NUSCTX 10S Final Exam Questions and
Answers
What is a Dietary Supplement? - Correct Answers -A product intended for ingestion—for
example a pill, capsule, tablet, powder, liquid—that contains a "dietary ingredient."
Examples of Dietary Ingredients - Correct Answers --Extracts/Metabolites
-Vitamins
-Minerals
-Amino Acids
-Herbs/Botanicals
Herbal Remedies - Correct Answers -•Herbal remedies are widely used throughout the
world
-Traditional Chinese Medicine (TCM)
-Complementary and Alternative Medicine (CAM)
-Integrative Medicine (as of 2014 US MDs are able to be accredited)
Supplement Labeling Regulations - Correct Answers -Must include:
1.Ingredients
2.Amount present in each pill
3.% Daily Value (if applicable)
4.Suggested daily dose
5.Common name of plant and part of plant used (if plant-based)
*Labels cannot claim it treats, prevents, or cures a disease
When are supplements appropriate? - Correct Answers -- Certain micronutrient
deficiencies
- Limited dietary patterns
*Consider:
1. Efficacy
2. Dosage
3. Labeling
4. Contraindications
5. Misleading claims
6. Cost
*Dietary Supplements should NOT replace a healthy diet that meets the DGAs
,Retinoids - Correct Answers -Retinoids are a collective term for the biologically active
forms of vitamin A. They are called preformed vitamin A because, unlike carotenoids,
they do not need to be converted in the body to become biologically active.
The Role of VA in Protein Synthesis and Cell Differentiation (retinoic acid) - Correct
Answers -•Epithelial cells of skin and mucous membranes are the 1stline of defense
against infection
•Supports differentiation and antibody production in T-and B-cells for specific immune
responses
Vitamin A intake - Correct Answers -Consuming the right amount of vitamin A is critical
to overall health. A very low (deficient) or very high (toxic) vitamin A intake (as retinoids)
can produce harmful symptoms and can even lead to death.
Roles of VD in the body - Correct Answers -•The active form of VD is a hormone, which
regulates gene transcription
•Maintains blood concentrations of calcium and phosphorous
•Regulates cell proliferation and differentiation
•Immune function
Factors Affecting VD Synthesis in the Body - Correct Answers -•Latitude
•Season
•Time of day
•Skin pigmentation
•Sun exposure
•Sunscreen use
Vitamin D (VD): Forms - Correct Answers -•Body can synthesize from cholesterol and
UV light
•VD2(ergocalciferol) in plant sources and supplements
•VD3(cholecalciferol) in animal source foods and human body
•VD2is less biologically active than VD3
•VD-binding-protein required for transport in blood
Vitamin D Deficiency: Rickets and Osteomalacia - Correct Answers -
VD Synthesis & Activation - Correct Answers -Whether synthesized in the skin or
obtained from dietary sources, vitamin D ultimately functions as a hormone:
1,25(OH)2vitamin D3(calcitriol).
Some functions of Calcium - Correct Answers --Bone structure
-Release of neurotransmitters
-Blood pressure
-Muscle contraction
-Cell Metabolism
,-Regulate enzyme activity
-Blood clotting
Functions of Calcium - Correct Answers -Bone mineralization*
Intracellular adhesion
Stabilize complexes(B12/IF)
2nd messenger
Neurotransmission
Fertility
Muscle contraction
Enzyme activity: PLA2, blood clotting
* ~1kg Ca/70kg body wt; 99% in bone. The remaining 1% performs all other functions
Trabecular bone - Correct Answers -Trabecular bone(spongy)
Cortical bone(compact)
Bone remodeling - Correct Answers -Bone mass is maintained by continual degradation
of existing bone and synthesis of new bone. This continual "remodeling" facilitates:
1.Adjustment to new strength level
2.Adjustment to new shape
3. Replacement of degrading matrix (collagen and proteoglycan) during normal turnover
Key players in bone remodeling - Correct Answers -•Osteoblasts are cells that produce
the protocollagen and proteoglycans that ultimately constitute the "matrix" of bone.
Vitamin C is involved in protocollagen synthesis. They respond to changes in
[1,25(OH)2D] via VitD receptors.
•Osteocytes are osteoblasts that become entrapped in the polymerizing collagen fibers.
•Osteoclasts act to degrade bone.
Osteomalacia vs. Osteoporosis - Correct Answers --Osteomalacia: Organic bone matrix
normal, but not calcified. matrix > calcium.
-Osteoporosis: Matrix/calcium ratio normal, both reduced. Thin and brittle bones.
Osteoporosis - Correct Answers --Ratio of mineral:matrix is NORMAL
-Amounts of both are REDUCED
-Bones are thin & brittle
Risk factors:
•being female
•race (white, Asian)
•small stature
•sedentary
-Menopause: bone mass drops due to decrease in estrogen levels
-The relationship between peak bone mass and the ultimate risk of developing
osteoporosis and related bone fractures.
Nutrient needs in early adulthood - Correct Answers -Calories
, Protein
Carbohydrates
Fat
Micronutrient
Calcium, vitamin D
Iron -premenopausal women
Nutrient needs in older adulthood - Correct Answers -Calories
Protein
Carbohydrates
Fat
Water
Nutrient needs in even older adulthood - Correct Answers -Calcium and vitamin D
Vitamin B12
Disease-related considerations
Cardiovascular disease
Cancer
Diabetes
Hypertension
Intestinal function of calcitriol - Correct Answers --Calcitriol, the hormone produced from
Vitamin D3, is the only hormone that can induce the intestine to absorb dietary Ca++.
-Without vitamin D and its conversion into calcitriol, dietary Ca++absorption by the
intestine is severely impaired.
Calcium absorption - Correct Answers -1.) High concentrations of calcium allow
absorption by passive diffusion.
2.) Low to moderate concentrations of calcium require active transport. Vitamin D turns
on the synthesis of calcium transport proteins.
3.) Calcium transport proteins shuttle calcium from the lumen across the mucosal cell.
4.) A calcium pump that requires energy moves calcium from the mucosal cells to the
bloodstream.
Hormones play important roles in regulating serum calcium - Correct Answers -
Regulation of blood calcium levels with Calcitonon - Correct Answers --High blood
calcium causes the release of calcitonon from the thyroid gland.
-Low blood calcium causes the release of PTH from the parathyroid gland.
Calcitonin moderates effects of PTH/1,25(OH)2D - Correct Answers -Calcitonin is
secreted by the thyroid gland when plasma [1,25(OH)2D] and [Ca] are high.
Calcitonin reduces plasma [Ca] by:
-Reducing osteolytic activity
-Reducing formation of new osteoclasts
-Increasing osteoblast activity
Answers
What is a Dietary Supplement? - Correct Answers -A product intended for ingestion—for
example a pill, capsule, tablet, powder, liquid—that contains a "dietary ingredient."
Examples of Dietary Ingredients - Correct Answers --Extracts/Metabolites
-Vitamins
-Minerals
-Amino Acids
-Herbs/Botanicals
Herbal Remedies - Correct Answers -•Herbal remedies are widely used throughout the
world
-Traditional Chinese Medicine (TCM)
-Complementary and Alternative Medicine (CAM)
-Integrative Medicine (as of 2014 US MDs are able to be accredited)
Supplement Labeling Regulations - Correct Answers -Must include:
1.Ingredients
2.Amount present in each pill
3.% Daily Value (if applicable)
4.Suggested daily dose
5.Common name of plant and part of plant used (if plant-based)
*Labels cannot claim it treats, prevents, or cures a disease
When are supplements appropriate? - Correct Answers -- Certain micronutrient
deficiencies
- Limited dietary patterns
*Consider:
1. Efficacy
2. Dosage
3. Labeling
4. Contraindications
5. Misleading claims
6. Cost
*Dietary Supplements should NOT replace a healthy diet that meets the DGAs
,Retinoids - Correct Answers -Retinoids are a collective term for the biologically active
forms of vitamin A. They are called preformed vitamin A because, unlike carotenoids,
they do not need to be converted in the body to become biologically active.
The Role of VA in Protein Synthesis and Cell Differentiation (retinoic acid) - Correct
Answers -•Epithelial cells of skin and mucous membranes are the 1stline of defense
against infection
•Supports differentiation and antibody production in T-and B-cells for specific immune
responses
Vitamin A intake - Correct Answers -Consuming the right amount of vitamin A is critical
to overall health. A very low (deficient) or very high (toxic) vitamin A intake (as retinoids)
can produce harmful symptoms and can even lead to death.
Roles of VD in the body - Correct Answers -•The active form of VD is a hormone, which
regulates gene transcription
•Maintains blood concentrations of calcium and phosphorous
•Regulates cell proliferation and differentiation
•Immune function
Factors Affecting VD Synthesis in the Body - Correct Answers -•Latitude
•Season
•Time of day
•Skin pigmentation
•Sun exposure
•Sunscreen use
Vitamin D (VD): Forms - Correct Answers -•Body can synthesize from cholesterol and
UV light
•VD2(ergocalciferol) in plant sources and supplements
•VD3(cholecalciferol) in animal source foods and human body
•VD2is less biologically active than VD3
•VD-binding-protein required for transport in blood
Vitamin D Deficiency: Rickets and Osteomalacia - Correct Answers -
VD Synthesis & Activation - Correct Answers -Whether synthesized in the skin or
obtained from dietary sources, vitamin D ultimately functions as a hormone:
1,25(OH)2vitamin D3(calcitriol).
Some functions of Calcium - Correct Answers --Bone structure
-Release of neurotransmitters
-Blood pressure
-Muscle contraction
-Cell Metabolism
,-Regulate enzyme activity
-Blood clotting
Functions of Calcium - Correct Answers -Bone mineralization*
Intracellular adhesion
Stabilize complexes(B12/IF)
2nd messenger
Neurotransmission
Fertility
Muscle contraction
Enzyme activity: PLA2, blood clotting
* ~1kg Ca/70kg body wt; 99% in bone. The remaining 1% performs all other functions
Trabecular bone - Correct Answers -Trabecular bone(spongy)
Cortical bone(compact)
Bone remodeling - Correct Answers -Bone mass is maintained by continual degradation
of existing bone and synthesis of new bone. This continual "remodeling" facilitates:
1.Adjustment to new strength level
2.Adjustment to new shape
3. Replacement of degrading matrix (collagen and proteoglycan) during normal turnover
Key players in bone remodeling - Correct Answers -•Osteoblasts are cells that produce
the protocollagen and proteoglycans that ultimately constitute the "matrix" of bone.
Vitamin C is involved in protocollagen synthesis. They respond to changes in
[1,25(OH)2D] via VitD receptors.
•Osteocytes are osteoblasts that become entrapped in the polymerizing collagen fibers.
•Osteoclasts act to degrade bone.
Osteomalacia vs. Osteoporosis - Correct Answers --Osteomalacia: Organic bone matrix
normal, but not calcified. matrix > calcium.
-Osteoporosis: Matrix/calcium ratio normal, both reduced. Thin and brittle bones.
Osteoporosis - Correct Answers --Ratio of mineral:matrix is NORMAL
-Amounts of both are REDUCED
-Bones are thin & brittle
Risk factors:
•being female
•race (white, Asian)
•small stature
•sedentary
-Menopause: bone mass drops due to decrease in estrogen levels
-The relationship between peak bone mass and the ultimate risk of developing
osteoporosis and related bone fractures.
Nutrient needs in early adulthood - Correct Answers -Calories
, Protein
Carbohydrates
Fat
Micronutrient
Calcium, vitamin D
Iron -premenopausal women
Nutrient needs in older adulthood - Correct Answers -Calories
Protein
Carbohydrates
Fat
Water
Nutrient needs in even older adulthood - Correct Answers -Calcium and vitamin D
Vitamin B12
Disease-related considerations
Cardiovascular disease
Cancer
Diabetes
Hypertension
Intestinal function of calcitriol - Correct Answers --Calcitriol, the hormone produced from
Vitamin D3, is the only hormone that can induce the intestine to absorb dietary Ca++.
-Without vitamin D and its conversion into calcitriol, dietary Ca++absorption by the
intestine is severely impaired.
Calcium absorption - Correct Answers -1.) High concentrations of calcium allow
absorption by passive diffusion.
2.) Low to moderate concentrations of calcium require active transport. Vitamin D turns
on the synthesis of calcium transport proteins.
3.) Calcium transport proteins shuttle calcium from the lumen across the mucosal cell.
4.) A calcium pump that requires energy moves calcium from the mucosal cells to the
bloodstream.
Hormones play important roles in regulating serum calcium - Correct Answers -
Regulation of blood calcium levels with Calcitonon - Correct Answers --High blood
calcium causes the release of calcitonon from the thyroid gland.
-Low blood calcium causes the release of PTH from the parathyroid gland.
Calcitonin moderates effects of PTH/1,25(OH)2D - Correct Answers -Calcitonin is
secreted by the thyroid gland when plasma [1,25(OH)2D] and [Ca] are high.
Calcitonin reduces plasma [Ca] by:
-Reducing osteolytic activity
-Reducing formation of new osteoclasts
-Increasing osteoblast activity
