Program Design
Program Design
This domain tests how you turn assessment data into a practical nutrition plan: energy targets, macronutrient distribution, food selection, timing, and progressive adjustments. The best answer is usually the plan the client can sustain, not the most aggressive one.
Core rules
- Set energy targets from estimated TDEE and a deficit or surplus that matches the goal; 250-500 kcal/day changes are common starting points.
- Set protein first for active clients, then fat, then carbohydrate. Use g/kg for protein and percentages for fat and carbohydrate.
- Build meals around preferences, culture, budget, cooking ability, and schedule. Use the plate method or exchange lists when tracking is a poor fit.
- Plan review points. Change one or two variables at a time, based on adherence and trend data.
Worked example
An 80 kg client with TDEE 2,800 kcal wants fat loss. Set 2,300 kcal (500 kcal deficit). Protein at 1.6 g/kg = 128 g (512 kcal). Fat at 25% = 575 kcal (64 g). Carbohydrate = 2,300 - 512 - 575 = 1,213 kcal, or about 303 g. Provide meal examples and a 2-week review; adjust if adherence or weight trend is off.
Traps
Do not prescribe very-low-calorie diets or eliminate food groups without justification. Do not copy a template without assessing preferences. Do not change everything at once. Do not ignore adherence, hunger, or disordered-eating signals.