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Chapter 8 – Energy Balance and Body Composition
MULTIPLE CHOICE
1. What would be the approximate weight gain of a person who consumes an excess of 500 kcalories
daily for 1 month?
a. 0.25 kg
b. 1 kg
c. 1.4 kg
d. 1.8 kg
ANS: D REF: p. 241-242, Section 8.1 Energy Balance
MSC: Application
2. When an adult gains an extra 4.5 kg of body weight, approximately how much of this weight is fat?
a. 2.3 kg
b. 3.4 kg
c. 4.3 kg
d. 4.5 kg
ANS: B REF: p. 241-242, Section 8.1 Energy Balance
MSC: Application
3. Approximately what percentage of weight loss during starvation is lean body mass?
a. 0 percent
b. 20 percent
c. 35 percent
d. 50 percent
ANS: D REF: p. 242, Section 8.1 Energy Balance
MSC: Application
4. In an adult who gains 9 kg of excess body weight, about how much of this is lean tissue?
a. 0 kg
b. 1 kg
c. 2.3 kg
d. 4.5 kg
ANS: C REF: p. 242, Section 8.1 Energy Balance
MSC: Application
6. Which of the following terms describes the number of kcalories that the body obtains from a food, in
contrast to the number of kcalories that are determined by burning the food in a bomb calorimeter?
a. direct calorimetry
b. indirect calorimetry
c. psychological food value
d. physiological food value
ANS: D REF: p. 242, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Application
7. Which of the following represents an indirect measure of the amount of energy released from food?
a. the increase in heat given off when the food is burned
b. quantity of oxygen consumed when the food is burned
c. quantity of carbon dioxide consumed when the food is burned
d. the increase in heat retained by the food when it is slowly brought to 100°C
ANS: B REF: p. 242, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Application
8. A person who exhibits a physiological need to eat is most likely experiencing the sensation of which of
the following?
a. hunger
b. appetite
c. stress eating
d. neuropeptide Y suppression
ANS: A REF: p. 243, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Application
10. After consuming a very large meal, the desire to eat a slice of chocolate cake is an example of
behaviour known as which of the following?
a. satiety
b. hunger
c. appetite
d. pigging out
ANS: C REF: p. 243, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Application
11. A person who eats in response to arousal is most likely experiencing which of the following?
a. stress eating
b. sensory influences
c. physiological influences
d. postabsorptive influences
ANS: A REF: p. 243, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Application
12. The feeling of satisfaction resulting from consumption of a meal is termed which of the following?
a. satiety
b. appetite
c. postabsorptive hunger
d. resting postabsorptive increment
ANS: A REF: p. 243, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Knowledge
13. An example of an external cue that may cause an obese person to respond to food typically is which of
the following?
a. TV commercials
b. outdoor exercises
c. satiation
d. lack of sleep
ANS: A REF: p. 243, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Knowledge
14. Which of the following hormones is most responsible for signalling satiety as well as reducing food
intake during a meal?
a. gastrin
b. adipokines
c. epinephrine
d. cholecystokinin
ANS: D REF: p. 243, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Knowledge
15. About how long does it take for a meal to be completely eliminated from the stomach?
a. 30 minutes
b. 1.5 hours
c. 4 hours
d. 8 hours
ANS: C REF: p. 243, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Knowledge
17. Which of the following foods would have a weakened effect on satiation?
a. watermelon and strawberries
b. toast and jam
c. skim milk and an oatmeal cookie
d. cheese dip and crackers
ANS: D REF: p. 243-245, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Application
18. Among the following foods, which has the greatest power to suppress hunger?
a. apples
b. peanuts
c. doughnuts
d. potato chips
ANS: A REF: p. 244, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Application
20. The day after Thanksgiving, you and your sisters are a little hungry and want to eat leftovers before
going shopping. Which of the following foods would most readily satisfy the feeling of hunger?
a. turkey
b. pecan pie
c. mashed potatoes
d. noodle casserole
ANS: A REF: p. 244-245, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Application
21. Which of the following hormones is released into the intestine after a person eats a high fat food?
a. norepinephrine
b. serotonin
c. cholecystokinin
d. adiponectin
ANS: C REF: p. 244-245, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Application
22. The brain chemical neuropeptide Y is known to specifically enhance the craving for which of the
following nutrients?
a. fat
b. salt
c. protein
d. carbohydrate
ANS: D REF: p. 245, Section 8.2 Energy In: The kCalories Foods Provide
MSC: Knowledge
25. Why might the measurement of the resting metabolic rate in a person be somewhat higher than her
basal metabolic rate?
a. She was mildly malnourished.
b. She slept through the procedure.
c. She was dehydrated.
d. She ate right before the measurement was done.
ANS: D REF: p. 246, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Application
26. What fraction of the day’s energy expenditure of the average person is represented by the basal
metabolism?
a. about 1/10
b. up to 1/2
c. about 2/3
d. over 9/10
ANS: C REF: p. 246, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Application
28. Which of the following factors has the most influence on the body’s metabolic rate?
a. age
b. gender
c. amount of fat tissue
d. amount of lean body tissue
ANS: D REF: p. 246, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
29. Which of the following measures may be used to calculate the amount of energy expended by the
body?
a. oxygen consumed
b. total air exchanged
c. intestinal gas expelled
d. carbon dioxide consumed
ANS: A REF: p. 246, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
30. Which of these methods is used to measure the amount of heat given off by the body?
a. bomb calorimetry
b. basal calorimetry
c. direct calorimetry
d. indirect calorimetry
ANS: C REF: p. 246, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
31. Which of the following measures are all used to compute a woman’s BMR?
a. Body fat, height, and age
b. Body weight, height, and age
c. Physical activity level, body weight, and height
d. Energy intake, physical activity level, and body weight
ANS: B REF: p. 246, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Application
32. Which of the following would best assess the energy expenditure of a bedridden patient?
a. body composition
b. basal metabolic rate
c. physical activity level
d. adaptive thermogenesis
ANS: B REF: p. 246, 248, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Application
33. Thyroid hormone activity can speed up or slow down the rate of metabolism by which of the following
percentages?
a. 10 percent
b. 15 percent
c. 20 percent
d. 25 percent
ANS: A REF: p. 247, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
34. Which of the following is an example of a moderate equivalent task (MET) activity?
a. stretching
b. sleeping
c. golfing
d. weight lifting
ANS: C REF: p. 248, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
35. Which of the following diets promotes the greatest loss of body heat?
a. high fat, low protein
b. high protein, low fat
c. high carbohydrate, low fat
d. balanced protein, fat, and carbohydrate
ANS: B REF: p. 248, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Application
36. Which of these terms describes the increase in energy expenditure that occurs in a person who
fractures a leg?
a. febrile hyperthermia
b. physical hyperthermia
c. specific thermogenesis
d. adaptive thermogenesis
ANS: D REF: p. 248, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Application
37. What is the approximate value for the thermic effect of a 2500-kcalorie diet?
a. 25 kcal
b. 250 kcal
c. 400 kcal
d. 500 kcal
ANS: B REF: p. 248, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Application
38. What is the primary reason for avoiding the value for adaptive thermogenesis when calculating energy
requirements?
a. It is too costly to measure.
b. It is too variable to measure.
c. The value is too low to be meaningful.
d. The value is highly influenced by the dietary ratio of protein, fat, and carbohydrate.
ANS: B REF: p. 248, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
39. Among the following groups, which has the highest metabolic rate?
a. females
b. older individuals
c. younger individuals
d. people with smaller surface areas
ANS: C REF: p. 248-249, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
40. If a dancer and a typist are the same height and have the exact same body build, the dancer will be
heavier because she has which of the following?
a. more body fat
b. stronger bones
c. stronger muscles
d. more muscle mass
ANS: D REF: p. 248-249, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Application
41. What is the main explanation for the difference in basal metabolic rates between males and females of
the same body weight?
a. Males are usually taller than females.
b. Females have lower levels of thyroid hormones.
c. Males have a higher percentage of lean body mass.
d. Females have a lower percentage of adipose tissue.
ANS: C REF: p. 248-249, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
42. For every decade beyond the age of 30, what is the percentage decrease in the need for total kcalories?
a. 2 percent
b. 5 percent
c. 10 percent
d. 15 percent
ANS: B REF: p. 249, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
43. If a normal 30-year-old woman has a daily energy expenditure of 2200 kcalories, what would be her
expected output when she reaches 60 years of age?
a. 1210 kcal
b. 1450 kcal
c. 1885 kcal
d. 2275 kcal
ANS: C REF: p. 249, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Application
44. To estimate the energy requirements of individuals, which of the following factors is used in the
equations?
a. weight
b. fat intake
c. surface area
d. fat-fold thickness
ANS: A REF: p. 249-250, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
45. For almost all people who use the equations for calculating Estimated Energy Requirements, the actual
values fall within a range of plus or minus which of these amounts?
a. 50–100 kcal
b. 125–200 kcal
c. 320–400 kcal
d. 500–750 kcal
ANS: C REF: p. 250, Section 8.3-Energy Out: The kCalories the Body Expends
MSC: Knowledge
46. The weight of the body less the fat content is known as which of the following terms?
a. cherubic index
b. lean body mass
c. body mass index
d. ideal body weight
ANS: B REF: p. 249, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
47. What is the approximate percentage of Canadian adults with a BMI over 25.0?
a. 30 percent
b. 40 percent
c. 50 percent
d. 60 percent
ANS: D REF: p. 251, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
48. An index of a person’s weight in relation to height is called which of these terms?
a. body mass index
b. height-to-weight index
c. ideal body weight index
d. desirable body weight index
ANS: A REF: p. 251, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
49. A person is at high risk for signs of illness and diminished work capacity when the BMI first drops
below which of these values?
a. 12
b. 14
c. 17
d. 18.5
ANS: C REF: p. 252, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
50. Jim is a 45 year old who eats fast food at least 3 times a week and smokes a pack of cigarettes each
day. He just had a physical examination and was told that his body mass index is 24. In what category
would Jim’s BMI be classified?
a. Obesity
b. Overweight
c. Underweight
d. Healthy weight
ANS: D REF: p. 252, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
51. Why does use of the BMI overestimate the prevalence of obesity in Canadians of African descent?
a. Blacks have a higher average height than whites.
b. Blacks have denser bones and higher body protein concentrations than whites.
c. Blacks tend to have different proportions of brown and white adipose tissue than whites.
d. The fat pads in blacks are situated primarily around the hips, whereas in whites the pads
are primarily abdominal.
ANS: B REF: p. 252, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
52. What is the range of body fat content for normal-weight women?
a. 9–17 percent
b. 23–31 percent
c. 33–37 percent
d. 38–44 percent
ANS: B REF: p. 252, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
53. What is the approximate body mass index of a woman who is 165 centimeters tall and weighs 57 kg?
a. 21
b. 26
c. 31
d. 36
ANS: A REF: p. 252, 253, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
54. Which of the following types of athlete may be classified as overweight by BMI standards, even
though he/she is not overfat?
a. cyclists
b. gymnasts
c. football players
d. marathon runners
ANS: C REF: p. 252-253, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
55. Jacki, who has a sedentary lifestyle, is 165 cm tall and weighs 75 kg. She calculated her BMI to be
27.5. She recognizes that her body weight is unhealthy and vows to improve her eating habits and
begin a regular program of physical fitness. Her goal is to achieve a BMI of 22. Approximately how
much weight must she lose?
a. 9.5 kg
b. 12.3 kg
c. 15 kg
d. 18.6 kg
ANS: C REF: p. 252-253, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
56. What is the weight classification assigned both to young women with 30 percent body fat and young
men with 20% body fat?
a. obese
b. normal
c. mildly overweight
d. slightly underweight
ANS: B REF: p. 252-254, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
57. Which of the following percentages of body fat can be present in excessively obese adults?
a. 55 percent
b. 60 percent
c. 65 percent
d. 70 percent
ANS: D REF: p. 253, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
58. What is the range of body fat content for normal-weight men?
a. 5–10 percent
b. 13–21 percent
c. 22–30 percent
d. 32–40 percent
ANS: B REF: p. 254, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
59. Which of the following conditions may occur in an individual whose body fat falls below a certain
threshold?
a. gallbladder disease
b. diabetes
c. hormone synthesis failure
d. dehydration
ANS: C REF: p. 254, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
60. Central obesity is associated with an increased risk for which of the following conditions?
a. infertility
b. clinical depression
c. hypertension
d. abnormal hunger regulation
ANS: C REF: p. 254, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
61. Jenny is 34 years old and has a BMI of 28. Her body type could be described as “pear-like.” John is 55
years old with a BMI of 28, and a body type that is “apple-like.” Why is John more likely than Jenny
to be at risk for degenerative diseases?
a. He is male.
b. He is older.
c. He weighs more.
d. He has central obesity.
ANS: D REF: p. 254, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
63. Research in obese people seems to show that there is less susceptibility to health problems provided
that the excess body fat is distributed around which of these areas?
a. stomach
b. arms and chest
c. hips and thighs
d. neck and shoulders
ANS: C REF: p. 254, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
64. Which of the following measures can be used to gauge the amount of a person’s abdominal fat?
a. BMI
b. essential body fat
c. hydrodensitometry
d. waist circumference
ANS: D REF: p. 254, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
66. Waist circumference can best be used to assess which of the following amounts?
a. BMI
b. total body water
c. abdominal fat stores
d. subcutaneous fat stores
ANS: C REF: p. 254, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
67. A high risk of weight-related health problems is seen in women whose waist circumference begins to
exceed which of these measurements?
a. 61 cm
b. 71 cm
c. 88 cm
d. 107 cm
ANS: C REF: p. 254, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
68. There is a high risk of obesity-related health problems when a man’s waist circumference begins to
exceed which of these measurements?
a. 102 cm
b. 116 cm
c. 127 cm
d. 133 cm
ANS: A REF: p. 254, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
69. Storage of excess body fat in which of these regions of the body is associated with the highest risks for
cardiovascular disease and diabetes?
a. neck
b. abdomen
c. hips and thighs
d. arms and shoulders
ANS: B REF: p. 254-255, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
70. Which of the following fruits is commonly linked to upper body fat levels as the fruit typifies the
body's shape?
a. pineapple
b. grape
c. pear
d. apple
ANS: D REF: p. 255, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
71. Which of the following methods measures body density by first weighing an individual on land and
then weighing him/her again while submerged in water?
a. air displacement plethysmography
b. dual energy x-ray absorptiometry
c. hydrodensitometry
d. bioelectrical impedance
ANS: C REF: p. 256, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
72. Which of the following methods assesses body fat by examining the thickness of a fold of body tissue
on the arm, below the shoulder blade and in other areas of the body?
a. dual energy x-ray absorptiometry
b. BMI
c. air displacement plethysmography
d. skinfold measures
ANS: D REF: p. 256, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
73. A graph of the relationship between mortality (left axis) and body mass index is shaped like a(n)
a. J
b. S
c. backslash
d. inverted U
ANS: A REF: p. 256, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
74. A known health risk for being underweight includes which of the following?
a. diabetes
b. respiratory infections
c. headaches
d. increased cancer-induced wasting
ANS: D REF: p. 256-257, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
75. In terms of preventable illnesses and early deaths, where does obesity rank?
a. first
b. second
c. third
d. fourth
ANS: B REF: p. 257, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
76. The risks for dying prematurely are doubled when the body mass index first rises above what value?
a. 27
b. 30
c. 32
d. 35
ANS: D REF: p. 257, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
77. Central obesity and weight gains of more than how many kg during early and middle adulthood
correlate with increased disease risks?
a. 3 kg
b. 6 kg
c. 9 kg
d. 12 kg
ANS: C REF: p. 257, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
78. Which of the following is a health risk associated with excessive body fat?
a. osteoporosis
b. fractures
c. gallbladder disease
d. lupus
ANS: C REF: p. 257, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
79. Ben is worried that his family history of heart disease and his BMI of 28 are putting him at very high
risk for developing cardiovascular disease. What would a clinician advise Ben to help lower his risk?
a. Take steps to raise the LDL and lower the HDL.
b. Consider liposuction surgery for removing extra abdominal fat.
c. Lose weight as it can lower both blood cholesterol and blood pressure.
d. Obtain genetic testing to determine the exact percent chance of developing cardiovascular
disease.
ANS: C REF: p. 257-258, Section 8.4-Body Weight, Body Composition, and Health
MSC: Application
80. Why is chronic inflammation a concern for overweight and obese individuals?
a. It increases the risk for obesity by 50 percent.
b. It promotes the development of metabolic syndrome.
c. It is commonly found in people with a BMI less than 24.
d. It enhances insulin sensitivity leading to periodic bouts of hypoglycemia.
ANS: B REF: p. 257-258, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
82. Which of the following statements illustrates the association between type 2 diabetes and body fat?
a. People with the disease often have central obesity rather than lower-body obesity.
b. A woman who has gained 5.5 kg since age 18 has doubled her risk of developing the
disease.
c. An obese person is 3 times more likely to develop the disease than is a nonobese
individual.
d. Overweight people with the disease who lose weight show no improvement in glucose
tolerance and insulin resistance.
ANS: D REF: p. 258, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
83. What is the resulting condition for a person who suffers from insulin resistance?
a. type 1 diabetes
b. type 2 diabetes
c. metabolic syndrome
d. pancreatic failure
ANS: B REF: p. 258, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
84. The major cause of insulin resistance is related to which of these factors?
a. low-protein diets
b. high-protein diets
c. excess body weight
d. prolonged excess carbohydrate intake
ANS: C REF: p. 258, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
85. Which of the following statements describes an association between body weight and mortality?
a. Obesity is the fourth leading cause of premature death.
b. Overweight men who are physically fit have a lower mortality risk than normal-weight,
unfit men.
c. Normal-weight men who are physically unfit have a similar mortality risk versus
normal-weight fit men.
d. The amount of weight gain in adulthood that is not associated with increased mortality is 9
kg or less.
ANS: B REF: p. 258, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
86. Which of the following statements may best explain the relationship between excess body fat and
higher risk for cancers of the female reproductive system?
a. Obese women are more sedentary, which promotes cancer development.
b. The higher levels of body fat act as a reservoir of carcinogenic substances.
c. Excess body fat produces more estrogen, which may promote tumour development.
d. The greater food consumption of obese women provides a higher intake of
naturally-occurring carcinogens.
ANS: C REF: p. 258, Section 8.4-Body Weight, Body Composition, and Health
MSC: Knowledge
87. Which of these terms is given to the condition of a female athlete who has an eating disorder and
develops amenorrhea and osteoporosis?
a. female athlete triad
b. triathlete medical disorder
c. high stress tertiary disorder
d. non-adaptable training syndrome
ANS: A REF: p. 261, Section 8.5-Eating Disorders
MSC: Knowledge
88. Among people with binge-eating disorder, approximately what percentage are females?
a. 5 percent
b. 15 percent
c. 25 percent
d. 50 percent
ANS: A REF: p. 261, Section 8.5-Eating Disorders
MSC: Knowledge
97. Approximately what fraction of people treated for anorexia nervosa show reasonable maintenance of
their weight gain?
a. 1/4
b. 1/2
c. 4/5
d. 9/10
ANS: B REF: p. 265, Section 8.5-Eating Disorders
MSC: Knowledge
98. A typical food chosen by a person with bulimia nervosa during a binge includes which of the
following?
a. bread
b. cookies
c. yogurt
d. vegetables
ANS: B REF: p. 266, Section 8.5-Eating Disorders
MSC: Application
99. Which of the following is the primary goal for the treatment of bulimia nervosa?
a. immediate discontinuation of purging
b. restriction of food intake to3 meals per day
c. maintenance of weight
d. suppression of sweet and high-fat food intake
ANS: C REF: p. 266, Section 8.5-Eating Disorders
MSC: Knowledge
100. Diet recommendations for people with bulimia nervosa include which one of the following?
a. Avoid skipping meals.
b. Include foods that are low in fibre.
c. Eat cold foods to stimulate satiety.
d. Eat large amounts of finger foods.
ANS: A REF: p. 266-267, Section 8.5-Eating Disorders
MSC: Knowledge
101. What is the primary factor that differentiates bulimia nervosa from binge eating?
a. Purging is rarely practiced in binge-eating disorder.
b. Higher rates of depression are reported in bulimia nervosa.
c. More food is consumed at one setting in binge-eating disorders.
d. Uncontrollable cravings for high-fat foods are seen only in bulimia nervosa.
ANS: A REF: p. 267-268, Section 8.5-Eating Disorders
MSC: Knowledge
MATCHING
a. 2
b. 5
c. 13
d. 20
e. 25
f. 100
g. 7000
h. Fasting
i. Satiety
j. Hunger
k. Caffeine
l. Appetite
m. External cue
n. Stress eating
o. Thermic effect
p. Basal metabolism
q. Direct calorimetry
r. Indirect calorimetry
s. Specific dynamic effect
t. Adaptive thermogenesis
1. Approximate number of kcalories in 1 kg of body fat
2. Technique used to measure the amount of heat given off when a food burns
3. Technique used to measure the amount of oxygen consumed when a food burns
4. Response to the smell of favourite food
5. Irritating sensation that initiates thoughts of food
6. A feeling of fullness after eating
7. Eating in response to arousal
8. Eating in response to the time of day
9. Energy needed to maintain the body at rest
10. A factor that lowers basal metabolism
11. A factor that raises basal metabolism
12. Approximate number of kcalories per minute expended by a person with a total daily energy need of
2900 kcalories
13. Term that describes the energy needed to process food
14. Changes in energy expenditure consequent to changes in environment
15. The amount of energy in a 1000-kcalorie meal that is expended as specific dynamic activity
16. Synonymous with the thermic effect of food
17. Thermic effect of alcohol as percent
18. The percentage decline in basal metabolism per decade of adult life
19. Body mass index of an adult of 82 kg and 180 cm
20. Lower range of body fat percentage in normal-weight men
ESSAY
1. Discuss common methods for determining the energy content of foods and energy expenditure of
individuals.
ANS:
Answers may vary.
ANS:
Answers may vary.
REF: p. 243
3. Discuss factors that can override hunger and satiety.
ANS:
Answers may vary.
REF: p. 243-244
4. Explain the difference between satiety and satiation. Give examples of nutrients with a high or low
satiating index.
ANS:
Answers may vary.
REF: p. 243-245
ANS:
Answers may vary.
REF: p. 244
6. How does consumption of fat, more so than protein and carbohydrate, induce satiation and satiety?
ANS:
Answers may vary.
REF: p. 244-245
ANS:
Answers may vary.
REF: p. 246
8. Define basal metabolic rate and discuss factors that increase and decrease it.
ANS:
Answers may vary.
REF: p. 246-247
9. List the major components that contribute to the body’s daily expenditure of energy. Compare the
relative contributions of each of these components in a sedentary person with their contributions in a
marathon runner of the same body weight.
ANS:
Answers may vary.
REF: p. 246-249
ANS:
Answers may vary.
REF: p. 248
11. What factors may account for the decline in BMR with age?
ANS:
Answers may vary.
REF: p. 249
12. In the estimation of energy requirements, discuss the contributions of gender, growth rate, age,
physical activity, and body composition.
ANS:
Answers may vary.
REF: p. 249
13. List 6 tips that promote a person’s acceptance of a healthy body weight.
ANS:
Answers may vary.
REF: p. 251
14. Present the BMI figures that denote underweight, healthy weight, overweight, and obese.
ANS:
Answers may vary.
REF: p. 252
15. Discuss the importance of fat distribution in the body in relation to risk for degenerative diseases.
ANS:
Answers may vary.
REF: p. 254
16. Under what conditions or circumstances would it be desirable for people to have less or more body fat
than normal?
ANS:
Answers may vary.
REF: p. 253-254
17. What factors should be considered in determining healthy body fat levels in people or population
groups?
ANS:
Answers may vary.
REF: p. 254-255
18. Why do health care professionals prefer to use BMI and waist circumference in preference to other
measures of body composition for assessment of health risk?
ANS:
Answers may vary.
REF: p. 254-255
19. Explain the adverse effects of excess body fat deposited around the abdominal region.
ANS:
Answers may vary.
REF: p. 254-256
20. What are some of the physiological consequences in a person who falls below a certain threshold for
body fat?
ANS:
Answers may vary.
REF: p. 256-257
21. Briefly explain the following techniques for the estimation of body composition:
a) skinfold measures,
b) hydrodensitometry,
c) bioelectrical impedance,
d) air displacement plethysmography, and
e) dual energy X-ray absorptiometry.
ANS:
Answers may vary.
REF: p. 256
22. List several health risks associated with being underweight and with being overweight.
ANS:
Answers may vary.
REF: p. 256-258
23. What is the association between chronic inflammation and the metabolic syndrome?
ANS:
Answers may vary.
REF: p. 257-258
24. What are some possible explanations of the association between excess body fat and cancer?
ANS:
Answers may vary.
REF: p. 258
ANS:
Answers may vary.
REF: p. 261-262
26. Explain the role that society plays in promoting eating disorders.
ANS:
Answers may vary.
27. Explain the relationship between eating disorders and osteoporosis in female athletes.
ANS:
Answers may vary.
REF: p. 262
28. List the characteristics of anorexia nervosa and bulimia nervosa. Describe the typical personality traits
of individuals with these eating disorders.
ANS:
Answers may vary.
REF: p. 263-267
29. Compare and contrast the characteristics of binge-eating disorder and bulimia nervosa.
ANS:
Answers may vary.
REF: p. 265-268
30. Outline important diet strategies for helping overcome bulimia nervosa.
ANS:
Answers may vary.
REF: p. 266-267
31. Discuss the general criteria for diagnosis and evaluation of unspecified eating disorders.
ANS:
Answers may vary.
REF: p. 267
32. Discuss the criteria for diagnosis and evaluation of binge-eating disorder.
ANS:
Answers may vary.
REF: p. 267
33. Discuss the characteristics of binge eating disorder. What is known about its treatment?
ANS:
Answers may vary.
REF: p. 267-268
Another random document with
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it,” concludes an anonymous writer.[99] The account of Mary
Johnston’s adventure given by this writer is as unsatisfactory as
secondhand versions of a mystical experience must necessarily be.
Miss Johnston may or may not write the story; Emerson said that
“the highest cannot be spoken,” and, most certainly, it cannot with
adequacy be written. Miss Johnston has made some attempt to put
her adventure on paper, but the result so far discourages her. In
what follows I am merely trying to convey the quality of her strange
experience. I have not her sanction for what I say; I had rather not
make the trial. But there is really no escape. If we are to understand
the growth of the writer we must have some notion of the thing that
befell.
ii
The child was not strong, and her Scots grandmother first, an aunt
afterward, taught her. She grew up in the village of Buchanan,
Botetourt County, Virginia, still in the 1870’s a place of canalboats
and the stagecoach. Major John William Johnston was a
Confederate veteran, a lawyer and ex-member of the Virginia
Legislature. Naturally the house was not without books. Mary
Johnston found the histories particularly engrossing. Then the family
moved to Birmingham, Alabama, and this daughter was sent to
school at Atlanta. She was then sixteen. In a few months her health
compelled her to return home where, a year later, her mother died.
As she was the eldest of several children the direction of the
household fell to her. She suffered intermittently from illness for
many years. In her twenties and while living in a New York apartment
she began a romance of colonial Virginia in the seventeenth century,
writing much of it in a quiet corner of Central Park, so as to be
outdoors. She had been writing short stories which editors sent back
to her and which she burned on the first rejection. It is said that the
late Walter H. Page, at the time with Houghton Mifflin Company,
discovered her.[100] The historical romance, Prisoners of Hope
(1898) became her first book and was successful; her second novel,
To Have and To Hold (1900) was a record-making best seller and
had literary merits most exceptional in the flood of historical fiction
then running. Miss Johnston traveled considerably in Europe in
quest of better health. After the death of her father she lived for
some time at 110 East Franklin Street, Richmond. Then she built a
home, “Three Hills,” near Warm Springs, Virginia, where she has
lived since. Knowing that her Civil War novels, The Long Roll and
Cease Firing, owe much to Major Johnston’s analyses and
recollections, some Southerners have said that Mary Johnston’s
father was at least equally responsible with her for the splendid
performance in her earlier novels. They quite misunderstand the
nature of the inspiration he undoubtedly gave her. Of direct help—
which is what these people really have in mind—he gave much, as
she has acknowledged; it was, however, unimportant. Direct help
can as well be got from books. If today you tell Miss Johnston how
well you liked such a novel of hers as Lewis Rand (1908), she will
probably respond: “Of course you realize that the picture of those
times is idealized.” In other words, although hers is one of those
natures which must seek the ideal, possess and be possessed by it,
the conception of the ideal has completely changed. Where once
she found it in the bright glints of an earlier American day, now she
finds it in our day and every day, past or present or to be—the pure
silver of the human spirit that runs in a deep if irregular vein through
the worn old rock of human destiny.
For she is like silver herself, like old silver choicely patterned. The
small, oval face and pointed chin are serene in expression beneath a
fine forehead and crisp hair with a great deal of its blackness still in
it. Her manner is reposeful, friendly, unaffected and sympathetic. She
talks readily about anything and everything but you have a feeling
that she is also, at moments, somewhere else—this quite without
any sacrifice or lessening of her hereness and attentiveness. I now
come to the personal experience which, to be intelligible to most of
us, must be put in a crude and simple kind of paraphrase.
If one has suffered much from illness and pain, one is very likely to
have occasional moments in which one returns to life newly-washed,
like the world in trembling freshness and sunlight on a morning after
storm. If one stands on a Virginia hill, or a hill anywhere, one may
sometimes have a distinct awareness that the length and breadth
and depth round about and below are only a kind of length and
breadth and descent to a creature measuring them with his legs;
even the eye seems to declare that genuine dimensions are
elsewhere. Stand on the hill one day, return to it one, five or ten
years afterward, standing in the same place. It is quite possible that
nothing has changed in the scene about you. A certain time has
passed, but you, to yourself, haven’t changed. You have grown a
little older, but the essential you is not anybody else. Suddenly you
realize that time is not a dimension, either, any more than the length
and breadth round about or the drop to the valley below; and that as
long as you are you and no one else, the day, the year or the century
would make no genuine difference. The only distance or direction
lies between the unchanging you and somebody else. You are really
no farther from Balboa discovering the Pacific from a Panama
summit than if you were standing beside him now sharing the
discovery; the direction is from your spirit to his, from his to yours,
and the distance is neither lessened nor increased by race,
nationality, religion, leagues or centuries.
That is, instead of merely acquiring the notion of the fourth
dimension of mathematics, you have come to see that all the so-
called dimensions, length, breadth, height, time and imaginable
others are merely conveniences of earthly existence, or necessities
of earthly existence, like eating and breathing.
As you stand on the hill, you are alone and yet not alone. The
physical you is alone, as always; but the unchanging you is one of a
company whom you can identify only to the extent of what you may
have read or heard about them. In the company will be Francis of
Assisi, Joan of Arc, Spinoza, Ludwig van Beethoven, Cardinal
Newman, William Blake, Walt Whitman—to mention a few of various
times and countries—as well as countless others.
Then will follow the strangest part of the experience and the part
most difficult to put in words. It is, however, something of which
some intimation comes even to the humblest pair of lovers, just as it
is the passionate fulfillment of the great, the immortal lovers of
legend.
There is a feeling so intense that it can find coherent expression
only in poetry which holds it securely in the rigid mold of metre and
rhyme; there is another feeling, or degree of feeling either more
intense or more delicate which can communicate itself only in a
language of cunningly-related sounds which we call music. And
there is even a pitch of feeling greater than these, higher and very
tranquil and most piercing in its intensity and loveliness. This feeling
has only one expression—love. The object of that love is immaterial
to it. That object may be, outwardly, the body of the beloved. It may
be a person or an idea. It may be anything. The effects of this feeling
are almost infinitely various. You will find some of them described in
William James’s Varieties of Religious Experience. The feeling itself
is a religious feeling but it may not expend itself on a religious object.
The feeling made Francis of Assisi the Clown of God. It brought
visions to Joan of Arc and put her at the head of a victorious army.
Under its influence Beethoven wrote symphonies, Blake made
pictures, and Whitman wrote Leaves of Grass. Sometimes, when the
effects are tranquil, we say that the Lover has found peace—to
which has sometimes been added a phrase of further description,
“the peace that passeth understanding.”
Nearly all these aspects of a continuous human experience came
to Mary Johnston. There was the not unusual preliminary
circumstance of invalidism. There was the loss of a father, much-
loved. There were the Virginia hills she walked upon and there was
frequent solitude. The sense of passing the boundaries of time and
space was facilitated by two things: first, her devotion to history, and
second, her strongly-developed novelist’s imagination. Shortly after
she was forty, therefore, she came to a day when, for an hour or part
of an hour, she had access to a state of knowledge, of sympathy, of
understanding which is so sane that it infuses its sanity into every act
of living and so joyous that those to whom the experience is
vouchsafed can throw aside every lesser joy. After that first
experience Mary Johnston waited for it to renew itself, and gradually
what had come as a miracle remained as a human faculty; so that
since then she has acquired the apparent power or privilege of
leaning out from the gold bar of Heaven, of letting earth slip without
loosing herself from earth. You know how your mind will pass behind
the stars while your feet yet continue to tread firm soil as you go on
walking. That is a feeble likeness to the thing.
iii
It was bound to affect her writing, and perhaps the first traces of it
are in The Witch (1914), but it was clearly apparent in Foes (1918),
where, as I have said before this, “upthrusting through the surface of
a stirring historical adventure, we had the evidence of the author’s
breathless personal adventure.” It is one thing to be by temperament
a mystic; quite another to become, as Miss Johnston had now
become, a mystic by the witness of some inner illumination. In some
cases the change has brought with it a proselyting spirit of great
fervor; in Miss Johnston’s there was a complete absence of any such
missionary zeal. All the same she could not go on writing novels in
which the picture of some bygone time was idealized simply for the
sake of a charming picture. Foes has been correctly described as “a
dramatic story of eighteenth century Scotland with a lasting feud, a
long chase, and a crescendo of hatred and peril.” But it is also a
story of sublime forgiveness, as much so as John Masefield’s The
Everlasting Mercy. In Michael Forth (1919) and Sweet Rocket (1920)
there was, as in certain novels of Herman Melville’s, notably Pierre,
more transcendentalism than story. It was inevitable that she should
be inarticulate for a while, but it was only for a while. For in 1922
appeared her story, Silver Cross, a tale of England in the time of
Henry VII. and of two rival religious establishments. Silver Cross was
both beautiful and intelligible. For the prose style I like best Stewart
Edward White’s word, “stippling.” It has also been said of what was
to be her mode of utterance for a book or two: “Written in a clipped
sort of prose stripped of ‘a’ and ‘an’ and ‘the’ and other particles as
well as articles, the text is a highly mannered English replete with
cadenced sentences and animated by nervous rhythms. The very
diction bears poetic surcharges, and the whole effect on the reader
is to distill in his soul a delicate enchantment or else to exasperate
him to death.”[101] The core of the tale is irony, irony directed at
religious bigotry and religious intolerance; it lies there at the base of
the flower and from it the reader may make his own bitter honey. Or,
if he have no stomach for that, he may take his satisfaction and
pleasure in the rich sound of ecclesiastical trumpets, the green
England, the pageant of a simple world unrolled before him.
In the same year with Silver Cross Miss Johnston’s 1492 was
published. The book is, of course, the story of Columbus, told with
the accurate historical coloring and the poetic feeling one would
expect of the author; but it uses a technical device which, while not
novel, is deserving of attention from the analyst of fiction. This is the
employment as narrator of the story of Jayme de Marchena, a
fictional person, represented as a Jew who has been banished from
Spain under the decree of exile promulgated by Ferdinand and
Isabella. Miss Johnston makes of him a man of philosophical mind,
an “obscure Spinoza” whose thoughts are a constant commentary
on the voyage from Palos and the succeeding voyages. Thus,
without distorting history or creating an imaginary portrait of the
Genoese sailor and discoverer, the book (in form a novel) gives us
one of the great events in human affairs in a perspective that neither
history nor biography affords. Again what we have is the vision of
one standing on a hilltop, alone and yet not alone—of one who is at
the same instant standing in the night watches on the deck of a
caravel and listening to the cry from the man on lookout....
iv
Slow turns the water by the green marshes,
In Virginia.
Overhead the sea fowl
Make silver flashes, cry harsh as peacocks.
Capes and islands stand,
Ocean thunders,
The light houses burn red and gold stars.
In Virginia
Run a hundred rivers.[102]
The fine opening of Miss Johnston’s poem might serve as an
evocation, except in the detail of the lighthouses, for her novel,
Croatan (1923). The mere fact of her return to the Virginia of colonial
days must have served to entice many readers to this book—who
were held, I think, by the tale itself, once they had begun it. The
legend of Raleigh’s lost colony of Roanoke and of a first white child
born in Virginia, “Virginia Dare,” is skilfully utilized for a romance
quite the most perfect Miss Johnston had imagined. The story of the
three young people who grew up together in the forest—English girl,
Spanish boy and Indian youth—is one of many overtones deftly
sounded. Is Miss Johnston proclaiming a creed of racial tolerance
and interracial understanding? Then the proclamation is made
pianissimo and with muted strings, not with brass instruments. And
the forest scenes—what delicious notes from oboes!
It is very natural to contrast Mary Johnston and Ellen Glasgow,
both Virginians and both novelists of distinction as well as
contemporaries. Their very agreeable personalities are, however,
markedly different. Miss Glasgow is a product of her background and
her time, as much so, for example, as Edith Wharton; Miss Johnston
has a great deal more likeness to, let us say, Miss May Sinclair.
Where Miss Glasgow tends to concern herself with Virginia of the
last half century, Miss Johnston, from going back to the beginnings
of her State, is quite as likely to plunge effortlessly forward into the
farthest imaginable future. For a witness of what she can do in that
direction one does well to read such a short story as “There Were No
More People,”[103] dealing with the extinction of man and the slow
emergence of “a creature who must be classed among aves. He was
small, two-footed, feathered and winged.... Slowly, taking aeons to
do it, he put out, in addition to his wings, rudimentary arms that grew,
taking a vast number of generations to accomplish it, into true arm
and hand. At the same time he began, very, very slowly, to heighten
and broaden his skull. Man would have thought him—as he would
have thought man—a strange looking creature.... It took time, but at
last there dawned self-consciousness. The old vehicle for sensation,
emotion, memory and thought that had been called man was gone.
But sensation, emotion, memory and thought are eternals, and a
new vehicle has been wrought. It is not a perfect vehicle. In much it
betters man, but it is not perfect. The new Thinker resembles the old
in that he knows selfishness and greed and uses violence.... It
remains to be seen if he can outwear and lay aside all that and
remain—as man could not remain.”
MARY JOHNSTON
Copyright, E. L. Mix.
v
Carl Van Doren’s words about Miss Johnston, in his Contemporary
American Novelists, 1900-1920, that she brings to the legends and
traditions of the Old Dominion no fresh interpretations, have been
made obsolete by Croatan, and are, of course, so far as they are
made applicable to legends in general, denied by her last half dozen
novels. It is most true, though, that Miss Johnston is an historian and
a scholar in her tastes. To the series of fifty volumes interlocking to
form a complete American history, and published by the Yale
University Press under the general title, The Chronicles of America,
Miss Johnston contributed the volume on Pioneers of the Old South.
The book deals with Maryland, the Carolinas and Georgia as well,
but Virginia is, of course, the principal subject. The period is 1607-
1735 and Miss Johnston’s short account is an admirable piece of
writing, concise, accurate, uncontroversial; alive with crisp human
portraits and touched with poetry and imagination in its occasional
descriptive passages.
Miss Johnston’s new novel, to be published late in 1924, under the
title, The Slave Ship, is a story of the American slave trade in the
eighteenth century. David Scott, a prisoner after the battle of
Culloden, is sold into slavery on the American plantations. The
cruelty with which he is treated hardens his conscience, so that
when he escapes he goes without much hesitation or scruple into a
slave ship and then into slave trading. The novel follows with
intensity and compassion the career which takes him from this most
abominable traffic to an understanding of what it means. The novel
is, therefore, a story (like Foes) of one who journeyed on the road to
Damascus. But I recall no story which pictures with more vividness
and power the Middle Passage of infamous memory. The Slave Ship
is notable, too, for the greater suavity of Miss Johnston’s prose style;
the “a’s,” “an’s,” and “the’s” are recovered and there are less tangible
changes—all for the better.
“Nothing can be done but by being greater than the thing to be
done” is a piece of wisdom uttered in Miss Johnston’s fable, “The
Return of Magic.”[104] A writer is, or should be, capable of growth in
two directions—as an artisan and as a source of emotion to be
communicated in terms of beauty. The number who show growth in
either fashion is not large; the number who grow both ways is very
small. Five years ago I had occasion to survey the work of thirty-five
American women novelists, three of whom have since died. One or
two others have produced no new work in the period since. With the
most liberal disposition toward the thirty or so others, it does not
seem to me that more than a half dozen show growth either as
writers or artists. Possibly three have produced work in these five
years indicative of a mind enlarging as the hand serving it has grown
more certain. Mary Johnston is one of the three.[105]
Addington, Sarah,
Round the Year in Pudding Lane, $2.00
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The Reconstruction of the Spiritual Ideal, $1.50
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Little Men: Life at Plumfield with Jo’s Boys, $1.50
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Rôles, $2.00
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