Special Populations and Clinical Considerations
Special Populations and Clinical Considerations
This domain tests adaptations for adolescents, older adults, pregnancy, diabetes, eating disorders, and gastrointestinal conditions. The exam expects you to recognize when standard sports nutrition advice must be modified or referred.
Core rules
- Adolescents: growth and development increase energy and nutrient needs; avoid restrictive dieting and emphasize calcium, iron, and adequate protein.
- Older adults: protein needs may be 1.0–1.2 g/kg/day or higher with resistance training; vitamin D and calcium support bone health.
- Pregnancy: energy needs increase modestly; avoid high-risk foods, limit caffeine, and refer for individualized care.
- Diabetes: carbohydrate consistency, timing, and medication coordination matter; refer to a diabetes care team.
- Eating disorders and RED-S: screen for disordered eating, low energy availability, menstrual dysfunction, and bone stress injury; refer promptly.
- Gastrointestinal issues: adjust fiber, fat, and lactose; consider low-FODMAP guidance only with a qualified dietitian.
Worked example
A 70-year-old strength trainee weighs 70 kg. Protein at 1.2 g/kg = 84 g/day, spread across meals with leucine-rich foods. Vitamin D 800–1,000 IU/day is a common maintenance dose, but status should be checked. Resistance training twice weekly supports muscle and bone. Reasoning: aging reduces anabolic sensitivity, so protein distribution and resistance exercise matter; supplementation should address documented risk, not guesswork.
Traps
Applying athlete macros to clinical populations; ignoring medications and comorbidities; over-restricting food in adolescents; and missing RED-S because the athlete looks fit.