activity is most likely to lead to successful weight loss if it ________. A. is performed at high intensity B. is performed regularly C. leads to significant loss of body water D. causes muscle soreness 37. Keeping tempting snack foods stashed in the cupboards or freezer instead of leaving them in plain view is an example of ________. A. cognitive restructuring B. chain-breaking C. self-monitoring D. stimulus control 38. Kevin wants to treat himself to a hot fudge sundae whenever he has a stressful day. He decides that a more appropriate response to a stressful day would be a brisk walk. Which of the following behavior modification techniques has he used? A. Cognitive restructuring B. Self-monitoring C. Contingency management D. Stimulus control 39. By keeping a detailed food diary, the individual who is trying to lose weight can discover ________. A. emotions that lead to poor eating habits B. social influences affecting eating and food choices C. external cues that lead to overeating D. All of these choices are accurate. 40. All of the following are useful behavior modification principles for weight control EXCEPT ________. A. eliminating favorite foods from one's diet B. working out with a friend C. recording eating behaviors to identify situations that contribute to overeating D. shopping from a grocery list 41. The best way to handle a situation in which you "go off" your meal plan for weight loss is to ________. A. go ahead and eat anything you want B. skip eating tomorrow C. assume lapses will occur and re-establish the program but feel guilty D. learn from the experience by identifying triggers so that a repeat can be avoided 42. Maintenance of weight loss is fostered by ________. A. eating breakfast B. having a regular exercise plan C. self-monitoring D. All of these responses are correct. 43. The highest rate of weight-loss success and maintenance among people with morbid obesity is seen with ________. A. very-low-calorie diets (VLCDs) B. jaw wiring C. gastroplasty D. commercial weight-loss programs 44. The primary intent of gastroplasty is to ________. A. speed transit time B. limit stomach volume C. prevent snacking D. All of these choices are correct. 45. A fad diet for weight loss ________. A. can result in quick weight loss B. usually fails because habits are not changed C. may be nutritionally inadequate D. All of these choices are correct. 46. A weight-loss program is probably a fad diet if it ________. A. recommends expensive nutrient supplements B. uses testimonials from famous people to promote the diet C. promotes quick weight loss D. guarantees weight-loss success for everyone E. All of these choices are accurate. 47. Eating disorders frequently co-occur with which of the following psychological disorders? A. depression B. substance abuse C. anxiety disorders D. All of these choices are accurate. 48. Anorexia nervosa can be defined as ________. A. compulsive eating B. purging C. hyperactivity D. psychological denial of appetite 49. A condition of self-induced semi-starvation is called ________. A. bulimia B. anorexia nervosa C. kwashiorkor D. baryophobia 50. The semi-starvation of anorexia nervosa results in many physiological changes, such as ________. A. decreased basal metabolism B. lanugo C. iron-deficiency anemia D. dry, scaly, cold skin E. All of these choices are accurate. 51. Anorexic individuals have trouble maintaining normal body temperature because of ________. A. loss of body fat as insulation B. lack of appropriate clothing as the person tries to show off his/her extreme thinness C. increased synthesis of the thyroid hormone D. wearing baggy clothes 52. Lanugo is ________. A. a substitute for missing adipose tissue B. an insulator of body organs C. fine, downy hair covering the body D. cessation of the menstrual cycle 53. The most successful treatment for anorexia nervosa involves ________. A. isolation from the family and forced tube feeding B. dietary counseling on an outpatient basis by a registered dietitian C. inpatient psychological, nutritional, and medical therapy, often involving the whole family D. use of diuretics 54. Bulimic patients often have a problem with ________. A. recognizing nutritious food choices B. eating enough food to maintain a healthy body weight C. obesity D. an inability to control responses to impulse and desire 55. The essential difference between anorexia and bulimia ________. A. is age of onset. Bulimia begins in early childhood B. is gender. Men are far more likely to suffer from anorexia nervosa when they enter their teens C. is that anorexic patients are much more secretive, while bulimia patients are much more open about their eating disorder D. is that the bulimic turns to food during a crisis or problem, whereas the anorexic turns away from food 56. To counteract the binge, the bulimic patient may ________. A. induce vomiting B. take laxatives C. over-exercise D. All of these choices are accurate. 57. Repeated self-induced vomiting may cause ________. A. tears in the esophagus B. stomach ulcers C. electrolyte imbalances D. tooth demineralization E. All of these choices are correct. 58. The major health risk from frequent vomiting due to bulimia nervosa is ________. A. potassium imbalance B. constipation C. lanugo D. swollen glands 59. Eating disorders not otherwise specified ________. A. are not really an eating disorder but more of a perception of having one B. occur when a person can't decide whether to become an anorexic or bulimic C. refers to a broad category that includes symptoms from both anorexia and bulimia D. None of the answers are correct. True / False Questions 60. Negative energy balance results from an energy deficit and weight loss occurs. TRUE 61. The part of our energy expenditure that we have direct control over is voluntary physical activity. TRUE 62. As cholecystokinin secretion increases, appetite increases. FALSE 63. Chewing contributes to satiety. TRUE 64. Hunger signals change even while we eat. TRUE 65. Stomach distention contributes to satiety. TRUE 66. Metabolism of protein may promote satiety by decreasing the secretion of a hormone called ghrelin. TRUE 67. Being classified as overweight according to BMI does not necessarily equate to excess health risks if a person makes wise food choices and exercises. TRUE 68. Women carry more body fat than men for reproductive purposes. TRUE 69. Identical twins raised in different environments tend to have different weight gain patterns. FALSE 70. Genes account for up to 20% of weight differences between people. FALSE 71. Environmental factors are important influences on what we eat. TRUE 72. Losing weight is easier than keeping it off. TRUE 73. Eating breakfast is a good strategy for losing weight. TRUE 74. Setting a weight-loss goal of 10 pounds in six weeks is sound and attainable. TRUE 75. Exercise leads to development of more lean tissue, which reduces basal metabolism. FALSE 76. In treating morbid obesity with gastroplasty, the volume of the stomach is reduced to approximately 30 milliliters. TRUE 77. A VLCD may only supply 400 to 800 kcal per day. TRUE 78. Fad diets rarely lead to lasting weight loss or positive changes in eating and exercise habits. TRUE 79. Treating physical and emotional problems early helps prevent eating disorders. TRUE Matching Questions 80. Match the term with its description.
1. Basal metabolism All involuntary activity
2. Fat tissue BMI > 30
3. Lean tissue Fat cells, adipose tissue
4. Obesity A method for evaluating health risk
5. Body Mass Index Muscles, liver, kidney, etc.
1. Basal metabolism All involuntary activity 1
2. Fat tissue BMI > 30 4
3. Lean tissue Fat cells, adipose tissue 2
4. Obesity A method for evaluating health risk 5
5. Body Mass Index Muscles, liver, kidney, etc. 3
81. Match the term with an example.
1. Self-monitoring Separating the act of watching a movie with the act of eating buttered popcorn and sliced cheese
2. Chain-breaking Taking the route home from work that does not go past a favorite fast food establishment
3. Cognitive restructuring Taking a jog with a friend instead of raiding the refrigerator after a stressful final exam
4. Contingency management Planning to work out with an aerobics DVD if bad weather prevents outdoor exercise
5. Stimulus control Keeping a record of diet and activity habits to identify patterns that contribute to obesity
1. Self-monitoring Separating the act of watching a movie with the act of eating buttered popcorn and sliced cheese 2
2. Chain-breaking Taking the route home from work that does not go past a favorite fast food establishment 5
3. Cognitive restructuring Taking a jog with a friend instead of raiding the refrigerator after a stressful final exam 3
4. Contingency management Planning to work out with an aerobics DVD if bad weather prevents outdoor exercise 4
5. Stimulus control Keeping a record of diet and activity habits to identify patterns that contribute to obesity 1
Essay Questions 82. How does leptin affect appetite? Answer: Role of Leptin: • Definition: Leptin is a hormone produced primarily by adipose (fat) tissue that plays a key role in regulating energy balance and appetite. • Appetite Regulation: Leptin acts on receptors in the hypothalamus of the brain, specifically targeting areas involved in appetite control and energy expenditure. • Satiation: When leptin levels are high, typically in response to increased fat stores (adiposity), it signals to the brain that the body has sufficient energy reserves. This leads to reduced appetite and increased energy expenditure, promoting weight maintenance. • Hunger Regulation: Low leptin levels signal hunger to the brain, stimulating appetite and reducing energy expenditure to encourage food intake and replenish energy stores. • Implications: Dysregulation of leptin signaling, such as leptin resistance seen in obesity, can disrupt appetite control mechanisms, leading to overeating and weight gain despite adequate energy stores. 83. Explain how hunger signals change as we eat. Answer: Phases of Hunger and Satiety: 1. Hunger Signals: • Ghrelin Release: Before eating, the stomach releases ghrelin, known as the hunger hormone, which stimulates appetite and increases food intake. • Stomach Contractions: Empty stomach contractions (growling) are another physical signal of hunger, indicating the need for food intake. • Brain Response: The hypothalamus integrates signals from ghrelin and other hormones to regulate appetite and initiate food-seeking behavior. 2. Satiety Signals During Eating: • Cholecystokinin (CCK): Released from the small intestine in response to food intake, CCK signals satiety by reducing gastric emptying and promoting feelings of fullness. • Peptide YY (PYY): Released by the gastrointestinal tract after meals, PYY suppresses appetite and reduces food intake. • Insulin: Secreted by the pancreas in response to glucose intake, insulin promotes cellular uptake of glucose and contributes to satiety. • Nutrient Absorption: As nutrients are absorbed into the bloodstream, blood glucose levels rise, providing energy and signaling to the brain that energy needs are being met. 3. Post-Meal Satiety: • Leptin Release: After meals, adipose tissue releases leptin, which suppresses appetite and promotes energy expenditure. • Long-Term Regulation: Over hours to days, nutrient levels and hormonal signals gradually return to baseline, regulating hunger and satiety cycles. 84. Is a craving for chocolate a sign of hunger? Answer: A craving for chocolate is not necessarily a sign of hunger but rather a desire for specific foods driven by psychological, physiological, or social factors: • Psychological Factors: Cravings can be influenced by mood, stress, emotions, or habit. Chocolate, in particular, contains compounds that may trigger pleasure responses in the brain, contributing to cravings. • Physiological Factors: Cravings can also be influenced by nutrient deficiencies or hormonal fluctuations, although specific cravings like chocolate are often more related to pleasure-seeking rather than hunger. • Social and Cultural Factors: Cultural influences, advertising, availability, and social situations can also influence food cravings, including cravings for specific foods like chocolate. While a craving for chocolate can occur alongside hunger, it is distinct from physiological hunger signals that typically involve appetite stimulation due to energy needs. Understanding the underlying reasons for cravings, whether emotional, social, or physiological, can help individuals make informed dietary choices. 85. What everyday physical activities can help increase energy output? Answer: Everyday physical activities that can help increase energy output include: 1. Walking: Walking is a low-impact activity that can be easily incorporated into daily routines. It helps burn calories, improve cardiovascular health, and boost overall energy expenditure. 2. Climbing Stairs: Taking the stairs instead of the elevator or escalator engages leg muscles and increases heart rate, contributing to higher energy expenditure. 3. Household Chores: Activities like vacuuming, gardening, and cleaning require physical movement and muscle engagement, contributing to calorie burning and energy expenditure. 4. Active Commuting: Walking or cycling to work, school, or nearby destinations instead of driving or taking public transport provides regular physical activity and enhances energy output. 5. Standing: Limiting sedentary behavior by standing rather than sitting for prolonged periods can increase calorie expenditure and promote better posture and circulation. 6. Dancing: Dancing is a fun way to increase physical activity levels, improve coordination, and burn calories, making it an enjoyable option for enhancing energy output. Incorporating these activities into daily routines can help individuals achieve recommended levels of physical activity, enhance overall fitness, and support weight management goals. 86. What are the advantages and disadvantages of skinfold measurements as a technique for assessing body composition? Answer: Advantages: • Accessibility: Skinfold measurements require minimal equipment (skinfold calipers) and can be performed in various settings, including clinics, gyms, and research facilities. • Affordability: Compared to more advanced techniques like DEXA or underwater weighing, skinfold measurements are relatively inexpensive. • Non-invasive: Skinfold measurements are non-invasive and generally well-tolerated by individuals. Disadvantages: • Accuracy: Skinfold measurements are operator-dependent and can vary based on the skill and experience of the technician performing the measurements. • Site Selection: Consistency in site selection and measurement technique is crucial for accuracy, which can be challenging to achieve consistently. • Population Variability: Accuracy may vary across different populations (e.g., athletes vs. sedentary individuals) and body types (e.g., obese individuals). 87. Which body fat measurement is the most accurate and why? Answer: The Dual-Energy X-ray Absorptiometry (DEXA) scan is considered one of the most accurate methods for measuring body fat percentage due to several reasons: • Technology: DEXA uses low-dose X-rays to differentiate between bone, fat tissue, and lean tissue (muscle), providing a detailed analysis of body composition. • Precision: DEXA provides precise measurements of total body fat percentage, as well as regional fat distribution, which can be valuable for assessing health risks associated with visceral fat accumulation. • Reliability: DEXA scans are highly reliable and offer consistent results when performed under standardized conditions by trained technicians. • Clinical Validation: DEXA is often used as a reference method in research settings for validating other body composition measurement techniques. While DEXA is considered highly accurate, it may not be widely accessible due to cost, availability, and the need for specialized equipment and trained personnel. However, its accuracy and comprehensive assessment of body composition make it valuable for clinical and research purposes. 88. Describe two genetic disorders/diseases that can cause obesity. Answer: 1. Prader-Willi Syndrome (PWS): • Genetic Cause: PWS is a complex genetic disorder caused by the loss of function of genes on chromosome 15, typically due to a deletion in the paternal chromosome 15 or other genetic abnormalities. • Symptoms: Individuals with PWS experience chronic hunger (hyperphagia), which leads to excessive eating and obesity from early childhood. Other symptoms include intellectual disabilities, behavioral problems, and hormonal imbalances. • Management: Treatment focuses on managing food intake through strict dietary control and behavioral interventions. Growth hormone therapy may also be used to improve growth and body composition. 2. Bardet-Biedl Syndrome (BBS): • Genetic Cause: BBS is a rare genetic disorder characterized by mutations in multiple genes, primarily affecting ciliary function and signaling pathways involved in cellular processes. • Symptoms: Obesity is a common feature of BBS, along with retinal degeneration, polydactyly (extra fingers or toes), renal abnormalities, and intellectual disability. The exact mechanisms leading to obesity in BBS are not fully understood but likely involve disruptions in metabolic and satiety signaling pathways. • Management: Treatment focuses on managing obesity-related complications through dietary management, exercise, and addressing other medical issues associated with the syndrome. 89. Name the three important components of a successful weight-management program. Answer: 1. Dietary Modification: • Caloric Control: Establishing a balanced, calorie-controlled diet that meets nutritional needs while promoting weight loss or maintenance. • Nutritional Quality: Emphasizing nutrient-dense foods such as fruits, vegetables, lean proteins, and whole grains to support overall health and satiety. • Behavioral Strategies: Incorporating behavioral techniques such as mindful eating, portion control, and tracking food intake to promote long-term adherence to dietary changes. 2. Physical Activity: • Exercise Regimen: Implementing regular physical activity that includes aerobic exercises (e.g., walking, jogging, cycling) and strength training to enhance metabolism, burn calories, and preserve lean muscle mass. • Lifestyle Integration: Encouraging daily movement and incorporating physical activity into daily routines to promote overall energy expenditure and maintain weight loss. 3. Behavioral Support: • Behavioral Counseling: Providing education and support to address psychological factors influencing eating behaviors, stress management, and motivation. • Lifestyle Modification: Promoting sustainable lifestyle changes through goal-setting, self-monitoring, and strategies for managing social and environmental triggers that contribute to overeating or sedentary behaviors. • Long-Term Maintenance: Offering ongoing support and monitoring to prevent weight regain and promote sustained behavior change beyond initial weight loss goals. 90. What usually happens when someone begins eating again after following a fad diet? Answer: When someone begins eating again after following a fad diet, several physiological and psychological responses may occur: • Weight Regain: Fad diets often promote rapid weight loss through severe calorie restriction or restrictive food choices. Once normal eating patterns resume, especially if there was a significant reduction in metabolic rate during the diet phase, weight regain can occur as the body adjusts to higher calorie intake. • Metabolic Adaptations: Prolonged calorie restriction can lead to metabolic adaptations where the body becomes more efficient at storing energy (fat) and conserving calories. This can make it challenging to maintain weight loss when normal eating patterns resume. • Psychological Impact: Fad diets may contribute to unhealthy relationships with food, guilt over eating certain foods, and cycles of restrictive eating followed by overeating. This can perpetuate a cycle of weight fluctuation and dissatisfaction with body image. • Nutritional Imbalance: Some fad diets restrict essential nutrients or food groups, potentially leading to nutritional deficiencies or imbalances when normal eating patterns are reintroduced. In summary, the sustainability and long-term effectiveness of fad diets in promoting lasting weight loss and health improvements are often limited. Healthy, balanced eating habits and lifestyle changes supported by evidence-based strategies are more effective for achieving and maintaining weight management goals over time. 91. Compare and contrast anorexia nervosa and bulimia. In what ways are they similar? In what ways are they different? Answer: Similarities: 1. Psychological Factors: • Both anorexia nervosa and bulimia involve distorted body image and an intense fear of gaining weight. • Individuals with both disorders often experience low self-esteem and feelings of guilt or shame related to their eating behaviors. 2. Health Consequences: • Both disorders can lead to serious health complications, including electrolyte imbalances, dehydration, cardiac issues, gastrointestinal problems, and nutritional deficiencies. • They can also co-occur with other psychiatric conditions such as depression, anxiety disorders, and substance abuse. Differences: 1. Behavioral Patterns: • Anorexia Nervosa: Characterized by extreme calorie restriction, refusal to maintain a healthy weight (often significantly below normal), and obsessive preoccupation with food intake and weight. • Bulimia: Involves recurrent episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives or diuretics, fasting, or excessive exercise to prevent weight gain. 2. Physical Presentation: • Anorexia Nervosa: Typically results in significant weight loss, extreme thinness (emaciation), and physical signs such as lanugo (fine body hair), dry skin, and brittle hair and nails. • Bulimia: Individuals with bulimia may maintain a relatively normal weight or even be overweight, making it less outwardly apparent. They may experience dental erosion due to frequent vomiting. 3. Medical Risks: • Anorexia Nervosa: Higher risk of severe malnutrition, starvation, and complications related to chronic undernutrition. • Bulimia: Higher risk of electrolyte imbalances, esophageal damage, and other complications related to purging behaviors. 92. How can family therapy help in the treatment of a patient with an eating disorder? Answer: Role of Family Therapy: • Education and Support: Family therapy provides education about eating disorders, helping family members understand the causes, symptoms, and treatment options. This reduces stigma and promotes empathy and support for the affected individual. • Identifying Family Dynamics: Therapy helps identify dysfunctional family patterns or dynamics that may contribute to the eating disorder, such as overprotection, criticism, or conflict related to body image or food. • Improving Communication: Therapy facilitates open and supportive communication within the family, fostering a safe environment for discussing emotions, concerns, and challenges related to the eating disorder. • Behavioral Changes: Family therapy promotes behavioral changes within the family that support recovery, such as promoting regular meals, reducing food-related conflicts, and encouraging healthy attitudes toward food and body image. • Supporting Recovery: Family involvement in therapy enhances treatment adherence and long-term recovery outcomes by providing ongoing support, encouragement, and accountability for the individual with the eating disorder. 93. Someone you know is suspected of having an eating disorder. What are some of the steps you can take to help this person? Answer: 1. Educate Yourself: Learn about eating disorders, including their signs, symptoms, and potential consequences. Understanding the disorder can help you provide informed support. 2. Express Concern: Approach the person with empathy and express your concern for their well-being. Choose a private and non-judgmental setting to initiate the conversation. 3. Encourage Professional Help: Encourage the individual to seek professional evaluation and treatment from healthcare providers specializing in eating disorders, such as doctors, psychologists, or registered dietitians. 4. Offer Support: Provide emotional support and reassurance. Listen actively, validate their feelings, and avoid criticizing or commenting on their appearance or eating habits. 5. Avoid Enabling Behaviors: Refrain from enabling disordered eating behaviors or participating in food-related rituals. Encourage healthy behaviors and activities that promote overall well-being. 6. Promote Positive Body Image: Foster a positive body image and self-esteem by emphasizing qualities beyond appearance. Encourage activities that promote self-care and self-acceptance. 7. Be Patient and Persistent: Recovery from an eating disorder can be challenging and may take time. Be patient, persistent, and supportive throughout the recovery process. True / False Questions 94. Ghrelin is a protein that increases appetite. TRUE Multiple Choice Questions 95. Which of the following represents a BMI range considered to be healthy for most adult men and women? A. 10-14 B. 15-18 C. 19-24 D. 25-30 96. The thermic effect of food represents A. the BMR minus the energy used in physical activity B. the decrease in food energy due to cooking C. the increase in energy expenditure associated with the body's digestion of food D. the body's storage of food as fat for insulation 97. Which of the following genetic disorders would cause a person to have limited fat stores? A. Marfan syndrome B. Hypothyroidism C. Ovarian cysts D. Prader-Willi syndrome 98. Which of the following meals would be the most satisfying to hunger? A. Potato chips, soft drink, hamburger B. Carrots, whole grain bread with turkey, apple slices with peanut butter, glass of water C. Yogurt, cheese sticks, meatloaf, juice D. Pizza with breadsticks, soft drink Short Answer Questions 99. Why is BMI not the best indicator of overfat? Answer: BMI (Body Mass Index) is limited as an indicator of overfatness because it doesn't distinguish between fat and muscle mass. Someone with high muscle mass can have a high BMI without being overfat, while someone with low muscle mass and high body fat may have a normal BMI. It also doesn't account for fat distribution, which is important for health risks. Therefore, BMI alone may not accurately reflect someone's body composition and overall health status. Multiple Choice Questions 100. Sally has had a rough day at work. Before she decided to lose weight, she would have normally gone straight to the freezer and eaten a large bowl of ice cream. Now, she recognizes that stress is a trigger for her to overeat. What strategy is Sally using to control her problem behavior? A. Chian-breaking B. Cognitive restructuring C. Contingency management D. Self-monitoring 101. What would be the best food for underweight individuals to add to their diet to increase their weight in a healthy manner? A. Cheeseburger B. Pizza C. Whole grain bread with turkey D. Salad with ranch dressing Short Answer Questions 102. Describe the differences between disorded eating and an eating disorder. Answer: Disordered eating refers to a range of irregular eating behaviors that may not meet the clinical criteria for an eating disorder. It can include patterns like restrictive dieting, binge eating, or excessive exercise. In contrast, an eating disorder involves more severe and persistent disturbances in eating habits and related thoughts and emotions, such as anorexia nervosa, bulimia nervosa, or binge-eating disorder. Eating disorders often require professional diagnosis and treatment, while disordered eating may not always indicate a diagnosable condition but can still impact health and well-being. Multiple Choice Questions 103. Which of the following health care professionals are most likely to be the first to identify a patient with bulimia nervosa? A. Medical doctor B. School nurse C. Dentist D. There are no physical signs of bulimia nervosa. Test Bank for Wardlaw's Perspectives in Nutrition Carol Byrd-Bredbenner, Gaile Moe, Jacqueline Berning, Danita Kelley 9780078021411, 9781259933844, 9780073522722
