NESTA Fitness Nutrition Coach cheat sheet

Energy yield: carbohydrate 4 kcal/g, protein 4 kcal/g, fat 9 kcal/g, alcohol 7 kcal/g, fiber ~2 kcal/g (fermentable).

Atwater general factors apply to mixed diets; specific factors are used for individual foods (e.g., protein 4.36 kcal/g for meat, 2.44 for legumes).

Digestion sequence: salivary amylase begins starch breakdown; gastric acid and pepsin denature protein; pancreatic amylase, protease, and lipase complete luminal digestion; brush-border enzymes finish at the enterocyte.

Absorption sites: monosaccharides and amino acids via portal vein to liver; long-chain fatty acids packaged into chylomicrons and enter lymphatics, bypassing portal circulation.

Gastric emptying is slowed by fat, fiber, protein, high osmolality, and high energy density; it is accelerated by large volume and low energy density.

Glycemic index compares a 50 g available-carbohydrate portion to a reference (glucose or white bread); glycemic load = GI x available carbohydrate (g) / 100.

Essential nutrients cannot be synthesized in adequate amounts: 9 amino acids, 2 fatty acids (linoleic, alpha-linolenic), 13 vitamins, and major/trace minerals.

Water-soluble vitamins (B-complex, C) are absorbed into portal blood and excreted renally; fat-soluble vitamins (A, D, E, K) require bile and micelle formation and are stored in liver and adipose.

AMDR: carbohydrate 45-65% of energy, fat 20-35%, protein 10-35% for adults; protein RDA 0.8 g/kg/day for healthy adults.

Fiber target ~14 g per 1,000 kcal; soluble fiber (beta-glucan, pectin, psyllium) lowers LDL cholesterol, insoluble fiber (cellulose, lignin) promotes laxation.

Complete proteins supply all nine indispensable amino acids in adequate amounts (animal proteins, soy, quinoa); limiting amino acid determines protein quality in incomplete sources.

Protein needs rise with resistance training (1.4-2.0 g/kg/day) and with endurance training (1.2-1.4 g/kg/day); distribute intake across 3-5 feedings of ~0.25-0.4 g/kg.

Fat intake: keep saturated fat <10% of energy, replace with unsaturated fat; trans fat <1% of energy; aim for ~250 mg/day EPA+DHA.

Iron: heme iron (animal) is absorbed 15-35%, non-heme iron 2-20%; vitamin C enhances non-heme absorption, while phytates, tannins, and calcium inhibit it.

Calcium RDA 1,000 mg/day for adults 19-50 and men to 70; rises to 1,200 mg/day for women over 50 and all adults over 70.

Vitamin D: 600 IU/day for ages 1-70, 800 IU/day over 70; status is assessed by serum 25-hydroxyvitamin D, not the active 1,25 form.

Total daily energy expenditure components: resting metabolic rate (~60-70%), thermic effect of food (~10%), and activity thermogenesis (exercise plus non-exercise activity).

Mifflin-St Jeor: men RMR = 10 x weight (kg) + 6.25 x height (cm) - 5 x age + 5; women RMR = same formula minus 161.

Katch-McArdle uses lean body mass: RMR = 370 + 21.6 x LBM (kg); preferred when body composition is known.

Energy deficit of ~500 kcal/day predicts ~0.45 kg (1 lb) fat loss per week; a 3,500 kcal deficit approximates 1 lb of fat tissue.

BMI = weight (kg) / height (m)^2; categories: underweight <18.5, normal 18.5-24.9, overweight 25-29.9, obesity >=30.

BMI misclassifies muscular individuals and does not locate fat; waist circumference adds risk information (men >102 cm, women >88 cm elevated).

Essential fat is ~3-5% of body weight in men and ~8-12% in women; athletic ranges are roughly 6-13% men and 14-20% women.

Adaptive thermogenesis: metabolic rate declines with weight loss beyond what fat and lean mass loss predicts, and non-exercise activity thermogenesis falls during caloric restriction.

Use the ABCDE framework: Anthropometric, Biochemical, Clinical, Dietary, and Environmental/behavioral data.

24-hour recall is quick but relies on memory and a single day; food frequency questionnaires capture habitual intake but depend on recall and fixed lists.

A 3-7 day food record reduces recall bias but risks reactivity (clients altering intake while recording).

Screen for red flags requiring medical referral: unintentional weight loss >5% in 1 month or >10% in 6 months, dysphagia, persistent GI bleeding, and unexplained anemia.

Readiness and stage of change (precontemplation through maintenance) should be assessed before prescribing behavior plans.

Screening tools: PAR-Q+ for exercise readiness; eating disorder screens (SCOFF, EAT-26) when weight, body image, or restrictive patterns are concerns.

Estimate usual intake by averaging multiple days and including weekends; compare with estimated needs rather than population averages alone.

Document baseline metrics (weight, waist, dietary pattern, activity, medical history, medications) so progress can be measured against a starting point.

Transtheoretical model stages: precontemplation, contemplation, preparation, action, maintenance; interventions should match the client's stage.

SMART goals are specific, measurable, achievable, relevant, and time-bound; vague goals such as "eat better" are not measurable.

Motivational interviewing uses open questions, affirmations, reflections, and summaries (OARS); the coach avoids the righting reflex and elicits change talk.

Self-determination theory: autonomy, competence, and relatedness support intrinsic motivation; controlling language undermines it.

Self-monitoring (food logs, weigh-ins, step counts) is among the strongest predictors of behavior change adherence.

Implementation intentions ("if situation X, then I will do Y") improve follow-through better than outcome intentions alone.

Relapse is a normal stage of change, not failure; the coaching response is to identify triggers and rebuild the plan without shame.

Social cognitive theory: self-efficacy, outcome expectations, and observational learning shape behavior; mastery experiences build self-efficacy most strongly.

Pre-exercise meal 3-4 hours out: 1-4 g/kg carbohydrate, moderate protein, low fat and fiber to speed gastric emptying.

Pre-event snack 30-60 minutes out: ~30-60 g easily digested carbohydrate (e.g., banana, sports drink, low-fiber bar).

During exercise over 60-90 minutes: 30-60 g carbohydrate per hour; for longer or higher-intensity efforts, up to 90 g/hour using multiple transportable carbohydrates (glucose+fructose).

Post-exercise recovery: 1.0-1.2 g/kg carbohydrate within 30 minutes for rapid glycogen resynthesis, plus 0.25-0.3 g/kg protein.

Hydration: aim for ~5-7 mL/kg body weight 4 hours before exercise; during exercise, replace ~80% of sweat losses; >2% body mass loss impairs performance.

Hyponatremia risk rises with excessive plain water intake during long events; include sodium (~300-600 mg/L) in fluids for events over 2-3 hours.

Creatine monohydrate 3-5 g/day increases phosphocreatine availability and supports repeated high-intensity efforts; loading is optional.

Caffeine 3-6 mg/kg body weight 30-60 minutes pre-exercise improves endurance performance; higher doses increase side effects without added benefit.

Sustainable weight loss targets 0.5-1% of body weight per week; faster loss increases lean mass loss and adherence failure.

Very-low-calorie diets (<800 kcal/day) require medical supervision and are reserved for specific clinical situations.

Preserve lean mass during deficit: protein 1.6-2.4 g/kg/day, resistance training 2-3 times weekly, and moderate (not extreme) deficits.

Weight regain after loss is common; long-term follow-up and self-monitoring reduce regain risk.

Pregnancy: add ~340 kcal/day in the second trimester and ~450 kcal/day in the third; avoid alcohol, high-mercury fish, and unpasteurized foods.

Older adults: protein 1.0-1.2 g/kg/day (higher with illness) plus vitamin D and calcium to support muscle and bone; sarcopenia risk rises with low intake and inactivity.

Type 2 diabetes: consistent carbohydrate distribution, fiber-rich choices, and weight loss of 5-10% improve glycemic control; monitor for hypoglycemia with medications.

Cardiovascular disease: Mediterranean-style pattern, sodium <2,300 mg/day (ideally <1,500), and replacement of saturated fat with unsaturated fat lower risk.

Fitness nutrition coaches provide general nutrition education and behavior support; they do not diagnose, prescribe diets for disease, or order labs.

Medical nutrition therapy for conditions such as diabetes, renal disease, and eating disorders belongs to registered dietitians and licensed clinicians.

Refer clients with red-flag symptoms, eating disorder signs, pregnancy complications, or medication interactions to an appropriate professional.

Informed consent, confidentiality, and accurate record-keeping are core ethical duties; client data must be stored securely and shared only with permission.

Avoid recommending supplements as treatment; disclose any conflicts of interest and do not sell products based on unproven claims.

Scope is defined by licensure and certification in the jurisdiction; a coach should verify state rules, which vary for nutrition counseling.

Ethical marketing: never guarantee results, use before/after images misleadingly, or make disease-treatment claims for foods or supplements.

When in doubt about a client's medical safety, document the concern, refer, and continue only within the coach's defined role.