BHS Nutrition and Dietetics 4 — Questions and Answers
Question 1: A 65-year-old patient with chronic kidney disease stage 3 should be counseled to restrict which nutrient to slow disease progression?
- Carbohydrate
- Dietary protein (Correct answer)
- Monounsaturated fat
- Soluble fiber
Correct answer: Dietary protein
Moderate protein restriction (0.6–0.8 g/kg/day) reduces glomerular hyperfiltration and slows CKD progression before dialysis.
Question 2: Which vitamin functions as a prohormone and regulates calcium absorption in the small intestine?
- Vitamin A
- Vitamin D (Correct answer)
- Vitamin E
- Vitamin K
Correct answer: Vitamin D
Vitamin D (calcitriol, the active form) stimulates synthesis of calbindin in enterocytes, enhancing calcium absorption.
Question 3: The glycemic index (GI) of a food is measured relative to which reference food assigned a GI of 100?
- White rice
- White bread or glucose (Correct answer)
- Whole wheat bread
- Sucrose
Correct answer: White bread or glucose
GI is standardly measured relative to pure glucose (GI = 100), though some researchers use white bread as the reference.
Question 4: Homocysteine levels in the blood are lowered by adequate intake of which combination of vitamins?
- Vitamins A, C, and E
- Vitamins B6, B12, and folate (Correct answer)
- Vitamins D, K, and B1
- Niacin, riboflavin, and pantothenic acid
Correct answer: Vitamins B6, B12, and folate
B6, B12, and folate are cofactors in the remethylation and transsulfuration pathways that clear homocysteine from the blood.
Question 5: Which type of dietary fiber has been most strongly associated with reducing LDL cholesterol by binding bile acids in the gut?
- Insoluble cellulose
- Soluble viscous fiber (e.g., beta-glucan, pectin) (Correct answer)
- Resistant starch
- Lignin
Correct answer: Soluble viscous fiber (e.g., beta-glucan, pectin)
Soluble viscous fibers like oat beta-glucan and pectin bind bile acids in the intestinal lumen, increasing fecal sterol excretion and lowering LDL.
Question 6: A breastfeeding woman in the US is advised to continue taking prenatal vitamins primarily to maintain adequate intake of which nutrient for infant neurodevelopment?
- Calcium
- Iron
- Iodine (Correct answer)
- Zinc
Correct answer: Iodine
Iodine is critical for thyroid hormone production and infant brain development; breast milk iodine depends directly on maternal intake.
Question 7: In the context of weight management, which term describes the energy cost of digesting, absorbing, and metabolizing food, accounting for approximately 10% of total energy expenditure?
- Basal metabolic rate
- Adaptive thermogenesis
- Thermic effect of food (Correct answer)
- Non-exercise activity thermogenesis
Correct answer: Thermic effect of food
The thermic effect of food (diet-induced thermogenesis) represents the metabolic energy used for digestion and nutrient processing, roughly 10% of TEE.
BHS Nutrition and Dietetics 4
A 65-year-old patient with chronic kidney disease stage 3 should be counseled to restrict which nutrient to slow disease progression?