Advanced Nutrition and Human

Metabolism 7th Edition Gropper Test

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Chapter 07 Integration and Regulation of Metabolism and
the Impact of Exercise

MULTICHOICE

1. What are the two compounds that connect the metabolism of carbohydrates, lipids, and proteins?​

(A) ​citrate and oxaloacetate

(B) ​succinyl-CoA and malate

(C) ​pyruvate and acetyl-CoA

(D) ​CO2 and NADPH

Answer : (C)

2. ​When the cellular energy status favors anabolic reactions, pyruvate is converted to ____.

(A) ​fructose

(B) ​glucose

(C) ​succinyl-CoA

(D) ​NADPH

Answer : (B)

3. One of the regulated enzymes when glycolysis occurs is ____.​

(A) ​isocitrate dehydrogenase

(B) ​pyruvate dehydrogenase

(C) ​fructose-1,6-bisphosphatase

(D) ​phosphofructokinase

Answer : (D)

4. In the human, most triacylglycerols are synthesized by the ____.​

(A) ​adipose tissue

(B) ​heart

(C) ​liver

(D) ​brain
Answer : (C)

5. Which of the following amino acids is glucogenic in the postabsorptive state?​

(A) ​taurine

(B) ​leucine

(C) ​alanine

(D) ​lysine

Answer : (C)

6. The lack of which muscle enzyme causes glucose, when phosphorylated in the muscle, to be
trapped?​

(A) ​glucose-6-phosphatase

(B) ​glycerol-3-phosphatase

(C) ​6-phosphoglycerate dehydrogenase

(D) ​glucokinase

Answer : (A)

7. ​How long does it take for the postabsorptive state to evolve into the fasting state?

(A) ​12-18 hours

(B) ​18-48 hours

(C) 24-36 hours

(D) ​36-72 hours

Answer : (B)

8. Amino acids from muscle breakdown provide the chief substrate for which metabolic process?​

(A) ​glycolysis

(B) ​gluconeogenesis

(C) ​glycogenesis

(D) ​pentose phosphate pathway

Answer : (B)
9. Which amino acid is considered purely ketogenic?​

(A) ​methionine

(B) ​histidine

(C) ​tryptophan

(D) ​leucine

Answer : (D)

10. A protein-sparing shift in metabolism from gluconeogenesis to lipolysis occurs during the ____.​

(A) ​early fasting state

(B) ​fasting state

(C) ​starvation state

(D) ​fed state

Answer : (C)

11. The brain cannot use fatty acids for energy because ____.​

(A) ​it lacks enzymes for oxidation of fats

(B) ​it lacks mitochondria

(C) ​glycerol cannot cross the blood-brain barrier

(D) ​fatty acids cannot cross the blood-brain barrier

Answer : (D)

12. Amino acids used primarily by muscle for synthesis of dispensable amino acids and for protein
synthesis are ____.​

(A) ​branched-chain amino acids

(B) ​aromatic amino acids

(C) ​basic amino acids

(D) ​acidic amino acids

Answer : (A)

13. Skeletal muscle accounts for what percentage of protein turnover?​

(A) ​10-15%

(B) ​15-20%

(C) ​20-25%

(D) ​25-35%

Answer : (D)

14. ​In which organ does urea synthesis occur?

(A) ​kidney

(B) ​spleen

(C) ​liver

(D) ​pancreas

Answer : (C)

15. What amino acid plays an important role in controlling toxicity from ammonia released during
amino acid catabolism by the glutamate dehydrogenase reaction?​

(A) ​glutamine

(B) ​glycine

(C) ​serine

(D) ​valine

Answer : (A)

16. What is the primary communication system that assesses the body's status in relation to its
environment and relays appropriate commands to tissues/organs?​

(A) ​endocrine system

(B) ​nervous system

(C) ​vascular system

(D) ​respiratory system

Answer : (B)

17. An individual who has not eaten in five days will most likely have an elevated level of which
hormone?​
(A) ​insulin

(B) ​norepinephrine

(C) ​glucagon

(D) ​ACTH

Answer : (C)

18. Which hormone has the primary responsibility for directing energy metabolism in the fed state?​

(A) ​growth hormone

(B) ​cortisol

(C) ​glucagon

(D) ​insulin

Answer : (D)

19. Under the influence of insulin, which of the following pathways is increased?​

(A) ​glycogenesis

(B) ​glycogenolysis

(C) ​phosphorylation of glycogen synthase

(D) ​phosphorylation of glycogen phosphorylase

Answer : (A)

20. ​The precursors for insulin's stimulation of fatty acid synthesis are excess ____.

(A) ​sucrose and maltose

(B) ​glucose and sucrose

(C) ​fructose and sucrose

(D) ​glucose and fructose

Answer : (D)

21. The fed state of the fed-fast cycle lasts about how long and is characterized by secretion of
which hormone?​

(A) ​1 hour/insulin
(B) 2 hours/insulin

(C) ​3 hours/insulin

(D) ​4 hours/insulin

Answer : (C)

22. After several weeks of starvation, what proportion of the energy needs of the brain is supplied
by β-hydroxybutyrate and acetoacetate?​

(A) ​one-fourth

(B) ​one-third

(C) one-half

(D) ​two-thirds

Answer : (D)

23. ​What is the preferred source of energy used by muscles to spare protein during prolonged
starvation?

(A) ​ketones

(B) ​glucose

(C) ​fatty acids

(D) ​amino acids

Answer : (A)

24. What is the term used to represent maximum oxygen consumption relating to exercise capacity?​

(A) ​respiratory quotient

(B) ​VO2 max

(C) ​ATP-CP

(D) ​lactic acid system

Answer : (B)

25. The lactic acid system is also referred to as ____.​

(A) ​aerobic metabolism

(B) ​anaerobic metabolism

(C) ​aerobic glycolysis

(D) ​anaerobic glycolysis

Answer : (D)

26. ​Which substances become the main fuel for high-intensity exercise lasting more than one hour?

(A) ​plasma fatty acids

(B) ​glucose and fructose

(C) ​glycogen and glucose

(D) ​ketone bodies

Answer : (A)

27. Training enhances utilization of fat as the primary energy substrate during submaximal exercise
due to ____.​

(A) ​enhanced activity of glycolytic enzymes

(B) ​fatty acid oxidation inhibiting glucose uptake and glycolysis

(C) ​enhanced glucose uptake

(D) ​decreased carnitine acyltransferase

Answer : (B)

28. ​Which of the following conditions is attributed to a primary failure of the β-cells of the pancreas
to secrete insulin?

(A) ​hyperinsulinism

(B) ​hyperglycemia

(C) ​hyperlipidemia

(D) ​hyperphosphatemia

Answer : (B)

29. Carbohydrate loading is a dietary and exercise strategy used to maximize ____.​

(A) ​glycogenolysis

(B) ​glycolysis

(C) ​lipolysis
(D) ​glycogen storage in muscle and live

Answer : (D)

30. An increase in glycolysis is accompanied by an increase in ____.​

(A) ​pyruvate dehydrogenase

(B) ​isocitrate dehydrogenase

(C) ​pyruvate kinase

(D) ​fructose-1,6-bisphosphatase

Answer : (C)

31. Citrate that moves from the mitochondria into the cytoplasm is converted by which enzyme into
oxaloacetate and acetyl-CoA?​

(A) ​citrate lyase

(B) ​citrate decarboxylase

(C) ​citrate hydrogenase

(D) ​citrate synthase

Answer : (A)

32. Malonyl-CoA plays a regulatory role in which two processes?​

(A) ​glycogenesis and gluconeogenesis

(B) ​fatty acid synthesis and β-oxidation

(C) ​glycolysis and protein degradation

(D) ​gluconeogenesis and glycolysis

Answer : (B)

33. A deficiency in carnitine acyltransferase I (CAT I) could lead to interference with ____.​

(A) ​glycolysis

(B) ​gluconeogenesis

(C) ​ATP production

(D) ​CO2 production

Answer : (C)

34. ​AMP-activated protein kinase (AMPK) controls both anabolic and catabolic pathways involving
all ____.

(A) ​macronutrients

(B) ​fatty acids

(C) ​micronutrients

(D) ​amino acids

Answer : (A)

35. ​The majority of energy for ATP production is provided by dietary ____.

(A) ​protein

(B) ​protein and lipid

(C) ​carbohydrate and protein

(D) ​carbohydrate and lipid

Answer : (D)

36. In humans, fatty acids cannot be used to synthesize glucose because we lack the enzymes
needed to convert ____.​

(A) ​acetyl-CoA to lactate

(B) ​glycogen to acyl-CoA

(C) ​acetyl-CoA to pyruvate

(D) ​acyl-CoA to acetyl-CoA

Answer : (C)

37. Most nutrients absorbed by the small intestine first pass through the ____.​

(A) ​liver

(B) ​pancreas

(C) ​spleen

(D) ​lymphatic system

Answer : (A)
38. ​The correct order of the pathway leading to glycogen production is ____.

(A) ​pyruvate, alanine, glucose, glycogen

(B) ​alanine, glucose, pyruvate, glycogen

(C) ​pyruvate, glucose, alanine, glycogen

(D) ​alanine, pyruvate, glucose, glycogen

Answer : (D)

39. ​Following a carbohydrate-rich meal, skeletal and cardiac muscle express which protein on their
cell surfaces?

(A) ​GLUT1

(B) ​GLUT2

(C) ​GLUT3

(D) ​GLUT4

Answer : (D)

40. ​Which GLUT protein is the only one whose function is dependent on insulin?

(A) ​GLUT1

(B) ​GLUT2

(C) ​GLUT3

(D) ​GLUT4

Answer : (D)

41. ​The adipocytes of an individual with hypoglycemia would have difficulty producing ____

(A) ​glycerol-3-phosphate

(B) ​acetyl-CoA

(C) ​acyl-CoA

(D) ​glucose-6-phosphate dehydrogenase

Answer : (A)

42. Muscle and adipose tissue must obtain glycerol-3-phosphate through ____.​
(A) ​gluconeogenesis

(B) ​glycolysis

(C) ​glycogenolysis

(D) ​glycogenesis

Answer : (B)

43. ​Only the glycerol portion of triacylglycerols can be converted into ____.

(A) ​fatty acids

(B) ​alcohols

(C) ​protein

(D) ​carbohydrate

Answer : (D)

44. An individual with a deficiency of glycerol-3-phosphate would have difficulty synthesizing ____.​

(A) ​fatty acids

(B) ​triacylglycerols

(C) ​acetyl-CoA

(D) ​glucose

Answer : (B)

45. ​Fatty acids with an even number of carbons are degraded exclusively into ____.

(A) ​glucose

(B) ​fructose

(C) ​acetyl-CoA

(D) ​triacylglycerols

Answer : (C)

46. Time frames assigned to each of the phases of the fed-fast cycle are strongly influenced by an
individual's ____.​

(A) ​metabolic rate

(B) ​age

(C) ​gender

(D) ​ethnic background

Answer : (A)

47. When glucose exceeds the glycogen storage capacity of the liver, the excess glucose can be
converted to ____.​

(A) ​acetyl-CoA

(B) ​fructose

(C) ​glucose-6-phosphate dehydrogenase

(D) ​fatty acids and triacylglycerols

Answer : (D)

48. ​During the postabsorptive state, the major provider of glucose to the blood is ____.

(A) ​hepatic glycolysis

(B) ​hepatic glycogenolysis

(C) ​renal gluconeogenesis

(D) ​hepatic gluconeogenesis

Answer : (B)

49. At rest, the brain uses what percentage of available energy?​

(A) ​5-10%

(B) ​15-20%

(C) ​20-25%

(D) ​30-40%

Answer : (C)

50. The metabolic fuel shifts associated with the starvation state are designed to spare body ____.​

(A) ​protein

(B) ​carbohydrates
(C) ​lipids

(D) ​glycogen

Answer : (A)

TRUEFALSE

51. ​Gluconeogenesis occurs exclusively in the liver.

(A) True

(B) False

Answer : (B)

52. The metabolic effects of glucagon occur in an effort to allow ATP production in the absence of
dietary carbohydrate.​

(A) True

(B) False

Answer : (A)

53. A fasted state is characterized by protein synthesis.​

(A) True

(B) False

Answer : (B)

54. Acetyl-CoA is a junction point for a number of metabolic processes, including metabolism of
carbohydrate, lipid, and cholesterol.​

(A) True

(B) False

Answer : (A)

55. ​Most regulatory enzymes act in a bidirectional manner.

(A) True

(B) False
Answer : (B)

56. ​Glucagon and insulin control metabolic pathways that reflect a fasting and fed state,
respectively; the primary signal to initiate this hormonal control is the glucose concentration in the
bloodstream.

(A) True

(B) False

Answer : (A)

57. During very prolonged starvation nearing death, the body shifts from using protein for energy to
using fat stores.​

(A) True

(B) False

Answer : (B)

58. Muscle supplies its own glucose for energy needs by first using glycogen stores, and then
converting amino acids to glucose.​

(A) True

(B) False

Answer : (B)

59. The Cori cycle would be active under anaerobic conditions, such as excessive muscle exertion.​

(A) True

(B) False

Answer : (A)

60. All tissues prefer glucose first, and then fatty acids, to meet their energy needs.​

(A) True

(B) False

Answer : (B)

61. Most nutrients absorbed by the small intestine first pass through the liver.​
(A) True

(B) False

Answer : (A)

62. ​The postabsorptive state evolves into the fasting state after 36-72 hours of no food intake.

(A) True

(B) False

Answer : (B)

63. ​The red color of muscle is due to the presence of myoglobin.

(A) True

(B) False

Answer : (A)

64. The end products of the oxidative system are acetyl-CoA and glucose-6-phosphate
dehydrogenase.​

(A) True

(B) False

Answer : (B)

65. Carbohydrate loading is a dietary and exercise strategy aimed at maximizing glycogenolysis in
muscle and liver.​

(A) True

(B) False

Answer : (B)

MATCH

66. ​Hormones: Match the regulatory hormones with their primary functions in integrative
metabolism.

MATCH
67. ​Metabolism: Match the metabolic activity to the correct organ.

SHORTANSWER

68. Define the two categories of metabolic pathways and explain the main purpose of each
one.Answer : The two pathways are catabolic or degradative and anabolic or synthetic.Catabolic
reactions break down macronutrients, so energy can be released and turned into ATP.Anabolic
reactions synthesize complex molecules from simple precursors by using ATP for energy (and in
some cases GTP and UTP).

69. ​Name the three systems that play a role in supplying energy during movement/exercise.
Describe briefly how they supply energy, and discuss the temporal relationship between them during
prolonged exercise. Any figures should be completely labeled and explained.Answer : [If students
redraw the graph in Figure 7.12 here to show the relationship between these systems and their
contribution to meeting energy needs as a function of time, that is fine as long as it was
appropriately drawn, labeled, and explained.]

70. ​Metabolic pathways are regulated to maintain homeostasis in the face of changing
environmental conditions, such as nutrient supply. Describe how this is accomplished during the fed-
fast cycle, that is, the progression from a fed state, to a postabsorptive/fasting state, to starvation, to
prolonged starvation. Your answer should include specific processes/ metabolic pathways that are
favored under each condition-make sure to cover pathways that are important to all three
macronutrients (CHOs, lipids, protein). Also indicate the signal(s) involved in modulating these
pathways. An example is provided in the table.
​
Fed Postabsorptive/ Starvation Prolonged
Fasting Starvation
↑ ​ ​ ​
glycolysis
​
Answer : FedPostabsorptive/ FastingStarvationProlonged Starvation
Answer : Fed
Answer : Postabsorptive/ Fasting
Answer : Starvation
Answer : Prolonged Starvation
Answer : ↑ glycolysis Signal:
Answer : insulin (in response to high blood glucose) Increases in:
Answer : Glycolysis
Answer : Glucose uptake (via GLUT 4 translocation)
Answer : Glycogenesis
Answer : Lipogenesis
Answer : Protein synthesis Signal:
Answer : glucagon (in response to low blood glucose) and epinephrine and cortisol Increases in:
Answer : Glycogenolysis
Answer : Gluconeogenesis
Answer : Urea synthesis
Answer : Protein degradation
Answer : Lipolysis (a little) Signal:
Answer : glucagon (in response to low blood glucose) and epinephrine and cortisol Increases in:
Answer : Lipolysis (glycogen stores are gone & need to spare body protein)
Answer : Ketogenesis Signal:
Answer : glucagon (in response to low blood glucose) and epinephrine and cortisol Increases in:
Answer : Gluconeogenesis
Answer : Protein degradation (lipid stores are depleted; all that is left is body protein, including
visceral sources)
Answer : ↑ glycolysis
Answer : Signal:
Answer : insulin (in response to high blood glucose)
Answer : Increases in:
Answer : Glycolysis
Answer : Glucose uptake (via GLUT 4 translocation)
Answer : Glycogenesis
Answer : Lipogenesis
Answer : Protein synthesis
Answer : Signal:
Answer : glucagon (in response to low blood glucose) and epinephrine and cortisol
Answer : Increases in:
Answer : Glycogenolysis
Answer : Gluconeogenesis
Answer : Urea synthesis
Answer : Protein degradation
Answer : Lipolysis (a little)
Answer : Signal:
Answer : glucagon (in response to low blood glucose) and epinephrine and cortisol
Answer : Increases in:
Answer : Lipolysis (glycogen stores are gone & need to spare body protein)
Answer : Ketogenesis
Answer : Signal:
Answer : glucagon (in response to low blood glucose) and epinephrine and cortisol
Answer : Increases in:
Answer : Gluconeogenesis
Answer : Protein degradation (lipid stores are depleted; all that is left is body protein, including
visceral sources)

71. ​Pick two (2) of the examples from question 3 and indicate specifically how the signal you
indicated in your answer is altering the pathway listed. For each example, write a one-sentence
answer that includes the condition, the signals, the mechanism, the protein/enzyme, the tissue, and
the result (all underlined in the example below).Example: Under fed conditions, high blood glucose
leads to insulin secretion by the pancreas, which in turn induces expression of the key glycolytic
enzyme phosphofructokinase in all cells, thereby increasing glycolysis.
Answer : Many potential examples – Students should follow the format in the example and not leave
out what cells or tissues in which the example was occurring, or fail to mention the name of the
enzyme.
Answer : One example: Under starvation conditions, low blood glucose levels lead to epinephrine
secretion by the adrenal glands, which stimulates hormone-sensitive lipase in the adipocytes to
increase lipolysis of stored triacylglycerols, thereby increasing the use of fatty acids to produce ATP.

72. Explain how endurance training increases an athlete's ability to perform more
aerobically.​Answer : Endurance training increases the number and size of mitochondria, which
increases the oxidative capacity of the muscle and allows a faster rate of ATP production per minute.
This capacity is amplified because cardiovascular and lung capacity to deliver oxygen to the muscle
is also improved by exercise. Thus it is possible for the trained athlete to use fatty acids at a higher
intensity of exercise because the capacity/rate of total aerobic ATP production has improved.
Glycogen is spared and duration of exercise can be longer. In addition, the capacity for glycogen
storage is increased.

73. In general, describe how opposing pathways are regulated during fasting versus fed conditions.
What are the primary signals involved? What would be an example of two opposing pathways? How
is one pathway favored over the other (you don't need to name specific proteins/ enzymes
here)?​Answer : A fed state is characterized by high blood glucose, which results in the pancreas
releasing insulin into the circulation. Insulin promotes glucose uptake, glycolysis/TCA, glycogenesis,
and lipogenesis by various mechanisms (including translocation, enzyme stimulation, enzyme
induction, etc.). A fasted state is characterized by low blood glucose levels, resulting in the release
of glucagon. Glucagon promotes gluconeogenesis, lipolysis, and glycogenolysis. Epinephrine also
plays a role in this, but more so under exercise and stress conditions to promote glycogenolysis in
muscle rather than fasting conditions.
Answer : For both fed and fasting, all of these pathways also regulate themselves in the sense that
high concentrations of products (e.g., ATP, citrate, NADH) allosterically inhibit many enzymes
involved in their production, whereas high concentrations of substrates (e.g., ADP, NAD)
allosterically stimulate these same enzymes.

74. ​Describe the four phases of the fed-fast cycle and include the time frames associated with each
state.Answer : The fed phase begins after ingestion of a meal and is associated with secretion of
insulin. This phase lasts about three hours.The postabsorptive phase occurs between three and 18
hours following the meal and is associated with a rise in glucagon secretion.The fasting phase occurs
when no additional food is ingested after the initial meal and is associated with a continued rise in
glucagon levels. This phase lasts from 18 hours to approximately two days.The starvation phase,
which is also called a long-term fast, occurs when the individual is deprived of food for longer than
two days. At this point, the body is fully adapted and will survive for a variable length of time
depending on factors such as body constitution, initial body weight (mass of stored fat) and other
underlying factors relating to the individual’s health.

75. ​The tricarboxylic acid cycle (TCA cycle) is used to produce ATP. It includes several intermediates
that enter into anabolic pathways. List three of these intermediates and briefly describe their
functions. Answer : Any three may be selected by the students. The following three examples may
be used:

76. ​Describe the various functions of insulin in the fed state.Answer : Insulin is the most important
anabolic hormone in the fed state as it has an impact on blood glucose levels, fatty acid synthesis
and protein synthesis and storage. It has several important functions.

77. What is the significant difference between red blood cells and other cells of the body? How does
this affect their metabolism and why is this an advantage and a disadvantage at the same
time?​Answer : The mature red blood cell does not possess a nucleus or any other organelles. They
rely exclusively on glucose as their energy source. Because they have no mitochondria, they must
produce ATP via anaerobic glycolysis. This means that they will not consume any of the oxygen they
are transporting which makes them very efficient at delivering the oxygen to all of the cells of the
body. The disadvantage is that glycolysis is an inefficient means of producing ATP from glucose. This
is overcome by the liver’s ability to use the lactate created from the pyruvate generated by glycolysis
to synthesize glucose via gluconeogenesis.
MULTICHOICE

78. ​One of the problems associated with the use of dietary supplements used to enhance athletic
performance is ____.

(A) ​they are difficult to obtain

(B) ​there is little scientific evidence to prove that they are effective

(C) ​there are many supplements that are considered to be performance enhancing

(D) ​advertising for these products is often based on research that the layperson has difficulty
understanding

Answer : (B)

79. ​The most accepted dietary compound used to enhance performance is/are ____.

(A) ​caffeine

(B) ​creatine

(C) ​buffering agents

(D) ​carbohydrate supplements

Answer : (A)

80. The ingestion of nitrate through nitrate-rich foods or supplementation will lead to an increase in
generation of ____.​

(A) ​nitrous oxide

(B) ​nitric acid

(C) ​calcium nitrate

(D) ​nitric oxide

Answer : (D)

81. ​How does creatine enhance muscle performance?

(A) ​It reduces the muscle's oxygen requirement.

(B) ​It speeds up ATP utilization.

(C) ​It improves contractile performance and brings about hypertrophy.

(D) ​It helps to add more muscle fibers to the muscle.

Answer : (C)

82. ​Supplementation with proteins and amino acids in conjunction with resistance training is aimed
at ____.

(A) ​increasing muscle mass

(B) ​speeding up muscle contraction

(C) ​adding more muscle fibers to the muscle

(D) ​reducing reliance on oxygen

Answer : (A)