ISSA Case Analysis & Practical Application 2 — Questions and Answers
Question 1: A 45-year-old male client with type 2 diabetes and a BMI of 32 wants to lose weight. He currently consumes 2,800 kcal/day. Which dietary strategy is MOST appropriate as a starting point?
- Reduce intake to 1,200 kcal/day immediately
- Create a 500–750 kcal/day deficit to lose 1–1.5 lb/week (Correct answer)
- Eliminate all carbohydrates to lower blood glucose
- Increase protein to 3 g/kg bodyweight to preserve muscle
Correct answer: Create a 500–750 kcal/day deficit to lose 1–1.5 lb/week
A moderate caloric deficit of 500–750 kcal/day promotes steady, sustainable weight loss while managing blood sugar in diabetic clients.
Question 2: A collegiate soccer player reports feeling fatigued during the second half of games despite eating a pre-game meal. Which nutrient timing adjustment is MOST likely to help?
- Add a high-fat snack 30 minutes before kickoff
- Consume a carbohydrate-electrolyte drink during half-time (Correct answer)
- Skip the pre-game meal to avoid GI distress
- Double protein intake the morning of the game
Correct answer: Consume a carbohydrate-electrolyte drink during half-time
A carbohydrate-electrolyte beverage at half-time replenishes glycogen and fluids, helping sustain energy during the second half.
Question 3: A 28-year-old vegan female client's bloodwork shows ferritin of 8 ng/mL (normal: 12–150 ng/mL). What is the BEST dietary recommendation?
- Advise her to start eating red meat immediately
- Increase non-heme iron sources and pair them with vitamin C-rich foods (Correct answer)
- Supplement with calcium to improve iron absorption
- Reduce dietary fiber to allow more iron absorption
Correct answer: Increase non-heme iron sources and pair them with vitamin C-rich foods
Combining non-heme iron sources with vitamin C significantly enhances iron absorption in plant-based diets.
Question 4: A 55-year-old postmenopausal woman wants to prevent osteoporosis. Her current calcium intake is 600 mg/day. What is the MOST appropriate recommendation?
- Increase calcium to 2,500 mg/day through supplements alone
- Aim for 1,200 mg/day of calcium and ensure adequate vitamin D intake (Correct answer)
- Focus only on weight training without dietary changes
- Recommend a low-protein diet to reduce urinary calcium loss
Correct answer: Aim for 1,200 mg/day of calcium and ensure adequate vitamin D intake
Postmenopausal women need 1,200 mg calcium daily along with sufficient vitamin D to optimize bone mineral density.
Question 5: A marathon runner reports GI distress during long training runs. She currently eats a high-fiber meal 2 hours before running. What adjustment should you recommend?
- Switch to a low-fiber, easily digestible meal 2–3 hours before running (Correct answer)
- Add more fiber to improve gut motility during exercise
- Fast completely for 4 hours before runs
- Increase fat intake before runs for sustained energy
Correct answer: Switch to a low-fiber, easily digestible meal 2–3 hours before running
High-fiber foods slow gastric emptying and can cause GI distress during running, so low-fiber meals are preferred pre-exercise.
Question 6: A client who is 6 months postpartum and breastfeeding wants to lose her pregnancy weight quickly. She asks about a 1,000 kcal/day diet. What should you advise?
- Approve the 1,000 kcal plan since weight loss is the priority
- Advise against severe restriction as breastfeeding requires an extra ~330–400 kcal/day (Correct answer)
- Recommend eliminating all fats to accelerate weight loss
- Suggest fasting for 16 hours daily while breastfeeding
Correct answer: Advise against severe restriction as breastfeeding requires an extra ~330–400 kcal/day
Breastfeeding mothers need additional calories to support milk production, and severe restriction can compromise milk supply and maternal health.
Question 7: A client presents with frequent muscle cramps during evening workouts. His diet is low in potassium and magnesium. Which food combination would BEST address both deficiencies?
- White rice and chicken breast
- Spinach and banana (Correct answer)
- Cottage cheese and white bread
- Pasta and tomato sauce
Correct answer: Spinach and banana
Spinach is rich in magnesium and potassium, while bananas are an excellent potassium source, making this combination ideal.
ISSA Case Analysis & Practical Application 2
A 45-year-old male client with type 2 diabetes and a BMI of 32 wants to lose weight.
He currently consumes 2,800 kcal/day.
Which dietary strategy is MOST appropriate as a starting point?