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NASM: Weight Loss Specialization
Questions and Answers Already Passed
T/F: Obesity is based on someone's weight.
False: It is based on how much body fat (adipose tissue) someone carries.
How is BMI determined?
weight (kg) / height (m2)
T/F: Education level and ethnicity are associated with the prevalence of obesity.
True
What percentage of people in America are overweight or obese?
69.2% with 35.9% of them obese (2012)
What are the BMI categories?
Normal: 18.5 - 24.
Overweight: 25 - 29.
Obese (class I): 30 - 34.
Obese (class II): 35 - 39.
Extreme Obesity (class III): 40+
After the age of 20, which of the following age groups has the lowest prevalence of being overweight?
20 - 29 years
What age range has the highest prevalence of being overweight or obese?
30 - 70 years
T/F: Measuring the body density in children is a better assessment of obesity rates than measuring their BMI.
False: Although measuring BMI is not the most ideal method for children, it is a good estimate.
What is the main cause of excess stored body fat?
consuming more calories than expended
What are main obstacles for fitness professionals coaching an overweight client?
Teaching how to overcome conveniences of: modern technology - food accessibility - societal norms - cultural norms
T/F: Socioeconomic status has impacted obesity rates.
True: Socioeconomic status affects one's ability to access and afford healthy food choices.
Where does obesity rank on the international risks of death?
5th (2012)
What is a multi-faceted approach for understanding how to train someone overweight or obese?
- the scope of the problem of obesity
- factors that contribute to the problem
- medical & physical challenges
Any exercise recommendations need to be prescribed and monitored by a physician.
What is metabolic syndrome?
when several cardiovascular risk factors exists (3 or more)
What effect do beta-blockers have on heart rate and blood pressure during exercise?
decrease heart rate and decrease blood pressure
What is dyslipidemia?
often referred to as high blood pressure, but is actually a disorder of lipoprotein metabolism
What can cause dyslipidemia?
- increase of total cholesterol
- increase in low-density lipoprotein (LDL) cholesterol
- increase in triglyceride concentrations
- decrease in high-density lipoprotein (HDL) cholesterol concentration in the blood
What does the dyslipidemia associated with obesity consists of?
- high triglycerides
- decreased HDL (good cholesterol)
- abnormal LDL (bad cholesterol) levels
What measurement is considered high blood pressure?
- stage 1: 140/
- stage 2: 150/
What effect can calcium channel blockers and vasodilators have during exercise?
Hypotension (low blood pressure)
What is important for clients who take medications such as calcium channel blockers and vasodilators (resulting in hypotension) during exercise?
a proper cool-down
What is peripheral neuropathy?
nerve damage that often causes numbness in the hands and feet
What is diabetic retinopathy?
damage to blood vessels of the eye
What is nephropathy?
kidney disease
What are some exercise precautions for people with neuropathy, diabetic retinopathy, and/or nephropathy?
- avoiding extreme environments
- proper foot care
- avoiding the Valsalva maneuver
- paying special attention to hydration
What are principal traits of the metabolic syndrome in a client who has type 2 diabetes?
What are ways that energy is expended daily?
Basal Metabolic Rate (BMR), Thermic Effect of Feeding (TEF), Physical Activity (PA)
What is Basal Metabolic Rate (BMR)?
BMR describes the rate at which the body expends energy to maintain basic physiological survival. It is measured while a person is awake but lying still after a restful sleep and an overnight fast.
How much of daily energy expenditure (DEE) does BMR make up?
about 75%
What is another way to describe and calculate the rate at which the body expends energy?
Resting Metabolic Rate (RMR) or Resting Energy Expenditure (REE)
What are some equations for measuring RMR/REE?
Harris-Benedict, Mifflin St. Joer, Owen
What is the Owen Equation?
Male: 10.2 * weight (kg) + 879
Female: 7.18 * weight (kg) + 795
What is Thermic Effect of Feeding (TEF)
TEF refers to an estimation of the energy required to digest, absorb, transport, metabolize, and store nutrients in the body (about 10% of DEE).
What is "Physical Activity" (PA)?
an estimation of energy required to support physical work outside of BMR (between 10-30% of DEE).
How much of one's daily expenditure of energy does physical activity make up for sedentary people?
less than half BMR
How much daily expenditure of energy does physical activity (PA) make up for active people?
may equal BMR
What are some weight loss caloric guidelines?
- Slow, steady goals of 0.5 to 2 lbs./week
- Decrease calorie intake (250-500 calorie deficit)
- Increase physical activity
What theory explains why most people only experience short term weight loss before they regain their weight?
The Set Point Theory
What does the Set Point Theory state?
Body weight is maintained at a set level, and deviations from the preferred set point are resisted and minimized by a feedback control system of the body.
What explains a plateau in weight loss?
Metabolic efficiency : when the energy expended equals the energy being consumed.
What are two general contributors of obesity?
binging - purging - food restriction - prolonged fasting - use of diet pills, diuretics, and laxatives
While a client may not use purging as a method, what other ways might a client show symptoms of bulimia nervosa?
excessive exercise
How can the body can be affected by a severe disordered eating habit?
disturbances of the endocrine , gastrointestinal , and cardiovascular systems; irreversible loss of bone mineral density ; and disruption of thermoregulation.
How should a fitness professional approach anorexia nervosa and bulimia?
Refer the client to a qualified medical professional (who diagnoses such issues according to DSM IV criteria).
What types of medical professionals can be qualified to diagnose and treat disordered eating?
a physician, registered dietician, and mental health professional
In a fasting state, as seen in people who significantly restrict calories, what becomes the predominant fuel source?
fat oxidation
What should be a primary concern for someone undergoing caloric restriction?
hydration, since there is also a loss of water that contributes to reduced body weight
What are general categories that influence one's body image?
Sensations in what we feel - Perceptions of social norms - Personal perceptions of one’s body
How does self-esteem relate to self-confidence and self-efficacy?
Self-Esteem encompasses the favorable views one holds regarding one’s self and is generally a stable variable.
What is the difference between self-confidence and self-efficacy?
Self-confidence is a belief that one can successfully perform a desired behavior while self- efficacy is a conviction that one can successfully execute the behavior required to produce a certain outcome.
What are some triggers to eating?
stress - past positive feelings - social gatherings - oral fixation - emotion
What are some mental health benefits to exercise?
improved self-confidence - decreased stress - enhanced moods - alleviation of depression
When setting goals, what does SMART stand for?
Specific : make the goal specific
Measurable : criteria for measuring progress
Attainable : slightly challenging but realistic
Reasonable : within the availability of resources, knowledge, and time
Time : time oriented
[ (220-age) * % of heart rate intensity desired for exercise]. Subtract 220 from their age (to find maximal heart rate) and then multiply that number by the percentage of intensity the client should perform a cardiorespiratory exercise.
How do you determine one's heart rate reserve in order to determine their target heart rate for exercise?
[(HRmax - HRrest) × desired intensity] + HRrest
What are some ways to measure body composition?
BMI, skin fold caliper, bioelectrical impedance, hip to waist ratio, girth measurement
When taken by a skilled person, the accuracy of skin-fold measures is typically what percentage?
within 4% of hydrostatic weighing
What precaution should a trainer have in using bioelectrical impulse to measure body fat?
The more fat a person has, the more current flow is impeded.
When is it acceptable to use a bioelectrical impulse to estimate one's body fat percentage?
if a client has fasted for at least 4 hrs, has not recently exercised or consumed alcohol, and is hydrated
How do you measure one's waist to hip ratio?
the circumference of the waist / the circumference of the hips
What measurement from a waist to hip ratio is considered a risk factor for coronary heart disease?
men: .95; women:.
Waist circumference alone can be a risk factor for which of the following?
hypertension
What are other areas of the body to measure girth and track progress?
neck, chest, thighs, calf, upper arm
What exercise training rate should a client begin with who scored "poor" on the Rockport Walk test?
⦁ Poor: Zone 1 — 65 to 75% of HRmax
⦁ Fair/Average: Zone 2 — 65 to 85% of HRmax
⦁ Good/Very Good: Zone 3 — 65 to 95% of HRmax
What is a reasonable rate for weight loss?
.5 - 2 pounds per week or 10% of body weight over six months
What are recommended calorie restrictions according to one's BMI?
BMI > 35: restriction of 500-1000 calories a day BMI 27-35: restriction of 300-500 calories a day
What are the macronutrient distribution of daily calories?
Protein: 10-35%; Fat: 20-35%; Carbs: 45-65%
What does "nutrient density" refer to?
essential nutrients per calorie
What is the daily recommended cholesterol intake?
< 300 mg
What is the daily recommended sodium intake?
1,500 to 2,300 mg
What is a healthy strategy for managing calorie intake and satiety?
eating large volumes of low energy density food
What are good attributes of meal replacements?
accurate colorie count & portion control
Are nutrient and dietary supplements recommended?
Yes as they can assist compliance with a daily routine.
What are some benefits of dietary supplements?
they can help create & maintain a calorie deficit - raise energy levels - reduce food cravings - decrease calorie absorption
What is marketing?
a social and managerial process by which individuals and groups obtain what they need and want through creating and exchanging value with others
What is marketing centered around?
building & managing profitable relationships
What is the first thing to do before building a marketing strategy?
understanding the consumer base you want to work with
What is a simple, four-step process to marketing one's self and services?
- understand what consumers want, 2) design marketing strategy around what customers want,
- build a program to deliver superior value, and 4) build strong and profitable relationships with consumers, working to exceed their expectations.
What should form the foundation of a marketing strategy?
the desires of the consumer base (in listed details)
What are examples of general segments of people a fitness professional could specifically target in marketing?
those who desire weight loss - those who desire weight gain - youth - seniors - etc.
What is a value proposition?
the set of benefits or values the professional promises to deliver to consumers to satisfy their needs; a statement which provides the reason why a customer should buy your services
What basic steps are involved in preparing a marketing plan?
determining price, place, and promotion method
What are three keys to building a healthy relationship in marketing?
effective & open communication - superior customer service - professionalism
How does a fitness professional determine the price of their services?
determining the overhead costs & assessing what their market will bear
Unlike a personal trainer certification, what characterizes the licensure of a Registered Dietician?
legally protected & authorized by the Commission of Dietetic Registration
What is a board-certified specialist in sports dietetics (CSSD)?
A registered dietitian with a minimum of 2 years of professional practice experience - A specialist in sports nutrition qualified to deliver medical nutrition therapy - Nationally certified by the Commission in Dietetic Registration
The S.O.A.P. Note is an acronym for which of the following?
Subjective, Objective, Assessment, Plan
What is the primary purpose of the S.O.A.P. note?
to document transactions and client participation
T/F: Laws exists in almost every state that allow fitness professionals to prescribe nutrition counseling (medical nutrition therapy).
False: Laws exist in almost every state that limit the practice of medical nutrition therapy to licensed or registered dietitians or nutritionists and specific health care professionals.
What is the organization that authorizes registered dietitians in the United States?
Commission on Dietetic Registration (CDR) - which is the credentialing organization of the Academy of Nutrition and Dietetics
T/F: Teaching about the difference between saturated and unsaturated fats lies within the scope of practice of a fitness professional.
True (general, non medical nutrition information)
What are two tools fitness professionals should be using in giving nutrition advice?
Nutrition facts panels & the Dietary Guidelines for Americans
What are some key questions to ask in order to determine if a fitness professional should refer their client to a specialist?
- Could this person be better helped by someone with more (or different) expertise? 2) Does this person's nutrition concern fall outside the realm (physically and/or psychologically) of a healthy individual? 3) Do I feel any discomfort with my ability to help this person?
What documentation(s) provides helpful information from a fitness professional about a client to a health professional?
S.O.A.P & PAR-Q
When performing assessments on clients who are overweight, the fitness professional should...
...use a private or semi-private location.
If a client expresses sore muscles due to her initial training sessions, the fitness professional should...
...use the opportunity to review the importance of flexibility training, nutrition, hydration, sleep, and a proper cool-down.
A way to modify postural assessments with clients who are overweight is to...
...observe the client as he is standing or have him sit or rise from a chair.
Why is it important for health and fitness professionals to have an understanding of how to set goals and be able to work with their clients around setting goals?
