Question 1

Plant sterols added to food products may reduce cardiovascular disease (CVD)because they interfere with cholesterol absorption.

Accepted Answer

Both the statement and the reason are correct and related.Plant sterols are bioactive compounds found in all vegetable foods and inhibit cholesterol absorption.If foods rich in plant sterols are consumed instead of animal and dairy products,it is thought that CVD can be reduced indirectly because plant sterols are absorbed at the same sites in the small intestine as cholesterol.Their ability to interfere with cholesterol absorption results in a 5% to 17% reduction of low-density cholesterol (the "bad" cholesterol).In the United States,sterols are added to margarine spread,orange juice,and other products.An important caveat is that a low-fat diet increases effectiveness of these products.

Question 2

A new patient expresses her interest in limiting fat kilocalorie intake,when the hygienist engages in nutritional counseling.Which strategy is NOT recommended?

Accepted Answer

Cream cheese is a poor choice for any food.Ninety percent of the kilocalories in cream cheese are from fat.At 9 kcal/g,the fat content on a sandwich will increase significantly.Instead of fat-laden spreads to add moisture to sandwiches,alternatives include mustard,salad greens,shredded carrots,tomato slices,and sweet peppers.

Question 3

High-density lipoproteins are considered detrimental to cardiovascular health because they contain only trace amounts of protein and large amounts of lipid.

Accepted Answer

Neither the statement nor the reason is correct.High-density lipoproteins (HDLs)are thought to protect against development of heart disease because they contain larger amounts of protein and less lipid than low-density lipoproteins (LDLs).An important concept is that lipoproteins are carriers that transport cholesterol to and from the cells.HDLs are known as the "good" cholesterol,whereas LDLs are known as the "bad" cholesterol.The ratio of lipid to protein content that determines density.In a lipoprotein,density increases as lipids decrease and protein increases.

Question 4

Which is the most common trans fatty acid?

Accepted Answer

Elaidic acid is the most common trans fatty acid.Vaccenic acid,also a trans fatty acid,is found in small amounts in milk and cow,sheep,and deer meat.Oleic acid is an unsaturated fatty acid,whereas stearic acid is a saturated fatty acid.

Question 5

Which fat is the most saturated?

Accepted Answer

Palm oil,a tropical oil,is high in unhealthy saturated fat.Other substances high in unhealthy saturated fat are butter,hard margarines,lard,shortening,and coconut oil.Conversely,vegetable oils such as canola,olive,and soybean oil contain more healthy omega-6 fatty acids.These products are referred to as n-6 polyunsaturated fatty acids.

Question 6

The body synthesizes linoleic acid,an omega-6 fatty acid.Deficiency symptoms include growth retardation,skin lesions,and reproductive failure.

Accepted Answer

The first statement is false; the second is true.Linoleic acid cannot be synthesized by the body and must be supplied from dietary sources.For this reason,linoleic acid is an essential fatty acid.Linoleic acid is an omega-6 fatty acid with 18 carbon atoms and two double bonds.The manifestations of deficiency stated in the question are correct.

Question 7

Dental hygienists should recommend that patients avoid beef graded "select" because this grade contains a high level of fat and marbling.

Accepted Answer

Neither the statement nor the reason is correct.The grade of "select" is a good selection because it contains fewer kilocalories as a result of less fat and marbling.Although fat content of meats also depends on the type of cut,leaner cuts such as flank steak,sirloin,or tenderloin are good selections.Also recommended is marinating leaner cuts of meat in flavored vinegars and fruit juices.Lemon juice is particular effective at tenderizing meat.

Question 8

Each is characteristic of fat,except one.Which is the exception?

Accepted Answer

Hard fats,such as meat,take longer to digest than soft fats,such as margarine.Margarine becomes liquid at body temperature,whereas meat does not.The improved palatability and texture that fats contribute to food make them difficult to eliminate from the diet.As a result of health concerns regarding dietary fats,numerous foods are being manufactured containing less fat.Those that replace fat with other substances are called fat replacers.

Question 9

To distinguish obesity from edema,the skin should be palpated and observed through light magnification.The skin of an obese patient will exhibit a flabby consistency in contrast to the spongy consistency found in edematous skin.

Accepted Answer

The first statement is false; the second is true.It is not necessary to observe palpation of skin through light magnification.Note that edema is the presence of fluid in interstitial spaces,which means that fluid has leaked from blood vessels into the spaces between cells.This results in swelling that should be differentiated from fat.A patient with congestive heart failure often has edematous lower legs,and a simple sprained ankle will appear large because of edema.

Question 10

The American Heart Association dietary guidelines recommend that egg consumption be limited to three per week.One large egg contains less than 200 mg of cholesterol.

Accepted Answer

The first statement is false; the second is true.The American Heart Association recommendations do not limit the number of eggs as long as total daily dietary cholesterol is limited to about 300 mg/day.One large egg contains less than 200 mg of cholesterol.Note that by eating one egg,1 cup of ice cream (58 mg cholesterol),and 1 oz of cheddar cheese (30 mg cholesterol),the recommended 300 mg will be exceeded.

Question 11

Which has the most satiety value?

Accepted Answer

Fats contribute to a feeling of fullness (satiety value)for a longer time than carbohydrates or protein.This validates descriptions of food containing fat that are described as "sticking to the ribs." The higher the fat content of a meal,the longer the food remains in the stomach.

Question 12

Stated in milligrams per deciliter (mg/dL),which optimal level is incorrect?

Accepted Answer

The National Cholesterol Education program (NCEP),a report issued by the National Institutes of Health,states that total cholesterol should be less than 200 mg/dL.The remaining selections are accurately stated as per the same report.

Question 13

Which statement is false?

Accepted Answer

LDL cholesterol levels less than 100 mg/dL,not 200 mg/dL,throughout life are associated with a low risk of CVD.An improvement in statistics from 2001 to 2008 may be attributable to changes in trans fatty acids in the food supply,use of statin mediations,or overall dietary changes.Experts worry that improving trends may have stalled in more recent years.

Question 14

The best way for a patient without cardiovascular disease to increase consumption of omega-3 fatty acids is to:

Accepted Answer

The American Heart Association recommends that patients without cardiovascular disease eat a variety of fish,preferably oily,at least twice a week.Salmon,sardines,and shellfish are oily fish.Note that intake of foods with healthy unsaturated fats can be found in nuts,seeds,and vegetable oils.Fish oil supplements provide benefits,but the best benefit comes from food.

Question 15

Proactive health care providers are wise to encourage patients to lower total dietary fat consumption because replacing fats with carbohydrates decreases cardiovascular risk factors.

Accepted Answer

Neither the statement nor the reason is correct.One of the most important facts for decreasing risk of cardiovascular disease (CVD)is the types of foods chosen to lower saturated fat intake.Current research indicates that while total dietary fat might not be a risk factor for CVD,the types of fat eaten have a greater impact.Health care providers should be thorough when educating patients about the risks and benefits of various fats.Replacing damaging saturated and trans fats with polyunsaturated fatty acids can benefit lipid profiles,but replacing them with refined carbohydrate foods would increase risk factors.It is thought that previous recommendations to decrease total dietary fat intake have resulted in increased consumption of refined carbohydrates.The unfortunate consequences include increased CVD risk.

Question 16

Which is NOT associated with the increased risk of cancer?

Accepted Answer

Omega-3 fatty acids and other polyunsaturated fatty acids have not been associated with an increased risk of cancer.Also considered safe are monounsaturated fatty acids.Despite many uncertainties about the relationship between dietary fat and cancer risk,the consensus is to limit total fat intake,especially saturated fat.

Question 17

Patients should be counseled to select foods labeled as "low cholesterol." Stick margarine,a cholesterol-free product,is a good selection because it is low in saturated fat and only partially hydrogenated.

Accepted Answer

Both statements are false."Low cholesterol" on a food label can be misleading.A cholesterol-free product such as stick margarine can still be high in detrimental saturated fat and trans fatty acids.Partially hydrogenated foods are high in trans fatty acids,which should be avoided because saturated fats have been modified through processing to an unhealthy alternative.The dental hygienist should teach patients to read the Nutrition Facts Label for saturated and trans fats to avoid substituting one unhealthy fat for another.

Question 18

Fats contribute to a feeling of fullness for a longer time than carbohydrates or protein because digestion of high-fat meals more efficiently deposits fat molecules in adipose tissue.

Accepted Answer

The statement is correct,but the reason is not correct.Although it is true that fats contribute to fullness for a longer time than carbohydrates or proteins,the reason is that digestion of fat occurs more slowly.A pertinent point to convey to patients is that the higher the fat content of a meal,the longer the food remains in the stomach.Regardless of the time that fat lingers in the stomach,95% of ingested fat is absorbed.Note that fat,which is not used for energy production,insulation,cushioning of vital organs,is stored in adipose tissue as fat.

Question 19

The diet of a patient who consumes 120 g of fat from eating 3000 kcal/day is 36% fat.Each gram of saturated fat has 9 cal,while each gram of unsaturated fat has only 4 cal.

Accepted Answer

The first statement is true; the second is false.Each gram of saturated fat,no matter which type,has 9 cal.Note that protein and carbohydrate each contain 4 cal/g.To calculate the percentage of kilocalories from fat,multiply grams of fat by 9 kcal/g of fat.Next,divide this result by the total number of calories consumed.In this case:
Step 1)120 g fat ´ 9 kcal from fat per gram of fat = 1080 kcal from fat.
Step 2)1080 kcal from fat ÷ 3000 cal consumed = 36% kcal consumed from fat.

Question 20

Which food group in MyPyramid always contains fat?

Accepted Answer

Although fat content varies,meat always contains fat.It is possible to consume skim milk,which is very low in fat,but it is not possible to consume meat without a far higher fat content.

Quiz 6: Lipids: The Condensed Energy

Plant sterols added to food products may reduce cardiovascular disease (CVD) because they interfere with cholesterol absorption.