Question 1

Each of the following groups of individuals is susceptible to insufficient intake of protein except one. Which one is the exception?

Accepted Answer

Additional dietary protein is unnecessary for healthy adults participating in endurance or resistance exercise; however, studies indicate that endurance- and strength-training athletes may need additional protein. Many factors make the elderly susceptible to insufficient protein intake including financial pressures, difficulty with food preparation, and dental issues. The dental hygienist can offer suggestions to the groups susceptible to protein deficiency that best suit their individual needs.

Question 2

Sources of vitamin B₁₂ include each of the following except one. Which one is the exception?

Accepted Answer

While walnuts enhance the diet by providing n-3 fats and other vitamins, they are not a source for vitamin B₁₂.

Question 3

Which food is most likely to contribute to protein deficiency?

Accepted Answer

Unless complemented by other sources, legumes, nuts, and grains are likely to contribute to protein deficiency because they are low-quality proteins. This category has at least one essential amino acid that is insufficient for optimal protein synthesis. If fed as the only protein source, low-quality proteins will support life, but normal growth cannot be supported. By contrast, high-quality proteins are well balanced in their essential amino acid content.

Question 4

In most cases, digestibility and nutritional value are adversely affected by cooking procedures. Although cooking makes egg albumin more readily digestible, cooking soybeans decreases amino acid bioavailability.

Accepted Answer

Cooking favorably affects digestibility and nutritional value of most foods; this includes both egg albumin and soybeans. With cooking, egg albumin becomes more digestible, and soy bean bioavailability is increased. Bioavailability indicates the amount of nutrient available to the body after absorption.

Question 5

Prognosis for a protein-deficient patient undergoing periodontal surgery is reduced because excess nitrogen reduces the ability of the periodontium to withstand stress of surgery.

Accepted Answer

Protein deficiency results in a negative nitrogen balance that depletes nitrogen reserves. This further reduces blood protein levels and impairs the ability of the periodontium to withstand the stress of surgery. Additionally, the resistance of the periodontium to new or advancing infection is also impaired.

Question 6

Patients with periodontal disease might require increased protein intake because the physiologic response to inflammation and infection can negatively affect protein synthesis.

Accepted Answer

Assessment of protein intake of patients with periodontal issues is important because protein deficiencies can compromise the physiologic systemic response to inflammation and infection. Periodontal problems can increase the protein requirement to promote healing.

Question 7

The intake of 193 g/day of protein is the highest level recommended, because consumption above this level can jeopardize adequate intakes of nutrients form other food sources.

Accepted Answer

Using the rule of thumb that protein should provide 10% to 35% of caloric intake and based on consumption of 2200 kcal/day, 193 g of protein means that 35% of this individual's diet is from protein. Because 35% is the upper limit, no more than 193 g of protein should be recommended.

Question 8

Each of the following is true of secretory immunoglobulin A (sIgA) except one. Which one is the exception?

Accepted Answer

Secretory immunoglobulin A is the predominant immunoglobulin, or antibody, in oral, nasal, intestinal, and other mucosal secretions. It provides the first line of defense in the oral cavity. Low sIgA levels in malnourished children are thought to play a role in their increased susceptibility to mucosal infections.

Question 9

In a 2-oz cooked serving, which food supplies the least protein?

Accepted Answer

A 2-oz serving of dark-meat chicken provides 18 g of protein, whereas light meat chicken, lean pork chop, and lean cut of beef provide 20, 19, and 19 g, respectively. Contrast this with a slice of enriched white bread, which provides 2 g of protein.

Question 10

Each of the following is a manifestation of protein deficiency except one. Which one is the exception?

Accepted Answer

A classic manifestation of protein deficiency, in the presence of other symptoms, is dry, brittle hair that breaks easily. The skin and hair are also affected. The skin tends to tends to be dry and flaky, and the fingernails appear dry, cracked, and spoon-shaped.

Question 11

During protein deficiency, a decreased amount of protein in the blood causes an accumulation of fluids within the blood vessels because a loss of osmotic balance occurs.

Accepted Answer

Although a loss of osmotic balance occurs during a protein deficiency, the result is loss of fluid from the blood vessels. The disturbance in osmotic pressure causes fluids to leave the blood vessels and enter the tissue spaces, called interstitial spaces. This results in swelling, also called edema.

Question 12

Per kilogram of body weight, which group has the lowest RDA for protein?

Accepted Answer

The RDA for men of all ages is lower than that for infants, children and pregnant women. Excluding pregnant and lactating women, the same is true for females.

Question 13

While counseling a patient who wishes to lose weight and eat a more healthy diet, a dental hygienist would recommend each of the following except one. Which one is the exception?

Accepted Answer

Calcium-fortified fruit juice counts both as a calcium-rich food and toward servings from the fruit group. The remaining selections provide sound recommendations that are achievable by a motivated patient. Note that n-3 fats are also called omega-3 fatty acids. There are many options for protein recommendations that can be tailored to the preferences and lifestyle of the patient.

Question 14

In patients with liver and kidney disease, increased levels of protein are recommended because these organs require continual cellular and tissue rebuilding that only protein can provide.

Accepted Answer

The liver and kidneys are heavily involved in protein metabolism and excretion of protein waste products. During disease within these organs, increased levels of protein would cause further stress and damage. Consequently, dietary protein is restricted in individuals with physiological disease that affects the liver or kidneys.

Question 15

Although it is controversial as to whether high-protein diets are excessive in content, scientific research has established each of the following facts except one. Which one is the exception?

Accepted Answer

High-protein diets appear to benefit weight control by increasing muscle mass, which burns more kilocalories; this increases thermogenesis (production of heat). Through these processes, satiation is increased and energy efficiency is decreased. Another aspect is that because protein increases satiety to a greater extent than carbohydrate or fat do, this can facilitate a reduction in ad libitum energy consumption.

Quiz 5: Protein: the Cellular Foundation