Adults

Question 1

What is the purpose of nutrition in adults?

Answer 1

• Maintenance and repair
• Avoid nutrient deficiencies (clinical and subclinical)
• ‘Optimise health’ (i.e. focus on disease risk reduction rather than simply meeting nutritional requirements)
• Minimise loss (older adults)

Question 2

At what serum level of vitamin D is there a risk to musculoskeletal health? Why can’t a number be suggested for other risks to health?

Answer 2

The evidence overall suggests that the risk of poor
musculoskeletal health is increased at serum 25(OH)D
concentrations < 25 nmol/L.
Evidence for the proposed benefits of vitamin D on nonmusculoskeletal health outcomes is drawn mainly from
observational studies so findings might be due to reverse
causality (isssue is after the cause)

Question 3

How many men are obese out of 10?

Answer 3

6

Question 4

How many women are obese in 10?

Answer 4

5

Question 5

What are some psychological issues associated with obesity?

Answer 5

Eating disorders, poor self-esteem, depression, poor body image, social isolation and stigmatisation.

Question 5

What are some psychological issues associated with obesity?

Answer 5

Eating disorders, poor self-esteem, depression, poor body image, social isolation and stigmatisation.

Question 6

Pulmonary issues associated with obessity?

Answer 6

Exercise intolerance (it’s an actual condition), obstructive sleep apnoea, asthma

Question 7

Gastrointestinal issues associated with obesity?

Answer 7

Gastro-oesophageal reflux (acid reflux/ GERD), gallstones, non-alcoholic fatty liver disorder.

Question 8

What are some renal(kidney) issues associated with obessity?

Answer 8

Glomerulosclerosis (scarring in the tiny blood vessels in the kidneys called the glomeruli)

Question 9

What are some musculoskeletal issues associated with obessity?

Answer 9

Ankle sprains, flat feet, forearm fracture, Tibia vara (also known as genu varus and bow-leggedness), slipped capital femoral epiphysis (hip disorder with the growth plate)

Question 10

What are the neurological issues associated with obesity?

Answer 10

pseudotumor cerebri/ idiopathic intracranial hypertension (pressure in the brain)

Question 11

Cardiovascular diseases associated with obesity?

Answer 11

hypertension, dyslipidemia is elevation of plasma cholesterol, triglycerides (TGs), or both, or a low high-density lipoprotein cholesterol level that contributes to the development of atherosclerosis, coagulopathy (impaired blood clotting), chronic inflamation, endothelial dysfunction.

Question 12

Endocrine disorders associated with obesity?

Answer 12

insulin resistance, impaired fasting glucose/ glucose intolerance, type 2 diabetes, precocious puberty (premature puberty), menstrual irregularities, polycystic ovary syndrome.

Question 13

What factors have convincing evidence that they decrease obesity?

Answer 13

High intake of NSP (non-starch polysaccharides which is dietary fibre) and regular physical activity.

Question 14

What factors have convincing evidence that they cause obesity?

Answer 14

sedentary life style, high intake of energy dense and micronutrient poor foods.

Question 15

What factors probably decrease obesity?

Answer 15

Home and school environments for children that support healthy eating. breastfeeding.

Question 16

What probably increases chances of obesity?

Answer 16

heavy marketing of energy dense food and fast food outlets, high intake of sugary soft drinks and fruit juices, adverse socioeconomic conditions (poor/ lower class) this is especially apparent in women in developed countries.

Question 17

Things you probably shouldn’t recommend to prevent obesity?

Answer 17

possible: low glycaemic index foods.
insufficient: increased eating frequency.

Question 18

What possibly has no influence on obesity?

Answer 18

protein content of diet.

Question 19

What cannot be said to be a cause of obesity?

Answer 19

Possibly: large food portions, high intake of food from outside the home (developed country), rigid restraint/ periodic disinhibition eating patterns.
Insufficient: alcohol

Question 20

Rates of d… is increasing?

Answer 20

Diabetes.

Question 21

What genetic factors put people at risk of type 2 diabetes?

Answer 21

People with a family history of diabetes and people with Asian/ African-Caribbean origin.

Question 22

What are factors that aren’t genetic which increase risk of type 2 diabetes?

Answer 22

People aged 40-75, people very overweight and women who have given birth to a large baby.

Question 23

There is convincing evidence that colon cancer can be reduced by what?

Answer 23

Physical activity.

Question 24

There is convincing evidence that what increases oesophagus, colorectum, breast (in postmenopausal women), endometrium(tissue that lines uterus) and kidney cancer?

Answer 24

overweight and obesity.

Question 25

There is convincing evidence that what increases risk of oral cavity (everywhere except back third of the togue), pharynx (throat), larynx (connects throat to the rest of of respiratory system), oesophagus, liver, breast cancer?

Answer 25

alcohol

Question 26

Aflatoxin has a convincing connection to what cancer?

Answer 26

Liver

Question 27

What has probable evidence that they decrease the chances of oral cavity, oesophagus, stomach and colorectum cancer?

Answer 27

Fruits and vegetables

Question 28

What probably reduces the chance of breast cancer?

Answer 28

Physical activity.

Question 29

What probably increases the chance nasopharynx cancer?

Answer 29

Chinese-style salted fish.

Question 30

What food probably increases the chances of colorectum cancer?

Answer 30

preserved meat.

Question 31

What foods probably increase the chance of stomach cancer?

Answer 31

Salt-preserved foods and salt.

Question 32

What foods probably increase the chance of oral cavity, pharynx and oesophagus cancer?

Answer 32

Very hot (thermally) drinks and foods

Question 33

What is premature menopause?

Answer 33

Reaching menopause before the age of 40.

Question 34

What causes menopause?

Answer 34

A change in the body’s sex hormones. Oestrogen levels decrease as a woman reaches
the menopause, which causes the ovaries to
stop producing an egg each month (ovulation).
Oestrogen is the female sex hormone that
regulates a woman’s periods.

Question 35

Changes that can occur in menopause?

Answer 35

Vasomotor instability (hot flushes), Metabolic Changes, Coronary Artery Disease, Accelerated bone loss, Skin changes, Urogenital atrophy (dry, inflamed thinning vagina)
• Cognition (?)
• Libido (?)

Question 36

What is osteoporosis?

Answer 36

A condition of fragility, with decreased bone
mass and microarchitectural deterioration
both contributing to the fragility. In females oestrogen plays an important role.

Question 37

What is type 1 osteoporosis?

Answer 37

Mainly trabecular bone loss: fractures wrist and
spine: age group 50-75: sex ratio 6F:1M
– Trabecular bone undergoes higher turnover rate
than cortical bone

Question 38

What is type 2 osteoporosis?

Answer 38

– Cortical and trabecular bone loss: fractures of

spine and hip:age group 70+: sex ratio 2F:1M

Question 39

What are the nutritional factors involved in osteoporosis part 1?

Answer 39

Protein malnutrition (low protein diets
linked to  IGF-I, loss of BMD and muscle
weakness)
• Low vitamin D (poor diet and  synthesis
in skin, decreased Ca absorption)
• Low K and fruit and vegetable intake
(alkaline producing dietary components
maintain BMD)
• Mg intake (Mg ↑ bone formation and
dynamic strength and ↓ bone resorption)
• Vitamin C (cofactor in the hydroxylation of
lysine and proline. Hydroxylation important
in the formation of cross-links in collagen)

Question 40

What are the nutritional factors involved in osteoporosis part 2?

Answer 40

High dietary Na intake (increased urinary
excretion of Na and Ca, PTH,  bone
loss)
• Vitamin K – low intake linked to  risk of
hip fracture; γ-carboxylation of osteocalcin;
inverse relationship between undercarboxylated osteocalcin and BMD
• Zn – appetite regulation
• Mn, Cu – enzyme co-factors for synthesis
and modification of bone-matrix proteins
• Phytoestrogens – interaction with the
estrogen receptor, have demonstrated
small protective effects