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Chapter 6 – Lipids
Multiple Choice
Answer, level, page Level: K = knowledge, A = application/critical thinking
c K 219 1. Lipids are generally soluble in organic solvents and insoluble in water. Thus, they are
classified as_____.
a. hydrophilic
b. alpha oils
c. hydrophobic
d. beta oils
d K 219 2. At room temperature, oils can be distinguished from fats because oils are _____ while
fats are _____.
a. fluid, dense
b. firm, stable
c. unstable, dehydrated
d. liquids, solids
b K 219 3. What does the alpha (α) end of a fatty acid contain?
a. A phosphorus atom
b. A carboxylic acid group
c. A methyl group
d. A nitrogen atom
a A 220 5. Nigel wants to choose a lipid to use in stir-frying that is more stable and thus won’t
smoke and burn as readily when he cooks with medium-high heat. To accomplish this, he
should select a lipid that contains _____ fatty acids.
a. mostly long-chain
b. mostly short-chain
c. a mix of short- and medium-chain
d. a mix of long- and medium-chain
a K 221 8. Susan is studying to be a chef and is making “compound butter”—butter that has been
softened, mixed with a seasoning to make it more flavorful, chilled, and then served in a
number of ways. What type of fat would compound butter be classified as?
a. Saturated
b. Unsaturated
c. Monounsaturated
d. Polyunsaturated
e. a and c
f. b and d
c K 222-223 9. Lea wants to limit her intake of trans fatty acids. Complete the following statement to
assist her in identifying this type of fatty acid. Trans fats are _____.
a. typically liquids at room temperature
b. generally found in foods containing polyunsaturated fatty acids (PUFAs)
c. produced commercially via a process called partial hydrogenation
d. generally found in non-organic foods
d A 223 10. You are purchasing a spread for your dinner rolls. The spread most likely to contain
substantial amounts of trans fatty acids is:
a. jelly.
b. apple butter.
c. butter.
d. margarine.
c K 222-223 11. What process is used to convert corn oil into sticks of corn-oil margarine?
a. Complete condensation
b. Partial saturation
c. Partial hydrogenation
d. Complete oxygenation
b A 223 12. Which of the following items in your grocery cart would be considered the main sources
of trans fatty acids in your diet?
a. Dairy products and fruits
b. Bakery products and margarine
c. Vegetables and fatty fish
d. Salad dressings and cooking oils
a K 224 13. In 2004, which city claimed to be the first “trans fat-free city,” leading the movement on
establishing trans fat-free zones?
a. Tiburon, California
b. Chicago, Illinois
c. New York City, New York
d. Seattle, Washington
d A 223 14. A fatty acid designated as 18:1 has:
a. 18 carbons.
b. 18 carbons in the backbone.
c. 1 double bond.
d. a and c
e. b and c
c A 224 16. A food product information sheet states that the food you are eating contains omega-6
fatty acids. Therefore, you know that the fatty acids in this food each have
a. 6 carbons.
b. 6 double bonds.
c. a double bond between carbons 6 and 7.
d. All of the above
d K 224 17. Dietitians often recommend that we frequently consume foods containing omega-3 fatty
acids. An omega-3 fatty acid is one that has its first double bond _____ end of the
molecule.
a. between the third and fourth carbons from the carboxylic acid
b. between the second and third carbons from the carboxylic acid
c. between the second and third carbons from the methyl
d. between the third and fourth carbons from the methyl
Which Fatty Acids Do We Need, and Where Do They Come From? (pp. 225-229)
b K 225 19. What are the two essential fatty acids for adults?
a. Linoleic and arachidonic
b. Linoleic and linolenic
c. Arachidonic and palmitic
d. Palmitic and docosahexaenoic (DHA)
a K 225 20. The human body cannot create double bonds in fatty acids in the _____ positions.
a. ω-3 and ω-6
b. ω-3 and ω-7
c. ω-6 and ω-9
d. ω-7 and ω-9
d K 225-226 21. Essential fatty acids are themselves required for the proper functioning of the body and
because they _____.
a. help control the levels of circulating cholesterol
b. can be converted into glycogen
c. help regulate the levels of circulating vitamins
d. can be converted into other fatty acids needed by the body
d K 225,227 22. From which fatty acids are the eicosanoids that assist and regulate the immune and
cardiovascular systems made?
a. Linoleic and arachidonic
b. Palmitic and arachidonic
c. Linolenic and palmitic
d. Linolenic and linoleic
b K 227 23. How do alterations in the balance of ω-3 to ω-6 (omega) eicosanoids influence a person’s
risk of heart disease?
a. These compounds tend to cause a heightened immune response in reaction to trauma.
b. These compounds tend to cause dilation or constriction of blood vessels.
c. These compounds tend to cause a lesser immune response in reaction to trauma.
d. These compounds tend to cause increased production of white blood cells.
a A 228 24. You are observing an outpatient dietitian working in a busy prenatal clinic. Which of the
following reasons is justification for promoting breastfeeding over formula feeding?
a. Formula lacks some of the conditionally essential long-chain polyunsaturated fatty
acids (PUFAs)
b. Formula provides too much of the conditionally essential long-chain PUFAs
c. Formula provides too much of the conditionally essential monounsaturated fatty
acids (MUFAs)
d. Formula lacks some of the conditionally essential MUFAs
c A 227 25. Your friend Ashok is consuming a very-low-fat diet in an attempt to lose weight. He
considers all dietary fats as “bad” for him and he thinks that the less fat he eats the better.
You should point out to him that a very-low-fat diet could put him at risk for developing
_____.
a. diabetes
b. gout
c. an essential fatty acid deficiency
d. an essential mineral deficiency
c A 227 26. Relatively high amounts of linoleic acid are found in soybean, safflower, and corn oils
and _____.
a. milk and dairy products
b. leafy green vegetables
c. walnuts and seeds
d. squash and pumpkins
a A 227-228 27. Which of the following food selections is most likely to provide a source of essential
fatty acids?
a. A salad with an oil and vinegar dressing
b. A smoothie made with strawberries and bananas
c. A chicken salad whole-wheat wrap
d. A vitamin- and mineral-fortified sports beverage
b K 228 28. Why do dietitians recommend that people eat salmon and other fatty fish and seafood?
a. They are good sources of palmitic acid
b. They are good sources of longer-chain ω-3 fatty acids
c. They are good sources of arachidonic acid
d. They are good sources of shorter-chain α-6 fatty acids
d A 228 29. Which of the foods listed below is most likely to provide you with a dietary source of
saturated fatty acids?
a. Green, leafy vegetables
b. Nuts, salad dressings, and cooking oils
c. Fruits and whole grains
d. Milk, eggs, and meat
b A 228 30. Marie wants to limit her intake of saturated fatty acids. To accomplish this, she should
avoid foods that have _____ oil or _____ oil as ingredients.
a. flaxseed, canola
b. coconut, palm
c. soy, corn
d. safflower, cottonseed
a A 228-229 31. Which of the following contains the greatest percentage of saturated fatty acids?
a. Pork fat
b. Margarine
c. Olive oil
d. Flaxseed oil
a K 229 32. Fatty acids are bonded to glycerol via _____ linkages.
a. ester
b. hydrogen
c. peptide
d. sulfur
b K 229 33. Fatty acids are typically found in food and in our bodies in the form of _____.
a. enzymes
b. triglycerides
c. hormones
d. glycerol
a K 229 34. Triglycerides consist of a _____ molecule chemically bonded to three fatty acids.
a. glycerol
b. glycogen
c. glucose
d. glucagon
c K 230 35. What is the process of breaking down triglycerides for the production of ATP called?
a. Lipid breakdown
b. Lipid degradation
c. Lipolysis
d. Lipogenesis
d K 230 38. The body produces _____ from fatty acids when its supply of glucose is limited.
a. glucose
b. glycogen
c. triglycerides
d. ketones
a K 230 39. Fatty acids not required for energy or other bodily functions are stored as _____ in
specialized cells called _____.
a. triglycerides, adipocytes
b. fatty acids, fat depositories
c. glycerol, lipid silos
d. ketones, ketose depositories
a K 231 40. If you have just eaten a big holiday meal, which hormone stimulates your body to store
triglycerides?
a. Insulin
b. Lipase
c. Glucagons
d. Epinephrine
d K 230 41. Which term refers to body fat or adipose tissue that is found around the vital organs?
a. Subcutaneous
b. Hidden
c. Concealed
d. Visceral
c K 231 42. Which of the following nutrients can the body store the most of in the least amount of
space?
a. Protein
b. Glucose
c. Fat
d. Glycogen
b K 231 43. The development of which of the following is an indication that someone lacks sufficient
subcutaneous adipose tissue?
a. Wrinkled skin
b. Lanugo
c. Muscle weakness
d. Lipiditis
c K 232 46. Which of the following is a common phospholipid often used as a stabilizer in food?
a. Agar
b. Ascorbic acid
c. Lecithin
d. Gum Arabic
a K 232-233 47. Because lipids are not water soluble, they require _____ to facilitate their circulation in
the body.
a. phospholipids
b. sodium
c. bile acids
d. cholesterol esters
d K 234 48. In the body, cholesterol is incorporated into cell membranes and is used to synthesize
many hormones and _____.
a. vitamin C
b. digestive enzymes
c. vitamin K
d. bile acids
c K 235 49. Eating a low-kcalorie or low-carbohydrate diet can decrease cholesterol synthesis in
_____.
a. everyone
b. adults over 50
c. some people
d. children under the age of 6
b A 235 50. Which of the following foods provides the most cholesterol in a single 3-ounce serving?
a. Peanut butter
b. Milk
c. Avocado
d. Bagel
d A 235 51. Which of the grocery items below does not contain significant amounts of cholesterol?
a. Lean beef
b. Chicken breast
c. Pork loin
d. Tofu
e. 2% milk
a K 236 52. The FDA has approved a health claim that indicates that including at least 3.4 grams of
_____ in two meals daily may reduce the risk of heart disease.
a. plant sterols
b. aspirin
c. “light” margarine
d. yogurt
How Are Dietary Lipids Digested? (pp. 236-240)
d K 236-240 54. Enzymes that can hydrolyze ester linkages are not produced in the
a. mouth.
b. stomach.
c. pancreas.
d. gallbladder.
c K 236-237 55. After fat is eaten, the majority of its digestion will take place in the:
a. mouth.
b. stomach.
c. small intestine.
d. large intestine.
b K 236 56. The basic goal of triglyceride digestion is to separate most of the fatty acids from the
_____ molecule they are attached to.
a. glucose
b. glycerol
c. sterol
d. phosphate
d K 236,240 57. Which enzymes are responsible for the digestion of triglycerides?
a. Lipidases
b. Fat depredators
c. Fat degradators
d. Lipases
c A 236 58. Gastrin circulates in the blood and stimulates the release of gastric lipase that is produced
in stomach cells. What is gastrin?
a. An enzyme
b. A very-low-density lipoprotein (VLDL)
c. A hormone
d. A high-density lipoprotein (HDL)
a K 238 59. In the first phase of intestinal triglyceride digestion, large lipid molecules are dispersed
into smaller lipid droplets called _____ so that they will not separate out into an oily layer
and thus can be further digested.
a. micelles
b. emulsions
c. suspensions
d. globules
b K 237 60. What hormone stimulates the gallbladder to contract and release bile into the duodenum?
a. Retinolase (RNS)
b. Cholecystokinin (CCK)
c. Insulin
d. Glucagon
c A 239 61. Kay has had her gallbladder removed. Which of the following foods is most likely to be
difficult for her to digest?
a. Spicy salsa
b. Steamed shrimp
c. French fries
d. Poppy-seed rolls
b K 240 62. What substance stimulates the pancreas to release pancreatic lipase?
a. Thyroxin
b. Secretin
c. Homocysteine
d. Phospholipids
How Are Dietary Lipids Absorbed and Circulated in the Body? (pp. 240-243)
d K 241-242 63. In order for short- and medium-chain fatty acids to be circulated away from the small
intestine in the blood, they are first bound to _____.
a. cholesterol
b. vitamin D
c. triglycerides
d. albumin
b K 242 64. Which lipoprotein do intestinal cells synthesize in order to circulate long-chain fatty acids
away from the gastrointestinal tract?
a. VLDL
b. Chylomicrons
c. Triglycerides
d. LDL
d K 243 65. What enzyme produced by muscle and adipose tissues enables the cells in these tissues to
release fatty acids from circulating chylomicrons?
a. Lipoprotein dehydrogenase
b. Lipid synthetase
c. Lipid oxygenase
d. Lipoprotein lipase
What Is the Role of Other Lipoproteins in Lipid Transport and Delivery? (pp. 243-246)
b K 243 66. What is the body’s central command center for regulating lipid metabolism?
a. Brain
b. Liver
c. Pancreas
d. Large intestine
a K 244 67. The more protein and less fat that a lipoprotein contains, the more _____ it is.
a. dense
b. unstable
c. bulky
d. resilient
c K 244 68. The difference between chylomicrons and VLDL is that chylomicrons are made from the
fat in ingested food by the _____ while VLDL can be made from excess carbohydrate,
lipid, or protein by the _____.
a. liver, adipocytes
b. gallbladder, adipiocytes
c. intestinal cells, liver
d. stomach, pancreas
b A 244-245 69. Lipoproteins vary in density. Select the grouping below that correctly orders the
lipoproteins from least to most dense (left to right).
a. HDL, LDL, IDL, VLDL
b. Chylomicrons, VLDL, IDL, LDL, HDL
c. Chylomicons, LDL, HDL, VLDL, IDL
d. HDL, chylomicrons, VLDL, LDL, IDL
c K 245 70. Low-density lipoproteins (LDLs) can contribute to the build-up of plaque that narrows
blood vessels; however, LDLs are necessary because they are used to synthesize _____.
a. cis fatty acids
b. ω-3 fatty acids
c. eicosanoids
d. chylomicrons
d K 245 71. While the relationship between diet and LDL blood levels is complex, there is evidence
that _____ and/or _____ can increase LDL concentrations.
a. polyunsaturated fatty acids, α-9 fatty acids
b. ω-3 fatty acids, cis fatty acids
c. fiber, ω-6 fatty acids
d. saturated fatty acids, trans fatty acids
a K 245 72. Which of the following reflects the major role of HDL, otherwise termed reverse
cholesterol transport?
a. To retrieve excess cholesterol from cells and transport it back to the liver
b. To convert cholesterol into a less harmful intermediate and transport it back to the
gallbladder
c. To chemically alter cholesterol so that it cannot form plaque and transport it out of
the body
d. To transport cholesterol to the intestines to be eliminated from the body
a A 245 73. If an individual consumes a diet high in PUFAs, omega-3 fatty acids, or dietary fiber, his
or her LDL levels will probably:
a. decrease.
b. stay the same.
c. increase.
d. None of the above
d K 245-246 74. Current research suggests that diets that are _____ in carbohydrate may actually increase
the risk of heart disease in some people because they sometimes lower HDL-C levels.
a. low
b. moderate
c. high
d. very high
What Is the Relationship Between Lipid Intake and Your Health? (pp. 246-248)
b K 247 75. Food manufacturers are required to add vitamins D, A, K, and E to foods containing
“olestra.” Why are these vitamins added?
a. Olestra increases the body’s utilization of fat-soluble vitamins.
b. Olestra interferes with the absorption of these fat-soluble vitamins in the
gastrointestinal tract.
c. Olestra increases the conversion of fat-soluble vitamins into cholesterol.
d. Olestra interferes with the uptake of fat-soluble vitamins by cell membranes.
b K 247 76. The ability of the cells to take up LDL particles may be influenced by mutations in the
genes that code for _____.
a. VLDL lipase
b. LDL receptor proteins
c. SFA receptor proteins
d. MUFA transferase
a K 248 77. Experts advised which of the following recommendations to reduce the risk of cancer?
a. Consume high-fat “fast foods” sparingly if at all
b. Choose energy-dense foods from each food group
c. Reduce overall kcalorie intake by consuming foods that contain “fat substitutes”
d. All of the above
b K 248 78. What are the Adequate Intakes (AIs) of linoleic acid for adults?
a. 15 g/day for males, 10 g/day for females
b. 17 g/day for males, 12 g/day for females
c. 19 g/day for males, 14 g/day for females
d. 21 g/day for males, 16 g/day for females
d K 248 79. If the AI for linolenic acid is 1.6 and 1.1 g/d for adult males and females, respectively,
how much soybean oil would an adult need to consume in a day to meet his needs?
a. 1 teaspoon
b. 1 ½ teaspoons
c. 1 tablespoon
d. 1 ½ tablespoons
b K 250-251 80. Healthy adults are recommended to consume _____ of their energy from lipids.
a. 5%-20%
b. 20%-35%
c. 35%-50%
d. 50%-65%
d A 250-251 81. According to the Acceptable Macronutrient Distribution Ranges (AMDRs), how much of
Leslie’s 2400-kcalorie intake should come from lipid?
a. 200-240 kcal
b. 250-330 kcal
c. 360-470 kcal
d. 480-840 kcal
d A 249 82. If Heather needs 1800 kcalories each day, what is the maximum number of kcalories that
should come from saturated fatty acids based on the American Heart Association
recommendations?
a. 135
b. 180
c. 360
d. 126
a K 249 83. The Dietary Guidelines suggest that saturated fatty acids should constitute no more than
_____ percent of one’s total kcalories.
a. 10
b. 15
c. 20
d. 25
d K 249 84. The USDA Dietary Guidelines recommend that we give priority to limiting our intake of
trans fatty acids, cholesterol, and _____.
a. triglycerides
b. cis fatty acids
c. monounsaturated fatty acids
d. saturated fatty acids
c K 250 85. The Dietary Guidelines recommend that we consume less than _____ of cholesterol
daily.
a. 100 mg
b. 100 grams
c. 300 mg
d. 30 grams
Refer to the food labels for milk, cereal, bagels, and cream cheese when answering questions 86-95.
d A 229,249 86. How many kcalories from fat are provided in 2 servings of Sunny Start cereal?
a. 1
b. 2
c. 9
d. 18
d A 249 87. Given that the Daily Value for fat is 65 g, what percentage of the DV for total fat is
obtained if 1 serving of Sunny cereal is consumed with 1 serving of milk?
a. 2
b. 5
c. 7
d. 9
b A 229,249 88. If Gayla’s energy requirement is 2100 kcal/day, and she eats an Oscar’s bagel with 2
tablespoons cream cheese, how many more grams of saturated fat can she consume that
day without exceeding the Dietary Guidelines recommendation?
a. 5
b. 19
c. 36
d. 174
Food Labels for Milk, Sunny Start Cereal, Oscar’s Bagels, and Auntie Em’s Cream Cheese (left to right)
c A 249 89. How many total grams of fat are provided in the following meal: 1 serving of Sunny Start
cereal with 1 cup of milk, 1 bagel with 1 Tbsp. cream cheese, and 1 cup of milk?
a. 10
b. 15
c. 16
d. 18
c A 229,249 90. How many total kcalories from fat are provided in the following meal: 1 serving of
Sunny Start cereal with 1 cup of milk, 1 bagel with 1 Tbsp. cream cheese, and 1 cup of
milk?
a. 90
b. 135
c. 144
d. 162
a A 229,249 91. What percentage of the total kcalories is provided by fat in the following meal: 1 serving
of Sunny Start cereal with 1 cup of milk, 1 bagel with 1 Tbsp cream cheese, and 1 cup of
milk?
a. 19
b. 22
c. 23
d. 24
d A 249 92. Given that the Daily Value for fat is 65 g. what percentage of the DV for total fat is
provided by the following meal: 1 serving of Sunny Start cereal with 1 cup of milk, 1
bagel with 1 Tbsp cream cheese, and 1 cup of milk?
a. 14
b. 16
c. 19
d. 24
c A 249 93. Given that quantities of macronutrients <0.5 g may be rounded down to 0 g for food
labels, what is the maximum amount of trans fatty acids that you would consume in the
following meal: 1 serving of Sunny Start cereal with 1 cup of milk, 1 bagel with 1 Tbsp
cream cheese, and 1 cup of milk?
a. 2 g
b. 3 g
c. 4 g
d. 5 g
d A 249 94. What percentage of the DV from trans fatty acids would you consume in the following
meal: 1 serving of Sunny Start Cereal with 1 cup of milk, 1 bagel with 1 Tbsp cream
cheese and 1 cup of milk?
a. Negligible, 0
b. Less than 1%
c. Closer to 2%
d. Unable to calculate; the FDA has not set a DV for trans fat
d A 249 95. Given that the Daily Value for cholesterol is 300 mg, what percentage of the DV for
cholesterol would you consume in the following meal: 1 serving of Sunny Start cereal
with 1 cup of milk, 1 bagel with 1 Tbsp cream cheese, and 1 cup of milk?
a. 7
b. 11
c. 14
d. 16
True/False
Answer, level, page
T K 219 1. All fatty acids contain a methyl end, a carboxylic acid end, and a backbone composed of
a carbon chain.
F K 219 2. The alpha end of a fatty acid is a methyl group.
F A 222 3. Most naturally-occurring unsaturated fatty acids are trans fatty acids.
F A 225 4. Humans cannot eat synthesized fatty acids.
F K 228 5. The typical American diet does not include foods rich in the essential fatty acids;
therefore, a supplement is needed.
F K 228 6. Generally speaking, saturated fatty acids are contributed primarily by plant foods,
whereas polyunsaturated fatty acids come primarily from animal foods.
T K 229 7. Lipid is the most concentrated source of energy among the energy-yielding nutrients.
T K 232 8. Cell membranes are composed of a phospholipid bilayer.
F K 233 9. Cholesterol is a fatty acid found in animal foods and made by the body.
F K 235 10. Cholesterol is made only in the liver.
F K 236 11. Although minor, fat digestion begins in the stomach.
T K 237 12. Emulsification of lipid globules in the small intestine is facilitated by bile.
F K 240 13. Both cholesterol and cholesterol esters need to be digested prior to absorption.
F K 242,244 14. Like the other lipoproteins, chylomicrons are synthesized in the liver.
F K 242 15. Chylomicrons are absorbed and go by way of the portal vein to be released into the
circulation.
T K 245 16. HDLs have more protein than the other lipoproteins.
F K 245 17. HDLs deliver cholesterol to tissues that use it for structural and metabolic purposes.
T A 245-246 18. Research now suggests that high-carbohydrate diets can lower HDL levels.
F K 247 19. Olestra is a fat substitute made from sucrose with fatty acids bonded to it. Consequently,
it provides the same amount of energy as fat does, gram for gram.
T K 248 20. Being obese increases your risk of cancer.
Discussion
1. How can consumers identify the types and amounts of lipid that they are consuming?
Answer (key points): The Nutrition Facts label provides information on the grams of total fat, saturated fat,
cholesterol, and trans fat per serving and the contributions of the first three to % DV. Calories from fat are
calculated as well. (p. 249)
2. What difference does it make if someone’s diet contains more saturated and/or trans fat than is recommended?
Answer (key points): Diets that are high in saturated fat and/or trans fat increase the risk for cardiovascular
disease in some people, whereas monounsaturated fat may have the opposite effect. (p. 246)
3. What are the pros and cons of requiring that the amount of trans fat that food items contain be indicated on the
food labels?
Answer (key points): Pro: Increases consumer awareness and ability to make better food choices. Many food
manufacturers have changed food preparation and processing methods in order to decrease or eliminate trans
fatty acids from many foods. Con: Food manufacturers are still allowed to label foods as “trans fat-free” if a
serving has <0.5 g trans fatty acids, and list “0 g trans fat” on its label and list “shortening” or “partially-
hydrogenated vegetable oil” on the Nutrition Facts label. This has caused enough concern that some cities have
created trans fat-free zones. (pp. 223, 224)
4. Why are some fatty acids considered essential, and what are their roles in the body?
Answer (key points): Linoleic acid and linolenic acid are essential fatty acids because the body cannot add a
double bond in a fatty acid between the third and fourth or sixth and seventh carbons from the methyl end.
Essential fatty acids (EFA) are precursors to eicosanoids, which are involved in regulating the immune and
cardiovascular systems and act as chemical messengers to direct a variety of physiological functions (such as
blood pressure regulation). Linolenic acid serves as a precursor for components of membranes in nerve tissue
and the retina. (pp. 225-227)
5. What fat-containing foods should be consumed as sources of “healthy” fats and what foods should be limited
because they are sources of less healthy fats? Does eating only “low-fat” foods ensure that one’s diet is healthy?
Answer (key points): Healthy fats would include those from nuts (walnuts), seeds, and certain oils such as
soybean, safflower, corn, flaxseed, olive, or canola oils. Less healthy fats would be those that are saturated
(from animal products), tropical oils (palm or coconut), and partially-hydrogenated fat (trans fatty acids). Low-
fat foods may be a better choice for cardiovascular health, but they are not “calorie-free” and so must be
consumed with portion control in mind. (pp. 227-229, 246-248)
6. What food preparation guidelines should consumers who want to decrease their intake of less healthy lipids
follow?
Answer (key points): The USDA Dietary Guidelines recommend limiting intake of saturated fatty acids, trans
fatty acids, and cholesterol. Consumers should:
• Limit intake of saturated fats (beef and butter fat)
• Limit intake of tropical oils such as coconut oil and palm oil
• Decrease intake of commercially prepared cakes, pastries, doughnuts, and French fries
• Use oils instead of partially-hydrogenated shortening
• Use tub or “trans fat-free” margarine instead of stick margarine—or use butter
• Choose cookies and crackers made with vegetable oil instead of partially-hydrogenated oils
• Limit intake of high-cholesterol foods such as liver, eggs, cheesecake, and custards.
• Replace high-fat animal products with lower-fat products such as lean cuts of meat and 2% milk.
(pp. 249-250)
7. What guidelines should parents who are planning to bottle-feed their infant be given with regard to the lipid
composition of the formula they choose?
Answer (key points): Some research suggests that it may be beneficial to purchase infant formula fortified with
long-chain PUFAs (arachidonic acid and docosahexaenoic acid or DHA) that are conditionally essential
nutrients during infancy and naturally found in breast milk. (p. 228)
8. What action should the consumer take if “partially-hydrogenated vegetable oil” is listed as one of the first three
ingredients on a food label? Why?
Answer (key points): To limit the sources of trans fatty acids in the diet (identified by “partially-hydrogenated
vegetable oil” as one of the first three ingredients listed on the label), replace the item with a similar food that
lists “liquid vegetable oil” as one of the first three ingredients. (pp. 223, 250)
10. How is it possible that someone could gain body fat without eating any lipid?
Answer (key points): Excess energy consumed in the form of carbohydrates or protein can be stored as lipid
for later use by the body. (pp. 230-231)
11. What are the advantages of having cell membranes that contain phospholipids rather than just lipids?
Answer (key points): Phospholipids are amphipathic—they contain both nonpolar and polar portions. In this
way, phospholipids can interact with water or other hydrophilic substances on their polar end and hydrophobic
substances such as lipids on the other end (fatty acid portion). They can form a bilayer that acts as a barrier
between the inside and outside of the cell (because of the hydrophobic interior) but still allows communication
between the inside and outside (because of the hydrophilic exterior). (pp. 232-233)
12. What foods do you eat that contain phospholipids, and why are these often added to foods?
Answer (key points): Phospholipids are found naturally in most foods because they are components of cell
membranes (animals) and cell walls (plants). They are also used as a food additive, particularly to stabilize
foods such as mayonnaise and ice cream so they don’t separate. Look for “lecithin” or its less common name,
phophatidylcholine, on the food label. (p. 232)
13. What are the current thoughts of researchers with regard to the role of various lipids in disorders and/or diseases
such as obesity, heart disease, and cancer?
Answer (key points): High dietary fat intake is associated with increased risk for obesity and cardiovascular
disease, and indirectly with increased risk for cancer. (pp. 246-248)
14. What is the Therapeutic Lifestyle Change (TLC) diet, and what recommendations are included?
Answer (key points): The TLC diet was recommended by the National Cholesterol Education Program
(NCEP) in 2001 for individuals with increased risk of cardiovascular disease. Recommendations include
obtaining less than 7% of your day’s total kcalories from SFA and consumption of no more than 200 mg/day of
cholesterol. (p. 250)
Figure Identification
A. Identify the degree of saturation of each fatty acid.
Key:
1. Glycerol
2. Ester
3. Fatty acids
4. triglyceride
Nutrition Matters 6 – Nutrition and Cardiovascular Health
Multiple Choice
Answer, level, page Level: K = knowledge, A = application/critical thinking
d K 254 3. The narrowing and hardening of the blood vessels that supply blood is termed _____.
a. aneurysm
b. hyperlipidemia
c. high blood pressure
d. atherosclerosis
b K 255 9. Emerging research suggests that chronic _____ may play a critical role in triggering the
process of atherosclerosis.
a. dieting
b. inflammation
c. high blood pressure
d. high cholesterol intake
a K 255 10. A high concentration of which of the following biological markers is related to increased
risk for cardiovascular disease?
a. C-reactive protein
b. Albumin
c. Blood glucose
d. HDL cholesterol
c K 256 11. When the heart muscle is still receiving some blood, but not as much as it needs, the
person suffers chest pain and discomfort. What is this condition called?
a. Infarction
b. Cardiac distress
c. Angina
d. Cardiac arrest
b K 256,257 12. What is the difference between a heart attack and a stroke?
a. The severity of symptoms
b. The organ affected
c. The rapid nature of the onset
d. The underlying cause
c A 254 13. When the blood supply to the heart is severely reduced or stopped, an individual has a
a. stroke.
b. TIA.
c. myocardial infarction.
d. DASH.
c K 257 14. A person who is experiencing sudden numbness or weakness on one side of the body,
confusion, slurred speech, or a severe headache is likely experiencing _____.
a. a heart attack
b. severe indigestion
c. a stroke
d. an aneurysm
What Are the Risk Factors for Cardiovascular Disease? (pp. 257-259)
a K 258 15. The risk factors for cardiovascular disease that include age, gender, genetics, and race are
classified as _____ and _____.
a. major, nonmodifiable
b. contributing, nonmodifiable
c. major, modifiable
d. contributing, modifiable
d K 258 16. The lifestyle risk factors for cardiovascular disease include elevated blood lipids, stress,
excessive alcohol consumption, and _____.
a. urban living
b. unemployment
c. air pollution
d. high blood pressure
d K 259 18. The most important modifiable risk factor for heart disease is probably:
a. high blood lipids.
b. smoking.
c. physical inactivity.
d. obesity.
a K 258 20. Of the modifiable risk factors for cardiovascular disease, which are major causes of high
blood pressure?
a. Obesity and smoking
b. Smoking and elevated lipids
c. Obesity and stress
d. Smoking and alcohol consumption
d K 258 21. What is the desirable level for total blood cholesterol?
a. 300 mg/dL and above
b. 240 mg/dL and above
c. 200-239 mg/dL
d. Below 200 mg/dL
b A 258-259 22. Jasmine’s high-density lipoprotein level is 60 mg/dL. This level is considered to be of
_____.
a. some concern and should be monitored
b. no concern and nothing more needs to be done
c. moderate concern and she should modify her diet
d. high concern and she likely needs medication to bring the level down
c K 258,259 23. A desirable total cholesterol level is below _____, while a desirable HDL is above _____.
a. 230, 50
b. 210, 40
c. 200, 60
d. 220, 70
e. All of the above
a K 259 24. Which lipoprotein transports cholesterol in the blood to cells?
a. Low-density lipoprotein (LDL)
b. Intermediate-density lipoprotein (IDL)
c. High-density lipoprotein (HDL)
d. Very-low-density lipoprotein (VLDL)
d A 259 25. Sam’s total cholesterol is 270 mg/dL and his HDL cholesterol is 30 mg/dL. What is his
cholesterol ratio, and is it healthy or not?
a. 1:9, healthy
b. 1:1, healthy
c. 1:1, not healthy
d. 9:1, not healthy
b K 259 28. For diabetics, controlling _____ is the most important factor in preventing complications
such as heart disease and stroke.
a. protein intake
b. blood glucose
c. fat intake
d. blood urea nitrogen
b K 260 29. Some sensitive people develop high blood pressure in response to consuming _____.
a. licorice
b. sodium
c. potassium
d. aspirin
b K 260 30. All of the following strategies are advisable for people reducing sodium except:
a. Choose fresh or frozen foods in place of canned.
b. Drink “sports drinks” instead of soda.
c. Choose low-salt prepared foods whenever possible.
d. Cut down on salted snack foods, such as chips.
c K 260 31. Higher consumption of some minerals, including calcium, potassium, and _____, may
help lower blood pressure.
a. zinc
b. chromium
c. magnesium
d. iodine
b K 260 32. What is the DASH diet an acronym for?
a. Daily Actions to Stem Hypertension
b. Dietary Approaches to Stop Hypertension
c. Daily Approaches for Stifling Hypertension
d. Dietary Actions to Suppress Hypertension
c A 260 33. Which of the foods that Sara eats frequently is the most likely to decrease her blood
cholesterol and triglyceride levels?
a. Cheeseburger
b. Salad dressing containing olive oil
c. Oatmeal with blueberries and 1% milk
d. Tuna salad sandwich
d A 260,261 34. You are starting the DASH diet. Your dietitian has recommended that you:
a. consume whole grains.
b. consume at least 8 servings of produce daily.
c. choose low-fat or fat-free dairy products.
d. All of the above
e. None of the above
c K 261 35. Consuming alcoholic beverages can have both a detrimental and a beneficial impact on
blood lipids. The beneficial impact is that moderate alcohol consumption tends to
increase _____ while the detrimental impact is that any level of alcohol consumption
tends to increase _____.
a. triglycerides, HDL cholesterol
b. LDL cholesterol, HDL cholesterol
c. HDL cholesterol, triglycerides
d. HDL cholesterol, LDL cholesterol
d K 261-262 36. Which nutrients must be consumed in adequate levels in order to prevent the
accumulation of homocysteine in the blood?
a. Vitamins A, C, and E
b. Selenium and iron
c. Calcium and potassium
d. Vitamin B6, vitamin B12, and folic acid
a K 262 37. Examples of nutrients that function as antioxidants include vitamin C, β-carotene,
selenium, and _____.
a. vitamin E
b. folic acid
c. B6
d. B12
c K 263 38. Diets such as the DASH diet, lacto-ovo-vegetarian diet, and the Mediterranean diet all
stress frequently eating ______ in order to promote heart health.
a. wine and cheese
b. palm oil
c. fruits and vegetables
d. soy
d K 263 39. The Mediterranean diet, which is associated with decreased risk for cardiovascular
disease, emphasizes fruits, vegetables, whole grains, olive oil, wine, and _____.
a. pasta
b. legumes
c. dried beans
d. nuts
What Are the General Nutrition Guidelines for Healthy Hearts? (pp. 263-264)
a A 263 40. If Dominique wanted to follow the current dietary recommendation related to the upper
limit of how many of his total kcalories should come from saturated fat, he would
consume no more than _____ kcalories of his total of 2700 kcalories from saturated fat.
a. 270
b. 340
c. 405
d. 485
c K 264 41. Experts recommend that we consume _____ or more servings of whole-grain products
daily.
a. 2
b. 5
c. 3
d. 6
c K 263 42. Experts recommend that healthy adults consume no more than _____ mg of cholesterol
daily.
a. 150
b. 200
c. 300
d. 450
b K 264 43. Experts recommend that we consume no more than 2300 mg of sodium per day, which is
equivalent to _____ of salt per day.
a. ½ teaspoon
b. 1 teaspoon
c. 1 ½ teaspoons
d. 1 tablespoon
c K 264 44. Experts recommend that we consume at least _____ mg of calcium per day.
a. 500
b. 750
c. 1000
d. 1250
True/False
Answer, level, page
F K 254 1. The leading cause of death for men is CVD, and for women it is cancer.
T K 257 2. A stroke occurs when a portion of the brain does not receive enough blood, and therefore
not enough oxygen and critical nutrients.
F K 260 3. The DASH diet requires participants to jog or run as part of the regimen.
T K 261 4. Moderate consumption of alcohol may reduce your risk for cardiovascular disease.
T K 263 5. The Mediterranean diet emphasizes use of olive oil.
Discussion
1. Why are chronic diseases becoming more common in the U.S.?
Answer (key points): Americans are living longer. Lifestyle risk factors such as smoking, high blood pressure,
elevated blood lipids, physical inactivity and obesity, diabetes, stress, and alcohol consumption are common
among many adults living in the U.S. today. (pp. 254, 258-259)
2. What are the similarities and differences between coronary heart disease and stroke?
Answer (key points): Both conditions are caused by atherosclerosis, characterized by a narrowing and
hardening of the blood vessels. When coronary arteries are affected it can cause coronary heart disease. When
cerebral arteries are affected it can cause a stroke. (p. 254)
3. What biological, lifestyle, and environmental factors influence someone’s risk for developing cardiovascular
disease, and which of these can the person modify?
Answer (key points): Nonmodifiable risk factors: age, sex, genetics, race, prior incidence of stroke or heart
attack, and having been born with low birth weight. Modifiable or lifestyle risk factors: smoking, high blood
pressure, elevated blood lipids, physical inactivity and obesity, diabetes, stress, and alcohol consumption. (p.
258)
6. What are the vitamins and minerals that impact heart health, and what is the role of each?
Answer (key points): Potassium, calcium, and magnesium (help lower blood pressure); vitamin E (serves as an
antioxidant and lowers circulating concentration of C-reactive protein); vitamin C, -carotene, zinc, and
selenium (antioxidants); and the B vitamins: folate, B6 , and B12 (deficiency in these B vitamins increases
homocysteine levels in the blood, which have been strongly associated with an increased risk for cardiovascular
disease). (pp. 260, 261-262)
7. Are there biological markers that identify people at risk for cardiovascular disease?
Answer (key points): Yes; C-reactive protein (CRP) is increased during the inflammatory response, which is
thought to trigger atherosclerosis. Increased homocysteine levels are associated with increased risk for
cardiovascular disease. (pp. 255, 262)
9. What are phytochemicals, where are they found, and how may they influence heart health?
Answer (key points): Phytochemicals are biologically active compounds thought to influence health. Specific
phytochemicals thought to benefit heart health include plant sterols, stanols, and isoflavones. They are found
mainly in soy products, compounds found in red wine and grapes, and sulfur-containing compounds abundant
in garlic, onions, and leeks. (p. 262)
10. What are the goals for the various lipids found in blood?
Answer (key points): Total cholesterol <200 mg/dL, LDL <100 mg/dL, HDL ≥60 mg/dL, triglycerides
<150 mg/dL (p. 258)
Key:
1. Atherosclerotic plaque
2. Blood clot
3. Aneurysm
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