Nutrition and Health Practice Questions

Q: What is the estimated daily energy requirement (in kcal/day) for a female engaged in heavy manual labor?

2850. ### Explanation The energy requirement of an individual is determined by their age, sex, body weight, and level of physical activity. According to the **ICMR-NIN (2020) guidelines**, energy requirements for adults are categorized based on physical activity levels: Sedentary, Moderate, and Heavy. **1. Why Option C (2850) is Correct:** For an adult female (ideal body weight of 55 kg) engaged in **heavy work** (e.g., construction workers, manual laborers), the Recommended Dietary Allowance (RDA) for energy is **2850 kcal/day**. This higher caloric intake is necessary to compensate for the high Total Energy Expenditure (TEE) associated with strenuous physical exertion. **2. Analysis of Incorrect Options:** * **Option A (1900 kcal/day):** This is the RDA for an adult female engaged in **sedentary work** (e.g., office workers, teachers). * **Option B (2230 kcal/day):** This is the RDA for an adult female engaged in **moderate work** (e.g., domestic help, weavers). * **Option D (3730 kcal/day):** This value corresponds to the energy requirement for an **adult male** engaged in **heavy work** (males have higher basal metabolic rates and muscle mass). **3. High-Yield Clinical Pearls for NEET-PG:** * **Reference Body Weight (ICMR 2020):** Adult Male = 65 kg; Adult Female = 55 kg. * **Pregnancy:** Add **+350 kcal/day** (2nd trimester) and **+400 kcal/day** (3rd trimester) to the basic requirement. * **Lactation:** Add **+600 kcal/day** (0–6 months) and **+520 kcal/day** (6–12 months). * **Male Energy Requirements:** Sedentary (2110 kcal), Moderate (2710 kcal), Heavy (3480 kcal). *Note: Older 2010 guidelines cited 3800 kcal for heavy work, but 2020 updates revised these values.*

Q: Which cooking oil has the most polyunsaturated fatty acids (PUFA)?

Safflower oil. **Explanation:** The core concept tested here is the classification of dietary fats based on their saturation levels. **Safflower oil** is the correct answer because it contains the highest concentration of Polyunsaturated Fatty Acids (PUFA), specifically Linoleic acid (Omega-6), among common cooking oils. It typically contains approximately **73–75% PUFA**, making it a potent agent for lowering serum cholesterol levels. **Analysis of Options:** * **Safflower oil (Correct):** Highest PUFA content (~75%). It is often the "gold standard" in exams for high PUFA content, followed closely by Sunflower and Soya bean oils. * **Coconut oil:** This is a **Saturated Fatty Acid (SFA)** powerhouse (approx. 90% SFA). It contains very little PUFA (approx. 2%) and is unique due to its high Medium Chain Triglyceride (MCT) content. * **Butter:** An animal fat predominantly composed of **Saturated Fatty Acids** and cholesterol. It contains minimal PUFA. * **Vanaspati:** This is vegetable oil that has undergone **hydrogenation**. It is high in Saturated Fats and, more importantly, **Trans-fatty acids**, which are atherogenic. **High-Yield NEET-PG Pearls:** 1. **PUFA Hierarchy:** Safflower (75%) > Sunflower (60%) > Soya bean (55%) > Corn oil (50%). 2. **P/S Ratio:** The recommended Polyunsaturated to Saturated fat ratio in a balanced diet is **0.8 to 1.0**. 3. **Essential Fatty Acids:** Linoleic acid (n-6) and Alpha-linolenic acid (n-3) cannot be synthesized by the body and must be obtained from oils like Safflower or Mustard oil. 4. **Clinical Note:** While high PUFA oils lower LDL (bad cholesterol), excessive intake can also lower HDL (good cholesterol). Therefore, a blend of oils is often recommended.

Q: What is an important point for a prudent diet?

Dietary fat should be limited to 20-30% of total intake. ### Explanation A **Prudent Diet** refers to a balanced dietary pattern designed to reduce the risk of non-communicable diseases (NCDs) like obesity, hypertension, and cardiovascular diseases. **1. Why Option B is Correct:** According to WHO and nutritional guidelines for a prudent diet, total dietary fat should be restricted to **20–30% of the total energy intake**. This range ensures sufficient intake of essential fatty acids while preventing excessive caloric density that leads to metabolic syndrome. **2. Analysis of Incorrect Options:** * **Option A:** In a prudent diet, it is **Saturated Fats** that should be limited to less than 10% of total energy intake. Unsaturated fats (MUFAs and PUFAs) are actually encouraged as substitutes for saturated fats to improve lipid profiles. * **Option C:** A prudent diet emphasizes the **increase** of complex carbohydrates (like whole grains, legumes, and fiber) and the **avoidance of refined/simple sugars** (which should be <10% of total energy). * **Option D:** Proteins should typically account for **10–15%** of the total daily energy intake. A diet where proteins account for 50–60% is physiologically unsustainable and potentially harmful to renal function. **3. High-Yield Clinical Pearls for NEET-PG:** * **Salt Intake:** Should be limited to less than **5g per day** to prevent hypertension. * **Dietary Fiber:** Recommended intake is **~40g/2000 kcal**. * **Cholesterol:** Dietary cholesterol should be restricted to below **300 mg/day**. * **PUFA/SFA Ratio:** The ideal ratio in a balanced diet should be between **0.8 and 1.0**. * **Free Sugars:** Should ideally be less than **5%** of total energy for additional health benefits.

Q: Which of the following is considered a primary source of iron for economically disadvantaged populations?

Jaggery. **Explanation:** **Why Jaggery is the Correct Answer:** In the context of public health and community medicine, Jaggery (unrefined sugar) is a vital source of non-heme iron for economically disadvantaged populations. It contains approximately **11 mg of iron per 100g**. Its significance lies in its **affordability, cultural acceptance, and accessibility** compared to expensive animal-based heme iron sources. In India, it is frequently recommended in nutritional programs to combat Iron Deficiency Anemia (IDA) among pregnant women and children in rural settings. **Analysis of Incorrect Options:** * **Soybeans:** While soybeans are rich in protein and contain iron, they also contain high levels of **phytates**, which significantly inhibit iron absorption. They are not the primary "go-to" source for iron supplementation in low-SES groups compared to jaggery. * **Oranges:** Oranges are a source of Vitamin C (Ascorbic acid). While they do not provide iron themselves, they are crucial for **enhancing the absorption** of non-heme iron when consumed with meals. * **Almonds:** Almonds are nutrient-dense but are **prohibitively expensive** for economically disadvantaged populations, making them an impractical primary source for public health interventions. **High-Yield NEET-PG Pearls:** * **Enhancers of Iron Absorption:** Vitamin C (Ascorbic acid), meat protein, and gastric acid. * **Inhibitors of Iron Absorption:** Phytates (cereals), Oxalates (spinach), Tannins (tea), Calcium, and Phosphates. * **National Iron Plus Initiative (NIPI):** Remember the dosage for "WIFS" (Weekly Iron Folic Acid Supplementation)—100 mg elemental iron and 500 µg folic acid for adolescents. * **Best Source:** While liver is the richest source of iron, Jaggery is the most "cost-effective" source for the masses.

Q: At what age is Vitamin A supplementation recommended?

9 months. **Explanation:** **1. Why 9 Months is Correct:** Under the National Immunization Schedule (NIS) in India, Vitamin A supplementation begins at **9 completed months**, administered along with the **Measles/MR vaccine**. This timing is strategic because maternal antibodies against Measles begin to wane around this age, increasing the risk of infection. Measles is a major cause of Vitamin A depletion, which can lead to xerophthalmia and increased childhood mortality. The first dose is **1 lakh IU (1 ml)**, given orally. **2. Why Other Options are Incorrect:** * **A. 2 months:** At this age, infants are typically breastfed. Exclusive breastfeeding provides sufficient Vitamin A for the first six months of life. Supplementation is not indicated this early. * **C. 5-6 years:** While Vitamin A prophylaxis continues until age 5, it does not *start* here. The program includes a total of 9 doses: the first at 9 months, the second at 18 months (2 lakh IU), and subsequent doses every 6 months until the child reaches 5 years of age. **3. High-Yield Clinical Pearls for NEET-PG:** * **Total Doses:** A child receives a total of **9 doses** (17 lakh IU total) by age 5. * **Dosage:** 1st dose = 1 lakh IU; 2nd to 9th doses = 2 lakh IU each. * **Target Group:** The Vitamin A Prophylaxis Programme targets children aged 9–59 months. * **Therapeutic Dose:** If a child presents with active Xerophthalmia (e.g., Bitot’s spots), the treatment schedule is: **Day 0, Day 1, and Day 14** (2 lakh IU per dose for children >1 year). * **Public Health Impact:** Vitamin A supplementation can reduce all-cause child mortality by up to 23-24% in deficient areas.

Q: Which of the following is considered the first immunization for a newborn?

Colostrum. **Explanation:** **Colostrum** is the correct answer because it is biologically referred to as the **"first immunization"** of the newborn. It is the thick, yellowish milk secreted by the mammary glands during the first 2–3 days after delivery. It is exceptionally rich in **Secretory IgA (Immunoglobulin A)**, which coats the infant's intestinal mucosa, providing passive immunity and protecting against enteric and respiratory pathogens. It also contains high concentrations of lactoferrin, lysozymes, and macrophages. **Analysis of Incorrect Options:** * **Option B (Handing over the baby):** While essential for "Skin-to-Skin" contact (Kangaroo Mother Care) and bonding, it does not provide immunological protection. * **Option C (OPV):** Though the "Zero Dose" of OPV is given at birth, it is an artificial active immunization. Colostrum is considered the natural, primary immunological shield. * **Option D (DPT + BCG):** BCG is given at birth, but DPT is never given at birth (it starts at 6 weeks). Neither constitutes the "first" protection compared to the immediate availability of colostrum. **High-Yield NEET-PG Pearls:** * **Immunoglobulin Profile:** Colostrum is richest in **IgA**. In contrast, the immunoglobulin that crosses the placenta is **IgG**. * **Nutritional Value:** Compared to mature milk, colostrum has more protein, vitamins (A, D, E, K), and minerals, but **less fat and lactose**. * **Purgative Action:** Colostrum helps in the passage of **meconium**, preventing early neonatal jaundice. * **WHO Recommendation:** Exclusive breastfeeding should be initiated within **one hour** of birth.

Q: Cereal protein is deficient in which amino acid?

Lysine. **Explanation:** The nutritional quality of a protein is determined by its **limiting amino acid**, which is the essential amino acid present in the smallest amount relative to human requirements. **1. Why Lysine is Correct:** Cereals (such as wheat, rice, and maize) are the primary source of energy in the Indian diet. However, they are universally **deficient in Lysine**. Conversely, cereals are relatively rich in methionine and cysteine (sulfur-containing amino acids). To achieve a "complete protein" profile, cereals are traditionally consumed with pulses (dal), which are rich in lysine but deficient in methionine. This is known as the **supplementary action of proteins**. **2. Analysis of Incorrect Options:** * **Leucine (A):** Most cereals contain adequate leucine. Notably, **Maize (Corn)** and **Jowar (Sorghum)** contain high levels of leucine. An excess of leucine can interfere with tryptophan metabolism, leading to Pellagra. * **Phenylalanine (C):** This is an essential amino acid generally found in sufficient quantities in most cereal grains. * **Tryptophan (D):** While most cereals have adequate tryptophan, **Maize** is uniquely deficient in both **Lysine and Tryptophan**. However, for the general category of "cereals," Lysine remains the primary deficiency. **3. High-Yield Clinical Pearls for NEET-PG:** * **Limiting Amino Acid in Pulses:** Methionine. * **Limiting Amino Acid in Cereals:** Lysine. * **The "Maize-Pellagra" Connection:** Maize is deficient in Tryptophan (a precursor to Niacin) and high in Leucine (which inhibits Niacin synthesis), leading to Niacin deficiency (Pellagra). * **Reference Protein:** Egg protein is considered the "standard" or reference protein (Biological Value = 100) because it contains all essential amino acids in the right proportions.

Q: Which amino acid is deficient in maize?

Tryptophan. **Explanation:** The nutritional quality of a cereal is determined by its limiting amino acids. **Maize (corn)** is notoriously deficient in two essential amino acids: **Tryptophan** and **Lysine**. 1. **Why Tryptophan is the correct answer:** Tryptophan is the precursor for the synthesis of Niacin (Vitamin B3). In populations where maize is the staple diet, the lack of dietary tryptophan leads to a secondary deficiency of Niacin. This clinically manifests as **Pellagra**, characterized by the "4 Ds": Dermatitis (Casal’s necklace), Diarrhea, Dementia, and Death. 2. **Why the other options are incorrect:** * **Threonine:** This is generally not a limiting amino acid in major cereals like maize or wheat. * **Methionine:** This is a sulfur-containing amino acid. While pulses (legumes) are deficient in Methionine, cereals are actually **rich in Methionine**. This is the basis for "Pulse-Cereal supplementation" to achieve a balanced protein profile. * **Leucine:** Maize actually contains **high levels of Leucine**. High leucine levels interfere with the conversion of tryptophan to niacin, further exacerbating the risk of Pellagra in maize eaters. **High-Yield Clinical Pearls for NEET-PG:** * **Limiting Amino Acids:** * Cereals (Rice, Wheat, Maize): Deficient in **Lysine**. * Pulses: Deficient in **Methionine**. * Maize (Specific): Deficient in **Tryptophan AND Lysine**. * **Pellagra Association:** Always associate a "Maize-based diet" with Tryptophan deficiency and Pellagra. * **Fortification:** To improve the biological value of maize, it is often fortified with lysine and tryptophan (e.g., Quality Protein Maize).

Q: The '12 by 12' initiative is primarily directed at:

Anaemia. The **'12 by 12' initiative** is a strategic collaboration between the Government of India (Ministry of Health and Family Welfare), WHO, and UNICEF. The primary objective is to ensure that every child in India achieves a **haemoglobin level of 12 g/dL by the age of 12 years**. ### Why Anaemia is Correct Iron Deficiency Anaemia (IDA) is a significant public health challenge in India, particularly among adolescents. This initiative targets the "second window of opportunity" (adolescence) to correct nutritional deficiencies before girls enter their reproductive years. By ensuring a Hb level of 12 g/dL by age 12, the program aims to reduce the prevalence of low birth weight and maternal mortality in the future. ### Why Other Options are Incorrect * **Population Control:** While a major focus of the National Health Mission, population control is addressed through the *Mission Parivar Vikas* and various contraceptive schemes, not the '12 by 12' initiative. * **Literacy:** Literacy is managed under the *Sarva Shiksha Abhiyan* and the Ministry of Education. * **Rural Electricity:** This falls under infrastructure development (e.g., *Deen Dayal Upadhyaya Gram Jyoti Yojana*), not health-specific initiatives. ### High-Yield Clinical Pearls for NEET-PG * **Target Group:** Specifically focuses on adolescents (boys and girls) to break the intergenerational cycle of anaemia. * **Anemia Mukt Bharat (AMB):** This is the broader current strategy using a **6x6x6 framework** (6 target groups, 6 interventions, 6 institutional mechanisms). * **Prophylaxis:** Under the Weekly Iron and Folic Acid Supplementation (WIFS) program, adolescents are given **100 mg elemental iron and 500 µg folic acid** weekly. * **Diagnostic Cut-off:** According to WHO, anaemia in adolescents (12–14 years) is defined as **Hb <12 g/dL**.

Q: According to the WHO, what is the BMI definition for malnutrition?

Below 18.5 kg/m2. **Explanation:** The Body Mass Index (BMI), also known as the **Quetelet Index**, is the standard international metric used to classify nutritional status in adults. It is calculated as weight in kilograms divided by the square of height in meters ($kg/m^2$). **Why Option B is Correct:** According to the World Health Organization (WHO) and the Global Database on Body Mass Index, a BMI of **less than 18.5 $kg/m^2$** is the official threshold for defining **underweight** or chronic energy deficiency (malnutrition) in adults. This cutoff is based on increased risks of morbidity and mortality observed in populations falling below this level. **Analysis of Incorrect Options:** * **Option A (Below 18):** While close, this is not the standardized WHO cutoff. However, a BMI <18.5 is further sub-classified, where 17.0–18.49 is mild thinness, 16.0–16.99 is moderate thinness, and <16.0 is severe thinness. * **Options C & D (Below 19/19.5):** These values are not recognized by the WHO for defining malnutrition. In some clinical settings, a BMI of 19–20 might be considered "low normal," but they do not meet the criteria for the diagnosis of underweight. **High-Yield Clinical Pearls for NEET-PG:** * **Asian-Indian Cutoffs:** Due to a higher predisposition to visceral fat and metabolic syndrome, the consensus BMI cutoffs for **Indians** are lower: * **Underweight:** <18.5 $kg/m^2$ * **Normal:** 18.5–22.9 $kg/m^2$ * **Overweight:** 23–24.9 $kg/m^2$ * **Obesity:** $\geq$25 $kg/m^2$ * **Ponderal Index:** Another measure of leaness ($Weight/Height^3$). * **Best Indicator of Childhood Nutrition:** Weight-for-height (Wasting) indicates acute malnutrition; Height-for-age (Stunting) indicates chronic malnutrition.

Question 1

What is the estimated daily energy requirement (in kcal/day) for a female engaged in heavy manual labor?

Accepted Answer

2850

Answer

1900

Answer

2230

Answer

3730

Question 2

Which cooking oil has the most polyunsaturated fatty acids (PUFA)?

Accepted Answer

Safflower oil

Answer

Coconut oil

Answer

Butter

Answer

Vanaspati

Question 3

What is an important point for a prudent diet?

Accepted Answer

Dietary fat should be limited to 20-30% of total intake

Answer

Unsaturated fats should be less than 10%

Answer

Avoidance of complex carbohydrates

Answer

Proteins should account for 50-60% of diet

Question 4

Which of the following is considered a primary source of iron for economically disadvantaged populations?

Accepted Answer

Jaggery

Answer

Soybeans

Answer

Oranges

Answer

Almonds

Question 5

At what age is Vitamin A supplementation recommended?

Accepted Answer

9 months

Answer

2 months

Answer

5-6 years

Answer

None of the above

Question 6

Which of the following is considered the first immunization for a newborn?

Accepted Answer

Colostrum

Answer

Handing over the baby to the mother

Answer

Oral Polio Vaccine (OPV)

Answer

DPT + BCG vaccine

Question 7

Cereal protein is deficient in which amino acid?

Accepted Answer

Lysine

Answer

Leucine

Answer

Phenylalanine

Answer

Tryptophan

Question 8

Which amino acid is deficient in maize?

Accepted Answer

Tryptophan

Answer

Threonine

Answer

Methionine

Answer

Leucine

Question 9

The '12 by 12' initiative is primarily directed at:

Accepted Answer

Anaemia

Answer

Population control

Answer

Literacy

Answer

Rural electricity

Question 10

According to the WHO, what is the BMI definition for malnutrition?

Accepted Answer

Below 18.5 kg/m2

Answer

Below 18 kg/m2

Answer

Below 19 kg/m2

Answer

Below 19.5 kg/m2

Nutrition and Health — MCQs

Nutrition and Health — MCQs

On this page

Practice by Chapter

Want unlimited practice?