SCHOOL OF HEALTH SCIENCES DIVISION OF DIETETICS, NUTRITION AND BIOLOGICAL SCIENCES, PHYSIOTHERAPY, PODIATRY, RADIOGRAPHY LEVEL 2 / DIET 1

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1 SCHOOL OF HEALTH SCIENCES DIVISION OF DIETETICS, NUTRITION AND BIOLOGICAL SCIENCES, PHYSIOTHERAPY, PODIATRY, RADIOGRAPHY LEVEL 2 / DIET 1 D2143/ Nutrition DATE: 28/04/2014 WRITING TIME: 120 minutes TIME: 9.30am READING TIME: 5 minutes INSTRUCTIONS: You should attempt to answer all questions. Part A: There are 20 multiple choice questions. There is only one correct answer for each question. Each correct answer equals one mark. Candidates should attempt to answer all questions. Answer each question on the exam paper. This section is worth 20 marks. Part B: Candidates should attempt to answer all questions. Answer each question on the exam paper in the space provided. This section is worth 80 marks. Calculators permitted. PAPER SETTER: Dr Elaine Bannerman MATRICULATION NUMBER:

2 Part A: (20 marks) 1) For a healthy individual of standard activity levels, which statement best describes the relative proportions of the different components of energy expenditure? a) 25% basal metabolic rate, 10% diet-induced thermogenesis, 65% physical activity b) 60-75% basal metabolic rate, 10% diet-induced thermogenesis, 15-30% physical activity c) 50% basal metabolic rate, 30% diet-induced thermogenesis, 20% physical activity d) 45% basal metabolic rate, 10% diet-induced thermogenesis, 45% physical activity 2) Which statement correctly describes the approximate amount of energy yielded from 1gram of each of the macronutrients? a) CHO 6 kcal, fat 9 kcal, protein 4 kcal, alcohol 7 kcal b) CHO 16 kj, fat 37 kj, protein 17 kj, alcohol 29 kj c) CHO 4 kcal, fat 7 kcal, protein 6 kcal, alcohol 9 kcal d) CHO 4 kj, fat 9 kj, protein 4 kj, alcohol 7 kj 3) A meal has 200g CHO, 65g protein and 75g fat how much energy is provided? a) 7080 kcal b) 1585 kj c) 1735 kj d) 1735 kcal 4) Deficiency states are more likely to be seen for water-soluble rather than fat-soluble vitamins because a) there are poor dietary intakes within the UK diet b) there is a lack of rich dietary sources within the UK food supply c) there is a lack of substantial body stores d) very few people consume supplements and this is the most important source 5) Pro-oxidants are a) the amino acid in shortest supply in a food in relation to need b) compounds or agents which slow or prevent oxidation c) compounds or agents capable of generating toxic oxygen species d) atom or group of atoms possessing one or more unpaired electrons rendering them highly unstable 6) Which of the following lists are all pro-oxidants a) Smoking, pollution, ischaemia, toxins b) Vitamin c, selenium, alpha-tocopherol c) Zinc, vitamin E, carotenoids d) None of the above

3 7) Microcytic anaemia may be a result of a) poor dietary intakes of vitamin B12 b) poor dietary intakes of folate c) lack of production of intrinsic factor d) none of the above 8) Which of the following statements is correct regarding energy stores? The body s energy stores provide a) approximately 24 hrs glycogen, unlimited adipose tissue, no protein store b) unlimited glycogen, unlimited adipose tissue & unlimited protein stores c) approximately 24 hrs glycogen, limited adipose tissue, no protein stores d) approximately 24 hrs glycogen, limited adipose tissue, unlimited protein stores 9) How much is a unit of alcohol? a) 10g b) 1 drink c) 14 g d) 21 g 10) What are the guidelines for sensible drinking for males and females in the UK? a) 14 and 21 units respectively b) 28 and 21 units respectively c) 21 and 14 units respectively d) 28 and 14 units respectively 11) Which of the following is not a monosaccharide? a) glucose b) fructose c) galactose d) sucrose 12) Which of the following foods is high in non-milk extrinsic sugars? a) fruit juice b) chicken c) apple d) milk

4 13) What is the richest dietary source of n-3 long chain polyunsaturated fatty acids? a) fish b) oily fish c) seeds d) vegetable oils 14) Which one of the following statements describes the conditions required for fat digestion & absorption a) hydrochloric acid & lipases b) hydrochloric acid & pepsinogen c) bile acids & pepsinogen d) cholecystokinin, bile acids & lipases 15) Which one of the following is involved in removal of circulating cholesterol from the body to the liver for excretion a) chylomicrons, b) HDL cholesterol c) triglycerides d) LDL cholesterol 16) Which dietary fatty acids are most susceptible to rancidity? a) saturated fatty acids b) trans fatty acids c) polyunsaturated fatty acids d) monounsaturated fatty acids 17) The requirement for protein is a requirement for a) energy b) peptides c) nitrogen and essential amino acids d) essential fatty acids 18) What is the limiting amino acid in a food? a) the amino acid in shortest supply in a food in relation to need b) the essential amino acid that is in shortest supply in a food in relation to need c) the essential amino acid with concentration that is below the concentration in the reference food d) any amino acid with concentration that is below the concentration in the reference food

5 19) What is the relationship between nitrogen and protein? a) 1g protein = N g x 16 b) 1g protein = N g x 6.25 c) 1g nitrogen = protein g x 6.25 d) 1 g nitrogen = protein g x 4 20) What is the key hormone that is stimulated when blood glucose concentrations fall? a) glucagon b) sucrase c) insulin d) cholecystokinin

6 Part B: 1) Define and explain the term Dietary reference values and provide examples of their use. [6 marks] 2) Using two specific nutrient examples, provide explanation for differences in nutrient requirements set according to a. Gender b. age

7 3) Define the term bioavailability. [3 marks] 4) Using examples, outline those factors that can influence the bioavailability of a nutrient. [7 marks]

8 5) A male 59 years old, has a body weight of 85 kg; height of 175 cm and waist circumference of 102cm a. What is your interpretation of his body mass index (BMI) according to WHO guidelines? b. What is your interpretation of his waist circumference? [3 marks] c. What is the limitation of using a BMI as a measure of body composition? d. Give two examples of alternative methods of body composition assessment. [3 marks]

9 6) Carbohydrates can be classified as glycaemic and non-glycaemic. a. Explain the difference between these types of carbohydrate. [4 marks] b. What is the advantage of classifying carbohydrates by this method rather than by molecular weight? c. Give two examples of (i) glycaemic carbohydrates (ii) non-glycaemic carbohydrates

10 7) Draw a labelled diagram that illustrates iron intakes, losses and turnover within the body. Outline the stages of deficiency that occur with ongoing inadequate iron intakes, highlighting the different parameters that indicate the different stages of deficiency. [10 marks]

11 8) There is a clear link between salt intakes and health. a) How do dietary intakes of salt compare with current dietary recommendations for adults in the UK? [3 marks] b) What are the key dietary sources of sodium in the UK diet? c) Discuss the limitations with dietary assessment of sodium intakes and suggest an alternative method of assessment? [5 marks]

12 9) Folic acid and food fortification is controversial. Present an argument for and against a mandatory food fortification policy for folic acid within the UK. [10 marks]

13 10) Using your knowledge of vitamin D, outline its role and function in calcium homeostasis. You should provide details of other key hormones involved in this endocrine system and also those organs in the body that are key to calcium regulation. [10 marks] End of paper