Clinical Nutritionist CCN Therapeutic Nutrition and Disease Management 1 — Questions and Answers
Question 1: Which dietary intervention is first-line therapy for managing non-alcoholic fatty liver disease (NAFLD)?
- 5-10% body weight reduction through caloric restriction and increased physical activity (Correct answer)
- High-protein, low-fat diet with vitamin E supplementation
- Mediterranean diet with omega-3 supplementation only
- Ketogenic diet with intermittent fasting
Correct answer: 5-10% body weight reduction through caloric restriction and increased physical activity
A 5-10% reduction in body weight through lifestyle modification is the most effective intervention for improving liver histology, reducing hepatic steatosis, and decreasing inflammation in NAFLD.
Question 2: In chronic kidney disease (CKD) stages 3-5 (non-dialysis), what is the recommended dietary protein intake?
- 0.6-0.8 g/kg body weight per day (Correct answer)
- 1.2-1.5 g/kg body weight per day
- 2.0 g/kg body weight per day
- 0.3 g/kg body weight per day
Correct answer: 0.6-0.8 g/kg body weight per day
Low-protein diets (0.6-0.8 g/kg/day) are recommended for non-dialysis CKD to reduce nitrogen waste accumulation, decrease uremic toxin burden, and slow disease progression.
Question 3: The DASH diet, designed to lower blood pressure, emphasizes which dietary pattern?
- High fruits, vegetables, low-fat dairy, whole grains, lean protein; low sodium, saturated fat, red meat (Correct answer)
- High protein, low carbohydrate, moderate fat intake
- Mediterranean-style with high olive oil and red wine
- Vegetarian diet with elimination of all animal products
Correct answer: High fruits, vegetables, low-fat dairy, whole grains, lean protein; low sodium, saturated fat, red meat
DASH (Dietary Approaches to Stop Hypertension) emphasizes potassium, magnesium, and calcium-rich foods while limiting sodium to 1,500-2,300 mg/day, reducing systolic BP by 8-14 mmHg.
Question 4: Which nutritional intervention is most effective for reducing LDL cholesterol in hyperlipidemia?
- Replacing saturated fats with unsaturated fats and increasing soluble fiber (Correct answer)
- Eliminating all dietary cholesterol
- Increasing omega-3 fatty acid intake alone
- Low-calorie diet regardless of fat type
Correct answer: Replacing saturated fats with unsaturated fats and increasing soluble fiber
Replacing saturated fatty acids with polyunsaturated fats and adding soluble fiber (psyllium, beta-glucan) are the two dietary changes with strongest evidence for LDL reduction.
Question 5: In type 2 diabetes management, what is the glycemic index (GI), and how is it used clinically?
- A ranking of carbohydrate foods based on their effect on blood glucose compared to pure glucose (GI=100) (Correct answer)
- A measure of total carbohydrate content per serving of food
- A score based on insulin response to protein and fat intake
- An index measuring speed of gastric emptying
Correct answer: A ranking of carbohydrate foods based on their effect on blood glucose compared to pure glucose (GI=100)
GI ranks foods on a 0-100 scale based on their postprandial blood glucose response relative to glucose; choosing low-GI foods can improve glycemic control in diabetes.
Question 6: For a patient with heart failure, which dietary restriction is critical to prevent fluid overload?
- Sodium restriction to 2,000 mg/day or less (Correct answer)
- Protein restriction to 0.5 g/kg/day
- Potassium restriction to 1,000 mg/day
- Total fluid restriction to 500 mL/day
Correct answer: Sodium restriction to 2,000 mg/day or less
Sodium restriction to ≤2,000 mg/day reduces fluid retention, decreasing preload and limiting exacerbations of heart failure symptoms such as edema and dyspnea.
