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NASM CNC Chapter 1 – 4 Questions with
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RDN ✔✔Registered Dietitian Nutritionist This term is used interchangeably with a Registered Dietitian (RD) and it is also a legally protected designation. CDR ✔✔Commission on Dietetic Registration acts as the credentialing arm of the Academy of Nutrition and Dietetics for the purpose of establishing and enforcing certification standards for registered dieticians and other licensed nutritional professionals and issues credentials to those who successfully meet said standards. The CDR also provides a professional code of ethics and recertification standards. CDE ✔✔certified diabetes educator 1000 contact hours in diabetes education is required for certification. ARNP ✔✔Advanced Registered Nurse Practitioner requiring 2 more years of college beyond an RN - many then choose a specialty or primary focus of care.
PA ✔✔Physician Assistant A licensed healthcare professional who works under the supervision of a doctor or other medical professional, typically requires a 4-year degree plus a post-graduate program. Pharm D ✔✔Doctor of Pharmacy A pharmacist with an advanced degree who works in conjunction with a medical doctor to prepare and/or dispense prescription drugs or compounds. Nutritionist ✔✔A generic term for someone who provides nutrition counseling Licensed vs Certified Nutritionist. ✔✔Licensing is typically provided on a state or federal level. Common prerequisites of licensing include formal education/training, a predetermined number of supervised contact hours, and successful completion of a standardized test. Most healthcare providers require licensure. Certification is granted to a person who has participated in an educational course (either live or online) and successfully completed a standardized test: written, practical, or both. Patient vs Client ✔✔Patient is used for licensed professionals Client is more appropriate for certified professionals
providing behavioral change and motivation What a Nutrition Coach CANNOT do? ✔✔- specific meal plans/ menus
- specific supplements / vitamins / minerals/doses
- suggest drastic caloric restric
- promote fasting / detoxes / other extreme nutritional practices
- prescribe diets that omit or severely restrict certain food groups
- go against recommendations fo licensed healthcare professionals.
- prescribe dietary plans for athletes in extreme training programs, OR those with chronic health conditions
- provide nutrition therapy to treat / prevent disease
- provide exercise prescriptions / programming *unless cpt What A Nutrition Coach CAN do? ✔✔- evaluate current eating plan + provide general guidance
- recommend the client discuss supplement use with their personal RDN, physician, or pharmacist.
- promote caloric guidelines outlined by USDA's myplate, the UK eatwell guide, or other acceptable entities
- Recommend gradual dietary modifications
- discuss importance of balance intake of macronutrients.
- refer back to clients personal healthcare provider when necessary
- provide guidance for healthy populations
- offer advice on eating behaviors and/or macronutrients that are known to reduce the risk of disease / slow progression
- offer exercise and physical activity guidelines 3 important steps to coaching ✔✔Assess Educate Implement
- The single parent with a full-time job and three children, who have a plethora of after-school activities, may not have time to prep food for an hour every day.
- Perceived to be important. If a client just lost a partner to a heart attack, the client may likely be very interested in heart-healthy foods. Important work with clients to allow for setbacks and develop strategies to overcome obstacles... i.e. late night cravings, boss bringing donuts to work, weekends, etc Implement ✔✔Extreme diets and extreme workouts cannot be maintained indefinitely, so it is important to have an open and honest conversation with the client who may have unrealistic expectations If a Nutrition Coach finds that a client is very preoccupied with body image and is considering extreme measures to enhance their physique, it would be prudent to refer the client to an RDN who specializes in disordered eating. Body dysmorphic disorder is a true medical condition that affects both men and women. The Nutrition Coach can offer advice on eating behaviors and/or macronutrients that are known to reduce the risk of disease or slow disease progression ✔✔True A nutrition coach can provide meal plans and recommend supplements to their client (T or F) ✔✔False
when providing information/educating to clients, what kind of information is this? If a client just lost a partner to a heart attack, the client may be likely be very interested in heart-healthy foods. ✔✔Perceived to be important when providing information/educating to clients, what kind of information is this? Discussions on meal prep for a family wouldn't be relevant if the client is single and lives alone. ✔✔Relevant when providing information/educating to clients, what kind of information is this? The client who has had countless attempts at weight loss can relate to weight loss strategies, especially if he or she is open to options and has bought into trying new things. ✔✔based on prior experience when providing information/educating to clients, what kind of information is this? The single parent with a full-time job, and three children who have a plethora of after-school activities may not have time to prep food for an hour every day. ✔✔practical When it comes to client confidentiality, all personal information should be kept in a locked or secure area. (T or F) ✔✔True
- Would you say that Food dominates your life? The Nutrition Coach could informally work these questions into conversation, but not necessarily as part of a formal eating disorder assessment. hypoglecemia and type 2 diabetes ✔✔hypoglycemia: significant hunger, dizziness, loss of energy, sweating, thirst *Those with pre-existing conditions will need detailed guidance on topics like food intake, timing of meals, and food interactions as they relate to their medications What should you do when a client has a change in health status? ✔✔if any client has a change in health status, shows an unexplained drop or increase in weight, or shows signs or symptoms of a psychological disorder, the coach must not only recommend that his or her client consult with a professional, but also refuse further sessions until cleared by a licensed healthcare provider. REFER to list with common reasons for referral !!! ✔✔ Which term refers to a hypothesis or set of hypotheses for which a large body of high quality evidence has been accumulated? ✔✔Theory Which of the following is an example of descriptive research? ✔✔Survey
Numerous studies, including genetic studies, randomized controlled trials on lipid lowering medications, and observational studies point to LDL having a causal role in heart disease. Which term best describes the concept that LDL plays a causal role in heart disease? ✔✔Theory Which term describes how a body of knowledge is based on observation and experience? ✔✔Empirical Scientists perform a diet study in which they assign half the people to a continuous dieting group and the other half to an intermittent fasting group. Which term best describes this study design? ✔✔Parallel A scientist proposes that sugar is inherently fattening, independent of its calorie content. If that proposal is true, then that would mean that high-sugar diets should increase fat gain independent of their calorie content. What term describes this potential consequence? ✔✔Prediction Scientists find that a protein supplement increases lean mass in the elderly. However, they caution that the results may not apply to other populations, like younger people. What term best describes what the scientists are referring to? ✔✔External Validity Which of the following represents a strength of observational studies? ✔✔Large subject numbers Which observational study design allows scientists to hypothesize a potential causal association? ✔✔Cohort Study Which of the following represents a critical evaluation of a study by other scientists? ✔✔Peer Review
scientific data is fixed and immutable (t or f) ✔✔False The uncertainty of science is a strength, as nothing is ever 100% certain (t or f) ✔✔True Emprical ✔✔based on observation or experience test- retest reliability ✔✔The ability to get similar results when something is measured under the same conditions. reliability ✔✔The consistency of a measure. Validity ✔✔The assessment of whether a tool is measuring what it is supposed to measure. selection bias ✔✔A sample of people under study is not representative of the larger population that scientists are looking to make inferences about. retrospective ✔✔Describes a study that looks backward in time. Recall bias ✔✔the inability to accurately remember past behaviors Types of scientific research: Interventional designs ✔✔in an interventional design, scientists directly intervene with subjects and look at the impacts of the intervention
2 types:
- True Experimental Design (RCT's)
- Quasi Experimental Designs RCT's (True Experimental Design) & 3 types ✔✔True experimental design consists of randomized controlled trials (RCTs) which are the gold standard of research due to degree of rigor and control
- parallel design
- Factorial Design
- crossover design parallel design ✔✔research track 2+ independent groups in parallel with each other factorial design ✔✔researchers test the impact of 2+ more variables simultaneously rather than isolating a single variable crossover design ✔✔the same group of subjects are assigned to both the treatment and control groups each subject acts as his/her own control
3 types of descriptive research ✔✔case studies surveys historical research case studies ✔✔track a single person / people over time discuss characteristics of or events that occur within that group/person limitation - may not be generalizable to larger populations surveys ✔✔questionnaires that are administered to a sample of respondents selected from a target population limitations-
- collect self reported data, and that can be subject to bias
- potential issues w/ reliability, validity, or how wording of questions can influence ppl's answers Historical Research ✔✔Looks at events in past and uses it to make inferences about other times, including the future limitations:
- info from past may be incomplete or inaccessible
- may be subject to biases of researchers involved. types of exploratory/epidemiological research ✔✔1.cross sectional studies 2.case control studies
- cohort studies Cross sectional studies ✔✔variables in a group at a specific point in time (cross section of ppl) most useful for:
- population bases surveys
- to assess the prevalence of diseases in a population primary limitation:
- impossible to assess causal relationships because its a one time snapshot measurements? case-control studies ✔✔determine if exposure to something is associated with an outcome scientists identify people with the outcome and similar ppl who dont have the outcome uses data that has already been collected or occurred in past cohort studies ✔✔group (cohort) followed over time to determine association between an exposure and an outcome or disease
- Scientists can explore mechanistic explanations for observed effects Limitations:
- The high degree of control, while a strength, is also a limitation. Notably, the study may not reflect real-world conditions. (limits external validity)
- these designs are only capable of examining a limited number of variables at a time High Quality Non peer reviewed sources of information ✔✔Recently published academic textbooks University public health websites (e.g., Harvard School of Public Health) Academy of Nutrition and Dietetics website (https://www.eatright.org/) U.S. government health websites (e.g., Centers for Disease Control and Prevention) International health websites (e.g., Eat Well Guide or World Health Organization) Conference presentations by primary researchers without a brand or ideology to defend or product or supplement to promote Podcast interviews with primary researchers
Questionable or poor, non-peer reviewed sources of information ✔✔Popular media. This includes television and radio shows (whose main objective is ratings and advertising revenues, not scientific accuracy) and most popular diet and health books. Anecdotes and testimonials. Anecdotes are at the bottom of the hierarchy of evidence and can be unreliable. Advertisements of products or special methods and protocols Most blogs (and their comment sections) What are the 3 components of evidence based practice? ✔✔1. The weight of the evidence from scientific research
- Field Observations
- Individual client needs and preferences evidence based practice ✔✔A three-pronged approach to working with clients, which consists of making decisions based on the weight of the scientific evidence, field observations, and individual client needs and preferences Science ✔✔a method of attempting to arrive at objective truths hypothesis ✔✔a proposed explanation for an observation scientific method ✔✔The process of formulating explanations about the natural world and testing those explanations with experiments and data.
