Nutrition

Vitamin C improves the absorption of non-haem iron, the form found mainly in plant foods. It can help convert ferric iron to the more absorbable ferrous form and can reduce the effect of some absorption inhibitors. Thus, foods such as citrus fruits, guava or tomatoes may be included with pulses and leafy vegetables. This supports dietary iron intake but does not replace medical treatment when anaemia is diagnosed.

Avoiding milk does not automatically mean that calcium needs cannot be met. The diet can include suitable alternatives such as curd or other tolerated dairy products, calcium-set tofu, ragi, sesame, leafy vegetables, legumes or fortified foods, depending on the patient's tolerance, culture and medical condition. The plan should also consider vitamin D and overall dietary adequacy. Therefore, selecting safe alternative calcium sources is the appropriate step.

Calcium is needed for bone mineralisation, muscle contraction, nerve transmission and other body functions. Vitamin D increases intestinal calcium absorption and helps maintain calcium balance, thereby supporting the formation and maintenance of healthy bones and teeth. Although both nutrients interact in bone health, calcium does not generally cause vitamin D absorption; therefore, option A correctly states the important relationship.

Iodized salt is used to help prevent iodine deficiency, which can affect thyroid hormone production and normal growth and development. Prolonged heating, storage in unsuitable conditions and exposure to moisture may reduce the iodine retained in salt or food. It is therefore sensible to store salt in a closed, dry container and add it toward the end of cooking when practical. This does not mean that all heating removes iodine immediately.

Dietary fibre adds bulk and can help regulate bowel movement, but many types of fibre work best when adequate fluid is available. Increasing fibre without enough fluid may cause bloating or worsen constipation in some people. A suitable plan usually combines gradual fibre increase, adequate fluids, regular physical activity and attention to the underlying cause. Fluid advice must still be individualised for patients with restrictions such as heart or kidney disease.

A broad evaluation of nutrition does not depend on one visible feature of food. It considers the amount eaten, nutrient quality, variety of food groups, hygiene and safety, suitability for the person, and the patient’s ability to follow the plan. Therefore, option A gives the most complete assessment.

Stable body weight mainly suggests that energy intake and expenditure may be relatively balanced; it does not prove that the diet supplies every nutrient. A monotonous diet can provide enough calories while lacking vitamins, minerals, fibre and sometimes essential fatty acids or protein quality. A detailed diet assessment is therefore still needed.

Energy-dense foods provide many calories in a small amount, but they may contain little fibre, vitamins and minerals, especially when they are highly processed or rich in added fat and sugar. A patient can therefore meet energy needs while developing poor micronutrient intake. The first assessment should check dietary quality and nutrient density.

Protein is needed for tissue growth, repair, enzymes, hormones and immune functions. When energy intake is inadequate, the body can break down and use protein as fuel, leaving less protein for these important roles. This is called the protein-sparing principle: sufficient energy helps preserve dietary protein for growth and repair.

Meal frequency records how many times a person eats or drinks during the day, including meals, snacks, and sometimes calorie-containing beverages. This information helps the nutrition professional estimate total intake, identify skipped meals, detect excessive snacking, and compare eating patterns with the person’s health needs. Therefore, option C is correct and is an important part of dietary assessment.

Water-soluble vitamins, mainly the B-complex vitamins and vitamin C, are generally not stored in large amounts in the body. Excess quantities are often excreted in urine, although this does not make unlimited intake safe. Regular consumption of varied foods helps maintain an adequate supply. Therefore, option A is correct. They support functions such as energy metabolism, blood formation, immunity, and tissue repair.

Vitamins A, D, E, and K are fat-soluble. A suitable amount of dietary fat helps the body digest and absorb these vitamins, so completely eliminating fat may reduce their utilization and may also lower energy intake. This does not mean that unlimited fat is desirable; the type and quantity should fit the person’s health needs. Therefore, option B is correct.

Iodized salt supplies iodine, which is needed for the production of thyroid hormones and normal growth and development. Prolonged exposure to high heat, especially during cooking and storage in open or humid conditions, may increase iodine losses. Keeping salt covered and adding it toward the end of cooking can help preserve more iodine. Thus, option D is correct; heating cannot increase fibre or protein.

Physical activity generally increases energy expenditure, although the exact requirement depends on the type, duration, intensity, age, body size, and health condition of the person. Diet planning should therefore reassess energy intake and, when necessary, the balance of carbohydrate, protein, fluids, and other nutrients rather than changing food randomly.

Repeated infections can increase the body's nutritional demands and may also reduce appetite and nutrient intake. Adequate energy and protein support immune-cell production, antibody formation and tissue repair. Vitamins and minerals such as vitamins A, C and D, iron and zinc are needed for normal immune functions, although food alone does not replace medical treatment. Thus, option A is correct.

A sample menu converts general nutrition advice into practical choices for meals and snacks. It can show suitable food groups, portion patterns, meal timing and possible substitutions, helping a learner understand how recommendations may be used in everyday life. It is a teaching guide, not a rigid prescription, and should be adapted to age, health condition, culture, budget and food availability. Therefore, option A is correct.

Normal body weight does not guarantee a balanced or adequate diet. Pulses provide protein and several minerals, milk is an important source of calcium and protein, and vegetables supply fibre, vitamins and protective phytochemicals. If these foods are consistently low, the patient may have hidden deficiencies despite acceptable weight. A nutrition expert should therefore assess diet quality and possible protein, calcium and micronutrient inadequacy. Option A is correct.

Hidden hunger refers mainly to deficiencies of vitamins and minerals that may occur even when a person consumes enough calories or has a normal body weight. A diet can provide adequate energy through refined or nutrient-poor foods while remaining low in iron, iodine, vitamin A, zinc, calcium or other micronutrients. Therefore, assessment must consider food variety, nutrient density and diet quality, not calories alone. Option C correctly explains hidden hunger.

Snacks and beverages are important parts of total dietary intake, even when people do not consider them to be meals. Sweetened drinks may add sugar and energy, while packaged snacks may provide excess sodium and fat with little fibre or micronutrient value. Asking about them makes the diet history more complete and helps the dietitian identify hidden sources of nutrients and calories before planning suitable advice.

Sugar-sweetened beverages can provide considerable energy while supplying very little protein, fibre, vitamins or minerals. If they replace nutritious meals, the patient may consume excess sugar and calories but still fail to meet requirements for essential nutrients. This pattern is therefore described as an increase in empty calories and a decline in overall dietary quality. The answer is D.