Nutrition A Functional Approach Canadian 3rd Edition Thompson Test Bank

Nutrition A Functional Approach
Canadian 3rd Edition Thompson Test

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Nutrition: A Functional Approach, Cdn. Ed. 3e (Thompson/Manore/Sheeshka)
Chapter 6: Proteins: Crucial Components of All Body Tissues
Multiple-Choice Questions
1) What element makes protein different from carbohydrate and fat?

A) carbon
B) hydrogen
C) oxygen
D) nitrogen
Answer: D
Page Ref: 186
Topic: What Are Proteins?
Skill: Factual
2) What dictates the structure of a protein molecule synthesized by the body?

A) the body's need for a protein
B) the DNA inside the nucleus of the cell
C) the number of essential amino acids available
D) the combination of proteins consumed in the diet
Answer: B
Page Ref: 186
Skill: Applied
3) Which of the following is NOT a component of an amino acid molecule?

A) a central carbon
B) an amine group
C) an acid group
D) a fatty acid group
Answer: D
Page Ref: 186
Skill: Factual
4) Which part of an individual amino acid distinguishes it from other amino acids?
A) side chain
B) central carbon
C) amine group
D) acid group
Answer: A
Page Ref: 186
Skill: Factual
6–1
Copyright © 2014 Pearson Canada, Inc.
5) The part of the protein molecule that carries nitrogen is the
A) acid group.
B) amine group.
C) side chain.
D) hydrogen group.
Answer: B
Page Ref: 186
Skill: Factual
6) In phenylketonuria (PKU), which amino acid becomes conditionally essential?

A) phenylalanine
B) tyrosine
C) alanine
D) cysteine
Answer: B
Page Ref: 188
Skill: Applied
7) How many strings of amino acids does a polypeptide consist of?

A) two
B) more than four
C) nine
D) more than ten
Answer: D
Page Ref: 188
Topic: How Are Proteins Made?
Skill: Factual
8) The twisting, spiral shape formed by the sequence and chemical properties of its amino acids
refers to what part of a protein's structure?
A) primary
B) secondary
C) tertiary
D) quaternary
Answer: B
Page Ref: 191
Skill: Applied
6–2
9) A complete protein
A) contains all 20 amino acids.
B) contains all 9 essential amino acids.
C) has not been denatured.
D) is composed of only di- and tripeptides.
Answer: B
Page Ref: 192
Skill: Factual
10) The process of transferring the amine group from one amino acid to another is called
A) gene expression.
B) alteration.
C) deamination.
D) transamination.
Answer: D
Page Ref: 188
Skill: Applied
11) Two amino acids are joined together by a peptide bond to form a dipeptide. What is the by-
product of this process?
A) ammonia
B) water
C) carbon dioxide
D) hydrochloric acid
Answer: B
Page Ref: 189
Skill: Applied
12) Which of the following foods is a source of complete protein?

A) broccoli
B) apple
C) chicken
D) whole grain bread
Answer: C
Page Ref: 193
Skill: Applied
6–3
13) Egg whites stiffen when they are whipped. The change that occurs in the protein is called
A) denaturation.
B) translocation.
C) transcription.
D) deamination.
Answer: A
Page Ref: 191
Skill: Applied
14) In what structure of the mammalian cell are proteins synthesized?

A) nucleus
B) ribosome
C) cell membrane
D) mitochondria
Answer: B
Page Ref: 189
Skill: Factual
15) MOST of the proteins in the body are synthesized from

A) nine amino acids.
B) twenty amino acids.
C) ten fatty acids.
D) fifteen fatty acids.
Answer: B
Page Ref: 187
Skill: Factual
16) The process through which mRNA copies genetic information from DNA and carries it to
the ribosome is called
A) translation.
B) deamination.
C) denaturation.
D) transcription.
Answer: D
Page Ref: 189
Skill: Applied
6–4
17) Which of the following is the MOST complete protein from a plant source?
A) green beans
B) soybeans
C) bread
D) apples
Answer: B
Page Ref: 192
Skill: Applied
18) Of the 20 amino acids relevant to the human body, how many are considered nonessential?
A) none
B) 9
C) 11
D) 20
Answer: C
Page Ref: 187
Skill: Factual
19) Which of the following is a body protein that is stored in a gland and secreted to an organ to
restore normal body conditions or balance?
A) enzyme
B) hormone
C) antibody
D) buffer
Answer: B
Page Ref: 194
Topic: Why Do We Need Proteins?
Skill: Applied
20) In the body, buffers are very important in

A) defending the body against bacteria and toxins.
B) maintaining acid-base balance in the body.
C) accelerating chemical reactions in the body.
D) maintaining and repairing body tissue.
Answer: B
Page Ref: 196
Skill: Conceptual
6–5
21) Which of the following is NOT a major function of protein in the human body?
A) maintaining fluid balance
B) providing energy to the body
C) growth and maintenance of new tissue
D) synthesis of hormones
Answer: B
Page Ref: 197
Skill: Applied
22) Which of the following proteins are fundamental to the immune system?
A) enzymes
B) antibodies
C) buffers
D) transport proteins
Answer: B
Page Ref: 197
Skill: Applied
23) Proteases are

A) protein messengers that are released from storage in response to an alteration in the body's
homeostasis.
B) transport proteins that move substances throughout the body.
C) defense proteins that attack foreign bacteria, viruses, and toxins.
D) enzymes that break down protein in the small intestine.
Answer: D
Page Ref: 198
Topic: How Do Our Bodies Break Down Proteins?
Skill: Factual
24) Conduction of nerve signals and contraction of muscles depends on the proper balance of
A) glucose.
B) electrolytes.
C) buffers.
D) nitrogen.
Answer: B
Page Ref: 195-196
Skill: Applied
6–6
25) Which of the following statements is FALSE?
A) HCl denatures protein to allow digestive enzymes to break down the protein.
B) HCl inhibits the digestion of fat so it does not compete with protein digestion.
C) HCl untangles the strands of protein and breaks the peptide bonds.
D) HCl converts pepsinogen into pepsin.
Answer: B
Page Ref: 197-198
Skill: Conceptual
26) Significant chemical digestion of protein begins in the

A) mouth.
B) stomach.
C) gallbladder.
D) pancreas.
Answer: B
Page Ref: 197-198
Skill: Factual
27) The process of combining two incomplete proteins to make a complete protein is called
A) the protein-combining method.
B) amino acid sequencing method.
C) mutual supplementation.
D) protein.
Answer: C
Page Ref: 193
Skill: Factual
28) Which of the following individuals is MOST likely to be in positive nitrogen balance?
A) a 29-year-old woman who is 6 months pregnant
B) a 20-year-old female who is consuming 500 calories a day
C) a 10-year-old boy recovering from severe burns
D) a 30-year-old man with a temperature of 103.7°F
Answer: A
Page Ref: 201
Topic: How Much Protein Should We Eat?
Skill: Conceptual
6–7
29) To conserve body protein for its vital functions and not use it to provide energy, you should
A) eat adequate amounts of carbohydrate and fat to conserve protein for other functions.
B) eat at least twice the recommended RDA for protein to ensure adequate protein stores.
C) work out in the gym at least three times a week to store additional protein for later use.
D) eat meat three times a week to ensure adequate protein storage.
Answer: A
Page Ref: 197
Skill: Conceptual
30) Which of the following is NOT typically a nutrient of concern for vegans?
A) iron
B) vitamin B12
C) vitamin C
D) calcium
Answer: C
Page Ref: 208
Topic: What Health Problems Are Related to Protein Intake?
Skill: Applied
31) The type of vegetarian who eats vegetables, grains, fruits, eggs, and milk but excludes all
other types of animal protein is called a
A) vegan.
B) lacto-vegetarian.
C) lacto-ovo vegetarian.
D) pesco-vegetarian.
Answer: C
Page Ref: 207
Topic: Can a Vegetarian Diet Provide Adequate Protein?
Skill: Applied
32) The type of protein-energy malnutrition characterized by a general lack of protein in the diet
is called
A) marasmus.
B) sickle cell anemia.
C) cystic fibrosis.
D) kwashiorkor.
Answer: D
Page Ref: 210-211
Skill: Applied
6–8
33) During the process of protein synthesis, what is the step in which messenger RNA is decoded
into an amino acid sequence at the cell's ribosome called?
A) transcription
B) translation
C) deamination
D) denaturation
Answer: B
Page Ref: 189
Skill: Conceptual
34) The absorption of proteins occurs in the

A) stomach.
B) small intestine.
C) large intestine.
D) liver.
Answer: B
Page Ref: 199
Skill: Factual
35) An acid-base imbalance can result in

A) no change in the pH of the blood.
B) an increased rate of absorption in the stomach.
C) coma and death.
D) digestive problems.
Answer: C
Page Ref: 196
Skill: Conceptual
36) Which of the following statements is FALSE?

A) The healthy body's primary energy source is carbohydrate and fat.
B) The body stores excess protein primarily for energy reserves.
C) To utilize protein for energy, the amine group is removed.
D) Eating sufficient carbohydrate and fat will spare body protein.
Answer: B
Page Ref: 194-197
Skill: Conceptual
6–9
37) Which of the following supplements would you recommend a vegan add to his/her diet?
A) protein
B) fiber
C) vitamin B12
D) vitamin C
Answer: C
Page Ref: 207
Skill: Applied
38) A well-planned vegetarian diet reduces the risk for many chronic diseases. For which of the
following conditions does such a diet NOT minimize the risk?
A) obesity
B) heart disease
C) anemia
D) cancer
Answer: C
Page Ref: 207-208
Skill: Factual
39) Which of the following is NOT associated with kwashiorkor?

A) flat belly and abdomen
B) fatty liver
C) loss of hair
D) weight loss and muscle wasting
Answer: A
Page Ref: 210-211
Skill: Applied
40) Vegetarian diets are associated with increased consumption of

A) carcinogens.
B) antioxidants.
C) prions.
D) vitamins B12 and D.
Answer: B
Page Ref: 208
Skill: Factual
6–10
41) Which hormone controls both the production of hydrochloric acid and the release of pepsin?
A) insulin
B) glucagon
C) gastrin
D) pepsin
Answer: C
Page Ref: 198
Skill: Factual
42) The enzymes that digest proteins in the small intestine are
A) proteases.
B) pepsins.
C) pepsinogens.
D) phosphofructokinases.
Answer: A
Page Ref: 198
Skill: Factual
43) The electrically charged particle that assists in maintaining the body's fluid balance is called
a(n)
A) enzyme.
B) protease.
C) hormone.
D) electrolyte.
Answer: D
Page Ref: 195
Skill: Factual
44) The positively charged electrolyte concentrated inside the cell is potassium, and the
positively charged electrolyte concentrated outside the cell is
A) oxygen.
B) sodium.
C) hydrogen.
D) nitrogen.
Answer: B
Page Ref: 195
Skill: Factual
6–11
45) A deficiency of protein can lead to what condition in which fluid accumulates in the body's
tissue spaces?
A) edema
B) celiac disease
C) marasmus
D) acidosis
Answer: A
Page Ref: 195
Skill: Applied
46) When a protein attracts or releases hydrogen, it acts as a

A) transporter.
B) limiter.
C) buffer.
D) hydrogenater.
Answer: C
Page Ref: 196
Skill: Applied
47) A substance (usually a protein) that the body recognizes as a foreign invader, triggering an
immune response is an
A) antibody.
B) antigen.
C) antihistamine.
D) antibiotic.
Answer: B
Page Ref: 196
Skill: Factual
48) Which of the following is an excellent source of protein that includes foods such as kidney
beans, pinto beans, black beans, soybeans, lentils, and chickpeas?
A) quorn
B) quinoa
C) nuts
D) legumes
Answer: D
Page Ref: 203-204
Skill: Applied
6–12
49) The proteins responsible for helping maintain fluid balance are known as
A) proteases.
B) transport proteins.
C) buffers.
D) hormones.
Answer: B
Page Ref: 195
Skill: Applied
50) Which of the following processes involves both the synthesis of new proteins and the
breakdown of existing proteins to provide amino acids for building new proteins?
A) transcription
B) translation
C) turnover
D) acidosis
Answer: C
Page Ref: 190
Skill: Conceptual
True/False Questions
1) Essential amino acids are more important to the human body than nonessential amino acids.
Answer: FALSE
Page Ref: 187
Skill: Applied
2) Under normal physiologic conditions, every cell of the body is capable of making each type of
protein needed by the body.
Answer: FALSE
Page Ref: 189
Skill: Conceptual
3) It is necessary to eat animal-based proteins to stay healthy.

Answer: FALSE
Page Ref: 192-193
Skill: Applied
6–13
4) As long as an athlete consumes adequate dietary protein, total caloric intake is not important
in athletic performance.
Answer: FALSE
Page Ref: 203
Skill: Applied
5) A healthy pregnant woman is in positive nitrogen balance.

Answer: TRUE
Page Ref: 201
Skill: Applied
6) Because of their increased protein needs, it is unhealthy for athletes to choose to become
vegetarians.
Answer: FALSE
Page Ref: 200
Skill: Applied
7) Protein-energy malnutrition is seen only in developing countries.

Answer: FALSE
Page Ref: 211
Skill: Applied
8) Individual amino acid supplements are absorbed better than a combination of amino acids.
Answer: FALSE
Page Ref: 199
Skill: Applied
9) Denaturation results in the loss of the protein's function.

Answer: TRUE
Page Ref: 191
Skill: Applied
10) The majority of protein digestion occurs in the mouth.

Answer: FALSE
Page Ref: 198
Skill: Factual
6–14
11) Hydrochloric acid converts the inactive pepsinogen into its active form pepsin.
Answer: TRUE
Page Ref: 198
Skill: Factual
12) Enzymes are proteins that catalyze chemical reactions without being physically altered.
Answer: TRUE
Page Ref: 194
Skill: Factual
13) Alkalosis is a condition in which the pH of the blood becomes too basic.
Answer: TRUE
Page Ref: 196
Skill: Applied
14) All legumes are complete proteins.

Answer: FALSE
Page Ref: 204
Skill: Applied
15) Most Canadians consume sufficient or excess amounts of dietary protein.

Answer: TRUE
Page Ref: 202
Skill: Factual
16) Soybeans are good sources of protein, and the protein quality is almost identical to that of
meat.
Answer: TRUE
Page Ref: 203
Skill: Factual
17) Diets high in protein are associated with low blood cholesterol levels.
Answer: FALSE
Page Ref: 209
Skill: Applied
6–15
18) Consuming individual amino acids and protein supplements can build muscle and improve
strength.
Answer: FALSE
Page Ref: 200
Skill: Applied
19) Marasmus is a serious condition resulting from inadequate intakes of protein and energy.
Answer: TRUE
Page Ref: 210
Skill: Factual
20) The process in which a protein loses its shape and function when exposed to acids, heat, and
heavy metals is deamination.
Answer: FALSE
Page Ref: 197
Skill: Factual
21) Peptide bonds are chemical bonds in which the amine group of one amino acid binds to the
acid group of another amino acid.
Answer: TRUE
Page Ref: 188
Skill: Factual
22) During transcription, mRNA copies genetic information from DNA and carries it to the
cytoplasm for synthesis.
Answer: TRUE
Page Ref: 189
Skill: Conceptual
23) The essential amino acid found in the shortest supply or missing from the amino acid pool is
called a complementary amino acid.
Answer: FALSE
Page Ref: 193
Skill: Applied
24) Complementary proteins provide all twenty essential amino acids.

Answer: FALSE
Page Ref: 192
Skill: Applied
6–16
25) People with phenylketonuria cannot make the non-essential amino acid tyrosine.
Answer: TRUE
Page Ref: 188
Skill: Factual
Essay Questions
1) Describe how proteins differ from carbohydrates and lipids.

Answer: The structure of each protein molecule is determined by genetic material (DNA), which
is not the case for carbohydrates and lipids. Another key difference between proteins and the
other macronutrients is that proteins contain a special form of nitrogen that our bodies can
readily use. By eating proteins found in plants and animals, we are able to break down these
proteins into their respective amino acid components and use the nitrogen for many important
body processes. Carbohydrates and lipids cannot provide this critical form of nitrogen.
Page Ref: 186
Skill: Factual
6–17
2) List 3 essential and 3 non-essential amino acids and describe the difference between the two
categories.
Answer:
Essential Amino Acids
• Histidine
• Isoleucine
• Leucine
• Lysine
• Methionine
• Phenylalanine
• Threonine
• Tryptophan
• Valine
Nonessential Amino Acids

• Alanine
• Arginine
• Asparagine
• Aspartic acid
• Cysteine
• Glutamic acid
• Glutamine
• Glycine
• Proline
• Serine
• Tyrosine
Of the 20 amino acids in our bodies, 9 are classified as essential. This does not mean that they
are more important than the 11 non-essential amino acids. An essential amino acid is one that
our bodies cannot produce at all or cannot produce in sufficient quantities to meet our
physiologic needs. Thus, we must obtain essential amino acids from our food. Without the
proper amount of essential amino acids in our bodies, we lose our ability to make the proteins
and other nitrogen-containing compounds we need. Nonessential amino acids can be made in
sufficient quantities so we do not need to consume them in our diets.
Page Ref: 187
Skill: Conceptual
3) Define transamination. What is the product of transamination?

Answer: Transamination is the process of transferring the amine group from one amino acid to
another in order to manufacture a new amino acid. The product is nonessential amino acids.
Page Ref: 187
Skill: Factual
6–18
4) Define denaturation and give 3 common household examples of protein denaturation?
Answer: Denaturation is a permanent change in the shape of a protein caused by heat, acids,
bases, heavy metals, alcohol, or other substances. Denaturation results in protein losing its ability
to function. It can occur when we digest protein.
Common household examples of protein denaturation include:

• Stiffening of egg whites when they are whipped
• Curdling of milk when lemon juice or another acid is added
• Solidifying of eggs as they cook
Page Ref: 191
Skill: Applied
5) Compare and contrast incomplete and complete proteins.

Answer: A protein that does not contain all of the essential amino acids in sufficient quantities to
support growth and health is called an incomplete (or low-quality) protein. Proteins that have all
nine of the essential amino acids are considered complete (or high-quality) proteins. The most
complete protein sources are from animal sources and include egg whites, ground beef, chicken,
tuna and other fish, and milk. Soybeans are the only complete source of plant protein. In general,
the Canadian diet is very high in complete proteins, as we eat proteins from a variety of food
sources.
Page Ref: 192-193
Skill: Applied
6) Define and provide an example of mutual supplementation.

Answer: Mutual supplementation is the process of combining two or more incomplete protein
sources to make a complete protein, and the two foods involved are called complementary foods.
Complementary foods provide complementary proteins that, when combined, provide all nine
essential amino acids. When we eat one complementary protein, its amino acids join those in the
free amino acid pool. It is not necessary to eat these foods at the same meal. The body maintains
a free pool of amino acids in the blood; these amino acids come from food and sloughed-off
cells. These free amino acids can combine to synthesize complete proteins as long as the amount
of amino acids present meets the requirements for a particular protein. It is wise to eat
complementary protein foods during the same day, as partially completed proteins cannot be
stored and saved for a later time. A dish of beans, rice, and vegetables is an example of mutual
supplementation.
Page Ref: 193
Skill: Factual
6–19
7) How do our bodies break down dietary protein?
Answer: The body does not directly use proteins from food to make protein for the body. Dietary
proteins are first digested and broken down into amino acids that are absorbed and transported to
the liver.
The Process of Protein Digestion
Mouth
• Virtually no enzymatic digestion of proteins occurs in the mouth.
• Proteins in food are crushed by chewing and moistened by saliva.
Stomach
• Proteins are denatured (uncoiled by hydrochloric acid).
• Pepsin is activated to break proteins into single amino acids and smaller polypeptides.
Small Intestine
• Proteases are secreted by cells in the pancreas and small intestine to digest polypeptides
into smaller units.
• Peptidases on the surface of cells in the small intestine complete the breakdown of
oligopeptides, tripeptides, and dipeptides into single amino acids.
Liver
• Amino acids are transported in the blood to the liver and sent to the cells as needed.
Page Ref: 197-199
Skill: Applied
8) List 5 roles of protein in the body.

Answer: The roles of protein in the body include the following:
• Proteins contribute to cell growth, repair, and maintenance.
• Proteins act as enzymes and hormones.
• Proteins help maintain fluid and electrolyte balance.
• Proteins help maintain acid-base balance.
• Proteins help maintain a strong immune system.
• Proteins serve as an energy source when insufficient carbohydrates and fats are available.
Page Ref: 194-197
Skill: Factual
6–20
9) Your swimming teammate has been taking amino acid and protein supplements so that he will
develop bigger muscles. What advice do you give to your friend about protein supplements and
his protein needs as an athlete?
Answer: Athletes need more protein than inactive people. At one time it was believed that the
Recommended Dietary Allowance (RDA) for protein (0.8 gram/kilogram body weight), was
sufficient for both inactive people and athletes. Recent studies show that athletes' protein needs
are higher because regular exercise increases the transport of oxygen to body tissues, requiring
changes in the oxygen-carrying capacity of the blood. To carry more oxygen, the body needs to
produce more of the protein that carries oxygen in the blood (i.e., hemoglobin). During intense
exercise, the body uses a small amount of protein directly for energy. The body also uses protein
to make glucose to maintain adequate blood glucose levels and to prevent hypoglycemia (low
blood glucose) during exercise. Regular exercise stimulates tissue growth and causes tissue
damage, which must be repaired by additional proteins.
Contrary to popular belief, most Canadian athletes already consume more than the RDA for
protein. Thus, taking amino acid and protein supplements is not necessary. In fact, eating more
protein does not cause muscles to become bigger or stronger, and taking individual amino acid
supplements can actually reduce protein production. Only regular strength training can achieve
the goal of bigger and stronger muscles.
Page Ref: 200
Skill: Applied
10) List and describe 2 ways in which too much dietary protein can be harmful.
Answer: High protein intake may increase the risk of some health problems. Three health
conditions that have received particular attention are heart disease, bone loss, and kidney disease.
High Protein Intake is Associated with High Cholesterol

• High-protein diets consisting of mainly animal foods are associated with higher blood
cholesterol levels. This is likely due to the saturated fat in animal products, which is
known to increase blood cholesterol levels and the risk of heart disease.
High Protein Intake Can Increase the Risk for Kidney Disease
• People who are susceptible to kidney disease, such as those with diabetes mellitus, may
benefit from a lower-protein diet. There is no evidence, however, that eating more protein
causes kidney disease in healthy people who are not susceptible to this condition. Experts
agree that eating no more than 2 grams of protein per kilogram body weight each day is
safe for healthy people.
Page Ref: 209
Skill: Factual
6–21
11) Define semi-vegetarian, lacto-ovo-vegetarian, and vegan. Give examples of the foods
consumed for each type and list any potential inadequacies of vitamins and minerals.
Answer: A semi-vegetarian (also called partial vegetarian) diet typically excludes or limits red
meat; and may also avoid other meats. Vegetables, grains, nuts, seeds, fruits, and legumes are
included, and sometimes seafood, poultry, eggs, and dairy products. A lacto-ovo-vegetarian diet
is one that excludes animal flesh and seafood but includes vegetables, grains, nuts, seeds, fruits,
legumes, dairy products (lacto) and eggs (ovo). A vegan (also called strict vegetarian) diet
includes only plant-based foods such as vegetables, grains, nuts, seeds, fruits, and legumes. This
diet may not provide adequate vitamin D, vitamin B12, zinc, iron, or calcium.
Page Ref: 207
Skill: Applied
12) What is the effect of protein energy malnutrition (PEM) in an individual with acquired
immune deficiency syndrome (AIDS)?
Answer: When a person consumes too little protein and energy, the result is protein-energy
malnutrition (PEM). This is the most serious nutrition problem in the world today, particularly
when it is combined with infectious and parasitic diseases that cause diarrhea, which means that
nutrients may not be absorbed, or internal blood loss. If the body does not receive adequate
protein, the immune system is weakened and the body becomes more susceptible to infections
and diseases. This is especially true in the case of AIDS, where a weakened immune system
makes adults more susceptible to the virus that causes the disease to develop. In addition,
malnutrition is thought to reduce the effectiveness of antiretroviral drugs used to treat AIDS.
Page Ref: 211
Skill: Applied
6–22
13) Compare and contrast the symptoms and consequences of marasmus and kwashiorkor.
Answer: The symptoms and consequences of marasmus and kwashiorkor include the following:
Marasmus: Wasting and Stunting

• Wasting and weakening of muscles, including the heart muscle
• Stunted brain development and learning impairment
• Depressed metabolism and little insulation from body fat, causing a dangerously low
body temperature
• Stunted physical growth and development
• Deterioration of the intestinal lining, which further inhibits absorption of nutrients
• Iron deficiency anemia (abnormally low levels of hemoglobin in the blood)
• Severely weakened immune system
• Fluid and electrolyte imbalances
If marasmus is left untreated, death from dehydration, heart failure, or infection will result.
Kwashiorkor: PEM plus Infection

• Some weight loss and muscle wasting, with some retention of body fat
• Retarded growth and development; less severe than that seen with marasmus
• Edema, which results in extreme distention of the belly and is caused by fluid and
electrolyte imbalances
• Fatty degeneration of the liver contributing to a swollen belly
• Loss of appetite, sadness, irritability, apathy
• Development of sores and other skin problems; skin pigmentation changes
• Dry, brittle hair that changes colour, straightens, and falls out easily
Kwashiorkor can be reversed if adequate protein and energy are given in time and underlying
infections are effectively treated. Because of their severely weakened immune systems, many
individuals with kwashiorkor die from diseases they contract in their weakened state.
Page Ref: 209-211
Skill: Applied
6–23
14) Discuss the steps involved in protein synthesis and gene expression.
Answer: Gene expression is a term used to refer to the process of using a gene in a cell to make a
protein. A gene is a segment of DNA that serves as a template for the structure of a protein. As
proteins are manufactured at the site of ribosomes in the cytoplasm, and DNA never leaves the
nucleus, a special molecule is needed to copy, or transcribe, the information from DNA and carry
it to the ribosome. Messenger RNA (messenger ribonucleic acid, or mRNA), copies genetic
information from DNA in the nucleus and carries it to the ribosomes in the cytoplasm during
transcription. Once this genetic information is at the ribosome, translation occurs. This involves
the translation of the genetic information from the mRNA into a growing chain of amino acids
that are bonded together to make a specific protein.
Although the DNA for making every protein in the human body is contained within each cell
nucleus, not all genes are expressed and each cell does not make every type of protein. For
example, each cell contains the DNA to manufacture the hormone insulin. However, only the
cells of the pancreas express the insulin gene, so they are the only cells that can produce insulin.
Physiological needs alter gene expression, as do various nutrients.
Page Ref: 188-190
Skill: Applied
15) Describe the effect of a limiting amino acid on protein synthesis, using hemoglobin as an
example.
Answer: For protein synthesis to occur, all essential amino acids must be available to the cell. If
this is not the case, the amino acid that is missing or in the smallest supply is called the limiting
amino acid. Without the proper combination and quantity of essential amino acids, protein
synthesis slows to the point at which proteins cannot be generated. The protein hemoglobin
contains the essential amino acid histidine. If we do not consume enough histidine, it becomes
the limiting amino acid in hemoglobin production. As no other amino acid can be substituted,
our body becomes unable to make adequate hemoglobin, and we lose the ability to transport
oxygen to our cells. Our cells cannot function and will eventually die if they do not receive
adequate oxygen.
Page Ref: 192
Skill: Applied
6–24
16) The quality of dietary protein differs among various food sources. List and explain the
factors that influence protein quality.
Answer: Various factors influence protein quality. The amount of essential amino acids is one
factor in determining quality — the more essential amino acids a food contains, the more
proteins are available to the body. Foods with more essential amino acids are therefore
considered to have better-quality protein than foods with fewer essential amino acids. Another
aspect of protein quality is digestibility, or how completely the body can digest a protein and
absorb the amino acids. Proteins from eggs, fish, meat, dairy products, and other animal foods
are highly digestible, as are many soy products. The body can absorb more than 90% of these
proteins. Legumes are also highly digestible (80%) while grains and many vegetable proteins are
less digestible, ranging from 60% to 90%.
Page Ref: 192, 199
Skill: Applied
17) List and explain the three methods by which protein quality is measured.
Answer: The protein-digestibility-corrected amino acid score (PDCAAS) is a measurement of
protein quality that considers the balance of essential amino acids, as well as the digestibility of
the protein in the food. To calculate the PDCAAS, the amount of each essential amino acid is
first calculated in milligrams per gram of the protein. These amounts are then compared to the
amounts in a reference protein, which has been calculated from the amino acid requirements of a
preschool-aged child. The most limiting essential amino acid determines the protein's amino acid
score. The amino acid score is then multiplied by a digestibility factor based on fecal
digestibility measured in studies of rats. The maximum PDCAAS value allowed is 100%, the
value given to egg white protein and the milk protein casein. In comparison, the PDCAAS for
beef, soy, and wheat are 92, 91, and 42 respectively.
Other measures of protein quality include the protein efficiency ratio and net protein utilization.
The protein efficiency ratio assesses protein quality by comparing the weight gained by a
laboratory animal consuming a test protein with the weight gained by a laboratory animal
consuming an equivalent amount of a reference, or standardized, protein. Net protein utilization
is a process that compares the amount of nitrogen retained in the body with the amount of
nitrogen consumed in the diet. The more nitrogen we retain, the higher the quality of the protein
food source we have consumed.
These measures of protein quality are useful when determining the quality of protein available to
populations of people. However, these measures are not practical or useful for individual diet
planning.
Page Ref: 199
Skill: Factual
6–25
18) Discuss the different reasons why a person might choose to become a vegetarian.
Answer: The following are possible reasons why a person might choose to become a vegetarian:
Religious and Ethical Reasons

• Some make the choice for religious or spiritual reasons.
• Several religions prohibit or restrict the consumption of animal flesh.
• Many vegetarians are guided by their personal philosophy to choose vegetarianism—they
may feel it is morally and ethically wrong to consume animals and any products from
animals because they view the practices in the modern animal industries as inhumane.
Ecological Benefits
• Many people choose vegetarianism because of their concerns about the effect of meat
industries on the global environment.
• Due to the high demand for meat in developed nations, meat production has evolved from
small family farming operations into the larger system of agribusiness. Critics of
agribusiness are concerned with the environmental damages that agribusiness can cause.
When animals are raised on smaller farms and/or allowed to range freely, they consume
grass, crop wastes, and scraps recycled from the kitchen, which is an efficient means of
utilizing food sources that humans do not consume. The waste produced by these animals
can be used for fertilizer and fuel.
• Other concerns are related to the waste produced from livestock operations and
greenhouse gas emissions. Although much of the livestock waste is used as fertilizer,
some of it can run off and pollute neighbouring streams, rivers, and lakes.
• Internationally, it is believed that millions of acres of rain forests have been destroyed to
provide grazing land for livestock and that the loss of these rain forests has been a major
contributor to global warming.
Health Benefits
• Vegetarian diets often have less fat and total energy, which reduces the risk for obesity.
This may in turn lower a person's risk of type 2 diabetes.
• Lower blood pressure, which may be due to a higher intake of fruits and vegetables.
People who eat vegetarian diets tend to be nonsmokers, to drink little or no alcohol, and
to exercise more regularly, which are also factors known to reduce blood pressure and
help maintain a healthy body weight.
• Reduced risk of heart disease, which may be due to lower saturated fat intake and a
higher consumption of antioxidants that are found in plant-based foods. Antioxidants are
substances that can protect our cells from damage. They are abundant in fruits and
vegetables.
• Fewer digestive problems such as constipation and diverticular disease, most likely due
to the higher fibre content of vegetarian diets.
• Reduced risk of some cancers. Research shows that vegetarians may have lower rates of
cancer, particularly colon cancer. Many components of a vegetarian diet could contribute
to reducing cancer risks, including higher fibre and antioxidant intakes, lower dietary fat
intake, lower consumption of carcinogens (cancer-causing agents) that are formed when
cooking meat, and higher consumption of soy protein, which may have anticancer
properties.
6–26
• Reduced risk of kidney disease, kidney stones, and gallstones. The lower protein contents
of vegetarian diets, plus the higher intake of legumes and vegetable proteins such as soy,
may be protective against these conditions.
Page Ref: 206-208
Skill: Applied
19) What are the health benefits associated with consuming a vegetarian diet?
Answer: Health benefits include the following:
• Reduced intake of fat and total energy, which reduces the risk for obesity. This may in
turn lower a person's risk of type 2 diabetes.
• Lower blood pressure, which may be due to a higher intake of fruits and vegetables.
People who eat vegetarian diets tend to be nonsmokers, to drink little or no alcohol, and
to exercise more regularly, which are also factors known to reduce blood pressure and
help maintain a healthy body weight.
• Reduced risk of heart disease, which may be due to lower saturated fat intake and a
higher consumption of antioxidants that are found in plant-based foods. Antioxidants are
substances that can protect our cells from damage. They are abundant in fruits and
vegetables.
• Fewer digestive problems such as constipation and diverticular disease, most likely due
to the higher fibre content of vegetarian diets.
• Reduced risk of some cancers. Research shows that vegetarians may have lower rates of
cancer, particularly colon cancer. Many components of a vegetarian diet could contribute
to reducing cancer risks, including higher fibre and antioxidant intakes, lower dietary fat
intake, lower consumption of carcinogens (cancer-causing agents) that are formed when
cooking meat, and higher consumption of soy protein, which may have anticancer
properties.
• Reduced risk of kidney disease, kidney stones, and gallstones. The lower protein contents
of vegetarian diets, plus the higher intake of legumes and vegetable proteins such as soy,
may be protective against these conditions.
Page Ref: 207-208
Skill: Applied
20) Discuss whether a vegetarian diet can provide enough protein.

Answer: Since high-quality protein sources are quite easy to obtain in developed countries, a
well-balanced vegetarian diet can provide enough protein. In fact, Dietitians of Canada endorses
an appropriately planned vegetarian diet as healthful, nutritionally adequate, and providing many
benefits in reducing and preventing various diseases. The emphasis is on balanced and adequate
vegetarian diet; thus, it is important for vegetarians to consume soy products, eat complementary
proteins, and obtain enough energy from other macronutrients to spare protein from being used
as an energy source. Although the digestibility of a vegetarian diet is potentially lower than an
animal-based diet, there is no separate protein recommendation for vegetarians who consume
complementary plant proteins.
Page Ref: 208-209
Skill: Applied
6–27
21) What is nitrogen balance? Describe the laboratory procedure used to determine protein status
in individuals.
Answer: Nitrogen balance is a method used to determine a person's protein needs. Nitrogen is
excreted through the body's processes of recycling or using the proteins; thus, the balance can be
used to estimate whether protein intake is adequate to meet protein needs.
The nitrogen balance procedure involves measuring both nitrogen intake and nitrogen excretion
over a two-week period. A standardized diet, of which the nitrogen content has been measured
and recorded, is fed to the study participant. The laboratory technicians directly measure the
nitrogen content of the subject's urine and fecal samples and then the loss of nitrogen through
skin, hair, and body fluids, such as mucus and semen, is estimated. The estimated nitrogen loss is
then added to the nitrogen lost in the urine and feces. Nitrogen balance is calculated as the
difference between nitrogen intake and nitrogen excretion.
A positive nitrogen balance means that more protein is being ingested than excreted. This infers
that the ingested protein is being incorporated into the tissue rather than being excreted. This
occurs during periods of growth, pregnancy or recovering from illness or a protein deficiency. A
negative nitrogen balance means that more protein is being excreted than is being ingested so the
body is losing more protein than it is taking in. This happens when protein is being used for
energy such as when someone is starving or on a very-low-energy diet.
Page Ref: 200-201
Skill: Conceptual
22) Differentiate between the four different levels of protein structure.

Answer: The primary structure of a protein is the sequential order of the amino acids. The
particular sequence of amino acids determines the interaction between side chains. It is these
interactions that determine way the amino acid chain folds and, therefore, the secondary
structure. The stability of the secondary structure is achieved through the bonding of hydrogen
atoms or sulphur atoms, which creates a bridge between two protein strands or two parts of the
same strand of protein. The spiral of the secondary structure further folds into a unique three-
dimensional shape, referred to as the protein's tertiary structure; this structure is critically
important because it determines each protein's function in the body. Often, two or more separate
polypeptides bond to form an even larger protein with a quaternary structure, which may be
globular or fibrous.
Page Ref: 190-191
Skill: Conceptual
6–28
23) What process does protein have to go through in order for it to be used for fuel? Under what
conditions would this occur?
Answer: When there is not enough carbohydrate to fuel the production of ATP, the body must
use the carbon skeleton of an amino acid to produce energy. In order to do this the nitrogen
group must first be removed from the amino acid via a process called deamination. The nitrogen
binds with hydrogen to form ammonia which is quickly converted to urea. The urea is then
transported to the kidneys and eliminated in the urine. The remaining fragments of the amino
acid contain carbon, hydrogen and oxygen. The body uses these fragments to generate energy or
to build carbohydrates. Certain amino acids can be converted into glucose via gluconeogenesis.
We do not have stores of protein in the body like we do for the other macronutrients. To protect
the proteins in our body tissues, it is important to consume an adequate amount of carbohydrate
and fat to provide energy. We also need to consume enough dietary protein to perform the
required work without using up the proteins that are already playing an active role in our bodies.
Page Ref: 197
Skill: Conceptual
Nutrition Debate Questions
1) Discuss how you, as an individual, can be part of the solution to the environmental challenges
that large-scale cattle production has created.
Answer: The United Nations Food and Agriculture Organization (FAO) states that livestock
production generates 18% of the gases responsible for global warming. Livestock production is
also a major source of land degradation, using 30% of the earth's land surface for pasture or feed
production. In addition, the production of feed crops for livestock uses 33% of global arable
land. Animal waste, antibiotics, hormones and fertilizers and pesticides used on feed crops may
run off into streams, rivers and lakes and leach into nearby farms that produce crops for human
consumption.
By decreasing my weekly consumption of meat, particularly beef, the demand for livestock
production will decrease. This means that less land will need to be cleared, creating less potential
for run-off and land erosion issues. More trees will be left standing, thereby increasing oxygen
production and carbon dioxide consumption through photosynthesis. Additionally, a lower
production of greenhouse gases may help slow global warming. If people were to significantly
reduce their consumption of meat, it might be possible to return to small family farming, which
is more environmentally friendly.
Page Ref: 212
Topic: Nutrition Debate: Do Meat-Based Diets Contribute to Global Warming?
Skill: Conceptual
6–29
2) According to the United Nations Food and Agriculture Organization (FAO), which of the
following is/are responsible for 18% of the gases responsible for global warming?
A) factories
B) vehicles
C) livestock production
D) agriculture
Answer: C
Page Ref: 212
Topic: Nutrition Debate: Do Meat-Based Diets Contribute to Global Warming?
Skill: Factual
Questions from Chapter Boxes
1) Carlos is a healthy 19-year-old college student who is sedentary. He is 1.8 m (5'11") tall and
weighs 79.5 kg (175 pounds). How many grams of protein would you recommend he consume
each day?
A) 55 grams
B) 64 grams
C) 75 grams
D) 84 grams
Answer: B
Page Ref: 202
Skill: Applied
2) The majority of athletes can obtain an adequate amount of protein from eating a healthy diet.
Answer: TRUE
Page Ref: 200
Skill: Applied
3) Which of the following is NOT a reason athletes have higher dietary protein needs than
sedentary individuals?
A) During exercise more protein is needed to carry oxygen in the blood.
B) During exercise additional protein is needed to make glucose to prevent hypoglycemia.
C) During exercise additional protein is needed to repair the tissue damaged during exercise.
D) During exercise, protein is used as a primary source of energy.
Answer: D
Page Ref: 200
Skill: Conceptual
4) Bodybuilders and weight lifters need as much as 2 times more protein than the RDA.
Answer: TRUE
Page Ref: 200
Skill: Factual
6–30

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Nutrition A Functional Approach

Canadian 3rd Edition Thompson Test

1) What element makes protein different from carbohydrate and fat?

2) What dictates the structure of a protein molecule synthesized by the body?

3) Which of the following is NOT a component of an amino acid molecule?

6) In phenylketonuria (PKU), which amino acid becomes conditionally essential?

7) How many strings of amino acids does a polypeptide consist of?

12) Which of the following foods is a source of complete protein?

14) In what structure of the mammalian cell are proteins synthesized?

15) MOST of the proteins in the body are synthesized from

20) In the body, buffers are very important in

23) Proteases are

26) Significant chemical digestion of protein begins in the

34) The absorption of proteins occurs in the

35) An acid-base imbalance can result in

36) Which of the following statements is FALSE?

39) Which of the following is NOT associated with kwashiorkor?

40) Vegetarian diets are associated with increased consumption of

46) When a protein attracts or releases hydrogen, it acts as a

3) It is necessary to eat animal-based proteins to stay healthy.

5) A healthy pregnant woman is in positive nitrogen balance.

7) Protein-energy malnutrition is seen only in developing countries.

9) Denaturation results in the loss of the protein's function.

10) The majority of protein digestion occurs in the mouth.

14) All legumes are complete proteins.

15) Most Canadians consume sufficient or excess amounts of dietary protein.

24) Complementary proteins provide all twenty essential amino acids.

1) Describe how proteins differ from carbohydrates and lipids.

Nonessential Amino Acids

3) Define transamination. What is the product of transamination?

Common household examples of protein denaturation include:

5) Compare and contrast incomplete and complete proteins.

6) Define and provide an example of mutual supplementation.

The Process of Protein Digestion

8) List 5 roles of protein in the body.

High Protein Intake is Associated with High Cholesterol

Marasmus: Wasting and Stunting

Kwashiorkor: PEM plus Infection

Religious and Ethical Reasons

20) Discuss whether a vegetarian diet can provide enough protein.

22) Differentiate between the four different levels of protein structure.

Nutrition Debate Questions

Questions from Chapter Boxes

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