FSN 338 Final Exam Study Guide

Instructor: Nasira Burkholder-Cooley, DrPH, RDN

1. Know how many calories per gram each macronutrient provides and the primary
function of each macronutrient.
1. Carbohydrates:
1. 4 kcal/g
2. Converted to glucose in the body and used as main energy source
2. Protein:
1. 4 kcal/g
2. Development, growth, and repair of muscle and other bodily tissue; critical
for recovery from intense physical training; can be used as source of energy
(not preferred source of energy)
3. Fat:
1. 9 kcal/g
2. Concentrated energy source; fuel at rest and during low-to moderate-intensity
exercise; providing structure to cell membranes; aid in hormone production;
insulation for nerve cells; facilitates absorption of fat-soluble vitamins

2. Understand which fuel sources (carb, protein, fat) are preferred during different types of
activity.
Carbs Fats Protiens
Glycolysis 1
Beta-oxidation 1
Deamination 1
Citric acid cycle 2 2 2
Electron transport chain 3 3 3

1. Anaerobic: carbs only (glucose)

2. Aerobic: carbs, fat, and sometimes protein
1. Fat provides most of the fuel for daily activity

3. Know the factors that influence resting metabolic rate.

1. The functions included in RMR are respiratory process, circulation, heartbeat, muscle
functions, nervous functions, temperature regulation, and all of the organ functions
that are metabolically active.
2. RMR can be influenced by body weight, surface area, lean body mass, caffeine
intakes, smoking, ambient temperature, rapid growth, and some medical conditions

4. Know the relative contributions of BMR, adaptive thermogenesis, and physical activity
to total energy expenditure.
1. Total energy expenditure: ~70% resting energy expenditure (fuel used to maintain
basic physiological functions), ~20% physical activity (fuel for physical activity),
~10% thermic effect of food (fuel to process the food we eat)
5. Understand the purpose of deamination and transamination of amino acids.
1. Deamination: the metabolic pathway that is responsible for removing the nitrogen or
amine group from the carbon structure of amino acids (strips the amino group from an
amino acid) so the remaining carbon molecule can pass through the citric acid cycle
and electron transport chain to produce ATP
1. Remove amine group
2. Transamination: used to synthesize nonessential amino acids
1. Transfer amine group

6. Know the three energy systems, when each is used, and the duration of time that each
system predominates.
1. Phosphagen system:
1. Used during short bursts of energy: 10 seconds of intense, all-out activity (ex.
100 m run)
2. Immediate energy system; produces ATP at fastest rate
2. Anaerobic system (glycolysis):
1. Longer lasting sprint activities of lower intensity: 1-3 minutes of all-out
activity (ex. 800 m run)
2. Generates ATP in absence of oxygen; formation of ATP and lactate
3. Aerobic system
1. Used during longer-lasting activities of even lower intensity; 4-6 minutes (ex.
Mile run)
2. Relies on presence of oxygen to make ATP; slowest at producing ATP but has
an almost unending capacity to make ATP

7. Understand the basic stages of carbohydrate breakdown (i.e., glycolysis and Citric Acid
Cycle. Are these aerobic or anaerobic? What are the substrates and end-products of each
stage?
1. Glycolysis: a metabolic pathway that is responsible for the breakdown of glucose. It is
unique in that it can function with or without the presence of oxygen
1. Anaerobic (no oxygen): pyruvate —> lactate
2. Aerobic (with oxygen): end products are ATP, carbon dioxide, and water
2. Citric acid cycle: one of the major metabolic pathways of the aerobic energy system.
It is also known as the Krebs cycle or the tricarboxylic acid cycle. Its main role is to
strip hydrogens from compounds passing through it.
1. Aerobic pathway common to all three energy nutrients
2. Citric acid cycle —> electron transport chain —> ATP

8. Where is the potential energy obtained from food actually stored and conserved?
1. CHO: stored as glycogen in muscle (1200-1600 kcal) and liver (300-400 kcal)
2. PRO: amino acids become part of amino acid pool; stored in muscle, skeleton, and
liver
 3. FAT: 300 g of triglyceride in intramuscular lipid droplets

9. Understand when, why and how lactic acid forms.

1. During the most intense activities, carbohydrates are the only macronutrient that can
be metabolized fast enough to produce energy. The energy comes from the anaerobic
breakdown of glucose to lactic acid.
2. Proteins help control the acidity level (pH balance) within the body. During exercise,
lactic acid is produced and increases the acidity of body fluids, and if not buffered can
cause fatigue within muscle. Proteins buffer the lactic acid and thus delay the onset of
fatigue, which is critical to an athlete’s performance.

10.Understand the function of the hormones insulin, glucagon, cholecystokinin (CCK) and
know when and from which organ they are released.
1. Insulin:
1. Produced by pancreas
2. Triggered by hyperglycemia as well as certain amino acids/fatty acids
3. Lowers blood glucose by increasing glucose uptake via GLUT 4, and
increasing glycogen and fatty acid synthesis in the liver
2. Glucagon:
1. Produced by pancreas
2. Stimulated by hypoglycemia
3. Brings blood glucose to normal by stimulating gluconeogenesis and breaking
down liver glycogen
3. Cholecystokinin (CCK):
1. Produced by cells of small intestine
2. Stimulates the release of bile salts and pancreatic enzymes

11.Know where in the digestive tract most nutrients are absorbed.

1. Most nutrients are absorbed in the small intestine

12.Know the purpose of the urea cycle and how the amine group of amino acids are
excreted.
1. Important for preventing ammonia toxicity
2. Disposal group for nitrogen gross from trans/deamination reactions
3. The urea cycle helps to excrete two harmful gases from the body: ammonia and
carbon dioxide
4. Amine groups are transferred (through transamination) or removed (through
deamination)
5. Excreted in urine

13.Know what influences how cells utilize protein for synthesis.

1. The specific protein constructed inside the cell is determined by current needs and/or
the influences of outside factors such s hormones.
 1. Ex. Testosterone causes muscle cells to increase production of contractile
proteins, thus causing the muscle to become bigger and stronger
2. Actual instructions for making specific proteins needed by the cel lie in the strands of
DNA found in the nucleus (genes)

14.Know the recommended intakes of carbohydrate and protein both as percentage of total
calories and as grams per kg per day.
1. Carbohydrates:
1. 3-12 g/kg BW per day; 45-65% of total calories
2. Protein:
1. 1.2-2.0 g/kg BW per day; 10-35% of total calories

15.Know which minerals are often lacking in the American diet.

1. Calcium, potassium, (iron), and magnesium

16.Understand what dietary fiber is and know examples of indigestible dietary fibers.
1. Dietary fiber: a complex carbohydrate obtained from plant sources that is not
digestible by humans. Although dietary fiber provides no energy for cellular activity,
it does help maintain a healthy digestive system, lower blood cholesterol levels, and
regulate blood glucose levels.
2. Consist of non digestible carbohydrates and lignin that are intrinsic and intact in
plants (ex. Cellulose, hemicellulose, pectin, gums, beta-glucans, fibers found in oat
and wheat bran, plant carbohydrates, and lignins)

17.Know the routes that glucose is transported and absorbed.

1. The monosaccharide glucose is absorbed across the intestinal lining via active
transport (an energy-requiring form of cellular absorption in which substances are
carried across membranes by protein molecules; not dependent on concentration
gradients)
2. The name of the transporter protein found in the intestines is SGLUT1. SGLUT1
must bind to both a sodium ion and sugar for transport into the cell to occur.

18.Understand glycemic index and know examples of foods that are low vs. high GI.
1. Glycemic index (GI): an index for classifying carbohydrate foods based on how
quickly they are digested and absorbed into the bloodstream. The more quickly blood
glucose rises after ingestion, the higher the glycemic index.
2. Glycemic effect of an isolated food based on elevation of blood sugar levels two
hours after ingestion
3. Low GI foods: peanuts, peppers, spinach, whole milk, dried apricots, whole wheat
spaghetti, apples
4. High GI foods: white rice, white bread, potatoes, sugary foods/drinks

19.Understand the basic purpose of gluconeogenesis.

 1. Gluconeogenesis: the formation of glucose from noncarbohydrate sources such as
proteins
1. Amino acids are converted to glucose with the removal of nitrogen
2. Glucose-alanine cycle is the conversion of amino acid in muscles to alanine,
and alanine is converted to pyruvate and then to glucose
3. Glycerol backbone of triglycerides also a source
2. When liver glycogen stores are depleted (starvation), gluconeogenesis is activated to
supply glucose to the brain and RBCs

20.Understand the effect of glycogen-depletion on concentrations of blood glucose, fatty

acids, and ketones. 3 charts on a slide in CHO lecture (glycogen depletion vs carb rich)
1. Low muscle glycogen causes fatigue (hitting the wall)
2. Blood glucose: decreases
3. Fatty acids: increases and then decreases
1. low glycogen forces your body to use fat as fuel
4. Ketones: possible increase if prolonged instance

21.Know the definitions and characteristics of macro- and micro-minerals, essential

vitamins and minerals, water-soluble and fat-soluble vitamins.
1. Major (macro) minerals: the minerals required by the body in amounts greater than
100 mg per day
1. Calcium, phosphorus, magnesium, sodium, chloride, potassium, sulfer
2. Trace (micro) minerals: minerals required by the body in quantities less than 100 mg
per day
1. Iron, zinc, chromium, fluoride, copper, manganese, iodine, molybdenum,
selenium
3. Essential vitamins and minerals: needed by bodies to develop and function normally
1. Vitamins: vitamin A, thiamin (B1), riboflavin (B2), niacin (B3), pantothenic
acid (B5), pyridoxine (B6), cobalamin (B12), biotin, folate, vitamin C,
vitamin D, vitamin E, vitamin K
2. Minerals: calcium, chromium, iodine, iron, magnesium, manganese,
molybdenum, potassium, selenium, zinc
4. Water-soluble vitamins: B complex vitamins (thiamin, riboflavin, niacin, B6, B12,
folate, biotin, and pantothenic acid), choline, and vitamin C
5. Fat-soluble vitamins: vitamin A, vitamin D, vitamin E, vitamin K

22.Compare and contrast fat- and water-soluble vitamins.

1. Water-soluble vitamins: a class of vitamins that dissolve in water and are easily
transported in the blood. Because of their water solubility, they are also turned over in
the body and as a result are not stored in the body in appreciable amounts. Utilization
of water-soluble vitamins occurs on an as-needed basis; excess B vitamins or vitamin
C are excreted in the urine. Because little storage of water-soluble vitamins occurs,
regular intake of these nutrients is important.
 2. Fat-soluble vitamins: require small amounts of dietary fat to help the body absorb,
transport, and utilize them. Unlike water-soluble vitamins, these vitamins can be
stored in the body, primarily in fat tissues and the liver, but also in other organ tissues
in smaller amounts. As a result, the levels of fat-soluble vitamins in the body can
build over time, potentially causing toxicity (more often from supplements than food)

23.Know when a multivitamin mineral supplement is recommended and what toxicities are
common. Know good food sources of vitamins like thiamin.
1. A multivitamin and mineral supplement that furnishes 100% of the RDA is
recommended for women of childbearing age, people on low-calorie diets, older
adults (>65 years old), physically or mentally challenged individuals, those unable to
eat a varied diet, individuals who choose to eat a restricted array of foods, and
individuals with diagnosed eating disorders or other conditions considered high risk
(ie. Alcoholics)
2. Commonly reported toxicities: vitamin A, vitamin D, vitamin B6
3. Good sources of thiamin: enriched bread and fortified foods (refined flours, grains,
breakfast cereals), whole grains, sweet potato, legumes, wheat germ, nuts, pork

24.Know what foods are often enriched or fortified in the US and which minerals are often
lacking in the American diet.
1. Enrichment and fortification of foods:
1. Bread/grains enriched with thiamin, riboflavin, niacin, iron, and folic acid
2. Milk fortified with vitamins A and D
3. Salt fortified with iodine
2. Minerals often lacking in the American diet: Calcium, potassium, iron, and
magnesium

25.Understand the biological dose-response of mineral intake.

1. Dose-response curve: each essential element has an optimal range of intake. Within
this level, the body maintains functions via homeostatic mechanisms. No health
benefits are recognized from intakes at the higher end of the range. Function declines
at both ends of the curve, and all elements are toxic in excess.

26.Be able to define bioavailability and know what factors reduce or enhance absorption of
minerals.
1. Mineral bioavailability: fraction of an ingested nutrient that enters the blood
circulation and that can be used for physiological functions or storage
2. Bioavailability is influenced by absorption, distribution, metabolism, and excretion
1. Factors favoring mineral absorption: physiological need, chemical form,
stomach acidity, lactose, ascorbic acid
2. Factors reducing mineral absorption: chelating substances, intestinal motility,
mineral interactions, intestinal mucosa damage
27.Know the necessary components of a dietary supplement label.
1. FDA approval not required before marketing
2. Must be labeled as a “dietary supplement”
3. “Supplement Facts” panel required
4. Supposed to list all ingredients
5. If the product contains a proprietary blend of ingredients, the total amount of the
blend and the identity of each dietary ingredient in the blend must be shown

28.Know what beverages are considered dietary fluid, and the daily recommended fluid
volume for adults.
1. Dietary fluids: milk, water, juice, tea, coffee, soda, sports drinks
2. Fluid needs for adult men and women: 11-16 cups (2.6-3.8 L according to the slides;
2.7-3.7 L according to the textbook) total fluid per day

29.Know the definitions of acclimatization and plasma osmolality.

1. Acclimatization: improvement in temperature regulation during exercise
1. Requires exercising at sufficiently high intensity
2. Plasma osmolality: measures the body’s electrolyte-water balance

30.Understand risk factors for hyperhydration.

1. Water intoxication
2. Water intake > water loss
3. Extensive sweating with only water replacement
4. Signs mimic those of dehydration
5. May cause nausea and headache
1. Sodium levels may also decrease causing confusion and instability
6. Risk factors: low body mass, endurance sport, overexertion and heat stress,
competitive eating training, MDMA (ecstasy use), psychiatric conditions, IV feeding

31.Be aware of recommendations for sports drinks and energy beverages.

1. Sports drinks should be consumed during exercise lasting longer than 60 minutes
2. Isotonic: 6-8% CHO plus electrolytes
3. Hypotonic: electrolytes and small amount of CHO
4. Hypertonic: Large amount of carbohydrate; ideal for refueling

32.Review components of energy expenditure.

1. Total energy expenditure: ~70% resting energy expenditure (fuel used to maintain
basic physiological functions), ~20% physical activity (fuel for physical activity),
~10% thermic effect of food (fuel to process the food we eat)

33.Understand the basics of immunity and the effect of acute vs. chronic exercise on
immune function.
 1. Natural (innate) immunity: skin, tears, saliva, mucus, acids; property of all living
creatures
2. Adaptive (acquired) immunity: specialist cells, cytokines, antibodies; specific/has
memory
3. Acute exercisers are more susceptible to infection
1. Increased stress hormones, free radicals, gut permeability
2. Decrease IgA, glutamine
3. Increased exposure to airborne pathogens
4. Chronic exercise has a protective effect
1. Increase cell circulation, response time to kill organism, neutrophils
2. After exercise, increase in macrophages and neutrophils

34.Understand the changes that occur with acclimatization and when exercising in hot
weather.
1. Acclimatization: improvement in temperature regulation during exercise
1. Requires exercising at sufficiently high intensity
2. Heat acclimatization affects exercise performance
1. Increased total body water —> increased plasma volume and sodium
preservation which helps regulate HR
2. Cardiac output is affected because increased blood volume —> better heart
pump and less stress on heart
3. More blood flow to muscles and skin
4. Less muscle glycogen use (ie. CHO sparing) —> improved ability to sustain
intense exercise
5. Threshold for sweating starts earlier at a lower temperature
6. Body salt losses decrease
7. Sweat glands secrete about 30% more sweat
8. Core temperature will not rise as high or as rapidly
9. Psychological stress is reduced
3. Heat illness common during exhaustive exercise in a hot, humid environment

35.Understand iron bioavailability, particularly differences between heme and non-heme

iron.
1. Heme iron: found in animal products (meat, poultry, seafood, etc…)
1. Absorbed easier
2. Non-heme iron: found in plant-based foods (grains, beans, vegetables, fruits, nuts,
seeds, etc…)
1. Less well absorbed
3. Vitamin C enhances iron absorption

36.Know the components of Female Athlete Triad and the types of athletes most
susceptible.
 1. Low bone and mineral densities (stress fractures), disordered eating, and amenorrhea
(no menstrual cycle for three months or more)
2. Athletes in aesthetic sports more susceptible
1. Gymnastics, dance, etc…

37.Know nutrients of concern for special athlete populations.

1. Diabetes: carbohydrate metabolism
2. Pregnant athletes: total calorie intake (need 300 additional kcal/day on average),
protein (need extra 20-25 g/day), B vitamins (energy production and tissue
development—especially folate), vitamin C (collagen formation, hormone synthesis,
immune function, iron absorption), vitamin A (cell differentiation and immune
function), magnesium (muscle contraction and energy production), iron (RBC
production, oxygen delivery, energy level)
3. Young athletes: fluids (less tolerant of heat, need reminders to consume fluids),
calcium, iron
4. College athletes: alcohol (banned, safety issues, nutritionally empty, poor CHO
source, can increase body fat, stimulates appetite)
5. Older athletes: altered calorie needs, decrease chromium/iron, increase vitamin D/
calcium/magnesium, food/drug interactions, chronic diseases

38.Review basic information on the diet recommendations for specific athletic events (e.g.,
boxing/wrestling, swimming, dance).
1. Gymnastics and dance:
1. CHO: main fuel for training
2. Snacks between meals and after intense training sessions
3. Protein/fats to support muscular growth and assist with recovery
1. Include protein in all/most meals (especially in post-training snacks
and meals)
2. Healthy fats needed to think clearly (memory and quick thinking)
4. Commonly low in iron, calcium, and vitamin D
2. Boxing and wrestling:
1. Carb rich diet is ideal
1. CHO in hours before training and ASAP after to help optimize
energy and promote recovery
2. Protein needs increased because of high volumes of strength training
3. Maximize intakes of healthy fats
4. Consume meal or snack ASAP after training (especially if training more than
once a day) to start recovery process
5. Dehydration/starvation to “make weight”
1. After weigh in, fuel up and hydrate; drink fluid at every opportunity
3. Endurance athletes
1. Choose foods with potassium and sodium after long exercise bouts to
replenish lost electrolytes
 2. Large caloric expenditures required for training
3. Matching caloric intake with expenditure during exercise is difficult and
many times not feasible
1. Provide athlete with some energy and maintain blood glucose levels
2. Focus on meeting CHO (30-60 g/hr) and fluid requirements
3. Sports drinks (6-8% CHO) are appropriate
4. 200-300 calorie snack immediately after exercise
5. Larger meal within 1-2 hours post exercise
6. CHO:
1. 50-65% of total daily calories
2. 6-10 g/kg body weight (1-3 hours training/day)
3. 8-12 g/kg body weight (4-5 hours training/day)
7. Maintain macronutrient balance
8. Carbohydrate loading: gradually increase intake to 65-70% while decreasing
total calorie/fiber/fat consumption
1. Juices/smoothies are an excellent source
9. Pre-exercise CHO intake
1. 1-4 g/kg in the 1-4 hours before exercise
2. Larger CHO intake —> longer time between ingestion and
competition
10.Post-exercise CHO intake
1. Provide rapid recovery of glycogen stores
2. 1-1.2 g/kg every hour for 4 hours after exercise
11.Protein
1. Tissue repair and muscle adaptation
2. 1.2-2.0 g/kg
3. Not major provider of energy, but high energy expenditures increase
utilization
4. Delay fatigue during prolonged exercise
5. 15-25 g immediately following endurance exercise is recommended
12.Fat
1. Source of energy
2. 20-35% of total calories
3. Before exercise: slows digestion/absorption
4. After exercise: slows digestion which can delay delivery of nutrients
for recovery
13.Vitamins: B complex, C, E
14.Minerals: Fe, Ca, Na, K
15.Fluids: hydration is critical to safety and performance
4. Swimming
1. Relies on both aerobic and anaerobic energy systems
2. Early morning/late evening training often interferes with breakfast and dinner
3. Need sustainable recovery snacks
 4. Aim to include low GI foods, fruits, and vegetables
5. Don’t try low carb diets
6. Include protein rich foods in all meals/most snacks
7. Moderate fat intake to maintain leanness
8. Low iron stores —> iron deficiency anemia
9. Sweat loss in the water is often ignored

39.Review claims, efficacy, and recommendations for use of ergogenic aids presented in
class.
1. Anabolics: enhance the body’s ability to build tissue, particularly muscle
1. Testosterone, anabolic-androgenic hormones, growth hormone
2. Pro-hormones and hormone releasers: substances touted to be converted to or increase
production of anabolic hormones in the body
1. Pro hormones: androstenedione/“andro,” HMB
2. Hormone releasers: ornithine, arginine, clonidine)
3. Fat reducers: decrease appetite, increase fat mobilization/utilization, block absorption
of ingested fats
1. Caffeine, L-carnitine, chitosan, ephedrine
4. Anticatabolics: substances that decrease the breakdown of body tissues, thus slowing
protein degradation
1. Glutamine, branched chain amino acids, leucine, whey protein
5. Vitamins and minerals: micronutrients that may enhance enzyme activities and thus
improve athletic performance
1. B vitamins, chromium, iron
6. Ergogenics used by endurance athletes: beet root, caffeine, coenzyme Q10, energy
bars/gel, ginseng, glycerol, L-carnitine, medium-chain triglycerides (MCT), pyruvate,
sodium/electrolyte tablets, sports beverages
7. Ergogenics used by strength athletes: anabolic steroids, beta-alanine, beta-hydroxy-
beta-methyl-butyrate, caffeine, chromium, conjugated linoleic acid, growth hormone,
medium-chain triglycerides, protein powders/bars

40. BMI Classifications (kg/m2):

1. Underweight: <18.5
2. Normal weight: 18.5-24.9
3. Overweight: 25.0-29.9
4. Obesity Class I: 20.0-34.5
5. Obesity Class II: 35.0-39.9
6. Obesity Class III (extreme obesity): > or equal to 40

QUIZ 1
1. True or false: The energy needs of athletes can be met by taking a daily multivitamin-mineral
supplement
1. False
2. True or false: Of the three energy systems, the aerobic system is the slowest at producing ATP
but has an unending capacity to make ATP
1. True
3. True or false: The amino acid pool found in body fluids and tissues is a collection of amino
acids available for protein synthesis
1. True
4. True or false: The enzyme responsible for breaking down carbohydrates into simple sugars is
called lipase
1. False: the enzyme responsible for breaking down carbohydrates into simple sugars is
called amylase
5. True or false: The hormone insulin is secreted by special cells of the small intestine
1. False: The hormone insulin is secreted by special cells of the pancreas
6. True or false: The anaerobic energy system relies on the presence of oxygen to make ATP
1. False
7. True or false: An anabolic pathway requires an input of energy and results in the formation of
larger, more complex molecules from similar compounds
1. True
8. True or false: Anaerobic glycolysis involves fat, protein, and carbohydrate substrates
1. False: Anaerobic glycolysis only utilizes carbohydrate substrates
9. True or false: Adequate carbohydrate intake spares muscle mass
1. True
10. True or false: Self-restriction of food intake increases basal metabolism (BMR)
1. False: Self-restriction of food intake reduces basal metabolism (BMR)
11. True or false: The primary function of carbohydrates is to act as enzymes and transporters
1. False: The primary function of carbohydrates is to supply energy for cellular work
12. True or false: Potential energy is extracted from food and conserved with high-energy
phosphate bonds of ATP
1. True
13. True or false: Cellulose is an indigestible dietary fiber made up of beta-1,4 glucose units
1. True
14. True or false: Skittles candy is an example of a low glycemic index food
1. False
15. True or false: Hypoglycemia is the main stimulus for the release of the hormone insulin
1. False: Hyperglycemia is the main stimulus for the release of the hormone insulin
16. True or false: An adult athlete should aim to consume at least 85 grams of fiber per day
1. False: An adult athlete should aim to consume at least 28 grams of fiber per day. The
AI for fiber is 14 g per 1000 kcal consumed
17. True or false: The most practical way to estimate the carbohydrate needs of an athlete is
using grams of carbohydrate per kg body weight
1. True
18. True or false: Glucose storage capacity is greatest in the blood
1. False: Glucose storage capacity is greatest in the muscle
19. True or false: During exercise, the liver releases glucose for use by active muscles as exercise
shifts from low to high intensity
1. True
20. True or false: A low carbohydrate diet helps delay fatigue during exercise
1. False
21. True or false: Low carbohydrate intake can promote muscle protein breakdown and loss of
muscle mass
1. True
22. True or false: During short bursts of intense activity (ie. 10 seconds of intense all-out
activity), the creatine-phosphate energy system is the main energy system that supplies the
ATP pool
1. True
23. True or false: During longer-lasting activities of lower intensity (eg. Mile run), the main ATP
supplier becomes the aerobic system with help from the anaerobic system
1. True
24. True or false: For a sedentary individual, resting metabolism typically makes up ~20% of the
day’s total energy expenditure
1. False: For a sedentary individual, resting metabolism typically makes up ~70% of the
day’s total energy expenditure
25. True or false: Protein is the preferred energy fuel during high-intensity anaerobic exercise
1. False: Carbohydrate is the preferred energy fuel during high-intensity anaerobic
exercise

QUIZ 2
1. Carbohydrate needs of athletes range from ___ grams per kg body weight per day.
1. 3 to 12
2. True or false: Carbohydrate loading is a diet plan used by endurance athletes designed to
engorge muscle cells with glycogen
1. True
3. True or false: Galactose is the most commonly occurring simple sugar in nature and is the
carbohydrate molecule that humans rely upon for cellular energy
1. False: Glucose is the most commonly occurring simple sugar in nature and is the
carbohydrate molecule that humans rely upon for cellular energy
4. True or false: Glycemic load is a way of assessing the overall glycemic effect of a diet based
on both the glycemic index and the number of carbohydrates provided per serving for each
food ingested
1. True
5. True or false: Absorption of whole proteins and peptides is common
1. False
6. True or false: There are 20 essential amino acids
1. False: There are nine essential amino acids
7. True or false: Soy, cheese, and chicken are considered complete proteins because they provide
all of the essential amino acids in adequate amounts to meet human needs
1. True
8. True or false: Eating black beans with pinto beans would be an appropriate complementary
protein combination to provide all the essential amino acids
1. False: Eating a whole wheat tortilla with pinto beans would be an appropriate
complementary protein combination to provide all the essential amino acids
9. In healthy adults, the total amount of body protein fluctuates constantly
1. False: In healthy adults, the total amount of body protein remains constant
10. Muscle protein synthesis rises following what type(s) of exercise:
1. High intensity interval training, resistance training, endurance exercise, etc… (muscle
protein synthesis rises following all types of exercise)
11. True or false: Eicosanoids are hormone-like substances produced from omega-3 and omega-6
long-chain fatty acids
1. True
12. True or false: Corn and safflower oil are sources of omega-6 polyunsaturated fatty acids
1. True
13. True or false: During sedentary or light activity, the body predominantly utilizes stored fat
1. True
14. True or false: All amino acids are metabolized in the liver
1. False: Branch-chain amino acids are metabolized in skeletal muscle
15. True or false: Adaptation refers to a process that permits the organism to respond to a dietary
change without adverse consequences
1. True
16. True or false: Bioavailability refers to the fraction of an ingested nutrient that enters the
blood circulation and that can be used for physiological functions or for storage
17. True or false: An essential amino acid cannot be synthesized from simpler molecules to meet
human body needs
1. True
18.True or false: In anaerobic conditions, excess hydrogen atoms from NADH are produced and
combine with pyruvate to reversibly form lactic acid
1. True
19. True or false: Casein is an example of a “fast protein” because it is digested and absorbed
rapidly
1. False: Casein is a slow protein, digested and absorbed slowly
20. True or false: In response to training, the body adapts to spare carbohydrate and protein and
more efficiently use fat for energy
1. True
21. Which of the following factors influence an athlete’s protein requirements?
1. Injury status, exercise intensity and duration, age, total energy intake, and
carbohydrate availability
22. True or false: In the hours leading up to a competition (approximately 4-24 hours prior), an
athlete should predominantly eat high-protein meals and snacks including a variety of new
foods
1. False: Balanced high-carb meals and snacks or familiar foods are recommended.
Carbs, not proteins should predominate
23.True or false: The recommended protein intake for strength athletes is generally 1.6-1.7 g per
kg body weight per day, which is about twice the value for the general population
1. True
24. True or false: The recommendation for fat intake after exercise is significantly higher than
the normal dietary recommendation for fat intake (20-35% of total calories)
1. False
25. True or false: Approximately 10,000 kcal can be stored in muscle glycogen
1. False: Approximately 1200-1600 kcal can be stored in muscle glycogen

QUIZ 3
1. True or false: Even slight dehydration hinders exercise performance
1. True
2. True or false: Symptoms of hyperhydration include nausea and headaches
1. True
3. True or false: Dehydration improves the body’s ability to dissipate heat
1. False
4. True or false: Sports beverages or electrolyte water may be favorable if training lasts more
than 60 minutes
1. True
5. Approximately what quantity of water is needed to rehydrate an athlete who lost 1 pound of
body weight during practice?
1. 2 cups
6. True or false: Weight loss occurs when energy intake exceeds energy expenditure
1. False: Weight loss results when energy intake is less than energy expenditure
7. True or false: A BMI of 18 would be classified as underweight
1. True
8. What is considered the most accurate measure of percent body fat in humans?
1. Underwater weighing
9. What is the name of the common eating disorder characterized by severe calorie restriction,
distorted body image, and in intense fear of weight gain?
1. Anorexia nervosa
10. True or false: Achieving a positive energy balance and a positive nitrogen balance are needed
for muscle gain
1. True
11. True or false: A product can be removed from sales after FDA proves that it presents
significant or unreasonable risk or illness or injury
1. True
12. True or false: A product that is labeled “natural” is always safe
 1. False
13. True or false: Depleted liver glycogen levels result in extreme fatigue
1. True
14. True or false: Science confirms that BCAAs are a group of amino acids that independently
improve muscle gains regardless of total protein intake and training load
1. False
15. True or false: Dietary supplements are regulated by the FDA in a similar manner as other
packaged foods
1. False
16. True or false: Doping is the practice of enhancing performance using foreign substances or
other artificial means
1. True
17. True or false: Antioxidants like vitamin C can donate an electron to neutralize a free radical
1. True
18. True or false: Some carotenoids can be converted into vitamin D
1. False: Some carotenoids can be converted into vitamin A
19. A multivitamin and mineral supplement that furnishes 100% of the RDA is recommended
for:
1. Women of childbearing age, those on restricted diets, older adults (>65 years), and
individuals with diagnosed eating disorders
20. True or false: Toxicities of vitamins A, D, and B6 are commonly reported
1. True
21. True or false: Health benefits are observed with extremely high intakes of minerals
1. False
22. True or false: Regular strenuous exercise can contribute to micronutrient deficiencies among
athletes
1. True
23. True or false: Athletes with adequate energy intake are at high risk for B vitamin deficiency
1. False: Athletes with inadequate energy intake are at high risk for B vitamin
deficiency. Generally, if calorie and carb requirements are met, B vitamin intake is
also achieved
24. True or false: Athletes are at high risk for vitamin C deficiency
1. False
25. True or false: Female athletes should consider taking calcium supplements, especially
amenorrheic females
1. True

QUIZ 4
1. True or false: Amenorrhea is defined as the absence of menstruation (fewer than four cycles
per year)
1. True
2. True or false: Power athletes always have higher protein needs than endurance athletes
1. False
3. True or false: Acute exercisers are typically more susceptible to infection compared to regular
exercisers
1. True
4. True or false: Moderate exercise increases leukocyte production and cell circulation and thus
prevents illness
1. True
5. True or false: Research indicates that vegetarian athletes have impaired exercise capacity
because of a lack of animal protein intake
1. False
6. True or false: Iron deficiency anemia can be caused by blood loss
1. True
7. True or false: Low carb diets are recommended for gymnasts and dancers
1. False
8. True or false: Exercise may slightly increase an athlete’s need for B vitamins
1. True
9. Which of the following micronutrients functions as an antioxidant?
1. Selenium
10. True or false: Iron supplementation has been shown to enhance exercise performance in
healthy athletes
1. False
11. True or false: Consuming large volumes of high-fiber foods before competition is a good
strategy for preventing gastrointestinal issues during competition
1. False
12. True or false: When an athlete exercises in hot weather, their energy needs are generally
higher than they would be in a more temperate climate
1. True
13. True or false: It is safe for a diabetic athlete to immediately initiate exercise if their blood
glucose reads 65 mg/dL
1. False
14. True or false: A pregnant athlete will require an average additional 300-400 calories per day
compared to her usual intake
1. True
15. True or false: Children are more tolerant of heat than adults and therefore do not get
dehydrated easily
1. False
16. True or false: Team sports athletes should consume 55-65% of total calories from
carbohydrate
1. True
17. True or false: At least 25 grams of essential amino acids are needed to stimulate protein
synthesis
1. False; at least 10 grams of essential amino acids (which can be obtained from 15-25
grams of protein) are needed to stimulate protein synthesis
18. True or false: Large quantities of dietary fat are used during strength/power activities
 1. False
19. True or false: Low calcium levels are often a concern for gymnasts
1. True
20. True or false: Activities such as baseball predominantly utilize the aerobic energy system
1. False
21. True or false: Obesity in athletes is very common
1. False: Obesity among athletes is relatively rare
22. True or false: Among athletes, football players, heavyweight wrestlers/boxers, and field
throwers are at risk for obesity
1. True
23. Which of the following behavior modifications may help an athlete lose weight?
1. Practice self monitoring, increase exercise/activity if feasible, set short and long term
goals
24. Which of the following is defined as overeating combined with feelings of lack of control
and depression or guild afterwards?
1. Binge eating disorder
25. True or false: Training for hypertrophy should include several workouts per week that
include 3-5 sets per muscle per group with 8-12 reps per set
1. True