Advanced Nutrition and Metabolism Review:
Carbohydrates, Proteins, Lipids, and
Micronutrient Essentials
Which of the following carbohydrates is not a monosaccharide?
a. fructose
b. galactose
c. maltose
d. glucose - ✔✔C. Maltose
Fructose found in fruit and is sweetest of all monosaccharides.
Galactose is derived from hydrolysis of lactose (milk sugar) during digestion. Not found freely in foods.
Glucose is the primary monosaccharide used for energy. Generally part of sucrose (disaccharide; glucose
+ fructose) or linked to lactose to form galactose (disaccharide; glucose + lactose). When glucose is
linked to another glucose molecule, it forms maltose and is considered a disaccharide.
Which of the following statements about glycogen is true?
a. Glycogen is a long-term energy source.
b. The liver stores approximately 100 grams of glycogen.
c. Glycogen is stored primarily in the liver but also appears in skeletal and heart muscles.
d. The glycogen found in skeletal muscles is catabolized for use anywhere in the body. - ✔✔B. The liver
stores approximately 100 grams of glycogen.
glycogen is short-term carbohydrate storage for the body. ~100g of glycogen is stored in the liver, which
when catabolized provides ~400 kcals. About 300-400g of glycogen is stored in the skeletal muscles,
which yields less than 1600kcal. Glycogen is NOT stored in the heart muscle. The glycogen stored in the
liver provides energy anywhere in the body, whereas the glycogen stored in the skeletal muscles
provides energy only to skeletal muscle cells. The amount of stored glycogen is sufficient to sustain an
70kg male for approximately 1 day.
Which of the following statements about controlling blood glucose levels is false?
a. Beta cells in the islets of Langerhans produce insulin, which is released when blood glucose levels rise
in response to a meal.
,b. Alpha cells in the islets of Langerhans secrete glucagon when the patient is fasting, which stimulates
the liver to break down glycogen to maintain blood glucose levels in the normal range of 80 to 120
mg/dl.
c. The adrenals secrete epinephrine and norepinephrine when the patient is fasting, which stimulates
muscles to release glycogen to maintain blood glucose levels.
d. Glucocorticoids, such as cortisol stimulate glycolysis to increase blood glucose levels. - ✔✔D.
Glucocorticoids, such as cortisol, stimulate glycolysis to increase blood glucose levels.
Blood glucose levels are influenced by hormones, drugs, and vagus nerve activity. The islets of
Langerhans in the pancreas produce insulin when the patient feeds and glucagon when the patient fasts.
In the postprandial period beta cells release insulin to normalize blood glucose levels. In the fasting
state, alpha cells release glucagon to stimulate glycogenolysis, which is glycogen breakdown.
Epinephrine and norepinephrine increase glucose levels during stress by promoting catabolism of
muscle cells for glycogen and adipose cells for triglycerides. Glucocorticoids increase blood glucose
levels by stimulating gluconeogenesis, not glycolysis. Glycolysis is the breakdown of glucose.
Gluconeogenesis is glucose formation, which occurs mainly in the liver. Glycolysis and gluconeogenesis
do not occur at the same time.
Body fat performs all of the following except:
a. Provides a concentrated source of energy
b. Protects bones and internal organs by cushioning them and regulating their temperature.
c. Provides a source of eicosapentaenoic (EPA) and docosahexaenoic (DHA) essential fatty acids.
d. Aids in absorption of the fat soluble vitamins A,D,E, and K. - ✔✔C. Provides a source of
eicosapentaenic (EPA) and docosahexaenoic (DHA) essential fatty acids.
Fat plays a very important role in the body. It provides a concentrated energy, at 9 kcal per gram,
whereas protein and carbohydrate only provide 4kcal/g. Structural fat pads cushion and protect the
body from injury, especially bones and internal organs. Fat provides a source of essential fatty acids,
which the body does not manufacture, but mostly obtain from seeds, oils, cold-water fish, or
supplements. The three essential fatty acids (EFAs) are arachnoidic, linoleic, and linolenic. EFAs are
important for blood clotting and brain development. Eicosapentaenoic (EPA) and docosahexaenoic
(DHA) derive from alpha-linolenic acid, but are not themselves essential fatty acids. Fats are also
required for the absorption of the fat-soluble vitamins A,D,E, & K.
Which of the following are not essential amino acids?
a. Lysine, leucine, valine
b. Isoleucine, tryptophan, phenylalanine
c. methionine, threonine, lysine
,d. tyrosine, glycine, alanine - ✔✔D. Tyrosine, glycine, alanine.
Amino acids are the building blocks of protein. There are 20 amino acids in total. Nine AA are essential
and cannot be made by the body: Isoleucine, leucine, lysine, methionine, phenylalanine, threonine,
tryptophan, valine, and histidine. Often, adults can synthesize enough histidine, but infants and children
cannot. Essential AAs must be obtained from food. The best sources of essential AAs are animal
products, such as meat, poultry, fish, dairy, and eggs. A diet containing 10% to 12% of calories from
protein should meet essential AAs requirements. The non-essential AAs are arginine, alanine,
asparagine, aspartic acid, cysteine, glutamine, glutamic acid, glycine, proline, serine, and tyrosine.
Which of the following statements about excessive protein intake is false?
a. Excessive protein intake is difficult to achieve and, therefore, is not a danger.
b. Excessive protein intake increases calcium excretion, which can potentially lead to osteoporosis.
c. Excessive protein in the diet is broken down in the kidneys and excreted in the urine as urea.
d. Excessive protein intake will not help an athlete build more muscles, but will instead convert into fat,
if it is not used as an energy source. - ✔✔A. Excessive protein intake is difficult to achieve and,
therefore, is not a danger.
The majority of Americans consume protein in excess requirements. Many people consume at least
twice as much as they need. Some excess protein becomes a calorie source or converts to fat. Studies
demonstrated an increase in calcium excretion related to an increase in protein intake, especially animal
protein, due to acidified blood. As the digestive system breaks down large amounts of protein, the
bones release calcium to neutralize the blood. Acidified blood leads to osteoporosis in predisposed
people. Normally functioning kidneys excrete nitrogenous wastes including urea derived from the
breakdown of protein. Athletes often consume more protein in the false hope that it will build bigger
muscles. There is no benefit to massive protein intake. Actual muscle development results form
exercise, weight training, and proper nutrition.
How many grams of protein are in a meal containing 6 ounces baked fish, 1 cup cooked pasta, 1 cup
steamed broccoli, 1 slice whole wheat bread, 1 cup skim milk, 1/2cup sliced strawberries, and 1 slice
angel cake?
a. 54grams
b. 66grams
c. 75grams
d. 83grams - ✔✔B. 66grams
In the above meal, the protein content is 66grams, as follows: fish 42grams; pasta 6grams; broccoli 4
grams. whole wheat bread 2 grams; milk 8 grams; and angel cake 3 grams.
, The ADA 2007 Choose Your Foods: Exchange Lists for Meal Planning, offers a quick way to calculate the
macronutrient content of many foods:
-meats and meat substitutes contain 7 grams PRO/ ounce
-starches contain 2 to 3 grams of PRO/ serving
-vegies contain 2 grams PRO/ serving
-milk contains 8 grams per 8 ounces serving
-there is no significant PRO in fruit.
*check serving size as portion sizes vary between food items.
Kwashiorkor patients have all of the following characteristics except:
a. loss of somatic stores
b. preservation of somatic stores
c. loss of visceral protein stores
d. large, protruding abdomen - ✔✔A. Loss of somatic stores.
Kwashiorkor is malnutrition for lack of amino acids. It usually affects weaned children between
12months and 3 y/o in third world countries with famine, drought, political unrest, or traditional eating
habits. The victim's diet is protein-deprived. Most calories are derived from a restricted carbohydrate
source, such as corn or sugar-water. Kwashiorkor is uncommon in the US., where it usually appears only
in severely abused children and neglected nursing home residents. The main characteristics include
preservation of somatic or fat stores and loss of visceral protein stores. The signs and symptoms of
kwashiorkor are: A large, protruding belly; significant edema; changes in hair and skin pigment; skin
rash; fatigue; irritability; diarrhea; and decreased immune function. Victims never reach their height
potential.
Which description of marasmus is most accurate?
a. Starvation from food deprivation, with a decrease in somatic and visceral protein stores, but
subcutaneous fat stores are preserved.
b. Protein deprivation, with adequate calories from carbohydrates and depletion of visceral protein
stores, but preservation of somatic stores.
c. Severe malnutrition, with loss of subcutaneous fat and depletion of muscle mass, followed by a
breakdown in lean body mass.
d. A form of malnutrition mainly seen in the US, due to limited access to food. - ✔✔C. Severe
malnutrition, with loss of subcutaneous fat and depletion of muscle mass, followed by a breakdown in
lean body mass.
Carbohydrates, Proteins, Lipids, and
Micronutrient Essentials
Which of the following carbohydrates is not a monosaccharide?
a. fructose
b. galactose
c. maltose
d. glucose - ✔✔C. Maltose
Fructose found in fruit and is sweetest of all monosaccharides.
Galactose is derived from hydrolysis of lactose (milk sugar) during digestion. Not found freely in foods.
Glucose is the primary monosaccharide used for energy. Generally part of sucrose (disaccharide; glucose
+ fructose) or linked to lactose to form galactose (disaccharide; glucose + lactose). When glucose is
linked to another glucose molecule, it forms maltose and is considered a disaccharide.
Which of the following statements about glycogen is true?
a. Glycogen is a long-term energy source.
b. The liver stores approximately 100 grams of glycogen.
c. Glycogen is stored primarily in the liver but also appears in skeletal and heart muscles.
d. The glycogen found in skeletal muscles is catabolized for use anywhere in the body. - ✔✔B. The liver
stores approximately 100 grams of glycogen.
glycogen is short-term carbohydrate storage for the body. ~100g of glycogen is stored in the liver, which
when catabolized provides ~400 kcals. About 300-400g of glycogen is stored in the skeletal muscles,
which yields less than 1600kcal. Glycogen is NOT stored in the heart muscle. The glycogen stored in the
liver provides energy anywhere in the body, whereas the glycogen stored in the skeletal muscles
provides energy only to skeletal muscle cells. The amount of stored glycogen is sufficient to sustain an
70kg male for approximately 1 day.
Which of the following statements about controlling blood glucose levels is false?
a. Beta cells in the islets of Langerhans produce insulin, which is released when blood glucose levels rise
in response to a meal.
,b. Alpha cells in the islets of Langerhans secrete glucagon when the patient is fasting, which stimulates
the liver to break down glycogen to maintain blood glucose levels in the normal range of 80 to 120
mg/dl.
c. The adrenals secrete epinephrine and norepinephrine when the patient is fasting, which stimulates
muscles to release glycogen to maintain blood glucose levels.
d. Glucocorticoids, such as cortisol stimulate glycolysis to increase blood glucose levels. - ✔✔D.
Glucocorticoids, such as cortisol, stimulate glycolysis to increase blood glucose levels.
Blood glucose levels are influenced by hormones, drugs, and vagus nerve activity. The islets of
Langerhans in the pancreas produce insulin when the patient feeds and glucagon when the patient fasts.
In the postprandial period beta cells release insulin to normalize blood glucose levels. In the fasting
state, alpha cells release glucagon to stimulate glycogenolysis, which is glycogen breakdown.
Epinephrine and norepinephrine increase glucose levels during stress by promoting catabolism of
muscle cells for glycogen and adipose cells for triglycerides. Glucocorticoids increase blood glucose
levels by stimulating gluconeogenesis, not glycolysis. Glycolysis is the breakdown of glucose.
Gluconeogenesis is glucose formation, which occurs mainly in the liver. Glycolysis and gluconeogenesis
do not occur at the same time.
Body fat performs all of the following except:
a. Provides a concentrated source of energy
b. Protects bones and internal organs by cushioning them and regulating their temperature.
c. Provides a source of eicosapentaenoic (EPA) and docosahexaenoic (DHA) essential fatty acids.
d. Aids in absorption of the fat soluble vitamins A,D,E, and K. - ✔✔C. Provides a source of
eicosapentaenic (EPA) and docosahexaenoic (DHA) essential fatty acids.
Fat plays a very important role in the body. It provides a concentrated energy, at 9 kcal per gram,
whereas protein and carbohydrate only provide 4kcal/g. Structural fat pads cushion and protect the
body from injury, especially bones and internal organs. Fat provides a source of essential fatty acids,
which the body does not manufacture, but mostly obtain from seeds, oils, cold-water fish, or
supplements. The three essential fatty acids (EFAs) are arachnoidic, linoleic, and linolenic. EFAs are
important for blood clotting and brain development. Eicosapentaenoic (EPA) and docosahexaenoic
(DHA) derive from alpha-linolenic acid, but are not themselves essential fatty acids. Fats are also
required for the absorption of the fat-soluble vitamins A,D,E, & K.
Which of the following are not essential amino acids?
a. Lysine, leucine, valine
b. Isoleucine, tryptophan, phenylalanine
c. methionine, threonine, lysine
,d. tyrosine, glycine, alanine - ✔✔D. Tyrosine, glycine, alanine.
Amino acids are the building blocks of protein. There are 20 amino acids in total. Nine AA are essential
and cannot be made by the body: Isoleucine, leucine, lysine, methionine, phenylalanine, threonine,
tryptophan, valine, and histidine. Often, adults can synthesize enough histidine, but infants and children
cannot. Essential AAs must be obtained from food. The best sources of essential AAs are animal
products, such as meat, poultry, fish, dairy, and eggs. A diet containing 10% to 12% of calories from
protein should meet essential AAs requirements. The non-essential AAs are arginine, alanine,
asparagine, aspartic acid, cysteine, glutamine, glutamic acid, glycine, proline, serine, and tyrosine.
Which of the following statements about excessive protein intake is false?
a. Excessive protein intake is difficult to achieve and, therefore, is not a danger.
b. Excessive protein intake increases calcium excretion, which can potentially lead to osteoporosis.
c. Excessive protein in the diet is broken down in the kidneys and excreted in the urine as urea.
d. Excessive protein intake will not help an athlete build more muscles, but will instead convert into fat,
if it is not used as an energy source. - ✔✔A. Excessive protein intake is difficult to achieve and,
therefore, is not a danger.
The majority of Americans consume protein in excess requirements. Many people consume at least
twice as much as they need. Some excess protein becomes a calorie source or converts to fat. Studies
demonstrated an increase in calcium excretion related to an increase in protein intake, especially animal
protein, due to acidified blood. As the digestive system breaks down large amounts of protein, the
bones release calcium to neutralize the blood. Acidified blood leads to osteoporosis in predisposed
people. Normally functioning kidneys excrete nitrogenous wastes including urea derived from the
breakdown of protein. Athletes often consume more protein in the false hope that it will build bigger
muscles. There is no benefit to massive protein intake. Actual muscle development results form
exercise, weight training, and proper nutrition.
How many grams of protein are in a meal containing 6 ounces baked fish, 1 cup cooked pasta, 1 cup
steamed broccoli, 1 slice whole wheat bread, 1 cup skim milk, 1/2cup sliced strawberries, and 1 slice
angel cake?
a. 54grams
b. 66grams
c. 75grams
d. 83grams - ✔✔B. 66grams
In the above meal, the protein content is 66grams, as follows: fish 42grams; pasta 6grams; broccoli 4
grams. whole wheat bread 2 grams; milk 8 grams; and angel cake 3 grams.
, The ADA 2007 Choose Your Foods: Exchange Lists for Meal Planning, offers a quick way to calculate the
macronutrient content of many foods:
-meats and meat substitutes contain 7 grams PRO/ ounce
-starches contain 2 to 3 grams of PRO/ serving
-vegies contain 2 grams PRO/ serving
-milk contains 8 grams per 8 ounces serving
-there is no significant PRO in fruit.
*check serving size as portion sizes vary between food items.
Kwashiorkor patients have all of the following characteristics except:
a. loss of somatic stores
b. preservation of somatic stores
c. loss of visceral protein stores
d. large, protruding abdomen - ✔✔A. Loss of somatic stores.
Kwashiorkor is malnutrition for lack of amino acids. It usually affects weaned children between
12months and 3 y/o in third world countries with famine, drought, political unrest, or traditional eating
habits. The victim's diet is protein-deprived. Most calories are derived from a restricted carbohydrate
source, such as corn or sugar-water. Kwashiorkor is uncommon in the US., where it usually appears only
in severely abused children and neglected nursing home residents. The main characteristics include
preservation of somatic or fat stores and loss of visceral protein stores. The signs and symptoms of
kwashiorkor are: A large, protruding belly; significant edema; changes in hair and skin pigment; skin
rash; fatigue; irritability; diarrhea; and decreased immune function. Victims never reach their height
potential.
Which description of marasmus is most accurate?
a. Starvation from food deprivation, with a decrease in somatic and visceral protein stores, but
subcutaneous fat stores are preserved.
b. Protein deprivation, with adequate calories from carbohydrates and depletion of visceral protein
stores, but preservation of somatic stores.
c. Severe malnutrition, with loss of subcutaneous fat and depletion of muscle mass, followed by a
breakdown in lean body mass.
d. A form of malnutrition mainly seen in the US, due to limited access to food. - ✔✔C. Severe
malnutrition, with loss of subcutaneous fat and depletion of muscle mass, followed by a breakdown in
lean body mass.
