Which of the following foods may be included in the MyPlate protein food group? (Select all that apply)

Choice A reason: High protein diets (>2.0 grams/kg daily) increase nitrogen from amino acid metabolism, forming urea that kidneys must excrete. Excessive nitrogen load can strain kidneys, potentially causing damage in susceptible individuals (e.g., those with renal disease), as filtration demands exceed normal capacity, leading to renal stress.

Choice B reason: Sodium is primarily linked to fluid balance and blood pressure, not protein metabolism. While high sodium intake can strain kidneys, it is not the primary substance excreted in high protein diets, which produce nitrogen waste, making sodium an incorrect choice for this context.

Choice C reason: Water is essential for kidney function, aiding waste excretion, but it is not a substance produced by protein metabolism. High protein diets increase water needs indirectly, but the kidneys excrete nitrogen-based urea, not water, making this an incorrect choice for the question.

Choice D reason: Potassium is involved in electrolyte balance, not directly linked to protein metabolism. High protein diets do not significantly increase potassium excretion compared to nitrogen, which forms urea, the primary waste product taxing kidneys, making potassium an incorrect choice for this question.

Choice A reason: A well-planned vegetarian diet, rich in plant-based proteins like beans and nuts, reduces saturated fat and cholesterol intake, lowering low-density lipoprotein (LDL) levels. This decreases atherosclerosis risk, reducing heart disease incidence by 20-30%. High fiber and antioxidants also lower colorectal and breast cancer risks, making this a key benefit.

Choice B reason: Vegetarian diets typically reduce saturated fat and cholesterol, as they exclude meat, a primary source of these lipids. Increased intake of these would occur with animal-based diets, not vegetarian ones, making this an incorrect choice, as it contradicts the dietary profile of vegetarianism.

Choice C reason: Vegetarian diets are high in fiber from fruits, vegetables, and whole grains (20-35 grams daily), not decreased. Fiber supports digestion and reduces cardiovascular and cancer risks, making this an incorrect choice, as vegetarian diets consistently promote higher, not lower, fiber intake.

Choice D reason: Vegetarian diets are associated with lower body mass index (BMI) due to high fiber and lower calorie density from plant-based foods. They reduce obesity risk by promoting satiety and balanced nutrient intake, making this an incorrect choice, as vegetarianism typically supports weight management, not weight gain.