Beverages & Bone Health CPE Quiz Answers
  1. d.
    The major factors contributing to poor bone health are poor overall diet quality, including low intake of key bone nutrients, and low levels of weight-bearing physical activity.
  2. a.
    True - High calcium intake and physical activity are required to significantly increase bone mineral density. Either factor alone does not.
  3. d.
    All of the Above. A "mono-nutrient" approach to bone health is wrong because nutrients do not work independently in the body—they work in "teams," diets that are low in one nutrient tend to be low in several nutrients, and bone, like all tissues, needs all nutrients.
  4. c.
    Taking a "mono-nutrient" approach to bone health is inadequate in Dawson-Hughes research study because significant BMD increases were almost completely limited to those subjects who received calcium and vitamin D supplements and whose dietary protein was also high.
  5. a.
    True - Heaney found a significant positive relationship between calcium intake and protein intake on calcium balance.
  6. b.
    Researchers examining the effectsof caffeine on urinary calcium loss concluded that 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.
  7. b.
    The amount of urinary calcium loss caused by consuming 6 ounces of caffeine containing coffee can be offset by increasing calcium intake by 40 mg, or about the amount of calcium in 2 tablespoons of milk.
  8. b.
    Neither carbonated beverages with phosphoric acid nor carbonated beverages with citric acid caused significant urinary calcium losses according to the Heaney and Rafferty study.
  9. d.
    All of the above. Carbonated soft drinks do not negatively affect bone health since research shows caffeine has no net effect on urinary calcium loss over 24 hours, the impact of colas containing phosphoric acid on calcium balance is small and biologically insignificant, and carbonated waters rich in calcium have a positive effect on bone density.
  10. d.
    All of the Above. Dr. Heaney agrees with the following statements:
    • 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.
    • 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.
    • 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.