Chapter 11 Nutrition and Body Composition Coaching and Assessment
After comparing the estimate body composition and dietary habits against the government standards, an allied health professional notes that a client falls into categories that place him at increased risk for hypertension, heart disease and type 2 diabetes. What would be the most appropriate step for the allied health professional to take in this situation? A. Refer to a physician and/or registered dietitian. B. Identify three very specific weight loss and nutrition goals for this client. C. Make recommendations for limiting caloric consumption to 1,000 cal/day and institute a cardio-focused exercise program. D. Start the client on a cardio and resistance training program, make nutrition-related recommendations and recheck body composition and dietary habits in three weeks.
A
How can allied health care providers best utilize body composition measurements when working with recreational athletes? A. To identify characteristics that can be used as a basis for goal setting B. To monitor progress made in a fitness program C. To provide counseling regarding chronic medical conditions D. To serve as a motivator
A
In addition to measuring body fat, what other important measure can be obtained from a dual-energy x-ray absorptiometry (DXA) scan? A. Bone density B. Muscle fiber type C. Hemoglobin concentration D. VO2 max
A
What variable can significantly impact the accuracy of a bioelectric impedance measure? A. Hydration status B. Time of day C. Medications D. Ambient temperature
A
When working with a client in the contemplative stage of the model of behavior change, which of the following strategies might best meet the client's needs? A. Sharing information about a nutrition and exercise program planned for the future B. Sharing knowledge about the importance of changing current habits C. Designing an individualized training program that will be initiated immediately and reassessed often D. Closely monitoring nutrition and exercise program for adherence to program guidelines
A
Which field method of assessing body composition was developed by life insurance companies as a means of categorizing a client based on the variables of height, frame size, and weight compared to normative data? A. Height-weight tables B. Body mass index C. Girth measures D. Bioelectric impedance
A
Which measure of body composition can provide information on regional fat distribution and can also provide measurement of bone density? A. Dual-energy x-ray absorptiometry (DXA) scan B. Air displacement plethysmography C. Near-infrared spectroscopy D. Bioelectric impedance
A
Which method of obtaining a diet history is likely to provide the most accurate nutrition information? A. 3-day food record B. 24-hour food recall C. Food frequency questionnaire D. Food checklist
A
Which of the following goals might be used to help a client reach the goal of losing 10 pounds so she can fit into her wedding dress in 12 weeks? A. Replacing her normal three regular sodas per day with water or tea and walking 30 to 45 minutes every day B. Getting fit and toned C. Exercising more than she is currently doing D. Eating only healthy foods, and only drinking soda when at a restaurant E. Finding a friend to exercise with on the weekends
A
What factors are assessed when field methods and laboratory methods of evaluating body composition are compared to reference methods? Select all that apply. A. Reliability B. Validity C. Accessibility D. Applicability E. Ease of completion
A, B
Which of the following is a nonmodifiable factor that contributes to body composition distribution? Select all that apply. A. Somatotype B. Distribution of muscle fiber types C. Training regimen D. Dietary habits E. Weight
A, B
Which of the following resources are generally accepted to be within the scope of practice for an allied health professional to use when providing nutrition information to their patients? Select all that apply. A. Government tools and guidelines B. Published position papers C. Research studies D. Published texts E. Individualized assessment of needs
A, B, C, D
Which of the following are field methods that might be used to assess a client's body composition? Select all that apply. A. Body mass index (BMI) B. Bioelectric impedance C. Dual-energy x-ray absorptiometry D. Girth measurements E. Air displacement plethysmography
A, B, D
Which of the following tools might be used by an allied health professional who is coaching a client through a behavioral change? Select all that apply. A. Helping client to visualize themselves with and without the unhealthy behavior and how each feels B. Asking client to consider the impact of their behavior on the people around them C. Telling a resistant client that they need to take the recommended steps or find another coach D. Initiating rewards for achieving planned behavioral changes E. Having a client post on their Facebook page their commitment to the change they are making
A, B, D, E
Which of the following are measures of fitness? Select all that apply A. Flexibility B. Agility C. Muscular strength and endurance D. Body composition E. Speed
A, C, D
Explain some of the ways in which an allied health professional might utilize a diet history when working with a client.
Attaining a diet history not only provides the allied health professional with baseline nutritional information about the client's typical eating habits, it also provides clients with insight into their own behaviors that they may not have considered previously. The allied health professional and client can use the information obtained from a diet history to better understand the types of foods eaten and the factors that influence intake, assess the quality of a client's nutritional habits, and evaluate how well the client's typical eating habits compare with an ideal diet. In some cases, the allied health professional may initiate the process of assessing diet history, and recognize that, to best meet the client's needs, referral to a registered dietitian is necessary.
A client goes to a nutrition and fitness consultation. During the initial meeting the client says "I only came to see you because my wife made me. I don't really think I need to change the way I eat." Which stage of the model of behavior change best characterizes this client? A. Contemplative B. Precontemplative C. Preparation D. Action
B
At what point in the hydrostatic weighing process should the measurement be taken to produce the most accurate results? A. As soon as the body is completely submerged B. After complete expiration C. 10 seconds after submersion D. As soon as the athlete is seated in the chair
B
In addition to assessing body composition, what other information might be provided by the serial measurement of skinfolds? A. Frame size B. Site-specific effects of a training program C. Waist-to-hip ratio D. Water weight
B
When estimating caloric needs, what measure must first be determined? A. Average number of calories consumed daily B. Resting energy expenditure (REE) C. Average number of calories burned daily during exercise D. Type of lifestyle the patient follows
B
Which method of body composition assessment utilizes full-body x-ray to provide feedback on the location of fat distribution, overall muscle mass, and fat mass characterization? A. Air displacement plethysmography B. Dual-energy x-ray absorptiometry (DXA) C. Near-infrared interactance D. Three-dimensional photonic scanning
B
Which somatotype would best be used to describe a tall, thin, lanky cross-country runner? A. Mesomorph B. Ectomorph C. Endomorph D. Mendomorph
B
Which of the following variables may impact the accuracy of an air displacement plethysmography (ADP) measure? Select all that apply. A. Hydration status B. Ambient air temperature C. Body temperature D. Relative humidity E. Clothing
B, D, E
Which of the following types of fat are considered essential fat? Select all that apply. A. Intramuscular triglycerides B. Liver fat C. Visceral fat D. Adipose tissue E. Brain tissue
B, E
A client wishes to follow a generally healthy eating plan that conforms to the daily reference intakes (DRIs) and other general standards. What recommendation should be made to this client? A. Ask the client to complete a 24-hour food recall, then identify nutrient deficiencies that should be corrected. B. Ask the client to keep a food record for a week, then evaluate the food record and provide specific recommendations for the foods and amounts that should be consumed. C. Utilize a food record or other tracking system, like http://supertracker.usda.gov, and compare those findings to the recommendations on http://www.choosemyplate.gov/. D. The client should complete a food frequency questionnaire, which should then be evaluated, and supplements should be recommended for every area in which the client is deficient.
C
At which stage in the model of behavioral change is a person most at risk of dropping out of a nutrition and exercise plan and returning to their previous habits? A. Maintenance stage B. Preparation stage C. Action stage D. Contemplative stage
C
Which of the following individuals might be at risk of obesity-related chronic medical conditions? A. Client with a body mass index of 24 B. Client in the underweight category on the height-weight table C. Client with a waist-to-hip ratio of 1.4 D. Client with a body fat percentage of 20%
C
Which of the following statements correctly describes current thinking regarding reference methods for measuring body composition? A. Magnetic resonance imaging is considered to be the preferred reference method due to the accuracy combined with ease of completion and cost effectiveness. B. X-ray computed tomography scans are the preferred reference method due to the quality of the image produced and low levels of radiation used, making it easily repeatable. C. The multicomponent model is considered the preferred reference method due to its high level of accuracy. D. The dual-spectrum x-ray absorptiometry scan is the preferred reference method as site-specific body composition methods can be easily obtained with little technical support or training.
C
Which relatively new technology can be used to create an image that is then measured at sites similar to those used with skinfold calipers to determine body composition? A. Three-dimensional photonic scanning B. Near-infrared interactance C. Ultrasound D. Computed tomography
C
In addition to recording the foods and the amount of a food consumed, what other information might be important to record when a food record is completed? Select all that apply. A. Cost of the food B. Others present C. Where food was consumed D. Mood at time of consumption E. Level of hunger (on a scale of 1: ravenous to 10: completely full)
C, D, E
What component is integral to the success of a lifestyle change program? A. Support system B. Identification of deficiencies C. Medical evaluation D. Behavioral assessment and plan
D
Which of the following athletes would benefit most from high muscle density, high weight, and low levels of body fat? A. Point guard B. Diver C. Golfer D. Body builder
D
Which of the following clients should be referred to a primary care physician for management of nutrition-related concerns? A. A 16-year-old basketball player who needs advice on recovery nutrition B. A 17-year-old soccer goalie who wants to gain muscle and change overall body composition C. A 60-year-old competitive recreational runner D. A 30-year-old recreational tennis player who is taking several prescription medications
D
Which type of fat is stored in subcutaneous tissue? A. Intramuscular triglycerides B. Essential fat C. Visceral fat D. Adipose tissue
D
Which of the following factors are included when calculating body mass index (BMI)? Select all that apply. A. Fat mass B. Lean mass C. Water weight D. Height E. Weight
D, E
Explain the role of body mass index (BMI) in assessing body composition and its limitations as the sole means of assessing body composition.
Despite BMI being a useful screening tool to approximate body fat and better understand a person's health risk related to weight, it may falsely categorize certain individuals, especially those with high muscle mass (e.g., many athletes) and those with low weight but high fat mass (e.g., many older adults).
T/F Gynoid obesity is often associated with a waist-to-hip ratio of 0.9 or lower.
False
Write a nutrition or fitness-related goal that is structured using the SMART goal format.
The goals should include the following components: S—specific. "What exactly do you hope to achieve?" M—measurable. "How will you know if you got there?" A—attainable. "Is this a goal you believe you can realistically achieve with a moderate amount of effort?" R—relevant. "When you achieve this goal, how will you feel?" Clients should choose a goal that is really meaningful to them so that they feel a sense of pride and accomplishment when they achieve the goal. T—time bound. "When do you want to achieve this goal?" Encourage clients to set a specific date by which the goal will be realized.
T/F In general, baseline nutrition knowledge among athletes is relatively low.
True