CSSD Nutrition Assessment & Counseling Strategies 3 — Questions and Answers
Question 1: During a nutrition assessment, an athlete's Relative Energy Deficiency in Sport (RED-S) Risk Assessment Tool (RED-S RAT) score indicates medium risk. What is the most appropriate next step?
- Monitor with monthly reassessment and provide education (Correct answer)
- Clear the athlete for unrestricted sport participation
- Require immediate medical withdrawal from sport
- Refer the athlete for dual-energy X-ray absorptiometry (DXA) only
Correct answer: Monitor with monthly reassessment and provide education
Medium risk on the RED-S RAT warrants close monitoring, nutrition education, and periodic reassessment rather than immediate withdrawal.
Question 2: Which dietary assessment tool provides the BEST estimate of habitual long-term nutrient intake in a large epidemiological cohort of athletes?
- Food Frequency Questionnaire (Correct answer)
- 24-hour dietary recall
- 3-day weighed food record
- Diet history interview
Correct answer: Food Frequency Questionnaire
Food Frequency Questionnaires are designed to capture habitual intake patterns over extended periods and are scalable for large groups.
Question 3: An athlete's resting metabolic rate (RMR) measured by indirect calorimetry is 72% of the Cunningham-predicted RMR. This ratio suggests which condition?
- Metabolic adaptation consistent with low energy availability (Correct answer)
- Normal metabolic variation
- Equipment calibration error requiring re-test
- Elevated catecholamine response from overtraining
Correct answer: Metabolic adaptation consistent with low energy availability
A measured-to-predicted RMR ratio below ~0.90 is a clinical indicator of metabolic suppression associated with chronic low energy availability.
Question 4: When counseling an athlete from a collectivist cultural background, which counseling adaptation is MOST important?
- Involve family or community members in the nutrition planning process (Correct answer)
- Focus exclusively on individual performance metrics
- Provide a standard meal plan without cultural modification
- Emphasize personal autonomy and self-reliance
Correct answer: Involve family or community members in the nutrition planning process
In collectivist cultures, food decisions are often family- or community-centered, so including key social members improves adherence and relevance.
Question 5: Which skinfold site is included in both the Jackson-Pollock 3-site formula for women AND the 7-site formula?
- Triceps (Correct answer)
- Biceps
- Midaxillary
- Abdominal
Correct answer: Triceps
The triceps skinfold is included in the Jackson-Pollock 3-site (women: triceps, suprailiac, thigh) and the 7-site formula.
Question 6: A sports dietitian documents an ADIME note. What does the 'E' stand for, and what does it contain?
- Evaluation; reassessment of nutrition diagnosis indicators and goal progress (Correct answer)
- Education; topics covered in the counseling session
- Estimation; caloric and macronutrient targets calculated
- Evidence; research citations supporting the intervention
Correct answer: Evaluation; reassessment of nutrition diagnosis indicators and goal progress
In ADIME (Assessment, Diagnosis, Intervention, Monitoring & Evaluation), 'E' stands for Monitoring & Evaluation and tracks progress toward nutrition goals.
Question 7: Which serum marker is MOST useful for assessing chronic protein status and identifying protein-energy malnutrition in athletes with very low energy intake?
- Albumin (Correct answer)
- C-reactive protein
- Ferritin
- Creatinine
Correct answer: Albumin
Albumin, while slow to change, reflects chronic protein-energy status and is a marker of prolonged malnutrition when other confounders are ruled out.
CSSD Nutrition Assessment & Counseling Strategies 3
During a nutrition assessment, an athlete's Relative Energy Deficiency in Sport (RED-S) Risk Assessment Tool (RED-S RAT) score indicates medium risk.
What is the most appropriate next step?