NESTA SAQ cheat sheet

Energy density: carbohydrate 4 kcal/g, protein 4 kcal/g, fat 9 kcal/g, alcohol 7 kcal/g.

General athlete carbohydrate range is 3-12 g/kg/day; the position within that range scales with training load, duration, and goals.

Protein needs for most athletes fall between 1.2 and 2.0 g/kg/day; intakes up to ~2.5 g/kg/day are reported for very high-volume or energy-restricted scenarios.

A 20-40 g protein dose containing roughly 0.3 g/kg leucine threshold (~2.5-3 g leucine) supports muscle protein synthesis per feeding.

Fat intake typically 20-35% of total energy; very low fat (<20%) can impair fat-soluble vitamin status and hormone production over time.

Fiber target for general health is ~25-38 g/day; pre-competition meals often lower fiber to reduce GI distress.

Glycemic index ranks carbohydrate foods 0-100 by blood glucose response; low-GI pre-event foods favor sustained glucose, high-GI foods favor rapid post-exercise glycogen restoration.

Essential amino acids: 9 total (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine); leucine is the primary anabolic signal.

Sweat sodium concentration varies widely (~200-1,500+ mg/L); sodium losses are individual and should be estimated, not assumed.

Sweat rate (L/h) = (pre-exercise body mass − post-exercise body mass + fluid consumed) ÷ exercise hours.

Body mass change of 1 kg approximates 1 L of fluid loss; >2% body mass loss is associated with impaired performance in many athletes.

Rehydration guideline: ~1.25-1.5 L fluid per 1 kg body mass lost to account for ongoing urine losses.

Iron: ferritin <30 ng/mL suggests iron depletion; <12 ng/mL indicates iron deficiency; athletes (especially endurance, female) are at elevated risk.

Vitamin D: 25(OH)D <20 ng/mL = deficiency, 20-30 ng/mL = insufficiency; sun exposure and dietary sources (fatty fish, fortified foods) are primary.

Calcium: 1,000 mg/day for most adults, 1,300 mg/day for adolescents; critical for bone health in weight-bearing and low-energy-availability athletes.

Electrolyte drinks typically contain 20-60 mmol/L sodium (~460-1,380 mg/L); hypertonic drinks slow gastric emptying versus isotonic/hypotonic options.

Phosphagen (ATP-PCr) system: maximal intensity, ~0-10 s duration, no oxygen required, limited by phosphocreatine stores.

Anaerobic glycolysis: ~10 s to ~2 min, produces lactate and H+; net ATP yield ~2 per glucose molecule.

Oxidative phosphorylation: dominant for efforts >2-3 min; yields ~30-32 ATP per glucose and ~100+ ATP per fatty acid.

RER (respiratory exchange ratio) = VCO2/VO2; ~0.70 indicates fat oxidation, ~1.00 indicates carbohydrate oxidation, >1.00 indicates hyperventilation or high-intensity non-steady state.

Lactate threshold occurs at ~50-70% VO2max in untrained and ~70-85% in trained endurance athletes; a key performance determinant.

VO2max is limited by central (cardiac output) and peripheral (muscle oxidative capacity) factors; interval training at 90-100% VO2max is a potent stimulus.

EPOC (excess post-exercise oxygen consumption) contributes a small but real component of total exercise energy expenditure, typically <10-15%.

Basal metabolic rate accounts for ~60-70% of total daily energy expenditure; thermic effect of food ~10%; physical activity the most variable component.

BMI = weight (kg) / height (m)^2; limited in athletes because it does not distinguish muscle from fat.

Skinfold equations (e.g., Jackson-Pollock 3- or 7-site) estimate body fat percentage; measurement error is ~3-5% with a skilled tester.

DXA is a reference method for body composition but is affected by hydration status, recent exercise, and positioning; standardize conditions.

Bioelectrical impedance (BIA) is sensitive to hydration, recent food intake, and exercise; best used for tracking trends under consistent conditions.

24-hour dietary recall is quick but relies on memory; food frequency questionnaires capture habitual intake; weighed food records are most precise but burdensome.

Energy availability (EA) = (energy intake − exercise energy expenditure) / fat-free mass (kg); <30 kcal/kg FFM/day indicates low energy availability.

Relative Energy Deficiency in Sport (RED-S) encompasses impaired metabolic rate, bone health, immunity, protein synthesis, and menstrual function.

Minimum body fat for health is ~5% in men and ~12% in women; below these, endocrine and bone risks rise substantially.

Pre-event meal: 1-4 g/kg carbohydrate 1-4 hours before exercise, low in fat, fiber, and unfamiliar foods.

During exercise >60-90 min: 30-60 g carbohydrate/hour; up to 90 g/hour with multiple transportable carbohydrates (glucose + fructose).

Post-exercise glycogen resynthesis: ~1.0-1.2 g/kg/hour carbohydrate for the first 4 hours when recovery time is short (<8 h).

Carbohydrate loading: 8-12 g/kg/day for 36-48 hours before endurance events >90 min can elevate muscle glycogen above normal.

Protein timing: consume 20-40 g high-quality protein within ~2 hours post-exercise and distribute 0.3 g/kg doses every 3-4 hours.

Caffeine: 3-6 mg/kg body mass ~60 min pre-exercise improves endurance performance; higher doses do not add benefit and increase side effects.

Taper: reduce training volume 40-60% while maintaining intensity for 1-2 weeks to optimize performance and glycogen stores.

Gut training: progressive increase in carbohydrate intake during training can improve tolerance and absorption over weeks.

Third-party testing programs (Informed Sport, NSF Certified for Sport, BSCG) reduce but do not eliminate contamination risk.

Creatine monohydrate: 3-5 g/day; loading 20 g/day for 5-7 days saturates muscle stores faster; ergogenic for short-duration, high-intensity efforts.

Caffeine: 3-6 mg/kg; mechanisms include adenosine receptor antagonism and reduced perceived exertion.

Beta-alanine: 3.2-6.4 g/day for 4-10 weeks raises muscle carnosine and benefits 1-4 min high-intensity efforts; paresthesia is a common side effect.

Nitrate (beetroot juice): ~300-600 mg nitrate (~6-13 mmol) 2-3 hours pre-exercise; benefits endurance and some team-sport performance.

Bicarbonate: 0.2-0.3 g/kg 60-180 min pre-exercise; buffers acidosis for 1-7 min high-intensity efforts; GI distress is common.

WADA Prohibited List categories include anabolic agents, peptide hormones, beta-2 agonists, hormone modulators, diuretics, and masking agents.

Therapeutic Use Exemption (TUE) requires a documented medical need, no reasonable alternative, and no performance enhancement beyond restoring health.

Energy deficit of ~500 kcal/day generally produces ~0.5 kg/week fat loss; larger deficits risk lean mass loss and performance decline.

Rate of loss for athletes: aim for 0.5-1% body mass per week to preserve lean mass and performance.

Protein during energy restriction: 1.6-2.4 g/kg/day supports lean mass retention; higher end for lean athletes in aggressive deficits.

Resistance training plus adequate protein preserves lean mass during caloric restriction; without it, a substantial portion of loss can be lean tissue.

Weight cutting in weight-class sports: gradual loss over weeks is safer than acute dehydration; >2% body mass loss via dehydration impairs performance and health.

Refeeds and diet breaks can mitigate metabolic adaptation and psychological stress during prolonged deficits.

Body composition goals should be set with a qualified practitioner and consider health, performance, and long-term sustainability, not just aesthetics.

Low energy availability (<30 kcal/kg FFM/day) impairs menstrual function, bone density, immunity, and recovery; screen for RED-S in at-risk athletes.

Adolescent athletes: energy and protein needs are elevated for growth; calcium 1,300 mg/day and iron monitoring are important.

Female athletes: menstrual dysfunction (amenorrhea/oligomenorrhea) is a red flag for low energy availability and requires multidisciplinary referral.

Athletes with type 1 diabetes: carbohydrate intake and insulin timing must be coordinated with exercise; hypoglycemia risk rises with prolonged activity.

Vegan/vegetarian athletes: monitor vitamin B12, iron, zinc, omega-3 (EPA/DHA), calcium, and vitamin D; plant protein sources should be combined for complete amino acid profiles.

Pregnancy and postpartum athletes: energy needs rise; hydration, iron, folate, and calcium are critical; exercise prescription should be individualized with medical oversight.

Older athletes (masters): protein needs may be higher (~1.2-2.0 g/kg/day) to counter anabolic resistance; vitamin D and calcium support bone health.

Athletes with food allergies or intolerances (e.g., celiac disease, lactose intolerance) require careful substitution to maintain energy and nutrient adequacy.

Gastrointestinal distress during exercise is common; low-FODMAP or reduced-fiber pre-event meals may help, but should be trialed in training.

Sports nutrition practitioners should work within their credential scope; medical diagnosis and prescription require licensed clinicians.

Informed consent, confidentiality, and accurate record-keeping are core ethical obligations.

Recommending or facilitating prohibited substances violates anti-doping rules and professional ethics; practitioners must verify supplement status.

Conflicts of interest (e.g., supplement company sponsorship) must be disclosed to clients and in professional communications.

Referral pathways: registered dietitians for medical nutrition therapy, physicians for diagnosis, and mental health professionals for disordered eating concerns.

Evidence-based practice integrates best available research, practitioner expertise, and client values and preferences.

Documentation should include assessment data, intervention rationale, and outcomes to support continuity of care and accountability.

Continuing education and staying current with anti-doping updates, position stands, and safety alerts are professional responsibilities.