CPE Quiz: Beverages and Bone Health

Question 1According to Dr. Heaney, what are the two major factors contributing to poor bone health today?A. Inadequate calcium intake and low levels of physical activity.
B. Inadequate calcium intake and inadequate protein intake.
C. Decreased milk consumption and increased soft drink consumption.
D. Poor overall diet quality, including low intake of key bone nutrients, and low levels of weight-bearing physical activity.

Question 2A research review conducted by Specker demonstrates that both a high calcium intake and physical activity are required to significantly increase bone mineral density, but either factor alone does not.A. True
B. False

Question 3For which of the following reasons is taking a "mono-nutrient" approach to bone health usually wrong?A. Nutrients do not work independently in the body they work in "teams."
B. Diets that are low in one nutrient tend to be low in several nutrients.
C. Bone, like all tissues, needs all nutrients.
D. All of the above are true.

Question 4Research conducted by Dawson-Hughes, et al., examined changes in bone mineral density (BMD) at the femoral neck of healthy elderly subjects who received either supplemental calcium and vitamin D or placebo. What finding from this research supports the concept that taking a mono-nutrient approach to bone health is inadequate?A. BMD increases in the group of subjects who received calcium and vitamin D supplements were not significantly different than the group who received the placebo (control).
B. Significant BMD increases in the group of subjects who received calcium and vitamin D supplements were almost completely limited to those who also exercised regularly.
C. Significant BMD increases were almost completely limited to those subjects who received calcium and vitamin D supplements and whose dietary protein was also high.
D. None of the above.

Question 5A reanalysis of 644 calcium balance studies by Heaney found a significant positive relationship between calcium intake and protein intake on calcium balance.A. True
B. False

Question 6Which of the following conclusions may be drawn from research examining the effects of caffeine on urinary calcium loss?A. Upon comparing subjects who received caffeine to those who didn't, neither group experienced a net increase in urinary calcium after two to five hours.
B. Subjects who received caffeine experienced a small increase in urinary calcium loss (~6.4 mg) two to five hours following ingestion, but after 24 hours, net calcium loss was no different than in subjects who did not receive caffeine.
C. Compared to subjects who did not receive caffeine, subjects who received caffeine experienced no increase in urinary calcium two to five hours following ingestion, but did experience a large net urinary calcium loss over 24 hours.
D. Compared to subjects who did not receive caffeine, subjects who received caffeine experienced a small net increase in urinary calcium loss (~6.4 mg) two to five hours following ingestion that persisted for 24 hours.

Question 7The amount of urinary calcium loss caused by consuming 6 ounces of caffeine-containing coffee can be offset by increasing calcium intake by about:A. 15 mg, or about the amount of calcium in 2 teaspoons of milk.
B. 40 mg, or about the amount of calcium in 2 tablespoons of milk.
C. 150 mg, or about the amount of calcium in 1/2 cup of milk.
D. 300 mg, or about the amount of calcium in 1 cup of milk.

Question 8What were the results of a study by Heaney and Rafferty that compared the effects of carbonated beverages containing phosphoric acid (colas) with those containing citric acid on urinary calcium loss?A. Carbonated beverages with phosphoric acid significantly increased urinary calcium losses, but carbonated beverages with citric acid did not.
B. Neither carbonated beverages with phosphoric acid nor carbonated beverages with citric acid caused significant urinary calcium losses.
C. Both carbonated beverages with phosphoric acid and carbonated beverages with citric acid caused significant urinary calcium losses.
D. Carbonated beverages with citric acid signific losses, but carbonated beverages with phosphoric acid did not.

Question 9Which research finding supports the conclusion that carbonated soft drinks do not negatively affect bone health?A. Caffeine has no net effect on urinary calcium loss over 24 hours.
B. The impact of colas containing phosphoric acid on calcium balance is small and biologically insignificant.
C. Carbonated waters rich in calcium have a positive effect on bone density.
D. All of the above.

Question 10According to Dr. Heaney, which of the following statements about bone health are true?A. Taking a mono-nutrient approach to bone health is usually wrong. Good bone health requires both regular weight-bearing physical activity and an overall nutritionally adequate diet that provides adequate amounts of key bone nutrients.
B. The primary concern regarding low milk intakes is that it is difficult to get adequate amounts of the key bone nutrients without milk in the diet.
C. Calcium balance studies show that the primary ingredients in soft drinks, including caffeine, phosphoric acid, citric acid, and carbonation, have no negative impact on bone health.
D. All of the above are true.