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Nutrition: The Complete Guide Workbook and Study Guide

Nutrition: The Complete Guide

Workbook and Study Guide

Second Edition

International Sports Sciences Association CERTIFICATION COURSES

International Sports Sciences Association CERTIFICATION COURSES

John Berardi, PhD, CSCS
Ryan Andrews, MS, MA, RD
Brian St. Pierre, MS, RD, CSCS
International Sports Sciences Association
Krista Scott-Dixon, PhD
1015 Mark Avenue • Carpinteria, CA 93013
1.800.892.4772 • 1.805.745.8111 (international) Helen Kollias, PhD, CSCS
issaonline.edu Camille DePutter
 John Berardi, PhD, CSCS
Ryan Andrews, MS, MA, RD
Brian St. Pierre, MS, RD, CSCS
Krista Scott-Dixon, PhD
Helen Kollias, PhD, CSCS
Camille DePutter

Workbook and Study Guide

Study Companion for Nutrition: The Complete Guide
Nutrition: The Complete Guide Workbook and Study Guide (Edition 2)
Official workbook for: International Sports Sciences Association’s Certified Nutrition Specialist program

10 9 8 7 6 5 4 3 2 1

Copyright © 2018 International Sports Sciences Association.

Published by the International Sports Sciences Association, Carpinteria, CA 93013.

All rights reserved. No part of this work may be reproduced or transmitted in any form or by any electronic, mechanical, or other means, now known or
hereafter invented, including xerography, photocopying, and recording, or in any information storage and retrieval system without the written permission of
the publisher.

Direct copyright, permissions, reproduction, and publishing inquiries to:

International Sports Sciences Association, 1015 Mark Avenue, Carpinteria, CA 93013

1.800.892.4772 • 1.805.745.8111 (local) • 1.805.745.8119 (fax)

DISCLAIMER OF WARRANTY
This text is informational only. The data and information contained herein are based upon information from various published and unpublished
sources that represents training, health, and nutrition literature and practice summarized by the author and publisher. The publisher of this text
makes no warranties, expressed or implied, regarding the currency, completeness, or scientific accuracy of this information, nor does it warrant the
fitness of the information for any particular purpose. The information is not intended for use in connection with the sale of any product. Any claims
or presentations regarding any specific products or brand names are strictly the responsibility of the product owners or manufacturers. This summary
of information from unpublished sources, books, research journals, and articles is not intended to replace the advice or attention of health care
professionals. It is not intended to direct their behavior or replace their independent professional judgment. If you have a problem or concern with your
health, or before you embark on any health, fitness, or sports training programs, seek clearance and guidance from a qualified health care professional.
 About | 1

About the Workbook and Study Guide

The purpose is to help you better understand the content of the main text. When you focus on the important
points and concepts in the text and then write the answers directly in this guide, you will better comprehend the
material. The most commonly used strategy for studying includes reading and underlining text material and/or
outlining and writing core concepts. This workout encourages each of those methods.

Evidence shows that students who use the workbook attain a greater understanding of the course material. ISSA
recommends that you actively use this tool to prepare for your exam.

The Best Way to Use the Workbook and Study Guide

As you read the text, open this workbook to the same unit. You can follow along with the main concepts as
they match up. In most cases, the questions in the workbook are in chronological order. This is a tried and true
method for study and retention of information. Filling in your responses reinforces what you have read and, most
importantly, will help you become a more effective Nutrition Coach.

International Sports Sciences Association

 INTRODUCTION

Nutrition: The Big Picture

 Nutrition: The Big Picture | 3

0.1 What does it mean to say that food is more than just fuel?

0.2 Define the following:

Micronutrients:

Phytochemicals:

Zoochemicals:

0.3 What does it mean to say that food tells a story?

0.4 If you were going to write your own “food story,” what would it say? What about the “food stories”
of your clients, friends and family?

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4 | Introduction

0.5 Without looking at the textbook… ask yourself: What do YOU think is good nutrition? Why do you
think that?

0.6 List the features of what WE think makes up “good nutrition.”

0.7 Did we miss anything in our definition of “good nutrition”? If yes, what? If no, why?

0.8 List the elements that can affect how clients respond to nutrition programs, or that could be limiting
factors.

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 Nutrition: The Big Picture | 5

0.9 Why is there no “best diet”?

0.10 List some of the things that a good nutrition coach does.

0.11 Explain your answer to the previous question: Why would a good nutrition coach do these things?

0.12 Explain what “scope of practice” is, and how it applies to you.

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6 | Introduction

0.13 Explain why the client featured in the case study rebounded.

Nutrition: The Complete Guide Workbook and Study Guide

UNIT 1

Cells
8 | Unit 1

1.1 Describe the two basic roles of cells.

1.2 What are the various functions that make up metabolism?

1.3 List the body’s systems from smallest to largest.

1.4 Our body breaks down macronutrients, micronutrients, phytochemicals and zoochemicals via diges-
tion into smaller compounds. How do our cells use those compounds?

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 Cells | 9

1.5 Building on your answer to the previous question: Why does this mean that food fundamentally
changes how our body works?

1.6 How does genetic individuality affect how our body uses nutrients?

1.7 What do we know and not know about this genetic individuality?

1.8 How do you think you might learn more about a given client’s genetic individuality?

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10 | Unit 1

1.9 What would happen if your cells DID NOT have:

A plasma membrane?

Mitochondria?

An endoplasmic reticulum?

A Golgi apparatus?

Lysosomes?

Peroxisomes?

1.10 Draw your best approximation of the following cells. Then describe where they’re found and what
their function is.

What they look like Where they’re found What they do

Enterocytes

Columnar epithelial cells

Cuboidal cells

Squamous cells

Myocytes

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 UNIT 2

Through the GI Tract

12 | Unit 2

2.1 ”Digestion” comes from the Latin digerere — to separate, divide, or arrange. How does our body
separate, divide, and arrange molecules during digestion?

2.2 How is the GI tract involved in other systems, besides just moving food through?

2.3 Why is it important for the brain and nervous system to be involved in digestion?

2.4 What happens if we can’t smell, taste, and/or chew our food properly? Why?

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 Through the GI Tract | 13

2.5 What is GERD and what does it tell you about how the esophagus should work?

2.6 If the stomach is full of strong acid, why doesn’t it digest itself?

2.7 If you had a client who needed a fast-digesting meal, what types of foods would you recommend?
Why?

2.8 What substances does the small intestine absorb compared with the large intestine?

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14 | Unit 2

2.9 If someone DID NOT have a liver, what would they not be able to do effectively? Why not?

2.10 What is the organ that produces insulin, glucagon, amylin, and somatostatin? What else does that
organ do?

2.11 What can we learn about an animal’s diet by looking at the structure of its digestive system?

2.12 Why does intestinal gas smell?

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 Through the GI Tract | 15

2.13 What is feces made of?

2.14 List the gastrointestinal hormones that play a role in hunger, appetite, gastric motility and satiety, and
their functions:

Hormone Action

2.15 Why do we need four branches of a nervous system — central, peripheral, autonomic, and enteric —
involved in digestion? What does each one contribute?

2.16 List the neurotransmitters that play a role in hunger, appetite, gastric motility and satiety, and their
functions:

Neurotransmitter Action

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16 | Unit 2

2.17 Fill in the table below for the three types of nutrient transport.

Facilitated
Simple diffusion Active transport
diffusion

Needs energy

Needs a carrier protein

Concentration gradient

Rate of absorption
limited by

2.18 Imagine you’re working a hospital triage desk. You have four patients.
• One has had diarrhea for the last 24 hours.
• One is having anaphylactic shock from a food allergy.
• One has chronic diverticulosis.
• One has nausea and a steady ache in the upper abdomen and between the shoulder blades.
Which one do you send to be treated first? Why?

2.19 In the case study about the Olympic triathlete, why did we recommend the client lower his fat
intake?

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 UNIT 3

Energy Transformation and Metabolism

18 | Unit 3

3.1 ATP is the body’s “energy currency.” Where does it come from? What are the two most important
“raw materials” for making it?

3.2 What are the three main processes or systems for generating ATP?

3.3 Why can’t you run fast forever?

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 Energy Transformation and Metabolism | 19

3.4 Which of the three energy systems would play the biggest role for each activity? Why?

Activity What energy system Why?

predominates?
Slow walking

Short track speed skating

A 1-rep max lift

Sleeping

400 m run

50 m sprint

Chess

Boxing

Chess boxing (yes, it’s a

thing)

3.5 Why can supplementing creatine help improve muscular performance?

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20 | Unit 3

3.6 Why is it a problem to have too many hydrogen ions circulating when muscles are doing work using
the glycolytic pathway?
• What does our body do to remedy this?
• Why aren’t hydrogen ions such a big problem when the Krebs cycle is the most active process?

3.7 What is the main function of the electron transport chain?

3.8 What are the two processes that make up the oxidative phosphorylative pathway?

3.9 What are antioxidants, how do they work in our body, and should we supplement with them? Why
or why not?

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 Energy Transformation and Metabolism | 21

3.10 What are all the possible pathways for carbohydrate metabolism? List them, and provide a brief sum-
mary of what each one involves. (We recommend also drawing a flowchart of each, to help yourself
better understand these pathways.)

Pathway What it involves

1.

2.

3.

4.

5.

3.11 Can you have lactic acid production if there is oxygen available?

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22 | Unit 3

3.12 What are the four main compounds that can go into gluconeogenesis?

3.13 What are all the possible pathways for fat metabolism? List them, and provide a brief summary of
what each one involves. (We recommend also drawing a flowchart of each, to help yourself better
understand these pathways.)

Pathway What it involves

1.

2.

3.

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 Energy Transformation and Metabolism | 23

4.

5.

6.

3.14 What four hormones activate lipid mobilization?

3.15 What enzyme responds to hormones that activate lipid mobilization?

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24 | Unit 3

3.16 What are the components of triglycerides? How many of each component?

3.17 What are all the possible pathways for protein metabolism? List them, and provide a brief summary
of what each one involves. (We recommend also drawing a flowchart of each, to help yourself better
understand these pathways.)

Pathway What it involves

1.

2.

3.

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 Energy Transformation and Metabolism | 25

3.18 In order to have protein synthesis, what is the protein status required?

3.19 What happens to excess amino acids when there are excess calories in the body?

3.20 What is the purpose of deamination in energy production?

3.21 What process does your body use to make non-essential amino acids?

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26 | Unit 3

3.22 Where is the only place your body can get essential amino acids from?

3.23 Why is beta oxidation not a true cycle and sometimes called the fatty acid spiral?

3.24 What is the relationship between glucose and insulin? What about glucose and epinephrine /
norepinephrine?

3.25 In what two sites is glycogen stored?

• What are the similarities and differences between these two storage sites?
• What relevance does this have for glycogenolysis?

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 Energy Transformation and Metabolism | 27

3.26 While glucose cannot leave a muscle cell once it enters, what glycolytic product can leave the muscle
and where does it go after it leaves the muscle?

3.27 What are the two molecules mostly responsible for energy production in a non-starvation state? What
pathways are used to make ATP with these two molecules? What are the similarity and differences
between these two pathways?

3.28 Compare and contrast glucose, fatty acids and amino acids. How are they similar? How are they
different?

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28 | Unit 3

3.29 Fill in the following table:

Basic building block Body’s Storage Molecule

Carbohydrates

Fats

Protein

3.30 McArdle syndrome is a genetic disease in which glycogen phosphorylase does not function. What
are the consequences to carbohydrate metabolism?

Nutrition: The Complete Guide Workbook and Study Guide

 UNIT 4

Energy Balance in the Body

30 | Unit 4

4.1 Fill in the table to convert the energy stored in the following foods.

Food Calories / kcal calories Joules

1 medium apple 95,000

1 avocado 1526

1 boiled egg 77

1 can of tuna 191,000 798

4.2 Review the definitions of calories and Calories / kilocalories. Do you think this a useful way to under-
stand how food works in the human body? Why or why not?

4.3 We say: “For the most part, precise calorie counting won’t help you or your clients.” List all the rea-
sons why we might say this.
• What are all the factors that affect how food is digested and used, and/or the factors that affect
energy content of the food itself?

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 Energy Balance in the Body | 31

4.4 List the five general categories of metabolism and what each one involves.

Metabolic category What it involves

4.5 What are all the ways in which we could measure metabolic rate?
• Once you’ve listed these, rank them: Which are the most accurate and precise methods, and which
are the least? Why?

4.6 In an everyday situation with a client, which method of metabolic measurement / prediction might
you use, and why?

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32 | Unit 4

4.7 Compare the advantages and disadvantages of a positive and negative energy balance.
• When would you suggest a positive energy balance to a client? Why?
• When would you suggest a negative energy balance? Why?

4.8 What are the signs and symptoms of lowered metabolic rate?
• If you had a client who showed signs of lowered metabolic rate, what factors might you investi-
gate? Why?

4.9 Your client tells you she is on a new diet in which she can eat as much as she wants and still lose
weight. Assuming she is actually eating food (and not, say, shredded newspaper):
• How might you explain that this diet probably isn’t scientifically accurate?
• How would you explain the concept of energy balance to her?

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 Energy Balance in the Body | 33

4.10 Your client above is now convinced that energy balance matters, but she wonders what exercise and
nutrition program would be best for weight / fat loss.
• What would you recommend, and why?
• What factors would you consider in this recommendation?
• How would you try to help your client implement this as easily and simply as possible?

International Sports Sciences Association

 UNIT 5

Aerobic and anaerobic Metabolism

 Aerobic and anaerobic Metabolism | 35

5.1 List the metabolic effects of exercise.

5.2 Imagine two people. Both are 40 years old.

• One has 8% body fat and is a longtime sprinter and weightlifter.
• One has 35% body fat and is a longtime sedentary desk worker.
Why will the first person probably age better, metabolically? List all the reasons.

5.3 Imagine two people again.

• One is the same 8% body fat sprinter and weightlifter as in the previous question.
• One also has 8% body fat, but is an elite ultramarathoner.
Describe all the ways in which their overall muscle fiber makeup is probably different.
If you only had a chunk of each person’s muscle tissue (rather than knowing about a whole person),
how could you guess each person’s preferred sport?

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36 | Unit 5

5.4 Draw a muscle and list all its structural and functional components.

5.5 What is a MET (metabolic equivalent) and what does it represent?

• Now imagine your sprinter is sprinting in competition. And your ultramarathoner is casually doing
a nice easy downhill recovery run. Explain how the METs of each athlete would differ while they’re
doing these things.

5.6 Explain “oxygen debt” or EPOC. What factors contribute to it?

• What types of activities might create the most oxygen debt?
• What types of activities might create the least oxygen debt?

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 Aerobic and anaerobic Metabolism | 37

5.7 What are the differences between aerobic and anaerobic exercise?

5.8 What are the various types of muscular hypertrophy, and what are the differences between them?

5.9 How do our muscles adapt to aerobic and anaerobic exercise?

5.10 How do we adapt structurally to aerobic and anaerobic exercise?

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38 | Unit 5

5.11 How do we adapt hormonally to aerobic and anaerobic exercise?

5.12 Imagine you have a client who doesn’t want to change their body composition (i.e., they don’t want
to lose fat or gain muscle). How would you explain the other benefits of exercise to them?

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 UNIT 6

Macronutrients
40 | Unit 6

6.1 List the processes in our body that macronutrients can affect.

6.2 We typically classify carbohydrates by their general chemical structure.

• Describe the three general groups of saccharides and what differentiates them.
• Give two examples of each type of saccharide, and where each might be found.

Saccharide type Description Examples Location

1.

2.

3.

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 Macronutrients | 41

6.3 What are the best types of potatoes for making potato salad and why? In your answer, describe the
differences between types of potato starch, and why that might matter.

6.4 Walk through the process of carbohydrate digestion step by step, describing what happens at each
stage, and why it might be important to know that information.

The mouth:

The stomach:

The small intestine:

The liver:

The bloodstream:

6.5 Your client asks you, “Is fructose bad for me?” What do you say and why?

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42 | Unit 6

6.6 Describe each of the following indexes:

• Glycemic index (GI)

• Glycemic load (GL)

• Insulin index (II)
What are they? What do they measure? What foods might score highest and lowest on each index?
Why?

6.7 Your client asks you whether they should use GI, GL, and/or II to make food choices. Which of these
factors would you consider in making nutritional recommendations? Why?

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 Macronutrients | 43

6.8 What is glucose transport? How does it work?

• Describe what you know of the GLUT isoforms we mention in the text. (For extra credit, have fun look-
ing up the rest.)
• How do GLUT1-GLUT3 differ from GLUT4, and why might that be important to know?

6.9 There is no “correct” amount of carbohydrates that is the same for everyone, all the time.
• What factors does carbohydrate intake depend on?
• If you consider the “big picture” for each client, what other factors should you take into account?
What should you prioritize in your recommendations, and why?

6.10 What does it mean to say “not all carbs are created equal”? How do carbs differ?

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44 | Unit 6

6.11 Carbohydrates may include soluble fiber, insoluble fiber, and resistant starch. Describe each of these,
where they might be found, and what they do.

Description Location Action

Soluble fiber

Insoluble fiber

Resistant starch

6.12 Your client asks you how to get more fiber in their diet. What do you recommend and why?

6.13 Describe the structure of fatty acids.

• What makes a fatty acid saturated or unsaturated?
• Where are fatty acids typically found in the body?

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 Macronutrients | 45

6.14 Describe the structure of triglycerides. Where are triglycerides typically found in the body?

6.15 What are the major roles of dietary fat in our body?

6.16 Fill in the table below.

Foods highest in Foods highest in Foods highest in

saturated fats monounsaturated fats polyunsaturated fats

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46 | Unit 6

6.17 • Client 1 asks you to help them eat fewer saturated fats. What’s a sample daily menu for them?
• Client 2 asks you to help them eat less fat overall. What’s a sample daily menu for them?
• Client 3 wants to try a high-fat, low-carb diet. What’s a sample daily menu for them?
In terms of hunger and/or satiety, what might these three clients notice about changing their fat
intake? How might you expect each of them to feel? Why?

6.18 When we eat and digest fat, we start with mostly triglycerides (in food) and end with mostly triglyc-
erides (in cells), doing some conversions in between.
• Describe, step by step, how this process happens. Include enzymes or hormones that change the
structure of the fats as they are processed.

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 Macronutrients | 47

6.19 How does the liver in particular help regulate lipid levels in the body? What factors affect this
process?

6.20 Describe each type of lipoprotein: what it is, where it’s found, and what it does.
• Why do we need lipoproteins?

Lipoprotein type Description Location Action

6.21 Your client is concerned about their blood lipid tests.

• What might they have found that concerned them? What indicators could suggest a potential
problem?
• Your client is worried that saturated fat is bad for them. How do you explain the relationship be-
tween saturated fat intake and blood cholesterol?

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48 | Unit 6

6.22 Your client has heard that omega-3 fats are good and omega-6s are less so, especially if processed.
• How would you explain the difference between omega-3s and omega-6s to them?
• What basic recommendations might you start with?
• They want to know if flax oil is the best source of omega-3. What do you tell them?
• Your client struggles with chronic inflammation. Does that change your perspective on their
omega-3 and omega-6 intake? If yes, how so? If not, why not?

6.23 What are trans fats?

• What makes fats hydrogenated?
• Why does this change in fat configuration matter for health and cellular function?

6.24 What are the major roles of proteins in our body?

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 Macronutrients | 49

6.25 All amino acids have four main characteristics. What are they?

1.

2.

3.

4.

6.26 For each of the following, describe each, what it might do, and provide 1-2 examples.

Description Action Example

Essential amino acid

Conditionally essential
amino acid

Non-essential amino
acid

Branched-chain
amino acid

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50 | Unit 6

6.27 What are peptides? What happens when we eat them?

6.28 When we eat and digest protein, we start with mostly secondary, tertiary, and quaternary forms of
protein (in food) and end with mostly amino acids (in cells).
• Describe, step by step, how this process happens. Include enzymes or hormones that change the
structure of the proteins as they are processed.

6.29 How does the liver in particular regulate protein digestion? What factors affect this process?

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 Macronutrients | 51

6.30 Your client wants to start eating more protein.

• What foods might you recommend they add to their diet, and why?
• Your client is vegetarian. How might that change your original recommendations?

6.31 Your client also wants to know about protein quality.

• List some of the most commonly used protein quality indices, and the general features of each.
• What do you think is the best protein quality index to use? Why?
• What would you say to your client about what matters most when choosing proteins?

6.32 What can increase a person’s / a client’s protein needs? Why?

What can decrease a person’s / a client’s protein needs? Why?

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52 | Unit 6

6.33 Your client wants to know whether they should consider a protein supplement.
• In making your recommendations, what factors do you consider? Why?
• What is most important in choosing a supplement?

Nutrition: The Complete Guide Workbook and Study Guide

 UNIT 7

Micronutrients
54 | Unit 7

7.1 What are micronutrients and why do we need them?

What are co-enzymes and why do we need them?

7.2 What can happen if we don’t get enough micronutrients?

What can happen if we get too much (e.g., through supplementation)?

7.3 Compare fat-soluble to water-soluble vitamins in terms of: their chemical structure; and how they’re
absorbed and excreted. Give examples of each.

Structure Absorption Excretion Examples

Fat-soluble vitamins

Water-soluble vitamins

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 Micronutrients | 55

7.4 What does it mean to say that different methods of food preparation can affect that food’s vitamin
content and bioavailability? Give examples of how this could be.

7.5 Vitamins come in different molecular forms. Why does this matter?

7.6 What are macrominerals? What are microminerals? Give examples of each.

7.7 What factors affect mineral absorption?

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56 | Unit 7

7.8 Your client wants to know how to improve their mineral intake.
• What are some factors that you consider — factors that could affect their mineral need and absorp-
tion? Why?
• How could you know for sure what your client needs, rather than just guessing?

7.9 Review each vitamin and mineral listed in the text. Choose three vitamins and three minerals.
For each one of these, describe:
• Where that vitamin or mineral is found
• What it does or is involved in
• What happens when you get too much
• What happens when you don’t get enough
(Of course, you should have a general concept of all of these, but we recommend you start by focus-
ing on a few.)

7.10 What are some things that phytonutrients and myconutrients do in our body?
What are some things that zoonutrients do in our body?

Nutrition: The Complete Guide Workbook and Study Guide

 UNIT 8

Water and Fluid Balance

58 | Unit 8

8.1 Different cells and tissues contain different amounts of water.

• What are some of the differences between specific cell and tissue types?
• What might these differences mean for judging how much water we’re carrying around?

8.2 How does bioelectrical impedance analysis (BIA) of body fat work?
• What can affect how accurate BIA is?
• What might be the advantages and disadvantages of using BIA to assess a client’s body fat?

8.3 Water has many important jobs in our body. For each one of these jobs, describe how it works and why
it’s important.

1. Dissolving other substances:

2. Transporting other substances:

3. Catalyzing (starting) chemical reactions:

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 Water and Fluid Balance | 59

4. Lubricating tissues:

5. Regulating temperature:

8.4 Fluid balance is the balance between fluid input and output. Describe how this works.
• What are all the ways we take in water?
• What are all the ways we lose water?
• What factors increase our need to take in fluids?
• What factors decrease our need to take in fluids?
• What factors increase our fluid output?
• What factors decrease our fluid output?

8.5 What is dehydration?

• What are symptoms of dehydration?
• What are the ways in which dehydration can happen?
• How might exercise play a role in dehydration?

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60 | Unit 8

8.6 What is hyponatremia?

• What are the three types of hyponatremia?
• What are symptoms of hyponatremia?
• What are the ways in which hyponatremia can happen?
• How might exercise play a role in hyponatremia?

8.7 What is edema?

• What can cause edema?
• What is nutritional edema?

8.8 What is the role of ADH in controlling fluid balance? Why do we have hangovers?

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 Water and Fluid Balance | 61

8.9 What is the role of the renin-angiotensin system in controlling fluid balance? What relationship
does this have to hypertension?

8.10 How can a woman’s menstrual cycle (or hormone fluctuations during pregnancy and perimeno-
pause / menopause) affect fluid balance?
• Why would you see sex differences in water manipulation and weight cutting in general?

8.11 Your client wants to know why they lost weight so quickly during the first week of a low-carbohy-
drate diet. How do you explain it?

8.12 What are electrolytes? Why should we replenish them? Who might need electrolyte replenishment
most?

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62 | Unit 8

8.13 Your client wants to know whether they should take in carbohydrates and electrolytes during and
after exercising. What factors do you consider in making your recommendation?

8.14 You decide your client should take in carbohydrates and electrolytes during and after exercising.
Review the “General hydration requirements” formula. What would you recommend...
• For a recreational hiker on a two-hour hike in relatively dry terrain?
• For a strength athlete looking to gain muscle, doing a 90-minute Olympic weightlifting workout?
• For a higher-level cyclist doing a three-hour training ride?

8.15 Compare and contrast the fluid manipulation strategies for physique athletes and weight-classed
athletes.
• How are they similar?
• How are they different?
• What are the basic factors that make fluid manipulation “work” this way, and why? (For example,
why would adjusting carbohydrate level matter?)

Nutrition: The Complete Guide Workbook and Study Guide

 UNIT 9

What It Means To Be a Good Coach

64 | Unit 9

9.1 Why do we include coaching as well as nutrition in this Certification? What are some of the general
things a good coach knows about change?

9.2 Why do we say that you help others best when you know more about yourself?

9.3 List some of the factors that make up the broad, general job description of a coach. Is there anything
you might add or change? What is YOUR job description of a coach? Why?

9.4 What are the “5 Whys”? Why might they be relevant to coaching?

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9.5 Review the 18 principles of good coaching.

Choose five and describe them. What does each principle involve? Give examples.

Principle What it involves What it might look like in practice

1.

2.

3.

4.

5.

Obviously, all principles are important. Which ones are most important to you, and why?

9.6 What are some of the ways in which clients can differ? Brainstorm as many as you can think of.

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9.7 What are mental skills?

• Why are they important in coaching?
• What is the relationship between stress and mental skills?
• Give five examples of mental skills.

Mental skill What it means What it might look like What it might look like
for a coach for a client

1.

2.

3.

4.

5.

9.8 What are communication skills?

• Why are they important in coaching?
• Why is it important to distinguish between what you should know and what clients should know?
• Take two technical nutrition coaching concepts (e.g., protein synthesis, GI motility). “Translate” them
into plain, simple, understandable language for a potential client.

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The ISSA Nutrition

Coaching Methodology
68 | Unit 10

10.1 List the six steps of coaching.

1.

2.

3.

4.

5.

6.

10.2 As a coach, you’re almost always gathering data in some form. What types of data might you be col-
lecting, especially in Step 1?

10.3 What types of tasks might you be doing at Step 2? Why?

• What are some important things to consider at this stage?

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10.4 What types of tasks might you be doing at Step 3? Why?

• What are some important things to consider at this stage?

10.5 What types of tasks might you be doing at Step 4? Why?

• What are some important things to consider at this stage?

10.6 What types of tasks might you be doing at Step 5? Why?

• What are some important things to consider at this stage?

10.7 What types of tasks might you be doing at Step 6? Why?

• What are some important things to consider at this stage?

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10.8 Why is the initial assessment important?

• What should you be focusing on during this time?
• As part of your initial assessment, we suggest you place each client into one of three nutritional
levels, based on four questions. What are those questions?

1.

2.

3.

4.

10.9 What areas does the Initial Assessment and Triage Questionnaire cover?
• Why do you think we chose those areas?
• Would you focus on other areas instead? Why or why not?

10.10 What are some of the questions you as a coach consider when you are collaborating with your clients
on their goals?

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10.11 List three examples of clear goals and three examples of unclear goals.

Clear goal Unclear goal

1.

2.

3.

10.12 List three examples of behavior goals and three corresponding examples of outcome goals.

Behavior goal Outcome goal

1.

2.

3.

10.13 Why should you:

a. explore trade-offs for goals with your client (i.e., what they want, what they’re willing to do for
that goal, what they won’t do right now)?
b. help set realistic expectations?

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10.14 What are some questions you could ask a client:

a. to identify “small wins” and “bright spots”?
b. to identify limiting factors?

10.15 In coming up with next actions, why should you ask the client to choose their possible next action
before you offer suggestions?

10.16 Give three examples of possible Big Kahuna (starting big) and Low Hanging Fruit (starting small)
actions.

Big Kahuna (ambitious, high-impact actions) Low Hanging Fruit (small, easy actions)

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10.17 Why do you think we recommend the 80/20 concept — 80% of the time expanding and improving
bright spots; and 20% of the time correcting limiting factors?
• Would you do the opposite — 80% limiting factors / 20% building out success? Why or why not?

10.18 What does “ready, willing, and able” mean?

• Why is it important to know how “ready, willing, and able” a client is?
• How would you find out if a client is “ready, willing, and able”?

10.19 What is ambivalence?

• Why is ambivalence a normal part of change?
• What should you do if you confront client resistance?
• What kind of useful information can you gain from setbacks and “failure”?

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10.20 What is reframing? Give three examples of what could go “wrong,” and how you might reframe it
for a client.

10.21 What are the 11 principles of successful communication?

1.

2.

3.

4.

5.

6.

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7.

8.

9.

10.

11.

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 UNIT 11

Nutritional Levels
 Nutritional Levels | 77

11.1 Why should you categorize clients by nutritional level?

• Why do we say that nutritional level is about the quality of the process?
• Why should you start clients at Level 1?
• Why don’t most clients — even athletes — progress past Level 1?

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11.2 Complete the table below. (If possible, try to do it without checking the Unit first!)

Level 1 Level 2 Level 3

Goals

Level of athletic perfor-

mance or body composi-
tion required

Training load

Knowledge

Competence and skill

Consistency

Mindset / psychology

Limiting factors

11.3 Why can’t you judge nutritional level from body fat levels / body composition alone?

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11.4 Fill in the following table with examples of things Level 1 clients may struggle with in each category
of limiting factors, and some appropriate Level 1 tasks you could assign to them.

Level 1 clients coaching

struggle with... So help them with... tasks could be...
Food choices

Eating behaviors

Exercise and activity

Recovery

Life skills

Mindset / psychology

Environment

11.5 What are the key things to know about Level 2 clients?

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80 | Unit 11

11.6 Fill in the following table with examples of things Level 2 clients may struggle with in each category
of limiting factors, and some appropriate Level 2 tasks you could assign to them.

Level 2 clients Coaching

struggle with... So help them with... tasks could be...
Food choices

Eating behaviors

Exercise and activity

Recovery

Life skills

Mindset / psychology

Environment

11.7 What are the key things to know about Level 3 clients?

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11.8 Fill in the following table with examples of what things Level 3 clients may struggle with in each
category of limiting factors, and some appropriate Level 3 tasks you could assign to them.

Level 3 clients coaching

struggle with... So help them with... tasks could be...
Food choices

Eating behaviors

Exercise and activity

Recovery

Life skills

Mindset and psychology

Environment

11.9 With Level 2 or 3 clients, what are the danger signs for when “healthy” behaviors can become
unhealthy?

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 UNIT 12

Working with Level 1 Clients

 Working with Level 1 Clients | 83

12.1 What’s the difference between “coach language” (e.g., “nutritionspeak,” jargon, technical termi-
nology) and “client language”?
• Why might Level 1 clients in particular need you to communicate clearly?

12.2 We give you some very specific principles on what to do at Step 1 and 2 (Assessment and
Understanding).
Explain why each principle is important, and how it benefits your coaching practice.

Principle This is important because... This benefits my coaching

practice because...
Get VERY clear
on what, exactly,
your client wants to do.

Do one SMALL thing

at a time.

Play the long game.

Keep it simple.

Start at the beginning.

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12.3 Why do we suggest that you collaborate with your clients in setting goals and identifying next ac-
tions or possible tasks to do?
• What are three examples of ways that you might ask for your client’s input?

12.4 All immediate short-term goals and tasks should connect and lead to the long-term outcomes that
you and your client want.
• You should also be able to show clearly what “I did task X” looks like.
• Give one example of how this might look in practice, using the following outline:

What i want to do:

Key behaviors that will get me there:

What does Why does How will I know What will tell me
it involve? this matter? if I’ve done it? it’s time to move on?
Behavior 1

Behavior 2

Behavior 3

Behavior 4

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Behavior 5

Behavior 6

12.5 What are the key principles of tracking progress? Why don’t you just gather a big pile of data?

12.6 Give one example for each of the following types of progress indicator:

1. Body measurements

2. Objective physiological indicators / lab tests

3. Subjective physiological indicators

4. Subjective psychological indicators

5. Subjective social and daily-life indicators

6. Behavior / task completion indicators

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12.7 List 1-2 specific ways that you might address each of the following Level 1 limiting factors. (In other
words, what specific coaching tasks might you assign, or what coaching techniques might you use?)

1. Too many processed foods

2. Not enough nutritious, whole, minimally processed foods

3. Not meeting basic nutrient needs (macronutrients and micronutrients)

4. Dehydration; poor beverage choices

5. Eating too quickly and/or mindlessly

6. Trouble recognizing hunger and fullness cues

7. Irregular eating habits

8. Using food to manage feelings / emotional eating

9. Disordered eating

10. Not getting enough regular physical activity

11. Over-training and not managing training loads

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12. Recovery and poor sleep

13. Food and cooking skills

14. Mindset and psychology issues

15. Life skills

16. Environment

12.8 At some point, you’ll have to troubleshoot, especially with Level 1s — either to help get through
inevitable setbacks, or to address plateaus.
• Give an example of how each type of troubleshooting technique might look in practice.

Troubleshooting technique An example of this could be...

Looking for what is already working

Deciding on meaningful progress metrics

Focusing mostly on behaviors

Setting reasonable expectations

Matching task difficulty to expected result

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Matching outcomes to stated behaviors

Focusing on the quality of the process

Reframing plateaus

12.9 Review the Unit 12 case study about Roy.

• What would you start with first? Why?
• Would you use any forms of body composition measures?
• After you come up with a plan, how would you determine if it’s the right plan?

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UNIT 13

Working with Level 2 Clients

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90 | Unit 13

13.1 Nutritional level isn’t just about physiology. It’s about psychology too. Level 2 clients don’t just have
advanced nutritional goals; they also have particular psychological skills.
To “graduate” to Level 2, clients must have a healthy, growth-oriented mindset along with emotional
maturity and resilience.
We’ve given you the mental makeup of someone who is NOT a Level 2 client (yet). How does a Level
2 client differ? Fill in the table with what features define a Level 2 client’s psychology.

Not a Level 2 client (yet) Level 2 client

Does not use objective indicators
appropriately or maturely. Either
gets anxious / obsessive about
measurement, or doesn’t bother to
measure at all.

Sees indicators, metrics, and out-

comes as a judge of their personal
“goodness” and “badness.”

Avoids feedback, or does the oppo-

site — constantly seeks validation in
a needy and anxious way.

Becomes defensive, resentful, frus-

trated, and/or demoralized when
feedback is given.

Becomes lost in details, paralyzed,

and/or over-anxious.

Can’t detach their own self-concept

from food and eating. Food and eat-
ing choices define who they are.

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Uses food / eating to manage emo-

tions; food / eating decisions driven
by emotions or other un-met psycho-
logical needs.

Deeply attached to Level 2 strate-

gies and outcomes. Reluctant to
give them up; may be anxious about
“losing control.”

Does not fully understand

trade-offs.
May be willing to sacrifice long-term
value or health for short-term gains.
(Or the perception of short-term
gains.)
Driven entirely by external factors
(e.g., get a trophy, get approval from
others).

Fixed mindset: Wants results with-

out effort; gives up easily; views
setbacks as personal deficiencies.
Avoids growth opportunities.

Does not take responsibility for

themselves. Victim or blaming
mentality.

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13.2 Here are the Level 2 strategies we recommend. For each one:
• Explain why it’s a Level 2 strategy.
• Explain what’s involved.
• Give examples of each.

WHY IT’S LEVEL 2 WHAT’S INVOLVED EXAMPLE

Continuing with
all of the Level 1
recommendations

More precise observa-

tion and analysis
(e.g., of food logs)

Improving food quality

and variety

Improving food
selection, preparation
and cooking skills

Workout nutrition
to fuel performance
and enhance recovery

Improving recovery
protocols

Eating according to
body type (e.g., ecto-
morph, mesomorph,
endomorph)

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Moderate carb and calo-

rie cycling (e.g., empha-
sizing carb-dense foods
only after workouts
allows for a natural carb
cycling rhythm)
Basic supplementation
if appropriate

Competition-day
nutrition

13.3 What types of things might you look for in a food record? Why?

13.4 For Level 2 athlete clients, why are carbohydrates important?

• Give examples of what types of workout carbohydrates you might recommend. Why would you
recommend these?
• What would you NOT recommend? Why not?
• What factors would you consider in making your recommendation? Why?

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94 | Unit 13

13.5 Fill in the chart below to describe each of the three general body types.

Ectomorph (I type) Mesomorph (V type) Endomorph (O type)

Skeletal structure and

morphology

Metabolism / response
to energy excess

Excess energy tends to...

Appetite regulation and

eating behavior

Hormonal environment

Carbohydrate tolerance

Trained / active

Untrained / inactive

13.6 Why might you try cycling carbs and/or calories for Level 2 clients?
• When would you NOT use carb / calorie cycling? Why?
• Give an example of how you might structure carb / calorie cycling for a Level 2 client over a two-
week period.

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13.7 What are some of the factors you should assess and understand before suggesting supplementation to
Level 2 clients?

13.8 How do you make sure the supplements you recommend are safe and/or won’t cause your client to
fail a drug test?

13.9 For each of the following supplement recommendations, explain why you might recommend it
to a client, when appropriate.

Supplement Why would you recommend it?

a multivitamin / multimineral
supplement

an omega-3 (EPA / DHA)

supplement

a powdered or liquid greens

supplement

protein powder

probiotics

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96 | Unit 13

digestive enzymes

creatine

beta-alanine

pre-workout caffeine

branched-chain amino acids

(BCAAs)

specific minerals
(e.g., magnesium, iron, zinc)

specific vitamins
(e.g., vitamin D, B12)

electrolyte solutions

anti-inflammatory formula-
tions (e.g., curcumin, ginger)

antioxidant formulations
(e.g., resveratrol, green tea
catechins)

bone and joint support (e.g.,

glycosamingens, eggshell
membrane)

supplements to support
sleep (e.g., L-theanine, 5-HTP,
valerian, ZMA)

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13.10 What are the main goals of competition-day nutrition?

13.11 In what ways might you set realistic expectations with Level 2 clients? What factors would you look
at?

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 UNIT 14

Working with Level 3 Clients

 Working with Level 3 Clients | 99

14.1 Review the key features of a Level 3 client. Imagine you are working with a Level 2 client who may be
seeking a Level 3 program.
• What indicators would tell you that your Level 2 client was ready to “graduate” to a Level 3
program?
• What indicators would tell you that a Level 2 client was NOT ready or not an appropriate candi-
date for a Level 3 program?

Ready to graduate to Level 3 NOT ready to graduate to Level 3

/ Not an appropriate candidate
Goals

Level of athletic per-

formance desired or
required

Body composition de-

sired or required

Training load

Knowledge

Competence and skill

Consistency

Mindset / psychology

Limiting factors

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100 | Unit 14

14.2 Why are Level 3 behaviors usually short-term strategies?

• What can happen if a client follows a Level 3 program stringently for too long?

14.3 Why should you monitor Level 3 clients closely? What might happen if you do not?

14.4 Coaching Level 3 clients is both an art and a science, and it’s not for everyone. Why not?
• What features does a good coach of Level 3 type clients have?

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14.5 While Level 3s will have cleared most of the limiting factors that Level 1s and Level 2s struggle with,
they still have their challenges. Most limiting factors relate to the toll that Level 3 takes on the body,
mind, and spirit.
• List some of the challenges and limiting factors that a Level 3 client might face.
• Why do we recommend that you have a strong support network if you want to be a coach for
Level 3 clients?

14.6 Fill in the table for what constitutes Level 3 tasks both generally and specifically.

Level 3 clients can So the “next level” of challenge, Level 3 coaching tasks could be...
consistently... precision, and difficulty involves...
FOOD CHOICES

Follow a basic meal

template using ISSA-style
portion sizes and food
options
Meet basic nutrient
needs (macronutrients
and micronutrients)

Stay hydrated
Drink mostly non-caloric
beverages

For fat loss: Tolerate

being almost constantly
hungry

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For mass gain: Tolerate

being too full

EXERCISE / ACTIVITY
Manage training loads

RECOVERY
Sleep 7-9 hours

Get enough basic

recovery

LIFE SKILLS /
ENVIRONMENT
Plan and prepare specific
meals

Establish clear priorities

and boundaries

Create and maintain a

supportive environment

Make thoughtful, in-

formed choices

Ensure that good op-

tions are available and
convenient
 Working with Level 3 Clients | 103

MINDSET /
PSYCHOLOGY
Have a growth mindset

Repeat a quality process

14.7 For each of the special dietary strategies for Level 3 clients:
• Clearly describe each one and what it involves specifically.
• Give real-life examples of how you’d apply each one in practice.

What is it and what does it involve What’s a real-life example a coach

specifically? might use?
Precise observation and
analysis

Meal plans with specific

calorie / macronutrient
allotments

Aggressive carb and

calorie cycling for fat
loss or muscle gain

Meal frequency adjust-

ments and intermittent
fasting

Very high-carbohydrate
diets

Water manipulation
strategies

Workout nutrition
strategies

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104 | Unit 14

14.8 For each of the special dietary strategies for Level 3 clients you just described in the previous
question:
• Explain why it’s a Level 3 strategy.
• Explain why it’s NOT a Level 1 or Level 2 strategy.

Why is this a Level 3 strategy? Why is it NOT a Level 1 or 2

strategy?
Precise observation and
analysis

Meal plans with specific

calorie / macronutrient
allotments

Aggressive carb and

calorie cycling for fat
loss or muscle gain

Meal frequency adjust-

ments and intermittent
fasting

Very high-carbohydrate
diets

Water manipulation
strategies

Workout nutrition
strategies

14.9 Before starting a Level 3 project, establish a clear set of metrics and monitoring techniques. Use as
many as possible.
• List all the metrics and monitoring techniques you could / should use for Level 3 programs.
• Describe why each one is important or valuable.

Metric / indicator / monitoring technique Why is this important?

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14.10 Describe, step by step, how you create meal plans with specific calorie / macronutrient allotments.

14.11 Describe how to calculate calories to macronutrient percentages.

14.12 For each of the following clients below:

• Give exact intake details (calories and macronutrient split) that you might recommend.
• Explain why you chose that recommendation.
1. 160 lb (73 kg), 20-year-old female rugby athlete on national team, 23% body fat, with O type
body, looking to improve on-field performance and get to 19% bodyfat.

2. 240 lb (109 kg), 24-year-old NFL linebacker, 18% body fat with V type body, looking for perfor-
mance and improved recovery.

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106 | Unit 14

3. 170 lb (77 kg), 32-year-old nationally competitive endurance cyclist, 10% body fat, with I type
body, looking to lose some more weight / fat before the competitive season without sacrificing
performance or pre-competition training improvements.

4. 120 lb (54 kg), 34-year-old female triathlete, 18% body fat, wants to lose some weight / fat to be
competitive at higher levels, but concerned about bone density and reproductive health.

14.13 For the same list of clients above:

• Describe how you would create a nutrient timing plan for each.
• Explain why you would make a given nutrient timing recommendation for each of those clients.

client Carbohydrate Typical activity Carbohydrate timing rules

tolerance

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14.14 After you created the nutritional programs above:

• How would you track each client to see whether they were meeting their goals, and whether your
original nutritional plan was a good fit?
• What would be some “red flags” to look for that would tell you your plan isn’t working?

14.15 For the same list of clients above:

• Create a day’s menu for each.
• Make sure to include “regular meals” (i.e., things they might eat at home) as well as options for pre
/ post training or “on the road.”

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14.16 When might you use aggressive carb / calorie cycling?

• What are some important factors to consider when using this technique?
• What are the different ways you might do it? Which methods are appropriate for which clients?

14.17 Describe, step by step, how you would plan out and execute the following carb / calorie cycling
plans for a client:
• Infrequent, large re-feeds
• Frequent, moderate re-feeds
• Strategic calorie cycling and carbohydrate cycling for fat loss
• Strategic calorie cycling and carbohydrate cycling for muscle gain

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14.18 Explain in detail what Intermittent Fasting (IF) is.

• When might you consider using IF with a client? With which types of clients? Why?
• When would you NOT use IF with a client, or certain types of clients? Why not?

14.19 When might you consider using a very high-carbohydrate diet with a client? With which types of
clients? Why?
• When would you NOT use a very high-carbohydrate diet with a client, or certain types of clients?
Why not?

14.20 Why is fluid manipulation potentially dangerous? How, specifically, do you ensure your client stays
safe when manipulating fluid and electrolyte levels?

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110 | Unit 14

14.21 Review the specific guidelines for fluid manipulation. Then fill in the table below.

Physique competitors Weight-classed athletes

8 days before competi-

tion or weigh-in

6 days before competi-

tion or weigh-in

2 days before competi-

tion or weigh-in

1 day before competi-

tion or weigh-in

Competition day or
leading up to weigh-in

After competition or
weigh-in

14.22 Fill in the table below with both general supplement recommendations, and recommendations for
Level 3 clients.
Put an asterisk beside the supplements that are Level 3 only. Explain why they are Level 3 only
supplements.

Frequency and
Purpose Supplement Dose Notes
timing
General Multivitamin /
health, prevent Multimineral
deficiencies

General Omega-3
health, prevent
deficiencies

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General health, Greens powder

boost vegetable
intake

General health, Protein powder

boost protein
intake

General health Probiotic

Calming, anxiety L-theanine

Sleep Melatonin

Sleep 5-HTP

Sleep Valerian

Sleep, recovery ZMA

Digestion, Digestive
enhance food enzymes
absorption
112 | Unit 14

General Specific vita-

health, prevent mins / minerals
deficiencies

Bone and joint Bone support

support formulations

Anti-inflammatory Curcumin

Anti-inflammatory Ginger

Ergogenic Creatine

General health Anti-oxidant

formulations

Support per- BCAAs

formance and
recovery

Hydration, Electrolyte
support solutions
performance

Ergogenic (more Beta alanine

noticeable effects
in shorter anaero-
bic activities last-
ing 1 to 4 min)
 Working with Level 3 Clients | 113

To improve CNS Caffeine

output prior to
training

Diuretic Herbal diuretic

14.23 What are some ways to troubleshoot and address problems or challenges in Level 3 programs? Ex-
plain specifically how you would work through each of these.
• Poor initial progress
• Good initial progress followed by a plateau
• Changing goals
• Changing training

14.24 In the Unit 14 case study, why did two athletes get different results?
• Consider all factors involved and list them.
• Explain how each factor could have led to the outcome.
• What lessons does this case study suggest about working with Level 3 clients?

International Sports Sciences Association

 UNIT 15

Special Scenarios
 Special Scenarios | 115

15.1 Why do we use the term “disordered eating” instead of “eating disorder”?

15.2 How do we define disordered eating? Would you add to or change anything about our definition?
How and why?

15.3 What does it mean to say that disordered eating “is a full-body, full-person, full-life experience that
involves multiple dimensions”?
• How does disordered eating “solve a problem,” i.e., act as a coping mechanism?
• How can disordered eating be cyclical, and often begin with dieting?

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15.4 For each of the possible features of disordered eating, describe clearly and specifically what it is and
involves, and provide a real-life example.

Possible feature Description / involves Real-life example

Restriction and control

Routines and rules

Bingeing

Compensation and
bargaining

Anxiety and avoidance

Judgment

Dissociation

External locus of
control

Orthorexia

Cognitive dietary re-

straint (CDR)

Body dysmorphia

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15.5 List the possible physiological effects of excessive restriction.

15.6 Food and nutrient restriction often leads to malnutrition, which further compounds the effects of
disordered eating. Describe how. (If you like, refer back to the Units on macro- and micronutrients
for more ideas.)

15.7 List the possible physiological effects of purging / compensation.

15.8 List the possible physiological effects of binge eating.

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15.9 Why do we say “Know your boundaries” when it comes to working with clients with disordered eat-
ing (or any other mental or physical health issue)? What does that mean?
What people might be helpful to have in your support network for disordered eating along with
other mental and physical health concerns?

15.10 Compete the Dos that go with the following Don’ts.

DO DON’T

Don’t use terms like “bad foods” or “eat-

ing clean.”

Don’t create a restricted roster of foods un-

less you are working with a Level 3 client
who needs it, and can handle it.

Don’t teach clients there are foods to

always eat, or foods to always avoid.

Don’t reinforce the feast-famine concept.

“Challenges” can be motivating for some
people, but for many folks, a “30-day de-
tox” or “two-week ‘eat clean challenge’”
just repeats the cycle of rigid deprivation
followed by a rebound.
Don’t talk about how you’re “feeling fat”
or “feeling scrawny.”

Don’t criticize yourself, or draw exces-

sive attention to your own body or eating
habits.

Don’t create an environment where “fat

talk” or self-criticism is appropriate.

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Don’t over-focus on external measures and

indicators such as calorie counts, scales,
girths, and body fat.

Don’t use food as a reward, or exercise as a

punishment.

Don’t use words like “deserve” or “earn”

with food. Don’t connect eating to “being
good,” or “treating oneself.”
Don’t over-schedule food / exercise or
make it more rigidly scheduled (unless
your client is a Level 3).

15.11 Generally speaking, what are the features of addictions?

• In particular, what are the specific features of food addiction?
• How does food addiction relate to other addictions?
• How is it different?

15.12 As a nutrition coach working within your scope of practice, how can you help clients who have
addictive-type behaviors with food?
• Give specific examples of each technique you could use.

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15.13 Describe the ways that “normal eaters” think.

• Describe the types of behaviors that “normal eaters” demonstrate.
• Would you add to or change anything about these descriptions beyond what we’ve listed? Why or
why not?

15.14 Describe, step by step, how alcohol is metabolized in the body.

• What are the physiological factors that affect the rate and effectiveness of alcohol metabolism?
• What are the effects of drinking too much, too often?

15.15 What characterizes “moderate drinking”? Do you agree? Why or why not?
What characterizes “problem drinking”? Do you agree? Why or why not?

15.16 In what ways can we compromise our immune system function and health?
• What factors besides stress, exercise, and nutrition can affect immunity?

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15.17 Compare the adaptive and innate immune systems. What are the features of each?

15.18 We say there’s a “J-shaped curve” to the relationship between immunity and exercise. What does this
mean?

15.19 What nutritional strategies may help boost immunity? Why do you think these might work?
• What nutritional behaviors or habits would likely make a client’s immunity WORSE? Why?

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15.20 After an injury, the recovery process follows a highly organized and predictable pattern.
• Describe the steps in detail. What does each step involve?
• Why would a nutrition coach need to know this?

15.21 Review the list of nutritional strategies that you might use with injured clients.
• Choose five and explain why they might be useful in general.
• If you could choose only three nutritional strategies for an injured client, which ones would they
be, and why? What would give you the most “bang for your buck,” or have the greatest benefit?

15.22 How might biological sex affect clients’ needs and/or responses to their nutritional programming?
• How might social / cultural gender roles and norms affect clients’ needs and/or responses to their
nutritional programming?

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15.23 In terms of foods, nutrients, overall energy intake, other lifestyle choices, etc.:
• During pregnancy, what should women decrease, or avoid? Why?
• During pregnancy, what should women increase, or get more of? Why?

get more… because…

Get less / Avoid... because…

15.24 Your pregnant client asks you about food cravings. Are they normal? How should she deal with
them? And so on.
• How do you respond, and why?
• How would you respond to a Level 1 client asking this? Why?
• What about a Level 2 client? Would you change your answer? Why or why not?

15.25 Your pregnant client is now dealing with nausea and vomiting. Working within your scope of prac-
tice as a nutrition coach, what are some options you could recommend?

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15.26 Describe specifically some of the ways in which sex hormones — such as testosterone, estrogen, and
progesterone — can significantly affect your clients’ metabolism, body composition, fat deposition
patterns, and overall health.
• What can happen when hormones are out of balance?
• What might you see specifically in men’s bodies and health?
• What might you see specifically in women’s bodies and health?

15.27 What does it mean to say that adipose tissue is endocrine tissue? What are adipokines?

15.28 Briefly describe PCOS and how it might manifest. Why might supplementation help?

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15.29 What is a hormonal “axis”?

• What is the HPA axis?
• What is the HPG axis?
• How are these affected by stress?
• How can stress-related disruptions of the HPA / HPG axis show up in male and female clients,
respectively?

15.30 How can our genetic makeup, epigenetic expression, and ethnic ancestry affect our nutritional
needs and responses to nutritional programs? In your answer, consider both biological and social /
cultural factors.

15.31 In terms of lifestyle, nutrition, and food choices, what can parents do to help ensure that their babies
have a healthy start?

15.32 In terms of general lifestyle, nutrition, and food choices, what can parents do to help ensure that
their children are as healthy as possible?

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15.33 Your client is a parent who would like her young children to start eating more fruits and vegetables.
• What strategies could you recommend? Why?
• What food and nutrition strategies would NOT work, or create undue anxiety and stress?

15.34 Your client is a parent of a teenager who would like to ensure this teenager meets their nutritional
needs and learns healthy practices.
• What strategies could you recommend? Why?
• What food and nutrition strategies would NOT work, or create undue anxiety and stress?
• How might your recommendation differ for a teenage boy versus teenage girl? Why?

15.35 Two of your clients are a married male-female couple in their 50s. Recently, they’ve both noticed that
they have less energy, feel a bit more irritable, and have gained weight.
• How do you explain menopause and andropause to your clients? What specifically can they both
expect to happen (in terms of symptoms and experiences)?
• Right now, changing hormone levels are just a working hypothesis. How might you know for sure
whether your clients’ hormone levels are declining?
• What other lifestyle / social factors could be involved? How might you explain this to them?
• Thinking back to the principles of effective coaching communication, what are some important
things to keep in mind about how you could have this conversation?

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15.36 You are working with a client in his early 80s.

• What potential challenges might he encounter in terms of his food choices and nutritional needs?
• How might you assess his needs to know for sure?
• What food preparation methods and/or supplements might you suggest?

15.37 What’s the difference between a food allergy and a food intolerance?
• What is the difference between celiac disease and possible gluten intolerance?

15.38 Your client is concerned that she is reacting to food X.

• How do you assess the relationship between food X and her symptoms?
• What symptoms might you look for?
• How do you tell whether food X is truly the offending food?
• If your client has a very stressful life, how do you explain to her that stress may be a factor? What
could be the links between her stress and food intolerance symptoms?

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15.39 What are FODMAPs?

• Where can they be found?
• What symptoms can they produce?

15.40 What are some key principles for working with plant-based eaters?
• How should you assess and understand their story?
• How should you approach supplementation? Why?
• What are some health “red flags” for plant-based eaters?

15.41 What is the “global food chain”?

• What are the trade-offs of global food production?
• Which trade-offs do you choose? (e.g., convenience versus cost) Why?

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15.42 To you, what defines “sustainable eating”? Why?

• What are some ways that you could make your own eating habits more sustainable?

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Business 101 for Fitness and Nutrition Pros

 Business 101 for Fitness and Nutrition Pros | 131

16.1 Review the “smart business strategies for nutrition coaching.” For each model:
• Describe what the model involves.
• What are the potential advantages and disadvantages of this model?
• What are some essential behaviors or practices that each model requires to succeed?
• Explain what type of coach / client group each model might be best suited for, and why.

Individual model

Small group model

Transformation contest model

Corporate model

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Online coaching model

Partnership model

16.2 Sum up, in your own words, the experts’ responses to these frequently asked questions.

“How do I answer the question ‘What do you do’?”

“How do I become a leader, authority, or celebrity in my industry?”

“How do I ‘win’ at Internet marketing?”

“How do I get people to say ‘yes’?”

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“How do I get a steady stream of referrals?”

“How much commitment should I ask for?”

16.3 What are some common mistakes in the business and practice of nutrition coaching? How can you
avoid these as best as possible?

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Continuing Ed for the Coach

 Continuing Ed for the Coach | 135

17.1 In describing your process of ongoing education and professional development, we suggest you
find some middle ground between those two extreme paths of under- and over-achievement.
• What specific paths and strategies do we recommend for this?
• How might each path or strategy look for you in your “real life”?

17.2 In terms of choosing your ongoing education and development, why should you “start with why”?

17.3 What are the specific learning skills we recommend?

• Why might you need them as a coach?
• What’s an example of each?

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17.4 What is formal and informal education?

• What are the benefits of each?
• Which educational methods currently “fit” you the best for your chosen career path? Why?

17.5 What is the difference between peer-reviewed and non-peer-reviewed research? Why does the dis-
tinction matter?
For each of the sources below, check PR for peer-reviewed, or NPR for non-peer reviewed. Why did
you choose that option for each?

Source PR NPR why

Blog or website

Newspaper

Study appearing on PubMed

Magazine

Academic journal

Book published by a university,

such as MIT Press

Book published by a popular pub-

lisher, such as Random House

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17.6 For a nutrition coach, what are the potential benefits of volunteering?

17.7 Why should you have key performance indicators (KPIs) for your coaching practice?
• What tells you that you’re making progress in your coaching practice and skills? What indicators
might you use?
• How often do you track your coaching performance, and what system do you have for regular
monitoring?

International Sports Sciences Association

 800.892.4772 • ISSAonline.edu

The Complete Guide to Nutrition Workbook and Study Guide

The Complete Guide to Nutrition
Workbook and Study Guide
Second Edition

International Sports Sciences Association CERTIFICATION COURSES

International Sports Sciences Association CERTIFICATION COURSES

John Berardi, PhD, CSCS
Ryan Andrews, MS, MA, RD
Brian St. Pierre, MS, RD, CSCS
International Sports Sciences Association
Krista Scott-Dixon, PhD
1015 Mark Avenue • Carpinteria, CA 93013
1.800.892.4772 • 1.805.745.8111 (international) Helen Kollias, PhD, CSCS
issaonline.edu Camille DePutter