Scientific American Nutrition for a

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Scientific American: Nutrition for a Changing World, First Edition
© 2016 by W. H. Freeman and Company. All rights reserved.

Chapter 9
Plant-Based Diets

Multiple-Choice Questions

1. Which list contains a food that a vegan would NOT consume?

A. legumes, wild rice, mashed potatoes
B. soft drink, French fries, chips
C. honey, chopped nuts, berries
D. corn, margarine, pasta with tomato sauce
E. peanut butter, white bread, soy milk
Answer: C
Type: Analysis
Difficulty: Medium
Concept: vegan diet
Keywords: vegan, honey

2. Which meal would you suggest for a pescatarian?

A. egg omelet with mushrooms and ham
B. surf and turf of scampi shrimp, steak, and lobster tail
C. turkey burger and garden salad
D. scrambled eggs, turkey bacon, and a glass of soy milk
E. smoked salmon on a cream cheese bagel and orange juice
Answer: E
Type: Applied
Difficulty: Medium
Concept: definition of vegetarian
Keyword: pescatarian

3. Which meal would you suggest for a lacto-vegetarian?

A. egg omelet with mushrooms and spinach
B. steamed salmon fillet and couscous
C. hamburger and French fries
D. scrambled egg and bacon on whole grain bread and apple juice
E. toast with honey, fruit cup, and a glass of 2% milk
Answer: E
Type: Applied
Difficulty: Medium
Concept: definition of vegetarian
Keyword: lacto-vegetarian

4. Which meal would you suggest for a lacto-ovo vegetarian?

A. egg omelet with mushrooms and spinach
B. grilled tilapia with broccoli
C. turkey breast and mustard on whole-wheat bread
D. sausage with bell peppers on a bun
E. toast with bacon, cheese, and a glass of 2% milk
Answer: A
Type: Applied
Difficulty: Medium
Concept: definition of vegetarian
Keyword: lacto-ovo vegetarian

5. A person who excludes red meats, but includes poultry and fish in their diet is considered
A. a flexitarian.
B. a lacto-ovo vegetarian.
C. a quasi-carnivore.
D. a quasi-vegetarian.
E. a pescatarian.
Answer: D
Type: Analysis
Difficulty: Medium
Concept: definition of vegetarian
Keyword: quasi-vegetarian

6. An individual who eats a plant-based diet, but includes both dairy and eggs is
A. a flexitarian.
B. a lacto-ovo vegetarian.
C. a quasi-carnivore.
D. a quasi-vegetarian.
E. a pescatarian.
Answer: B
Type: Analysis
Difficulty: Medium
Concept: definition of vegetarian
Keyword: lacto-ovo vegetarian

7. A person who consumes a plant-based diet, but occasionally consumes meat is

A. a Mediterranean.
B. a flexitarian.
C. a quasi-carnivore.
D. a quasi-vegetarian.
E. a pescatarian.
Answer: B
Type: Analysis
Difficulty: Easy
Concept: definition of vegetarian
Keyword: flexitarian

8. In a randomized clinical trial, lower heart disease in participants who eat a Mediterranean
diet compared with participants who eat a low-fat diet was attributed to
A. lower caloric intake and higher olive oil intake.
B. red wine intake.
C. higher olive oil or mixed nut intake.
D. higher olive oil intake, lower fat intake, and exercise.
E. higher lean-meat intake and lower-fat dairy intake.
Answer: C
Type: Comprehension
Difficulty: Medium
Learning Objective: Compare and contrast the dietary recommendations and potential benefits
of a vegetarian and a Mediterranean diet (Infographics 9.9 and 9.10)
Keywords: Mediterranean diet, olive oil, nuts

9. Olive oil and mixed nuts in the Mediterranean diet result in

A. high omega-3 fatty acids (EPA and DHA) intake.
B. high linoleic acid intake.
C. high omega-6 and omega-3 polyunsaturated fatty acids intake.
D. high monounsaturated and omega-3 fatty acid intake.
E. high partially hydrogenated oil intake.
Answer: D
Type: Analysis
Difficulty: Medium
Concept: Mediterranean diet
Keywords: Mediterranean diets, monounsaturated fatty acids, olive oil, nuts

10. Which is NOT a health benefit of plant-based diets?

A. lower risk of autoimmune disorders
B. lower risk of hypertension
C. lower risk of certain cancers
D. lower body mass index and obesity
E. lower circulating cholesterol and LDL
Answer: A
Type: Comprehension
Difficulty: Medium
Concepts: Health benefits of plant-based diets
Keywords: cancer, mortality, vegetarian
11. Which list presents the correct order of cancer development?
A. initiation, progression, promotion, metastasis
B. progression, promotion, apoptosis, metastasis
C. apoptosis, progression, promotion, metastasis
D. mutation, initiation, promotion, metastasis, progression
E. initiation, promotion, progression, metastasis
Answer: E
Type: Comprehension
Difficulty: Medium
Learning Objective: Describe the steps that occur during the development of cancer
(Infographic 9.2)
Keywords: initiation, promotion, progression, metastasis

12. Which is the first step in cancer development?

A. uncontrolled cell division and growth
B. cell DNA mutation
C. invasion and destruction of surrounding tissues
D. tumor spread
E. increased apoptosis and tumor formation
Answer: B
Type: Comprehension
Difficulty: Medium
Learning Objective: Describe the steps that occur during the development of cancer
(Infographic 9.2)
Keywords: initiation, mutation

13. A plant-based diet is most effective at

A. reducing the replication of mutated cells.
B. reducing development of a blood vessel supply to the tumor.
C. reducing invasion and destruction of surrounding tissues.
D. preventing tumor spread.
E. reducing apoptosis.
Answer: A
Type: Comprehension
Difficulty: Medium
Learning Objective: List the recommendations that reduce the risk of cancer (Infographic 9.3)
Keywords: promotion, cancer

14. At what stages of cancer is a plant-based diet most likely to be effective?

A. initiation and invasion
B. initiation and promotion
C. invasion and progression
D. progression and metastasis
E. invasion and metastasis
Answer: B
Type: Comprehension
Difficulty: Medium
Learning Objective: Describe the steps that occur during the development of cancer
(Infographic 9.2)
Keywords: promotion, cancer

15. Which cancer stage has the worst prognosis?

A. uncontrolled cell division and growth
B. cell DNA mutation
C. invasion and destruction of surrounding tissues
D. metastasis
E. reduced cancer cell apoptosis
Answer: D
Type: Comprehension
Difficulty: Medium
Learning Objective: Describe the steps that occur during the development of cancer
(Infographic 9.2)
Keyword: metastasis

16. Which food may increase cancer risk?

A. soy foods because of hormone-like phytoestrogens
B. food high in sugar because of high glycemic response
C. refined grains because of loss of antioxidant vitamins
D. dairy because of trans fatty acids
E. processed meats because of nitrates/nitrites
Answer: E
Type: Analysis
Difficulty: Medium
Learning Objective: List the recommendations that reduce the risk of cancer (Infographic 9.3)
Keywords: cancer, nitrites

17. To reduce cancer risk, red meat and processed meat consumption should be limited to
A. 20 ounces, 2 to 3 times a week
B. 20 ounces per week
C. 18 ounces, 2 to 3 times a week
D. 18 ounces per week
E. 5 ounces per day
Answer: D
Type: Analysis
Difficulty: Medium
Learning Objective: List the recommendations that reduce the risk of cancer (Infographic 9.3)
Keywords: cancer, nitrites

18. Which statement is NOT true about plant foods and cancer risk?
A. Soy foods lower cancer risk because of their hormone-like phytoestrogens.
B. Soy foods lower cancer risk because they are a high-quality protein.
C. Colorful vegetables lower cancer risk because of their antioxidant vitamins.
D. Colorful vegetables lower cancer risk because of their phytochemical content.
E. Vegetables lower cancer risk because of their high dietary fiber content.
Answer: B
Type: Analysis
Difficulty: Medium
Learning Objective: List the recommendations that reduce the risk of cancer (Infographic 9.3)
Keywords: cancer, phytochemicals, plant foods

19. Overconsumption of which of the following is mostly likely to increase cancer risk?
A. alternative sweeteners such as xylitol
B. whole-fat dairy because of saturated and trans fatty acids
C. black tea because of high EGCG content
D. wine because of alcohol content
E. nonorganic fruits and vegetables because of pesticides
Answer: D
Type: Analysis
Difficulty: Medium
Learning Objective: List the recommendations that reduce the risk of cancer (Infographic 9.3)
Keywords: carcinogens

20. Eating a plant-based diet consisting of fruits and nonstarchy vegetables probably protects
against
A. kidney cancer.
B. colon, breast, and prostate cancer.
C. liver and gallbladder cancer.
D. mouth, stomach, and lung cancer.
E. pancreatic cancer.
Answer: D
Type: Analysis
Difficulty: Medium
Learning Objective: List the recommendations that reduce the risk of cancer (Infographic 9.3)
Keywords: mouth cancer, stomach cancer, lung cancer

21. Which of the following is the most likely to lower cancer risk?
A. foods fortified with vitamin E, A, and iron because of high antioxidant content
B. colorful plant foods because of phytochemicals and antioxidant vitamins
C. vitamin A supplements because of a high antioxidant content
D. red wine because of its anti-inflammatory resveratrol content
E. organic fruits and vegetables because of low pesticide contamination
Answer: B
Type: Analysis
Difficulty: Medium
Learning Objective: List the recommendations that reduce the risk of cancer (Infographic 9.3)
Keywords: cancer, antioxidants, phytochemicals

22. Grapes and red wine are a rich source of which phytochemical?
A. vitamin E and C
B. zeaxanthin
C. vitamin A and carotenoids
D. isoflavones and lignans
E. resveratrol
Answer: E
Type: Analysis
Difficulty: Medium
Learning Objective: Provide examples of two specific phytochemicals and their significant
dietary sources (Infographics 9.4 and 9.5)
Keywords: phytochemicals, resveratrol

23. Dark chocolate and cocoa are a rich source of which phytochemical?
A. vitamin E and C
B. flavanols
C. anthocyanins
D. isoflavones and lignans
E. resveratrol
Answer: B
Type: Analysis
Difficulty: Medium
Learning Objective: Provide examples of two specific phytochemicals and their significant
dietary sources (Infographics 9.4 and 9.5)
Keywords: phytochemicals, flavanols

24. Which phytochemical has been reported to reduce the risk of prostate cancer?
A. resveratrol
B. lutein
C. lycopenes
D. zeaxanthin
E. isoflavones
Answer: C
Type: Analysis
Difficulty: Medium
Learning Objective: Provide examples of two specific phytochemicals and their significant
dietary sources (Infographics 9.4 and 9.5)
Keywords: phytochemicals, lycopenes

25. Which phytochemical combination has been reported to benefit eye health?
A. resveratrol and lignans
B. resveratrol and flavanols
C. zeaxanthin and lutein
D. isoflavones and flavanols
E. isoflavones and lignans
Answer: C
Type: Analysis
Difficulty: Medium
Learning Objective: Provide examples of two specific phytochemicals and their significant
dietary sources (Infographics 9.4 and 9.5)
Keywords: phytochemicals, lutein, zeaxanthin

26. Which foods are rich sources of the phytochemical lycopene?

A. grapes and red wine
B. tomato, tomato products, and watermelon
C. soy and soy products
D. blueberries, blackberries, and cherries
E. dark chocolate and cocoa
Answer: B
Type: Analysis
Difficulty: Medium
Learning Objective: Provide examples of two specific phytochemicals and their significant
dietary sources (Infographics 9.4 and 9.5)
Keywords: phytochemicals, carotenoids, lycopenes

27. Which foods are rich sources of the phytochemicals called anthocyanins?
A. grapes and red wine
B. tomato, tomato products, and watermelon
C. soy and soy products
D. blueberries, blackberries, and cherries
E. dark chocolate and cocoa
Answer: D
Type: Analysis
Difficulty: Medium
Learning Objective: Provide examples of two specific phytochemicals and their significant
dietary sources (Infographics 9.4 and 9.5)
Keywords: phytochemicals, flavonoids, anthocyanins

28. Which foods are rich sources of the phytoestrogens called isoflavones?
A. grapes and red wine
B. tomato, tomato products, watermelon
C. soy and soy products
D. blueberries, blackberries, raspberries
E. dark chocolate and cocoa
Answer: C
Type: Analysis
Difficulty: Medium
Learning Objective: Provide examples of two specific phytochemicals and their significant
dietary sources (Infographics 9.4 and 9.5)
Keywords: phytochemicals, isoflavones

29. Which is NOT an example of a carotenoid?

A. resveratrol
B. lycopene
C. beta-carotene
D. lutein
E. zeaxanthin
Answer: A
Type: Analysis
Difficulty: Medium
Learning Objective: Provide examples of two specific phytochemicals and their significant
dietary sources (Infographics 9.4 and 9.5)
Keywords: phytochemicals, resveratrol

30. Vegetarians do not consume gelatin because it

A. is high in sugar.
B. is high in artificial food coloring.
C. is a protein derived from animal bone and skin.
D. is a carbohydrate derived from animal bone and skin.
E. binds calcium and iron interfering with bioavailability.
Answer: C
Type: Analysis
Difficulty: Medium
Concept: Types of vegetarian diets
Keywords: gelatin

31. Salted cured meat and other salt-preserved food should be limited because of increased risk
of
A. colorectal cancer.
B. prostate cancer.
C. stomach cancer.
D. lung cancer.
E. obesity.
Answer: C
Type: Analysis
Difficulty: Medium
Learning Objective: List the recommendations that reduce the risk of cancer (Infographic 9.3)
Keywords: salt, stomach cancer

32. Which are more bioavailable in plant foods than in animal foods?
A. calcium and iron
B. vitamin C and E
C. retinoids and thiamin
D. vitamin D and cholesterol
E. zinc and riboflavin
Answer: B
Type: Analysis
Difficulty: Medium
Learning Objective: Identify challenges that vegetarians may experience in meeting their
requirements for specific nutrients and provide strategies to alleviate these concerns
(Infographics 9.6 and 9.7)
Keywords: vegans, vegetarians, bioavailability

33. Vegans may have difficulty obtaining adequate amounts of

A. vitamin C and folate.
B. zinc and potassium.
C. complete proteins and vitamin B12.
D. cholesterol and omega-3 fatty acids.
E. vitamin E and omega-3 fatty acids.
Answer: C
Type: Analysis
Difficulty: Medium
Learning Objective: Identify challenges that vegetarians may experience in meeting their
requirements for specific nutrients and provide strategies to alleviate these concerns
(Infographics 9.6 and 9.7)
Keywords: vegans, complete proteins, vitamin B12

34. The recommended non-heme iron intake for vegans is_____ higher than the iron
recommendations of nonvegetarians.
A. 100%
B. 80%
C. 65%
D. 50%
E. 25%
Answer: B
Type: Analysis
Difficulty: Medium
Learning Objective: Identify challenges that vegetarians may experience in meeting their
requirements for specific nutrients and provide strategies to alleviate these concerns
(Infographics 9.6 and 9.7)
Keywords: vegans, vegetarian, complete proteins, vitamin B12

35. Algae provides an important source of _____ for vegans.

A. omega-3 fatty acid (DHA)
B. complete protein
C. vitamin B12 and calcium
D. essential fatty acids, linoleic acid, and alpha-linolenic acid
E. heme iron and antioxidant vitamins
Answer: A
Type: Analysis
Difficulty: Medium
Learning Objective: Identify challenges that vegetarians may experience in meeting their
requirements for specific nutrients and provide strategies to alleviate these concerns
(Infographics 9.6 and 9.7)
Keywords: vegan, algae, DHA

36. Which is NOT a dietary guideline for vegetarians?

A. Choose from a variety of plant foods.
B. Choose complementary proteins.
C. Pay particular attention to vitamin B12 and iron.
D. Limit intake of fatty, sugary, and refined foods.
E. Limit food choices to fruits and vegetables.
Answer: E
Type: Analysis
Difficulty: Medium
Learning Objective: Identify challenges that vegetarians may experience in meeting their
requirements for specific nutrients and provide strategies to alleviate these concerns
(Infographics 9.6 and 9.7)
Keywords: vegetarian guidelines, variety, moderation

37. Vegetarians who do not consume seafood may need to take care to consume adequate
A. antioxidant vitamins.
B. iodized table salt, EPA, and DHA.
C. vitamin E and A.
D. monounsaturated fatty acids.
E. essential fatty acids.
Answer: B
Type: Analysis
Difficulty: Medium
Learning Objective: Identify challenges that vegetarians may experience in meeting their
requirements for specific nutrients and provide strategies to alleviate these concerns
(Infographics 9.6 and 9.7)
Keywords: iodized salt, EPA, DHA

38. Vegan may increase non-heme iron absorption by

A. consuming it with soy protein or legumes.
B. consuming it with vegetable oil.
C. consuming it with orange juice.
D. consuming it with fat-soluble vitamins.
E. consuming it with antioxidant vitamins.
Answer: C
Type: Analysis
Difficulty: Medium
Learning Objective: Identify challenges that vegetarians may experience in meeting their
requirements for specific nutrients and provide strategies to alleviate these concerns
(Infographics 9.6 and 9.7)
Keywords: vegan, non-heme iron, orange juice

39. Which statement is NOT true about vegetarian children and teens?
A. Lacto-ovo vegetarian children have similar growth to nonvegetarian children.
B. Some vegan children can have reduced growth due to deficient protein and calories.
C. Vegetarian teens consume more fiber, folate, and vitamin C than nonvegetarian teens.
D. Vegetarian teens consume more carbohydrates and sweets than nonvegetarian teens.
E. Vegetarian teens have lower risk of obesity and chronic disease later in life.
Answer: D
Type: Comprehension
Difficulty: Easy
Concept: vegetarian dietary and health
Keywords: children, adolescents, vegetarians, vegans

40. Which statement is NOT true about organic foods?

A. Organic foods conserve biodiversity.
B. Organic foods foster recycling of resources.
C. Organic foods expose consumers to fewer antibiotic resistant bacteria.
D. Organic foods expose consumers to fewer pesticides.
E. Organic foods are more nutritious and have more health benefits.
Answer: E
Type: Comprehension
Difficulty: Medium
Concept: organic foods
Keywords: organic foods, USDA

41. According to the USDA, food can be labeled as 100% organic if it contains a minimum of
A. 100% organic ingredients.
B. 95% organic ingredients.
C. 70% organic ingredients.
D. 50% organic ingredients.
E. 25% organic ingredients.
Answer: B
Type: Comprehension
Difficulty: Medium
Concept: organic foods
Keywords: organic foods, USDA

42. According to the USDA, food can be labeled as made with organic ingredients if it contains a
minimum of
A. 100% organic ingredients.
B. 95% organic ingredients.
C. 70% organic ingredients.
D. 50% organic ingredients.
E. 25% organic ingredients.
Answer: C
Type: Comprehension
Difficulty: Medium
Concept: organic foods
Keywords: organic foods, USDA

43. According to the USDA, foods labeled as made with some organic ingredients are composed
of
A. 95% organic ingredients.
B. 90% organic ingredients.
C. 80% organic ingredients.
D. 70% organic ingredients.
E. less than 70% organic ingredients.
Answer: E
Type: Comprehension
Difficulty: Medium
Concept: organic foods
Keywords: organic foods, USDA

44. Which statement is NOT true about the Mediterranean diet’s effects on health?
A. The Mediterranean diet reduces the risk of diabetes.
B. The Mediterranean diet reduces the risk of celiac disease.
C. The Mediterranean diet reduces the risk of Alzheimer’s disease.
D. The Mediterranean diet reduces the risk of cancer.
E. The Mediterranean diet reduces the risk of cardiovascular disease.
Answer: B
Type: Comprehension
Difficulty: Medium
Learning Objective: Compare and contrast the dietary recommendations and potential benefits
of a vegetarian and a Mediterranean diet (Infographics 9.9 and 9.10)
Keywords: Mediterranean, Spanish clinical trial

45. Which statement is NOT true about the nutritional value of Mediterranean diets?
A. Higher fruit consumption increases antioxidant intake.
B. Higher vegetable consumption increases fiber intake.
C. Higher fish consumption increases monounsaturated fatty acids.
D. Lower meat consumption decreases cholesterol intake.
E. Higher fruit and vegetable consumption increases polyphenol intake.
Answer: C
Type: Comprehension
Difficulty: Medium
Learning Objective: Compare and contrast the dietary recommendations and potential benefits
of a vegetarian and a Mediterranean diet (Infographics 9.9 and 9.10)
Keywords: Mediterranean, Spanish clinical trial

Essay Questions

46. Name and explain why certain nutrients are of particular concern for individuals who eat a
plant-based diet.
Type: Application
Difficulty: Medium
Learning Objective: Identify challenges that vegetarians may experience in meeting their
requirements for specific nutrients and provide strategies to alleviate these concerns
(Infographics 9.6 and 9.7)
Keywords: vegetarians, protein complementation, vitamin B12, non-heme iron

47. Describe a Mediterranean diet and the potential health benefits that can result from this
dietary approach.
Type: Application
Difficulty: Medium
Learning Objective: Compare and contrast the dietary recommendations and potential benefits
of a vegetarian and a Mediterranean diet (Infographics 9.9 and 9.10)
Keywords: Mediterranean diet, plant-based diet, whole diet approach

48. Explain the French paradox and its significance in illustrating a relationship between health
and diet.
Type: Application
Difficulty: Medium
Learning Objective: Provide examples of two specific phytochemicals and their significant
dietary sources (Infographics 9.4 and 9.5)
Keywords: French paradox, resveratrol, polyphenols

49. Describe the beneficial role of plant-based diets in reducing the risk of cancer development.
Type: Application
Difficulty: Medium
Learning Objective: List the recommendations that reduce the risk of cancer (Infographic 9.3)
Keywords: phytochemicals, initiation, promotion

50. Describe several methods whereby vegetarians can ensure adequate vitamin B12 intake,
since this nutrient is found only in animal food sources.
Type: Application
Difficulty: Medium
Learning Objective: Identify challenges that vegetarians may experience in meeting their
requirements for specific nutrients and provide strategies to alleviate these concerns
(Infographics 9.6 and 9.7)
Keywords: vitamin B12, supplementation, fortification