ACE 6th Edition Chapter 6: Nutrition for Health and Fitness
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ACE 6th Edition Chapter 6: Nutrition for Health and Fitness 1

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    Chapter Goals:

    • Know the scope of practice for personal trainers in relation to the realm of nutrition.
    • Be able to discuss the dietary guidelines for Americans and other patterns of evidence based eating.
    • Know the makeup for nutrition labels and be able to find the main categories on the labels. 
    • Outline the practical strategies within a trainer’s scope of practice to improve the client’s literacy of food. 
    • Be able to discuss the proper strategies for fueling and hydration for before, during, and after exercise. 
    • Talk about the nutritional supplementation with clients while keeping within the scope of practice.

    Introduction

    Trainers will enjoy helping clients when it comes to not just exercise, but also adopting the healthy habits of nutrition. 

    But with this comes some strict dos and don’ts for the scope of practice for ACE certified personal trainer. 

    The trainers should be sure to incorporate the talk of nutrition into their session while still abiding by the scope of practice and ACE guidelines. 

    ACE Position Statement on Nutrition Scope of Practice for Personal Trainers

    Ace declares that their trainers should do their best to share nonmedical nutrition information with their clients, as it is an important part of changing clients. 

    The current climate for people shows an epidemic of obesity, lacking nutritional levels, and overall inactivity. Put all of this with the multibillion dollar dieting industry and strong general public interest in improvements for their eating habits and physical activity changes, and we as trainer are well positioned to affect the journey of our clients. 

    The ultimate position for the trainer in the realm of nutrition is decided by the policies and regulations of the state or states that they operate in, their education and experience with nutrition, and the skills and competencies they’ve accumulated. 

    The trainers should be ready and able to discuss the following topics to stay within their scope of practice:

    • The principles of healthy nutrition and preparation of meals.
    • Foods that should be included in a balanced and healthy diet.
    • The essential nutrients that the body needs. 
    • The actions of nutrients when they are in the body.
    • Effects of deficiencies or excess amounts of nutrients. 
    • How the requirements for nutrients will vary throughout your life.
    • The principles of nutrition and hydration when looking at before, during, and after a workout. 
    • Information about the nutrients that are within foods or supplements. 

    The trainers that are not completely comfortable with sharing and giving out the information above should ensure that they continue their education and work on developing competency in the realm of nutrition. 

    It could be good to develop relationships with registered dieticians. This will give you someone to refer your clients to for information you can’t give, or for information you can give, but aren’t informed on. 

    Some ACE personal trainers wish to expand the nutrition part of their job with added certifications and things so that they can give you the information that you need. This is important as the subjects of physical activity and nutrition will often be together. 

    The actions regarding nutrition that we consider outside of the scope of practice and see often are:

    • Giving personalized nutrition recommendations and planning meals outside of what is already available for people within the government guidelines and recommendations. 
    • Nutritional assessments for the determining of needs or nutritional status of clients. 
    • Specific programming for nutrient or nutritional intakes, caloric intake, or specialty diets. 
    • Nutritional counseling, education, or advice that is aimed at preventing, treating or curing diseases or conditions. Or really anything in the realm of medical nutrition therapy.
    • The development, administration, evaluation, and consultation of the nutrition care standards or the process of nutritional care.
    • Anything along the lines of recommending, selling, or supplying supplements for clients. 
    • Promoting or identifying yourself as a nutritionist or a dietician. 

    Engaging in these activities will put the health and safety of the client at risk and also expose the trainer to litigation and disciplinary action. It is important for trainers to stay up to date on the legal and regulatory issues regarding the use of supplements and their ingredients. 

    Another important thing for trainers to receive is insurance in the case of these legal actions being taken against the trainer. We will discuss this in the last chapter of the book. 

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    Dietary Reference Intake and Acceptable Macronutrient Distribution Ranges

    Dietary reference intake is a generic term we use for four types of reference values:

    • The RDA or recommended dietary allowance is the level of intake of nutrients that is adequate enough to meet the needs for almost all healthy people in a population. This is about 97 – 98 percent of people generally. 
    • The estimated Average Requirement is also the EAR. This is the amount that is adequate enough to meet the needs of 50% of all people within age and sex specific groups. If someone’s intake is lower than the EAR, they are likely not getting enough of that nutrient. 
    • The UL or the tolerable upper intake level is the maximal intake that is not likely to have any risk of adverse health effects with it for most people in age and sex specific groups. If someone is taking in over this amount, they are likely to form some kind of negative effects. 
    • The AI or the adequate intake is the recommended intake of a nutrient that is based on research to be sufficient for good health. This is used when the EAR is unable to be determined. 

    Along with the dietary reference intakes, we have established ranges in the form of macronutrient distribution ranges.

    These AMDRs represent the percentages for calories that need to come from carbs, protein, and fats for optimal health and reducing chronic disease risks. 

    It is important to go over the table in this chapter that goes over the macronutrients and breaks those macronutrients into subcategories also. 

    Dietary Guidelines

    Every 5 years, a panel of experts from many fields will go through and update the dietary guidelines and do a review of a lot of scientific literature and a series of meetings over the years. 

    The dietary guidelines to emphasize in our diet have been narrowed down to 5 key guidelines.

    Key Guideline 1: Follow a Healthy Eating Pattern Across the Lifespan

    All of the choices made in food and beverages matter. Choosing a healthy eating pattern at the right caloric level will help to achieve and keep a healthy body weight, support adequate nutrients, and reduce the risks for chronic disease. 

    The main parts of a healthy pattern of eating are:

    • Variety in the vegetables and ensuring you get some from each of the five subgroups of dark green, red and orange, legumes, starches, and others. 
    • Fruit items
    • Grains, primarily the whole grains.
    • Fat free and low fat dairy like milk, yogurt, cheese, and soy products that are fortified. 
    • A variety of foods that are rich with protein like the seafood, lean meats and poultry, eggs, legumes, nuts, seeds, and soy products. 
    • Limited amounts of saturated fats, trans fats, added sugars, and alcohol.

    To really teach this well to the clients and to give them a tool to utilize, we like to recommend the MyPlate Food Plan which is from the USDA and is the recommended way for Americans to eat. This tool breaks down the plate in sections based on how much of each food group you should be getting. This includes proteins, fruits, grains, vegetables, and dairy. 

    The recommended number of servings per day are also found here. 

    The NIH body weight planner is another thing to utilize when someone is trying to decrease their weight by use of a calorie deficit and tracking those calories. There are around 3,500 calories in one pound of fat, and the recommendation is for there to be a deficit of 500 – 1,000 calories through the decrease of food and the increase in physical activity. This 500 – 1,000 calorie deficit means that you would lose 1 – 2 pounds per week. 

    Key Guideline 2: Focus on Variety, Nutrient Density, and Amount

    To meet the needs for nutrients and stay within the limits of calories, the goal is to really get nutrient dense foods in all of the recommended food groups in the appropriate amount. 

    We put vegetables into 5 categories and then we want to make sure we are receiving the nutrients from each of those groups in varied amounts. Skipping out on one could lead to a deficiency. 

    Fruits that are whole and not frozen are better at providing the appropriate nutrients. The goal should be to receive whole fruits and not the juices or frozen variants. 

    Grains, and more specifically the whole grains, are needed from sources like bread, cereals, crackers, and pasta. Grains that are refined are less beneficial than the ones that are whole. 

    Dairy products stay high in some important minerals and vitamins that we don’t find in many other foods. They are not necessary to be healthy, but they do contain many things in high amounts that makes reaching the nutrient goals easier. 

    Protein foods will include a lot of sources varying from plant to animal and one main thing to think about is the need for seafood due to the body not being able to make omega 3 fatty acids on its own. 

    Oils are important. These are fats that have a high amount of monounsaturated and polyunsaturated fats. These are needed for the intake and absorption of certain vitamins. 

    Key Guideline 3: Limit Calories from Added Sugars and Saturated Fats and Reduce Sodium Intake

    It is important to take in eating patterns that are low in these three things. They are also three of the things increasing very quickly in the foods we eat every day. 

    The added sugars really add to the calories that are in foods and beverages, and they can come in many forms. Any of the additional sugars that we do not burn, we will turn to fat and store it in the body. 

    The most common added sugar foods are the sugar beverages and snacks and sweets. 

    The type of fatty acid that is consumed will have a greater role in health than the amount of actual fat that is consumed. This high intake in saturated fats will be likely to increase the levels of LDLs in the body. this is the bad cholesterol and leads to poor health. 

    Trans fats are going to be naturally occurring in meat and dairy products, but the largest amount is going to come from the processed foods. 

    Sodium is something that is increasing with foods as we have needs for storing foods for longer times, and this helps with that. Sodium has a role in the blood pressure of a person, so high amounts of sodium usually see people having blood pressure problems. 

    Key Guideline 4: Shift to Healthier Food and Beverage Choices

    Choose foods that are nutrient dense and beverages across and in all of the food groups in place of less healthy choices. The overall general advise that Americans should take to shift their eating patter is to consume more veggies, fruits, whole grains, dairy, increase the protein variety, exchange solid fats for oils, reduce the added sugars, saturated fats, and sodium intake. 

    Some examples of things to help implement this is to:

    • Shift from high-calorie snacks to more nutrient-dense snacks like veggies or fruits.
    • Shift from fruits that have sugar added, to fruits that are whole.
    • Shift from refined grains to whole grains.
    • Shift from snacks high in sodium to unsalted ones. 
    • Shift from beverages with added sugars to beverages without sugar. 

    Key Guideline 5: Support Healthy Eating Patterns for All

    Everyone has a role in helping to create and support healthy eating patterns in multiple settings worldwide, from the school, to home, and to communities. 

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    Personal trainers can look eat the categories of Food access, Household food insecurity, and Acculturation to help with clients learning about foods. 

    We should take a look at all of the locations that we go to throughout our days and try to change certain things about them or look for help specific to those locations. 

    Food Labels

    For people to make healthy decisions, they have to first be able to understand the nutrients that contribute to a diet that is healthy, and to know the foods that have those nutrients. 

    While there are many diets that are healthy and only use whole and unprocessed foods, there are actually many refined and processed foods that are still good to consume for a healthy diet. 

    There are many health claims to know and go through on the website provided in the text. 

    Nutrition Label Parts

    • Serving size – this is the amount of servings that are within the package and the amount a person usually consumes in one sitting. 
    • Calories – this is the number of calories altogether from the fat, protein, and carbs. 
    • Total Fat – this is the most calories dense macronutrient and it’s important to know how much of the food is made up of it. 
    • Saturated Fat – this is a part of the total fat and it plays a role in the rise in blood cholesterol and the risk for heart disease. 
    • Trans Fats – this is like saturated fats, but they are actually considered to be worse and people should be aware of their levels in food. 
    • Cholesterol – many foods that have high cholesterol levels are also high in the saturated fats. 
    • Sodium – this again, has a high relation with blood pressure levels and some people really need to control their intake of this nutrient. 
    • Total Carbohydrate – these are the main source of energy for humans and we have them in many of the foods we eat. 
    • Dietary Fiber – there are two kinds included here. The first is soluble and the other is the insoluble fiber. 
    • Sugars – this is major as it is a major source of energy and calories in general, so people should watch this one close. 
    • Protein – possibly the most valuable source of calories, and 10 – 35% of total daily calories. 
    • Vitamins and Minerals – the goal here is going to be to get 100% of the recommendations on each one for every day. 

    Practical Consideration for Personal Trainers

    A lot of the talk around nutrition relates to the individual ingredients or a proportion of calories from specific macronutrients. There is an increasing movement toward whole foods being the main source of food. 

    There are some ways that trainers can work with their clients and guide them to further their support and their client’s knowledge. 

    One way is to provide grocery store tours with your client, or multiple clients. Grocery shopping can be overwhelming and confusing for many people, so it helps if the trainer is willing to walk through the store and show them the things they should think about in person for when they go on their own. 

    Collaborating with registered dieticians is a way to not only have someone more knowledgeable to refer clients to, but also someone you can learn from and enhance your ability to answer the questions your clients bring up. 

    Fueling Before, During, and After Exercise

    The main goal of fueling before exercise is to do two things: optimize the availability of glucose and stores of glycogen in the body and then to provide the fuel needed to support your performance during the exercise. For the more serious athletes that need to have larger stores for an endurance event, the pre-exercise fueling should start a week in advance of the event. In these times people will go through the process of carbohydrate loading to enhance the body’s ability to perform. 

    During exercise, the goal is going to be providing the body with the essential nutrients needed by the muscle cells and to keep the blood glucose levels at the appropriate point. 

    Post-exercise has the main goal of replenishing the glycogen stores in the body and facilitating the best form of muscle repair. 

    Fluid and Hydration Before, During, and After Exercise

    Maintaining the right fluid balance where the percent of weight lost during exercise is no more than 2% is the ideal thing for us to try to do. 

    Drinking too few amounts of liquid will lead to dehydration, and then drinking too many liquids will lead to things like hyponatremia if it is too much of just plain water. 

    The goal should also be to replace the lost electrolytes so that exercise continues. 

    One of the main things to think about during exercise is that you need to replace the fluid you lose at a ratio of 1:1.

    Sports drinks should be utilized when we are working out for over an hour and need to replace some energy and electrolytes that are lost. 

    And then when we look at fluid replacement after exercise, where the main goal is going to be like with the food. we want to replace all of the lost fluid back to pre-exercise levels. 

    ACE 6th Edition Chapter 6: Nutrition for Health and Fitness 2
    ACE CPT Chapter 1: Role and scope of practice for the personal trainer 2
    ACE 6th Edition Chapter 6: Nutrition for Health and Fitness 3

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