Nutrition
Core concepts
Candidates must understand macronutrient roles and energy balance, dietary patterns (Mediterranean, DASH, plant-predominant), fiber and the gut microbiome, glycemic index/load, and the distinction between nutrient adequacy and therapeutic dosing. Know that dietary pattern quality matters more than single nutrients, and that whole-food, plant-forward patterns are the best-evidenced for cardiometabolic risk.
Traps in questions
- Confusing glycemic index (GI, quality) with glycemic load (GL, quantity = GI × carbohydrate amount).
- Assuming "natural" or "clean" equals healthier; ultra-processed foods are associated with adverse outcomes independent of nutrient content.
- Overstating single-nutrient effects (e.g., a single vitamin "cures" disease) versus whole-diet effects.
- Confusing kcal values: carbohydrate and protein ~4 kcal/g, fat ~9 kcal/g, alcohol ~7 kcal/g.
- Misreading fiber recommendations: most adults need ~25–38 g/day; typical intake falls short.
Worked example / rule of thumb
A patient with prediabetes wants to "cut carbs." Rule of thumb: emphasize diet quality and glycemic load, not carbohydrate elimination. A Mediterranean-style, plant-predominant pattern with adequate fiber and minimized ultra-processed foods is a defensible, evidence-supported recommendation. Refer to a registered dietitian for individualized plans.
Clinical integration
Understand food as medicine, food insecurity as a health determinant, and the role of the dietitian on the care team. Recognize that dietary change is a behavior-change problem (see Domain 6) as much as a knowledge problem.