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Chapter 1. Carbohydrates

A 13-year-old competitive gymnast and her mother have scheduled a consultation with you because the gymnast has experienced increased difficulty with her cardiovascular training over the past few months. She is constantly fatigued. She is consuming adequate calories and 60% of her calories are from carbohydrates. When asked what types of foods she consumes, she indicates that due to her busy schedule she is constantly grabbing quick items such as granola bars, chips, crackers, pretzels, and candy bars. The client’s mom brings with her a copy of the gymnast’s last sports physical from her pediatrician, which was completed 3 months ago and was normal, including a blood test confirming that she is not anemic. Her weight is normal for her age and height. What is the MOST LIKELY explanation for the gymnast’s decreased performance?

A. Severe restriction of dietary intake

B. Insufficient carbohydrate intake to fuel her exercise

C. Consumption of high glycemic index carbohydrates

D. Overconsumption of carbohydrates

A healthy 55-year-old athlete tells you that every time he runs outside in the morning he initially feels great, but after about 15 minutes he frequently has to stop because he quickly becomes lightheaded and dizzy. On further questioning he tells you that he typically eats a bowl of cornflakes about 90 minutes before exercising and that he is careful to consume sips of water every 10 minutes or so during his workouts. What is the MOST LIKELY source of his symptoms?

A. Cornflakes are a high glycemic index food, possibly leading to hypoglycemia during his run.

B. Cornflakes are a low glycemic index food, possibly leading to hypoglycemia during his run.

C. Water retention due to his intake of corn flakes.

D. Cornflakes are a nutrient-dense food that can cause dizziness during running.

What is the theory behind why lower glycemic index carbohydrates may be better for health?

A. The shorter glucose chains provide less of a spike in blood sugar.

B. They have a lesser effect on blood insulin levels.

C. They help to remove “bad” cholesterol from the bloodstream.

D. The increased extent of processing allows for faster absorption.

Where does carbohydrate digestion begin?

A. Pancreas

B. Small intestine

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