York University - KINE 4020

Nutrients for Energy Metabolism

MULTIPLE CHOICE

1)In addition to a folate-rich diet, women who are pregnant should include a daily supplement of how many milligrams of additional folic acid?

1. 1. 100 µg
   2. 200 µg
   3. 300 µg
   4. 400 µg

2. Nicole is pregnant and is trying to monitor her folate intake. She is eating foods high in folate as well as taking folate supplements, and she is having a hard time determining how many dietary folate equi- valents (DFEs) she is consuming. Below is a list of her daily intake with respect to folate:

• 125 mL of cooked lentils (180 μg food folate)
• 125 mL of fresh orange juice (60 μg food folate)
• folate supplement (200 μg)

How many DFEs is Nicole consuming? a.  440

b.   480

c.     540

d.   580

3. Because of adverse interactions with other vitamins, a safe daily folate intake is up to which of the fol- lowing amounts?
   1. 400 µg
   2. 600 µg
   3. 1000 µg
   4. 2000 µg

4. A deficiency of which of the following vitamins results in accumulation of homocysteine in the blood?
   1. folate
   2. biotin
   3. niacin
   4. vitamin K

5. The appearance of vitamin B₁₂ deficiency symptoms may be delayed due to high intake of supplements of which of the following vitamins?
   1. folate
   2. niacin
   3. vitamin C
   4. vitamin B₆

6. Which of the following vitamins is involved mainly with the replacement of red blood cells and digest- ive tract cells?
   1. folate
   2. niacin
   3. thiamin
   4. riboflavin

7. Which of the following substances is known to adversely affect folate utilization?
   1. insulin
   2. calcium supplements
   3. regular use of antacids
   4. vitamin B12 supplements

8. Which of the following statements is representative of folate availability in foods?
   1. Good sources are dairy products and meats.
   2. Poor sources are fruit juices and vegetable juices.
   3. Much of the vitamin is lost due to heat and oxidation.
   4. Only about 10 percent of the amount in foods is bioavailable.

9. Which of the following factors is known to significantly affect the body’s folate status?
   1. sedentary lifestyle
   2. some anticancer drugs
   3. excess protein intake

1. 4. insufficient fibre intake

10. Physiological stresses such as blood loss, burns, measles, and cancer are known particularly to increase the risk of deficiency for which of the following vitamins?
    1. biotin
    2. folate
    3. riboflavin
    4. pantothenic acid

11. Which of the following is associated with a deficiency of folate?
    1. hemolysis
    2. hypoxemia
    3. hemolytic anemia
    4. macrocytic anemia

12. Folate deficiency has been reported in infants fed which of the following foods?
    1. soy milk
    2. goat’s milk
    3. rice milk
    4. infant formula

13. Which of the following, among all the vitamins, is believed to be most vulnerable to interactions with drugs?
    1. folate
    2. niacin
    3. vitamin B₆
    4. vitamin B₁₂

14. What is the RDA for folate for a woman weighing 60 kilograms?
    1. 180 μg
    2. 220 μg
    3. 242 μg
    4. 400 μg

15. Which of the following is the adult RDA for folate?
    1. 100 µg
    2. 200 µg
    3. 400 µg
    4. 800 µg

16. Which of the following foods is highest in folate?
    1. meats

1. 2. starches
   3. dairy products
   4. green, leafy vegetables

17. Which of the following is required for the absorption of dietary vitamin B₁₂?
    1. bile
    2. lipase
    3. intrinsic factor
    4. carboxypeptidase

18. What is the function of intrinsic factor in vitamin B₁₂ absorption?
    1. It catalyzes release of the vitamin from its protein-bound form.
    2. It attaches to the vitamin, thereby allowing absorption from the intestines.
    3. It acts as a storage protein for the vitamin within the intestinal epithelial cells.
    4. It acts as a cofactor for mucosal enzymes involved in absorption of the vitamin.

19. What is the name of the mineral that is found at the centre of a B₁₂ molecule?
    1. chloride
    2. calcium
    3. copper
    4. cobalt

20. What is the most likely reason for the development of a vitamin B₁₂ deficiency?
    1. inadequate intake
    2. increased excretion
    3. inadequate absorption
    4. increased losses in food preparation

21. Pernicious anemia results from a deficiency of which of the following nutrients?
    1. folate
    2. selenium
    3. vitamin B₁₂
    4. iron and copper

22. The nasal spray route represents a safe and efficacious means for the supply of which of the following vitamins?
    1. folate
    2. vitamin B₁
    3. vitamin C
    4. vitamin B₁₂

23. Which of the following vitamin’s absorption is most affected by the disorder atrophic gastritis?
    1. choline
    2. vitamin C
    3. vitamin B₁₂
    4. pantothenic acid

24. Which of the following is a property of vitamin B₁₂?
    1. It is efficiently recycled by the body.
    2. It is necessary for protection from pinpoint hemorrhages.
    3. It requires attachment to fatty acids for transport in the circulation.
    4. It is absorbed from the stomach with the aid of a special binding protein.

25. A similar type of anemia is produced when there is a deficiency of which of the following vitamins?
    1. either riboflavin or niacin
    2. either vitamin B12 or folate
    3. either thiamin or riboflavin
    4. either vitamin B6 or vitamin B12

26. Which of the following is a common treatment for pernicious anemia caused by inadequate absorption?
    1. injection of cobalamin
    2. topical administration of liver extract
    3. oral supplements of B-vitamin complex
    4. a diet high in liver and green, leafy vegetables

27. If a person refrained from ingesting any of the water-soluble vitamins, deficiency symptoms would oc- cur for which of the following vitamins?
    1. folate
    2. vitamin C
    3. vitamin B₁
    4. vitamin B₁₂

28. Normally, the body’s storage and re-utilization of vitamin B₁₂ prevents a primary or secondary defi- ciency from occurring until after about which of the following times?
    1. 3 days
    2. 3 weeks
    3. 3 months
    4. 3 years

29. In a person who loses the ability to absorb vitamin B₁₂, approximately what period of time could elapse before deficiency signs develop?
    1. 1 month

30. Pernicious anemia results from a combination of lack of intrinsic factor and which of the following situations?
    1. pharmacologic intakes of cobalamin
    2. lack of hydrochloric acid
    3. lack of pancreatic vitaminases
    4. pharmacologic intakes of folate

31. Which of the following is known to be a risk factor for development of atrophic gastritis?
    1. age over 40 years
    2. lack of protein
    3. Helicobacter pylori infection
    4. avoidance of leafy vegetables

32. A marginal vitamin B₁₂ deficiency can impair which one of the body's functions?
    1. cognition
    2. digestion
    3. respiration
    4. circulation

33. Among the following water-soluble vitamins, a secondary deficiency would most likely be seen for which of the following vitamins?
    1. biotin
    2. thiamin
    3. vitamin C
    4. vitamin B₁₂

34. Vegetarians at risk of developing a vitamin B₁₂ deficiency for which of the following reasons?
    1. Vegetarian diets inhibit absorption of the vitamin.
    2. Vegetarian diets provide insufficient amounts of the vitamin.
    3. The fibre content of vegetarian diets causes decreased storage by the liver.
    4. The fibre content of vegetarian diets causes increased excretion of the vitamin.

35. Which of the following foods would be the only source of vitamin B₁₂?
    1. pecans
    2. hot dog
    3. cauliflower
    4. whole-grain bread

36. A vegan vegetarian should include which of the following best sources of B₁₂-rich foods in his/her diet?
    1. spirulina
    2. miso
    3. B12-enriched soy milk
    4. B₁₂-enriched yeast

37. The adult RDA for vitamin B₁₂ is which of the following?
    1. 0.5 µg
    2. 1.2 µg
    3. 2.4 µg
    4. 4.0 µg

38. Which of the following vitamins has an RDA?
    1. biotin
    2. choline
    3. cobalamin
    4. pantothenic acid

39. Which of the following is known to perform an essential function in the human body?
    1. carnitine
    2. orotic acid
    3. methoxatin
    4. pangamic acid

40. Which of the following is considered a non-vitamin in the human diet?
    1. folic acid
    2. lipoic acid
    3. ascorbic acid
    4. pantothenic acid

41. Which of the following is classified as a conditionally essential nutrient?
    1. PABA
    2. choline
    3. inositol
    4. ubiquinone

42. Which of the following substances is probably required in the diet of human beings?
    1. choline

1. 2. inositol
   3. lipoic acid
   4. pangamic acid

43. Which of the following has been mistaken to be an essential nutrient for human beings?
    1. cobalamin
    2. ubiquinone
    3. pyridoxine
    4. pantothenic acid

44. Which of the following body parts is frequently affected by deficiencies of the B vitamins?
    1. bones
    2. tongue
    3. liver
    4. hair and nails

45. Which of the following is an overt sign of a possible B vitamin deficiency?
    1. anemia
    2. smooth tongue
    3. abnormal liver function
    4. abnormal heart function

46. Sulphur is present in practically all of which of the following compounds?
    1. vitamins
    2. proteins
    3. fatty acids
    4. carbohydrates

47. Some amino acids can link to each other by bridges made of which mineral?
    1. sulphur
    2. calcium
    3. chloride
    4. magnesium

48. What is the major source of dietary sulphur?
    1. fats
    2. protein
    3. mineral salts
    4. carbohydrates

49. Which one of the following body components is known to have a high sulphur content?
    1. skin
    2. eyes
    3. teeth
    4. bones

50. A deficiency of which of the following minerals is the primary cause of goitre?
    1. iron
    2. zinc
    3. iodine
    4. selenium

51. What mineral is critical to the synthesis of thyroxine?
    1. iron
    2. copper
    3. iodine
    4. magnesium

52. Which of the following is a thyroid gland hormone?
    1. thyroxine
    2. goitrogen
    3. thyrotropin
    4. tissue stimulating hormone

53. What is the primary function of the thyroid hormones?
    1. precursors for hemoglobin synthesis
    2. counteract a deficiency of goitrogens
    3. control the rate of oxygen use by cells
    4. regulate acetylcholine concentrations in the central nervous system

54. Which is the most common cause of iodine deficiency?
    1. insufficient intake of iodine from foods
    2. over-consumption of other trace elements
    3. over-consumption of anti-thyroid substances
    4. pituitary deficiencies of thyroid-stimulating hormone

55. What is the response of the thyroid gland to an iodine deficiency?
    1. increase in its size to trap more iodine
    2. increase in its size to trap more thyroxine
    3. decreased release of thyroid-stimulating hormone
    4. decreased release of thyroid-stimulating hormone

56. Which of the following conditions may result from iodine deficiency?
    1. gout
    2. goitre
    3. anemia
    4. hypertension

57. What of the following conditions may be present in a child born to a woman with a severe iodine defi- ciency during pregnancy?
    1. anemia
    2. rickets
    3. cretinism
    4. allergies

58. What nutrient deficiency during pregnancy may give rise to a child with cretinism?
    1. iodine
    2. copper
    3. chromium
    4. molybdenum

59. A goitrogen is which of the following?
    1. a hormone produced by the thyroid gland
    2. a substance that enhances absorption of dietary iodide
    3. a substance that interferes with the functioning of the thyroid gland
    4. a compound used to supplement salt as a way to increase iodide intake

60. Which of the following conditions does a person risk developing if they ingest large amounts of thyroid antagonist substances?
    1. cretinism
    2. simple goitre
    3. high blood T₃ levels
    4. high blood thyroxine levels

61. Which of the following foods are known to contain goitrogens?
    1. shellfish
    2. whole grains
    3. cauliflower and broccoli
    4. blueberries and raspberries

62. Which of the following fruits are known to contain substances that inhibit the functioning of the thyroid gland?
    1. apples and pears
    2. lemons and limes

1. 3. avocados and mangos
   4. peaches and strawberries

63. Which of the following is a prominent feature of mild iodine deficiency in children?
    1. demineralization
    2. growth retardation
    3. discoloration of teeth
    4. poor performance in school

64. What is the origin of goitrogens in the diet?
    1. naturally occurring
    2. food industry additives
    3. excessive use of fortified salt
    4. hydrogenation of certain minerals

65. You have just been hired by the World Health Organization to promote nutrition education and policies in a small country in Asia, whose population has a high prevalence of goitre. Which of the following policies would be the best to implement with respect to iodine status, cost, and efficiency?
    1. Fortify the salt with iodine.
    2. Promote free iodine supplements for all who want them.
    3. Educate the population to avoid all goitrogens in their diet.
    4. Educate the population to spend more time at the beach, as seawater, sea mist, and seafood are sources of iodine.

66. How did the recent Canadian Health Measures Survey test for the iodine nutritional status of Cana- dians?
    1. by feces samples
    2. by blood samples
    3. by urine samples
    4. by saliva samples

67. Which one of the following types of salt has iodine added to it?
    1. Kosher salt
    2. table salt
    3. sea salt
    4. pickling salt

68. Which of the following is the richest source of iodine?
    1. corn
    2. seafood
    3. orange juice
    4. cruciferous vegetables

69. If cow’s milk is found to contain unusually high levels of iodine, what is the most likely explanation?
    1. storage of milk in galvanized tanks
    2. grazing of cows on high-iodine soils
    3. addition of fortified salt at the milk processing plant
    4. exposure of cows to iodide-containing medications and disinfectants

70. Approximately how much iodized salt must be consumed to meet but not exceed the RDA for iodine?
    1. 1 mL
    2. 2 mL
    3. 3 mL
    4. 4 mL

71. What is the adult RDA for iodine?
    1. 45 µg
    2. 100 µg
    3. 150 µg
    4. 225 µg

72. Which of the following would most likely result from an excessive intake of iodine?
    1. diarrhea
    2. skin rashes
    3. dehydration
    4. thyroid gland enlargement

73. What is the Tolerable Upper Intake Level for iodine?
    1. 200 µg
    2. 450 µg
    3. 1100 µg
    4. 2000 µg

74. Which of the following would be the most appropriate food source of iodide for a person who lives in- land?
    1. fresh-water fish
    2. iodized table salt
    3. locally grown produce
    4. plants of the cabbage family

75. Which of the following foods makes the greatest contribution of manganese to the diet?
    1. meats and fish
    2. breads and cereals
    3. fruits and vegetables
    4. dairy products

76. Which of the following represents the most likely cause of manganese toxicity?
    1. consumption of supplements
    2. increased absorption due to genetic defect
    3. inhalation of dust contaminated with manganese
    4. consumption of foods grown on manganese-rich soils

77. Which of the following food components does chromium help to metabolize?
    1. iron
    2. proteins
    3. carbohydrates
    4. metallothionein

78. As far as is known, what hormone is dependent upon chromium for optimal activity?
    1. renin
    2. gastrin
    3. insulin
    4. antidiuretic hormone

79. Which of the following is one of the best food sources of chromium?
    1. grapefruit
    2. cabbage
    3. liver
    4. shrimp

80. What is a glucose tolerance factor?
    1. a protein that stimulates glycolysis
    2. a mineral cofactor for a specific enzyme
    3. a hormone that enhances pancreatic function
    4. a small organic compound that promotes the action of insulin

81. Which of the following conditions is characteristic of chromium deficiency?
    1. hypertension
    2. hyperglycemia
    3. enlargement of the liver
    4. enlargement of the thyroid gland

82. A vitamin supplement labelled as “high potency” contains an amount that is which of the following?
    1. 50 percent of the Daily Value
    2. equal to the UL
    3. up to 200 percent of the Daily Value
    4. 100 percent or more of the Daily Value

83. Approximately what percentage of the Canadian population takes multinutrient supplements regularly?
    1. 5 percent
    2. 33 percent
    3. 50 percent
    4. 80 percent

84. Which one of the following supplemental vitamins is most likely to cause toxicity?
    1. biotin
    2. riboflavin
    3. thiamin
    4. niacin

85. Which of the following statements is representative of vitamin supplementation practices?
    1. Most people who take supplements consume a poor diet.
    2. Most people should take supplements daily because of the great difficulty in obtaining the needed amounts from food.
    3. People who have low energy intakes or are pregnant are at risk for developing deficiencies and may benefit from supplementation.
    4. People should take supplements daily because nutrition surveys in Canada have detected deficiencies in some population groups.

86. A person who shuns dairy and spends most of her time indoors would likely benefit from a supplement of which of the following?
    1. vitamin A
    2. vitamin B₆
    3. vitamin C
    4. vitamin D

87. Which of the following individuals should consume a vitamin and mineral supplement?
    1. Samantha, a vegetarian who consumes eggs and dairy.
    2. Fred, a 40-year-old male who consumes a 2000 kcalorie diet with a variety of foods.
    3. John, an elderly gentleman who lacks the intrinsic factor.
    4. Gina, a lactose intolerant mother who consumes soy milk which is fortified with vitamins A and D and calcium.

88. Which of the following problems occurs with chewable vitamin C supplements?
    1. The supplements dissolve tooth enamel.

1. 2. The supplements cause headaches.
   3. The supplements cause dehydration.
   4. The supplements cause the skin to turn green.

MATCHING

1. Pork
2. Corn
3. Dairy
4. Folate
5. Biotin
6. Niacin
7. Chromium
8. Anemia
1. Brewer's yeast
10. Beriberi
11. Goitre
50. Riboflavin
1000. Vitamin B₆
14. Vitamin B₁₂
15. Tryptophan
16. Liver
17. Tea
18. Intrinsic factor
19. Ultraviolet light
20. Pantothenic acid

1. Name of thiamin deficiency disease
2. A food unusually rich in thiamin
3. Exposure to this leads to destruction of riboflavin
4. A food source that supplies a substantial amount of people’s riboflavin intake
5. Deficiency of this vitamin leads to cracks and redness at corners of the mouth
6. Used for synthesis of niacin
7. Over-consumption of this food has resulted in pellagra
8. High doses are known to lower LDL cholesterol
9. Deficiency of this vitamin is induced by feeding raw egg whites
10. This vitamin is a component of acetyl-coA
11. Toxicity from this vitamin is known to cause nerve damage and inability to walk
12. Prevention of neural tube defects is related to increased intake of this substance by pregnant women
13. One of the first symptoms of folate deficiency
14. Required to maintain nerve fibre sheath
15. Required for absorption of vitamin B12
16. Helps to metabolize carbohydrate
17. Food source of manganese
18. Food source of chromium
19. Food source of sulphur
20. Adult deficiency disease of iodine