Test bank for Understanding Nutrition Loose leaf Version 14th Edition by Whitney

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1 Test bank for Understanding Nutrition Loose leaf Version 14th Edition by Whitney Link download full: Chapter 10 The Water-Soluble : B and Vitamin C MULTIPLE CHOICE Chapter 10: The Water-Soluble : B and Vitamin C 1. Which of the following is a feature of vitamins? a. Many serve in the role of enzyme inhibitors. b. Structurally, many are found linked together. c. Several may be oxidized to yield 4 kcalories per gram. d. The quantities present in foods are measured in micrograms or milligrams. e. Some are both water- and fat-soluble. ANS: D DIF: Bloom s: Remember REF: 10.1 The an Overview OBJ: UNUT.WHRO Describe how vitamins differ from the energy nutrients and how fat-soluble vitamins differ from water-soluble vitamins. 2. What is a precursor?

2 a. A conditionally essential vitamin b. A sign or symptom of a clinical vitamin deficiency disorder c. A substance that is used to synthesize another compound d. A substance that is recycled through the liver and intestines e. A sign or symptom of a subclinical vitamin deficiency disorder ANS: C DIF: Bloom s: Remember REF: 10.1 The an Overview OBJ: UNUT.WHRO Describe how vitamins differ from the energy nutrients and how fat-soluble vitamins differ from water-soluble vitamins. 3. What is meant by the bioavailability of a vitamin in food? a. The total amount available from plant and animal food b. The amount absorbed and subsequently used by the body c. The amount that escapes destruction from food processing d. The number of different chemical forms of the same vitamin e. The number of kcal that can be produced from the vitamin ANS: B DIF: Bloom s: Remember REF: 10.1 The an Overview

3 OBJ: UNUT.WHRO Describe how vitamins differ from the energy nutrients and how fat-soluble vitamins differ from water-soluble vitamins. 4. Milk and milk products provide much of the in people s diets. a. Thiamin b. Vitamin A c. Riboflavin d. Vitamin B12 e. Vitamin C ANS: C DIF: Bloom s: Remember REF: 10.1 The an Overview OBJ: UNUT.WHRO Describe how vitamins differ from the energy nutrients and how fat-soluble vitamins differ from water-soluble vitamins. 5. What is the primary excretory route for the water-soluble vitamins? a. Bile b. Kidney c. Intestine d. Perspiration e. Feces

4 ANS: B DIF: Bloom s: Remember REF: 10.1 The an Overview OBJ: UNUT.WHRO Describe how vitamins differ from the energy nutrients and how fat-soluble vitamins differ from water-soluble vitamins. 6. What is a chief function of the B vitamins? a. Antioxidation b. Anticoagulation c. Antibody stabilization d. Coenzyme participation e. Reproductive support ANS: D DIF: Bloom s: Remember REF: 10.2 The B 7. Which of the following functions has a requirement for thiamin? a. Blood coagulation

5 b. Formation of red blood cells c. Energy release from energy-yielding nutrients d. Formation of epithelial cell mucopolysaccharides e. Production of histamine ANS: C DIF: Bloom s: Remember REF: 10.2 The B 8. Which of the following is the coenzyme form of thiamin? a. Thiaminacide b. Thiamin pyrophosphate c. Thiamin adenine dinucleotide d. Thiamin mononucleotide e. Thiamin flavin ANS: B DIF: Bloom s: Remember REF: 10.2 The B

6 9. Beriberi results from a deficiency of a. niacin. b. thiamin. c. vitamin C. d. vitamin B12. e. riboflavin. ANS: B DIF: Bloom s: Remember REF: 10.2 The B 10. Which of the following diets is most likely to lead to beriberi? a. High intakes of white rice b. Low intakes of whole grains c. High intakes of unrefined rice d. Low intakes of enriched grains e. High intakes of corn

7 ANS: A DIF: Bloom s: Remember REF: 10.2 The B 11. The Wernicke-Korsakoff syndrome may be treated with supplements of a. folacin. b. thiamin. c. vitamin C. d. vitamin B12. e. niacin. ANS: B DIF: Bloom s: Remember REF: 10.2 The B 12. Which of the following is a characteristic of thiamin nutrition? a. It contains pyrosulfate. b. It is required for regeneration of folate c. It is required for regeneration of niacin d. It is an integral part of the nerve cell membrane

8 e. It is integral in carrying activated carbon dioxide. ANS: D DIF: Bloom s: Remember REF: 10.2 The B 13. Which of the following provides the most thiamin per serving size? a. Ham b. Squash c. Whole milk d. Whole-grain breads e. Cheddar cheese ANS: A DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, & food 14. How does the method of cooking affect thiamin stability? a. Microwaving the food conserves much of the thiamin.

9 b. Prolonged heating of the food has little, if any, effect on the thiamin. c. Boiling the food tends to conserve thiamin by forming a stable, hydrated complex. d. Steaming the food can lead to substantial thiamin loss due to the high heat needed to form the steam. e. Blanching the food before cooking it will preserve thiamin content. ANS: A DIF: Bloom s: Remember REF: 10.2 The B 15. Which of the following contains the highest concentration of thiamin? a. Pork b. Fish c. Beef d. Chicken e. Tofu

10 ANS: A DIF: Bloom s: Remember REF: 10.2 The B 16. Which of the following is indicative of a dietary deficiency of riboflavin? a. Beriberi b. Diarrhea c. Keratomalacia d. Inflamed mouth membranes e. Facial clefts ANS: D DIF: Bloom s: Remember REF: 10.2 The B 17. Which of the following contains the highest amount of riboflavin when expressed per kcalorie? a. Cheddar cheese b. Pinto beans

11 c. Tuna (in water) d. Liver e. Strawberries ANS: D DIF: Bloom s: Remember REF: 10.2 The B 18. The signs and symptoms of riboflavin deficiency are known collectively as a. pellagra. b. antiflavonosis. c. ariboflavinosis. d. flavin adenine dinucleosis. e. beriberi. ANS: C DIF: Bloom s: Remember REF: 10.2 The B

12 19. Riboflavin needs are more difficult to meet when the diet is low in a. meats. b. grains. c. vegetables. d. dairy foods. e. fruits. ANS: D DIF: Bloom s: Remember REF: 10.2 The B 20. The coenzyme FAD is formed from what vitamin? a. Niacin b. Choline c. Thiamin d. Riboflavin e. Pantothenic acid ANS: D DIF: Bloom s: Remember REF: 10.2 The B

13 21. Of the following commonly eaten foods, which makes the greatest contribution to riboflavin intake? a. Milk b. Potatoes c. Orange juice d. Peanut butter e. Carrots ANS: A DIF: Bloom s: Remember REF: 10.2 The B 22. A deficiency of what vitamin produces a characteristic cracking and redness at the corners of the mouth? a. Biotin

14 b. Niacin c. Riboflavin d. Ascorbic acid e. B6 ANS: C DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, & food 23. Which of the following is a property of riboflavin in nutrition? a. Stability to heat is good. b. Deficiency leads to beriberi. c. Requirements are proportional to body weight. d. Significant amounts are found in citrus products. e. Stability to irradiation is good. ANS: A DIF: Bloom s: Remember REF: 10.2 The B

15 24. Which of the following is a property of niacin in nutrition? a. It is susceptible to destruction in foods exposed to light b. It participates primarily in reactions involving amino acids c. It is soluble in both water and lipids depending upon its chemical form d. It can be synthesized in the body from the essential amino acid tryptophan e. It can increase LDL and decrease HDL in large doses. ANS: D DIF: Bloom s: Remember REF: 10.2 The B 25. When the diet contains an adequate amount of protein, what amino acid can be used by the body to synthesize niacin? a. Lysine b. Valine c. Tryptophan d. Phenylalanine e. Glycine

16 ANS: C DIF: Bloom s: Remember REF: 10.2 The B 26. Which of the following nutrients functions to prevent the appearance of a bilateral, symmetrical dermatitis, primarily on areas exposed to the sun? a. Niacin b. Choline c. Inositol d. Riboflavin e. Vitamin C ANS: A DIF: Bloom s: Remember REF: 10.2 The B 27. What vitamin deficiency disease appeared in people who had subsisted on a diet high in corn and low in protein?

17 a. Scurvy b. Pellagra c. Wet beriberi d. Pernicious anemia e. Scaly dermatitis ANS: B DIF: Bloom s: Remember REF: 10.2 The B 28. Which of the following overt side effect(s) is likely to appear after a person ingests a high quantity of nicotinic acid? a. Constipation b. Mental confusion c. Painful, tingling, itching sensation d. Hair loss, bloating, and photophobia e. Sudden increase in blood pressure ANS: C DIF: Bloom s: Remember REF: 10.2 The B

18 29. Which of the following is a feature of niacin nutrition? a. Low doses may lead to kidney stones. b. High doses may lower blood cholesterol. c. Low doses may lead to heartburn and low blood pressure. d. High doses may elevate red blood cell count in mildly anemic individuals. e. High doses may cause hypoglycemia. ANS: B DIF: Bloom s: Remember REF: 10.2 The B 30. Your friend Jane just returned from the doctor, who diagnosed her with a specific vitamin B toxicity. However, she doesn t recall the name of the vitamin. Which of the following is the only possible culprit associated with toxicity symptoms? a. Niacin b. Biotin

19 c. Riboflavin d. Vitamin B12 e. Thiamin ANS: A DIF: Bloom s: Remember REF: 10.2 The B 31. Among the following, which would be the best source of niacin equivalents? a. Milk b. Broccoli c. Chicken d. Strawberries e. Whole wheat bread ANS: C DIF: Bloom s: Remember REF: 10.2 The B

20 32. Which of the following is a feature of pantothenic acid in nutrition? a. Absorption from foods is inhibited by aspirin. b. A deficiency or a toxicity shows similar symptoms. c. Deficiencies are seen primarily in children ages 4-10 years. d. It functions in the metabolism of amino acids, glucose, and fatty acids. e. It is possible to develop toxic levels on pantothenic acid if too much is ingested. ANS: D DIF: Bloom s: Remember REF: 10.2 The B 33. Which of the following foods contains a protein that decreases bioavailability of biotin? a. Aged wine b. Aged cheese c. Raw egg whites d. Raw cauliflower e. Citrus fruits

21 ANS: C DIF: Bloom s: Remember REF: 10.2 The B 34. Biotin can be synthesized by a. avidin. b. the skin. c. the liver. d. intestinal bacteria. e. bone marrow. ANS: D DIF: Bloom s: Remember REF: 10.2 The B 35. Which of the following vitamins is known to sustain substantial losses during processing of food? a. Biotin b. Niacin

22 c. Vitamin B12 d. Pantothenic acid e. Inositol ANS: D DIF: Bloom s: Remember REF: 10.2 The B 36. Which of the following vitamins is stored primarily in muscle tissue? a. Biotin b. Folate c. Vitamin B6 d. Pantothenic acid e. Thiamin ANS: C DIF: Bloom s: Remember REF: 10.2 The B

23 37. What vitamin is involved intensively in amino acid metabolism? a. Biotin b. Vitamin A c. Vitamin B6 d. Riboflavin e. Vitamin C ANS: C DIF: Bloom s: Remember REF: 10.2 The B 38. A common drug for the treatment of tuberculosis is known to markedly interfere in the metabolism of vitamin a. B2. b. B6. c. B12. d. C. e. D.

24 ANS: B DIF: Bloom s: Remember REF: 10.2 The B 39. Irreversible nerve damage has been reported in people taking large doses of vitamin a. B1. b. B2. c. B6. d. B7. e. B12. ANS: C DIF: Bloom s: Remember REF: 10.2 The B 40. In what major way does alcohol intake affect vitamin B6 metabolism? a. It reduces acetaldehyde formation. b. It increases fecal excretion of the vitamin.

25 c. It dislodges the PLP coenzyme from its enzyme. d. It interferes with synthesis of the PLP coenzyme. e. It increases urinary excretion of B6. ANS: C DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, & food 41. On a per-kcalorie basis, which of the following foods is richest in vitamin B6? a. Meats b. Fruits c. Legumes d. Grains e. Dairy ANS: B DIF: Bloom s: Remember REF: 10.2 The B

26 42. Pteroylglutamic acid is known as a. folate. b. choline. c. inositol. d. pyridoxamine. e. niacin. ANS: A DIF: Bloom s: Remember REF: 10.2 The B 43. Which of the following vitamins undergoes significant enterohepatic circulation? a. Folate b. Niacin c. Thiamin d. Pyridoxine e. Pantothenic acid ANS: A DIF: Bloom s: Remember REF: 10.2 The B

27 44. Which of the following vitamins is usually found in a form that is bound to one or more pteroylglutamic acid molecules in food? a. Folate b. Thiamin c. Vitamin B6 d. Ascorbic acid e. Vitamin B12 ANS: A DIF: Bloom s: Remember REF: 10.2 The B 45. A person with a disorder that limits absorption of bile is at increased risk for deficiency of a. folate.

28 b. niacin. c. riboflavin. d. ascorbic acid. e. pantothenic acid ANS: A DIF: Bloom s: Remember REF: 10.2 The B 46. Research has shown that the risk for neural tube defects is lowered by taking supplements of a. niacin. b. folate. c. vitamin C. d. vitamin B12. e. thiamin. ANS: B DIF: Bloom s: Remember REF: 10.2 The B

29 47. Which of the following is true regarding B vitamins and homocysteine metabolism? a. Folate catabolyzes homocysteine b. Biotin supplements reduce blood homocysteine levels c. Excessive homocysteine intake reduces vitamin B12 absorption d. High blood homocysteine levels correlate with reduced incidence of colon cancer e. High folate levels are necessary for the synthesis of homocysteine ANS: A DIF: Bloom s: Remember REF: 10.2 The B 48. What vitamin contains cobalt? a. A b. B6 c. B12 d. Pantothenic acid

30 e. Ascorbic acid ANS: C DIF: Bloom s: Remember REF: 10.2 The B 49. A deficiency of which of the following vitamins results in accumulation of homocysteine in the blood? a. Folate b. Biotin c. Niacin d. Vitamin K e. Vitamin C ANS: A DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, & food

31 50. What vitamin is involved mainly with the replacement of red blood cells and digestive tract cells? a. Folate b. Niacin c. Thiamin d. Riboflavin e. Choline ANS: A DIF: Bloom s: Remember REF: 10.2 The B 51. Which of the following is representative of folate availability in foods? a. Good sources are dairy products and meats. b. Poor sources are fruit juices and vegetable juices. c. Much of the vitamin is lost due to heat and oxidation. d. Only about 10% of the amount in foods is bioavailable. e. Legumes, nuts, and seeds have very little folate.

32 ANS: C DIF: Bloom s: Remember REF: 10.2 The B 52. Which of the following foods is highest in folate? a. Meats b. Starches c. Dairy products d. Green, leafy vegetables e. Fruits ANS: D DIF: Bloom s: Remember REF: 10.2 The B 53. What is the most likely reason for the development of a vitamin B12 deficiency? a. Inadequate intake b. Increased excretion c. Inadequate absorption d. Increased losses in food preparation

33 e. Inadequate digestion ANS: C DIF: Bloom s: Remember REF: 10.2 The B 54. Pernicious anemia results from a deficiency of a. folate. b. selenium. c. vitamin B12. d. iron and copper. e. vitamin B6. ANS: C DIF: Bloom s: Remember REF: 10.2 The B 55. The absorption of which of the following vitamins is most affected by the disorder

34 atrophic gastritis? a. Choline b. Vitamin C c. Vitamin B12 d. Pantothenic acid e. Vitamin E ANS: C DIF: Bloom s: Remember REF: 10.2 The B 56. Normally, the body s storage and re-utilization of vitamin B12 prevents a primary or secondary deficiency from occurring until after about a. 3 days. b. 3 weeks. c. 3 months. d. 1 year. e. 3 years.

35 ANS: E DIF: Bloom s: Remember REF: 10.2 The B 57. Of the following foods, which would be the only source of vitamin B12? a. Pecans b. Hot dog c. Cauliflower d. Whole-grain bread e. Plain soy or rice milk ANS: B DIF: Bloom s: Remember REF: 10.2 The B 58. Which of the following vitamins has an RDA? a. Biotin b. Choline c. Cobalamin

36 d. Pantothenic acid e. Carnitine ANS: C DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, & food 59. Which of the following is a feature of choline in nutrition? a. It is an analog of ascorbic acid. b. It is abundant in green leafy vegetables. c. The body can synthesize it from cysteine. d. Average intakes in the United States are lower than recommended. e. There is no RDA for it. ANS: D DIF: Bloom s: Remember REF: 10.2 The B 60. What is a free radical?

37 a. An inactive vitamin b. An unphosphorylated vitamin c. A molecule of unbound cobalamins d. A molecule with at least one unpaired electron e. A nonbound vitamin ANS: D DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 61. Which of the following is a general function of vitamin C? a. Antiviral agent b. Antifungal agent c. Anticancer agent d. Antioxidant agent e. Emulsifying agent ANS: D DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food

38 vitamin C. 62. The synthesis of collagen requires both vitamin C and a. iron. b. zinc. c. cobalamin. d. beta-carotene. e. copper. ANS: A DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 63. What organ stores the highest concentration of vitamin C? a. Liver b. Muscle c. Thyroid gland d. Adrenal glands e. Hypothalamus

39 ANS: D DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 64. Why might vitamin C supplements be beneficial in treating the common cold? a. They deactivate histamine. b. They reduce episodes of diarrhea. c. They destroy intestinal pathogens. d. They alter hypothalamic control of body temperature. e. They improve blood oxygenation. ANS: A DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 65. Which of the following is an early sign of vitamin C deficiency? a. Bleeding gums b. Pernicious anemia c. Appearance of a cold

40 d. Hysteria and depression e. Oily skin ANS: A DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 66. Which of the following food groups is a rich source of vitamin C? a. Milk group b. Meat group c. Fruit group d. Grains group e. Oils group ANS: C DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C.

41 67. Which of the following would be a very good source of vitamin C for the lactoovo- vegetarian? a. Milk b. Eggs c. Broccoli d. Whole-grain bread e. Bananas ANS: C DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 68. Approximately what percentage of the U.S. population takes a multivitaminmineral supplement regularly? a. 10 b. 20 c. 30 d. 40 e. 50

42 ANS: D DIF: Bloom s: Remember REF: H-10 Vitamin and Mineral Supplements OBJ: UNUT.WHRO Present arguments for and against the use of dietary supplements 69. What nutrient is responsible for causing the most accidental ingestion deaths in children? a. Iron b. Calcium c. Vitamin A d. Vitamin D e. Magnesium ANS: A DIF: Bloom s: Remember REF: H-10 Vitamin and Mineral Supplements OBJ: UNUT.WHRO Present arguments for and against the use of dietary supplements 70. If a dietary supplement poses a significant risk of illness to consumers, what agency must prove harm before removing the product from the market? a. FDA b. CDC

43 c. USDA d. USPHS e. DHHS ANS: A DIF: Bloom s: Remember REF: H-10 Vitamin and Mineral Supplements OBJ: UNUT.WHRO Present arguments for and against the use of dietary supplements MATCHING a. Pork k. Broccoli b. Corn l. Riboflavin c. Dairy m. Vitamin B6 d. Folate n. Vitamin B12 e. Biotin o. Tryptophan f. Niacin p. Iron overload g. Choline q. Ascorbic acid h. Anemia r. Intrinsic factor i. Collagen s. Ultraviolet light j. Beriberi t. Pantothenic acid

44 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. Overconsumption 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

45 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 fiber sheath 15. Required for absorption of vitamin B Made in the body from methionine 17. The antiscorbutic factor 18. Vitamin C is required for the synthesis of this substance 19. Excess intake of vitamin C may aggravate this disorder 20. A concentrated source of vitamin C 1. ANS: J DIF: Bloom s: Remember REF: 10.2 The B

46 2. ANS: A DIF: Bloom s: Remember REF: 10.2 The B 3. ANS: S DIF: Bloom s: Remember REF: 10.2 The B 4. ANS: C DIF: Bloom s: Remember REF: 10.2 The B

47 5. ANS: L DIF: Bloom s: Remember REF: 10.2 The B 6. ANS: O DIF: Bloom s: Remember REF: 10.2 The B 7. ANS: B DIF: Bloom s: Remember REF: 10.2 The B 8. ANS: F DIF: Bloom s: Remember REF: 10.2 The B

48 9. ANS: E DIF: Bloom s: Remember REF: 10.2 The B 10. ANS: T DIF: Bloom s: Remember REF: 10.2 The B 11. ANS: M DIF: Bloom s: Remember REF: 10.2 The B

49 12. ANS: D DIF: Bloom s: Remember REF: 10.2 The B 13. ANS: H DIF: Bloom s: Remember REF: 10.2 The B 14. ANS: N DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, & food 15. ANS: R DIF: Bloom s: Remember REF: 10.2 The B

50 16. ANS: G DIF: Bloom s: Remember REF: 10.2 The B 17. ANS: Q DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 18. ANS: I DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 19. ANS: P DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food

51 vitamin C. 20. ANS: K DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. COMPLETION 1. Compounds that can be converted to vitamins in the body are called. ANS: precursors; provitamins DIF: Bloom s: Remember Overview REF: 10.1 The an OBJ: UNUT.WHRO Describe how vitamins differ from the energy nutrients and how fat-soluble vitamins differ from water-soluble vitamins. 2. Water-soluble vitamins are absorbed directly into. ANS: blood

52 DIF: Bloom s: Remember Overview REF: 10.1 The an OBJ: UNUT.WHRO Describe how vitamins differ from the energy nutrients and how fat-soluble vitamins differ from water-soluble vitamins. 3. Prolonged thiamin deficiency can result in the disease. ANS: beriberi DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food 4. The niacin-deficiency disease,, produces the symptoms of diarrhea, dermatitis, dementia, and eventually death ANS: pellagra DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food

53 5. In order to protect against, all women of childbearing age who are capable of becoming pregnant should consume 0.4 milligram of folate daily. ANS: neural tube defects DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food 6. Of all the vitamins, appears to be most vulnerable to interactions with drugs, which can also lead to a secondary deficiency. ANS: folate DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food 7. Older adults with B12 deficiencies may develop, a condition that damages the cells of the stomach.

54 ANS: atrophic gastritis DIF: Bloom s: Remember REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food 8. A(n) is a molecule with one or more unpaired electrons, which makes it unstable and highly reactive. ANS: free radical DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 9. Vitamin C helps to form the fibrous structural protein of connective tissues known as. ANS: collagen

55 DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 10. When vitamin C concentrations fall to about a fifth of optimal levels symptoms of appear. ANS: scurvy DIF: Bloom s: Remember REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. ESSAY 1. Provide a brief definition of a vitamin. ANS: The vitamins differ from carbohydrates, fats, and proteins in the following ways: Structure. are individual units; they are not linked together (as are molecules of

56 glucose or amino acids). Function. do not yield energy when metabolized; many of them do, however, assist the enzymes that participate in the release of energy from carbohydrates, fats, and proteins. Food contents. The amounts of vitamins people ingest from foods and the amounts they require daily are measured in micrograms (µg) or milligrams (mg), rather than grams (g). DIF: Bloom s: Understand REF: 10.1 The an Overview OBJ: UNUT.WHRO Describe how vitamins differ from the energy nutrients and how fat-soluble vitamins differ from water-soluble vitamins. 2. What is meant by the bioavailability of a vitamin? How is it determined? ANS: Some water-soluble vitamins are synthesized by GI tract bacteria and absorbed by the large intestine, but not in quantities great enough to meet the body s needs; foods must supply these essential nutrients. The amount of vitamins available from foods depends not only on the quantity provided by a food but also on the amount absorbed and used by the body referred to

57 as the vitamins bioavailability. The quantity of vitamins in a food can be determined relatively easily. Researchers analyze foods to determine the vitamin contents and publish the results in tables of food composition. Determining the bioavailability of a vitamin is a more complex task because it depends on many factors, including: Efficiency of digestion and time of transit through the GI tract Previous nutrient intake and nutrition status Method of food preparation (raw, cooked, or processed) Source of the nutrient (synthetic, fortified, or naturally occurring) Other foods consumed at the same time DIF: Bloom s: Understand REF: 10.1 The an Overview OBJ: UNUT.WHRO Describe how vitamins differ from the energy nutrients and how fat-soluble vitamins differ from water-soluble vitamins. 3. Discuss thiamin nutrition including functions, risk factors for deficiency, symptoms of deficiency, food sources, and stability. ANS:

58 Thiamin is the vitamin part of the coenzyme TPP (thiamin pyrophosphate) that assists in energy metabolism. The TPP coenzyme participates in the conversion of pyruvate to acetyl CoA. Besides playing these pivotal roles in energy metabolism, thiamin occupies a special site on the membranes of nerve cells. Consequently, nerve activity and muscle activity in response to nerves depend heavily on thiamin. People who fail to eat enough food to meet energy needs risk nutrient deficiencies, including thiamin deficiency. Inadequate thiamin intakes have been reported among the nation s malnourished and homeless people. Similarly, people who derive most of their energy from empty-kcalorie foods and beverages risk thiamin deficiency. Alcohol provides a good example of how empty kcalories can lead to thiamin deficiency. Alcohol contributes energy but provides few, if any, nutrients and often displaces food. In addition, alcohol impairs thiamin absorption and enhances thiamin excretion in the urine, doubling the risk of deficiency. An estimated four out of five alcoholics are thiamin deficient, which damages the brain s structure and impairs its function.

59 Prolonged thiamin deficiency can result in the disease beriberi, which was first observed in Indonesia when the custom of polishing rice became widespread. Rice provided 80 percent of the energy intake of the people of that area, and the germ and bran of the rice grain was their principal source of thiamin. When the germ and bran were removed in the preparation of white rice, beriberi became rampant. Meats in the pork family are exceptionally rich in thiamin. Grains whole grains or enriched are a reliable source of thiamin. Prolonged cooking can destroy thiamin. Also, like other water-soluble vitamins, thiamin leaches into water when foods are boiled or blanched. Cooking methods that require little or no water such as steaming and microwave heating conserve thiamin and other water-soluble vitamins. DIF: Bloom s: Understand REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food

60 4. Discuss riboflavin nutrition including functions, risk factors for deficiency, symptoms of deficiency, food sources, and stability. ANS: Like thiamin, riboflavin serves as a coenzyme in many reactions, most notably in energy metabolism. The coenzyme forms of riboflavin are FMN (flavin mononucleotide) and FAD (flavin adenine dinucleotide); both can accept and then donate two hydrogens. Riboflavin deficiency most often accompanies other nutrient deficiencies. Lack of the vitamin causes inflammation of the membranes of the mouth, skin, eyes, and GI tract. Excesses of riboflavin appear to cause no harm, and no UL has been established. The greatest contributions of riboflavin come from milk and milk products. Wholegrain or enriched grains are also valuable sources because of the quantities people typically consume. When riboflavin sources are ranked by nutrient density (per kcalorie), many dark green, leafy vegetables (such as broccoli, turnip greens, asparagus, and spinach) appear high on the list.

61 Ultraviolet light and irradiation destroy riboflavin. For these reasons, milk is sold in cardboard or opaque plastic containers, instead of clear glass bottles. In contrast, riboflavin is stable to heat, so cooking does not destroy it. DIF: Bloom s: Understand REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food 5. What factors are associated with vitamin B12 inadequacy other than low intake? ANS: Most vitamin B12 deficiencies reflect inadequate absorption, not poor intake. Inadequate absorption typically occurs for one of two reasons: a lack of hydrochloric acid or a lack of intrinsic factor. Without hydrochloric acid, the vitamin is not released from the dietary proteins and so is not available for binding with the intrinsic factor. Without the intrinsic factor, the vitamin cannot be absorbed.

62 DIF: Bloom s: Understand REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food 6. Discuss through the use of examples the importance of folate in development of the neural tube during the early weeks of pregnancy. ANS: The brain and spinal cord develop from the neural tube, and defects in its orderly formation during the early weeks of pregnancy may result in various central nervous system disorders and death. Folate supplements taken 1 month before conception and continued throughout the first trimester of pregnancy can help prevent neural tube defects. For this reason, all women of childbearing age who are capable of becoming pregnant should consume 0.4 milligram (400 micrograms) of folate daily easily accomplished by eating folate-rich foods, folate-fortified foods, and a

63 multivitamin supplement daily. Because half of the pregnancies each year are unplanned and because neural tube defects occur early in development before most women realize they are pregnant, the Food and Drug Administration (FDA) has mandated that grain products be fortified to deliver folate to the U.S. population. Labels on fortified products may claim that adequate intake of folate has been shown to reduce the risk of neural tube defects. Fortification has improved folate status in women of childbearing age and lowered the prevalence rate of neural tube defects. Some research suggests that folate taken before and during pregnancy may also prevent congenital birth defects, such as cleft lip and cleft palate, and neurodevelopmental disorders, such as autism. Such findings strengthen recommendations for women to pay attention to their folate needs. DIF: Bloom s: Understand REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food

64 7. What are the associations between folate intake and development and progression of certain cancers? ANS: Because the synthesis of DNA and the transfer of methyl groups depend on folate, its relationships with cancer are complex, depending on the type of cancer and the timing of folate supplementation. Some research suggests that sufficient folate may protect against the initiation of cancer, whereas other studies report that high intakes may enhance progression once cancer has begun. In general, foods containing folate probably reduce the risk of pancreatic cancer. Limited evidence suggests that folate may also reduce the risk of esophageal and colorectal cancer. DIF: Bloom s: Understand REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food

65 8. Discuss the association between marginal vitamin B12 deficiency and cognitive function. ANS: Marginal vitamin B12 deficiency impairs cognition. Advanced neurological symptoms include a creeping paralysis that begins at the extremities and works inward and up the spine. Early detection and correction are necessary to prevent permanent nerve damage and paralysis. With sufficient folate in the diet, the neurological symptoms of vitamin B12 deficiency can develop without evidence of anemia and the cognitive decline is especially rapid. Such interactions between folate and vitamin B12 highlight some of the safety issues surrounding the use of supplements and the fortification of foods. No adverse effects have been reported for excess vitamin B12, and no UL has been set. DIF: Bloom s: Understand REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food 9. Discuss the essentiality of choline, including chief functions and major food sources.

66 ANS: Although not defined as a vitamin, choline is an essential nutrient that is commonly grouped with the B vitamins. The body uses choline to make the neurotransmitter acetylcholine and the phospholipid lecithin. During fetal development, choline supports the structure and function of the brain and spinal cord, by supporting neural tube closure and enhancing learning performance. Choline is found in a variety of common foods such as milk, eggs, and peanuts and as part of lecithin, a food additive commonly used as an emulsifying agent. DIF: Bloom s: Understand REF: 10.2 The B OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food 10. Explain the modes of action of vitamin C. ANS: As an antioxidant: Vitamin C loses electrons easily, a characteristic that allows it to perform as

67 an antioxidant. In the body, antioxidants defend against free radicals. A free radical is a molecule with one or more unpaired electrons, which makes it unstable and highly reactive. Antioxidants can neutralize free radicals by donating an electron or two. In doing so, antioxidants protect other substances from free radical damage. As a cofactor in collagen formation: Vitamin C helps to form the fibrous structural protein of connective tissues known as collagen. Collagen serves as the matrix on which bones and teeth are formed. When a person is wounded, collagen glues the separated tissues together, forming scars. Cells are held together largely by collagen; this is especially important in the walls of the blood vessels, which must withstand the pressure of blood surging with each beat of the heart. As a cofactor in other reactions: Vitamin C also serves as a cofactor in the synthesis of several other compounds. As in collagen formation, vitamin C helps in the hydroxylation of carnitine, a compound that transports fatty acids, especially long-chain fatty acids, across the inner membrane of mitochondria in cells. It also participates in the conversions of the amino acids

68 tryptophan and tyrosine to the neurotransmitters serotonin and norepinephrine, respectively. Vitamin C also assists in the making of hormones, including thyroxine, which regulates the metabolic rate; when metabolism speeds up in times of extreme physical stress, the body s use of vitamin C increases. In stress: Among the stresses known to increase vitamin C needs are infections; burns; extremely high or low temperatures; intakes of toxic heavy metals such as lead, mercury, and cadmium; the chronic use of certain medications, including aspirin, barbiturates, and oral contraceptives; and cigarette smoking. During stress, the adrenal glands which contain more vitamin C than any other organ in the body release vitamin C and hormones into the blood. In the prevention and treatment of the common cold: Vitamin C has been a popular option for the prevention and treatment of the common cold for decades, but research supporting such claims has been conflicting and controversial. Some studies find no relationship between vitamin C and the occurrence of the common cold, whereas others report modest benefits fewer colds,

69 fewer days, and shorter duration of severe symptoms, especially for those exposed to physical and environmental stresses. A review of the research on vitamin C in the treatment and prevention of the common cold reveals a slight, but consistent reduction in the duration of the common cold in favor of those taking a daily dose of at least 200 milligrams of vitamin C. In disease prevention: Whether vitamin C may help in preventing or treating cancer, heart disease, cataract, and other diseases is still being studied DIF: Bloom s: Understand REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 11. In what ways have vitamin C supplements been shown to affect nasal congestion from a cold? ANS: In the prevention and treatment of the common cold: Vitamin C has been a popular option for the prevention and treatment of the common cold for decades, but research supporting such

70 claims has been conflicting and controversial. Some studies find no relationship between vitamin C and the occurrence of the common cold, whereas others report modest benefits fewer colds, fewer days, and shorter duration of severe symptoms, especially for those exposed to physical and environmental stresses. A review of the research on vitamin C in the treatment and prevention of the common cold reveals a slight, but consistent reduction in the duration of the common cold in favor of those taking a daily dose of at least 200 milligrams of vitamin C. Discoveries about how vitamin C works in the body provide possible links between the vitamin and the common cold. Anyone who has ever had a cold knows the discomfort of a runny or stuffed-up nose. Nasal congestion develops in response to elevated blood histamine, and people commonly take antihistamines for relief. Like an antihistamine, vitamin C comes to the rescue and deactivates histamine. DIF: Bloom s: Understand REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C.

71 12. Describe the potential hazards of excessive vitamin C intake. ANS: The availability of vitamin C supplements and the publication of books recommending vitamin C to prevent colds and cancer have led many people to take large doses of vitamin C. Not surprisingly, side effects of vitamin C supplementation such as gastrointestinal distress and diarrhea have been reported. The UL for vitamin C was established based on these symptoms. Several instances of interference with medical regimens are also known. Large amounts of vitamin C excreted in the urine obscure the results of tests used to detect glucose or ketones in the diagnosis of diabetes. In some instances, excess vitamin C gives a false positive result; in others, a false negative. People taking anticlotting medications may unwittingly counteract the effect if they also take massive doses of vitamin C. Those with kidney disease, a tendency toward gout, or a genetic abnormality that alters vitamin C s breakdown to its excretion products are prone to forming kidney stones if they take large doses of vitamin C. Vitamin C supplements

72 may adversely affect people with iron overload. Vitamin C enhances iron absorption and releases iron from body stores; too much free iron causes the kind of cellular damage typical of free radicals. These adverse consequences illustrate how vitamin C can act as a prooxidant when quantities exceed the body s needs. DIF: Bloom s: Understand REF: 10.3 Vitamin C OBJ: UNUT.WHRO Identify the main roles, deficiency symptoms, and food vitamin C. 13. List population groups that have a physiological need for vitamin/mineral supplements. ANS: Correct Overt Deficiencies In the United States, adults rarely suffer nutrient deficiency diseases such as scurvy, pellagra, and beriberi, but nutrient deficiencies do still occur. To correct an overt deficiency disease, a physician may prescribe therapeutic doses two to ten times the RDA (or AI) of a nutrient. At such high doses, the supplement is having a pharmacological effect and acting as a drug.

73 Support Increased Nutrient Needs Nutrient needs increase during certain stages of life, making it difficult to meet some of those needs without supplementation. For example, women who lose a lot of blood and therefore a lot of iron during menstruation each month may need an iron supplement. Women of childbearing age need folate supplements to reduce the risks of neural tube defects. Similarly, pregnant women and women who are breastfeeding their infants have exceptionally high nutrient needs and so usually need special supplements. Newborns routinely receive a single dose of vitamin K at birth to prevent abnormal bleeding. Infants may need other supplements as well, depending on whether they are breastfed or receiving formula, and on whether the water they drink contains fluoride. Improve Nutrition Status In contrast to the classical deficiencies, which present a multitude of symptoms and are relatively easy to recognize, subclinical deficiencies are subtle and easy to overlook and they are also more likely to occur. Without fortification or supplementation, many adults in the United States

74 fall short of recommended intakes for several vitamins and minerals. People who do not eat enough food to deliver the needed amounts of nutrients, such as habitual dieters and the elderly, risk developing subclinical deficiencies. Similarly, vegetarians who restrict their use of entire food groups without appropriate substitutions may fail to fully meet their nutrient needs. If there is no way for these people to eat enough nutritious foods to meet their needs, then vitamin- mineral supplements may be appropriate to help prevent nutrient deficiencies. Improve the Body s Defenses Health-care professionals may provide special supplementation to people being treated for addictions to alcohol or other drugs and to people with prolonged illnesses, extensive injuries, or other severe stresses such as surgery. Illnesses that interfere with appetite, eating, or nutrient absorption impair nutrition status. For example, the stomach condition atrophic gastritis often creates a vitamin B12 deficiency. In addition, nutrient needs are often heightened by diseases or medications. In all these cases, supplements are appropriate. Reduce Disease Risks

75 Few people consume the optimal amounts of all the vitamins and minerals by diet alone. Inadequate intakes have been linked to chronic diseases such as heart disease, some cancers, and osteoporosis. For this reason, some physicians recommend that all adults take vitamin- mineral supplements. Such regular supplementation would provide an optimum intake to enhance metabolic harmony and prevent disease at relatively little cost. Others recognize the lack of conclusive evidence and the potential harm of supplementation and advise against such a recommendation. A statement from the National Institutes of Health acknowledges that evidence is insufficient to recommend either for or against the use of supplements to prevent chronic diseases. DIF: Bloom s: Remember Supplements REF: H-10 Vitamin and Mineral OBJ: UNUT.WHRO.16.H-10 Present arguments for and against the use of dietary supplements. 14. What type of testing is done by the U.S. Pharmacopeia to assure the quality and safety of certain vitamin and mineral supplements? ANS:

76 Supplements with a USP verification logo have been tested by the US Pharmacopeia (USP) to ensure that the supplement: Contains the declared ingredients and amounts listed on the label Does not contain harmful levels of contaminants Will disintegrate and release ingredients in the body Was made under safe and sanitary conditions DIF: Bloom s: Remember Supplements REF: H-10 Vitamin and Mineral OBJ: UNUT.WHRO.16.H-10 Present arguments for and against the use of dietary supplements. 15. Explain the major provisions of the Dietary Supplement Health and Education Act of ANS: Details of supplement regulation are defined in the Dietary Supplement Health and Education Act of 1994, which was intended to enable consumers to make informed choices about dietary supplements. The act subjects supplements to the same general labeling requirements that apply to foods. Specifically: Nutrition labeling for dietary supplements is required.

77 Labels may make nutrient claims (as high or low ) according to specific criteria (for example, an excellent source of vitamin C ). Labels may claim that the lack of a nutrient can cause a deficiency disease, but if they do, they must also include the prevalence of that deficiency disease in the United States. Labels may make health claims that are supported by significant scientific agreement and are not brand specific (for example, folate protects against neural tube defects ). Labels may claim to diagnose, treat, cure, or relieve common complaints such as menstrual cramps or memory loss, but may not make claims about specific diseases (except as noted previously). Labels may make structure-function claims about the role a nutrient plays in the body, how the nutrient performs its function, and how consuming the nutrient is associated with general well- being. The manufacturer is responsible for ensuring that the claims are truthful and not misleading. Claims must be accompanied by an FDA disclaimer statement: This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

78 DIF: Bloom s: Remember Supplements REF: H-10 Vitamin and Mineral