Choose the ONE best answer.
7.1. For the child shown at right, which of the statements would support a diagnosis of kwashiorkor? The child:
A. appears plump due to increased deposition of fat in adipose tissue.
B. displays abdominal and peripheral edema.
C. has a serum albumin level above normal.
D. has markedly decreased weight for height.
The correct answer = B. Kwashiorkor is caused by inadequate protein intake in the presence of fair to good energy (calorie) intake. Typical findings in a patient with kwashiorkor include abdominal and peripheral edema (note the swollen belly and legs) caused largely by a decreased serum albumin concentration. Body fat stores are depleted, but weight for height can be normal because of edema. Treatment includes a diet adequate in calories and protein.
7.2. Which one of the following statements concerning dietary fat is correct?
A. Coconut oil is rich in monounsaturated fats, and olive oil is rich in saturated fats.
B. Fatty acids containing trans double bonds, unlike the naturally occurring cis isomers, raise high-density lipoprotein cholesterol levels.
C. The polyunsaturated fatty acids linoleic and linolenic acids are required components.
D. Triacylglycerols obtained from plants generally contain less unsaturated fatty acids than do those from animals.
Correct answer = C. Humans are unable to make linoleic and linolenic fatty acids. Consequently, these fatty acids are essential in the diet. Coconut oil is rich in saturated fats, and olive oil is rich in monounsaturated fats. Trans fatty acids raise plasma levels of low-density lipoprotein cholesterol, not high-density lipoprotein cholesterol. Triacylglycerols obtained from plants generally contain more unsaturated fatty acids than do those from animals.
7.3. Given the information that a 70-kg man is consuming a daily average of 275 g of carbohydrate, 75 g of protein, and 65 g of fat, which one of the following conclusions can reasonably be drawn?
A. About 20% of calories are derived from fats.
B. The diet contains a sufficient amount of fiber.
C. The individual is in nitrogen balance.
D. The proportions of carbohydrate, protein, and fat in the diet conform to current recommendations.
E. The total energy intake per day is about 3,000 kcal.
Correct answer = D. The total energy intake is (275 g carbohydrate × 4 kcal/g) + (75 g protein × 4 kcal/g) + (65 g fat × 9 kcal/g) = 1,100 + 300 + 585 = 1,985 total kcal/day. The percentage of calories derived from carbohydrate is 1,100/1,985 = 55, from protein is 300/1,985 = 15, and from fat is 585/1,985 = 30. These are very close to current recommendations. The amount of fiber or nitrogen balance cannot be deduced from the data presented. If the protein is of low biologic value, a negative nitrogen balance is possible.
7.6. In chronic bronchitis, excessive mucus production causes airway obstruction that results in hypoxemia (low blood oxygen level), impaired expiration, and hypercapnia (carbon dioxide retention). Why might a high-fat, low-carbohydrate diet be recommended for a patient with chronic obstructive pulmonary disease caused by chronic bronchitis?
A. Fat contains more oxygen atoms relative to carbon or hydrogen atoms than do carbohydrates.
B. Fat is calorically less dense than carbohydrates.
C. Fat metabolism generates less carbon dioxide.