Vol. 33, No.2

1. GLP-1 RA is an acronym for __________. GLP-1 RA drugs work by binding to a receptor inside a cell or on its surface, mimicking the action of naturally occurring GLP-1.

a. Glucose like peptide receptor agonist

b. Glucagon like peptide receptor agonist

c. Ghrelin like peptide receptor agonist

d. Glucagon like peptide receptor antagonist

2. GLP-1 is an ________, which is a hormone released by the gut that helps regulate appetite, blood sugar and digestion.

a. Endogetin

b. Exogetin

c. Incretin

d. Excretin

3. GLP-1 binds to GLP-1 receptors in multiple organs, including the brain, helping to regulate appetite and body weight by promoting satiety, reducing food intake and _________ , leading to a prolonged feeling of fullness.

a. Increasing digestion

b. Increasing carbohydrate absorption

c. Slowing gastric emptying

d. Increasing fat metabolism

4. GLP-1 RA medications are a breakthrough for those trying to lose weight because these drugs mimic the action of GLP-1. Research has shown that in addition to weight loss, these drugs may also lower the risk of ________

a. Cardiovascular disease

b. Kidney disease

c. Liver disease

d. All of the above

5. Mary is a 62-year-old woman with type 2 diabetes and cardiovascular risk factors including obesity and hypercholesterolemia. She started semaglutide, a GLP-1 RA drug, 4 months ago and has lost 33 pounds so far, experiencing minimal side effects. However, Mary is feeling physically weaker complaining of weakened muscles. What might be the potential cause of this weakness?

a. These drugs don’t cause any weakness, so it is probably her imagination.

b. Research shows GLP-1 RA medication users may lose 25–40% of muscle during weight loss.

c. She’s not eating enough carbohydrate and fat and drinking too much water.

d. Research shows GLP-1 RA users who don’t eat enough simple sugars lose muscle.

6. Marc, a 55-year-old patient who has been on a GLP-1 RA drug for 1 month, had been experiencing diarrhea initially, now he has constipation. Marc is exercising more and interested in a plant centric diet that provides protein and higher fiber. What suggestions might you provide?

a. Advise him that he cannot get enough protein from plant sources so include 2 servings of red meat at dinner with vegetables.

b. Explain that he needs to supplement with a whey protein powder and include more vitamin supplements along with a fiber powder.

c. Advise him that higher fiber foods may be helpful and to get both protein and fiber, soy foods such as whole soybeans, edamame, and soynuts may be good choices to add to his diet.

d. Explain that while some soy foods are good choices for both protein and fiber, soy is a poor-quality protein so he will have to include animal sources to get enough essential amino acids.

7. Mary is interested in increasing her dietary protein, but she is worried about how doing so might raise her blood lipids and cholesterol even more; Mary’s doctor has told her to limit foods high in saturated fats and simple sugars. Which of the following dietary strategies might you may consider for Mary?

a. Advise her that soy foods don’t provide the amounts of saturated fat animal sources provide and soy protein directly lowers blood cholesterol levels, therefore you suggest inclusion of more soy in her diet.

b. Advise Mary to consume more protein rich animal sources and call her doctor to recommend increasing her GLP-1 RA drug dose so she can lose more weight which should lower her blood lipids.

c. Advise Mary to consume more calories in the form of monounsaturated fat and follow a ketogenic diet which has been shown to help control weight and cholesterol levels.

d. Advise her to consume less dietary protein since her muscle weakness is probably due to higher blood glucose levels and changes in appetite regulating hormones.

8. Marc returns to your clinic after 6 months of GLP-1 RA treatment and reports he has reached his goal weight. Marc wants to maintain his weight loss and says he has enjoyed adding more soy to his diet. How do soy foods contribute to weight maintenance?

a. Soy is a great source of quality protein and contributes to a feeling of fullness.

b. Unsweetened soymilk is low in saturated fat and has no added sugars, making it good for weight management.

c. Soybeans and edamame are not helpful for weight maintenance since both are high in calories and low in fiber.

d. A and B

9. Soybean oil carries a Food and Drug Administration qualified health claim which suggests that it may reduce the risk of heart disease by lowering blood cholesterol levels. The claim states, “Supportive but not conclusive scientific evidence suggests that eating about 1½ tablespoons (20.5 grams) daily of soybean oil, which contains ________ fat, may reduce the risk of coronary heart disease.”

a. Saturated

b. Unsaturated

c. Essential

d. Nonessential

10. Although GLP-1 RA drugs have been helpful to patients desiring to lose weight, it is estimated that 50-75% of patients discontinue use after one year, primarily due to cost and unwanted side effects. What are the most common gastrointestinal side effects of these drugs?

a. Nausea and/or heartburn

b. Vomiting

c. Constipation and/or diarrhea

d. All of the above

11. GLP-1 RAs have been used to treat type 2 diabetes for years and work, in part, by boosting _______secretion after meals, improving blood sugar control, particularly for those with type 2 diabetes.

a. Glucose

b. Amylase

c. Insulin

d. Estrogen

12. For those patients on GLP-1 RA treatment, long-term success depends on these four interventions, developed, and provided by health professionals to their patients and clients for sustainable weight management.

a. Medication, strength training, nutrition, and personalized lifestyle strategies.

b. Stimulants, walking, dietary restriction, and generalized lifestyle strategies.

c. High dose GLP-1 RA medication, walking, a ketogenic diet, and no lifestyle changes.

d. Medication, strength training, a low protein, high sugar diet, and no lifestyle changes.

Continuing Professional Education Credit