NASM final exam study guide

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Five stages in the OPT model

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Five stages in the OPT model

  1. stabilization endurance

  2. strength endurance

  3. muscular development

  4. max strength

  5. power

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Stabilization endurance. What does it help develop, correct and promote?

  • Developing proper movement patterns: squat, push, pull, press, hip hinge, and multiplanar movements

  • Correcting muscle imbalances and helping with stabilization

  • Promoting client confidence and adherence to exercise.

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Stabilization Endurance. sets, reps, tempo, rest, warm up and cool down

Sets: 1-3 sets

Reps: 12-20

Tempo: 4,2,1

Rest: 0-90's

Warm up/Cool Down: 1-3sets SMR/static stretching

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What phases perform active stretching 1-2 s, hold, 5-10 rep) and SMR for warm up?

Strength Endurance, Muscular Development, Maximal Strength

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Why is static stretching more prominent in phase 1 in the OPT model , stabilization endurance?

It helps with muscular imbalances

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Phase 2 : Strength Endurance. WHat is Introduced? How can things be progressed? What stage is this in?

  • Supersets. Strength move immediately followed by stabilization move with similar motions

  • Things can be progressed by increasing proprioceptive demand, volume, intensity or shorter breaks

  • First of three strength phases

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Phase 2: Strength Endurance. Sets, reps, tempo (strength and stability), Rest

Sets: 2-4

Reps: 8-12

2,0,2 tempo for strength exs. - 4,2,1 tempo for stability exs.

Rest: 0-60's in this phase

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Phase 3: Muscular Development. Sets (resistance and core/balance), Reps (resistance and core/balance), Tempo, Rest (resistance and core/balance)

Sets: 3-6 sets of resistance training 2-4 for core and balance

Reps: 6-12 for resistance training exercises and 8-12 for core and balance exercises

Tempo: 2,0,2

Rest: 0-3 mins rest for resistance training, 0-60's rest for core, balance, plyo's, (Optional) SAQ's (optional)

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Why can rest be up to 3 mins for resistance training in the muscular development phase?

That how long it takes to recover close to 100% ATP

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Phase 4: Maximal Strength (Is it required, what type of clients do this phase)

This is an optional phase of the OPT model

This is an advanced form of training and only recommended for experienced lifters and exercisers who have worked their way up to this phase of the model.

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Phase 4: Maximal Strength. Sets (resistance and core), Reps (resistance and core), Tempo, Rest (resistance and core)

Sets: 4-6 for resistance training moves and 2-4 for core and balance

Reps: 1-5 for resistance training and 8-12 for core and balance

Tempo: Explosive or as fast as possible with good form

Rest: 2-4 mins for resistance training 0-60's for core, balance - Greater than six sets

resistance training sets for advanced clients is ok

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Phase 5: Power. What does these super sets contain of? What is the goal?

Superset strength focused move (heavy 1-5 reps) with a power focused move (lighter 8-10 reps) -

The goal in this phase is to improve a clients strength and their explosive speed/force.

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Phase 5: Power. Sets, Reps (resistance/power), Tempo, Rest

Sets: 3-5 for resistance training

Reps: 1-5 for resistance training (85-100%1RM) and 8-10 for power (30-45%1RM)

Tempo: Explosive or as fast as possible with good form

Rest: 1-2 mins between pairs 3-5 mins between circuits optional in this phase (only in power)

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All warm up for the OPT Model Include

  • SMR for 1-3 body parts (hold 30's on tender areas) followed by

  • stretching ((1)Static>(2,3,4)Active>(5)Dynamic)

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All cool down for the OPT Model Include

Cardio (optional), Static Stretching and SMR

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SAQ Progression for OPT MODEL

  1. Stabilization Level

  2. Strength Level

  3. Power Level

  1. Stabilization Level - Limited horizontal inertia

    and unpredictability

  2. Strength Level - Increase horizontal inertia

    limited unpredictability

  3. Power Level - Max horizontal inertia

    and unpredictability

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OPT model for body fat reduction

phases 1,2,3

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OPT model for increasing lean mass:

phases 1 (initially) then cycle>2,3,4

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OPT model for sports performance:

phases 1,2,5

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systematic planning

The aim is to reach the best possible performance for a specific time frame or event.

You achieve this by changing up exercise variables when appropriate.

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A week long block of training

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A month long block of training

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A year long block of training

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Linear Periodization

A traditional method of program

aims to gradually increase the intensity of the training load while simultaneously decreasing volume over a set period of time.

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Undulating Periodization (nonlinear periodization)

A programming scheme,

uses changes in volume, intensity, and exercise selection to provide loading differences on a daily or weekly basis.

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Over Training

Excessive frequency, volume, or intensity of training, resulting in reduction of performance, which is also caused by a lack of proper rest and recovery.

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ATp or Adenosine Triphosphate

molecules provide the body with energy

Breaking these molecules down is how your body powers itself

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  • anaerobic does not require oxygen

  • powers body for 10-15s

  • short sprints, olympic weightlifting, jumping/plyometrics

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Anaerobic Glycolysis

  • uses glucose to pyruvate and ATP

  • Powers body for 30-60 s

  • Strength Training

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Oxidative system (oxidation phosphorylation)

  • uses oxygen to convert food to ATP

  • 60-120s

  • long term exercise (endurance events)

  • pathway happens in the mitochondria

  • other components such as Krebs Cycle and Electronic

    Transport Chain

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Smart Goals (what does it stand for and what does each word mean)

Specific: anyone should understand goal

Measurable: measure if achieving goals

Attainable: challenging, not extreme

Realistic: able/willingness to work towards goals

Timely: set time frame on goals

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process goal

shorter term. Completing a single session or making it to the gym

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Clients have a habit of not setting a bunch of ______ goals to achieve this __ goal.

process, outcome

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outcome goal

represents a longer term change such as an increase in strength, \n or significant amount of weight loss.

typically the client's long term goal or end result.

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Types of Active Listening and their meaning

Asking Questions: open ended questions with a positive vibe.

Reflecting : repeat something back to a client to show that you understood them.

Summarizing: reflecting multiple pieces of information to show understanding.

Affirming: show appreciation for clients and their strengths. start with “you”

Asking Permission : Making sure the client is comfortable before giving help

"Do you want to try assisted stretching?" \n - "Does that lunge variation look like something you'd be willing to try?"

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Cognitive Strategies (definition, types and what do they mean)

Intended to change the way someone thinks about exercise/activity

- Positive Self Talk : a form of encouraging and motivating internal dialogue that increases self-efficacy.

  • Psyching Up : When internal dialogue is developed and used to increase excitement and motivation before exercise. (also listening to music)

  • Mental Imagery : imagining a situation that improves client self efficacy, confidence and motivation to exercise.

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4 main things to do in Session #1

  1. Discuss health concern goals

  2. Clarify fitness goals

  3. Review past exercise experiences

  4. Fitness assessment

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transtheoretical model (stages of change)

  1. Pre-contemplation

  2. contemplation

  3. Preparation

  4. Action

  5. Maintenance

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here people are physically inactive. They're not intending on beginning an exercise program, and they don't see exercise as worth their time.

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People who are inactive, but thinking about becoming more active in the next six months go here. They're still weighing the pros and cons of exercise, but they're starting to consider the benefits.

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people in this stage are doing some physical activity and preparing to adopt a more consistent activity program.

These people are only doing things like sporadic walking, but they're ready to adopt an active lifestyle.

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action stage

People are here when they're engaging in regular physical activity but have been doing so for less than six months.

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People on this stage have been working out consistently for longer than six months

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a subjective yes or no questionnaire that is used to determine whether it's safe or not for a client to begin an exercise program. It has follow up portions to

reduce false positive readings.

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Health History Questionnaire

gets you more detailed info on your client.

pertain to health history and habits, such as exercise history, eating behaviors, and general lifestyle

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Subjective assessments

reflect what an individual feels (PAR-Q,HHQ,RPE).

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quantified through data collection (blood pressure,HR).

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Superior -




Medial -

Lateral -

Proximal -

Distal -

Superior -toward the head end of the body

Inferior- away from the head or lower

Anterior- front of the body

Posterior- back of the body

Medial - toward the midline of the body

Lateral - away from the midline of the body

Proximal - nearest the trunk or the point of origin

Distal - farthest from the trunk or the point or origin

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Movements In the Sagittal Plane (4)

  • Flexion: Decreasing the joint angle

  • Extension: Increasing the joint angle

  • Dorsiflexion: Moving the top of the foot toward the shin (ankle only)

  • Plantar Flexion: Moving the sole of the foot down towards the ground (pointing toes)

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Exercises in the Sagittal Plane

biceps curls, triceps pushdowns, squats, front lunges, calf raises, walking, running, vertical jump, climbing stairs, and shooting a basketball.

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Movements In the Frontal Plane

  • Adduction: Movement toward the midline

  • Abduction: Movement away from the midline of the body

  • Elevation: Moving to a superior position (scapula)

  • Depression: Moving to an inferior position (scapula)

  • Inversion: Tilting the foot towards midline

  • Eversion: Tilting the foot away from the midline

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Examples of predominantly frontal plane exercises include

jumping jacks, side lunges, lateral shoulder raises, and side shuffling.

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Movements In the Transverse Plane

  • Rotation: When the torso or a limb moves around its vertical axis \n

  • Pronation: Rotating the forearm or foot to a palm-side or foot-side down position \n

  • Supination: Rotating the forearm or foot to a palm-side or foot-side up position

  • Horizontal abduction: Moving the upper arm away from the midline of the body when it is elevated to 90 degrees

  • Horizontal adduction: Moving the upper arm towards the midline of the body when it is elevated to 90 degrees

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Examples of predominantly transverse plane exercises include

performing a cable trunk rotation, a dumbbell chest fly, and swinging a bat or golf club.

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Let's say I have a client lunging, but they're wobbly. How should I regress the exercise?

Allow the client to support themselves against the wall

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Let's say I have a beginner client lunging, they're doing great, and I need to make the exercise harder. How should I progress the exercise?

Give the client light dumbbells to hold onto while doing the exercise.

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Let's say I have a client who's squatting and leaning too far forward. Choose the best cueing advice to give this client.

Tell the client to shift the weight back onto the ball of their foot, heels, and hips

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agonist vs antagonist vs synergists

prime mover or muscle that does most of the work during a specific exercise vs is the muscle that opposes the agonist vs which assist prime movers or agonists with movements.

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Reciprocal Inhibition:

The relaxation of muscles on one side of a joint to accommodate contraction on the other side.

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Autogenic Inhibition

The ability of a muscle to relax when it experiences a stretch or increased tension.

used during SMR

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Golgi Tendon Organ (GTO)

  • Located at the point where the muscle and tendon meet (musculotendinous junction).

  • sensitive to change in muscle tension and the speed of tension change.

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Muscle Spindle

  • Sensory organs that lie parallel to the muscle fibers.

  • detect muscle length and the speed/rate at which a muscle is stretching.

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muscle shortens

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muscle lengthens, leads to the most muscular breakdown, soreness and muscle growth.

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kInetic Chain checkpoints

  • feet and ankles

  • knees

  • lumbo-pelvic-hip-complex

  • shoulders

  • head and neck

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Lower Crossed Syndrome

(define, what are the over (2) and underactive muscles(3))

client has overly lordotic posture.

overactive (tight and short) - hip flexors and lumbar extensors

underactive (lengthened and weakened) - hip extensors (glutes and hamstrings) and core muscles

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Upper Crossed

(define, what are the over 4 and underactive muscles 4)

overly kyphosis client

overactive (tight and shortened) = anterior chest, shoulder muscles, lats and neck extensors

underactive (lengthened and weak) = rhomboids, lower and mid traps and neck flexors

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Anterior Pelvic Tilt occurs alongside…

lordosis and kyphosis postures

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Forward Head Posture

(over 3 and underactive muscles 4 , associated with…)

overactive: cervical spine extensors, upper trap and levator Scapula

underactive: rhomboids, lower and mid traps and neck flexors

typically happens with overly kyphosis posture

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Overhead Squat Assessment

  • Typically the first movement assessment done

  • Assess dynamic posture, core stability, neuromuscular control

  • A good way to spot muscle imbalances (knee valgus, limited ankle mob.)

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Overhead Squat Anterior (what are you looking for)

Foot and ankles: The feet should stay straight ahead

Knees: They should track straight forward or over the second and third toes

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Overhead Squat (feet turn out)

(over 3 and under 4 active muscles)


  • Gastrocnemius/soleus (calves)

  • Hamstrings complex


- Anterior and posterior tibialis (shin muscles)

- Gluteus maximus and medius

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Overhead Squat and Single Leg Squat (knees valgus) over 2 and underactive muscles 4



- Adductors


- Glutes (med and max)

- Anterior and posterior tibialis

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Overhead Squat and Pushing and Pulling (low back arches)

(over 3 and under active muscles 3 )


- Hip Flexors

- Lumbar Extensors

- Lats (minus pushing and pulling)


- Glute max

- Hamstrings

- Abdominals

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Overhead Squat (forward lean)

(over5 and under active muscles 3 )


- Hip Flexors

- Gastrocnemius and soleus

- Rectus Abdominis and External Obliques


- Glute max

- Hamstrings

- Lumbar extensors

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Overhead Squat (arms fall forward)

(over 3 and under active muscles 4 )


- Lats


- Teres Major


- Middle and Lower Traps

- Rhomboids

- Posterior Delts & some R.cuff

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Pes Planus Distortion Syndrome (how does it look at certain joints)

Ankle joints—pes planus (collapsed arch)

Knee joints—valgus and internally rotated

Hip joints—adducted and internally rotated

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Pes Planus Distortion Syndrome

Overactive (4) Underactive (4)


- Adductor Complex (inner thigh muscles)

- Gastrocnemius and Soleus

- Hip Flexors


- Anterior & posterior tibialis (shin muscles)

-Glute Max and Med. (butt muscles)

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Pushing and Pulling Assessment (stance, reps, how you should view cilent)

The client should be standing in a narrow split stance.

- The client does 10 reps with challenge but not exhaustion

  • From the side we're viewing LPHC, shoulders, cervical spine, and the head

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Pushing & Pulling (head forward) (over 3 and under active muscles 1 )


-Levator Scapula

- Sternocleidomastoid

- Cervical Spine Extensors


- Deep Cervical Flexors

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Pushing & Pulling (scap. elevation) (over 2 and under active muscles 1)


-Levator Scapula

- Upper Traps


- Lower Traps

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Two spots to take a clients pulse

carotid artery or (radial artery!!)

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A normal male heart rate is between ? and ? BPM. For females, it's ? to ?

male : between 60 and 70 BPM.

females, it's 72 to 80

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If a clients heart rate is five beats higher than their typical resting heart rate for a period of a few days, they may be….

overtraining and that would be a reason to ease up on training

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Taking Heart Rate While Client Is Exercising

Measure heart rate for 10 seconds and then multiply that HR # by 6 to get BPM

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valsalva maneuver

Breathe out strongly through your mouth while holding your nose tightly closed.

This creates a forceful strain that can trigger your heart to react and go back into normal rhythm.

Avoid with Clients

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40 yard dash test…

reaction capabilities, acceleration, and maximal sprinting speed

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Pro Shuttle Assessment assesses…

acceleration, deceleration, agility, and control.

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VO2 max:

The most valid measurement of aerobic fitness.

Also known as maximal oxygen uptake, or peak VO2.

This is not something that will be done with typical clients

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Sequencing Assessments

  • Pre-participation health screening (PAR Q, Health History)

  • Physiological Assessments (ex blood pressure)

  • Body Composition Assessments (skinfold)

  • Postural and Movement assessments (OHS, no warmup)

  • Cardio Assessments (3 min step test)

  • Performance Assessments (40 Yard dash)

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Things we can and cannot do as a PT in regards in Nutrition


  • develop meal plans/medical nutrition therapy


  • Help understand food labels, what nutritions do in body

  • use dietary guidelines

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Calorie amounts for 1 gram of Macronutrients

1 gram of protein = 4 calories

1 gram of carbohydrate = 4 calories

1 gram of fat = 9 calories

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Vitamins, minerals, and phytonutrients.

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Complete Protein:

Provides all essential amino acids. Animal and dairy proteins fall into this category

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Incomplete Protein

Missing one or more amino acids. Plant proteins fall into this category

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Macronutrient RDA's

Protein: .8 grams per kg of body weight for sedentary adults (higher for other populations)

Carbs: 3-5 grams per kg of body weight for lightly active adults (higher for other populations)

Fat: 20% to 35% of total calories. Saturated fats should only make up 10%, or less of total cals.

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If there is 3,500 calories in a pound of fat, how much of deficit would get a cilent to lose about one lb per week?

A 500 calorie daily deficit

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Monounsaturated Fats

Polyunsaturated Fats

Saturated Fats

Trans Fats

  1. heart healthy (olive oil, olives, avocado, peanut, canola)

  2. Omega 3 (heart healthy, nuts seeds and oils) and Omega 6 (growth/development, fatty fish, walnuts, chia seeds, fortified milk/eggs)

  3. limit (animal fats, full fat dairy, coconut and palm oil)

  4. bad, (artificial)

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Fat Soluble Vitamins

ADEK, can consume too much which can be dangerous , can store in fat

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Major Minerals (7)

Calcium, Phosphorus, magnesium, sodium, potassium, chloride, sulfur

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