Nutrition and Health — MCQs

Nutrition and Health Indian Medical PG Practice Questions and MCQs

Question 161: Fish is a primary source of which nutrient?

A. Vitamin A
B. Proteins
C. Iron
D. Iodine (Correct Answer)

Explanation: **Explanation:** **1. Why Iodine is the Correct Answer:** In the context of Community Medicine and public health, **sea fish** (and other seafood) are considered the richest natural source of **Iodine**. Iodine is concentrated in marine life because it is abundant in seawater. While fish contain other nutrients, they are the primary dietary vehicle for naturally occurring iodine, which is essential for the synthesis of thyroid hormones (T3 and T4). In areas where soil is iodine-deficient (like the Himalayan goiter belt), the consumption of fish and iodized salt are the main strategies to prevent Iodine Deficiency Disorders (IDD). **2. Analysis of Incorrect Options:** * **Vitamin A:** While Fish Liver Oil (e.g., Cod liver oil) is a potent source of Vitamin A and D, the **flesh** of the fish is not the primary source of Vitamin A in a general diet compared to animal liver or yellow-orange vegetables (Beta-carotene). * **Proteins:** Fish is indeed a high-quality "Class 1" protein source. However, in nutritional hierarchy, pulses, meat, and eggs are also major contributors. In NEET-PG questions, when "Fish" is linked to a specific micronutrient, Iodine is the prioritized "textbook" answer. * **Iron:** Fish contains some iron, but it is not considered a primary source. Organ meats (liver), green leafy vegetables, and jaggery are superior sources of iron. **3. High-Yield Clinical Pearls for NEET-PG:** * **Iodine Content:** Sea fish contain roughly 300–3000 µg/kg of iodine. * **Biological Value:** Fish protein has a high biological value (approx. 80) and is easily digestible due to lack of tough connective tissue. * **PUFA:** Fish (especially fatty fish like mackerel/salmon) are rich in **Omega-3 fatty acids** (EPA and DHA), which lower serum triglycerides and reduce the risk of cardiovascular diseases. * **Iodine Requirement:** The adult daily requirement for iodine is **150 µg/day**.

Question 162: What is the purpose of parboiling?

A. Milling process
B. Polishing of rice
C. Preservation of nutrition (Correct Answer)
D. Storage of rice

Explanation: **Explanation:** **Parboiling** is a hydrothermal process applied to paddy (rice) before milling. It involves three main steps: soaking, steaming, and drying. **1. Why "Preservation of Nutrition" is correct:** In raw rice, essential nutrients—specifically **Thiamine (Vitamin B1)** and minerals—are concentrated in the outer layers (aleurone layer and germ). During the steaming process of parboiling, these water-soluble vitamins diffuse from the outer husk into the inner starchy endosperm. Consequently, even after the husk is removed during milling, the nutrients remain "locked" inside the grain. This makes parboiled rice nutritionally superior to polished white rice and prevents deficiency diseases. **2. Why other options are incorrect:** * **Milling process:** Milling refers to the mechanical removal of the husk and bran. Parboiling is a *pre-treatment* done before milling, not the milling process itself. * **Polishing of rice:** Polishing is the removal of the bran layer to make rice white and shiny. This actually *depletes* nutrients; parboiling is done specifically to counteract the nutritional loss caused by subsequent polishing. * **Storage of rice:** While parboiling hardens the grain and makes it more resistant to insects/fungi during storage, its primary medical and public health objective is nutritional fortification. **High-Yield Clinical Pearls for NEET-PG:** * **Beriberi Prevention:** Parboiling is the most effective community-level intervention to prevent **Beriberi** (Thiamine deficiency) in populations where rice is the staple diet. * **Nutrient Retention:** Parboiled rice retains about **80%** of the vitamins and minerals found in the whole grain. * **Physical Benefits:** Parboiling reduces "grain breakage" during milling, making it economically beneficial for farmers as well.

Question 163: Which of the following food groups is deficient in the essential amino acid lysine?

A. Pulses
B. Wheat (Correct Answer)
C. Both pulses and wheat
D. None of the above

Explanation: This question tests the concept of **limiting amino acids**, which are essential amino acids present in a food source in the lowest amount relative to human requirements. ### 1. Why Wheat is the Correct Answer Cereals, including **wheat**, rice, and maize, are characteristically deficient in the essential amino acid **Lysine**. However, they are relatively rich in sulfur-containing amino acids like **Methionine** and Cysteine. In wheat, lysine is the primary limiting amino acid, which reduces the overall biological value of its protein if consumed in isolation. ### 2. Analysis of Other Options * **A. Pulses:** Pulses (legumes) are actually **rich in Lysine** but are deficient in **Methionine**. This is the opposite of the amino acid profile found in cereals. * **C. Both pulses and wheat:** This is incorrect because their deficiencies are complementary. Pulses provide the lysine that wheat lacks, and wheat provides the methionine that pulses lack. * **D. None of the above:** Incorrect, as wheat has a well-documented deficiency in lysine. ### 3. High-Yield Clinical Pearls for NEET-PG * **Mutual Supplementation:** To achieve a "complete protein" profile, cereals and pulses should be consumed together (e.g., Dal-Chawal or Khichdi). This is known as the **supplementary action of proteins**. * **Maize (Corn):** It is unique because it is deficient in both **Lysine and Tryptophan**. A diet solely based on maize can lead to **Pellagra** because tryptophan is a precursor for Niacin (Vitamin B3). * **Reference Protein:** Egg protein is considered the "standard" or reference protein (Biological Value = 100) because it contains all essential amino acids in the correct proportions. * **Limiting Amino Acid Summary:** * **Cereals:** Lysine (Threonine is the second limiting amino acid). * **Pulses:** Methionine. * **Maize:** Lysine and Tryptophan.

Question 164: Which of the following statements is/are false about lathyrism?

A. Vitamin C prophylaxis
B. Banning of crop
C. Flaccid paralysis (Correct Answer)
D. Parboiling detoxicates pulses

Explanation: **Explanation:** Lathyrism is a form of permanent neurological damage caused by the excessive consumption of *Lathyrus sativus* (Khesari dal), which contains the neurotoxin **BOAA** (Beta-oxalyl-amino-alanine). **Why Option C is False (The Correct Answer):** Lathyrism causes **Spastic Paraplegia**, not flaccid paralysis. The toxin BOAA causes the destruction of upper motor neurons in the spinal cord, leading to increased muscle tone, exaggerated tendon reflexes, and a characteristic "scissor gait." Flaccid paralysis is associated with lower motor neuron lesions (like Polio), making this statement incorrect. **Analysis of Other Options:** * **A. Vitamin C prophylaxis:** Studies have shown that Vitamin C provides a protective effect against the neurotoxicity of BOAA. Its deficiency may predispose individuals to the disease. * **B. Banning of crop:** To control the disease, the Government of India historically banned the sale of Khesari dal under the Prevention of Food Adulteration Act to limit human consumption. * **C. Parboiling detoxicates pulses:** BOAA is water-soluble. Methods like **steeping** (soaking in hot water) or **parboiling** (similar to rice processing) effectively leach out the toxin, making the pulse safe for consumption. **High-Yield Clinical Pearls for NEET-PG:** * **Toxin:** BOAA (also known as ODAP). * **Safe Limit:** Consumption is generally safe if it constitutes less than 25% of the total calorie intake for less than 6 months. * **Stages of Lathyrism:** 1. **Latent stage:** No symptoms, but positive Tug-of-war test. 2. **No-stick stage:** Short steps, jerky gait. 3. **One-stick/Two-stick stage:** Progression of spasticity requiring support. 4. **Crawler stage:** Total loss of walking ability. * **Demographics:** Most common in young adult males (15–45 years).

Question 165: An egg lacks which of the following?

A. Protein
B. Cholesterol
C. Carbohydrate (Correct Answer)
D. Vitamins

Explanation: **Explanation:** The egg is often referred to as a "complete food" because it contains almost all essential nutrients required for life, with two notable exceptions: **Carbohydrates** and **Vitamin C**. 1. **Why Carbohydrate is the Correct Answer:** An average egg (approx. 60g) contains negligible amounts of carbohydrates (less than 1%). Its primary biological function is to provide the building blocks (proteins and lipids) for a developing embryo. Since it lacks fiber and significant sugars, it is considered a zero-carbohydrate food source in clinical nutrition. 2. **Why Other Options are Incorrect:** * **Protein:** Eggs are the "Gold Standard" for protein quality. They have a **Biological Value (BV) of 100** and a Net Protein Utilization (NPU) of 94. The "Reference Protein" used for comparing other foods is the egg protein. * **Cholesterol:** Eggs are rich in lipids. A single egg contains approximately 200–250 mg of cholesterol, primarily found in the yolk. * **Vitamins:** Eggs are a powerhouse of fat-soluble vitamins (A, D, E, K) and B-complex vitamins (especially B12 and Riboflavin). **High-Yield Clinical Pearls for NEET-PG:** * **The "Missing" Nutrients:** Remember the mnemonic: Eggs lack **"C & C"** — **C**arbohydrates and Vitamin **C**. * **Biological Value:** Egg (100) > Milk (95) > Meat (74) > Soy (74). * **Iron Content:** While eggs contain iron, it is present in the yolk. However, the bioavailability is low due to the presence of phosvitin, which inhibits absorption. * **Energy:** One standard egg provides approximately **70 kcal** of energy.

Question 166: Based on epidemiological studies, which of the following has been found to be most protective against carcinoma of the colon?

A. High fiber diet (Correct Answer)
B. Low fat diet
C. Low selenium diet
D. Low protein diet

Explanation: **Explanation:** **High fiber diet** is the most protective factor against colorectal carcinoma. Epidemiological studies, most notably by Denis Burkitt, first highlighted that populations consuming high amounts of dietary fiber have significantly lower rates of colon cancer. The protective mechanism is multi-factorial: 1. **Dilution:** Fiber increases fecal bulk, thereby diluting potential carcinogens and bile acids in the colon. 2. **Transit Time:** It speeds up the passage of stool, reducing the duration of contact between the colonic mucosa and carcinogens. 3. **Fermentation:** Gut bacteria ferment soluble fiber into **Short-Chain Fatty Acids (SCFAs)** like butyrate, which have anti-inflammatory and pro-apoptotic effects on cancer cells. **Analysis of Incorrect Options:** * **Low fat diet:** While high intake of saturated animal fats is a known risk factor (as it increases bile acid secretion which can be converted into secondary carcinogens), a low-fat diet alone is considered less protective than the active mechanical and chemical benefits of high fiber. * **Low selenium diet:** This is incorrect because **Selenium** is actually an antioxidant. Low levels of selenium are associated with an *increased* risk of various cancers; therefore, an adequate or high selenium intake (not low) would be protective. * **Low protein diet:** There is no strong epidemiological evidence suggesting that a low protein diet is specifically protective against colon cancer, though high consumption of *processed red meats* is a recognized risk factor. **High-Yield Pearls for NEET-PG:** * **Burkitt’s Hypothesis:** High fiber intake protects against "Western diseases" like appendicitis, diverticulitis, and colon cancer. * **Best Sources:** Whole grains, green leafy vegetables, and pulses. * **Other Protective Factors:** Physical activity, Vitamin D, and Calcium. * **Major Risk Factors:** Obesity, smoking, alcohol, and high intake of processed red meat.

Question 167: Which of the following is the richest source of Vitamin C?

A. Orange
B. Guava
C. Cabbage
D. Amla (Correct Answer)

Explanation: **Explanation:** Vitamin C (Ascorbic Acid) is a water-soluble vitamin essential for collagen synthesis, antioxidant defense, and iron absorption. In the context of Indian dietetics and NEET-PG, the concentration of Vitamin C per 100g of edible portion is the standard for comparison. **Why Amla is the correct answer:** **Amla (Indian Gooseberry)** is recognized as the richest source of Vitamin C among common foods, containing approximately **600 mg per 100g**. It is unique because its Vitamin C content is highly stable even when dried or heated, due to the presence of tannins that prevent oxidation. **Analysis of Incorrect Options:** * **Guava:** While an excellent source, it contains roughly **212 mg per 100g**. It is often considered the "cheapest" rich source but ranks second to Amla. * **Orange:** Citrus fruits are the most famous sources, but they contain only about **30–50 mg per 100g**, significantly less than Amla or Guava. * **Cabbage:** Among vegetables, green leafy vegetables and cabbage are good sources (approx. **120 mg per 100g**), but they do not surpass the concentrations found in Amla. **High-Yield NEET-PG Pearls:** 1. **Richest Source overall:** Barbados Cherry (approx. 1600 mg/100g), but Amla is the richest among *commonly available* Indian sources. 2. **Animal Sources:** Vitamin C is generally absent in animal products, except in small amounts in liver and kidney. **Milk is a very poor source.** 3. **Scurvy:** Deficiency leads to "corkscrew hair," perifollicular hemorrhages, and swollen, bleeding gums. 4. **Cooking:** Vitamin C is the most heat-labile vitamin; it is easily destroyed by prolonged boiling or cooking in open pans.

Question 168: Which replacement of an amino acid does not alter its normal function?

A. Glutamine replaced by arginine
B. Glutamine replaced by alanine
C. Glutamine replaced by glutamate
D. Glutamine replaced by asparagine (Correct Answer)

Explanation: ### Explanation The functionality of a protein is primarily determined by the chemical properties of its constituent amino acids. When one amino acid is replaced by another with **similar chemical properties** (size, charge, and polarity), the protein's structure and function are often preserved. This is known as a **conservative substitution**. **1. Why Option D is Correct:** Both **Glutamine** and **Asparagine** belong to the same chemical group: **Polar, Uncharged (Amide-containing) amino acids**. They are structurally very similar, differing only by one methylene (—CH2—) group in their side chains. Because they share the same functional amide group and lack a net charge at physiological pH, replacing glutamine with asparagine is unlikely to disrupt the protein's folding or its biochemical activity. **2. Why Incorrect Options are Wrong:** * **A. Arginine:** This is a **Basic (Positively charged)** amino acid. Replacing a neutral polar amino acid with a large, positively charged one would significantly alter the electrostatic environment of the protein. * **B. Alanine:** This is a **Non-polar (Hydrophobic)** amino acid. Replacing a polar residue with a hydrophobic one can cause misfolding, especially if the residue is on the protein's surface. * **C. Glutamate:** Although structurally similar to glutamine, glutamate is **Acidic (Negatively charged)**. This change in charge can disrupt ionic bonds (salt bridges) within the protein. ### Clinical Pearls for NEET-PG * **Non-conservative Substitution:** The classic example is **Sickle Cell Anemia**, where Glutamic acid (Polar/Charged) is replaced by Valine (Non-polar) at the 6th position of the beta-globin chain, leading to catastrophic functional changes. * **Essential vs. Non-essential:** Both Glutamine and Asparagine are non-essential amino acids. * **Ammonia Transport:** Glutamine is the most important non-toxic transporter of ammonia in the blood.

Question 169: What is the Body Mass Index (BMI) of a 46-year-old man who weighs 98kg and is 175cm tall?

A. 28
B. 32 (Correct Answer)
C. 36
D. 40

Explanation: **Explanation:** The Body Mass Index (BMI), also known as the Quetelet Index, is a standard anthropometric measure used to classify nutritional status in adults. It is calculated using the formula: **BMI = Weight (kg) / [Height (m)]²** **Step-by-Step Calculation:** 1. **Convert Height to Meters:** 175 cm = 1.75 m. 2. **Square the Height:** 1.75 × 1.75 = 3.0625. 3. **Divide Weight by Height Squared:** 98 / 3.0625 = **32.0 kg/m²**. **Analysis of Options:** * **Option B (32) is Correct:** Based on the calculation above. According to WHO classification, a BMI of 32.0 falls into **Obesity Class I** (30.0–34.9). * **Option A (28):** This would correspond to a weight of approximately 85 kg. This range (25–29.9) is classified as **Overweight**. * **Option C (36):** This would require a weight of approximately 110 kg. This falls into **Obesity Class II** (35.0–39.9). * **Option D (40):** This would require a weight of approximately 122 kg. A BMI ≥ 40 is classified as **Obesity Class III** (Morbid Obesity). **High-Yield Clinical Pearls for NEET-PG:** * **Asian-Indian Specific Criteria:** Due to higher body fat percentages at lower BMIs, the cut-offs for Indians are lower: * Normal: 18.5–22.9 kg/m² * Overweight: 23.0–24.9 kg/m² * Obese: ≥ 25.0 kg/m² * **Limitation:** BMI does not distinguish between muscle mass and fat mass (e.g., athletes may have a high BMI but low body fat). * **Ponderal Index:** Another measure calculated as Weight (kg) / [Height (m)]³. It is often used in neonatology to assess intrauterine growth retardation.

Question 170: Soya bean is rich in which of the following amino acids?

A. Lysine (Correct Answer)
B. Aspartic acid
C. Glycine
D. Alanine

Explanation: **Explanation:** The correct answer is **Lysine (Option A)**. In Community Medicine and Nutrition, proteins are categorized based on their amino acid profile. Most plant-based proteins are "incomplete" because they lack one or more essential amino acids. However, **Soybean** is a unique exception; it is a high-quality plant protein that contains all essential amino acids. Specifically, it is exceptionally rich in **Lysine**, which is the "limiting amino acid" in most cereal grains (like wheat and rice). **Why other options are incorrect:** * **Options B, C, and D (Aspartic acid, Glycine, Alanine):** These are **non-essential amino acids**, meaning the body can synthesize them internally. While they are present in soybean, they are not the defining nutritional characteristic of the legume. In the context of competitive exams, the focus is always on the **limiting amino acids** (Lysine in cereals, Methionine in pulses). **High-Yield Clinical Pearls for NEET-PG:** * **The "Mutual Supplementation" Concept:** Since cereals are deficient in Lysine but rich in Methionine, and pulses (like Soy) are rich in Lysine but deficient in Methionine, a diet combining both (e.g., Dal-Chawal) provides a complete protein profile. * **Protein Efficiency Ratio (PER):** Soybean has a high PER (approx. 2.1), making it one of the best vegetarian sources of protein. * **Limiting Amino Acids Table:** * **Cereals (Wheat/Rice):** Lysine (Deficient), Methionine (Rich). * **Pulses/Legumes:** Methionine (Deficient), Lysine (Rich). * **Maize:** Tryptophan and Lysine (Deficient). * **Soybean Composition:** It contains approximately 40% protein and 20% fat, making it a "dual-purpose" crop.

Practice by Chapter

Basic Nutritional Requirements

Practice Questions

Assessment of Nutritional Status

Practice Questions

Protein-Energy Malnutrition

Practice Questions

Micronutrient Deficiencies

Practice Questions

Nutritional Programs in India

Practice Questions

Dietary Guidelines

Practice Questions

Food Safety and Security

Practice Questions

Diet and Non-Communicable Diseases

Practice Questions

Nutrition in Pregnancy and Lactation

Practice Questions

Infant and Young Child Nutrition

Practice Questions

Nutrition in Emergencies

Practice Questions

Food Fortification and Supplementation

Practice Questions

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