Vol. 33, No.4

1. What are the names of the three soy isoflavones that are phytoestrogens and can interact with estrogen receptors (ERs), thereby conferring potential health benefits?

a. Daidzein, lutein, and glycerin

b. Daidzein, genistein, and glycine

c. Lutein, genistein and glutamate

d. Daidzein, genistein and glycitein

2. Soy isoflavones preferentially bind to and activate ER‑β, which is abundant in the _____ and ______, two brain structures vital for memory, learning, and decision making.

a. hippocampus and prefrontal cortex

b. brain stem and amygdala

c. cerebellum and occipital lobe

d. pons and medulla

3. Denise, a post-menopausal woman, read that soy isoflavones may support cognitive health. She asks about incorporating soy or soy derived supplements into her daily intake to help improve her memory. What does the scientific literature say about soy isoflavone consumption and cognitive effects in post-menopausal women?

a. There is no evidence that suggests soy isoflavone consumption is beneficial to post-menopausal women and in fact, could be harmful.

b. A meta-analysis of 16 randomized controlled trials, involving 1,386 participants, 90% of whom were postmenopausal women, found small but significant improvements in memory, from soy isoflavone consumption

c. Short term consumption of soy isoflavones, for approximately one week, consistently produce significant improvements in cognition and memory in post-menopausal women.

d. Soy isoflavones, derived only from organic soy sources, like edamame and soymilk, were found to moderately improve cognition and memory in pre-menopausal women only.

4. Forty men participated in a 12-week double blind, placebo controlled cross over clinical trial in which they received daily encapsulated supplements containing 116 mg of isoflavones or placebo. As compared with placebo subjects, those men receiving the isoflavone supplement:

a. Experienced enhanced spatial working memory

b. Had fewer attempts and errors

c. Required less time to correctly identify information

d. All of the above

5. ____________is a metabolite produced by certain gut microbiota from the soy isoflavone daidzein; it is more biologically active than its parent isoflavone, and following soy consumption.

a. Equol

b. Equate

c. Equinox

d. Equal

6. A recent analysis of incident all-cause dementia risk in 60,298 participants who were followed for an average 9.1 years found higher adherence to a ____________was associated with an approximate 25% lower dementia risk.

a. Mediterranean diet

b. Carb fast diet

c. Ketogenic diet

d. Sleeping beauty diet

7. The Nurses' Health Study and the Health Professionals Follow-up Study followed participants for over 20 years and indicated that, in comparison with carbohydrates, consumption of ___________is associated with lower chances of developing cognitive decline later in life.

a. Saturated fat

b. Monounsaturated fat

c. Protein

d. Vitamin D

8. Andy is a 43-year-old patient interested in boosting his brain health through diet. He has allergies to tree nuts, seafood, and shellfish; he is not allergic to soy or eggs. Based on the scientific research, which of the following food selections may support Andy’s cognitive function?

a. tofu, cocoa, olive oil, water

b. red meat, milk, eggs, olive oil

c. olive oil, turkey, salt, spices

d. cocoa, water, red meat, salt

9. Denise is a self-proclaimed “chocaholic” and has recently stopped consuming chocolate for her “health”. She misses eating chocolate, and through behavioral counseling, she has been successful at managing cravings for sweets and portion sizes. She asks if there is a type of chocolate that would be less sweet and a better choice when she needs a chocolate fix. You advise her:

a. All chocolate is bad; you shouldn’t eat any.

b. The darker the chocolate, the better. Look for selections that are at least 70% cocoa.

c. Milk chocolate is the best, especially with added milk and nuts.

d. Lighter chocolate is better, especially white chocolate

10. Soy is a source of ________a key nutrient involved in the production of acetylcholine, a neurotransmitter important for memory and learning

a. Chloride

b. Cobalt

c. Choline

d. Carotene

11. Evan is the parent of 10-year-old Tyler. Evan follows a plant-centric diet and asks you about the benefits of soy foods on childhood cognition. Your best response would be:

a. The effects of soy foods or isoflavones on brain health and cognitive function has been well studied in children. Tyler should eat at least eight servings of soy foods a day.

b. Children should not follow plant-centric diets; they need mostly animal products to grow normally and should eat at least three servings of animal derived meat and/or dairy every day and avoid plant proteins.

c. The effects of soy foods or isoflavones is limited to adults. A study investigating the effects of daily soy consumption on child health outcomes is underway. Given the significance of establishing healthy eating habits early in life, introducing some plant-based soy foods in childhood, like tofu or soymilk, might be beneficial assuming Tyler does not have a soy allergy.

d. The effects of soy foods or isoflavones is limited to adults. There are no studies planned to investigate the effects of daily soy consumption on child health outcomes. Given the significance of establishing healthy eating habits early in life, plant-based proteins should be avoided until after age 15.

12. Soy foods are important sources of plant protein and protein intake may also influence cognition and affect the progression of mild cognitive impairment to Alzheimer’s Disease. A two-year interim analysis of a three-year longitudinal study found that plasma concentrations of all nine essential amino acids were lower in the AD-convert group with the three branched-chain amino acids _______, _______ and _______ showing the most significant difference.

a. Lutein, leucine, isoleutein

b. Leucine, isoleucine and valine

c. Valine, isovaline, glutamine

d. Glutamine, glutamate, isovaline

Continuing Professional Education Credit