Nutrition and Health — MCQs

Nutrition and Health Indian Medical PG Practice Questions and MCQs

Question 611: What is the Recommended Dietary Allowance (RDA) for iodine in adults?

A. 300 microgram
B. 500 microgram
C. 150 microgram (Correct Answer)
D. 50 microgram

Explanation: ***150 microgram*** - The **Recommended Dietary Allowance (RDA) for iodine in adults** is set at **150 micrograms (µg)** per day globally by organizations like the World Health Organization (WHO) and is adopted by many national dietary guidelines. - This amount is considered sufficient to maintain **normal thyroid function** and prevent iodine deficiency disorders in the majority of healthy adults. *300 microgram* - While a higher intake of iodine can be recommended in specific physiological states, such as **pregnancy and lactation** (often around 220-250 µg/day), 300 µg is generally above the standard RDA for healthy non-pregnant adults. - Consistently exceeding the **Upper Limit (UL)** for iodine intake (typically 1,100 µg/day) can lead to adverse effects like **iodine-induced hyperthyroidism or hypothyroidism**. *500 microgram* - An intake of 500 µg exceeds the RDA for healthy adults and approaches the **upper tolerable limits** for some individuals, potentially leading to adverse effects with prolonged consumption. - This level of iodine intake is typically not necessary for maintaining **euthyroid status** in most average adults without underlying conditions. *50 microgram* - An intake of **50 µg** per day is generally considered **insufficient** to meet the iodine requirements for most adults and would likely lead to an **iodine deficiency** over time. - Chronic intake at this level can increase the risk of developing **goiter**, **hypothyroidism**, and other **iodine deficiency disorders**.

Question 612: What is the role of iodized salt in the iodine deficiency control programme?

A. Primary prevention of iodine deficiency (Correct Answer)
B. Secondary prevention of iodine deficiency
C. Tertiary prevention of iodine deficiency
D. Not applicable

Explanation: ***Primary prevention of iodine deficiency*** - **Iodized salt** is a population-wide strategy to ensure adequate **iodine intake** in communities, preventing deficiency before it even occurs. - It aims to maintain normal **thyroid hormone** production and prevent disorders like **goiter** and **cretinism** in healthy individuals. *Secondary prevention of iodine deficiency* - **Secondary prevention** focuses on early diagnosis and prompt treatment in individuals already showing signs of a disease to prevent progression. - While screening for **iodine deficiency disorders (IDD)** might be secondary prevention, the universal use of iodized salt is not targeted at already deficient individuals but at the entire population. *Tertiary prevention of iodine deficiency* - **Tertiary prevention** involves managing existing conditions to prevent complications, reduce disability, and improve quality of life after a disease has manifested. - This would involve treating conditions like **severe hypothyroidism** or **cretinism** that result from prolonged iodine deficiency, for which **iodized salt** is not a direct treatment but a preventative measure. *Not applicable* - This option is incorrect as **iodized salt** plays a crucial and well-established role in public health for controlling **iodine deficiency**. - The scientific evidence and public health initiatives globally highlight its significant applicability in preventing **iodine deficiency disorders**.

Question 613: What are the recommended iodine levels in iodized salt at production and consumer levels?

A. 20 & 10 PPM
B. 30 & 10 PPM
C. 30 & 15 PPM (Correct Answer)
D. 30 & 20 PPM

Explanation: **30 & 15 PPM** - As per the **WHO**, **UNICEF**, and **ICCIDD guidelines**, iodized salt should contain **30 ppm** of iodine at the **production level** to ensure adequate intake. - Due to losses during storage, transport, and cooking, a minimum of **15 ppm** of iodine is recommended at the **consumer level** to meet the daily iodine requirements. *20 & 10 PPM* - These levels are **lower** than the international recommendations and may not be sufficient to prevent **iodine deficiency disorders** effectively. - Insufficient iodine content can lead to continued public health challenges despite salt iodization. *30 & 10 PPM* - While **30 ppm** at the production level is appropriate, **10 ppm** at the consumer level is **too low**. - A 10 ppm concentration at the consumer level would likely result in an inadequate iodine intake for the population, leaving a significant gap in daily requirements. *30 & 20 PPM* - While **30 ppm** at the production level is correct, **20 ppm** at the consumer level is **higher** than the recommended minimum. - While it ensures sufficiency, the 15 ppm minimum is established to strike a balance between efficacy and cost-effectiveness.

Question 614: What is the key characteristic of Body Mass Index (BMI) considerations for the Asian population?

A. Increased morbidity at lower values (Correct Answer)
B. BMI cut-offs for obesity differ from international standards
C. Increased morbidity at higher BMI values
D. Obesity is defined as > 25 kg/m2

Explanation: ***Increased morbidity at lower values*** - Due to differences in body composition and fat distribution, Asian populations tend to experience **higher risks of developing obesity-related diseases** (e.g., type 2 diabetes, cardiovascular disease) at **lower BMI values** compared to non-Asian populations. - This increased morbidity at lower BMI values highlights the need for population-specific BMI cut-offs for health risk assessment. *BMI cut-offs for obesity differ from international standards* - While it is true that **BMI cut-offs for obesity differ for Asian populations**, this option does not fully describe *why* these cut-offs differ. - The difference in cut-offs is precisely *because* increased morbidity is seen at lower BMI values, making this option less specific than the correct answer. *Increased morbidity at higher BMI values* - While morbidity does increase at higher BMI values in all populations, this statement is **true for Caucasians and other populations**, but the defining characteristic for Asian populations is the *lower* BMI at which morbidity risk begins to significantly increase. - This option does not capture the unique aspect of BMI and health risks in the Asian population. *Obesity is defined as > 25 kg/m2* - For many Asian populations, a BMI of **> 25 kg/m²** is often used as the cut-off for **overweight**, not necessarily obesity, and **obesity is often defined at > 27.5 kg/m² or 30 kg/m² depending on the specific group**. - The international standard for obesity (BMI ≥ 30 kg/m²) is often considered too high for many Asian populations to capture risk effectively.

Question 615: How much cereal do students in primary classes (I-V) receive per day under the Mid Day Meal Program (PM POSHAN)?

A. 75 grams
B. 100 grams (Correct Answer)
C. 150 grams
D. 50 grams

Explanation: ***100 grams*** - Under the **PM POSHAN (erstwhile Mid Day Meal) scheme**, students in **primary classes (I-V)** receive **100 grams of cereals** per day. - This quantity is designed to provide a significant portion of their daily nutritional requirements, contributing to **450-500 kcal of energy** and **12 grams of protein**. - This is the current guideline as per the scheme norms. *75 grams* - This quantity represents **outdated norms** from earlier versions of the Mid Day Meal Program. - The current scheme has **revised upward** the cereal allocation to meet the increased nutritional needs of growing children. *50 grams* - This quantity is **significantly lower** than prescribed standards for the PM POSHAN scheme. - Providing only 50 grams would result in **insufficient caloric intake** and fail to meet the program's nutritional objectives. *150 grams* - While 150 grams of cereals are prescribed for students in **upper primary classes (VI-VIII)**, it is **not the correct amount for primary students (I-V)**. - The question specifically asks about primary class students, for whom 100 grams is the prescribed quantity.

Question 616: What is the primary strategy of the Iodine Deficiency Control Programme?

A. Health education
B. Water testing
C. Fortification of salt (Correct Answer)
D. Iodine supplementation

Explanation: ***Fortification of salt*** - **Iodization of salt** is the most cost-effective and widely implemented strategy globally to prevent and control iodine deficiency disorders (IDDs), ensuring a consistent intake of iodine in the population. - This public health intervention targets a staple food item, making it accessible to a broad population regardless of socioeconomic status. - **India's National Iodine Deficiency Disorders Control Programme (NIDDCP)** mandates universal salt iodization as the primary strategy. *Health education* - While important for promoting the consumption of iodized salt and understanding the benefits, it is a **supportive measure** rather than the primary strategy for ensuring widespread iodine intake. - Health education alone cannot guarantee the universal availability and consumption of iodine, especially in areas where iodized salt is not readily supplied. *Water testing* - **Testing water for iodine content** is not a primary strategy as water is generally not a significant source of dietary iodine, and iodine deficiency is primarily addressed through food fortification. - Water quality testing is typically for contaminants and minerals affecting health, not specifically for iodine deficiency control. *Iodine supplementation* - While supplementation (iodized oil capsules) is used in **specific high-risk groups** or areas with severe deficiency, it is not sustainable as a universal primary strategy. - Supplementation requires active distribution and monitoring, making it less cost-effective than salt fortification for population-wide coverage.

Question 617: Anthropometric assessment, which does not show much change over a period of 1-4 years, is characteristic of:

A. Chest-to-head circumference ratio (Correct Answer)
B. Mid arm circumference
C. Skin fold thickness
D. Height

Explanation: ***Chest-to-head circumference ratio*** - **Chest-to-head circumference ratio remains relatively stable between 1-4 years of age** after the initial crossover period. - At birth, head circumference is greater than chest circumference. - At approximately **6-12 months**, the two measurements equalize, and chest circumference exceeds head circumference. - **After 1 year of age, this ratio stabilizes** and remains relatively constant throughout the 1-4 year period, making it a useful stable reference point. - This stability makes it less useful for detecting acute changes but confirms normal proportionate growth. *Mid arm circumference* - Mid-arm circumference (MAC) is used to assess nutritional status but **does show changes during the 1-4 year growth period**. - MAC typically ranges from 14-16 cm in this age group and increases with normal growth. - It is **sensitive to acute malnutrition** and can fluctuate with nutritional status, making it less stable over time. *Height* - Height is a dynamic measure that **changes significantly during childhood**. - Children grow approximately 10-12 cm per year between ages 1-4 years. - Height is used to assess **chronic malnutrition (stunting)** and shows continuous change, not stability. *Skin fold thickness* - Skin fold thickness (e.g., triceps skin fold) measures subcutaneous fat and reflects nutritional status. - It is **variable based on calorie intake, physical activity, and nutritional fluctuations**. - It does not remain stable over the 1-4 year period and is used to detect changes in fat stores.

Question 618: Quetelet's index, used to assess obesity, is represented as:

A. Weight divided by height
B. Height divided by weight
C. Weight divided by the square of height (Correct Answer)
D. Height divided by the square of weight

Explanation: ***Weight divided by the square of height*** - **Quetelet's index**, more commonly known as **Body Mass Index (BMI)**, is calculated as an individual's **weight in kilograms** divided by the **square of their height in meters**. - This formula provides a standardized measure for assessing whether a person's weight is healthy for their height, indicating categories like **underweight, normal weight, overweight, or obese**. *Weight divided by height* - This formula yields a linear ratio of weight to height, which does not accurately account for the increasing surface area of the body with height. - It would disproportionately classify taller individuals as heavier (and vice versa) even if their proportions are healthy. *Height divided by weight* - This inversion of the ratio would give a smaller value for heavier individuals, making it unsuitable for assessing obesity. - It would not align with established health metrics for weight assessment. *Height divided by the square of weight* - This formula would result in very small numbers, particularly for heavier individuals, and is not a recognized or validated measure for assessing body composition or obesity. - Squaring the weight in the denominator creates an exaggerated inverse relationship, rendering it clinically meaningless.

Question 619: What is the BMI of a person who is 1.72 meters tall and weighs 89 kilograms?

A. 30 (Correct Answer)
B. 25
C. 27
D. 33.5

Explanation: ***30*** - The Body Mass Index (BMI) is calculated using the formula: **BMI = weight (kg) / (height (m))^2**. - In this case, BMI = 89 kg / (1.72 m)^2 = 89 / 2.9584 ≈ **30.08**, which rounds to 30. - This falls into the **obese class I category** (BMI ≥ 30.0). *25* - This BMI represents the **threshold between normal weight and overweight** according to WHO classification. - BMI 18.5-24.9 is normal; BMI ≥ 25.0 is overweight. A BMI of exactly 25 marks this boundary. - A BMI of 25 would be achieved with a weight of approximately 74 kg for this height (25 × 1.72² = 74 kg). *27* - This BMI falls within the **overweight category** (25.0-29.9), but it is not the precise calculation for the given weight and height. - A BMI of 27 would be achieved with a weight of approximately 79.9 kg for this height (27 × 1.72² = 79.9 kg). *33.5* - This BMI falls within the **obese class I category** (30.0-34.9), but it is a higher value than the actual calculation for the given weight and height. - This BMI would correspond to a weight of approximately 99 kg for this height (33.5 × 1.72² = 99.1 kg).

Question 620: Which index of obesity does not include height?

A. BMI
B. Broca's index
C. Ponderal's index
D. Waist circumference (Correct Answer)

Explanation: ***Waist circumference*** - **Waist circumference** directly measures abdominal fat accumulation, which is a significant indicator of health risk independent of height. - It does not incorporate height in its calculation, making it a simple and practical tool for assessing **central obesity**. *BMI* - **Body Mass Index (BMI)** is calculated using a person's **weight in kilograms divided by the square of their height in meters** (kg/m²). - Therefore, height is an integral component of the BMI calculation. *Ponderal's index* - **Ponderal's index** (also known as the Rohrer Index) is calculated as **weight in kilograms divided by the cube of height in meters** (kg/m³). - This index explicitly includes height as a cubed variable in its formula. *Broca's index* - **Broca's index** estimates ideal body weight based on height (ideal weight in kg = height in cm - 100). - It is directly dependent on height for its calculation.

Practice by Chapter

Basic Nutritional Requirements

Practice Questions

Assessment of Nutritional Status

Practice Questions

Protein-Energy Malnutrition

Practice Questions

Micronutrient Deficiencies

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Nutritional Programs in India

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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

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Nutrition in Emergencies

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Food Fortification and Supplementation

Practice Questions

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