True or False

1
True or False

• Obesity is defined as a BMI greater than 30?

2

• True
• Obesity is defined as greater than 30.

3
True or False

• An acceptable waist to hip ratio for males is 0.80

4

• False
• An acceptable waist to hip ratio for females is
  0.8

5

• Increasing amounts of the sugar lactose in the US
  diet is believed to be one of the major causes of
  obesity?

6

• False
• Increasing amounts of the sugar fructose is
  believed to be one of major causes of obesity

7
True or False

• All of the artificial sweeteners on the US market
  can be considered to have no calories.

8

• True

9

• Obesity increases the risk of Type 1 diabetes?

10

• False
• Obesity increases the risk of type 2 diabetes

11

• The hormone considered to be the most sensitive
  to the glycemic index of food is ghrelin?

12

• False
• The hormone considered to be the most sensitive
  to the glycemic index of food is?

13

• The current recommended surgical treatment for
  morbidly obese patients is ______________?

14

• Gastric bypass or gastric banding

15
True or False

• While you are taking this examination, the main
  source of ATP for your hand an am that you are
  using to write this examination is anaerboic
  oxidation of fatty acids?

16

• False
• Aerobic

17

• The most sensitive method for obtaining a dose
  response curve for a vitamin is determined of
  serum levels.

18

• True

19

• The oxidation level of retinol that is a ligand
  for the RAR and RXR receptors retinoic acid

20

• True
• The oxidation level of retinol that is a ligand
  for the RAR and RXR receptors is retinoic acid

21

• Retina is the colored (yellow ) form of vitamin A
  found in plants.

22

• False
• Beta Carotene is the coloured (yellow) form of
  vitamin A found in plants.

23

• Chronic hypervitaminosis A can cause nontraumatic
  rib facture.

24

• False
• Chronic hypervitaminosis A can cause nontraumatic
  HIP factures.

25

• The hormone produced in the kidneys that
  regulates calcium transport across the intestinal
  mucosa is 1,25-dihydroxy cholecalciferol

26

• True
• The hormone produced in the kidneys that
  regulates calcium transport across the intestinal
  mucosa is 1,25-dihydroxy cholecalciferol

27

• Removal of the parathyroid gland causes
  hypercalcemia

28

• False
• Removal of the parathyroid gland causes
  hypocalcemia

29

• Methotrexate inhibits generation of the active
  forms of cyanocobalamin

30

• False
• Methotrexate inhibits generation of the active
  forms of folic acid

31

• A 400 Calorie (kcal) liquid protein diet is a
  widely used diet for individuals with BMIs
  between 26 - 29

32

• False
• A 400 Calorie (kcal) liquid protein diet is a

33

• A vitamins UL is the dose where toxicities are
  readily observed?

34

• False
• A vitamins UL is the dose just before toxicities
  are readily observed.

35

• The RDA value for a vitamin is the amount of
  vitamin needed by 50 percent of the individuals
  in a defined group.

36

• True
• EAR 2 STD ????

37

• A vitamin dose-response curve is an example of
  nutrition science.

38

• True
• A vitamin dose response curve is an example of
  nutrition science

39

• Vitamin A prevents blindness in infants and
  children?

40

• True
• Vitamin A prevents blindness in infants and
  children.

41

• The FDAs daily Value (DV) for vitamin A is 1500
  mcg which is within the adult RDA range for this
  vitamin.

42

• False
• Above
• The FDAs daily Value (DV) for vitamin A is 1500
  mcg which is above the adult RDA range for this
  vitamin.

43

• The rhodopsin cycle takes place in dim light in
  the cones of the eye?

44

• False
• The rhodopsin cycle takes place in dim lght in
  the RODS of the eye.

45

• Absence of this vitamin produces goose bump or
  acne like appearances?

46

• Vitamin A.

47

• Rank the following sources of vitamin A in terms
  of bioavailability.
• A. Beta-Caroteine in capsules
• B. Retinol palmitate in calves liver
• C. Beta-Caroteine in carrots
• D. Reinol palmitate in vitamin capsule

48

• NAFC (Not A FUCKING CLUE)
• 1. D
• 2. A
• 3. B
• 4. C

49

• True or False

50

• True or False
• Ergocalciferol is considered equivalent to
  cholecalciferol.

51

• True
• Ergocalciferol is considered equivalent to
  cholecalciferol.

52

• True or False
• The water soluble commercial form of
• a-tocopherol is the acetate ester.

53

• False
• The water soluble commercial form of
  alpha-tocopherol is the hemisuccinate

54

• Dr. Steenbock demonstrated that irradiation of
  certain foods would produce diets that prevented
  (name of the disease)

55

• Rickets

56

• Most calcium is excreted in the

57

• Feces

58

• Of the three hormones that control calcium
  concentration, the one that acts on the most
  sites including at least two effects on the
  kidney is

59

• Parathyroid or PTH

60

• Chronic administration of drugs that interfere
  with lipid absorption in the intestinal tract
  might lead to deficiences of (names of vitamins)

61

• Cholecalciferol/Ergocalciferol/D3/D2
• Alpha-tocopherol
• Phytonadine (K1)
• Retinol palmitate/retinol acetate/ retinol

62

• Write the numbers of the asymmetric (chiral)
  carbons of vitamin E that make its
  stereochemistry so complex?

63

• 2, 4 and 8 from structure I
• Think double 2
• 2 2
• 2x24 4
• 2x2x28 8

64
What am I
65
What am I
66
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67
What am I
68
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69
What am I
70
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71
What am I
72

• a-Carotene

73

• What was Professor Steenbocks (University of
  Wisconsin) key discovery that answered the
  question about fish oil and plant sources of
  vitamin A?

74

• Steenbock pointed that the vitamin A potency of
  certain plant sources seemed to run parallel with
  the amount of yellow, fat soluble pigments
  present in them.

75

• Of all the various ways to determine a vitamins
  DRI, which one of the newer methods appears to
  provide the most accurate information to arrive
  at a reliable DRI?

76

• Biochemical activity usually a coenzyme role
• Direct determination of the concentration in
  serum or plasma.

77

• There are several ways to develop a vitamin
  deficiency. Keeping in mind the potential to
  store a several month supply of vitamin A, how
  might a person develop a vitamin A deficiency?

78

• If you were to put someone in well for say
  greater than nine months (or until they were thin
  enough) then they would deplete the vitamin A
  levels.
• Long term malnutrition, possibly involving
  protein malnutrition preventing synthesis of
  adequate amounts of RBP sever liver disease,
  intestinal malabsorption.

79

• The are several characteristics for a vitamin.
  Name two that definitely apply to vitamin A other
  than it being organic (4 pts)

80

• (A) Essential, normal component of diet, required
  for a biochemical function, normal constituent of
  the diet.,

81
True or False

• The artificial sweetener derived from
  carbohydrate is aspartame?

82

• FaLse
• The artificial sweetener derived from peptide or
  amino acids or protein is aspartame.

83

• The thrifty gene model is one explanation why
  certain ethic groups are at increased risk of
  developing obesity?

84

• True
• Why J-Lo has a nice ass
• (No pictures of J-Los ass because I would get in
  trouble.

85

• As a person ages, the number of calories required
  to maintain the individuals weight increases.

86

• False as a person ages, the number of calories
  required to maintain the individuals weight
  decreases.
• In class we pointed out that as individuals age
  their muscle mass decreases resulting in less
  caloric needs.

87

• The daily adult female-male RDA range for vitamin
  A is 700-900 µg

88

• True
• The daily adult female-male RDA range for vitamin
  A is 700 -900 µg.

89

• The most rapidly absorbed form of vitamin A is an
  oil-based retinol acetate dosage form.

90

• False
• The most rapidly absorbed form of vitamin A is an
  aqueous or emulsion retinol acetate dosage form.

91

• The form of vitamin A required for visual process
  is 11-cis-retinol acetate.

92

• False
• The form of vitamin A required for the visual
  process is 11-cis-retinal

93

• Starting with the following structure, draw the
  form of vitamin A that is a ligand for the RAR
  receptor.

94

• Replace the alcohol with a carboxylic acid
  forming retinoic acid.

95
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96

• Lean Cusine contains 180 Calories (kcal) per
  serving. Forty percent of these calories is the
  protein. How many grams of protein are in a
  serving of this product?

97

• (180)(.4) 72 Cal
• 72 Cal / 4 Cal 18 gm protein

98
Vitamin A Study Guide

• What are the advantage of Vitamin A esters in
  dosage forms?

99

• Vitamin A esters are more readily absorbed in the
  intestine than carotenes are.

100

• What is the role of Vitamin A in the visual
  process?

101

• Vitamin A is required for vision
• Part of the visual pigments in the rods
• Vit A deficiencies can cause night blindness and
  xerophthalmia

102

• Retinoic acid receptors are __________

103

• Nuclear receptors
• What are the nuclear receptors

104

• RARa,ß,? (ligand trans-retinoic acid)
• RXRa,ß,? (ligand 9-cis-retinoic acid)

105

• What is the role of Vit A in cell differentiation?

106

• Required for cell differentiation in the
  developing embryo
• Retinoic acid is now considered a hormone and
  plays a vital role in cell differentiation in
  embryos
• Deficiencies affect cells of the skin, cornea,
  lungs, and digestive tract

107

• What are symptoms and occurances of
  hypervitaminosis A and hypercarotenosis?

108

• HA
• Vertigo
• Diarrhea
• Nausea
• Vomiting

109

• Hypervitaminosis A Chronic symptoms?

110

• Fatigue
• Malaise
• Lethargy
• The list goes on an on

111

• What are the three dosage forms of Vitamin A?

112

• Retinol
• Retinol Acetate
• Retinol Palmitate

113

• Dietary forms of vitamin A?

114

• Fish and animal liver
• Carotene containing veggies
• Fortified milk
• Genetically modified rice

115
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116
Obesity
117

• What are the many causes of obesity?

118

• Excess adipose tissue
• Shift in eating habits
• Social class
• Hormone Imbalances

119

• Why do overweight children have problems
  maintaining their weight as adults?

120

• Adipocyte numbers stay constant
• The more adipocytes that are created during
  youth, the more weight control problems will
  occur in the future
• Basically adipose tissue is like a storage that
  that increases. The bigger it is the easier to
  fill up.

121

• What is the thrifty gene model?

122

• Basically evolution selected individuals who
  could best store fat and then breed. Skinny women
  died off. Our bodies are constantly under the
  assumption that a famine is approaching and
  therefore our bodies want to hold on to fat
  tighter.

123

• Name Three Reasons for the increase in the number
  of obese people.

124

• Increased caloric consumption
• Increased sedentary behavior
• Genetics can cause overweight parents to produce
  overweight kids.

125

• Potential role of peroxisomes and
  hormonal/cytokine control?

126
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127

• Types of PPARs?

128

• PPARalpha
• PPaRbeta
• PPARgamma

129

• What does PPAR alpha do?

130

• Found in cardiac cells and other gluconeogenic
  organs

131

• What is the equation for BMI

132
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133

• My BMI is 35 according to the BMI scale how fat
  am I?

134

• Obese

135

• My BMI is 19.2 how fat am I?

136

• Normal weight
• Normal weight
• 18.5-24.9

137

• What is considered overweight but not obese?

138

• What is considered overweight but not obese?
• 25-29.9

139

• What is considered underweight according to the
  BMI?

140

• lt18.5

141

• What are the waist to hip ratios for men and
  women?

142

• Men lt 0.95
• Women lt 0.80

143

• People with apple shapped bodies are more likely
  to suffer what diseases?

144

• Apple shaped bodies are more prone to?
• Type 2 Diabetes,
• Hypercholesterolemia,
• Cardiovascular disease.

145

• What is the definition of nutrition science?

146

• The emphasis is on science which uses the
  scientific method to reach conclusions
• 1. Determine the dose to prevent a nutritional
  deficiency.
• 2. Determine the dose to cause a toxic response.

147

• What is the definition of nutrition policy?

148

• This is the approach used to determine the dose
  required to maintain well being.

149

• What are some causes of nutrient deficiencies?

150

• Inadequate ingestion usually from a poor diet.
• Inadequate absorption
• Inadequate utilization
• Increased requirements

151

• RDA stands for?

152

• Recommended Dietary Allowances (RDA)

153

• The last official set of reference values were in
  the year _________?

154

• 1989

155

• What do the following acronyms mean?
• 1. EAR
• 2. RDA
• 3. AI
• 4.UL

156

• 1. EAR Estimated Average Requirement
• The intakes that meets the estimated nutrient
  need of 50 of the individuals in that group.
• Based on a median rather than a mean.

157

• 2. Recommended Dietary Allowance (RDA)
• RDA EAR 2SDEAR
• Covers 97.5 of people

158

• 3. AI adequate Intake (AI)
• Derived from MEAN intakes

159

• UL Tolerable Upper Intake Level
• The maximum intake by an individual that is
  UNLIKELY to pose risks of adverse health effects
  in almost all (97 to 98 percent) individuals.

160

• What vitamins covered at this point do not have
  an EAR but instead an AI level?

161

• D and K

162

• True or false vitamins fall under the Food
  portion of the Food and Drug Cosmetic Act.

163

• True.

164

• What is the name of the act that makes it so
  manufacturers need not prove efficacy?

165

• DSHEA act
• Dietary Supplement Health and Education Act of
  1994.

166

• What does leptin do?

167

• This cytokine (adipokine) is synthesized
  primarily in adipose tissue and released from
  that tissue.
• It travels to the hypothalamus to inform the
  body about the quantity of fat stores in the body.

168

• What does Resistin do?

169

• It maintains blood glucose levels during fasting.
  
• Resisten the urge to Eat
• And some times

170

• What does Ghrelin do?

171

• Ghrelin is secreted in a pulsatile manner.
• It is released when food is needed and then falls
  off with the intake of food.
• It is elevated in patients on low calorie diets
  causing to desire food.
• Its production is reduced after gastric bypass
  surgery which may explain satiation in these
  patients.

172

• Salatrim (Nabisco) is the underlying chemistry
  for this product?

173

• Salatrim (Nabisco)
• stearic acid and short chain fatty acids

174

• Olestra

175

• Sucrose fatty acid

176

• Simplese

177

• Protein
• 1.5 calories/gm

178

• Saccharin

179

• Carbohydrate
• Sulfimide

180

• Aspartame

181

• Protein/AminoAcid

182

• What is Sucralose (Splenda)

183

• Carbohydrate

184

• Neotame

185

• Amino Acids/protein

186

• At rest, the body prefers to metabolize _______

187

• Lipid

188

• Sudden increase in physical activity, body
  metabolizes _______

189

• Carbohydrate

190

• Most valid diets tend towards __________ and
  _____________ for several reasons.

191

• Complex carbohydrate
• High Bulk

192

• When should a person on a diet take a vitamin
  mineral supplement.

193

• For people on a diet of 1,200 Calories or less.

194

• What does a high glycemic index food do?

195

• Rapidly digested forming glucose.

196

• What is the glycemic load?

197

• Glycemic load
• (glycemic index)(gm CHO consumed
• 100

198

• What are the characteristics of valid diet?

199

• Weight loss averages 1 2 lbs per week
• It recognizes that the persons former excess
  weight will return unless the person monitors
  what is eaten and maintains an active life style.
  
• Mentions physically activity

200

• What are some of the characteristics of a fad
  diet?

201

• Magic or miracle foods that burn fat
• Bizarre quantities of only one food or type of
  food
• Rigid menus limited selection of foods
• Specific combinations
• Rapid weight loss gt2lbs per week
• No emphasis on physical activity

202

• What is characteristics of the Pritikin Diet?

203

• High fruits/vegs
• Limited Fat
• Non-fat dairy
• Devoid of cholesterol
• Main protein source if fish
• Eat small amounts several times a day

204

• How is the Pritikin diet different than the
  Ornish diet?

205

• Ornish ? exercise
• Ornish ? lacking protein source from fish ie. The
  cardiac protective effects of polyunsaturated
  vegetable oils including omega-3 and -6 fatty
  acids from fish and nuts.

206

• Out of the Atkins, Zone, LEARN, and Ornish diets
  which has the best outcomes

207

• Atkins Diet generally showed better outcomes HDL,
  LDL, triglycerides, blood pressure and body fat
  when compared with the other diets.

208

• Bariatric surgery has shown to improve the
  following conditions?

209

• 61.2 Lost excess weight
• 76.8 Type 2 diabetes completely resolved
• 70 Hyperlipidemia improved
• 61.7 Hypertension resolved
• 85.7 Obstructive sleep apnea resolved

210

• What day do you not want to have bariatric
  surgery?

211

• New surgen July 2nd

212

• Of the following what does liposuction improve?

213

• None of the Following!!!! Sorry about that!
• Just testing you..
• Plasma glucose
• Insulin resistance
• Hyperlipidemia
• Hypertension
• Onset of type 2 diabetes

214

• When does Oregon Health Plan Cover Bariatric
  Surgery?

215

• January 1, 2008

216

• Here is my condition, I want to know if I am
  eligible for bariatic surgery
• Age 24
• BMI 37.3 Obese

217

• NO because I mention nothing about type II
  diabetes. I must have type 2 diabetes.

218

• Restrictions on Oregon health Plan for Bariatric
  Surgery

219

• Patients must be gt18 years old
• Diagnosed with type 2 diabetes
• Body Mass Index above 35
• Must be preformed a recognized center of
  excellence.

220

• Should I commit suicide because my BMI is gt30.

221

• A person may not have to be concerned even if the
  height weight tables or the persons BMI indicates
  being overweight.

222

• What is metabolic syndrome X?

223

• Also known as Insulin Resistance Syndrome.
• Criteria
• Abdominal obesity
• Low HDL
• Elevated Blood glucose
• Hypertension

224

• How many lbs does it take to gain a lb of fat lb?

225

• 7,000 calories to gain
• How many to burn off one lb?

226

• 3,500 calories

227

• What does PPARa do?

228

• Found in tissues with a high capacity for fatty
  acid oxidation

229

• What does PPARß do?

230

• Activated by fatty acids but not well understood.

231

• What does PPAR? do?

232

• Found in white adipose tissue and immune cells.
  Considered the master regulator pf adipocyte
  differentiation.
• Stimulates storage of fatty acids in adipose
  tissue
• Fatt? Receptor!!!!!

233

• People with type II diabetes have decreased
  expression of what PPAR? coactivator?

234

• PCG-1

235

• Where do Actos and Avandia bind?

236

• Actos and Avandia bind at the PPAR? receptor.

237

• Insulin is required for?

238

• Transport of glucose into muscle and adipose
  tissue
• And..

239

• Required for release of dietary triglycerides
  from chylomicrons and endogenous triglycerides
  from VLDL
• Hypertriglyceridemia is one of the complications
  seen in uncontrolled diabetes
• AND???

240

• Proper function of the PPAR? site of insulin
  resistance in forms of diabetes

241

• Orlistat inhibits lipase in the intestinal tract
  preventing triglyceride digestion and absorption
  What multivitamin would you want to supplement.

242

• Vitamins
• KADE
• Vitamin K
• Vitamin A
• Vitamin D
• Vitamin E

243

• What is mesotherapy?

244

• Several Subcutaneous injections
• Melt Fat Away
• Requires diet and exercise.

245

• Name one Alternate Medicine for weight loss.

246

• Hoodia
• Decreases appetite.

247

• Describe the New Beverly Hills Diet.

248

• Basically combining foods to prevent fatty build
  up
• 15 lbs in 35 days.

249

• Sugar Busters

250

• Sugar and Insulin make you fat
• Decrease sugar content in food

251

• Zone Diet
• Protein 30
• CHO 40
• Fat 30
• Basically correct insulin imbalance. To prevent
  weight gain

252

• South Beach Diet

253

• No eat High Glycemic index foods
• Low carbohydrate diet.

254

• Ornish Diet

255

• Essentially low fat, vegetarian diet
• Exercise included
• No Omega

256

• True or False
• The RDA for alpha-tocopherol is based on a groups
  polyunsaturated fatty acid intake.

257

• True

258
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