Nutrition practice questions

Answer: B) About 0.5 to 1 lb (0.25 to 0.5 kg) per week

For lean-mass gain, athletes are usually advised to aim for about 0.5–1 lb per week (about 0.25–0.5% of body weight). This comes from a modest surplus of about 300–500 kcal/day plus resistance training. Faster gains mostly add fat.

• AIncorrect. This rate is so small that it is hard to tell apart from daily weight changes. It would need an energy surplus too small to support meaningful muscle gain.
• BCorrect. A moderate surplus of roughly 300–500 kcal/day, combined with resistance training and enough protein, supports gains of about 1 lb per week or less, mostly as lean mass. This range is about 0.25–0.5% of body weight per week for this athlete.
• CIncorrect. Muscle protein accretion cannot keep up with this rate. Gaining this fast takes a large surplus, and most of the added weight would be fat and water.
• DIncorrect. This would take a surplus well over 2,000 kcal/day. It would mainly add body fat, not lean tissue.

Answer: B) Iron

Female endurance athletes are at higher risk of iron deficiency from menstrual losses, hemolysis, GI and sweat losses, and low intake. Low iron can impair oxygen transport and endurance performance.

• AIncorrect. Sodium is lost in sweat, but typical diets supply plenty. Low blood sodium in endurance athletes usually comes from drinking too much fluid, not from a long-term dietary deficiency.
• BCorrect. Female endurance athletes are especially prone to iron depletion because of menstrual blood loss, foot-strike hemolysis, gastrointestinal and sweat losses, and often low intake. This can reduce oxygen transport and cause fatigue and poorer performance.
• CIncorrect. Vitamin K deficiency is rare in healthy adults and is not a typical concern linked to endurance training in women.
• DIncorrect. Phosphorus is plentiful in most diets, and deficiency is uncommon. It is not a recognized risk specific to female endurance athletes.

Answer: C) Hyponatremia

• AIncorrect. Sodium is the concern.
• BIncorrect. Sodium falls.
• CCorrect. Low blood sodium.
• DIncorrect. Sodium is the concern.

Answer: C) About 5 to 7 mL per kg of body weight

• AIncorrect. Pre-hydration helps.
• BIncorrect. That's far too much.
• CCorrect. More may be needed if urine is dark.
• DIncorrect. That's too little.

Answer: A) (Energy intake − exercise energy) ÷ fat-free mass

• ACorrect. Low values raise RED-S risk.
• BIncorrect. That's BMI.
• CIncorrect. That isn't the formula.
• DIncorrect. That isn't the formula.

Answer: C) 8–10 g/kg/day

Carbohydrate needs rise with training volume and intensity. Athletes doing high-volume intense training (3–6 h/day) are advised to take in about 8–10 g/kg/day to replenish glycogen.

• AIncorrect. This is a low-carbohydrate intake. It would not replace the glycogen used by several hours of intense daily training and would likely lead to fatigue and poorer performance.
• BIncorrect. This range fits general fitness or light training. It is too low for 3–6 hours of intense training per day.
• CCorrect. For high-volume intense training (about 3–6 h/day in 1–2 sessions, 5–6 days/week), 8–10 g/kg/day of carbohydrate is recommended to restore muscle and liver glycogen.
• DIncorrect. This is above the recommended ranges for daily training. It would displace protein and fat and is not needed to keep glycogen stores up.

Answer: A) An ice hockey player who makes repeated all-out skating bursts with brief recovery between shifts

Creatine raises intramuscular phosphocreatine. This mainly improves single and repeated bouts of short, high-intensity work, such as intermittent sprints, rather than prolonged aerobic performance.

• ACorrect. Creatine raises muscle phosphocreatine stores, which supports the phosphagen system. This helps with repeated short, high-intensity efforts and with recovery between them.
• BIncorrect. Marathon performance depends mainly on oxidative metabolism and glycogen. Creatine does little for prolonged submaximal efforts, and the water weight it can add may be a disadvantage.
• CIncorrect. Creatine works through the phosphocreatine system during brief maximal efforts. It is not used to raise fat oxidation during prolonged low-intensity exercise.
• DIncorrect. Low-intensity aerobic activity does not depend much on phosphocreatine, so creatine's ergogenic effect is minimal here.

Answer: A) 40–48 oz (about 1.2–1.4 L)

NSCA advises drinking 20–24 oz of fluid for every pound lost during exercise, so a 2-lb loss calls for about 40–48 oz.

• ACorrect. NSCA recommends 20–24 oz of fluid per pound of body weight lost, so 2 lb works out to about 40–48 oz. This allows for ongoing urine losses during recovery.
• BIncorrect. This replaces at most 100% of the weight lost (16 oz per lb). It ignores ongoing fluid losses, so the athlete would likely still be under-hydrated.
• CIncorrect. This is roughly the amount for only 1 lb of loss. It would replace only about half of what this athlete lost.
• DIncorrect. This doubles the per-pound guideline, which is more than needed and raises the risk of overdrinking.

Answer: C) Being converted to nitric oxide, which dilates blood vessels and lowers the oxygen cost of exercise

The body converts nitrate to nitric oxide, a vasodilator that improves blood flow to muscle and reduces the oxygen cost of submaximal exercise. Effects are more consistent in non-elite athletes.

• AIncorrect. Extracellular buffering is how sodium bicarbonate works. Nitrate acts through nitric oxide production, not acid buffering.
• BIncorrect. Raising muscle carnosine is how beta-alanine works. Nitrate does not act through carnosine.
• CCorrect. The body converts nitrate to nitrite and then to nitric oxide. This dilates blood vessels, increases oxygen and nutrient delivery, and reduces the oxygen cost of submaximal work. Benefits show up mainly in non-elite athletes.
• DIncorrect. That describes leucine or protein intake after resistance training. Nitrate's proposed benefits are vascular and metabolic, not anabolic.

Answer: C) Relative Energy Deficiency in Sport (REDs)

The IOC's 2023 consensus uses the term Relative Energy Deficiency in Sport (REDs) for the health and performance problems caused by problematic low energy availability. It extends the older, female-only female athlete triad model.

• AIncorrect. The triad (low energy availability, menstrual dysfunction, low bone mineral density) is the older and narrower model that applies only to women. REDs expands it to include male athletes and more body systems.
• BIncorrect. Overtraining syndrome comes from a long-term imbalance between training load and recovery. It is not defined by low energy availability, although the two can overlap and must be told apart.
• CCorrect. The 2023 IOC consensus uses 'REDs' for the syndrome caused by problematic low energy availability. It affects many body systems, including endocrine, bone, metabolic and psychological function, as well as performance, in both female and male athletes.
• DIncorrect. Amenorrhea is one possible result of low energy availability in female athletes. It is a single symptom, not the umbrella term for the whole syndrome.