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Chapter 8 – Energy Balance and Body Weight Regulation

Multiple Choice
Answer, level, page Level: K = knowledge, A = application/critical thinking
What Is Energy Balance? (pp. 323-324)
c A 323 1. Sara requires 2100 kcalories each day. Currently, she is consuming between 2200 and
2300. What is her state of energy balance?
a. Neutral
b. Negative
c. Positive
d. Balanced
b K 323 2. When someone is in severe negative energy balance, what serves as the body’s primary
energy source?
a. Food being consumed
b. Adipose tissue
c. Muscle tissue
d. Chylomicrons
d A 323 3. If John wants to lose one pound of body fat, how many kcalories will he have to expend
in activity and/or omit from his usual intake?
a. 1,500 kcalories
b. 2,000 kcalories
c. 2,500 kcalories
d. 3,500 kcalories
b K 323 4. What happens when a person increases his or her energy intake?
a. There is always a corresponding increase in body weight.
b. There is usually a corresponding increase in body weight.
c. There is always a corresponding increase in blood glucagon.
d. There is usually a corresponding increase in neuropeptide production.
b K 323 5. Negative energy balance is when:

a. energy intake = energy consumption.
b. energy intake < energy consumption.
c. energy intake > energy consumption.
b K 323 6. One pound of stored body fat is equivalent to about _____ kcal.
a. 3000
b. 3500
c. 4000
d. 4500
a K 324 7. You have gained weight, and your adipocytes are filling with triglycerides. This is called:
a. hypertrophic growth.
b. hyperplastic growth.
c. hypermetabolism.
d. hyperlipidemia.
© 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
437
b K 324 8. What is the process called when adipocytes grow in number?
a. Hypertrophic growth
b. Hyperplastic growth
c. Expansive growth
d. Unreserved growth
d K 324 9. What happens when a person loses body fat?

a. The triglycerides in adipocytes are replaced with water.
b. The number of adipocytes decreases.
c. The number of adipocytes increases.
d. Adipocytes shrink in size.
a K 324 10. Which type of fat found deposited between internal organs and the torso is otherwise
known as intra-abdominal fat?
a. VAT
b. SCAT
c. ABAT
d. TAT
What Determines Energy Intake? (pp. 325-331)
c K 325 11. What is the physiological response to having eaten enough called?
a. Contentment
b. Satisfaction
c. Satiety
d. Fulfillment
c K 325 12. How is energy intake regulated?

a. By distinct hunger and satiety centers in the brain
b. By distinct hunger and satiety centers in the liver
c. By specific neural connections to and within the brain
d. By specific neural connections to and within the liver
b K 326 13. What “control center” in the body responds to hunger and satiety cues?
a. Liver
b. Hypothalmus
c. Pancreas
d. Gastrointestinal tract
b K 326 14. How do neurotransmitters differ from hormones?

a. They regulate activities mainly in the liver.
b. They regulate activities mainly in the central nervous system.
c. They regulate activities mainly in adipocytes.
d. They regulate activities mainly in the small intestine.
a K 325-326 15. What primarily influences short-term food intake?

a. Neural and hormonal signals from the gastrointestinal (GI) tract
b. Neural and hormonal signals from the brain and central nervous system
c. The interplay between hunger and satiety
d. The interplay of socio-cultural and visual stimuli
a K 326 16. What happens when the brain releases anabolic neurotransmitters?
a. Weight gain is promoted
b. Weight loss is promoted
c. Satiety is stimulated
d. Cravings are stimulated
438
d K 327 17. What is the branch of medicine that is concerned with treating obesity and obesity-related
conditions called?
a. Hyperbarics
b. Neuro-physiology
c. Otolaryngology
d. Bariatrics
d K 327 18. Gastric banding involves:

a. reducing the size of the stomach.
b. limiting food digestion and absorption.
c. creating a small stomach pouch.
d. a and c
e. All of the above
a K 327 19. All of the following statements about gastric bypass surgery are true except:
a. gastric bypass reroutes the GI tract to bypass the stomach.
b. bypass surgery reduces food intake, limiting nutrient digestion and absorption.
c. the risk of developing nutritional deficiencies is much greater after this procedure.
d. surgical reversal is difficult and can pose certain risks.
c K 327 20. Experts recommend that patients be considered for bariatric surgery only if they have a
BMI of:
a. ≥30 kg/m2 with or without a serious weight-related medical condition.
b. ≥35 kg/m2 or ≥30 kg/m2 with a serious weight-related medical condition.
c. ≥40 kg/m2 or ≥35 kg/m2 with a serious weight-related medical condition.
d. ≥40 kg/m2 with or without a serious weight-related medical condition.
b K 327 21. How much food can the stomach hold after gastric banding?
a. 1 tablespoon
b. 2-3 tablespoons
c. ½ cup
d. 1 cup
a K 327 22. Which of the following is not a symptom of dumping syndrome, a possible side effect of
gastric bypass?
a. Hyperglycemia
b. Nausea
c. Dizziness
d. Diarrhea
c K 328 23. A rise in what in the blood following a meal seems to stimulate satiety?
a. Low-density lipoproteins or micelles
b. Triglycerides or phospholipids
c. Glucose or amino acids
d. Epinephrine or norepinephrine
d K 328 24. What two foods are good sources of tryptophan and thus may promote both satiety and
sleepiness?
a. Whole grains and peanut butter
b. Grapes and bananas
c. Avocado and beef
d. Turkey and dairy products
439
c K 328 25. Why would 2 cups of grapes increase satiety more than ¼ cup of raisins?
a. The grapes have more kcalories than the raisins.
b. The grapes contain more sugar than the raisins.
c. The volume of grapes is greater than that of the raisins.
d. There is no difference—they are both fruits.
a K 329 26. What recently discovered hormone appears to increase food intake by signaling the
release of anabolic neurotransmitters?
a. Ghrelin
b. Melatonin
c. Adrenocorticotropic hormone
d. Oxytocin
c K 328 27. Which hormone whose level is increased after tryptophan intake helps people feel calm
and relaxed?
a. Ghrelin
b. Galanin
c. Serotonin
d. Leptin
c K 329 28. _____ can be defined as the longing or desire for food.
a. Hunger
b. Satiety
c. Appetite
d. Thermic effect of food
d K 330 29. Melanie is pregnant and is having a craving for chocolate brownies. What do scientists
think may be causing her to crave the brownies?
a. Need for a nutrient provided by the brownies
b. High serotonin levels in the brain
c. Low glucagon levels in the blood
d. Scientist do not have a clear explanation.
c A 330 30. Which of the following food choices reflect(s) the most commonly craved foods?
a. Steak and a mug of beer
b. Slice of pizza and a Coke®
c. Hot fudge sundae with nuts
d. Fresh fruit salad
b K 330 31. All of the following contribute to causing food cravings except:
a. overly restrictive food regimens.
b. too much sleep.
c. stress.
d. inactivity.
b K 331 32. What do the appearance, taste, and aroma of food stimulate?
a. Hunger
b. Appetite
c. Hypertrophic growth
d. Hyperplastic growth
440
What Determines Energy Expenditure? (pp. 331-335)
c K 331 33. What are the three main components of total energy expenditure?
a. Thyroid activity, environmental temperature, and mental activity
b. Mental activity, basal metabolism, and thermic effect of food
c. Basal metabolism, physical activity, and thermic effect of food
d. Environmental temperature, basal metabolism, and thyroid activity
d K 331 34. Shivering when you are cold at an event outdoors is an example of:
a. thermic effect of food.
b. physical activity.
c. basal metabolism.
d. adaptive thermogenesis.
e. nonexercise activity thermogenesis.
b K 331-332 35. About how much of one’s total energy expenditure is due to one’s basal metabolic rate
(BMR)?
a. 30-40 percent
b. 50-70 percent
c. 10-20 percent
d. 60-95 percent
c K 331-332 36. The majority of TEE is accounted for by:

a. thermic effect of food.
b. physical activity.
c. basal metabolism.
d. adaptive thermogenesis.
e. nonexercise activity thermogenesis.
c K 331 37. Basal metabolism is the energy expended to sustain all the following functions except:
a. respiration.
b. beating of the heart.
c. digestion.
d. nerve function.
d K 332 38. In order to use the Harris-Benedict equation to calculate an individual’s REE, you will
need all of the following except the individual’s:
a. gender.
b. age.
c. height.
d. activity level.
c K 332 39. What is the definition of resting energy expenditure (REE)?

a. The amount of kcalories required during an 8-hour period usually associated with
sleep
b. The amount of kcalories required for the 16-hour period associated with one’s time
not spent in sleep
c. The amount of kcalories required for a 24-hour period by the body during a non-
active period
d. The amount of kcalories required for a 24-hour period by the body during a period of
fasting and inactivity
441
a K 332 40. What is the Harris-Benedict equation used to calculate?
a. Resting energy expenditure (REE)
b. Estimated energy requirement (EER)
c. Basal metabolic rate (BMR)
d. Total energy expenditure (TEE)
b K 332 41. What two factors are not accounted for in the formula for calculating one’s resting energy
expenditure (REE)?
a. Height and current body weight
b. Physical fitness and body composition
c. Age and height
d. Current body weight and physical fitness
d A 332 42. Even though they are the same age and have the same height and weight, Matt has more
lean mass than Rob. Which of the following is true in this case?
a. Rob has a higher basal metabolic rate than Matt.
b. Rob has a higher estimated resting energy expenditure than Matt.
c. Matt has a higher estimated resting energy expenditure than Rob.
d. Matt has a higher basal metabolic rate than Rob.
a A 332 43. Your Asian-American, female client is 25 years old, weighs 110 pounds, and is 61 inches
tall. According to the Harris-Benedict equation, her REE (in kcal/day) is:
a. 1296.
b. 1414.
c. 1531.
d. 1741.
c A 332-333 44. Sheila is 20 and her mother, Donna, is 50 years of age. Which statement accurately
describes the relationship between their basal metabolic rates (BMR)?
a. Donna’s BMR is roughly twice that of Sheila.
b. Sheila’s BMR is twice that of Donna.
c. Donna’s BMR is 4 to 10% less than Sheila’s.
d. Sheila’s BMR is roughly 30% less than Donna’s.
a K 333 45. What effect does hyperthyroidism have on basal metabolic rate (BMR)?
a. It causes BMR to increase.
b. It causes BMR to decrease.
c. It causes BMR to decrease only during sleep.
d. It causes BMR to increase only during sleep.
b K 333 46. Why is it difficult to lose weight by simply eating fewer kcalories?
a. The body’s response to receiving fewer calories is to increase the BMR.
b. The body’s response to receiving fewer calories is to reduce the BMR.
c. The body’s response to receiving fewer calories is to increase the synthesis of
neurotransmitters.
d. The body’s response to receiving fewer calories is to reduce the synthesis of
neurotransmitters.
c K 333 47. Physical activity can be quite variable, accounting for, at most, _____% of TEE.
a. 10
b. 15
c. 30
d. 50
442
d K 331-334 48. Which of the following is a list of energy expenditure factors arranged in order, left to
right, from the one that requires the most to the one that requires the fewest kcalories?
a. Basal metabolic rate, thermic effect of food, energy for physical activity
b. Energy for physical activity, basal metabolic rate, thermic effect of food
c. Energy for physical activity, thermic effect of food, basal metabolic rate
d. Basal metabolic rate, energy for physical activity, thermic effect of food
c K 334 49. What is the energy expenditure called the “thermic effect of food” used for?
a. Warming ingested food to 98.6 degrees—that is, body temperature
b. Transport of stored food nutrients to body tissues between meals
c. Digestion, absorption, transport, metabolism, and storage of nutrients following a
meal
d. Modifying the temperature of both hot and cold foods to 98.6 degrees—that is, body
temperature
a A 334 50. Ramón consumed 2700 kcalories yesterday. What was his thermic effect of food (TEF)
estimated to be?
a. 135-270 kcalories
b. 170-350 kcalories
c. 215-405 kcalories
d. 260-475 kcalories
d A 334 51. Which food combination would have the highest thermic effect of food (TEF)?
a. 6 fried chicken wings, French fries, and soda
b. One slice of pepperoni pizza with extra cheese and lemonade
c. One bagel with jelly, whole-milk yogurt, and orange juice
d. 6 ounces of roast turkey, baked sweet potato, and skim milk
b K 334 52. What does indirect calorimetry measure?

a. Heat lost from the body
b. The exchange of oxygen and carbon dioxide
c. Heat gained by the body
d. The number of kcalories consumed from 24 hours of food intake
b K 335 53. Which technique is considered to be the “gold standard” for estimating total energy
expenditure (TEE)?
a. Indirect calorimetry
b. Use of doubly labeled water
c. Circuitous calorimetry
d. Harris-Benedict equation
d K 335 54. Stan participated in a scientific study in which he had measurements of oxygen and
hydrogen taken. What did Stan experience?
a. Direct calorimetry
b. Indirect calorimetry
c. Use of the Harris-Benedict equation
d. Use of doubly labeled water
b K 335 55. In order to estimate energy requirements (EER) for adults, which of the following
information will you need?
a. Age, weight, and height
b. Age, weight, height, gender, and physical activity level
c. Age, weight, height, physical activity level, and thermic effect of food
d. Age, weight, height, gender, physical activity level, and stress factor
443
How Are Body Weight and Body Composition Assessed? (pp. 335-341)
c K 335-336 56. What is the definition of “obesity”?

a. Excess weight in proportion to height
b. A BMI of 20-25
c. Abundance of body fat
d. A BMI of 25-30
a A 335-336 57. Juan-Juan is an elite athlete who runs a marathon 3-5 times each year. Would relying on
her BMI to assess body weight be appropriate?
a. No, because she has a high lean mass relative to fat.
b. No, because she has inadequate body fat.
c. Yes, because the formula for calculating BMI considers body composition.
d. Yes, because she has nearly the same fat mass as other people.
d A 336 58. What is the approximate BMI for a person who weighs 220 pounds and is 5 feet 11
inches tall?
a. 25 kg/m2
b. 27 kg/m2
c. 29 kg/m2
d. 31 kg/m2
c A 336 59. Your client is 69 inches tall and weighs 185 pounds. His BMI is:
a. 23.6.
b. 25.9.
c. 27.3.
d. 45.4.
c A 336 60. Assessing your client’s BMI (69 inches, 175 pounds), you find that she is:
a. underweight.
b. at a healthy weight.
c. overweight.
d. obese.
a K 336 61. What is considered to be the healthy range for an adult’s BMI?
a. 18.5-24.9 kg/m2
b. 14.5-19.0 kg/m2
c. 25.0-28.9 kg/m2
d. 29.5-35.0 kg/m2
a A 337 62. Your female client has 28 percent body fat. She is:
a. normal.
b. borderline obese.
c. obese.
c K 337 63. What body fat percentages for males and females, respectively, indicate obesity?
a. females, > 25%; males, > 20%
b. females, > 40%; males, > 30%
c. males, > 25%; females, > 33%
d. males, > 15%; females, > 20%
444
d K 338 64. What principle is hydrostatic weighting based upon?
a. The more fat a person has, the more dense he/she is and the more he/she weighs
underwater.
b. The less fat a person has, the more dense he/she is and the less he/she weighs
underwater.
c. The more fat a person has, the less dense he/she is and the more he/she weighs
underwater.
d. The more fat a person has, the less dense he/she is and the less he/she weighs
underwater.
b K 339 65. What is the technique for determining body composition that relies on measuring the
conduction of weak electric currents by adipose and lean tissue called?
a. Hydrostatic weighing
b. Bioelectrical impedance
c. Near-infrared interactance
d. Dual-energy x-ray absorptiometry
c K 338-339 66. Which body composition assessment method is considered the “gold standard”?
a. Hyrdrostatic weighing
b. Bioelectrical impedance (BIA)
c. Dual-energy X-ray absorptiometry (DEXA)
d. Skinfold thickness
b K 340 67. What are the characteristics of central adiposity?

a. Large amounts of subcutaneous fat in the thighs and hips
b. Accumulation of adipose tissue in the abdominal region
c. Large amounts of subcutaneous fat in the upper arms and chest
d. Accumulation of adipose tissue that is evenly distributed throughout the body
c K 340 68. What type of obesity is associated with increased risk for developing cardiovascular
disease, type 2 diabetes, and hypertension?
a. “Pear-shaped” adiposity
b. Subcutaneous adiposity
c. Central adiposity
d. Etymoloid adiposity
a A 340 69. Ryan has a waist circumference of 43 inches and a hip circumference of 40. What might
a clinician conclude about Ryan?
a. He has central adiposity
b. He has subcutaneous adiposity
c. He has a low risk of cardiovascular disease
d. He has a favorable body composition
How Does Lifestyle Contribute to Obesity? (pp. 341-345)
b K 341 70. Approximately what percentage of adults in the United States are classified as obese?
a. 26%
b. 35%
c. 42%
d. 65%
445
b K 342 71. By approximately how many kcalories has the daily energy intake of American adults
increased over the last 40 years?
a. 100-200
b. 200-300
c. 300-400
d. 400-500
b K 342 72. What have researchers found when studying portion sizes?
a. When larger portions are served, people tend to eat the same amount.
b. When larger portions are served, people tend to eat more.
c. People depend more on social cues than on visual cues to judge how much to eat.
d. People depend more on physiological cues than on visual cues to judge how much to
eat.
b K 342 73. A super-sized “value” fast-food meal can provide _____ of the calories required in a day.
a. more than one-third
b. more than half
c. more than two-thirds
d. more than three-fourths
c K 342 74. What percentage of adults and children, respectively, are estimated to eat fast food daily?
a. 13, 18
b. 25, 30
c. 37, 42
d. 49, 54
a K 343 75. Choose the list that correctly orders the following groups of Americans from the greatest
prevalence of obesity (left) to the least (right).
a. African-American females, Hispanic females, white females
b. Hispanic females, white females, African-American females
c. White females, African-American females, Hispanic females
d. White females, Hispanic females, African-American females
d K 344 76. What type of relationship is there between the level of physical activity and the risk of
being overweight?
a. Proportional
b. Converse
c. Direct
d. Inverse
a K 344 77. If Sal added an extra mile of walking to his routine every day for one month, how much
weight could he expect to lose by making only this change?
a. One pound
b. Two pounds
c. Three pounds
d. Five pounds
446
d K 345 78. Which of the following recommendations is not included in the Physical Activity
Guidelines for Americans?
a. Every U.S. adult should get 30 minutes or more of moderate-intensity activity five
days a week (or an equivalent amount of vigorous-intensity activity).
b. Every U.S. adult should get 25 minutes a day, 3 days a week, of vigorous-intensity
physical activity (or an equivalent amount of moderate-intensity activity).
c. Every U.S. adult should perform moderate- or vigorous-intensity muscle-
strengthening activities at least twice a week.
d. Every U.S. adult should get 30 minutes or more of moderate-intensity activity twice
a week.
c K 345 79. According to the Physical Activity Guidelines for Americans, how much time, at a
minimum, should children spend being physically active per week?
a. 30 minutes a day, at least 5 days a week
b. 45 minutes a day, at least 5 days a week
c. 60 minutes a day, preferably 7 days a week
d. 90 minutes a day, preferably 7 days a week
c K 344 80. What is the definition of moderate-intensity physical activity?

a. Exertion that does not raise your heart rate or cause you to sweat
b. Exertion that is 2.0-2.5 times as intense as rest
c. Exertion that is 3.0-5.9 times as intense as rest
d. Exertion that raises your heart rate to the point of breathlessness
Can Genetics Influence Body Weight? (pp. 345-346)
b K 345 81. What have researchers learned about the causes of obesity from studying identical twins
separated at birth?
a. Genetics contributes 60% risk, lifestyle contributes 40% risk
b. Genetics contributes 50% risk, lifestyle contributes 50% risk
c. Genetics contributes 40% risk, lifestyle contributes 60% risk
d. Genetics contributes 30% risk, lifestyle contributes 70% risk
d K 346 82. What hormone, discovered in mice in 1994, is thought to be a potent satiety signal?
a. Calcitonin
b. Parathyroid hormone
c. Norepinephrine
d. Leptin
b K 346 83. Why hasn’t the hormone originally thought to be a potent satiety signal in mice been a
miracle cure for obesity in people?
a. The hormone may protect against starvation rather than obesity.
b. Few humans actually have a deficiency of this hormone.
c. This hormone is a hormone for mice but not people.
d. Most humans have defective hormone receptors.
447
How Does the Body Regulate Energy Balance and Body Weight? (pp. 346-350)
c K 348 84. What does the set point theory suggest with regard to the body’s regulation of weight?
a. When the amount of food intake increases beyond a “set point” a signal causes food
intake to decrease and/or energy expenditure to increase.
b. When the amount of insulin released increases beyond a “set point” a signal causes
food intake to decrease and/or energy expenditure to increase.
c. When the amount of adipose tissue increases beyond a “set point” a signal causes
food intake to decrease and/or energy expenditure to increase.
d. When the amount of adipose tissue increases beyond a “set point” a signal causes
serotonin production to decrease and appetite to decrease.
b K 348-349 85. Which tissues generate signals communicating information about the body’s energy
reserves?
a. Liver and gall bladder
b. Brain and adipose tissue
c. Central nervous system and muscle
d. Brain and liver
a K 349-350 86. Which of the following hormones appears to work in opposition to leptin?
a. Adiponectin
b. Cortisol
c. Epinephrine
d. Insulin
What Are the Best Approaches to Weight Loss? (pp. 350-354)
a A 351 87. James is 5’8” and weighs 235 pounds. What total level of weight loss is considered a
realistic goal for James?
a. 12-24 pounds
b. 19-42 pounds
c. 25-50 pounds
d. 30-60 pounds
d A 351 88. If Lynn, who now weighs 170 pounds, achieves the recommended rate of weight loss,
what will she weigh (in pounds) in 8 weeks?
a. 130-135
b. 136-139
c. 145-152
d. 154-162
b A 351,354 89. Which of these foods are considered high-energy-density foods?

a. Roast turkey, skim milk, whole-grain cereals
b. Brownies, candy bars, crackers with cheese
c. Eggs, raisins, tomato soup
d. Broccoli, oranges, blueberries
c A 353 90. Maria has lost 30 pounds. How many fewer kcalories does she now need every day just
to maintain her new, lower body weight?
a. 60
b. 180
c. 240
d. 360
448
Does Macronutrient Distribution Matter? (pp. 353-359)
c K 356 91. Typically, what is the ingredient that replaces the fat in low-fat snack products?
a. Fiber
b. Water
c. Refined carbohydrate
d. Fat substitutes such as olestra
a K 356-357 92. What accounts for much of the initial weight loss associated with a low-carbohydrate
diet?
a. Loss of stored glycogen and associated water
b. Loss of body fat in “temporary” storage sites
c. Loss of body fat from adipocytes
d. Loss of fat from muscle tissues
b K 357 93. What are the long-term weight loss differences between those following low-
carbohydrate diets and those following low-fat diets?
a. Those on low-fat diets lose the most.
b. Those on low-carbohydrate diets lose the most.
c. None have been found.
d. Those on low-fat diets regain the most.
d K 358 94. What is most likely to be lacking in low-carbohydrate diets?

a. Lactose, adequate protein, and vitamin B12
b. Non-essential micronutrients and essential amino acids
c. Maltose, vitamin D, and vitamin K
d. Essential micronutrients, dietary fiber, and phytochemicals
Use the following case study to answer questions 95-104.1
Case Study: Jim, a 21-year-old, medium-frame 6’2” senior weighing in at 205 lbs is a very active varsity wrestler
majoring in psychology. He is participating in a “Hydration Study” that includes the collection of the following data:
body composition analysis utilizing the Bod Pod®, food/beverage intake via dietary assessment questionnaire, urine
sample, and analysis of saliva. The following data have been provided to assist in answering the questions.
Bod Pod® Results:

59% body water
86.7% lean mass
13.3% fat mass
Reference Values for Bod Pod®:

Risky (high body fat) = men: >30%; women: >40%
Excess fat = men: 21%-30%; women: 31%-40%
Moderately lean = men: 13%-20%; women: 23%-30%
Lean = men: 9%-12%; women: 19%-22%
Ultra lean = men: 5%-8%; women: 15%-18%
Risky (low body fat) = men: <5%; women: <15%
1These questions require comprehension of various sections of the chapter to answer, but are placed together here to
keep them together with the case study. Specifically, questions 95-97 test on “How are body weight and body
composition assessed?”; 98-100 on “What determines energy expenditure?”; and 101-104 on “Does macronutrient
distribution matter?”
449
24-Hour Recall:
3540 kcalories
177 grams protein
118 grams fat
Males: EER = 662 - [9.53 x Age (y)] + PA x [(15.91 x weight in kg) + (539.6 x height in m)]
PA Values: Sedentary = 1.0, Low Active = 1.11, Active = 1.25, Very Active = 1.48
c A 336 95. Based on his BMI, Jim would be considered:

a. within his ideal body weight range.
b. below his ideal body weight range.
c. above his ideal body weight range.
d. Not enough information provided to determine
b A 336 96. Based on the information provided, what is Jim’s BMI?

a. 26.1
b. 26.3
c. 27.1
d. 27.8
d A 336-337 97. Given the information available, which of the following would best describe Jim?
a. Healthy weight and lean
b. Healthy weight and moderately lean
c. Overweight but lean
d. Overweight but moderately lean
d A 335 98. How many kcalories would Jim require to meet his estimated energy requirements
(EER)?
a. 2955
b. 3325
c. 3665
d. 4157
d A 335 99. The wrestling season has ended and Jim does not want to gain weight. His activity level
will change from very active to sedentary. Approximately how many kcalories less per
day will he need post season?
a. 600
b. 800
c. 1000
d. 1200
a K 335 100. How many total kcalories would Jim require post season to meet his estimated energy
requirements (EER)?
a. 2958
b. 3325
c. 3665
d. 4157
c A 355-356 101. How many grams of carbohydrate did Jim consume based on his 24-hour recall?
a. 118
b. 177
c. 442
d. 1770
450
c A 355-356 102. What was the total percentage of kcalories from carbohydrates in Jim’s diet based on his
24-hour recall?
a. 40
b. 45
c. 50
d. 55
b A 355 103. Based on the Acceptable Macronutrient Distribution Range (AMDR) suggested for
carbohydrates and Jim’s daily energy intake from his 24-hour recall, calculate the range
(in grams) of carbohydrates recommended for Jim each day.
a. 354-531
b. 398-575
c. 442-531
d. 486-575
d A 355-358 104. It is the end of summer and Jim realizes that he has gained 10 lbs. What would be the best
approach for Jim to take to maintain muscle mass and promote fat loss?
a. He should go on a low-fat diet, since those on low-fat diets lose the most.
b. He should go on a low-carbohydrate diet, since those on low-carbohydrate diets lose
the most.
c. He should increase his activity level.
d. He should increase his activity level and reduce his kcalorie intake.
True/False
Answer, level, page
F K 324 1. Adipocytes decrease in number as an individual loses weight.

T K 325 2. An individual is satiated when he or she has satisfied his/her hunger.
T K 326 3. Expansion of the stomach signals satiety to the brain.
T K 327 4. Obese individuals tend to have larger stomachs than lean individuals.
F K 327 5. Bariatric surgery is designed only for those with serious medical problems.
T K 333 6. An elevated body temperature temporarily increases your BMR.
F K 333 7. Loss of body tissue associated with fasting and starvation increases your basal metabolic
rate.
F K 334 8. Direct calorimetry measures the exchange of oxygen intake and carbon dioxide output.
F K 334 9. Direct calorimetry is inexpensive to do and routinely used by registered dietitians in a
practice setting.
F K 334 10. The energy required to process food is called the processing load.
T K 336 11. A BMI of 30 kg/m2 or greater is indicative of obesity.
T K 338-339 12. DEXA uses X-ray beams to assess body composition.
F K 338 13. Hydrostatic weighing uses a sealed chamber to measure air displacement.
T K 340 14. Central adiposity is characterized by an apple shape.
F K 340 15. Central obesity is more common in men and is characterized by subcutaneous fat deposits
in the hips and thighs.
T K 340 16. The waist-to-hip ratio or waist circumference can be used to determine one’s body fat
distribution pattern.
451
F K 345 17. Genetic traits are the only factors that influence the development of obesity.
F K 346 18. The hormone leptin is produced by the liver and helps to regulate body weight.
T A 354 19. An individual is likely to feel more full after eating a 200-kilocalorie portion of
cantaloupe, compared to a 200–kilocalorie portion of cheese.
T K 356-357 20. Low-carbohydrate diets are more effective than other diets in helping individuals lose
weight.
Discussion
1. When might someone want or need to be in positive or negative energy balance?
Answer (key points): Positive energy balance occurs when energy intake > energy expenditure. Negative
energy balance occurs when energy intake < energy expenditure. In most cases, weight change is a good
indicator of energy balance: Weight gain indicates positive energy balance, weight loss indicates negative
energy balance, and no change indicates energy balance.
Positive energy balance is desirable during periods of growth such as infancy, pregnancy, and intense weight
training to increase muscle mass. Negative energy balance is the goal for individuals who want to lose weight.
(p. 323)
2. How does the number of adipocytes in a person’s body impact on his/her ability to avoid obesity? How can a
person minimize the number of adipocytes he or she has?
Answer (key points): Some scientist believe that the number and size of adipocytes may influence the ability to
maintain a healthy weight. People with fewer, enlarged adipocytes may have less difficulty maintaining weight
loss than those with a greater number of smaller adipocytes. Avoiding excessive weight gain can help minimize
one’s adipocyte population, since in adults new adipocytes are not formed until existing ones are full of stored
lipids. Once the number of adipocytes has increased, it usually remains higher than before despite any
subsequent weight loss. (pp. 323-324)
3. What are the pros and cons of resorting to surgical procedures to promote weight loss?
Answer (key points): Pros: Improved quality of life both physically and emotionally. A recent study of 4,000
obese subjects showed significant improvement in survival rates in obese individuals. Gastric bypass surgery
may help lower death rates associated with type 2 diabetes, heart disease, and cancer. Cons: heartburn,
abdominal pain, and vomiting. Increased risk of nutritional deficiencies, dumping syndrome, and other
complications from surgery. Death rate within one year of surgery is 1%-5%. (p. 327)
4. What regulates hunger and satiety? What can an individual do to increase his/her own sensations of each?
Answer (key points): Hunger and satiety are influenced by concentrations of glucose, amino acids, and lipids
in the blood. Elevated blood glucose, amino acids, and lipids promote satiety. Decreased levels of glucose,
amino acids, and lipids release neurotransmitters that stimulate hunger. The presence of food in the stomach and
small intestine can trigger the release of GI hormones (CCK, PYY)—the majority of which promote satiety.
Ghrelin is one of the few that doesn’t promote satiety but appears to signal hunger to the brain. (pp. 325-327,
328-329)
5. Why do some people eat primarily in response to hunger while others eat in response to appetite and/or
cravings? How likely is each group to eat nutrient-dense foods?
Answer (key points): “Some people eat to live and others live to eat.” People who eat primarily in response to
hunger are responding physiologically to the need to meet their energy needs. People that eat in response to
appetite or cravings are responding psychologically and may or may not physically be “hungry” or be in an
energy deficit.
452
People who eat because of appetite, if they are influenced by food cravings, may be more prone to eat calorie-
rich, less-nutrient-dense foods high in refined carbohydrate and/or fat. For those who eat in response to
cravings, new information on the role of neurochemicals is becoming available. Hormones are thought to be
involved, since food cravings are more common in women, especially during menstruation or pregnancy. (pp.
325, 329-331)
6. What parameters are considered in helping someone estimate his/her energy expenditure?
Answer (key points): Total energy expenditure (TEE) takes into account three components: (1) basal
metabolism, (2) physical activity, and (3) thermic effect of food. As it is too difficult to measure basal
metabolism because of the stringent conditions required, resting metabolic rate (RMR) is often used. RMR
expressed over 24 hour period = resting energy expenditure (REE). The Harris-Benedict Equation can be used
to calculate REE. The DRIs developed by Institute of Medicine include calculations for Estimated Energy
Requirements (EERs) that take into account TEE and energy to support growth. EERs for adults are intended
for weight maintenance. Adjustments in energy intake and physical activity can be made to support weight loss
or gain. (pp. 331-332, 335)
7. Why is it important to assess body composition as well as body weight?

Answer (key points): A person’s weight does not provide information about body composition—i.e., % lean
muscle mass, % body fat, and body water. It would be particularly helpful to assess body composition, as it
changes throughout the life cycle and is affected by health status, diet, and overall energy balance. It is possible
for physically fit people to weigh more and appear “overweight” or “obese” when they are actually lean. Muscle
is more dense than fat; thus, the more muscle mass a person has, the more dense he/she will be and the more
he/she will weigh. (pp. 337-339)
8. What lifestyle, socio-cultural, and genetic factors influence food preferences, dietary practices, and whether or
not someone becomes obese?
Answer (key points): The obesity epidemic in the U.S. is multi-factorial. One major contributing factor is an
increase in energy intake over the last few decades (200-300 kcal/day). Societal influences on eating include
number of meals, eating outside the home, increased portion sizes, increased consumption of energy-dense
foods, and changes in snack habits. Socio-cultural and psychological factors such as differences in income,
education, dietary beliefs, and acceptability of being overweight can increase risk of obesity. Psychological
influences such as family and the social environment can provide permissive cues for others to gain weight.
People who are depressed, anxious, or impulsive, have low self-esteem, or have suffered emotional trauma may
turn to food for emotional comfort, making them more likely to suffer from obesity. Genetics can predispose
individuals to becoming obese (or not) in response to these socio-cultural and lifestyle factors. (pp. 341-345)
9. What role does physical activity have in maintaining fitness and a healthy body weight?
Answer (key points): Physical inactivity has contributed to the growing rates of obesity—most worrisome are
rates among children and adolescents. Inactivity has been studied extensively in this age group (television
viewing, video games, and computers). This trend is changing and opportunities to increase physical activity are
increasing. New physical activity recommendations for adults released by the U.S. government recommend that
adults engage in at least 150 minutes/week of moderate-intensity or 75 minutes/week of vigorous-intensity
aerobic activity, plus moderate- or vigorous-intensity muscle-strengthening activities on 2 or more days/week.
According to an International Association for the Study of Obesity expert panel, daily exercise assists in
prevention of weight gain among adults. (pp. 344-345, 352-353)
10. Why does most people’s weight remain stable over time?
Answer (key points): Scientists have long suspected that a complex signaling system regulating body weight
exists in humans. To test this theory, researchers observed weight gain and weight loss cycles in mice. When
food-restricted, mice lost weight. When taken off food restriction, the mice increased their food consumption
and soon returned to their original weight. Once the mice returned to their original weight, their consumption
dropped off. This phenomenon was termed the set point theory of body regulation. Adipose tissue is now
known to be a very active tissue that responds to factors circulating in the blood and communicated to the brain.
453
When adipose tissue increases beyond a “set point” in humans, it is believed that a signal causes food intake to
decrease and/or energy expenditure to increase to promote weight loss. On the other hand, if adipose tissue
stores decrease below a “set point,” food intake increases and energy expenditure decreases, favoring weight
gain. Ultimately, body weight is set and remains relatively stable. (p. 348)
11. What changes in supermarket choices and the food-away-from-home industry might have a positive impact on
the nutrition and health of U.S. residents?
Answer (key points): Being able to choose salads and sandwiches made with lean meats and whole-grain
breads. Purchasing 100-kcalorie snack packs, pre-portioned items, and other reduced-kcalorie, portion-
controlled foods. Having an assortment of low-fat single-serving dairy products such as yogurts, low-fat cheese
sticks, and frozen pops/ice cream (low in added sugars) available. Providing conveniently packaged or easy
“grab ‘n’ go” fruits and vegetables. (pp. 351-352)
12. What are the hallmarks of “healthy” and “likely-to-be-successful” weight management regimes?
Answer (key points): They require making lasting lifestyle changes—most importantly food choice and
physical activity. The focus should be more on healthy eating and becoming more physically active and less on
“dieting.” The hallmarks are: (1) set reasonable goals, (2) choose nutritious foods in moderation, and
(3) increase energy expenditure by daily physical activity. (pp. 351-353)
13. What practical suggestions might you make to anyone wanting to increase his/her energy expenditure?
Answer (key points): Increasing energy expenditure requires becoming physically active. Physical activity can
be incorporated into a person’s daily routine—e.g., taking the stairs instead of the elevator, walking or biking
instead of driving, and daily chores. Leisure activities that include physical activity such as a hike, bicycling, or
a ski trip can be a fun way to contribute to increasing energy expenditure. Regular planned exercise can go a
long way to promote an increase in energy expenditure. The most important thing to consider about planned
exercise is that the exercise be something that is enjoyed and varied often to avoid monotony. (pp. 352-353)
14. What is the best balance of nutrients for achieving weight loss?
Answer (key points): No consensus. It appears that weight loss reported is due to kcalorie reduction rather than
to a direct effect of the manipulation of the macronutrient composition of the diet. (pp. 353-358)
15. Is a low-carbohydrate diet safe and effective for losing weight?

Answer (key points): A recent study evaluated the effectiveness and safety of low-carbohydrate weight-loss
diets, reporting that a low-carbohydrate diet was an effective alternative to low-fat diets and a Mediterranean
diet with little loss of lean tissue and no harmful effects on bone health. Those following a low-carbohydrate
diet lost on average of 10 lbs. after 2 years and had improvements in blood lipid levels and glucose levels when
compared to participants consuming the low-fat diet and Mediterranean diet.
Due to the high protein intake, a low- carbohydrate diet is not advisable for people with impaired kidney
function. Of concern is the restriction of healthy high-carbohydrate foods such as fruits, vegetables, and whole-
grains. Low-carbohydrate diets may lack essential micronutrients, dietary fiber, and beneficial phytochemicals.
A low-carbohydrate diet consists of limited food choices due to restricted carbohydrates, and appetite is
decreased with ketosis. Thus, overall kcalorie reduction is most likely the cause for the weight reduction and not
the body burning energy more efficiently. (pp. 357-358)
Fill in the Blank

1. _______________ are a group of hormones released by adipocytes that allow them to communicate with other
tissues and organs.
Answer: Adipokines (p. 323)
454
2. Energy expended for movement such as fidgeting and maintaining posture is categorized as _______________.
Answer: nonexercise activity thermogenesis or NEAT (p. 331)
3. The energy Karen’s body expends for basal metabolism over a 24-hour period is Karen’s _______________.
Answer: basal energy expenditure or BEE (p. 332)
4. _______________ is energy expenditure required to adapt to changes in the environment or to physiological
conditions.
Answer: Adaptive thermogenesis (p. 331)
5. Shane’s _______________ includes all energy his body expends to sustain metabolic activities related to his
basic vital body functions such as respiration, muscle tone, and nerve function.
Answer: basal metabolism (p. 331)
6. The energy expended for resting metabolism over a 24-hour period is termed _______________.
Answer: resting energy expenditure or REE (p. 332)
7. One’s energy expenditure for basal metabolism expressed as kcal per hour is one’s _______________; one’s
_______________ is a similar measure of energy expenditure, but is assessed under less stringent conditions.
Answer: basal metabolic rate or BMR, resting metabolic rate or RMR (pp. 331-332)
8. The energy expended for the digestion, absorption, and metabolism of nutrients is known as the
_______________.
Answer: thermic effect of food or TEF (p. 334)
455
Nutrition Matters 8 – Disordered Eating

Multiple Choice
Answer, level, page Level: K = knowledge, A = application/critical thinking
Introduction (p. 365)
d K 365 1. Based on the American Psychological Association estimates, how many women in the
U.S. battle some form of eating disorder?
a. 1 million
b. 2 million
c. 4 million
d. 8 million
How Do Eating Disorders Differ from Disordered Eating? (pp. 365-372)
a K 365 2. Disordered eating can be defined as:

a. irregular eating, consistent undereating, or consistent overeating.
b. binging, purging, and/or food restriction.
c. anorexia nervosa, bulimia nervosa, or EDNOS.
d. None of the above
c K 366 3. Eating disorders are classified into distinct categories by:

a. the American Dietetic Association.
b. the American Medical Association.
c. the American Psychiatric Association.
d. a and b
e. b and c
d K 366 4. How many times per week must someone binge and purge to be diagnosed as having
bulimia nervosa?
a. 5
b. 4
c. 3
d. 2
c K 366 5. Which eating disorder is most characterized by an irrational fear of gaining weight or
becoming obese?
a. Bulimia nervosa
b. Binge-eating disorder
c. Anorexia nervosa
d. Eating disorders not otherwise specified
b K 367 6. How do persons suffering from anorexia nervosa typically view self-starvation?
a. As punishment
b. As an accomplishment
c. As necessary in order to make friends
d. As a way to reduce guilt
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CHAPTER XIV
Antagonisms
Dinner was finished and yet it was early evening.

Over in the west the sunset was flaming the sky with the brilliant
colors of this land of clear atmospheres.
Seated in a group about a smouldering outdoor fire were eight girls
—seven of them in ceremonial camp fire costumes and one of them
dressed as an Indian. Curious that the Indian girl should be the
fairest of them all!
Her pale yellow hair was fixed in the elaborate fashion of the Hopi
maidens, with great loops over each ear, her dress of white. About
her throat were several strings of uncut turquoise. The dress itself
was made of a single piece of woolen cloth—really a white blanket—
with a deep border of bright blue and red at the bottom and at the
top. Around her waist was a white belt and on her feet soft white
moccasins, with strings of white leather wound about her legs almost
to the knees until she looked as if she were wearing white top boots.
Dawapa was also in her ceremonial costume, as she was the guest
of the Camp Fire girls. At the moment she was deftly fashioning a
baho, or feather prayer plume. The other girls were watching her
with interest.
They were at some distance back from the fire with the evening
wind blowing the smoke away to the northwest among the blue peaks
of the San Francisco hills and the gorges of the Grand Canyon.
Gerry Williams was sitting next to Dawapa, with Sally Ashton on
her other side, Sally’s brown head resting against Gerry’s shoulder
and her lids closing now and then over her big brown eyes. She
looked like a sleepy, sweet-tempered doll.
Opposite were Vera and Bettina, and in front Alice, Peggy and
Ellen. They had broken their usual Camp Fire circle formation in
order the better to observe their guest.
Their Camp Fire guardian was not with them at the moment,
having gone to her tent after dinner. It seemed better, now and then,
to Polly that she leave the girls alone.
On the ground beside Dawapa was a large round basket, flat like a
tray and woven in red and green grasses, with a disk inside to
represent the sun.
In spite of the lateness of the hour, as it was still sufficiently light,
Alice and Ellen and Vera were working at their own weaving. Since
her arrival two days before, the Indian girl had been teaching the
Sunrise Hill Camp Fire club to improve their hand craft in more than
one way. Although Dawapa was not yet an artist to equal her mother,
her skill in basketry, in silver work and more especially in pottery
had awed the American girls. It was one thing to be a modern Camp
Fire girl, no matter how successful in the obtaining of the green
honors, and another to have been born to the life of the camp and the
inheritances of generations of hand workers.
“What is that pretty thing you are making used for, Dawapa?”
Gerry asked, glancing up from her own pretty hands, which were idly
crossed in her lap, toward the other still fairer girl. Gerry did not
seem to be making a great effort to add to her Camp Fire honors and
thus attain to a higher membership.
The Indian girl was almost abnormally shy and timid—or at least
she appeared timid to the Camp Fire girls. But she had been to a
government school and spoke a fair amount of English.
“We plant our prayer plumes on the altar when we pray to the
Indian Gods,” she answered gently, with a faraway look in her light
blue eyes. “Our first prayer is for good thoughts—then that our
children may be wise and strong, and that the God of the Sky may be
glad of us.”
Gerry laughed. It was odd how few things seemed to strike her as
serious.
Alice Ashton frowned. She was not pleased at her younger sister’s
intimacy with Gerry, of whose history they knew almost nothing.
“That is lovely, Dawapa; thank you for telling us,” she returned,
wondering if the Indian girl would feel that they had less good
manners than her own people. “After that, do you not pray for
something you especially wish for—the thing you most desire?”
Alice spoke earnestly and the other girls remained silent. Perhaps
there was not one among them who did not cherish a secret wish;
perhaps for some simple, material possession, or perhaps an
ambition which only the future could gratify.
But Dawapa only nodded her head and did not reply.
Gerry leaned over.
“Oh, if that prayer plume thing brings one good luck, give it to
me?” she demanded, reaching over and making an attempt to take
the baho from the Indian girl’s hand.
But Dawapa held to it firmly.
“Don’t do that, Gerry,” Bettina Graham said hastily and with a note
of authority. “Dawapa told you that the prayer plume is a part of the
Indian religious ceremony.”
After all, Bettina Graham was her mother’s daughter, and courtesy
and good breeding had been the rule of her life. She did not dislike
Gerry; indeed, she had not paid a great deal of attention to her, but
occasionally something in the other girl’s behavior offended her
almost unconsciously.
And, in a way, Gerry knew and resented this. In fact, she had
immediately decided that what Bettina’s friends called shyness was
only hauteur, due to her father’s prominence and her own social
position.
At Bettina’s speech she now flushed angrily, but drew away from
the Indian girl. Then she laughed a faintly mocking, insinuating
laugh.
“I beg your pardon; I had forgotten what a convert you have
become to ‘the poor Indian.’”
Just exactly what Gerry meant by this stupid speech, Bettina did
not appreciate. However, she did know that it was her intention to be
rude.
“You have extraordinarily bad manners, Gerry. I wonder if it is
because you do not know better?” Bettina returned quietly. By this
time she was also angry, but she had a self-possession which gave her
the advantage. Yet, the moment her sentence was finished, Bettina
regretted it. Among the new Sunrise Hill Camp Fire club this was the
first open quarrel, and the other girls were looking uncomfortable.
Bettina had not meant to make her accusation so sweeping. Having
lost her temper, she had simply said more than she should, as most
of us do under similar circumstances. Moreover, Bettina felt a little
stab at realizing that Gerry would doubtless tell her side of their
difficulty to their Camp Fire guardian. In Bettina’s mind there was
little doubt whose part she would take.
“You are hateful, Bettina,” Sally Ashton murmured, still a little
sleepily. She had not listened carefully to what had been said, but
wished to announce herself as Gerry’s champion. The truth was that
Alice had recently lectured her younger sister on the subject of their
intimacy, and Sally intended to show how utterly unimpressed she
was by family advice.
If Gerry intended continuing the quarrel she did not say anything
more at this instant. For, glancing up, she had seen that Mrs. Burton
had come out of her tent and was walking slowly towards them.
Bettina also had seen her and was a little puzzled that Gerry did
not make the best of her present opportunity. Then she concluded
that Gerry was a little ashamed, as she herself was, over their
childish lack of self-control. Perhaps next day there would be a
chance to straighten things out when they were alone, particularly as
they were expecting guests to arrive at their camp fire at any
moment.
“Our visitors have not yet appeared, have they?” Polly asked a
moment later, as she sat down next to her niece.
Straightway Gerry kissed her hand to their Camp Fire guardian
across the intervening space, looking as sweet and unruffled as if
nothing unpleasant had occurred.
Really, by this time only Peggy showed any especial expression of
annoyance. Peggy simply refused at all times to pretend to any state
of mind she did not feel. Although she had not spoken, recognizing
that she had no part in Bettina’s and Gerry’s quarrel, none the less
was she ruffled.
Recognizing this fact, but not understanding the cause, Polly
slipped her arm affectionately through Peggy’s and held her close for
a moment. She could feel the girl grow less rigid; see her expression
change and soften. There was no doubting the sincerity of the
devotion between the niece and aunt, even if now and then they did
not entirely approve of each other’s actions. Mrs. Burton, however,
had not the faintest idea that Peggy would at any time oppose her in
a matter of importance. Perhaps she had grown too accustomed to
believing in her own charm and unconsciously in the influence of her
own success. So far no one appreciated the fact that Peggy Webster
was one of the few people who absolutely had to think for herself,
and to be faithful to the truth and to justice as she saw it.
“Terry Benton’s note to me said he wished to bring half a dozen
other friends with him tonight, so that was rather an unnecessary
question on my part,” Mrs. Burton went on, wondering why the
group of girls remained so silent and constrained, and glancing with
more attention from one face to the other.
Some little time before, Mrs. Burton had been compelled to
surrender the idea that she could order her Sunrise Hill Camp Fire
club as if it were a nunnery and she the Mother Superior. At least,
this was the accusation which Mrs. Gardener had certainly made on
their arrival. Really, Polly had only wished to keep clear of
entanglements. But Terry Benton, although not permitted to remain
as guide, had manifested no ill feeling. Indeed, ever since he had
been a more or less frequent visitor at camp, bringing an occasional
friend with him. He and Gerry and Sally seemed to have formed a
kind of three-cornered friendship.
Tonight, however, was the first time that he had suggested
bringing so many visitors at one time. But Terry had written to say
he had a friend from the East who had just arrived at the Gardener
ranch and wanted to call. There were also four or five western fellows
who declined to be put off any longer.
Therefore Mrs. Burton had acquiesced and written to say she and
the Camp Fire girls would be glad to see them. After all, she
remembered how important a part their boy friends had played in
her own Camp Fire days. Perhaps it was a sign of age to have
expected other girls to be different. Anyhow, Mrs. Burton had the
grace to laugh at herself after submitting to the inevitable. And she
was now first to spy their expected guests.
But the moment after, Sally also had seen them and jumping
quickly to her feet, all her sleepiness vanished, began waving a yellow
scarf.
The newcomers made an effective picture, riding in single file
along the trail which led from the Gardener ranch. Although the sun
was not entirely down, the moon had risen and was showing faintly
in the opposite sky. Later would be revealed, the Pleiades which the
Indian calls the time of the sweet influences.
The young men were wearing rough-rider costumes. Observing
Sally’s signal, Terry Benton, who was leading the line of march, rose
in his saddle and saluted. The next instant six other men followed
suit and together they halloed across the desert the long, curious cry
of the western cowboy.
But the girls had also risen in a picturesque group about their
camp fire, calling back in return the now world-famous camp fire
cheer:
“Wohelo for aye, Wohelo for aye, Wohelo, Wohelo, Wohelo for aye!
Wohelo for work, Wohelo for health, Wohelo for love.”
Ten minutes later, leaving their burros below fastened to the trees
near Cottonwood Creek, Terry and his friends, after climbing the
mesa, came directly toward Mrs. Burton. And before Terry could
introduce any one of them, a young man held out his hand.
“I have met you before, Mrs. Burton. You remember you said I
could not be a member of your Camp Fire club? Well, I have done the
next best thing, I am a visitor at the Gardener ranch. Benton and I
are old friends, and when he wrote me of what was going on out here,
I guessed the rest. Besides Mrs. Webster and Mrs. Graham
confessed. I think they want a first-hand report of Miss Bettina and
Miss Peggy from me.”
But Peggy had by this time joined her aunt.
“Ralph Marshall; how extraordinary to see you out here! You are
the very last person I would ever have dreamed of. I thought, after
your visit to us, you were to stay on and study scientific farming with
father.”
“Oh, well, I have concluded to be a ranchman instead,” Ralph
returned, smiling and shaking hands with Peggy.
Peggy was pleased to see him. He had been a guest at their place
several times while she was growing up and was really a charming
fellow, if a little spoiled by his father’s wealth. Then his people were
friends of Bettina’s mother and father, as well as of her own.
CHAPTER XV
The Storm
Ralph Marshall decided that he never had seen Bettina Graham so

agreeable nor so good looking as she was tonight.
Ralph was a great admirer of Bettina’s mother; indeed, whenever
he made a visit to Washington, he was always in Mrs. Graham’s
train. And he knew that Mrs. Graham wished him to be friends with
her daughter; indeed, she had frankly told him so, announcing that
she believed the one would be good for the other. For Bettina, in her
mother’s eyes, was too grave, too given to yielding to odd fancies and
too indifferent to people, while Ralph, in contrast, was too frivolous
and fond of society. He was some day to inherit great wealth, so his
father was trying vainly to interest him in something of importance.
His excursions to Washington and his connection with Senator
Graham were in order to inform him of national affairs. Failing that
interest, for Ralph had announced himself as bored to death by
politics, he had gone for a few weeks to the Webster farm, pretending
to have developed a curiosity concerning scientific farming.
But, really, Ralph was only concerned at present with having an
agreeable time. He was not a student and had barely managed to be
allowed to remain at college. He was not a first-rate athlete, for
athletics required too much self-sacrifice to appeal to Ralph. But he
had a charming voice and was one of the stars of his college glee club,
and there was not a man in college who danced better.
So he and Bettina really were too great a contrast in all their ideas
and desires ever to have been intimate friends up to the present time,
in spite of the family wishes.
Tonight, however, Ralph had concluded that Bettina was almost a
real girl, and not a prig given to writing poetry and reading a lot of
dull books that would bore any natural human being to death. She
was evidently interested in all kinds of outdoor sports, which she
must have learned through her Camp Fire work, and Ralph always
had been forced to concede that Bettina knew how to dance. She was
so tall and slender and, just as she had a peculiar light grace in
walking, so she had it in dancing.
Ralph and Bettina were dancing together at the time the young
man was reaching these conclusions—dancing outdoors on the
smooth plateau of the mesa on a wonderful, white night. Bettina’s
hair was shining in the moonlight, and she was stirred out of her
usual coldness by the beauty and novelty of her surroundings. So it
was small wonder that Ralph, who was a romantic person, was at
present taking a more kindly view of his companion.
However, Bettina had not changed to the same degree in her
opinion of Ralph. She was still convinced that he was exactly the kind
of man she would always least admire. Bettina’s ideal was
represented by her father, who had made his own way by a strenuous
and self-denying youth. Moreover, Bettina had never forgiven Ralph
for his discovery of the poem she had written and believed she had
safely burned that afternoon at the Webster farm.
But the music ceased. After Bettina and Ralph stopped dancing
they walked together to the side of the mesa and Bettina sat down.
The music consisted of a Victor, which Mrs. Burton had brought
with them as a part of the camping outfit, and tonight Marie had the
music in charge.
She looked like a little French figure of Pierette in her tight-fitting
black dress, and with her face oddly white in the moonlight. For
Marie insisted upon following the French fashion of using a great
deal of white powder in spite of her mistress’ remonstrances.
The Victor had been placed in a convenient position and Marie
mounted on a stool beside it. Almost for the first time since their
arrival in camp, Marie appeared almost gay as she ground out the
records and watched the dancers.
Mr. Jefferson Simpson had come forth from his lone tent near the
creek and established himself several yards away, to smoke a
meditative cigar and observe the proceedings with his twinkling,
philosophic eyes.
“It is great out here, isn’t it?” Ralph said, as he arranged himself in
a picturesque attitude, lying at full length on the sands near Bettina’s
feet.
“And it wasn’t so worse—that little poem of yours I found this
spring; at least, not for stuff of that kind.” And Ralph spoke with a
fine scorn of the poets and poetry of all ages.
“I can repeat the thing, I think. Indeed, to tell you the truth, after I
read it over I learned the words and have been singing them to some
music I know.”
And Ralph sang under his breath in a charming voice:
“In the moon of the peach blossoms,
Toward the land of the setting sun,
Ghosts of old camp fires keep calling;
Camp fires whose race has been run.
“I can see the sands of the desert;

I can hear strange desert cries;
And ever my thoughts go homing
To a tent under desert skies.”
In the beginning Bettina was uncertain whether she was pleased or

annoyed at Ralph’s reminding her of an embarrassing experience.
But undoubtedly, by the close of the song, she was flattered. Ralph
really made the most of her little poem.
“The meter is very poor—so poor I threw my poem away—but the
music is lovely and you sing awfully well,” Bettina conceded, finding
herself not so bored by her companion as she always had been in the
past. But then, they had scarcely been together for a ten-minutes’
conversation alone in their entire acquaintance before tonight, both
Bettina and Ralph having taken pains to avoid it.
“Anacoana, Flower of Gold, is your Camp Fire name, isn’t it?”
Ralph continued, gazing somewhat sentimentally at Bettina with his
hazel-brown eyes. His hair was nearly the same color, and his teeth
strong and white. Indeed, the only contradictory thing in Ralph’s
appearance was his mouth, which was fine and clearly cut—
contradicting the weakness of the rest of his face.
This time Bettina was annoyed. It was useless to try to be sensible
with Ralph Marshall, as he was always under the impression that he
must be languishing when talking to a girl.
And Bettina did not like this; neither did she know exactly how to
behave under the circumstances. It would have been simple enough
to have laughed Ralph into better judgment of her and of the
situation. But Bettina was no longer sufficiently at ease.
“Oh, that is rather an absurd name which my father once chose for
me as a Camp Fire name and by which I have been embarrassed ever
since,” she answered coldly, not returning her companion’s gaze, but
sitting up stiffly.
Her attitude gave Ralph the desire to flee. Bettina was a literary
iceberg, after all! But how escape when one was lying at full length on
the ground gazing with at least an appearance of ardor upon an
unresponsive maiden, unless some one came to the rescue?
Ralph glanced about and suppressed a sigh of relief.
Terry Benton and a girl were coming toward them.
And Bettina was equally relieved by the vision of Sally Ashton—a
Sally no longer suggesting the least appearance of sleepiness, or of
anything but sweetness and animation. It is curious, but there are a
number of girls in this world—and an equal number of women—who
really never do wake up until something masculine appears upon
their horizon.
Sally was laughing and talking, her cheeks crimson and her big
brown eyes shining.
“We have come to look for you, Bettina. Tante was afraid you and
Mr. Marshall might be lost.” For Polly was ‘Tante’ to all of the Camp
Fire girls who were the daughters of her old friends, as well as to her
own niece.
The fact was, however, that she had not suggested to Sally to look
for Bettina and Ralph—the suggestion had come from Gerry. And
Gerry had not mentioned Bettina. She had simply told Terry Benton
that she had not yet met his eastern friend, and did he suppose that
Ralph had already run away?
So Terry and Sally had good-naturedly set off to find him.
Sally’s explanation had been the only excuse she could think of at
the moment, since, under the circumstances, she did not wish to
mention Gerry’s name. She was not really bad-tempered or deceitful;
it seemed impossible that any daughter of Esther and Dick Ashton’s
could be! But the fact was that Sally was like a pretty, soft kitten. She
did not wish her pleasures interfered with, and if they were she was
capable of a scratch. Moreover, she had fallen very much under the
influence of an older girl who had experiences of life which Sally
considered extremely fascinating. And at present Gerry’s power was
perhaps stronger than the Camp Fire’s.
Bettina and Ralph both got up hastily. The four of them were about
to move away when, unexpectedly and almost simultaneously, their
attention was attracted by the silhouette of a figure coming alone
along the western trail from the desert to the ranch, running with
extraordinary swiftness.
But at some distance off he stopped and stood perfectly still,
gazing in the direction of the mesa.
“An Indian—and a stunning one!” Ralph exclaimed in surprise and
excitement. Having only just arrived in Arizona, he had not yet
learned to take the appearance of an Indian upon the scene as a
matter of course.
And the figure below was a fine one—nearly six feet in height, with
broad, slender shoulders, perfectly erect, the head thrown back,
motionless as a man in bronze.
“Oh, that is our Indian, or Tante’s or Bettina’s,” Sally replied
teasingly. “However, I ought not to speak of him disrespectfully, for
he is the son of an Indian chief and a chief himself, I believe, when he
happens to be at home from college. Really, he does seem to be an
unusual fellow.”
“There are several of these Indian students at my college,” Ralph
remarked. “Queer contrast their existence must offer, if they return
to their own people in the holidays.”
Ralph was watching as he talked.
The man below had started to move again and was climbing the
ascent to the mesa. It chanced that the trail was not far from the spot
where the two Camp Fire girls and their companions were standing.
When the Indian reached the top he hesitated a moment, perhaps
surprised by the unexpectedness of seeing two strange young men.
But, without making any sign, he went on in the direction of the
group of tents.
Not far from her own tent Mrs. Burton was sitting in a big camp
chair, with Dawapa on the ground beside her. The Indian girl had
been frightened by the appearance of so many strangers.
Standing in front of Mrs. Burton was a big, good-looking fellow
named Howard Brent, the son of another Arizona ranchman, with
whom she was talking.
The Indian stopped in front of them, but Polly did not notice until
she heard a little suppressed cry from the girl beside her.
Mrs. Burton was not altogether pleased at the sight of the young
man.
After all, he had too mysterious a fashion of appearing at camp
unexpectedly.
But something in the dignity and aloofness of his manner always
impressed her.
“I am sorry,” he said. “I did not know you had friends with you or I
would not have come. They must have told you to be prepared before
now.”
“Told me what?” Mrs. Burton demanded with her usual
impatience.
“That a storm is coming.”
The Indian pointed toward the southwest.
“Nonsense,” the young ranchman beside Polly replied. And then in
a patronizing fashion: “The Indians out here think they are great
weather prophets, and that they know the signs in the sky as well as
we know the face of a clock.”
The young ranchman looked up at the sky and then sniffed the air.
“Not a sign of a storm that I can make out, and I was born and
brought up in Arizona.”
“Oh, well; even if a storm does break on us, I suppose we can find
refuge in our tents,” Mrs. Burton added, not specially interested in
the subject of the weather at the present moment, and thinking that
Tewa might have manufactured a more worthwhile excuse for his
appearance.
In response the Indian said nothing, but the other man laughed.
“I don’t believe you realize what an Arizona storm toward the end
of July may mean, Mrs. Burton. However, there is no reason for
worrying tonight.”
Tewa turned away, not replying to Mrs. Burton’s vague invitation
to remain.
The next instant, however, Dawapa had jumped up and seized the
young man by the arm.
“Take me home; I don’t like it here. I have fear, Tewa,” Dawapa
whispered.
Her companion shook his head.
“It is too far; there will be no time before the storm gets here.”
Freeing himself, he walked quickly away.
Half an hour later the first informal Sunrise Camp Fire dance was
over. The young men guests had started back on the trail toward the
Gardener ranch.
In another half hour Mrs. Burton and the girls were in their tents
asleep.
Tewa, the Indian, had disappeared.
Only Mr. Simpson had not retired. He had gone down to his own
solitary tent after the young men visitors departed. But he did not
seem able to sleep.
The moon had gone down, but the night was still fairly clear, with
a few stars overhead.
However, over toward the southwest there was a yellowish white
cloud rolling up the horizon. Suddenly, all the vitality and freshness
had gone from the atmosphere.
But more important, down in the neighborhood of the creek there
were queer rustlings in the branches of the tall cottonwood trees, as
if the birds were whispering together. On the ground there was the
faint sound of running, soft-padded feet.
Also Mr. Simpson heard familiar cries of the animals farther off—
the queer barking of the coyotes, the snarl of a wild cat—signaling
each other of the approach of danger.
Perhaps the tents ought to be more securely fastened down in case
of danger.
Mr. Simpson was again climbing the mesa when he saw away off,
coming from the neighborhood of the Painted Desert toward them,
what appeared like a giant. It was a huge column of sand borne
straight upright.
A hurricane was behind it!
CHAPTER XVI
After Effects
One of the conspicuous characteristics of Mrs. Richard Burton was

that she was at her best in emergencies. But, as she was a celebrated
actress, it was of course easy to understand her appreciation of
dramatic moments.
Before Mr. Simpson reached the top of the mesa she had
awakened.
Something—a sound or an increasing heaviness in the atmosphere
—had brought her slowly back to consciousness. Half a moment she
lay wondering why she felt such a sense of impending calamity when,
so far as she knew, everything about her was peaceful. Marie was
breathing contentedly in her cot on the opposite side of the tent.
Getting up, Polly put on a heavy rose-colored silk dressing gown—
the admiration of the Camp Fire girls—and walked to the opening of
a tent.
The air was thick; the sense of calamity more convincing.
Going outdoors, Mrs. Burton looked up at the sky. The funnel-
shaped, yellowish white cloud was coming closer, but not so close as
the extraordinary pillar of sand. Then she saw Mr. Simpson and ran
forward to meet him.
“Get the girls out of their tents quickly, or the tents will be down
upon them.”
There was a great bell fastened to a post near one of the tents for
use in emergencies, but Mrs. Burton could not have reached it in
time. However, before she got there it had begun ringing and the
girls had run quickly out in response.
Some instinct must have taught them the proper thing to do, for,
in an instant, they had dropped flat down on the ground. There was
no place nearby to take refuge—no cavern in the rocks—only the flat
surface of the mesa.
It is extraordinary how few people show nervousness or cowardice
in the face of unexpected danger.
Now, of the little Camp Fire party, none of whom knew anything
before of the perils of an Arizona storm, and entirely unprotected as
they were, only Gerry Williams and Marie were frightened.
When Gerry came out of her tent she was clad only in a thin little
wrapper. As soon as she looked up at the sky and heard the muffled
roar of the oncoming storm, which in a strange way seemed only to
increase the stillness nearer by, quite senselessly she started running
—running alone along the top of the mesa as if she meant to plunge
over for safety.
Sally Ashton, who had followed nearest her, made no effort to stop
her. Indeed, Sally flew straight to her sister Alice’s arms and they
quietly lay down beside each other, covering their faces with their
hands. For it is an odd thing how many differences members of a
family may have and yet, in a moment of peril, they are reunited,
deserting many an affection which had seemed a stronger tie than
blood.
But, fortunately for Gerry Williams, Vera had seen her loss of
judgment. Vera it was who had aroused soon after Polly had left her
tent and, guessing at once what was about to take place, had rung the
bell. For Vera had the gift for sudden, quick action without waiting
for advice.
That instant she seized Gerry by the shoulders and, as she was
much the stronger, threw her down in the sand, pinioning herself on
top of her and holding her still. She was not a moment too soon, for
almost at once the storm passed over them. And all this, of course,
has taken longer in the telling than in the time of action.
The column of sand drew nearer, like a vast herald of disaster with
the wind roaring behind it.
And in the face of the terrific sound, Marie began screaming.
It was so nonsensical and yet it set on edge the nerves of everybody
who was close enough to hear her.
She was kneeling with her face buried in her hands, crying as loud
as a frightened child, and occasionally murmuring a word or two of a
Latin prayer, when she could gather sufficient self-control.
Mrs. Burton chanced not to be near enough to speak to her, but
she did see Mr. Simpson go to Marie and sit down beside her. What
he said must have had a somewhat soothing effect, for she did not cry
quite so noisily, or it may have been that the storm was at the instant
passing over them.
Any one who has ever experienced a western storm will tell you of
having gone through almost the same physical experience. First,
there is a terrible sense of oppression, then, a sound of a tremendous
roaring in the ears and of heavy pressure, followed by a queer
tingling and burning of the skin.
However, as a matter-of-fact, the Sunrise Camp Fire party did not
meet the real force of the storm. In the eccentric fashion that a
hurricane often shows, it turned as it neared their mesa and swerved
toward the south. But they had at least a portion of it and were
bathed in fine sand like a down-pouring of rain.
Yet the whole incident was over in such a little while! And the
entire party got up almost simultaneously, as if they had been
Mohammedans praying in the desert—the early morning prayer of
every true follower of the Prophet. For it is the Mohammedan
custom at a given moment at sunrise and at sunset to kneel and,
burying the face in the hands, pray with the face turned toward
Mecca. And, also, at a given moment, in Moslem countries the prayer
is over with the ringing of a great muezzin bell.
Naturally, as Camp Fire guardian, Polly was most anxious to learn
the effects of the past few moments upon the girls, whose welfare she
took almost too seriously perhaps.
But as soon as she staggered up she heard a voice beside her saying
quietly:
“Don’t try to talk for a moment, Mrs. Burton, please. The air is still
bad. It may hurt your throat.”
And Polly saw that Ellen Deal had come directly to her. The next
moment she had brought a camp chair and was gently forcing her
into it.
Polly was pleased and touched. She had not devoted as much
attention to Ellen as she had to some of her other guests. For one
thing, Ellen was older and seemed to have one of the slight natures it
is hard to be intimate with at first. However, she believed that Ellen
must have fine qualities, else the severe Dr. Sylvia Wharton would
never have been so anxious for her to be one of the party. And later,
perhaps, she would have her chance.
“You are very good; there is nothing the matter with me,” Mrs.
Burton murmured, and then frowned and smiled apologetically at
the same time. For her voice apparently seemed to have departed
and she was absurdly weak. But, then, she must remember that she
had originally come to Arizona because this very trouble made her
acting impossible.
However, the Camp Fire girls really appeared more entertained
than frightened by what they had undergone.
“I feel rather like a kitten that has been left out over night,” Sally
remarked. “My fur is all ruffled.” She sat blinking her big soft brown
eyes and shaking her brown hair, which was in a mass of brown fluff
over her shoulders. If Sally had dreamed how much she did make
people think of a kitten, perhaps she would not have said this. Yet
she did know, since “kitten” had been her father’s name for her ever
since she was a tiny child.
At present Alice was entirely concerned with her younger sister.
“You are sure you are all right, dear? I was so worried about you.
As the storm blew across us I was thankful to remember you had
gained five pounds since we arrived at the Camp Fire,” Alice said,
speaking with such an appearance of solemnity that it was difficult to
decide whether she was joking. But, then, as growing too fat was
Sally’s particular horror in life, she was of course teasing her in the
usual elder sister fashion.
Sally pretended not to hear.
“Where is Gerry? Is she all right?” she demanded. “She was just in
front of me before the storm broke. Here she comes, now.”
In fact, Gerry was at the moment only a few steps away, leaning on
Vera’s arm and looking fragile and shaken.
“I am abominably afraid of storms; have been always,” she
exclaimed petulantly. “So I suppose you were right not to let me run.
Perhaps I might have been knocked down. Still, I think you were
frightfully rough, Vera. Perhaps you can’t help it, having been
brought up in the country.” And Gerry ended her speech with the
fine scorn which one remembers the city mouse felt for the country
mouse in the old fable.
“Yes, I am sorry if I hurt you,” Vera returned, quietly disengaging
her arm from the other girl’s, now that she saw there was nothing the
matter and knowing that she preferred being with Sally. She herself
wished to learn how Peggy and Bettina and their Camp Fire guardian
had passed through the storm.
It was now nearly daylight on the top of the mesa. The sun had not
risen, but there was a kind of general grayness that preceded the
approach of dawn. At least, it was possible for the girls to grope their
way about and to recognize each other as they approached close by.
Vera now saw that Bettina had gone over toward Mrs. Burton and
that Peggy, in her usual practical fashion, was wandering about
trying to discover how much damage had been done. The Indian girl
was with her.
It was a piece of good fortune, or perhaps what is usually the cause
of good fortune—a piece of good sense—that the camp fire had been
put out before the girls had retired for the night. In these dry months
in Arizona, when there is ordinarily so little rainfall and living so
near the great ranch fields of corn and alfalfa, Mr. Gardener had
suggested that it was wiser to take every precaution. Now the ashes
had blown in every direction and the three sticks, which usually
stood like a tripod above the camp fire, had tumbled abjectly down.
More important, the kitchen tent had collapsed.
When Vera reached Peggy she discovered that she was pulling at
the tent ropes and trying to find out the extent of the damage.
“Do try to dig out a saucepan or a kettle or anything you can find,
please, Vera,” Peggy suggested. “I am going to start a fire and make
some coffee, if one of us can find the stuff. Nothing happened of any
consequence and yet my knees are as shaky as if I had been through
the war. And I’m afraid Tante will be ill. Mother wrote me not to
forget—even if she never spoke of the fact—that she really is out here
for her health. I don’t know whether being a Camp Fire guardian can
be much of a health cure, but at least it is stimulating.” And Peggy

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Chapter 8 – Energy Balance and Body Weight Regulation

What Is Energy Balance? (pp. 323-324)

b K 323 5. Negative energy balance is when:

d K 324 9. What happens when a person loses body fat?

What Determines Energy Intake? (pp. 325-331)

c K 325 12. How is energy intake regulated?

b K 326 14. How do neurotransmitters differ from hormones?

a K 325-326 15. What primarily influences short-term food intake?

d K 327 18. Gastric banding involves:

c K 331-332 36. The majority of TEE is accounted for by:

c K 332 39. What is the definition of resting energy expenditure (REE)?

b K 334 52. What does indirect calorimetry measure?

c K 335-336 56. What is the definition of “obesity”?

b K 340 67. What are the characteristics of central adiposity?

How Does Lifestyle Contribute to Obesity? (pp. 341-345)

c K 344 80. What is the definition of moderate-intensity physical activity?

Can Genetics Influence Body Weight? (pp. 345-346)

What Are the Best Approaches to Weight Loss? (pp. 350-354)

b A 351,354 89. Which of these foods are considered high-energy-density foods?

d K 358 94. What is most likely to be lacking in low-carbohydrate diets?

Use the following case study to answer questions 95-104.1

Bod Pod® Results:

Reference Values for Bod Pod®:

c A 336 95. Based on his BMI, Jim would be considered:

b A 336 96. Based on the information provided, what is Jim’s BMI?

F K 324 1. Adipocytes decrease in number as an individual loses weight.

7. Why is it important to assess body composition as well as body weight?

15. Is a low-carbohydrate diet safe and effective for losing weight?

Fill in the Blank

Nutrition Matters 8 – Disordered Eating

Introduction (p. 365)

How Do Eating Disorders Differ from Disordered Eating? (pp. 365-372)

a K 365 2. Disordered eating can be defined as:

c K 366 3. Eating disorders are classified into distinct categories by:

Dinner was finished and yet it was early evening.

Ralph Marshall decided that he never had seen Bettina Graham so

“I can see the sands of the desert;

In the beginning Bettina was uncertain whether she was pleased or

One of the conspicuous characteristics of Mrs. Richard Burton was

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