A person with high blood levels of hepcidin responds by
a. decreasing iron absorption.
b. increasing iron absorption.
c. decreasing zinc absorption.
d. increasing zinc absorption
What is hepcidin?
a. A factor in meats that enhances iron absorption
b. An intestinal mucosa protein that assists in iron turnover
c. A substance in legumes that interferes with iron absorption
d. A liver-derived hormone that helps regulate iron absorption and transport
Which of the following is a characteristic of iron utilization?
a. Most of the body's iron is recycled
b. The chief storage site for iron is the intestinal epithelium
c. Iron is absorbed better from supplements than from foods
d. Iron from nonheme food sources is absorbed better than that from heme food sources
What is the average lifespan of red blood cells?
a. Two weeks
b. One month
c. Four months
d. Six months
Approximately how many people worldwide are thought to be affected by iron-deficiency anemia?
a. 1 million
b. 100 million
c. 1.6 billion
d. 3.5 billion
About how much iron is absorbed from a vegetarian diet compared with an omnivorous diet?
a. The same
b. One-half as much
c. Twice as much
d. Three times as much
What is the chief function of hemosiderin?
a. Stores excess body iron
b. Inhibits hemoglobin synthesis
c. Enhances heme iron absorption
d. Enhances nonheme iron absorption
Approximately how much iron is lost daily by adults from urine, sweat, and shed skin?
a. 1 mg
b. 5 mg
c. 12 mg
d. 18 mg
All of the following are known to reduce the absorption of iron except
b. MFP factor.
c. soybean protein.
d. tannic acid in tea
Which of the following population groups is least susceptible to iron-deficiency anemia?
a. Older infants
b. Children 2-10 years of age
c. Women of childbearing age
d. Men 20-45 years of age
Which of the following is found in the first stage of iron deficiency?
a. Iron stores decline, as assessed by serum ferritin
b. Hemoglobin levels fall, as assessed by complete blood count
c. Red blood cell count falls, as assessed by hematocrit count
d. Hemoglobin synthesis declines, as assessed by erythrocyte protoporphyrin
Which of the following represents the order of the stages of iron deficiency?
a. Iron stores decline - iron transport diminishes - hemoglobin synthesis falls
b. Hemoglobin synthesis falls - iron transport diminishes - iron stores decline
c. Iron transport diminishes - hemoglobin synthesis falls - iron stores decline
d. Iron transport diminishes - iron stores decline - hemoglobin synthesis falls
What is the major cause of iron deficiency?
a. Blood loss
b. Poor nutrition
c. Hereditary defect
d. Parasitic infections of the GI tract
Iron deficiency in children is likely to result from a diet that overemphasizes
d. dried beans
Taking into account the efficiency of intestinal absorption of iron, approximately how much dietary iron must be consumed to account for the iron lost by donating a pint of blood?
a. 5 mg
b. 15 mg
c. 50 mg
d. 100 mg
Which of the following individuals would most likely not need an iron supplement?
b. Elderly female
c. Pregnant female
d. Adolescent female
What is erythrocyte protoporphyrin?
a. Iron chelating drug
b. Hemoglobin precursor
c. Indicator of iron toxicity
d. Inherited iron-deficiency disease
The erythrocyte protoporphyrin level is used as an indicator of
a. late iron toxicity.
b. early iron toxicity.
c. late iron deficiency.
d. early iron deficiency.
The most common tests to diagnose iron deficiency include all of the following measures except
a. size of red blood cells.
b. number of red blood cells.
c. DNA content of red blood cells.
d. hemoglobin content of red blood cells.
What type of anemia results from iron deficiency?
c. Microcytic hypochromic
d. Macrocytic hyperchromic
Low levels of blood hemoglobin most likely indicate a deficiency of
Which of the following symptoms would ordinarily not be found in individuals with iron-deficiency anemia?
c. Concave nails
d. Diminished sense of smell
Why are hemoglobin and hematocrit tests of limited usefulness in the assessment of iron status?
a. They are expensive to perform
b. They are notoriously inaccurate
c. They are late indicators of iron deficiency
d. The range of normal value is usually wide
Which of the following is a characteristic of iron deficiency?
a. Blood erythrocyte protoporphyrin levels decline as anemia worsens
b. Iron supplements are not as effective at treating anemia as is proper nutrition
c. People with anemia generally become fatigued only when they exert themselves
d. The concave nails of iron-deficiency anemia result from abnormal ferritin levels
Which of the following is a characteristic of iron deficiency and behavior?
a. Erythrocyte iron levels fall before mental alertness is affected
b. Moderate iron deficiency promotes constipation and hyperactivity
c. Mild iron deficiency impairs energy metabolism and neurotransmitter synthesis
d. Iron deficiency increases risk for infections that promote dysfunctional behavior
Which of the following is descriptive of iron deficiency and behavior?
a. The practice of pica may enhance iron absorption
b. Changes in behavior precede the appearance of anemia
c. The practice of pica may delay the onset of iron-induced behavioral changes
d. Adults are more resistant to iron-induced behavioral changes than children
Iron overload is also known as
What is the name given to the ingestion of nonnutritive substances?
Common terms that describe the body's accumulation of excess iron include all of the following except
a. iron overload.
Which of the following foods should be especially limited in the diet of individuals with hemochromatosis?
a. Dairy products
b. Fluoridated water
c. Iron-fortified cereals
d. Carbonated beverages
Why are people with iron overload at increased risk for infections?
a. Excess tissue iron destroys vitamin C
b. Iron-rich blood favors growth of bacteria
c. Iron-rich blood impairs the immune system
d. Excess tissue iron interferes with antibiotic function
Which of the following is a feature of the disorder hereditary hemochromatosis?
a. It is characterized by acrodermatitis
b. It is found primarily in women of child-bearing age
c. It is associated with defects of copper and zinc absorption
d. It is the most common genetic disorder in the United States
Which of the following disorders may be linked with the presence of high blood iron?
c. Heart disease
d. Neural tube defects
Which of the following describes one aspect of iron toxicity?
a. Among men in the United States, it is twice as common as iron-deficiency anemia
b. In adults, the consumption of alcohol is somewhat protective against absorption of excess iron
c. In most people with this disorder, infections are rare because bacteria are killed by excess iron in the blood
d. It is usually caused by a virus that attacks the intestinal mucosal cells leading to unregulated and excessive iron absorption
The most common cause of iron overload is
a. an injury to the GI tract.
b. a genetic predisposition.
c. excessive use of iron cookware.
d. excessive use of iron supplements
What population group is at the highest risk for iron overload?
a. Adult men
b. Adult women
c. Pregnant women
For every 10 adult males with iron deficiency, how many have iron overload?
Signs of iron toxicity include all of the following except
c. hypochromic anemia.
d. increases in infections
Approximately how much iron would be provided by a balanced diet supplying 2000 kcalories?
a. 3 mg
b. 6 mg
c. 12 mg
d. 30 mg
When eaten in the same meal, which of the following foods enhances the absorption of iron in legumes?
d. Whole-grain breads
Approximately how much higher is the RDA for iron for a vegetarian woman of childbearing age compared with her nonvegetarian counterpart?
Which of the following is the most effective and least costly strategy for preventing an iron deficiency?
a. Consume iron supplements at a level 2-3 times the RDA
b. Switch to iron cooking utensils and eat 4 servings of red meat daily
c. Eat small amounts of citrus products and increase intake of low-fat milk
d. Eat small quantities of meat, fish, and poultry frequently together with liberal amounts of vegetables and legumes
Which of the following is a feature of iron nutrition?
a. Iron plays an important role in the synthesis of thyroxine
b. On average, people absorb about 50-60% of dietary iron
c. On average, women do not eat enough iron-containing foods
d. Iron deficiency represents the second most common mineral deficiency in the United States
Which of the following foods provides the greatest amount of iron per serving?
b. Skim milk
c. Pinto beans
d. American cheese
A child diagnosed with iron-deficiency anemia would most likely benefit from increasing the consumption of
b. red meat.
c. fresh fruits.
d. yellow vegetables
In the United States, iron is currently added to which of the following foods?
a. Milk and cheese
b. Breads and cereals
c. Peanut butter and jellies
d. Orange juice and tomato juice
If a normal, healthy young adult woman loses an average of 2 mg/day of iron from the body, approximately what minimum amount (mg/day) should she consume from the diet to prevent negative iron balance?
Which of the following would represent a source of possible iron contamination?
a. An iron frypan
b. An iron chelate
c. A ferric iron supplement
d. A ferrous iron supplement
Which of the following is a common example of iron contamination in the diet?
a. Using an iron skillet to scramble eggs can triple their iron content
b. Cooking acidic foods in a copper pot can extract chelate iron from the pot
c. Simmering acidic foods in glass dishes leads to leaching of iron salts from the glass
d. Cooking leafy vegetables in a galvanized pot leads to a six-fold increase in iron content
Which of the following has been shown to improve absorption of iron from iron supplements?
a. Taking then with milk
b. Taking them with orange juice
c. Taking them on an empty stomach rather than with meals
d. Taking them in the form of the ferric salt rather than the ferrous salt
Why is taking vitamin C ineffective at enhancing iron absorption from standard iron supplements?
a. The iron in the supplement is in a chelated form
b. The iron in the supplement is already in the ferrous form
c. The iron in the supplement binds irreversibly with vitamin C
d. The iron supplement already contains MFP to enhance absorption
Which of the following is a common side effect from taking iron supplements?
d. Black tongue
An enzyme in which zinc or copper is an integral part of its structure is classified as a(n)
Which of the following defines an association between a protein and a function of zinc?
a. Thyroxine: zinc transporter
b. Globulin: transports zinc into cells
c. Transferrin: essential to zinc excretion
d. Metallothionein: promotes zinc homeostasis
Which of the following is a major binding protein for zinc?
Which of the following is a feature of zinc in nutrition?
a. Pancreatic enzymes are rich in zinc
b. The body's primary excretory route is urine
c. Good food sources are whole-grain products
d. Toxicity symptoms include constipation and low body temperature
Which of the following is known to regulate the absorption of zinc?
a. Metallothionein in the intestinal cells
b. Zinc-releasing enzymes in the intestinal mucosa
c. Pancreatic juice containing zinc-absorption enhancers
d. Bile acids which form a complex with zinc to promote its absorption
Which of the following minerals undergoes enteropancreatic circulation during normal metabolism?
Zinc is known to play an important role in all of the following functions except
a. wound healing.
b. synthesis of retinal.
c. production of sperm.
d. oxidation of polyunsaturated fatty acids.
What is the chief transport substance for zinc in the circulation?
c. Carbonic anhydrase
d. High-density lipoproteins
What dietary ratio of iron to zinc inhibits zinc absorption?
a. 0.5 to 1
b. 1 to 1
c. Less than 2 to 1
d. Greater than 2 to 1
Which of the following would be the minimum amount of dietary iron known to impair zinc absorption in an individual with a zinc intake of 15 mg?
a. 5 mg
b. 15 mg
c. 30 mg
d. 60 mg
Which of the following conditions is known to lead to copper deficiency?
a. Excess zinc
b. Excess protein
c. Insufficient iodine
d. Insufficient calcium
Which of the following is a known side effect of prolonged ingestion of excessive amounts of zinc supplements?
a. Iron toxicity due to increased ferritin synthesis
b. Zinc salt deposits in soft tissues such as the heart and kidneys
c. Copper deficiency due to interference with copper absorption
d. Mineral-binding protein deficiency due to a decrease in metallothionein production
Deficiency of which of the following minerals is associated with retarded growth and sexual development in children?
Conditions associated with zinc deficiency include all of the following except
a. altered taste.
b. kidney failure.
c. abnormal night vision.
d. poor healing of wounds
All of the following are recognized symptoms of zinc deficiency except
b. altered taste acuity.
c. impaired vision in dim light.
d. increased susceptibility to infection
Which of the following represents the most reliable dietary source of zinc?
a. Nuts and oils
b. Milk and yogurt
c. Fruits and vegetables
d. Meats and whole-grain cereals
Zinc is highest in foods that also contain a high amount of
All of the following are known to result from excessive zinc intake except
a. inhibition of iron absorption.
b. galvanized liver and kidneys.
c. inhibition of copper absorption.
d. decreases in high-density lipoproteins
Under which of the following conditions are certain supplements of zinc reported to be beneficial?
a. In the treatment of colds
b. In the treatment of Menkes syndrome
c. In the treatment of toxicity from certain other metals
d. In the treatment of slow growth syndrome in U.S. children
What formulation of zinc has been found effective in treating the symptoms of the common cold?
a. Zinc chelator
b. Zinc gluconate
c. Zinc plus ferrous iron
d. Zinc plus copper salt
Commercially available zinc-containing lozenges are advertised to be effective against
b. vitamin A toxicity.
c. the common cold.
d. slowing of the BMR
Which of the following is not a feature of zinc supplements?
a. They induce nausea and bad taste reactions when administered in zinc lozenges
b. They reduce the incidence of goiter in developing countries
c. They reduce the incidence of diarrhea-related deaths in children
d. They reduce the incidence of pneumonia-related deaths in the elderly
One of the thyroid gland hormones is called
c. thiostimulating hormone.
d. tissue stimulating hormone
What is the primary function of the thyroid hormones?
a. Precursors for hemoglobin synthesis
b. Counteract a deficiency of goitrogens
c. Control the rate of oxygen use by cells
d. Regulate acetylcholine concentrations in the central nervous system
The most common cause of iodine deficiency is
a. insufficient intake of iodine from foods.
b. overconsumption of other trace elements.
c. overconsumption of anti-thyroid substances.
d. pituitary deficiencies of thyroid-stimulating hormone
What is the response of the thyroid gland to an iodine deficiency?
a. Increase in its size to trap more iodine
b. Increase in its size to trap more thyroxine
c. Increased release of thyroid-stimulating hormone
d. Decreased release of thyroid-stimulating hormone
Which of the following may result from iodine deficiency?
A woman with a severe iodine deficiency during pregnancy may give birth to a child with
What nutrient deficiency during pregnancy may give rise to a child with cretinism?
What is a goitrogen?
a. One of the hormones produced by the thyroid gland
b. A substance that enhances absorption of dietary iodide
c. A substance that interferes with the functioning of the thyroid gland
d. A compound used to supplement salt as a way to increase iodide intake
A person ingesting large amounts of thyroid antagonist substances is at high risk of developing
b. simple goiter.
c. high blood T3 levels.
d. high blood thyroxine levels
Which of the following foods are known to contain goitrogens?
b. Whole grains
c. Cauliflower and broccoli
d. Blueberries and raspberries
Which of the following fruits are known to contain substances that inhibit the functioning of the thyroid gland?
a. Apples and pears
b. Lemons and limes
c. Avocados and mangos
d. Peaches and strawberries
Which of the following is a prominent feature of mild iodine deficiency in children?
b. Growth retardation
c. Discoloration of teeth
d. Poor performance in school
What is the origin of goitrogens in the diet?
a. Naturally occurring
b. Food industry additives
c. Excessive use of fortified salt
d. Hydrogenation of certain minerals
You have just been hired by the World Health Organization to promote nutrition education and policies in a small country in Asia, whose population has a high prevalence of goiter. Which of the following policies would be the best to implement with respect to iodine status, cost, and efficiency?
a. Fortify the salt with iodine
b. Promote free iodine supplements for all who want them
c. Educate the population to avoid all goitrogens in their diet
d. Educate the population to spend more time at the beach as seawater, sea mist, and seafood are sources of iodine
Which of the following is a feature of iodide utilization?
a. It is an integral part of pituitary thyroid-stimulating hormone
b. Ingestion of plants of the cabbage family stimulates iodide uptake
c. A deficiency or a toxicity leads to enlargement of the thyroid gland
d. The amount in foods is unrelated to the amount of iodine present in the soil
Which of the following is a feature of iodine in nutrition?
a. Excessive intakes shrink the thyroid gland
b. Processed foods in the United States do not use iodized salt
c. Iodization of salt is mandatory in the United States but not in Canada
d. Worldwide, the prevalence of iodine deficiency and iodine toxicity are approximately the same
Which of the following is the richest source of iodine?
c. Orange juice
d. Cruciferous vegetables
If cow's milk is found to contain unusually high levels of iodine, what is the most likely explanation?
a. Storage of milk in galvanized tanks
b. Grazing of cows on high-iodine soils
c. Addition of fortified salt at the milk processing plant
d. Exposure of cows to iodide-containing medications and disinfectants
Approximately how much iodized salt must be consumed to meet but not exceed the RDA for iodine?
a. 1 mg
b. ½ teaspoon
c. 1 teaspoon
d. 1 tablespoon
Which of the following would most likely result from an excessive intake of iodine?
b. Skin rashes
d. Thyroid gland enlargement
Which of the following would be the most appropriate food source of iodide for a person who lives inland?
a. Fresh-water fish
b. Iodized table salt
c. Locally grown produce
d. Plants of the cabbage family
Your uncle Carlos has survived two heart attacks, and recently asked if he might be deficient in selenium, which he had just heard is essential to heart health. You are aware of his food habits and explain that his condition could not be the result of a dietary deficiency of selenium because
a. tap water is a source of selenium.
b. selenium is prevalent in most food groups.
c. he consumes legumes, a rich source of selenium.
d. he drinks fluoridated water, which increases bioavailability of selenium
Which of the following is an important function of selenium?
a. Helps blood to clot
b. Inhibits the formation of free radicals
c. Stabilizes the alcohol content of beer
d. Acts as a cross-linking agent in collagen
What trace element is part of the enzyme glutathione peroxidase?
Which of the following is a property of selenium in nutrition?
a. It participates in the functioning of insulin
b. Severe deficiency is associated with heart disease in China
c. Significant food sources include dairy and unprocessed vegetables
d. It has no RDA but the estimated safe and adequate dietary intake is only 2-3 μg/day
Which of the following nutrients has functions similar to those of vitamin E?
Which of the following minerals functions primarily in reactions that consume oxygen?
Your aunt Thelma has been anemic for some time and was recently shown to be deficient in copper. Which of the following explains the association of copper and anemia?
a. Copper is required for hemoglobin synthesis
b. Copper plays a role in wound healing, which prevents excessive blood loss
c. Anemia affects synthesis of protoporphyrin, which interferes with iron absorption
d. Copper is known to protect against free radical formation, which prevents excess damage of red blood cells
All of the following are characteristics of copper in nutrition except
a. deficiency is rare.
b. legumes are a rich source.
c. absorption from foods is poor.
d. absorption is reduced by ingestion of zinc supplements
The rare genetic disorders Menkes disease and Wilson's disease result from abnormal utilization of
Which of the following is a feature of copper nutrition?
a. Absorption efficiency is similar to that of iron
b. It is involved in collagen synthesis and wound healing
c. Soft water may provide significant amounts in the diet
d. Deficiency is common in children of Middle East countries
Which of the following meats would be the best source of copper?
Which of the following minerals is a cofactor in the formation of hemoglobin?
Characteristics of manganese in nutrition include all of the following except
a. plant foods are good sources.
b. deficiencies are seen primarily in the elderly.
c. absorption is inhibited by calcium supplements.
d. toxicity is more common from environmental contamination than from the diet
Which of the following represents the most likely cause of manganese toxicity?
a. Consumption of supplements
b. Increased absorption due to genetic defect
c. Inhalation of dust contaminated with manganese
d. Consumption of foods grown on manganese-rich soils
Which of the following characteristics are shared by copper and fluoride?
a. Both may be obtained from drinking tap water
b. Both serve as cofactors for a number of enzymes
c. Neither is involved in the integrity of bones and teeth
d. Neither is known to be toxic at intakes of 10 times the estimated safe and adequate dietary intake
What is the primary mechanism associated with the role of fluoride in prevention of dental caries?
a. Fluoride increases calcium absorption, which increases crystal formation of teeth
b. Decay is inhibited due to neutralization of organic acids produced by bacteria on the teeth
c. Decay is reduced due to the inhibitory effects of fluoride on growth of bacteria on the teeth
d. Fluoride becomes incorporated into the crystalline structure of teeth, making them less susceptible to decay
Which of the following mechanisms explains why fluoride is effective in controlling tooth decay?
a. It helps regulate calcium levels in saliva
b. It helps form decay-resistant fluorapatite
c. It inhibits growth of decay-producing bacteria
d. It changes the pH of the mouth, inhibiting bacterial growth
What percent of the U.S. population is not exposed to a fluoridated public water supply?
You have just been elected mayor of Smalltownville, where the major source of drinking water is from wells. What major health problem would be expected among the children of Smalltownville?
b. Dental caries
c. GI infections
What is the most reliable source of dietary fluoride?
a. Public water
b. Dark green vegetables
c. Milk and milk products
d. Meats and whole-grain cereals
Which of the following is a feature of fluoride in nutrition?
a. Most bottled waters are fluoridated
b. A severe deficiency is known as fluorosis
c. Fluorapatite refers to an increase in the desire to eat fluoride-rich foods
d. A deficiency contributes to the most widespread health problem in the United States
Fluoride deficiency is best known to lead to
a. dental decay.
c. discoloration of teeth.
d. nutritional muscular dystrophy
Naturally occurring food sources of fluoride include all of the following except
What is the optimal fluoride concentration in community water supplies?
a. 1 ppm
b. 2 ppm
c. 2.5 ppm
d. 4 ppm
Which of the following is known to cause discolored enamel of the teeth?
a. Excessive fluoride in the water
b. Insufficient fluoride in the water
c. Excessive intake of simple sugars
d. Inability of the body to absorb fluoride
One of the chief functions of chromium is participation in the metabolism of
As far as is known, what hormone is dependent upon chromium for optimal activity?
d. Antidiurectic hormone
Which of the following is a characteristic of chromium in nutrition?
a. A deficiency leads to hypothyroidism
b. Supplements are known to be helpful
c. Whole grains represent an excellent source
d. In the body, it enhances the action of ceruloplasmin
What is a glucose tolerance factor?
a. A protein that stimulates glycolysis
b. A mineral cofactor for a specific enzyme
c. A hormone that enhances pancreatic function
d. A small organic compound that promotes the action of insulin
Chromium deficiency is characterized by
c. enlargement of the liver.
d. enlargement of the thyroid gland
Which of the following is a characteristic of the mineral molybdenum?
a. Enhances the activity of insulin
b. Deficiency symptoms in people are unknown
c. Unusually poor food sources are legumes and cereal grains
d. Toxicity symptoms in human beings include damage to red blood cells
Which of the following trace minerals is known to be involved in bone development?
Evidence to date in animals and/or human beings suggests that normal bone metabolism requires all of the following trace minerals except
In the body, lead is known to significantly interfere with utilization of all of the following minerals except
To serve its function in oxygen delivery to body tissues, iron must interact closely with
a. copper and vitamin C.
b. selenium and iodine.
c. zinc and vitamin A.
d. chromium and calcium
What term designates foods that contain nonnutrient substances which may provide health benefits beyond basic nutrition?
a. Health foods
b. Organic foods
c. Functional foods
d. Disease preventative foods
Which of the following is a rich source of phytoestrogens?
c. Cold-water fish
d. Green, leafy vegetables
All of the following are classified as phytonutrients except