Nutrition and Health Practice Questions

Q: The most important indicator for assessment of impact in Salt Iodization Programme is:

Testing median urinary iodine excretion. ***Testing median urinary iodine excretion*** - **Urinary iodine excretion** is the most reliable biochemical indicator of recent **iodine intake** and is considered the best measure for assessing the iodine status of a population. - The **median urinary iodine concentration** is used to categorize a population's iodine nutrition status as deficient, adequate, or in excess, providing a direct measure of programme impact. *Testing iodine content of salt at consumer level* - While important for monitoring **salt iodization efforts**, this only reflects the availability of iodized salt, not necessarily the actual **iodine intake** or nutritional status of the consumers. - Salt content can degrade over time due to improper storage, heat, and humidity, leading to discrepancies between the salt's iodine content and the iodine actually consumed. *Testing iodine content of salt at production level* - This is crucial for **quality control** and ensuring compliance with iodization standards at the source. - However, it does not account for potential **iodine loss** during transport, storage, and household use, nor does it directly reflect the population's actual iodine status. *Testing serum iodine levels* - **Serum iodine levels** are primarily regulated by the thyroid gland and are not a sensitive indicator of a population's *recent iodine intake* or overall iodine nutrition status. - These levels are often maintained within a narrow range even with varying intake, making them less useful for monitoring large-scale intervention programmes like **salt iodization**.

Q: The most sensitive indicator of environmental iodine deficiency is

Urinary iodine excretion. ***Urinary iodine excretion*** - **Urinary iodine excretion** reflects recent dietary iodine intake, making it the most sensitive and commonly used indicator for assessing current iodine status in a population. - A median urinary iodine concentration of less than 100 μg/L in a population indicates **iodine deficiency**. *Prevalence of neonatal hypothyroidism* - While reflecting severe iodine deficiency, **neonatal hypothyroidism** occurs later in the deficiency cascade and is not sensitive enough to detect mild to moderate deficiencies early. - It would indicate a long-standing, significant deficiency rather than an early environmental change. *Prevalence of cretinism* - **Cretinism** is a severe and irreversible consequence of prolonged and profound iodine deficiency during critical periods of development (fetal and early infancy). - Its prevalence indicates severe, chronic iodine deficiency and is not a sensitive marker for early or mild environmental iodine deficiency. *Prevalence of goitre* - The **prevalence of goitre** (enlarged thyroid gland) can be used as an indicator of iodine deficiency, but it is less sensitive than urinary iodine excretion. - Goitre develops over a longer period in response to chronic iodine deficiency and may not reflect recent changes in environmental iodine levels.

Q: A 25 year old woman is a sedentary worker. She is a lactating mother with a 3 month old child. Which one among the following is the best approximation of her energy requirement in terms of kilocalories per day ?

2500 kcal/d. ***2500 kcal/d*** - A lactating woman generally requires an additional 500 kcal/day above her baseline energy needs to support milk production. - For a sedentary woman, a typical baseline intake is around 2000 kcal/day, making 2500 kcal/day a good approximation during lactation. *1500 kcal/d* - This value is significantly low for a lactating woman, as it would likely lead to a **caloric deficit** and could compromise milk supply and maternal health. - This energy level might be appropriate for a woman on a **weight-loss diet**, but not for supporting lactation. *2250 kcal/d* - While closer than 1500 kcal/d, this value still falls slightly short of the recommended additional energy intake for lactation, which is typically an extra 500 kcal/day. - This might represent a moderate activity level for a non-lactating woman, but not optimal for **milk production**. *2830 kcal/d* - This amount would be more appropriate for a lactating woman with a **higher activity level** or a greater baseline energy requirement than a sedentary individual. - While some lactating women may need this much, it is likely an **overestimation** for a sedentary worker.

Q: Beta oxalyl amino alanine (BOAA) is found in:

Lathyrus sativus. ***Lathyrus sativus*** - **Lathyrus sativus**, also known as **grass pea**, is a legume that contains the neurotoxin **beta-oxalyl-amino-alanine (BOAA)**. - Consumption of **Lathyrus sativus** in large quantities over a prolonged period can lead to **lathyrism**, a neurological disorder causing paralysis. *Argemone mexicana* - **Argemone mexicana**, or **prickly poppy**, contains **sanguinarine** and **dihydrosanguinarine** alkaloids, which can cause **epidemic dropsy**. - Its oil is sometimes used as an adulterant in mustard oil, leading to symptoms like **edema** and **cardiac issues**. *Crotalaria medicaginea* - Species of **Crotalaria** (e.g., Crotalaria retusa, Crotalaria medicaginea) are known to contain **pyrrolizidine alkaloids**, which can be **hepatotoxic** and **pneumotoxic**. - Consumption can lead to **liver damage** and **pulmonary hypertension** in livestock and humans. *Aspergillus flavus* - **Aspergillus flavus** is a fungus that produces **aflatoxins**, potent **carcinogens** and **hepatotoxins**. - Aflatoxins are often found in contaminated food products like peanuts, corn, and tree nuts, causing **liver cancer** and **immunosuppression**.

Q: Among the following foodstuffs, which one has the highest protein content per 100 gm?

Black gram. ***Black gram*** - **Black gram (Urad dal)** is a pulse known for its high protein content, typically around **24-25 grams per 100g**. - It is a staple in many cuisines and provides essential amino acids, making it a valuable protein source. *Ragi* - **Ragi (finger millet)** is a nutritious grain, but its protein content is relatively lower, around **7-8 grams per 100g**. - It is more notable for its high **calcium** and **fiber** content rather than protein. *Wheat* - **Wheat** contains a moderate amount of protein, usually around **12-14 grams per 100g**. - While it's a significant source of calories and carbohydrates, its protein content is less than that of black gram. *Egg* - A whole **egg** contains about **13 grams of protein per 100g**. - While eggs are an excellent source of high-quality protein, black gram typically surpasses this amount per 100g.

Q: For adolescents, what is the weekly iron and folic acid supplementation dose?

100 mg elemental iron and 500 microgram folic acid. ***100 mg elemental iron and 500 microgram folic acid*** - This is the **current recommended dosage** for India's **Weekly Iron and Folic Acid Supplementation (WIFS) program** for adolescents (10-19 years). - The **Government of India's National Health Mission** and **WHO guidelines** endorse this specific amount for weekly supplementation to prevent and control **iron deficiency anemia** in adolescents. - This dosage is used in school-based and community programs across India. *120 mg elemental iron and 400 microgram folic acid* - This was an **earlier recommendation** that has since been updated to the current standard of 100 mg + 500 mcg. - While previously used, current WIFS guidelines have standardized the dose at **100 mg elemental iron** and **500 mcg folic acid**. *60 mg elemental iron and 400 microgram folic acid* - **60 mg elemental iron** is typically a **daily therapeutic dose** or used for younger children, and is insufficient for weekly prophylactic supplementation in adolescents. - This lower dose would not provide adequate coverage for the weekly supplementation schedule. *150 mg elemental iron and 500 microgram folic acid* - This dose of **elemental iron (150 mg)** is higher than the standard weekly recommendation (100 mg) for routine adolescent supplementation. - The higher iron dose is not necessary for general prophylactic supplementation and could increase the risk of gastrointestinal side effects.

Q: Consider the following statements: 1. Protein content of soyabean is more than that of meat (per 100 gm) 2. Fat content of fish is more than that of soyabean (per 100 gm) 3. Calorie yield for each 100 gm of fish is almost the same as for 100 gm of banana 4. Fat content of soyabean is more than that of eggs (per 100 gm) Which of the above statements are correct?

1 and 4 only. ***1 and 4 only*** - **Statement 1 is correct**: Soybean has a significantly higher protein content (approximately 36g/100g) compared to most meats (20-26g/100g for beef, chicken, pork). - **Statement 4 is correct**: Soybean has a higher fat content (approximately 20g/100g) than whole eggs (approximately 10-11g/100g). - **Statement 2 is incorrect**: Fish generally has lower fat content than soybean. Most fish varieties contain 2-10g fat/100g (lean fish like cod: 0.5-2g; moderately fatty fish like salmon: 10-14g), which is less than soybean's 20g/100g. - **Statement 3 is incorrect for exam purposes**: While some very lean fish (cod: ~82 kcal/100g) may be close to banana (89 kcal/100g), most commonly consumed fish provide 100-150 kcal/100g or more, making them significantly higher in calories than banana. The statement's use of "almost the same" is too broad to be considered correct. *1 and 2* - Statement 1 is correct, but statement 2 is incorrect because **fish has less fat than soybean**, not more. *1, 3 and 4* - Statements 1 and 4 are correct, but statement 3 is incorrect because **the calorie yield of most fish varieties (100-150+ kcal/100g) is notably higher than banana (89 kcal/100g)**. Only specific lean fish varieties approach banana's calorie content, which doesn't justify the blanket statement. *2 and 3* - Both statements are incorrect. Statement 2: **fish has less fat than soybean**. Statement 3: **most fish have higher calorie yields than banana**.

Q: Consider the following statements about content/yield of 100 gm of some foodstuffs: 1. Fat content of Bengal gram is less than that of maize 2. Protein content of maize is more than that of rice 3. Calorie yield of fish and egg is same Which of the statements given above is/are correct?

2 only. ***Correct Answer: 2 only*** **Statement 2 is correct:** Protein content of maize (9-10g per 100g) is indeed more than that of rice (7-8g per 100g). This is an important nutritional distinction for dietary planning. **Why other statements are incorrect:** *Statement 1 is incorrect:* Fat content of Bengal gram (chickpea) is approximately 6g per 100g, while maize (corn) contains about 4.7g per 100g. Therefore, Bengal gram actually has **more** fat content than maize, not less. This makes statement 1 false. *Statement 3 is incorrect:* Calorie yield varies significantly between fish and eggs. Fish provides 100-200 kcal per 100g depending on the type (lean vs. fatty fish), while whole eggs provide approximately 155 kcal per 100g. The variability in fish calorie content makes it inaccurate to state they are "same." **Clinical Relevance:** Understanding macronutrient composition of common food items is essential for providing appropriate dietary counseling and nutritional recommendations in clinical practice. --- *Option A (2 and 3):* Incorrect because statement 3 is false - calorie yields are not the same. *Option C (1 and 2):* Incorrect because statement 1 is false - Bengal gram has more fat than maize. *Option D (1 only):* Incorrect because statement 1 is false, and statement 2 is actually correct.

Q: A rapid mass screening method that can be employed by a paramedical worker for detecting malnutrition in pre-school (age: 1 to 5 years) children is:

Mid-arm circumference. ***Mid-arm circumference*** - **Mid-upper arm circumference (MUAC)** is a simple, quick, and effective anthropometric measure that can be used by paramedical workers for rapid screening of malnutrition in pre-school children. - It is particularly useful in community settings as it requires minimal training and readily available tools, making it ideal for **mass screening** in resource-limited environments. *Body Mass Index* - **Body Mass Index (BMI)** calculation requires both height and weight, which can be more challenging to accurately measure in young, uncooperative children during rapid field screenings. - While useful for assessing nutritional status, BMI charts can be complex, making them less suitable for rapid use by paramedical workers for mass screening. *Height for age* - **Height for age** is a key indicator for assessing **stunting (chronic malnutrition)** but requires accurate measurement of height, which can be difficult in young children, especially infants and toddlers who cannot stand independently. - Its primary use is for long-term monitoring of growth rather than a quick, immediate screening tool for acute malnutrition or overall nutritional status in a rapid mass campaign. *Weight for age* - **Weight for age** is an indicator for determining **underweight**, reflecting both acute and chronic malnutrition, but it requires accurate weighing scales and meticulous recording. - Although it is a standard anthropometric index, its application in rapid mass screening might be limited by the availability of reliable weighing scales and the time required for accurate measurements in a large population.

Q: Children of severe acute malnutrition discharged from Nutritional Rehabilitation Centres (NRCs) should be observed in the community by an Anganwadi Worker (AWW) as per which one of the following schedules?

Twice weekly in first month and then once a week. ***Twice weekly in first month and then once a week*** - According to national guidelines for the management of **Severe Acute Malnutrition (SAM)** in India, children discharged from NRCs require intensive follow-up to prevent relapse. - This specific schedule ensures close monitoring initially when the child is most vulnerable, gradually reducing frequency as their health stabilizes. *Once a week for first month and then twice weekly* - This option reverses the logical progression of follow-up frequency, suggesting increased visits after the first month, which is not aligned with standard protocols. - Initial follow-up for SAM children needs to be more frequent than once a week in the first month. *Twice weekly in first month and then once fortnightly* - While initial follow-up is appropriate, reducing the frequency to **once fortnightly** after the first month might be too infrequent for continued close monitoring of a child recovering from SAM. - This schedule could miss early signs of deterioration. *Once a week for first month and then once fortnightly* - This schedule provides insufficient monitoring both in the **initial critical month** (only once a week) and in the subsequent period (once fortnightly is too spread out). - It does not meet the recommended intensity of follow-up for children discharged after SAM treatment.

Question 1

The most important indicator for assessment of impact in Salt Iodization Programme is:

Accepted Answer

Testing median urinary iodine excretion

Answer

Testing Iodine content of salt at consumer level

Answer

Testing iodine content of salt at production level

Answer

Testing serum iodine levels

Question 2

The most sensitive indicator of environmental iodine deficiency is

Accepted Answer

Urinary iodine excretion

Answer

Prevalence of neonatal hypothyroidism

Answer

Prevalence of cretinism

Answer

Prevalence of goitre

Question 3

A 25 year old woman is a sedentary worker. She is a lactating mother with a 3 month old child. Which one among the following is the best approximation of her energy requirement in terms of kilocalories per day ?

Accepted Answer

2500 kcal/d

Answer

1500 kcal/d

Answer

2250 kcal/d

Answer

2830 kcal/d

Question 4

Beta oxalyl amino alanine (BOAA) is found in:

Accepted Answer

Lathyrus sativus

Answer

Argemone mexicana

Answer

Crotalaria medicaginea

Answer

Aspergillus flavus

Question 5

Among the following foodstuffs, which one has the highest protein content per 100 gm?

Accepted Answer

Black gram

Answer

Ragi

Answer

Wheat

Answer

Egg

Question 6

For adolescents, what is the weekly iron and folic acid supplementation dose?

Accepted Answer

100 mg elemental iron and 500 microgram folic acid

Answer

60 mg elemental iron and 400 microgram folic acid

Answer

120 mg elemental iron and 400 microgram folic acid

Answer

150 mg elemental iron and 500 microgram folic acid

Question 7

Consider the following statements:

1. Protein content of soyabean is more than that of meat (per 100 gm)
2. Fat content of fish is more than that of soyabean (per 100 gm)
3. Calorie yield for each 100 gm of fish is almost the same as for 100 gm of banana
4. Fat content of soyabean is more than that of eggs (per 100 gm)
Which of the above statements are correct?

Accepted Answer

1 and 4 only

Answer

1 and 2

Answer

1, 3 and 4

Answer

2 and 3

Question 8

Consider the following statements about content/yield of 100 gm of some foodstuffs:

1. Fat content of Bengal gram is less than that of maize
2. Protein content of maize is more than that of rice
3. Calorie yield of fish and egg is same

Which of the statements given above is/are correct?

Accepted Answer

2 only

Answer

2 and 3

Answer

1 and 2

Answer

1 only

Question 9

A rapid mass screening method that can be employed by a paramedical worker for detecting malnutrition in pre-school (age: 1 to 5 years) children is:

Accepted Answer

Mid-arm circumference

Answer

Body Mass Index

Answer

Height for age

Answer

Weight for age

Question 10

Children of severe acute malnutrition discharged from Nutritional Rehabilitation Centres (NRCs) should be observed in the community by an Anganwadi Worker (AWW) as per which one of the following schedules?

Accepted Answer

Twice weekly in first month and then once a week

Answer

Once a week for first month and then twice weekly

Answer

Twice weekly in first month and then once fortnightly

Answer

Once a week for first month and then once fortnightly

Nutrition and Health — MCQs

Nutrition and Health — MCQs

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