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Chapter 18 Diet and Health

Terms in this set (279)

Antibodies are the scavengers of the immune system.

a. True
b. False
False
Disease and malnutrition can create a synergistic downward spiral that must be broken for recovery to occur.

a. True
b. False
True
Selenium helps to resolve inflammation when it is no longer needed for the immune response.

a. True
b. False
False
Nutrition plays a role in both of the two top causes of death in the United States.

a. True
b. False
True
Many chronic diseases are, themselves, risk factors for other chronic disease.

a. True
b. False
True
The inflammatory response of atherosclerosis weakens the walls of the arteries and may cause an aneurysm.

a. True
b. False
True
The low-density lipoproteins are clearly the most atherogenic lipoproteins.

a. True
b. False
True
Trans fat should be limited to less than 10% of total kcalories, and saturated fat to less than 1%.

a. True
b. False
False
The single most effective step people can take against hypertension is to find out whether they have it.

a. True
b. False
True
Eating in accordance with the DASH pattern not only lowers blood pressure, but also decreases total cholesterol and LDL cholesterol.

a. True
b. False
True
Type I diabetes is the more prevalent form of diabetes caused by insulin resistance.

a. True
b. False
False
In type 2 diabetes, insulin secretion can vary from normal, to increased, to decreased.

a. True
b. False
True
Exposure to cancer-causing substances, or tumors, may induce genetic mutations that lead to cancer.

a. True
b. False
False
Recommendations to prevent chronic diseases take a population approach, similar to strategies used for immunizations.

a. True
b. False
True
In the United States, the safety and effectiveness of medicinal herbs are regulated the same as other medications.

a. True
b. False
False
Infectious diseases
diseases caused by bacteria, viruses, parasites, or other microorganisms that can be transmitted from one person to another through air, water, or food; by contact; or through vector organisms such as mosquitoes.
immune system
the body's natural defense against foreign materials that have penetrated the skin or mucous membranes.
antibodies
large proteins of the blood and body fluids, produced by the immune system in response to the invasion of the body by foreign molecules (usually proteins called antigens). Antibodies combine with and inactivate the foreign invaders, thus protecting the body.
antigens
substances that elicit the formation of antibodies or an inflammation reaction from the immune system. Examples of antigens include viruses, bacteria, and toxins.
B-cells
lymphocytes that produce antibodies. B stands for bone marrow, where the B-cells develop and mature.
cytokines (SIGH-toe-kines)
special proteins that direct immune and inflammatory responses.
immune response
the body's reaction to foreign antigens, which neutralizes or eliminates them, thus preventing damage.
immunoglobulins (IM-you-noh-GLOB-you-linz)
proteins capable of acting as antibodies.
lymphocytes (LIM-foh-sites)
white blood cells that participate in acquired immunity; B-cells and T-cells.
macrophages (mak-roe-fay-jez)
large phagocytic cells that serve as scavengers of the blood, clearing it of old or abnormal cells, cellular debris, and antigens.
neutrophils (new-tro-fills)
the most common type of white blood cell. Neutrophils destroy antigens by phagocytosis.
Phagocytes (FAG-oh-sites)
white blood cells (neutrophils and macrophages) that have the ability to ingest and destroy foreign substances. phagein = to eat
phagein =
to eat
phagocytosis (FAG-oh-sigh-TOH-sis)
the process by which phagocytes engulf and destroy foreign materials.
T-cells
lymphocytes that attack antigens. T stands for the thymus gland, where the T-cells mature.
The body's first lines of defense
skin, mucous membranes, GI tract
If the body's first lines of defense - the skin, mucous membranes, and GI tract barriers fail then what organs go into action?
spleen, lymph nodes, thymus, cells of the immune system
The immune system requires all nutrients for optimal functioning.
...
Protein key role(s) in immune function
Maintains healthy skin and other epithelial tissues (barriers to infection); participates in the synthesis and function of the organs and cells of the immune system and antibody production
Omega-3 fatty acids key role(s) in immune function
Helps resolve inflammation when it is no longer needed for the immune response through production of lipid mediators known as resolvins and protectins, which also play a role in enhancing host defense
Vitamin A key role(s) in immune function
Maintains healthy skin and other epithelial tissues (barriers to infection); participates in the cell replication and specialization that supports immune-cell and antibody production and the anti-inflammatory response
Vitamin D key role(s) in immune function
Regulates immune cell (T-cell) responses; participates in antibody production
Vitamin C and E key role(s) in immune function
Protect against oxidative damage
Vitamin B6 key role(s) in immune function
Helps maintain an effective immune response; participates in antibody production
Vitamin B12 and folate key role(s) in immune function
Assist in cell replication and specialization that support immune cell and antibody production
Selenium key role(s) in immune function
Protects against oxidative damage
Zinc key role(s) in immune function
Helps maintain an effective immune response; participates in antibody production
synergistic
multiple factors operating together in such a way that their combined effects are greater than the sum of their individual effects.
Identify factors that protect people from the spread of infectious diseases and describe the role of nutrition in immunity.
Public health measures such as purification of water and safe handling of food help prevent the spread of infection in developed nations, and immunizations and antibiotics protect individuals. Nevertheless, some infectious diseases still endanger people today. Nutrition cannot prevent or cure infectious diseases, but adequate intakes of all the nutrients can help support the immune system as the body defends against disease-causing agents. If the immune system is impaired because of malnutrition or disease, a person becomes vulnerable to infectious disease. Inflammation underlies obesity and many chronic diseases.
Many deaths have multiple causes, but diet influences the development of several chronic diseases—notably, heart disease, some cancers, stroke, and diabetes.
...
The 10 Leading Causes of Death in the United States
Vegetables rich in fiber, phytochemicals, and the antioxidant nutrients (beta-carotene, vitamin C, and vitamin E) help protect against chronic diseases.
...
Risk Factors and Chronic Diseases
Many chronic diseases are themselves risk factors for other chronic diseases and that all of them are linked to obesity. The risk factors highlighted in blue define the metabolic syndrome.
List the leading nutrition-related causes of death in the United States.
Heart disease and cancers are the two leading causes of death in the United States, and strokes and diabetes also rank among the top 10. All four of these chronic diseases have significant links with nutrition. Other lifestyle risk factors and genetics are also important.
cardiovascular disease (CVD)
diseases of the heart and blood vessels throughout the body. Atherosclerosis is the main cause of CVD. When the arteries that carry blood to the heart muscle become blocked, the heart suffers damage known as coronary heart disease (CHD).
CVD stands for
cardiovascular disease
aneurysm (AN-you-rizm)
an abnormal enlargement or bulging of a blood vessel (usually an artery) caused by damage to or weakness in the blood vessel wall.
angina (an-JYE-nah or AN-ji-nah)
a painful feeling of tightness or pressure in and around the heart, often radiating to the back, neck, and arms; caused by a lack of oxygen to an area of heart muscle.
atherosclerosis (ATH-er-oh-scler-OH-sis)
a type of artery disease characterized by plaques (accumulations of lipid-containing material) on the inner walls of the arteries.
CHD risk equivalents
disorders that raise the risk of heart attacks, strokes, and other complications associated with cardiovascular disease to the same degree as existing CHD. These disorders include symptomatic carotid artery disease, peripheral arterial disease, abdominal aortic aneurysm, and diabetes mellitus.
coronary arteries
blood vessels that supply blood to the heart.
Coronary heart disease (CHD)
the damage that occurs when the blood vessels carrying blood to the heart (the coronary arteries) become narrow and occluded.
CHD stands for
coronary heart disease
embolism
the obstruction of a blood vessel by an embolus (EM-boh-luss), or traveling clot, causing sudden tissue death. embol = to insert, plug
embolus (EM-boh-luss)
traveling clot
embol =
to insert, plug
heart attack
sudden tissue death caused by blockages of vessels that feed the heart muscle; also called myocardial (my-oh-KAR-dee-al) infarction (in-FARK-shun) or cardiac arrest. myo = muscle cardial = heart infarct = tissue death
myocardial infarction (my-oh-KAR-dee-al) (in-FARK-shun) is known as a
heart attack
cardiac arrest is known as a
heart attack
myo =
muscle
cardial =
heart
infarct =
tissue death
hypertension
consistently higher-than-normal blood pressure. Hypertension that develops without an identifiable cause is known as essential or primary hypertension; hypertension that is caused by a specific disorder such as kidney disease is known as secondary hypertension.
plaque
an accumulation of fatty deposits, smooth muscle cells, and fibrous connective tissue that develops in the artery walls in atherosclerosis. Plaque associated with atherosclerosis is known as atheromatous (ATH-er-OH-ma-tus) plaque.
prehypertension
slightly higher than normal, but below the diagnosis of hypertension (see Table 18-4).
stroke
an event in which the blood flow to a part of the brain is cut off; also called cerebrovascular accident (CVA).
cerebro =
brain
vascular =
blood vessels
thrombosis (throm-BOH-sis)
the formation of a thrombus (THROM-bus), or a blood clot, that may obstruct a blood vessel, causing gradual tissue death.
thrombus (THROM-bus)
a blood clot
thrombo =
clot
transient ischemic attack (TIA) (is-KEY-mik)
a temporary reduction in blood flow to the brain, which causes temporary symptoms that vary depending on the part of the brain affected. Common symptoms include light-headedness, visual disturbances, paralysis, staggering, numbness, and inability to swallow.
TIA stands for
transient ischemic attack
Plaque associated with atherosclerosis is known as
atheromatous plaque.
C-reactive protein (CRP)
a protein released during the acute phase of infection or inflammation that enhances immunity by promoting phagocytosis and activating platelets. Its presence may be used to assess a person's risk of an impending heart attack or stroke.
CRP
C-reactive protein
lipoprotein-associated phospholipase A(2) or Lp-PLA(2)
a lipoprotein-bound enzyme that generates potent proinflammatory and proatherogenic products such as oxidized free fatty acids and lysophosphatidylcholine. Lp-PLA(2) is a specific marker of plaque inflammation.
vulnerable plaque
Plaque that is susceptible to rupture because it has only a thin fibrous barrier between its lipid-rich core and the artery lining
platelets
tiny, disc-shaped bodies in the blood, important in blood clot formation.
coronary thrombosis
a clot that blocks blood flow through an artery that feeds the heart muscle
cerebral thrombosis
a clot that blocks blood flow through an artery that feeds the brain
Risk Factors for CHD
atherogenic
able to initiate or promote atherosclerosis.
Standards for CHD Risk Factors
Regular aerobic exercise can help defend against heart disease by strengthening the heart muscle, promoting weight loss, and improving blood lipids and blood pressure.
...
metabolic syndrome
a combination of risk factors—elevated fasting blood glucose, hypertension, abnormal blood lipids, and abdominal obesity—that greatly increase a person's risk of developing heart disease.
insulin resistance
the condition in which a normal amount of insulin produces a subnormal effect in muscle, adipose, and liver cells, resulting in an elevated fasting glucose; a metabolic consequence of obesity that precedes type 2 diabetes.
Describe how atherosclerosis develops and strategies to lower blood cholesterol levels.
Atherosclerosis is characterized by plaque build-up in artery walls. Plaques rupturing or blood clotting can cause heart attacks and strokes. Dietary recommendations to lower the risks of cardiovascular disease are summarized in Table 18-5. Quitting smoking and engaging in regular physical activity also improve heart health.
Cardiac output
the volume of blood discharged by the heart each minute; determined by multiplying the stroke volume by the heart rate. The stroke volume is the amount of oxygenated blood the heart ejects toward the tissues at each beat. Cardiac output (volume/minute) = stroke volume (volume/beat) × heart rate (beats/minute).
peripheral resistance
the resistance to pumped blood in the small arterial branches (arterioles) that carry blood to the tissues.
Several major risk factors predicting the development of hypertension have been identified, including:
aging, genetics, obesity, salt intake, alcohol
To guard against hypertension, have your blood pressure checked regularly.
...
Lifestyle Modifications to Reduce Blood Pressure
Increasing potassium in the diet helps lower blood pressure and defend against losses caused by some hypertension medicines. The richest sources of potassium are fresh fruits and vegetables of all kinds.
...
Present strategies to lower blood pressure.
The most effective dietary strategy for preventing hypertension is weight control. Also beneficial are diets rich in fruits, vegetables, nuts, and low-fat milk products and low in fat, saturated fat, and sodium.
prediabetes
condition in which blood glucose levels are higher than normal but below the diagnosis of diabetes; formerly called impaired glucose tolerance. Prediabetes is considered a major risk factor for future diabetes and cardiovascular diseases.
Diabetes mellitus
metabolic disorder characterized by elevated blood glucose resulting from insufficient insulin, ineffective insulin, or both; the complete medical term is diabetes mellitus (meh-LIE-tus). When blood glucose levels are higher than normal but below the diagnosis of diabetes, the condition is called prediabetes. mellitus = honey-sweet (sugar in urine)
type 1 diabetes
the less common type of diabetes in which the pancreas produces little to no insulin. Type 1 diabetes usually results from autoimmune destruction of pancreatic beta cells.
type 2 diabetes
the more common type of diabetes in which the cells fail to respond to insulin. Type 2 diabetes usually accompanies obesity and results from insulin resistance coupled with insufficient insulin secretion.
hyperglycemia
elevated blood glucose concentrations.
fasting plasma glucose
a test that measures plasma glucose after a person has fasted (no food or kcaloric beverages) for at least 8 hours.
A1C
a test that measures the percentage of hemoglobin that has glucose attached, which helps diagnose diabetes and evaluate long-term glycemic control.
Criteria for the Diagnosis of Diabetes
Features of Type 1 and Type 2 Diabetes
autoimmune disorder
a condition in which the body develops antibodies to its own proteins and then proceeds to destroy cells containing these proteins. In type 1 diabetes, the body develops antibodies to its insulin and destroys the pancreatic cells that produce the insulin, creating an insulin deficiency.
The metabolic consequences of type 1 diabetes differ from those of type 2. In type 1, no insulin is available to allow any glucose to enter the cells. When glucose cannot enter the cells, a cascade of metabolic changes quickly follows. In type 2 diabetes, some glucose enters the cells. Because the cells are not "starved" for glucose, the body does not shift into the metabolism of fasting (losing weight and producing ketones).
...
Metabolic Consequences of Untreated Diabetes
Intensive treatment may be inappropriate for some individuals with diabetes; examples include individuals with limited life expectancy, a history of hypoglycemia, or previous heart disease or multiple heart disease risk factors.
...
microangiopathies
disorders of the small blood vessels. micro = small angeion = vessel pathos = disease
Compare the dietary strategies to manage type 1 diabetes with those to prevent and treat type 2 diabetes.
Diabetes is characterized by high blood glucose and insufficient insulin, ineffective insulin, or a combination of the two. People with type 1 diabetes coordinate diet, insulin, and physical activity to help control their blood glucose. Those with type 2 diabetes benefit most from a diet and physical activity program that controls glucose fluctuations and promotes weight loss.
malignant (ma-LIG-nant)
describes a cancerous cell or tumor, which can injure healthy tissue and spread cancer to other regions of the body.
antipromoters
factors that oppose the development of cancer.
cancers
malignant growths or tumors that result from abnormal and uncontrolled cell division.
carcinogenesis (CAR-sin-oh-JEN-eh-sis)
the process of cancer development.
carcinogen
a substance that can cause cancer; the adjective is carcinogenic.
initiators
factors that cause mutations that give rise to cancer, such as radiation and carcinogens.
metastasize (me-TAS-tah-size)
the spread of cancer from one part of the body to another.
promoters
factors that favor the development of cancers once they have begun.
tumor
an abnormal tissue mass with no physiological function; also called a neoplasm (NEE-oh-plazm). Cancers are classified by the tissues or cells from which they develop: Adenomas (ADD-eh-NOH-mahz) arise from glandular tissues. Carcinomas (KAR-see-NOH-mahz) arise from epithelial tissues. Gliomas (gly-OH-mahz) arise from glial cells of the central nervous system. Leukemias (loo-KEE-mee-ahz) arise from white blood cell precursors. Lymphomas (lim-FOH-mahz) arise from lymph tissue. Melanomas (MEL-ah-NOH-mahz) arise from pigmented skin cells. Sarcomas (sar-KOH-mahz) arise from connective tissues, such as muscle or bone.
Cancer Development
Examples include viral hepatitis and liver cancer, human papillomavirus and cervical cancer, and Helicobacter pylori bacterium (the ulcer bacterium) and stomach cancer.
...
These carcinogens are heterocyclic amines.
...
These carcinogens are polycyclic aromatic hydrocarbons.
...
cruciferous vegetables
vegetables of the cabbage family, including cauliflower, broccoli, and brussels sprouts.
Cruciferous vegetables, such as cauliflower, broccoli, and brussels sprouts, contain nutrients and phytochemicals that may inhibit cancer development.
...
Differentiate among cancer initiators, promoters, and antipromoters and describe how nutrients or foods might play a role in each category.
Some dietary factors, such as alcohol and heavily smoked foods, may initiate cancer development; others, such as animal fats, may promote cancer once it has gotten started; and still others, such as fiber, antioxidant nutrients, and phytochemicals, may act as antipromoters that protect against the development of cancer. By eating many fruits, vegetables, legumes, and whole grains and reducing saturated fat intake, people obtain the best possible nutrition at the lowest possible risk. Minimizing weight gain through regular physical activity and a healthy diet is also beneficial.
Physical activity and a moderate weight loss of even 10 to 20 pounds can help improve blood glucose, blood lipids, and blood pressure.
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The Healthy Eating Plate—An Alternative to USDA MyPlate
Summarize dietary recommendations to prevent chronic diseases.
Clearly, optimal nutrition plays a key role in keeping people healthy and reducing the risk of chronic diseases. To have the greatest impact possible, dietary recommendations are aimed at the entire population, not just at the individuals who might benefit most. Recommendations focus on weight control and urge people to limit saturated and trans fat; increase fiber-rich fruits, vegetables, legumes, and whole grains; and balance food intake with physical activity.
Complementary and alternative medicine (CAM)
diverse medical and health-care systems, practices, and products that are not currently considered part of conventional medicine; also called adjunctive, unconventional, or unorthodox therapies.
CAM stands for
Complementary and alternative medicine
conventional medicine
diagnosis and treatment of diseases as practiced by medical doctors (MD), doctors of osteopathy (DO), and allied health professionals such as physical therapists and registered nurses; also called allopathy; Western, mainstream, orthodox, or regular medicine; and biomedicine.
Integrative medicine
care that combines conventional and complementary therapies for which there is some high-quality scientific evidence of safety and effectiveness. Integrative medicine emphasizes the importance of the relationship between the practitioner and the patient and focuses on wellness, healing, and the whole person.
acupuncture (AK-you-PUNK-cher)
a technique that involves piercing the skin with long thin needles at specific anatomical points to relieve pain or illness. Acupuncture sometimes uses heat, pressure, friction, suction, or electromagnetic energy to stimulate the points.
aroma therapy
a technique that uses oil extracts from plants and flowers (usually applied by massage or baths) to enhance physical, psychological, and spiritual health.
ayurveda (AH-your-VAY-dah)
a traditional Hindu system of improving health by using herbs, diet, meditation, massage, and yoga to stimulate the body, mind, and spirit to prevent and treat disease.
bioelectromagnetic medical applications
the use of electrical energy, magnetic energy, or both to stimulate bone repair, wound healing, and tissue regeneration.
biofeedback
the use of special devices to convey information about heart rate, blood pressure, skin temperature, muscle relaxation, and body functions to enable a person to learn how to consciously control these medically important activities.
biofield therapeutics
a manual healing method that directs a healing force from an outside source (commonly God or another supernatural being) through the practitioner and into the client's body; commonly known as "laying on of hands."
cartilage therapy
the use of cleaned and powdered connective tissue, such as collagen, to improve health.
chelation (kee-LAY-shun)
therapy: the use of ethylene diamine tetraacetic acid (EDTA) to bind with metallic ions, thus healing the body by removing toxic metals.
chiropractic manipulation (KYE-roh-PRAK-tik)
a manual healing method of adjusting the spine to restore health.
faith healing
healing by invoking divine intervention without the use of medical, surgical, or other traditional therapy.
herbal medicine (ERB-al)
the use of plants to treat disease or improve health; also known as botanical medicine or phytotherapy.
homeopathy (hoh-me-OP-ah-thee)
a practice based on the theory that "like cures like," that is, that substances that cause symptoms in healthy people can cure those symptoms when given in very dilute amounts. homeo = like pathos = suffering
hydrotherapy
the use of water (in whirlpools, as douches, or packed as ice, for example) to promote relaxation and healing.
hypnotherapy
a technique that uses hypnosis and the power of suggestion to improve health behaviors, relieve pain, and heal.
imagery
a technique that guides clients to achieve a desired physical, emotional, or spiritual state by visualizing themselves in that state.
iridology
the study of changes in the iris of the eye and their relationships to disease.
macrobiotic diet
a philosophical eating pattern based on mostly plant foods such as whole grains, legumes, and vegetables, with small amounts of fish, fruits, nuts, and seeds. macro = large, great biotic = life
massage therapy
a healing method in which the therapist manually kneads muscles to reduce tension, increase blood circulation, improve joint mobility, and promote healing of injuries.
meditation
a self-directed technique of relaxing the body and calming the mind.
naturopathic medicine (nay-chur-oh-PATH-ick)
a system that taps the natural healing forces within the body by integrating several practices, including traditional medicine, herbal medicine, clinical nutrition, homeopathy, acupuncture, East Asian medicine, hydrotherapy, and manipulative therapy.
orthomolecular medicine
the use of large doses of vitamins to treat chronic disease.
ozone therapy
the use of ozone gas to enhance the body's immune system.
qi gong (chee GUNG)
a Chinese system that combines movement, meditation, and breathing techniques to enhance the flow of qi (vital energy) in the body.
geophagia (gee-oh-FAY-gee-uh) is also known as
pica
pica
a craving for and consumption of nonfood substances. Pica is known as geophagia (gee-oh-FAY-gee-uh) when referring to eating clay, baby powder, chalk, ash, ceramics, paper, paint chips, or charcoal; pagophagia (pag-oh-FAY-gee-uh) when referring to eating large quantities of ice; and amylophagia (AM-ee-low-FAY-gee-ah) when referring to eating uncooked starch (flour, laundry starch, or raw rice).
Risk-Benefit Relationships
Digoxin, the most commonly prescribed heart medication, derives from the leaves of the foxglove plant (Digitalis purpurea).
...
Aloe (gel) Aloe vera
common/scientific herb name
Claims Promote wound healing
Research Findings May help heal minor burns and abrasions; may cause infections in severe wounds
Risks Generally considered safe
Black cohosh (stems and roots) Actaea racemosa, Cimifuga racemosa
common/scientific herb name
Claims Ease menopause symptoms
Research Findings Conflicting evidence
Risks May cause headaches, stomach discomfort, liver damage
Chamomile (flowers) Matricaria recutita, Chamomilla recutita
common/scientific herb name
Claims Relieve indigestion
Research Findings Little evidence available
Risks Generally considered safe
Chaparral (leaves and twigs) Larrea tridentata
common/scientific herb name
Claims Slow aging, "cleanse" blood, heal wounds, cure cancer, treat acne
Research Findings No evidence available
Risks Acute, toxic hepatitis; liver damage
Cinnamon (bark) Cinnamomum zeylanicum, C. cassia
common/scientific herb name
Claims Relieve indigestion, lower blood glucose and blood lipids
Research Findings May lower blood glucose in type 2 diabetes
Risks May have a blood-thinning effect; not safe for pregnant women or those taking diabetes medication
Comfrey (leafy plant) Symphytum officinale, S. asperum, S. x uplandicum
common/scientific herb name
Claims Soothe nerves
Research Findings No evidence available
Risks Liver damage
Echinacea (roots) Echinacea angustifolia, E. pallida, E. purpurea
common/scientific herb name
Claims Alleviate symptoms of colds, flus, and infections; promote wound healing; boost immunity
Research Findings Ineffective in preventing colds or other infections
Risks Generally considered safe; may cause headache, dizziness, nausea
Ephedra (stems) Ephedra sinica
common/scientific herb name
Claims Promote weight loss
Research Findings Little evidence available; FDA has banned the sale of ephedra-containing products
Risks Rapid heart rate, tremors, seizures, insomnia, headaches, hypertension
Feverfew (leaves) Tanacetum parthenium
common/scientific herb name
Claims Prevent migraine headaches
Research Findings May prevent migraine headaches
Risks Generally considered safe; may cause mouth irritation, swelling, ulcers, and GI distress
Garlic (bulbs) Allium sativum
common/scientific herb name
Claims Lower blood lipids and blood pressure
Research Findings May lower blood cholesterol slightly; conflicting evidence on blood pressure
Risks Generally considered safe; may cause garlic breath, body odor, gas, and GI distress; inhibits blood clotting
Ginger (roots) Zingiber officinale
common/scientific herb name
Claims Prevent motion sickness, nausea
Research Findings May relieve pregnancy-induced nausea; conflicting evidence on nausea caused by motion, chemotherapy, or surgery
Risks Generally considered safe
Ginkgo (tree leaves) Ginkgo biloba
common/scientific herb name
Claims Improve memory, relieve vertigo
Research Findings Little evidence available
Risks Generally considered safe; may cause headache, GI distress, dizziness; may inhibit blood clotting
Ginseng (roots) Panax ginseng (Asian), P. quinquefolius (American)
common/scientific herb name
Claims Boost immunity, increase endurance
Research Findings Little evidence available
Risks Generally considered safe; may cause insomnia, headaches, and high blood pressure
Goldenseal (roots) Hydrastis canadensis
common/scientific herb name
Claims Relieve indigestion, treat urinary infections
Research Findings Little evidence available
Risks Generally considered safe; not safe for people with hypertension or heart disease
Kava (roots) Piper methysticum
common/scientific herb name
Claims Relieves anxiety, promotes relaxation
Research Findings Little evidence available
Risks Liver failure
Saw palmetto (ripe fruits) Serenoa repens
common/scientific herb name
Claims Relieve symptoms of enlarged prostate; diuretic; enhance sexual vigor
Research Findings Little evidence available
Risks Generally considered safe; may cause nausea, vomiting, diarrhea
St. John's wort (leaves and tops) Hypericum perforatum
common/scientific herb name
Claims Relieve depression and anxiety
Research Findings May relieve mild depression
Risks Generally considered safe; may cause fatigue, increased sensitivity to sunlight, and GI distress
Turmeric (roots) Curcuma longa
common/scientific herb name
Claims Reduces inflammation; relieves heartburn; prevents or treats cancer
Research Findings No evidence available
Risks Generally considered safe; may cause indigestion; not safe for people with gallbladder disease
Valerian (roots) Valeriana officinalis
common/scientific herb name
Claims Calm nerves, improve sleep
Research Findings Little evidence available
Risks Long-term use associated with liver damage
Yohimbe (tree bark) Pausinystalia yohimbe
common/scientific herb name
Claims Enhance "male performance"
Research Findings No evidence available
Risks Kidney failure, seizures
American ginseng
herb
Drug Estrogens, corticosteroids, Breast cancer therapeutic agent
Interaction Enhances hormonal response, Synergistically inhibits cancer cell growth
American ginseng, karela
herb
Drug Blood glucose regulators
Interaction Affect blood glucose levels
Echinacea (possible immunostimulant)
herb
Drug Cyclosporine and corticosteroids (immunosuppressants)
Interaction May reduce drug effectiveness
Evening primrose oil, borage
herb
Drug Anticonvulsants
Interaction Lower seizure threshold
Feverfew
herb
Drug Aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs
Interaction Negates the effect of the herb in treating migraine headaches
Feverfew, garlic, ginkgo, ginger, and Asian ginseng
herb
Drug Warfarin, coumarin (anticlotting drugs, "blood thinners")
Interaction Prolong bleeding time; increase likelihood of hemorrhage
Garlic
herb
Drug Protease inhibitor (HIV drug)
Interaction May reduce drug effectiveness
Kava, valerian
herb
Drug Anesthetics
Interaction May enhance drug action
Kelp (iodine source)
herb
Drug Synthroid or other thyroid hormone replacers
Interaction Interferes with drug action
Kyushin, licorice, plantain, uzara root, hawthorn, Asian ginseng
herb
Drug Digoxin (cardiac antiarrhythmic drug derived from the herb foxglove)
Interaction Interfere with drug action and monitoring
St. John's wort, saw palmetto, black tea
herb
Drug Iron supplements
Interaction Tannins in herbs inhibit iron absorption
St. John's wort
herb
Drug Protease inhibitors (HIV drugs), warfarin (anticlotting drug), digoxin (cardiac antiarrhythmic drug), oral contraceptives, tamoxifen (breast cancer drug)
Interaction May enhance or reduce drug effectiveness
Valerian
herb
Drug Barbiturates
Interaction Causes excessive sedation
How would you judge the accuracy or validity of complementary and alternative medicine practices?
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A friend of yours was recently diagnosed with cancer. His physician discussed surgery, radiation, and possibly chemotherapy as recommended treatment options. His sister suggested that in addition to the physician's treatment, your friend might also benefit from a few acupuncture sessions and yoga classes. His roommate disagreed, suggesting that instead of following the physician's recommendations, your friend should start taking high doses of dietary supplements and doing colonic enemas daily. At this point, your friend is confused. What advice might you offer to help him make an informed decision?
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Choose the food items that would most likely comprise an atherogenic diet, or a diet that increases the likelihood of atherosclerosis and heart disease. Check all that apply.

a. French fries
b. Beef liver
c. Low-fat yogurt
d. Bacon
e. Vegetable stir-fry
French fries
Beef liver
Bacon
An atherogenic diet is one that promotes the formation of plaque along the inner lining of arteries to cause atherosclerosis. The Western diet tends to be high in atherogenic foods, which include high amounts of saturated and trans-fats, cholesterol, and high levels of sodium and sugar. Processed and fast food items tend to contain many atherogenic ingredients.
In the list, bacon, French fries, and beef liver are all high in saturated fat and cholesterol, as well as sodium, and would therefore be considered part of an atherogenic diet. However, low-fat yogurt and a vegetable stir-fry are both foods with healthful ingredients that tend to be associated with a decrease in cardiovascular disease risk.
...
According to MyPlate, approximately half of an individual's plate at a meal should consist of _______ ____
_____________. Current evidence suggests that low fruit and vegetable consumption is associated with mortality, particularly mortality from cardiovascular disease and some cancers.
fruits and vegetables
The graph represents a dose-response relationship between fruit and vegetable consumption and all-cause mortality. Three labels are missing from the horizontal axis. Select the correct option for these missing axis labels in the questions that follow the graph.

Which label below belongs to A?

Low Fruit and Vegetable Consumption
Moderate Fruit and Vegetable Consumption
High Fruit and Vegetable Consumption
Low Fruit and Vegetable Consumption
The graph represents a dose-response relationship between fruit and vegetable consumption and all-cause mortality. Three labels are missing from the horizontal axis. Select the correct option for these missing axis labels in the questions that follow the graph.

Which label below belongs to B?

Low Fruit and Vegetable Consumption
Moderate Fruit and Vegetable Consumption
High Fruit and Vegetable Consumption
Moderate Fruit and Vegetable Consumption
The graph represents a dose-response relationship between fruit and vegetable consumption and all-cause mortality. Three labels are missing from the horizontal axis. Select the correct option for these missing axis labels in the questions that follow the graph.

Which label below belongs to C?

Low Fruit and Vegetable Consumption
Moderate Fruit and Vegetable Consumption
High Fruit and Vegetable Consumption
High Fruit and Vegetable Consumption
MyPlate suggests that half the plate should be comprised of fruits and vegetables; however, the standard Western diet generally falls far below recommendations. The low fruit and vegetable consumption commonly found in Western countries is strongly associated with increased levels of atherosclerosis and cardiovascular disease.
The lowest level of fruit and vegetable consumption is associated with the highest level of all-cause mortality, particularly from cardiovascular disease. Conversely, the highest intake of fruits and vegetables is associated with the lowest levels of all-cause mortality.
...
MyPlate suggests that dietary protein and dairy foods should generally be ____ ____. However, some fats increase one's risk for disease, particularly cardiovascular disease. Foods including pizza, ice cream, burgers, and sausage are all high in __________ fat and should therefore be limited in the diet.
low fat
saturated
All of the following are risk factors of a diet high in saturated fat except:

a. Low LDL cholesterol
b. Atherosclerosis
c. Stroke
d. High blood pressure
Low LDL cholesterol
MyPlate recommends that individuals choose low-fat dairy products, as well as low-fat or lean meats and proteins. This recommendation is intended to help decrease the amount of saturated fat and cholesterol in the diet. Consumption of foods that are high in saturated fat, including pizza, ice cream, burgers, and sausage, are associated with many risk factors, including high LDL cholesterol levels, stroke, high blood pressure, and atherosclerosis, as well as increased mortality.
...
if a plaque or a blood clot blocks blood flow to a section of the brain, brain cells can die, resulting in __ ______.
a stroke
Strokes are one of the many possible dangerous results of cardiovascular disease. A stroke occurs when the blood flow to part of the brain is cut off, either from an atherosclerosis plaque in an artery or a blood clot that has formed somewhere else in the body and traveled to the arteries of the brain. When blood flow is cut off, the cells in the brain are starved of oxygen and rapidly die.
...
Identify which step in the diagram each of the given statements is discussing. The first step has already been identified for you.

Descriptions
1.) __ As part of the body's effort to heal the initial blood vessel damage, LDL accumulates in the vessel wall. The cholesterol in the LDL becomes oxidized.
2.) __ Once the monocytes enter the vessel wall, they enlarge and become macrophages. The macrophages engulf oxidized LDL until they become fat-packed cells called foam cells. When foam cells collect in the vessel wall, they begin to form a fatty streak.
3.) __ As the fatty streak grows, smooth muscle cells migrate from deeper inside the vessel wall to the interior surface of the vessel wall. These smooth muscle cells enlarge and contribute to the expanding plaque.
4.) _1_ An injury to the interior blood vessel wall triggers an inflammatory response.
5.) __ The bulging, mature plaque made of inflamed tissue and fatty deposits can grow so large that it obstructs the flow of blood. Sometimes the plaque is hardened by calcium deposits, which further limits the flexibility and blood flow of the blood vessel.
6.) __ Oxidized LDL in the vessel wall attracts white blood cells called monocytes, which enter the cell wall and increase the inflammatory response.
1.) _2_
2.) _4_
3.) _5_
4.) _1_
5.) _6_
6.) _3_
Ellen is a 55-year-old woman with multiple medical problems, including chronic back pain. She is 66 inches tall and weighs 286 pounds. She takes medications for high blood pressure and hypercholesterolemia, both of which are currently under control. She also takes pain medications every day and has difficulty walking, although she occasionally attends a water exercise class at the local sports center. She states that she has been overweight most of her life and confesses that foods, especially sweet foods, are a comfort to her when she experiences physical or emotional pain. Her diet history reveals an intake of two or three cans of ginger ale or root beer each day. Her usual meals with her husband include meat or chicken (she does not like fish) and vegetables, such as corn or potatoes. She snacks on several types of frozen desserts between meals. She enjoys milk on occasion but admits that it is not a part of her regular diet. A recent visit to her doctor reveals a weight gain of 15 pounds over the past six months and an increase in her fasting blood glucose level into the "pre-diabetes" range. She has no family history of diabetes. Her doctor has recommended she lose weight and make lifestyle changes to prevent her from developing diabetes.

1. Prior to gaining 15 pounds over the last six months, Ellen was _____ which is associated with _______, an underlying cause of most other chronic diseases.

a. overweight; heart disease
b. obese; chronic inflammation
c. obese; heart disease
d. overweight; metabolic syndrome
e. obesity; cancer
obese; chronic inflammation
Ellen is a 55-year-old woman with multiple medical problems, including chronic back pain. She is 66 inches tall and weighs 286 pounds. She takes medications for high blood pressure and hypercholesterolemia, both of which are currently under control. She also takes pain medications every day and has difficulty walking, although she occasionally attends a water exercise class at the local sports center. She states that she has been overweight most of her life and confesses that foods, especially sweet foods, are a comfort to her when she experiences physical or emotional pain. Her diet history reveals an intake of two or three cans of ginger ale or root beer each day. Her usual meals with her husband include meat or chicken (she does not like fish) and vegetables, such as corn or potatoes. She snacks on several types of frozen desserts between meals. She enjoys milk on occasion but admits that it is not a part of her regular diet. A recent visit to her doctor reveals a weight gain of 15 pounds over the past six months and an increase in her fasting blood glucose level into the "pre-diabetes" range. She has no family history of diabetes. Her doctor has recommended she lose weight and make lifestyle changes to prevent her from developing diabetes.

2. Which is a risk factor for chronic diseases based on Ellen's current diet and lifestyle?

a. High consumption of plant proteins
b. A diet high in vitamins and/or minerals
c. Low intake of fiber and phytochemicals
d. Low added sugar intake
e. Excessive alcohol intake
Low intake of fiber and phytochemicals
Ellen is a 55-year-old woman with multiple medical problems, including chronic back pain. She is 66 inches tall and weighs 286 pounds. She takes medications for high blood pressure and hypercholesterolemia, both of which are currently under control. She also takes pain medications every day and has difficulty walking, although she occasionally attends a water exercise class at the local sports center. She states that she has been overweight most of her life and confesses that foods, especially sweet foods, are a comfort to her when she experiences physical or emotional pain. Her diet history reveals an intake of two or three cans of ginger ale or root beer each day. Her usual meals with her husband include meat or chicken (she does not like fish) and vegetables, such as corn or potatoes. She snacks on several types of frozen desserts between meals. She enjoys milk on occasion but admits that it is not a part of her regular diet. A recent visit to her doctor reveals a weight gain of 15 pounds over the past six months and an increase in her fasting blood glucose level into the "pre-diabetes" range. She has no family history of diabetes. Her doctor has recommended she lose weight and make lifestyle changes to prevent her from developing diabetes.

3. Ellen's high intake of added sugars from frozen desserts and daily soft drink consumption puts her at higher risk for:

a. stroke.
b. hypertension.
c. cancer.
d. atherosclerosis.
e. obesity.
obesity.
Ellen is a 55-year-old woman with multiple medical problems, including chronic back pain. She is 66 inches tall and weighs 286 pounds. She takes medications for high blood pressure and hypercholesterolemia, both of which are currently under control. She also takes pain medications every day and has difficulty walking, although she occasionally attends a water exercise class at the local sports center. She states that she has been overweight most of her life and confesses that foods, especially sweet foods, are a comfort to her when she experiences physical or emotional pain. Her diet history reveals an intake of two or three cans of ginger ale or root beer each day. Her usual meals with her husband include meat or chicken (she does not like fish) and vegetables, such as corn or potatoes. She snacks on several types of frozen desserts between meals. She enjoys milk on occasion but admits that it is not a part of her regular diet. A recent visit to her doctor reveals a weight gain of 15 pounds over the past six months and an increase in her fasting blood glucose level into the "pre-diabetes" range. She has no family history of diabetes. Her doctor has recommended she lose weight and make lifestyle changes to prevent her from developing diabetes.

4. Ellen's doctor also orders a lipid profile and reviews the results in conjunction with the results of her history and physical examination. Which of the following is considered to indicate high risk of heart disease?

a. Total blood cholesterol of 220 mg/dL
b. HDL cholesterol of 30 mg/dL
c. Triglycerides of 165 mg/dL
d. LDL cholesterol of 95 mg/dL
e. Blood pressure of 136/85
HDL cholesterol of 30 mg/dL
Ellen is a 55-year-old woman with multiple medical problems, including chronic back pain. She is 66 inches tall and weighs 286 pounds. She takes medications for high blood pressure and hypercholesterolemia, both of which are currently under control. She also takes pain medications every day and has difficulty walking, although she occasionally attends a water exercise class at the local sports center. She states that she has been overweight most of her life and confesses that foods, especially sweet foods, are a comfort to her when she experiences physical or emotional pain. Her diet history reveals an intake of two or three cans of ginger ale or root beer each day. Her usual meals with her husband include meat or chicken (she does not like fish) and vegetables, such as corn or potatoes. She snacks on several types of frozen desserts between meals. She enjoys milk on occasion but admits that it is not a part of her regular diet. A recent visit to her doctor reveals a weight gain of 15 pounds over the past six months and an increase in her fasting blood glucose level into the "pre-diabetes" range. She has no family history of diabetes. Her doctor has recommended she lose weight and make lifestyle changes to prevent her from developing diabetes.

5. To decrease her risk of cardiovascular disease, Ellen should:

a. Limit saturated fat to less than 15% of daily kcalories.
b. Limit cholesterol to less than 400 milligrams per day.
c. Limit sodium intake to less than 2500 milligrams per day.
d. Limit trans fats to less than 1% of daily kcalories.
e. Consume three alcoholic beverages per day if male, and two if female.
Limit trans fats to less than 1% of daily kcalories.
Ellen is a 55-year-old woman with multiple medical problems, including chronic back pain. She is 66 inches tall and weighs 286 pounds. She takes medications for high blood pressure and hypercholesterolemia, both of which are currently under control. She also takes pain medications every day and has difficulty walking, although she occasionally attends a water exercise class at the local sports center. She states that she has been overweight most of her life and confesses that foods, especially sweet foods, are a comfort to her when she experiences physical or emotional pain. Her diet history reveals an intake of two or three cans of ginger ale or root beer each day. Her usual meals with her husband include meat or chicken (she does not like fish) and vegetables, such as corn or potatoes. She snacks on several types of frozen desserts between meals. She enjoys milk on occasion but admits that it is not a part of her regular diet. A recent visit to her doctor reveals a weight gain of 15 pounds over the past six months and an increase in her fasting blood glucose level into the "pre-diabetes" range. She has no family history of diabetes. Her doctor has recommended she lose weight and make lifestyle changes to prevent her from developing diabetes.

6. If Ellen were to reduce her weight to a healthy level and maintain a BMI of between 18.5 and 24.9, how much of a blood pressure reduction would she likely achieve for each 10 kg she lost?

a. 2 mm Hg
b. 6 mm Hg
c. 8 mm Hg
d. 4 mm Hg
e. 10 mm Hg
10 mm Hg
Ellen is a 55-year-old woman with multiple medical problems, including chronic back pain. She is 66 inches tall and weighs 286 pounds. She takes medications for high blood pressure and hypercholesterolemia, both of which are currently under control. She also takes pain medications every day and has difficulty walking, although she occasionally attends a water exercise class at the local sports center. She states that she has been overweight most of her life and confesses that foods, especially sweet foods, are a comfort to her when she experiences physical or emotional pain. Her diet history reveals an intake of two or three cans of ginger ale or root beer each day. Her usual meals with her husband include meat or chicken (she does not like fish) and vegetables, such as corn or potatoes. She snacks on several types of frozen desserts between meals. She enjoys milk on occasion but admits that it is not a part of her regular diet. A recent visit to her doctor reveals a weight gain of 15 pounds over the past six months and an increase in her fasting blood glucose level into the "pre-diabetes" range. She has no family history of diabetes. Her doctor has recommended she lose weight and make lifestyle changes to prevent her from developing diabetes.

7. Ellen's doctor encourages her to reduce her risk of developing type 2 diabetes by making some lifestyle changes. All of the following diet and lifestyle changes associated with reducing risk of diabetes except:

a. Lose weight.
b. Snack on an apple with peanut butter instead of frozen desserts.
c. Stop smoking.
d. Increase physical activity.
e. Drink water in place of soda.
Stop smoking.
Ellen is a 55-year-old woman with multiple medical problems, including chronic back pain. She is 66 inches tall and weighs 286 pounds. She takes medications for high blood pressure and hypercholesterolemia, both of which are currently under control. She also takes pain medications every day and has difficulty walking, although she occasionally attends a water exercise class at the local sports center. She states that she has been overweight most of her life and confesses that foods, especially sweet foods, are a comfort to her when she experiences physical or emotional pain. Her diet history reveals an intake of two or three cans of ginger ale or root beer each day. Her usual meals with her husband include meat or chicken (she does not like fish) and vegetables, such as corn or potatoes. She snacks on several types of frozen desserts between meals. She enjoys milk on occasion but admits that it is not a part of her regular diet. A recent visit to her doctor reveals a weight gain of 15 pounds over the past six months and an increase in her fasting blood glucose level into the "pre-diabetes" range. She has no family history of diabetes. Her doctor has recommended she lose weight and make lifestyle changes to prevent her from developing diabetes.

8. Ellen's excess body fat combined with her the lack phytochemicals and antioxidants from non-starchy vegetables and low physical activity increases her risk for ______.

a. high blood pressure
b. stroke
c. cancer
d. high HDL
e. osteoporosis
cancer
In Diet & Wellness Plus you will create the below profile and add the foods below. You will then pull Reports and answer the questions.

Topic: Diabetes
Menu: One Day Menu for Diabetes Management
DWP Reports Used:
Intake vs. Goals
Source Analysis: Carbohydrate
Exchanges Spreadsheet
Profile for Sue Zhu:
Birth Date: Insert a birthday so that Sue is 36 months old when you deploy the assignment.
Gender: Female
Height: 3 ft, 4 inches
Weight: 34 lbs
Not Pregnant, Non-Smoker, Non Strict Vegetarian/Vegan
Activity Level: Active
Track Diet:
Sample Menu for Child with Type 1 Diabetes
Breakfast
Pancakes (1 item)
Peanut Butter, Smooth (2 teaspoons)
Juice, Orange (4 fluid ounces)
Morning Snack
Grapes, Red or Green (0.5 cups - Seedless)
Cheese, Mozzarella, Part Skim Milk (0.5 ounce)
Lunch
Bread, 100% Whole Wheat (1 slices - 3 ¾ in. x 5 in. x ½ in.)
Ham, Sliced, Prepackaged or Deli (1 slice - 4 ¼ in. squares)
Avocado, California (0.22 items fruit without skin)
Milk, Low Fat, 1% (4 fluid ounces)
Afternoon Snack
Cereal, Granola, Prepared (0.25 cups)
Dinner
Soup, Chicken Noodle (0.75 cups)
Cornbread (0.5 pieces)
Broccoli, Chopped, Boiled, Drained (0.5 cups)
Milk, Low Fat, 1% (4 fluid ounces)

1. Sue is a 4-year-old girl who was diagnosed with Type 1 diabetes when she was 1. Her parents have learned that spacing out Sue's carbohydrates throughout the day helps to keep her blood sugar levels stable. Each meal (breakfast, lunch, and dinner) provides roughly how many grams carbohydrate per meal?

a. 30 grams carbohydrate per meal
b. 15 grams carbohydrate per meal
c. 50 grams carbohydrate per meal
d. 20 grams carbohydrate per meal
30 grams carbohydrate per meal
In Diet & Wellness Plus you will create the below profile and add the foods below. You will then pull Reports and answer the questions.

Topic: Diabetes
Menu: One Day Menu for Diabetes Management
DWP Reports Used:
Intake vs. Goals
Source Analysis: Carbohydrate
Exchanges Spreadsheet
Profile for Sue Zhu:
Birth Date: Insert a birthday so that Sue is 36 months old when you deploy the assignment.
Gender: Female
Height: 3 ft, 4 inches
Weight: 34 lbs
Not Pregnant, Non-Smoker, Non Strict Vegetarian/Vegan
Activity Level: Active
Track Diet:
Sample Menu for Child with Type 1 Diabetes
Breakfast
Pancakes (1 item)
Peanut Butter, Smooth (2 teaspoons)
Juice, Orange (4 fluid ounces)
Morning Snack
Grapes, Red or Green (0.5 cups - Seedless)
Cheese, Mozzarella, Part Skim Milk (0.5 ounce)
Lunch
Bread, 100% Whole Wheat (1 slices - 3 ¾ in. x 5 in. x ½ in.)
Ham, Sliced, Prepackaged or Deli (1 slice - 4 ¼ in. squares)
Avocado, California (0.22 items fruit without skin)
Milk, Low Fat, 1% (4 fluid ounces)
Afternoon Snack
Cereal, Granola, Prepared (0.25 cups)
Dinner
Soup, Chicken Noodle (0.75 cups)
Cornbread (0.5 pieces)
Broccoli, Chopped, Boiled, Drained (0.5 cups)
Milk, Low Fat, 1% (4 fluid ounces)

2. The carbohydrate recommendation for people who have diabetes is the same as it is for people without diabetes: 45-65% of total calories should come from carbohydrate. What percent of calories in this menu come from carbohydrate?

a. 57% of calories from carbohydrate
b. 12% of calories from carbohydrate
c. 62% of calories from carbohydrate
d. 49% of calories from carbohydrate
49% of calories from carbohydrate
In Diet & Wellness Plus you will create the below profile and add the foods below. You will then pull Reports and answer the questions.

Topic: Diabetes
Menu: One Day Menu for Diabetes Management
DWP Reports Used:
Intake vs. Goals
Source Analysis: Carbohydrate
Exchanges Spreadsheet
Profile for Sue Zhu:
Birth Date: Insert a birthday so that Sue is 36 months old when you deploy the assignment.
Gender: Female
Height: 3 ft, 4 inches
Weight: 34 lbs
Not Pregnant, Non-Smoker, Non Strict Vegetarian/Vegan
Activity Level: Active
Track Diet:
Sample Menu for Child with Type 1 Diabetes
Breakfast
Pancakes (1 item)
Peanut Butter, Smooth (2 teaspoons)
Juice, Orange (4 fluid ounces)
Morning Snack
Grapes, Red or Green (0.5 cups - Seedless)
Cheese, Mozzarella, Part Skim Milk (0.5 ounce)
Lunch
Bread, 100% Whole Wheat (1 slices - 3 ¾ in. x 5 in. x ½ in.)
Ham, Sliced, Prepackaged or Deli (1 slice - 4 ¼ in. squares)
Avocado, California (0.22 items fruit without skin)
Milk, Low Fat, 1% (4 fluid ounces)
Afternoon Snack
Cereal, Granola, Prepared (0.25 cups)
Dinner
Soup, Chicken Noodle (0.75 cups)
Cornbread (0.5 pieces)
Broccoli, Chopped, Boiled, Drained (0.5 cups)
Milk, Low Fat, 1% (4 fluid ounces)

3. Sue has Type 1 diabetes, meaning she does not produce any insulin. Her parents give her 1 unit of insulin for every 15 grams of carbohydrate they feed her. Just before her afternoon snack of Cereal, Granola, Prepared (0.25 cups), how many units of insulin should they prepare to inject?

a. 1 unit
b. 0.5 units
c. 15 units
d. 2 units
1 unit
In Diet & Wellness Plus you will create the below profile and add the foods below. You will then pull Reports and answer the questions.

Topic: Diabetes
Menu: One Day Menu for Diabetes Management
DWP Reports Used:
Intake vs. Goals
Source Analysis: Carbohydrate
Exchanges Spreadsheet
Profile for Sue Zhu:
Birth Date: Insert a birthday so that Sue is 36 months old when you deploy the assignment.
Gender: Female
Height: 3 ft, 4 inches
Weight: 34 lbs
Not Pregnant, Non-Smoker, Non Strict Vegetarian/Vegan
Activity Level: Active
Track Diet:
Sample Menu for Child with Type 1 Diabetes
Breakfast
Pancakes (1 item)
Peanut Butter, Smooth (2 teaspoons)
Juice, Orange (4 fluid ounces)
Morning Snack
Grapes, Red or Green (0.5 cups - Seedless)
Cheese, Mozzarella, Part Skim Milk (0.5 ounce)
Lunch
Bread, 100% Whole Wheat (1 slices - 3 ¾ in. x 5 in. x ½ in.)
Ham, Sliced, Prepackaged or Deli (1 slice - 4 ¼ in. squares)
Avocado, California (0.22 items fruit without skin)
Milk, Low Fat, 1% (4 fluid ounces)
Afternoon Snack
Cereal, Granola, Prepared (0.25 cups)
Dinner
Soup, Chicken Noodle (0.75 cups)
Cornbread (0.5 pieces)
Broccoli, Chopped, Boiled, Drained (0.5 cups)
Milk, Low Fat, 1% (4 fluid ounces)

4. One of Sue's mom's friends said she heard people with diabetes should not have fruit because it contains sugar. Sue's mom informed her that fruit is a very good carbohydrate source for people with diabetes because although it contains the natural fruit sugar fructose, it is also a good source of other nutrients and fiber. Fiber helps stabilize blood sugar. How does Sue's daily fiber intake compare to her goal?

a. She ate 82% of her recommended fiber
b. She ate 101% of her recommended fiber
c. She ate 93% of her recommended fiber
d. She ate 69% of her recommended fiber
She ate 69% of her recommended fiber
In Diet & Wellness Plus you will create the below profile and add the foods below. You will then pull Reports and answer the questions.

Topic: Diabetes
Menu: One Day Menu for Diabetes Management
DWP Reports Used:
Intake vs. Goals
Source Analysis: Carbohydrate
Exchanges Spreadsheet
Profile for Sue Zhu:
Birth Date: Insert a birthday so that Sue is 36 months old when you deploy the assignment.
Gender: Female
Height: 3 ft, 4 inches
Weight: 34 lbs
Not Pregnant, Non-Smoker, Non Strict Vegetarian/Vegan
Activity Level: Active
Track Diet:
Sample Menu for Child with Type 1 Diabetes
Breakfast
Pancakes (1 item)
Peanut Butter, Smooth (2 teaspoons)
Juice, Orange (4 fluid ounces)
Morning Snack
Grapes, Red or Green (0.5 cups - Seedless)
Cheese, Mozzarella, Part Skim Milk (0.5 ounce)
Lunch
Bread, 100% Whole Wheat (1 slices - 3 ¾ in. x 5 in. x ½ in.)
Ham, Sliced, Prepackaged or Deli (1 slice - 4 ¼ in. squares)
Avocado, California (0.22 items fruit without skin)
Milk, Low Fat, 1% (4 fluid ounces)
Afternoon Snack
Cereal, Granola, Prepared (0.25 cups)
Dinner
Soup, Chicken Noodle (0.75 cups)
Cornbread (0.5 pieces)
Broccoli, Chopped, Boiled, Drained (0.5 cups)
Milk, Low Fat, 1% (4 fluid ounces)

5. Children 4-18 years old, regardless of whether they have diabetes or not, should have 25-35% of their calories coming from fat. What percent of calories in this one-day menu come from total fat?

a. 31% calories from fat
b. 29% calories from fat
c. 35% calories from fat
d. 27% calories from fat
35% calories from fat
In Diet & Wellness Plus you will create the below profile and add the foods below. You will then pull Reports and answer the questions.

Topic: Diabetes
Menu: One Day Menu for Diabetes Management
DWP Reports Used:
Intake vs. Goals
Source Analysis: Carbohydrate
Exchanges Spreadsheet
Profile for Sue Zhu:
Birth Date: Insert a birthday so that Sue is 36 months old when you deploy the assignment.
Gender: Female
Height: 3 ft, 4 inches
Weight: 34 lbs
Not Pregnant, Non-Smoker, Non Strict Vegetarian/Vegan
Activity Level: Active
Track Diet:
Sample Menu for Child with Type 1 Diabetes
Breakfast
Pancakes (1 item)
Peanut Butter, Smooth (2 teaspoons)
Juice, Orange (4 fluid ounces)
Morning Snack
Grapes, Red or Green (0.5 cups - Seedless)
Cheese, Mozzarella, Part Skim Milk (0.5 ounce)
Lunch
Bread, 100% Whole Wheat (1 slices - 3 ¾ in. x 5 in. x ½ in.)
Ham, Sliced, Prepackaged or Deli (1 slice - 4 ¼ in. squares)
Avocado, California (0.22 items fruit without skin)
Milk, Low Fat, 1% (4 fluid ounces)
Afternoon Snack
Cereal, Granola, Prepared (0.25 cups)
Dinner
Soup, Chicken Noodle (0.75 cups)
Cornbread (0.5 pieces)
Broccoli, Chopped, Boiled, Drained (0.5 cups)
Milk, Low Fat, 1% (4 fluid ounces)

6. Sue's parents are concerned because their daughter is somewhat picky about which foods she eats. They often worry about whether she is getting enough vitamins and if she might need a supplement. Which vitamin is Sue's diet deficient in and from which she might benefit from a supplement to help meet her needs?

a. Vitamin C
b. Vitamin D
c. Vitamin A
d. Vitamin B6
Vitamin D
In Diet & Wellness Plus you will create the below profile and add the foods below. You will then pull Reports and answer the questions.

Topic: Diabetes
Menu: One Day Menu for Diabetes Management
DWP Reports Used:
Intake vs. Goals
Source Analysis: Carbohydrate
Exchanges Spreadsheet
Profile for Sue Zhu:
Birth Date: Insert a birthday so that Sue is 36 months old when you deploy the assignment.
Gender: Female
Height: 3 ft, 4 inches
Weight: 34 lbs
Not Pregnant, Non-Smoker, Non Strict Vegetarian/Vegan
Activity Level: Active
Track Diet:
Sample Menu for Child with Type 1 Diabetes
Breakfast
Pancakes (1 item)
Peanut Butter, Smooth (2 teaspoons)
Juice, Orange (4 fluid ounces)
Morning Snack
Grapes, Red or Green (0.5 cups - Seedless)
Cheese, Mozzarella, Part Skim Milk (0.5 ounce)
Lunch
Bread, 100% Whole Wheat (1 slices - 3 ¾ in. x 5 in. x ½ in.)
Ham, Sliced, Prepackaged or Deli (1 slice - 4 ¼ in. squares)
Avocado, California (0.22 items fruit without skin)
Milk, Low Fat, 1% (4 fluid ounces)
Afternoon Snack
Cereal, Granola, Prepared (0.25 cups)
Dinner
Soup, Chicken Noodle (0.75 cups)
Cornbread (0.5 pieces)
Broccoli, Chopped, Boiled, Drained (0.5 cups)
Milk, Low Fat, 1% (4 fluid ounces)

7. Last year Sue was admitted to the hospital with diabetic ketoacidosis (DKA), a severe condition that results in electrolyte imbalance, dehydration, hyperglycemia (high blood sugar) and the production of dangerous ketoacids. Since then Sue's parents carefully watch her fluid intake as dehydration may be a symptom of DKA. How many more cups of water per day does Sue need to meet her fluid needs? (Hint: 1 g water = 1 ml water and there are 237 mls in 1 cup of water.)

a. About 4 ½ more cups
b. About 5 ½ more cups
c. About 2 ½ more cups
d. About 1 ½ more cups
About 2 ½ more cups
In Diet & Wellness Plus you will create the below profile and add the foods below. You will then pull Reports and answer the questions.

Topic: Diabetes
Menu: One Day Menu for Diabetes Management
DWP Reports Used:
Intake vs. Goals
Source Analysis: Carbohydrate
Exchanges Spreadsheet
Profile for Sue Zhu:
Birth Date: Insert a birthday so that Sue is 36 months old when you deploy the assignment.
Gender: Female
Height: 3 ft, 4 inches
Weight: 34 lbs
Not Pregnant, Non-Smoker, Non Strict Vegetarian/Vegan
Activity Level: Active
Track Diet:
Sample Menu for Child with Type 1 Diabetes
Breakfast
Pancakes (1 item)
Peanut Butter, Smooth (2 teaspoons)
Juice, Orange (4 fluid ounces)
Morning Snack
Grapes, Red or Green (0.5 cups - Seedless)
Cheese, Mozzarella, Part Skim Milk (0.5 ounce)
Lunch
Bread, 100% Whole Wheat (1 slices - 3 ¾ in. x 5 in. x ½ in.)
Ham, Sliced, Prepackaged or Deli (1 slice - 4 ¼ in. squares)
Avocado, California (0.22 items fruit without skin)
Milk, Low Fat, 1% (4 fluid ounces)
Afternoon Snack
Cereal, Granola, Prepared (0.25 cups)
Dinner
Soup, Chicken Noodle (0.75 cups)
Cornbread (0.5 pieces)
Broccoli, Chopped, Boiled, Drained (0.5 cups)
Milk, Low Fat, 1% (4 fluid ounces)

8. Whereas the majority of people with Type 2 diabetes are overweight or obese, people with Type 1 diabetes tend to be normal weight or may be even be underweight. As she is growing, Sue's parents carefully watch her weight gain patterns and calorie intake to make sure Sue is progressing at the proper rate. How does Sue's daily caloric intake on this one day compare to her calorie goals?

a. She is eating twice as many calories as she needs
b. She is eating about half as many calories as she needs
c. She is eating only three-quarters the calories that she needs
d. She is eating about as many calories as she needs
She is eating about as many calories as she needs
In Diet & Wellness Plus you will create the below profile and add the foods below. You will then pull Reports and answer the questions.

Topic: Diabetes
Menu: One Day Menu for Diabetes Management
DWP Reports Used:
Intake vs. Goals
Source Analysis: Carbohydrate
Exchanges Spreadsheet
Profile for Sue Zhu:
Birth Date: Insert a birthday so that Sue is 36 months old when you deploy the assignment.
Gender: Female
Height: 3 ft, 4 inches
Weight: 34 lbs
Not Pregnant, Non-Smoker, Non Strict Vegetarian/Vegan
Activity Level: Active
Track Diet:
Sample Menu for Child with Type 1 Diabetes
Breakfast
Pancakes (1 item)
Peanut Butter, Smooth (2 teaspoons)
Juice, Orange (4 fluid ounces)
Morning Snack
Grapes, Red or Green (0.5 cups - Seedless)
Cheese, Mozzarella, Part Skim Milk (0.5 ounce)
Lunch
Bread, 100% Whole Wheat (1 slices - 3 ¾ in. x 5 in. x ½ in.)
Ham, Sliced, Prepackaged or Deli (1 slice - 4 ¼ in. squares)
Avocado, California (0.22 items fruit without skin)
Milk, Low Fat, 1% (4 fluid ounces)
Afternoon Snack
Cereal, Granola, Prepared (0.25 cups)
Dinner
Soup, Chicken Noodle (0.75 cups)
Cornbread (0.5 pieces)
Broccoli, Chopped, Boiled, Drained (0.5 cups)
Milk, Low Fat, 1% (4 fluid ounces)

9. As Sue ages, if she can keep her blood sugar well-controlled, she will have a lower risk of cardiovascular and other chronic diseases. Although she is young, maintaining a diet low in saturated and trans fat will further help to reduce heart disease risk. Which statement about the trans fat content of this one-day menu is correct?

a. She is eating 2 grams of trans fat less per day than she should
b. This is a trans fat-free diet
c. There is more trans fat than unsaturated fat in her diet
d. She is eating 5 more grams of trans fat per day than she should
This is a trans fat-free diet
In Diet & Wellness Plus you will create the below profile and add the foods below. You will then pull Reports and answer the questions.

Topic: Diabetes
Menu: One Day Menu for Diabetes Management
DWP Reports Used:
Intake vs. Goals
Source Analysis: Carbohydrate
Exchanges Spreadsheet
Profile for Sue Zhu:
Birth Date: Insert a birthday so that Sue is 36 months old when you deploy the assignment.
Gender: Female
Height: 3 ft, 4 inches
Weight: 34 lbs
Not Pregnant, Non-Smoker, Non Strict Vegetarian/Vegan
Activity Level: Active
Track Diet:
Sample Menu for Child with Type 1 Diabetes
Breakfast
Pancakes (1 item)
Peanut Butter, Smooth (2 teaspoons)
Juice, Orange (4 fluid ounces)
Morning Snack
Grapes, Red or Green (0.5 cups - Seedless)
Cheese, Mozzarella, Part Skim Milk (0.5 ounce)
Lunch
Bread, 100% Whole Wheat (1 slices - 3 ¾ in. x 5 in. x ½ in.)
Ham, Sliced, Prepackaged or Deli (1 slice - 4 ¼ in. squares)
Avocado, California (0.22 items fruit without skin)
Milk, Low Fat, 1% (4 fluid ounces)
Afternoon Snack
Cereal, Granola, Prepared (0.25 cups)
Dinner
Soup, Chicken Noodle (0.75 cups)
Cornbread (0.5 pieces)
Broccoli, Chopped, Boiled, Drained (0.5 cups)
Milk, Low Fat, 1% (4 fluid ounces)

10. The exchange system is one approach to meal planning for people with diabetes. The exchange system works by grouping foods into lists or exchange groups with other foods of similar carbohydrate and calorie content. Which exchange group did Sue eat the greatest number of total exchanges from in this one day menu?

a. Fat
b. Lean Meat
c. Bread or Starch
d. Fruit
Bread or Starch
Chronic diseases develop over a lifetime as a result of metabolic abnormalities induced by such factors as genetics, age, gender, and lifestyle. Diet is among the many lifestyle factors that influence the development of chronic diseases.
...
Nutrition cannot prevent or cure infectious diseases, but adequate intake of all the nutrients can help support the immune system as the body defends against disease-causing agents.
...
Heart disease, cancers, and strokes are the three leading causes of death in the United States, and diabetes also ranks among the top 10. These four chronic diseases have significant links with nutrition and with one another; other lifestyle risk factors and genetics also play a role.
...
The major causes of death around the world today are diseases of the heart and blood vessels, collectively known as cardiovascular disease (CVD).
...
The most effective dietary strategy for preventing hypertension is weight control.
...
Diabetes is characterized by high blood glucose and either insufficient insulin, ineffective insulin, or a combination of the two.
...
To obtain the best possible nutrition at the lowest possible cancer risk, eat many fruits, vegetables, legumes, and whole grains and little saturated fat; minimize weight gain through regular physical activity and a healthy diet
...
Optimal nutrition keeps people healthy and reduces the risk of chronic diseases.
...
Proteins maintain healthy skin and other epithelial tissues; participates in the synthesis and function of the organs and cells of the immune system and antibody production. Omega-3 fatty acids help to resolve inflammation when it is no longer needed for the immune response through production of lipid mediators known as resolvins and protectins, which also play a role in enhancing host defense. Vitamin A maintains healthy skin and other epithelial; participates in the cell replication and specialization that supports immune-cell and antibody production and the anti-inflammatory response. Vitamin D regulates immune cell (T-cell) responses; participates in antibody production.
...
A downward _______________ effect is often seen when impaired immunity leads to infectious diseases that further increase nutrient needs while decreasing food intake.
synergistic
A downward synergistic spiral is often seen when impaired immunity leads to infectious diseases that further increase nutrient needs while decreasing food intake.
...
All of the following are dietary-related risk factors associated with chronic diseases in this chapter except:

a. A diet high in added sugars
b. A diet high in pickled foods
c. A diet high in trans fats
d. A diet low in vitamins and minerals
e. A diet high in artificial sweeteners
A diet high in artificial sweeteners
The top two leading causes of death in the United States are ______ and ________.

a. Alzheimer's disease; cancers
b. cancers; strokes
c. heart disease; cancers
d. chronic lung disease; accidents
e. heart disease; diabetes mellitus
heart disease; cancers
An abnormal enlargement or bulging of a blood vessel (usually an artery) caused by damage to or weakness in the blood vessel wall is called an _____________.
aneurysm
An aneurysm is an abnormal enlargement or bulging of a blood vessel (usually an artery) caused by damage to or weakness in the blood vessel wall while an embolism is the obstruction or blockage of a blood vessel by a clot.
...
A heart attack is also referred to as a __________________ _____________.
myocardial infarction
Myocardial infarction is another name for a heart attack while a transient ischemic attack is a temporary reduction in blood flow to the brain.
...
_____________ ________ __________ is the most common form of cardiovascular disease.
Coronary heart disease
Coronary heart disease is the most common form of cardiovascular disease. Angina is a feeling of tightness or pressure around the heart.
...
Mary is a 25-year-old African American woman who has a family history of high blood pressure. She has not been diagnosed with hypertension, but her BMI is 31 and her diet is high in processed foods. Her doctor tells her she has several risk factors for developing hypertension. Which of the following is not currently a risk factor for Mary?

a. Age
b. Genetics
c. Ethnicity
d. Obesity
e. Sodium intake
Age
Physical activity appears to have the greatest effect on reducing blood pressure in individuals who have ____________________________________________________________________.
higher blood pressure and are less active to begin with
The higher the blood pressure and the less active a person is to begin with, the greater the effect physical activity has in reducing blood pressure.
...
Match the fasting blood glucose level with the appropriate diagnosis.
Fasting blood glucose levels are used as criteria for diabetes diagnosis and are as follows: 70-99mg/dL is normal, 100-125mg/dL is prediabetes, ≥126mg/dL is diabetes.
...
Fill in the Table
Fill in the type of diabetes described by the characteristic in the first column.
Type 1 diabetes is typically diagnosed before the age of 30, is caused by a sudden lack of insulin production and secretion by the pancreas, and always requires insulin therapy. Type 2 diabetes accounts for 90 to 95% of diabetes cases and is associated with obesity, aging, and genetics.
...
All of the following are protective factors against various forms of cancer except:

a. garlic
b. lactation
c. physical activity
d. non-starchy vegetables
e. diets high in calcium
diets high in calcium
Fill in the Table
Order the steps of cancer development from 1 to 4.
Cancer develops in the following order: 1. Mass of abnormal cells; 2. Mutagens alter the DNA in a cell and induce abnormal cell division; 3. Promoters enhance the development of abnormal cells, resulting in formation of a tumor; 4. Cancerous tumor metastasizes.
...
Which two dietary excesses are associated with an increased risk for cardiovascular disease, hypertension, diabetes, and cancer? __________________________________________________________
excess energy intake and saturated fat
Excess food energy and saturated fat intakes increase the likelihood of all four diseases.
...
Which of the following is not typically recommended for disease prevention?

a. a healthy body weight
b. no more than two alcoholic drinks a day for a man or one drink a day for a woman
c. dietary supplements
d. a physically active lifestyle
e. a diet focused on abundant plant foods
dietary supplements
Special proteins that direct immune and inflammatory responses are known as ____.

a. neutrophils
b. lymphocytes
c. cytokines
d. phagocytes
e. antigens
cytokines
Which nutrient protects the body against oxidative damage?

a. vitamin C
b. omega-3 fatty acids
c. vitamin D
d. protein
e. zinc
vitamin C
_______ participates in the cell replication and specialization that supports immune-cell and antibody production and the anti-inflammatory response.

a. Vitamin D
b. Omega-3 fatty acids
c. Zinc
d. Protein
e. Vitamin A
Vitamin A
Nutrition plays a role in ____ of the top 10 causes of death in the United States.

a. four
b. five
c. seven
d. six
e. three
four
_______ is a protein released during the acute phase of infection or inflammation that enhances immunity by promoting phagocytosis and activating platelets.

a. LDL
b. C-reactive protein
c. HDL
d. Soy protein
e. Lipoprotein-associated phospholipase A(2)
C-reactive protein
A desirable level of HDL is considered ____.

a. 60 or greater
b. 40 or greater
c. < 100
d. 40-59
e. < 150
60 or greater
Metabolic syndrome includes all of the following signs and symptoms except ___________.

a. waist circumference of greater than 35 for men and greater than 30 for women
b. blood pressure > 120/80 mm Hg
c. HDL < 40 mg/dL
d. triglycerides > 199mg/dL
e. fasting glucose > 100 mg/dL
waist circumference of greater than 35 for men and greater than 30 for women
Performing aerobic physical activity for ______ is expected to result in a blood pressure reduction of 2 to 5 mm Hg.

a. 30 minutes per day, three days per week
b. at least 40 minutes per day, most days of the week
c. at least 15 minutes per day, most days of the week
d. 60 minutes per day, two days per week
e. at least 20 minutes per day, most days of the week
at least 40 minutes per day, most days of the week
Type 1 diabetes is ____.

a. an autoimmune disorder
b. most commonly diagnosed after age 40 years
c. associated with aging and obesity
d. associated with insulin resistance
e. more common, accounting for about 90% of cases
an autoimmune disorder
In type 2 diabetes, ____.

a. ketones are produced for energy
b. cells break down protein and fat
c. some glucose enters the cells, but slowly
d. weight loss occurs despite polyphagia
e. no glucose enters the cells
some glucose enters the cells, but slowly
High consumption of red meat raises the risk of ____ cancer.

a. colon and rectum
b. liver
c. kidney
d. postmenopausal breast
e. lung
colon and rectum
The recommendation to keep total fat to 20 to 35 percent of kcalories pertains to reduction in risk of ____.

a. chronic obstructive pulmonary disease
b. diabetes
c. cardiovascular disease
d. hypertension
e. cancer
cardiovascular disease
_____ is an herb that may interact with warfarin and coumarin, prolonging bleeding time and increasing the risk of hemorrhage.

a. Saw palmetto
b. Karela
c. St. John's wort
d. Feverfew
e. Black tea
Feverfew
Which claim about herbal preparations has research support?

a. Garlic may lower blood pressure.
b. Chaparral may clear up acne.
c. Ginkgo may relieve vertigo.
d. Goldenseal may cure urinary tract infections.
e. Turmeric may reduce inflammation.
Garlic may lower blood pressure.
_______ is the use of large doses of vitamins to treat chronic disease.

a. Orthomolecular medicine
b. Macrobiotics
c. Naturopathic medicine
d. Chelation therapy
e. Homeopathy
Orthomolecular medicine
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