DH 209 Midterm Review

As adults age their caloric intake should decrease because:

basal metabolic rate (BMR) decreases as well

The Guidelines that offer nutrient adequacy for groups of a population rather than individuals are:

estimated average requirements (EAR)

What do both milk and unsweetened juices contain:

naturally occurring sugar (lactose and fructose)

Name the macronutrients:

carbohydrates, protein, fat, alcohol, water

Which of the 5 macronutrients is the most important to the human body?

water

Vitamins and minerals are known as:

micronutrients (provide no energy-kcal)

Of the 20 amino acids, how many are indispensible (essential) and what does that mean?

•9 are indispensable (essential) which means they must be obtained in the diet.

•11 are dispensable (non-essential) which means our body can produce them from the indispensable amino acids

A substance that is obtained from food and promotes growth, maintenance, and repair is a:

nutrient

The breakdown of starches in the oral cavity begins with what enzyme?

salivary amylase

The accessory organs provide essential secretions for digestion and absorption. List the 4 accessory organs:

salivary glands, liver, gallbladder, pancreas

The 2 basic types of action on food during the digestion process are:

•Mechanical

–Chewing

–Peristalsis

•Chemical

–Salivary enzymes

–Digestive juices

The sphincter that is located at the base of the esophagus that relaxes and allows food to move into the stomach is the:

lower esophageal sphincter

What nutrients are absorbed from the large intestines?

water, alcohol, a few amino acids

The majority of our nutrients are absorbed here:

small intestine

Nutrients are transported from the GI tract through which vein to the liver?

portal vein

The liver is responsible for the production of bile. What organ stores the bile until its' release?

gallbladder

For most adults the time it takes for food to travel the entire length of the gut is:

16-24 hours

How long does our food remain in the stomach during the digestive process?

3-4 hours

Proteases, amylases, and lipases are responsible for the digestion of dietary proteins, carbohydrates, and fats. They are known as:

enzymes

The 3 classifications of carbohydrates are:

monosaccharides, disaccharides, polysaccharides

The Kreb's cycle is the aerobic oxidation of glucose which produces the following:

carbon dioxide, water, and ATP

The loss of smell is known as:

anosmia

The sense of taste is:

gustatory

The result of acids produced by fermentable carbohydrates combining with acidogenic bacteria on the dentition is:

demineralization

Name the food group from MyPlate that contains the least amount of carbohydrates:

meat, poultry, fish, eggs, and nuts

As the frequency of fermentable carbohydrates increases, the pH of plaque decreases. For a fermentable carbohydrate to be deemed cariogenic it must cause the salivary pH to drop below:

pH of 5.5 or below

Many of the sugar alcohols used for artificial sweetening can result in GI upset. The sugar alcohol most likely to have this effect is:

sorbitol

Adequate fiber intake for men and women:

men: 38 g/daily

women: 25 g/daily

What effect does a high-fiber diet have on the caries potential?

Increasing whole grain (fiber) consumption can have a positive effect on caries because a diet high in fiber decreases the potential for acidic pH changes

Periodontal disease can increase the need for which macronutrient in order to promote healing:

protein

If a patient is on a strict no-carb diet to lose weight, which nutrients and minerals would most likely become insufficient?

iron, fiber, and B vitamins

The type of vegetarian that is most at risk for nutrient deficiencies is:

vegan

If a patient is only eating low-quality protein their body may support life, but may not exhibit normal:

growth

The substance that is most supportive of bones and teeth is:

collagen

For a patient that dislikes eating meat, what other sources of protein could the RDH recommend?

milk

The physiologic role of protein is:

•Resistance to disease

•Regulation of fluid balance

•Repair of tissue

•Rebuild

•Can be used for energy, but is not the preferred source

How many kcal/gm does a carbohydrate contain?

4 kcal/gm

How many kcal/gm does fat contain?

9 kcal/gm

Hormones are messengers that control ______________ functions.

metabolic (affect growth/secretions)

The energy required for involuntary physiological functions to maintain life is known as:

basal metabolic rate (BMR)

The hunger center that is located in the center of the brain is known as the:

hypothalamus (controls hunger/satiety)

Name the type of Diabetes that requires that the patient use insulin daily?

type I

What type of diabetes is seen in 90-95% of Americans that have diabetes?

type II

Name the fat-soluble vitamins:

A, D, E, K

One main difference between the fat-soluble vitamins and water-soluble vitamins is:

Fat-soluble vitamins are stored in the body and can create toxicity if supplementation is over used

Vitamins A, E, K, and C are all known as antioxidants. What does an antioxidant do?

Prevents or delays the damaging effects of a reactive substance (free radicals)

Calcitonin is secreted by the thyroid gland, parathyroid gland, and thymus tissue. Calcitonin helps to regulate mineralization of bones and teeth. Without adequate amounts of vitamin_________ calcitonin is unable to regulate blood calcium and phosphorus levels.

vitamin D

What is xeropthalmia:

dry eyes; decreased tear production

Vitamin K is found in green leafy vegetables, meat, and dairy products. Vitamin K can also be produced by:

The bacterial flora & microflora in the gut (E-coli)

Vitamin D deficiency in adults is called

osteomalacia

Rickets is caused by:

Vitamin D deficiency in children (1-3 years old)-Deformities such as knock-kneed, bow-legs, or pigeon chest can occur

Which fat-soluble vitamin helps the body absorb and regulate calcium? This vitamin is also classified as a hormone.

vitamin D

This fat-soluble vitamin acts as a coagulant (blood clotting) and is often given to newborn babies at birth:

vitamin K

This fat-soluble vitamin functions as an anticoagulant (blood thinner):

vitamin E

Inadequate amounts of which fat-soluble vitamin can result in night blindness?

vitamin A

The mathematical equation that is used to determine a patients weight status and predict their health risks based on their height and weight is:

body mass index (BMI)

To maintain a healthy weight adult women should consume 1600-2400 kilocalories/day and men should consume ______________.

2000-3000 kcal/day

To maintain a healthy balanced diet, we should recommend:

variety of foods

These guidelines specifically address individuals whose requirements are not affected by a diseased state (have replaced the RDA’s):

daily recommended intake (DRI)

The average amount of a nutrient that seems to maintain a defined nutritional state is known as:

adequate intake (AI)

The daily reference values for the macronutrients are:

•Protein: 10-35%

•Carbohydrates: 45-65%

•Total Fat: 20-35% (30% or less is goal)

•Saturated Fat: <10% of total fat

•Fiber: 25-38 grams/day

•Water: minimum intake 2 cups/day; optimal intake ½ cup per 100 calories

Acceptable ranges for blood lipids:

–Triglycerides: <150 mg/dL

–Total Cholesterol: <200 mg/dL

–HDL’s: >60 mg/dL

–LDL’s: <100 mg/dL

Name some of "Life's Simple 7" health and behavior modifications that can impact health and quality of life:

Do not smoke

•Maintain healthy weight

•Engage in regular physical activity

•Manage BP•Eat healthy

•Take charge of cholesterol

•Keep blood sugar (glucose) at healthy levels

BMI should be less than _______ in order to fall within the "healthy" range.

25

•Over 25 is considered overweight

•BMI of 30+ is considered obese

While BMI is generally a fair way to analyze a person's weight to height ratio, there are some individuals that this is not an appropriate for:

•Pregnant/breastfeeding women

•Infants/children under 2 years of age

•Athletes' w/ a large % of muscle

Saturated fats should be replaced with:

monounsaturated fats (MUFA's) and polyunsaturated fats (PUFA's)

What does nutrient-dense mean?

foods provide substantial amounts of vitamins and minerals and relatively low kilocalories

How many grams of sugar are found in 1 level teaspoon of sugar?

4 grams

When reading food labels, how are ingredients listed?

Ingredients are listed on food labels in order of quantity (by weight)

For patients that are lactose intolerant it is not advisable to cut out all lactose due to the inadequate intake of calcium this can cause. What are some recommendations the RDH can make for these patients?

Milk is tolerated best when taken w/ a meal and in small 8 oz servings

•Whole milk is better tolerated than skim milk

•Fermented dairy products: yogurt, buttermilk, aged cheese, and sour cream (contain lactase rather than lactose due to fermentation)

•Lactaid can be taken before ingestion of lactose and it's activity lasts for approx. 45 min

When calcium, phosphate and other minerals are lost from tooth enamel, what results:

demineralization

For a patient suffering from xerostomia (dry mouth), what sugar alcohol could be suggested by the RDH?

Xylitol (thought to be anticariogenic)

What type of fiber decreases transit time:

Viscous fiber (soluble)- have gel-forming abilities.

–Pectins, gums, psyllium, etc.

The best source of dietary fiber to relieve constipation:

bran- insoluble (best to initiate slowly to avoid severe gas and bloating)

Dietary fiber and functional fiber do what to transit time?

accelerate transit time (relief of constipation)

How often does the American Heart Association (AHA) recommend that individuals (over 20 years old) have a fasting lipoprotein panel done?

every 5 years

What is an undesirable side effect that can accompany the use of fat replacers?

GI distress (diarrhea)

What are the desirable blood glucose levels:

Normal range: 70-100 mg/dL

•30-60 minutes after a meal- 140 mg/dL

–Hyperglycemia- elevated blood glucose

–Hypoglycemia- decreased blood glucose levels

The consumption of the following will increase body weight the most:

kilocalorie intake

Name the macronutrients that supply physiologic energy (calories) for the body:

•Carbs (4 kcal/gram)

•Protein (4 kcal/gram)

•Alcohol (7 kcal/gram)

•Fat (9 kcal/gram)

If our intake of kcal is in excess of our output, these excess kcal will be stored as the following:

adipose tissue

The process of restoring vitamins and minerals that are removed from foods during processing is known as:

enrichment

The stored form of glucose is known as __________ which is stored in the liver.

glycogen

Alcohol, along with many drugs, is metabolized in what organ:

liver

Sugar substitutes can reduce the energy (caloric) content of many foods which can also decrease the carcinogenicity as well. The main draw back of sugar alcohols can be:

GI distress (especially sorbitol)

The physiological drive to eat is known as:

hunger

Which non-nutritive sweetener should not be recommended to patients that have phenylketonuria:

aspartame (nutrisweet)

The hormone that is secreted by the thyroid and has a significant impact on our metabolism is:

thyroxin

For individuals with diabetes, blood glucose levels before a meal should be less than 130 mg/dL; Blood glucose levels that are below 70 mg/dL would be considered:

hypoglycemic

The only sugar that is transported through the bloodstream is:

glucose (our body's preferred source of energy- it can nourish all cells of the body)

Name the parts of the alimentary canal:

•Oral cavity

•Pharynx

•Esophagus

•Stomach

•Small intestine (duodenum, jejunum, ileum)

•Large intestine (cecum, colon, rectum)

•Rectum

•Anus

The doorlike mechanisms that prevent food from backing up in the GI tract and then allow the food to pass to the next segment are known as:

valves or sphincters

State the characteristic manifestations of necrotizing ulcerative gingivitis:

•Metallic taste

•Foul (fetid) odor

•Gingival erythema

•Necrosis of interdental papilla

•Pseudomembrane

•Pain

What are the functions of saliva:

•Buffers bacterial acids

•Can provide a source of calcium and phosphate that can aid in remineralization

•Lubrication

•Antibacterial action

What is the cause of demineralization:

acids (produced by fermentable carbs) combine with acidogenic bacteria causing a loss of calcium and phosphate in tooth enamel

The progressive loss of muscle mass and strength that occurs as we age is known as:

sarcopenia

Would it be a good idea for a patient that suffer from liver or kidney disease to consume a diet high in protein? Why?

No, if these organs are not functioning at a healthy level high protein diets would be very taxing on them as this is where protein is filtered and broken down

Mastication helps to maintain the balance between bone breakdown and:

new bone formation (lack of function leads to resorption of the alveolar ridge)

Saturated fatty acids are composed of what kind of bond?

single hydrogen bonds (saturated fats contain the most hydrogen as well)

•solid at room temp (animal fat)

Does a patient with full dentures ever regain their masticatory efficiency?

No (it is usually around 40% of what a patient had w/ natural teeth)