NESTA Sports Nutrition Specialist cheat sheet

Energy systems: ATP-PC (0–10 s) uses creatine phosphate; glycolysis (10 s–2 min) yields 2 ATP per glucose and lactate; oxidative phosphorylation (>2 min) yields ~30–32 ATP per glucose.

Macronutrient energy: carbohydrate 4 kcal/g, protein 4 kcal/g, fat 9 kcal/g, alcohol 7 kcal/g.

Resting metabolic rate (RMR) typically accounts for 60–75% of total daily energy expenditure (TDEE); thermic effect of food ~10%; exercise activity thermogenesis is the most variable component.

Mifflin–St Jeor equation: men RMR = 10×weight(kg) + 6.25×height(cm) − 5×age + 5; women RMR = 10×weight + 6.25×height − 5×age − 161.

Carbohydrate recommendations (g/kg/day): general training 3–5; moderate endurance 5–7; high-volume endurance 6–10; extreme training 8–12; pre-event meal 1–4 g/kg 1–4 h before; post-exercise 1–1.2 g/kg/h for 4 h.

Protein recommendations (g/kg/day): general active adults 1.2–2.0; endurance 1.2–1.4; strength/power 1.6–2.0; per-meal dose 0.25–0.3 g/kg (20–40 g) to stimulate muscle protein synthesis; leucine threshold ~2.5–3 g per meal.

Fat recommendations: 20–35% of total energy; avoid <20% long-term; pre-exercise meals low in fat (<10–15 g) to reduce gastric emptying delay.

Hydration: body-mass change method - sweat loss (L) = pre-body mass (kg) − post-body mass (kg) + fluid consumed (L); replace 125–150% of sweat deficit over 2–4 h post-exercise; sodium 300–700 mg/L of sweat lost for heavy salty sweaters.

Supplement evidence tiers: strong (creatine monohydrate 3–5 g/day, caffeine 3–6 mg/kg 30–60 min pre-exercise, beta-alanine 3.2–6.4 g/day for 4+ weeks, sodium bicarbonate 0.2–0.3 g/kg 60–180 min pre-exercise); limited/equivocal (BCAAs, glutamine, most antioxidants).

Pre-participation screening must include PAR-Q+ or equivalent, medical history, medication/supplement list, injury history, and current training load.

Risk stratification: known cardiovascular, metabolic, or renal disease → medical clearance before moderate/vigorous exercise; symptoms (chest pain, dizziness, syncope) → stop and refer.

Anthropometry: BMI = weight(kg) / height(m)²; waist-to-hip ratio >0.90 (men) or >0.85 (women) indicates elevated cardiometabolic risk; skinfolds use 3- or 7-site equations (Jackson-Pollock) with ±3–5% measurement error.

Dietary assessment methods: 24-hour recall (quick, relies on memory), food frequency questionnaire (habitual intake, not acute), weighed food record (most accurate, high burden), diet history (comprehensive, time-consuming).

Energy availability (EA) = (energy intake − exercise energy expenditure) / fat-free mass (kg); low EA <30 kcal/kg FFM/day; RED-S affects bone health, menstrual function, immunity, and performance.

Hydration assessment: urine color chart (pale straw = euhydrated), urine specific gravity >1.020 suggests dehydration; pre-exercise body mass baseline within 1% of normal.

Readiness screening: sleep duration/quality, resting heart rate, perceived stress, and session RPE load (RPE × duration) to detect non-functional overreaching.

Referral triggers: disordered eating signs (food rituals, weight preoccupation, purging), unexplained weight loss >5% in 1 month, amenorrhea >3 months, or suspected RED-S → refer to physician/registered dietitian.

Scope of practice: NESTA specialists may screen, educate, and coach within scope; they must not diagnose, prescribe therapeutic diets, or recommend supplement doses outside evidence-based general guidance.

Program design sequence: assess → set goals → calculate energy and macronutrient targets → distribute across meals/snacks → plan timing around training → monitor and adjust every 2–4 weeks.

Energy target: TDEE = RMR × activity factor (sedentary 1.2, light 1.375, moderate 1.55, very active 1.725, extremely active 1.9); adjust ±10–20% for weight gain/loss goals.

Carbohydrate periodization: 'train low' (low glycogen) for selected sessions to enhance mitochondrial adaptation; 'compete high' (high glycogen) for competition; avoid chronic low availability.

Nutrient timing: pre-exercise meal 3–4 h before (1–4 g/kg carbohydrate, 0.15–0.25 g/kg protein, low fat/fiber); during exercise >60–90 min: 30–60 g carbohydrate/h (up to 90 g/h with glucose+fructose 2:1); post-exercise 1–1.2 g/kg carbohydrate + 0.25–0.3 g/kg protein within 0–2 h.

Meal distribution: 3–5 eating occasions/day; protein evenly distributed every 3–4 h; include 20–40 g protein at each main meal.

Weight loss: deficit 300–500 kcal/day (0.25–0.5 kg/week); preserve lean mass with protein 1.6–2.4 g/kg/day and resistance training; avoid deficits >500–750 kcal/day for athletes.

Weight gain: surplus 300–500 kcal/day; protein 1.6–2.0 g/kg/day; carbohydrate 5–8 g/kg/day to support training volume.

Special populations: youth - emphasize adequacy and calcium/iron/vitamin D; masters athletes - higher protein (1.2–1.6 g/kg) and vitamin D/calcium; vegetarian athletes - monitor iron, B12, zinc, omega-3, and protein quality/combining.

Travel and competition planning: pack familiar foods, confirm venue food availability, plan hydration and electrolyte strategy, and rehearse race-day nutrition in training.

Transtheoretical Model stages: precontemplation, contemplation, preparation, action, maintenance, termination; match interventions to stage (e.g., consciousness raising in precontemplation, self-liberation in preparation).

Motivational interviewing (MI) core skills: open questions, affirmations, reflections, summaries (OARS); avoid the righting reflex; elicit change talk (DARN: desire, ability, reasons, need).

SMART goal criteria: Specific, Measurable, Achievable, Relevant, Time-bound; process goals (e.g., eat protein at breakfast) outperform outcome goals for adherence.

Self-determination theory: autonomy, competence, relatedness → intrinsic motivation; support autonomy by offering choices rather than prescribing.

Behavior change techniques with evidence: self-monitoring, action planning (if-then), stimulus control, social support, and relapse prevention planning.

Coaching communication: use reflective listening, avoid judgmental language, obtain informed consent, document sessions, and maintain confidentiality per privacy regulations.

Professional boundaries: do not diagnose or treat medical conditions; refer to registered dietitian, physician, or mental health professional when needs exceed scope; carry professional liability insurance.

Ethics: avoid guaranteeing results, disclose conflicts of interest (supplement endorsements), use evidence-based recommendations, and respect client autonomy and cultural food preferences.

Documentation: record assessment data, goals, plan, progress, and referrals; retain records per local requirements; use secure storage for personal health information.