Nutrition and Health — MCQs

Nutrition and Health Indian Medical PG Practice Questions and MCQs

Question 431: Which food source has the highest biological value?

A. Egg (Correct Answer)
B. Milk
C. Soyabean
D. Pulses

Explanation: **Explanation:** The **Biological Value (BV)** of a protein is a measure of the proportion of absorbed protein from a food which becomes incorporated into the proteins of the organism's body. It essentially measures how efficiently the body utilizes the dietary protein. **1. Why Egg is the Correct Answer:** The **Egg** is considered the "Gold Standard" in nutrition because it contains all essential amino acids in the correct proportions required by the human body. It has a **Biological Value of approximately 94–96%** (often rounded to 100 in comparative indices). Because of its near-perfect amino acid profile, it is used as the reference protein against which all other food proteins are compared. **2. Analysis of Incorrect Options:** * **Milk:** While milk is a high-quality animal protein, its BV is approximately **84–90%**. It is slightly lower than egg because it is relatively lower in sulfur-containing amino acids. * **Soyabean:** This is the best plant-based protein source, but its BV is around **70–75%**. Like most legumes, it is deficient in methionine. * **Pulses:** Most pulses have a BV ranging from **50–70%**. They are generally limiting in methionine and cysteine, though they are rich in lysine. **3. NEET-PG High-Yield Pearls:** * **Net Protein Utilization (NPU):** For Egg, NPU is **100**, making it the most efficiently utilized protein. * **Reference Protein:** Egg is the standard reference protein used by the WHO. * **Limiting Amino Acids:** * Pulses/Cereals: Pulses are low in Methionine; Cereals are low in Lysine. * **Pulse-Cereal Mix:** Combining them (e.g., Khichdi) provides a complete amino acid profile (Supplementary action of proteins). * **Highest Protein Content:** While Egg has the highest *quality* (BV), **Soyabean** has the highest *quantity* of protein (approx. 40g/100g).

Question 432: Which of the following is considered the reference protein?

A. Egg (Correct Answer)
B. Fish
C. Milk
D. Meat

Explanation: **Explanation:** The concept of a **Reference Protein** refers to a protein source that contains all essential amino acids in the optimal proportions required by the human body. **Why Egg is the Correct Answer:** Egg protein (specifically the whole egg) is considered the "Gold Standard" or reference protein because it has the highest **Biological Value (BV)** of approximately 94-96% and a **Net Protein Utilization (NPU)** of 94. It contains all essential amino acids in a pattern that most closely resembles human tissue requirements. Because of its near-perfect digestibility and amino acid profile, it is used as the benchmark against which the quality of all other dietary proteins is compared. **Analysis of Incorrect Options:** * **Milk:** While milk is a high-quality protein (BV ~84-90), it is slightly lower in sulfur-containing amino acids compared to eggs. It is often used as a reference for infant nutrition but not as the universal biological reference. * **Fish and Meat:** Both are excellent sources of "First Class" animal proteins with high biological values (BV ~75-80). However, they contain more connective tissue and slightly different amino acid ratios than eggs, making them less efficient in terms of net utilization. **High-Yield NEET-PG Pearls:** * **Net Protein Utilization (NPU):** Egg (94) > Milk (75) > Meat (65) > Fish (70) > Dal/Pulses (45). * **Limiting Amino Acids:** Pulses are deficient in **Methionine**, while Cereals are deficient in **Lysine**. * **Protein Efficiency Ratio (PER):** Defined as the weight gain per gram of protein intake. * **Safe Intake of Protein:** For an average Indian adult, the recommended dietary allowance (RDA) is **0.83 g/kg body weight/day** (as per latest ICMR-NIN guidelines).

Question 433: What are the components of nutrition surveillance?

A. Policy maker and Nutritional survey
B. Policy maker
C. Nutritional survey and census (Correct Answer)
D. Nutritional survey and low birth rate

Explanation: **Explanation:** **Nutritional Surveillance** is the continuous monitoring of the nutritional status of a population to provide data for policy-making and program evaluation. Unlike a one-time survey, surveillance is an ongoing process designed to detect trends and trigger action. **1. Why the Correct Answer (C) is Right:** According to the WHO, the primary components and data sources for nutritional surveillance include: * **Nutritional Surveys:** These provide cross-sectional data on anthropometry (weight-for-age, height-for-age) and biochemical markers (hemoglobin levels) to identify the prevalence of malnutrition. * **Census and Demographic Data:** Census data provides the "denominator" (the total population at risk). It helps in understanding the socio-economic context, population distribution, and vital statistics necessary to interpret nutritional trends over time. **2. Analysis of Incorrect Options:** * **Option A & B (Policy Maker):** While policy makers are the *users* of the data generated by surveillance, they are not a "component" or data source of the surveillance system itself. * **Option D (Low Birth Weight):** While Low Birth Weight (LBW) is a specific *indicator* used within a surveillance system, it is too narrow to be considered a primary component compared to the broader scope of a census. **3. High-Yield Pearls for NEET-PG:** * **Surveillance vs. Survey:** A *Survey* is a "snapshot" (one-time), while *Surveillance* is "continuous" (long-term). * **Triple Burden of Malnutrition:** Modern surveillance now monitors undernutrition, micronutrient deficiencies, and overweight/obesity simultaneously. * **Key Indicators:** In India, the **National Family Health Survey (NFHS)** is the most vital tool for nutritional surveillance. * **Sentinel Surveillance:** This involves monitoring specific "at-risk" groups or geographical areas to act as early warning signs for the larger population.

Question 434: Which component of breast milk is highest in protein content?

A. Foremilk (Correct Answer)
B. Hindmilk
C. Transitional milk
D. None of the above

Explanation: **Explanation:** The composition of breast milk changes dynamically during a single feed and throughout the lactation period to meet the specific nutritional needs of the infant. **1. Why Foremilk is the correct answer:** Foremilk is the milk secreted at the **beginning** of a feed. It is characterized by being watery and bluish in appearance. Its primary physiological role is to quench the infant's thirst and provide essential proteins, lactose, vitamins, and minerals. Compared to hindmilk, **foremilk has a higher protein concentration** and a higher water content, but it is significantly lower in fat. **2. Why the other options are incorrect:** * **Hindmilk:** This is the milk secreted towards the **end** of a feed. It is thicker and whiter because it contains a much **higher fat content** (and thus more calories) than foremilk. While it provides satiety and energy for growth, its protein concentration is lower than that of foremilk. * **Transitional milk:** This refers to the milk produced between the 5th and 14th day postpartum (after colostrum but before mature milk). While its protein content is higher than mature milk, the question specifically compares components within a single feeding session (Foremilk vs. Hindmilk). **3. High-Yield Clinical Pearls for NEET-PG:** * **Colostrum:** Secreted during the first 3–5 days. It has the **highest protein and immunoglobulin (IgA)** content of all stages but is low in fat and lactose. * **Fat Content:** Hindmilk > Foremilk. * **Protein Content:** Colostrum > Transitional Milk > Mature Milk (Foremilk > Hindmilk). * **Energy Value:** Hindmilk provides more calories per ml due to its high fat content. * **Clinical Tip:** Mothers should be advised to empty one breast completely before switching to the other to ensure the baby receives both the protein-rich foremilk and the calorie-dense hindmilk.

Question 435: Which of the following processes prevents lathyrism from Khesari dal?

A. Parboiling (Correct Answer)
B. Filtration
C. Sunlight exposure
D. Soaking

Explanation: **Explanation:** **Lathyrism** is a condition caused by the excessive consumption of *Lathyrus sativus* (Khesari dal), which contains the neurotoxin **BOAA (Beta-oxalyl-amino-alanine)**. To make the dal safe for consumption, the toxin must be removed. 1. **Why Parboiling is Correct:** **Parboiling** (steeping the seeds in hot water) is the most effective method for large-scale detoxification. BOAA is a water-soluble toxin. During parboiling, the dal is soaked in hot water for several hours and then drained. This process leaches out approximately **90% of the BOAA**, making the dal safe for consumption. 2. **Why Other Options are Incorrect:** * **Filtration:** This is a physical separation process used for liquids and solids; it has no effect on chemical toxins embedded within a seed. * **Sunlight exposure:** While UV rays can degrade some toxins, BOAA is heat-stable and resistant to light; sunlight does not neutralize it. * **Soaking:** While simple soaking in cold water can remove some toxin, it is significantly less efficient than parboiling or "steeping" in hot water, which is the standardized recommended preventive measure. **Clinical Pearls for NEET-PG:** * **The Toxin:** BOAA is also known as **ODAP** (Oxalyldiaminopropionic acid). * **Clinical Presentation:** It causes **Spastic Paraplegia** (upper motor neuron lesion) due to the destruction of pyramidal tracts. * **Stages:** It progresses through four stages: Latent, No-stick, One-stick, Two-stick, and Crawler stage. * **Lathyrism vs. Epidemic Dropsy:** Do not confuse these. Lathyrism is caused by Khesari dal (BOAA), while Epidemic Dropsy is caused by **Argemone mexicana** (Sanguinarine toxin) contaminating mustard oil. * **Home Method:** Another effective method is "Steeping," where dal is soaked in boiling water for 30–60 minutes and the water is discarded.

Question 436: According to WHO, what is the cut-off for the diagnosis of anemia in non-pregnant females?

A. 7 g%
B. 10 g%
C. 11 g%
D. 12 g% (Correct Answer)

Explanation: **Explanation:** The diagnosis of anemia is based on hemoglobin (Hb) levels falling below the established physiological requirements for an individual's age, sex, and physiological status (like pregnancy). According to the **WHO criteria**, the cut-off for anemia in **non-pregnant females (≥15 years of age)** is **<12 g/dL**. * **Why Option D is correct:** In non-pregnant adult females, the lower limit of normal hemoglobin is set at 12 g/dL. This threshold accounts for menstrual blood loss and lower androgen levels compared to males. * **Why Option C is incorrect:** **11 g/dL** is the WHO cut-off for **pregnant women** and **children aged 6–59 months**. During pregnancy, hemodilution (disproportionate increase in plasma volume over red cell mass) leads to a lower physiological cut-off. * **Why Option B is incorrect:** **10 g/dL** is often used as a threshold for "moderate anemia" (7.0–9.9 g/dL) but is not the diagnostic cut-off for the presence of anemia. * **Why Option A is incorrect:** **7 g/dL** is the threshold for **severe anemia**. Patients with Hb <7 g/dL often require urgent intervention or blood transfusion. **High-Yield Facts for NEET-PG:** * **Adult Males:** <13 g/dL * **Pregnant Females:** <11 g/dL * **Children (6 months to 5 years):** <11 g/dL * **Children (5 to 11 years):** <11.5 g/dL * **Children (12 to 14 years):** <12 g/dL * **Anemia Mukt Bharat (AMB) Strategy:** Uses a "6x6x6" strategy to combat anemia in India, targeting six age groups with six interventions and six institutional mechanisms.

Question 437: What is the level of dietary fibre intake above which it is considered harmful to humans?

A. 30 g
B. 40 g
C. 50 g
D. 60 g (Correct Answer)

Explanation: **Explanation:** Dietary fibre consists of non-digestible carbohydrates that provide numerous health benefits, including improved glycemic control and bowel regularity. However, excessive intake can lead to adverse nutritional consequences. **Why 60 g is the correct answer:** According to the World Health Organization (WHO) and various nutritional guidelines (including ICMR), the recommended daily intake of dietary fibre is approximately **25–40 g/day**. Intake exceeding **60 g/day** is considered harmful. At this high level, the fibre acts as an anti-nutrient by binding to essential minerals (such as calcium, iron, zinc, and magnesium) and increasing their excretion. Furthermore, extreme fibre intake can lead to intestinal malabsorption, severe abdominal bloating, and potential bowel obstruction if fluid intake is inadequate. **Analysis of Incorrect Options:** * **A (30 g) & B (40 g):** These values represent the **optimal/recommended** range for healthy adults. Consuming fibre at these levels is associated with a reduced risk of coronary heart disease, Type 2 diabetes, and colorectal cancer. * **C (50 g):** While this is a high intake, it is generally tolerated by most individuals without significant clinical toxicity or mineral depletion, provided the transition to high fibre is gradual. **High-Yield Facts for NEET-PG:** * **Recommended Intake:** 40 g per 2000 kcal (or roughly 25-40 g/day). * **Crude vs. Dietary Fibre:** Dietary fibre includes lignin and non-starch polysaccharides; Crude fibre is only the residue remaining after acid/alkaline treatment. * **Energy Value:** Dietary fibre provides approximately **2 kcal/g** due to fermentation in the colon. * **Clinical Pearl:** High-fibre diets are contraindicated in patients with intestinal strictures or acute exacerbations of inflammatory bowel disease (IBD).

Question 438: Niacin deficiency causes which of the following conditions?

A. Pellagra (Correct Answer)
B. Scurvy
C. Rickets
D. Lathyrism

Explanation: **Explanation:** **Niacin (Vitamin B3)** is a water-soluble vitamin essential for cellular metabolism as a precursor to NAD and NADP. Its deficiency leads to **Pellagra**, a systemic disease traditionally characterized by the **"4 Ds"**: 1. **Dermatitis:** Bilateral, symmetrical photosensitive rash (e.g., **Casal’s necklace** around the neck). 2. **Diarrhea:** Due to inflammation of the gastrointestinal mucosa. 3. **Dementia:** Including irritability, poor concentration, and delirium. 4. **Death:** If left untreated. **Analysis of Incorrect Options:** * **Scurvy (Option B):** Caused by **Vitamin C (Ascorbic acid)** deficiency. It presents with gingival bleeding, perifollicular hemorrhages, and impaired wound healing. * **Rickets (Option C):** Caused by **Vitamin D** deficiency in children (Osteomalacia in adults). It leads to defective mineralization of bones, resulting in bow legs and "rickety rosary." * **Lathyrism (Option D):** A nervous system disorder (Neurolathyrism) caused by the chronic consumption of **Khesari Dal (*Lathyrus sativus*)**, which contains the neurotoxin **BOAA**. **High-Yield Clinical Pearls for NEET-PG:** * **Tryptophan Connection:** Niacin can be synthesized from the amino acid Tryptophan (60 mg Tryptophan = 1 mg Niacin). * **Maize/Jowar Link:** Pellagra is common in populations dependent on Maize (low in Tryptophan and bound Niacin) or Jowar (high Leucine levels interfere with Niacin synthesis). * **Hartnup Disease:** A genetic disorder of tryptophan absorption that can present with pellagra-like symptoms.

Question 439: What is the percent of total energy supplied by fish protein (PE % Kcal)?

A. 20%
B. 40%
C. 60%
D. 80% (Correct Answer)

Explanation: ***80%*** - Fish is a **high-quality protein source** with minimal carbohydrates and fats, making protein contribute approximately **80% of total calories**. - This high **PE% Kcal** makes fish an excellent source for meeting **protein requirements** with relatively few calories. *20%* - This percentage is too low for fish protein and more representative of **mixed diets** or **carbohydrate-rich foods**. - Fish has much higher protein density compared to foods that would yield only **20% protein energy**. *40%* - This value is closer to **mixed protein sources** like eggs (~35%) but significantly underestimates fish protein contribution. - Fish has **minimal non-protein calories** from carbohydrates, making this percentage inadequate. *60%* - While higher than many foods, this still underestimates the **protein energy percentage** of fish. - Fish has very low **carbohydrate content** and moderate fat, allowing protein to dominate the caloric contribution more than 60%.

Question 440: Which of the following is not present in pulses?

A. Lysine
B. Cysteine (Correct Answer)
C. Arginine
D. Protein

Explanation: **Explanation:** The correct answer is **Cysteine** (Option B). Pulses (legumes) are a vital source of dietary protein, especially in vegetarian populations. However, they are characterized by a specific amino acid profile that makes them an "incomplete" protein source. 1. **Why Cysteine is the correct answer:** Pulses are notoriously deficient in **sulfur-containing amino acids**, specifically **Methionine and Cysteine**. In the context of NEET-PG, Methionine is the most frequently cited deficiency, but Cysteine is also lacking. 2. **Why other options are incorrect:** * **Lysine:** Pulses are **rich in Lysine**. This is clinically significant because cereals (wheat, rice) are deficient in Lysine but rich in Methionine. * **Arginine:** This is a non-essential/semi-essential amino acid that is present in pulses. * **Protein:** Pulses are a major source of plant-based protein, typically containing **20-25% protein** by weight (Soybean being the highest at ~40%). **High-Yield NEET-PG Pearls:** * **Mutual Supplementation (Pulse-Cereal Mix):** To achieve a "complete" protein profile (Biological Value), pulses and cereals should be consumed together in a **1:4 ratio**. The Lysine from pulses compensates for the deficiency in cereals, while the Methionine from cereals compensates for the deficiency in pulses. * **Limiting Amino Acid:** The amino acid in shortest supply in a food is called the "limiting amino acid." For pulses, it is **Methionine**; for cereals, it is **Lysine**; for maize, it is **Tryptophan**. * **Anti-nutritional factors:** Pulses often contain phytates and tannins which can inhibit mineral absorption.

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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