Nutrition and Health — MCQs

Nutrition and Health Indian Medical PG Practice Questions and MCQs

Question 581: Best indicator of protein-energy malnutrition in community?

A. Mid-arm circumference (Correct Answer)
B. Weight for height
C. Height for age
D. Weight for age

Explanation: ***Mid-arm circumference (MUAC)*** - **Best indicator for community-level screening** of protein-energy malnutrition, as recommended by WHO - Simple to measure with MUAC tape, requiring **minimal training** for community health workers - Does not require complex equipment or calculations, making it ideal for **field conditions** - Strong predictor of **mortality risk** in malnourished children - Can be rapidly deployed in **mass screening programs** and emergency situations - Age-independent between 6-59 months, simplifying community surveys *Weight for height* - Excellent indicator for **clinical/facility-based assessment** of acute malnutrition (wasting) - Requires accurate height/weight measurement equipment and trained personnel - More **time-consuming and complex** for large-scale community screening - Better suited for individual clinical diagnosis rather than community-wide surveys *Weight for age* - Reflects **composite measure** of both acute and chronic malnutrition (underweight) - Cannot differentiate between wasting and stunting - Less specific for identifying current protein-energy deficits - Used in growth monitoring programs but not the best for community PEM screening *Height for age* - Measures **chronic malnutrition (stunting)**, not acute protein-energy deficits - Reflects long-term nutritional status rather than current PEM - Important for longitudinal growth monitoring but not for acute PEM identification

Question 582: What is the best indicator for monitoring iodine deficiency in a population?

A. TSH levels
B. Serum iodine
C. Thyroid size
D. Urinary iodine level (Correct Answer)

Explanation: ***Urinary iodine level*** - **Urinary iodine concentration** is the most widely used and reliable indicator for assessing **iodine nutrition status** in a population. - It reflects recent iodine intake, as more than 90% of ingested iodine is excreted in the urine within 24–48 hours. *TSH levels* - **TSH levels** are useful for screening **congenital hypothyroidism** in neonates or detecting **severe iodine deficiency** in populations. - However, TSH levels may not be sensitive enough to detect **mild to moderate iodine deficiency** in older children and adults. *Serum iodine* - **Serum iodine** is not a good indicator of iodine status because it is subject to **rapid fluctuations** based on recent dietary intake. - It does not accurately reflect the **body's iodine stores** or overall iodine nutritional status. *Thyroid size* - **Thyroid size**, assessed by palpation or ultrasound, can indicate **chronic iodine deficiency** leading to **goiter**. - However, it is a less sensitive and specific indicator compared to urinary iodine, as goiter can have **other causes** and may not develop in all individuals with iodine deficiency.

Question 583: Which of the following anthropometric indicators best reflects acute malnutrition (wasting) in children?

A. Weight for height (Correct Answer)
B. Height for age
C. BMI for age
D. Weight for age

Explanation: ***Weight for height*** - **Weight for height** directly measures a child's **current weight** relative to their **height**, providing a snapshot of their nutritional status. - A low weight for height indicates **wasting**, which is a sign of **acute malnutrition** resulting from recent or rapid weight loss. *Height for age* - **Height for age** measures the child's **height** relative to standard measurements for children of the same age. - A low height for age indicates **stunting**, which is a chronic nutritional problem reflecting **long-term malnutrition**. *BMI for age* - **BMI for age** can be used as an indicator for both **underweight** and **overweight** in children over 2 years of age. - While it reflects nutritional status, **weight-for-height** is generally considered a more direct and sensitive indicator for **acute malnutrition** (wasting) in young children. *Weight for age* - **Weight for age** measures the overall nutritional status by comparing a child's **weight** to that of a reference population of the same age. - It reflects both **acute and chronic malnutrition** (underweight) but cannot distinguish between wasting and stunting alone.

Question 584: Which program is associated with providing fortified foods to school-aged children to address malnutrition?

A. Mid-Day Meal Scheme (Correct Answer)
B. Integrated Child Development Services
C. National Nutrition Mission
D. Food Safety and Standards Authority of India

Explanation: ***Mid-Day Meal Scheme (PM POSHAN)*** - This program provides **fortified hot cooked meals** to children in government and government-aided schools (Classes 1-8) to improve their nutritional status. - The meals are **fortified with micronutrients** including iron, folic acid, and vitamin A to combat **malnutrition** and micronutrient deficiencies. - The focus is on combating **malnutrition** in **school-aged children** and encouraging school attendance by offering a balanced meal. - This directly addresses the question's requirement for a program providing fortified foods to school-aged children. *Integrated Child Development Services (ICDS)* - ICDS primarily focuses on children **under six years old** (pre-school age), pregnant women, and lactating mothers, not specifically school-aged children. - It offers a package of services including **supplementary nutrition**, immunization, health check-ups, and pre-school education. - While it provides nutrition, it targets a different age group than the question specifies. *National Nutrition Mission (POSHAN Abhiyaan)* - This is an overarching mission designed to improve nutritional outcomes across various age groups, not a specific food provision program. - It aims to reduce **stunting**, underweight, anemia, and low birth weight through a **convergent approach** that coordinates multiple programs. - It's an umbrella strategy rather than a direct food delivery program. *Food Safety and Standards Authority of India (FSSAI)* - FSSAI is a regulatory body responsible for **food safety standards** and consumer protection. - Its role is to ensure food quality and safety across India, not directly implement food provision programs for specific population groups. - It sets standards but doesn't operate feeding programs.

Question 585: What is the primary goal of the Mid-Day Meal Scheme?

A. Increase school attendance only
B. Improve the nutritional status of school-age children only
C. Provide employment to local women
D. Both increase school attendance and improve nutritional status of school-age children (Correct Answer)

Explanation: ***Both increase school attendance and improve nutritional status of school-age children*** - The Mid-Day Meal Scheme (now PM-POSHAN) has **dual primary objectives**: to **attract children to school and retain them**, and to **improve their nutritional levels**. - By providing a free meal, the scheme addresses both **food insecurity** and **educational access**, particularly for vulnerable populations. - This is explicitly stated in the scheme's objectives and has been documented to achieve both outcomes. *Increase school attendance only* - While increasing school attendance is a significant goal, it is not the **sole purpose** of the scheme. - The program also places strong emphasis on addressing **malnutrition** among schoolchildren. *Improve the nutritional status of school-age children only* - Improving nutritional status is a crucial objective, but it's not the **only outcome** sought by the scheme. - The meal provides an incentive for children to **enroll in and regularly attend school**. *Provide employment to local women* - While the scheme does provide **ancillary employment** to local women as cooks and helpers, this is a **secondary benefit**, not a primary goal. - The primary objectives remain focused on **education and nutrition** for children.

Question 586: What is the recommended concentration of iodine in iodized salt for consumers according to WHO guidelines?

A. 10 ppm
B. 15 ppm (Correct Answer)
C. 5 ppm
D. 20 ppm

Explanation: ***15 ppm*** - The **World Health Organization (WHO)** recommends a minimum iodine concentration of **15 parts per million (ppm)** in salt at the **consumer/household level** to ensure adequate population iodine intake. - This concentration ensures that consumers receive sufficient iodine to prevent **iodine deficiency disorders (IDD)** after accounting for losses during storage and transport from production to consumption. - At the **production level**, salt is fortified with 20-40 ppm to account for these inevitable losses, ensuring 15 ppm reaches the consumer. *20 ppm* - While 20 ppm is the WHO-recommended concentration at the **production level**, this is higher than what is expected at the consumer level. - The question specifically asks about consumer level, where 15 ppm is the minimum recommended concentration after accounting for losses during storage and distribution. *10 ppm* - An iodine concentration of 10 ppm at the consumer level is below the WHO's recommendations and would likely be inadequate to address **iodine deficiency** in a population. - Such low levels could lead to insufficient iodine intake and increased risk of **IDD**. *5 ppm* - A concentration of 5 ppm is far too low and would be ineffective in preventing **iodine deficiency disorders** on a population scale. - This level would not provide any meaningful public health benefit in terms of iodine supplementation.

Question 587: Which of the following interventions should be prioritized in the Anemia Mukt Bharat Programme to further reduce the prevalence of anemia?

A. Enhancing compliance and follow-up (Correct Answer)
B. Increasing the dosage of IFA supplementation
C. Discontinuing the program
D. Shifting focus to deworming interventions

Explanation: ***Enhancing compliance and follow-up*** - **Poor adherence** and a lack of systematic follow-up are major barriers to the effectiveness of existing anemia control programs. People often stop taking supplements due to side effects or lack of perceived benefit. - Strengthening mechanisms for regular monitoring, counseling, and addressing side effects can significantly improve the **uptake and efficacy of iron and folic acid (IFA) supplementation**. *Increasing the dosage of IFA supplementation* - While IFA supplementation is crucial, simply increasing the dosage without addressing **absorption issues**, **compliance**, or underlying causes of anemia may not lead to significant improvements. - Higher doses can also increase the risk of **gastrointestinal side effects**, potentially reducing compliance. *Discontinuing the program* - Anemia remains a **significant public health problem in India**, affecting various population groups, including women, children, and adolescents. - Discontinuing a program aimed at addressing such a widespread issue would likely lead to a **rebound or worsening prevalence of anemia** with severe health and economic consequences. *Shifting focus to deworming interventions* - **Deworming** is an important component of anemia control, particularly in areas with a high prevalence of soil-transmitted helminth infections, as these can cause chronic blood loss and nutrient malabsorption. - However, deworming is **not a standalone solution** for all forms of anemia (e.g., iron deficiency from inadequate dietary intake) and should be integrated within a comprehensive strategy rather than being the sole focus.

Question 588: According to the National Family Health Survey-5 (NFHS-5), what percentage of children under five years of age are stunted due to chronic undernutrition?

A. Approximately 10%
B. Approximately 20%
C. Approximately 30%
D. Approximately 35% (Correct Answer)

Explanation: ***Approximately 35%*** - According to the **National Family Health Survey-5 (NFHS-5)**, a significant proportion of children under five years of age in India are affected by stunting. - The survey reported that **35.5%** of children under five are stunted, indicating chronic undernutrition. *Approximately 10%* - This percentage is significantly lower than the actual figure reported by the NFHS-5 for stunting in children under five years of age. - While reflecting an ideal scenario, it does not represent the current prevalence of **chronic undernutrition** as per the survey data. *Approximately 20%* - This figure is below the actual prevalence of stunting documented by the NFHS-5, which indicates a higher burden of chronic malnutrition. - This percentage might be more aligned with rates of **wasting** (low weight-for-height), which represents acute malnutrition, rather than stunting. *Approximately 30%* - While closer to the correct figure, this percentage is still an underestimation of the stunting prevalence reported by the NFHS-5. - The actual data shows that a slightly higher proportion of children are affected by **stunting**, indicating a persistent public health challenge.

Question 589: A public health survey shows a high prevalence of goiter in a population. Which nutritional deficiency is most likely responsible?

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

Explanation: ***Correct: Iodine*** - **Iodine** is an essential component of thyroid hormones. A deficiency leads to decreased thyroid hormone production. - The thyroid gland compensates by **enlarging (goiter)** to try and capture more iodine, resulting in a visible swelling in the neck. - **Endemic goiter** in populations is a classic public health indicator of iodine deficiency, which is why iodized salt programs are implemented globally. *Incorrect: Iron* - **Iron deficiency** primarily causes **anemia**, leading to fatigue, weakness, and pallor, but it is not directly linked to goiter. - While iron is involved in thyroid hormone synthesis, its deficiency is not the primary cause of goiter. *Incorrect: Vitamin D* - **Vitamin D** plays a crucial role in **calcium and phosphate homeostasis** and bone health, and its deficiency can lead to rickets or osteomalacia. - It is not directly involved in thyroid hormone production or the pathogenesis of goiter. *Incorrect: Zinc* - **Zinc** is important for immune function, wound healing, and growth, and its deficiency can cause growth retardation, skin lesions, and impaired immunity. - Although zinc is a cofactor for some thyroid enzymes, it is not the primary nutritional deficiency responsible for goiter prevalence.

Question 590: What public health measure is recommended for the prevention of iodine deficiency disorders?

A. Universal salt iodization (Correct Answer)
B. Mass administration of iodine tablets
C. Dietary diversification to include more seafood
D. Fortification of water with iodine

Explanation: ***Universal salt iodization*** - **Universal salt iodization (USI)** is the most widely recognized and cost-effective public health strategy for preventing **iodine deficiency disorders (IDD)**. - It ensures a consistent, low-dose intake of iodine across the population through a staple food item, thus reaching a large number of individuals without requiring individual compliance. *Mass administration of iodine tablets* - **Mass administration of iodine tablets** is typically used in emergency situations, such as **nuclear incidents**, to block radioactive iodine uptake by the thyroid. - It is not a sustainable or practical long-term strategy for routine prevention of **iodine deficiency** in the general population due to concerns about overtreatment and compliance. *Dietary diversification to include more seafood* - While **seafood** is a good natural source of iodine, relying on **dietary diversification** alone is often insufficient to address widespread iodine deficiency, especially in landlocked or resource-poor regions. - This approach is challenging to implement universally and consistently across diverse populations and dietary habits. *Fortification of water with iodine* - **Fortification of water with iodine** is technically challenging due to concerns about the stability of iodine in water, potential for over- or under-dosing, and interactions with water purification processes. - **Salt iodization** is generally preferred because salt consumption is more uniform across populations and iodine is relatively stable when added to salt.

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

Want unlimited practice?

Get full access to all questions, explanations, and performance tracking.

Start For Free