CDCES CDCES Nutrition and Meal Planning 2 — Questions and Answers
Question 1: What is the glycemic index (GI)?
- The amount of carbohydrate in a food per gram
- A ranking of foods based on their effect on blood glucose compared to a reference food (Correct answer)
- The percentage of calories from carbohydrate in a food
- A measure of insulin secretion required for a food
Correct answer: A ranking of foods based on their effect on blood glucose compared to a reference food
The glycemic index ranks foods on a scale of 0–100 based on how much they raise blood glucose compared to pure glucose or white bread as a reference.
Question 2: A patient with diabetes and chronic kidney disease stage 3 asks about protein intake. Which recommendation is most appropriate?
- Increase protein to 2.0 g/kg/day
- Maintain protein at 0.8 g/kg/day to avoid worsening kidney function (Correct answer)
- Restrict protein below 0.6 g/kg/day
- Protein intake has no impact on kidney disease progression
Correct answer: Maintain protein at 0.8 g/kg/day to avoid worsening kidney function
For people with diabetes and CKD not on dialysis, the ADA recommends maintaining protein intake at approximately 0.8 g/kg/day to avoid accelerating kidney decline.
Question 3: Which nutrient, when reduced, most directly lowers LDL cholesterol in patients with diabetes and dyslipidemia?
- Monounsaturated fat
- Dietary cholesterol
- Saturated fat (Correct answer)
- Omega-3 fatty acids
Correct answer: Saturated fat
Reducing saturated fat intake is the primary dietary strategy for lowering LDL cholesterol in people with diabetes and dyslipidemia.
Question 4: When teaching carbohydrate counting to a patient on a basal-bolus insulin regimen, what is the purpose of an insulin-to-carbohydrate ratio (ICR)?
- To calculate how much carbohydrate to eat at each meal
- To determine how many units of bolus insulin to take per gram of carbohydrate consumed (Correct answer)
- To set the basal insulin dose for overnight glucose control
- To predict hypoglycemia risk after exercise
Correct answer: To determine how many units of bolus insulin to take per gram of carbohydrate consumed
The insulin-to-carbohydrate ratio tells the patient how many units of rapid-acting insulin to administer for each gram (or 15 g) of carbohydrate eaten.
Question 5: Which type of dietary fat is associated with improved insulin sensitivity and reduced cardiovascular risk in diabetes?
- Saturated fat
- Trans fat
- Monounsaturated and polyunsaturated fat (Correct answer)
- Partially hydrogenated oil
Correct answer: Monounsaturated and polyunsaturated fat
Replacing saturated and trans fats with monounsaturated and polyunsaturated fats is associated with improved insulin sensitivity and cardiovascular outcomes.
Question 6: A patient with type 1 diabetes asks whether they need to count carbohydrates in vegetables. What is the best response?
- All vegetables must be counted because any carbohydrate affects glucose
- Non-starchy vegetables are very low in carbohydrate and generally do not need to be counted (Correct answer)
- Vegetables never contain carbohydrate and can always be ignored
- Only raw vegetables need to be counted
Correct answer: Non-starchy vegetables are very low in carbohydrate and generally do not need to be counted
Non-starchy vegetables (e.g., broccoli, spinach, peppers) are very low in carbohydrate and generally do not require carbohydrate counting for most meal plans.
CDCES CDCES Nutrition and Meal Planning 2
What is the glycemic index (GI)?