Domains and Content Items

A. Fundamental Principles of Nutrition (25% of exam)

• Basic understanding of nutritional genomics research in practice
• Nutritional considerations related to physiologic changes associated with life cycle stage
• Tailoring of assessment and therapy specific to life cycle stage
• Nutritional considerations related to psychological and social factors associated with life cycle stage
• Estimation of caloric values of specific meals
• Calculation of individual caloric requirements
• Effects of age, gender, and physical activity on body composition and energy expenditure
• Effect of microbiome on body composition and metabolism
• Metabolism (biochemical pathways and reactions) of carbohydrates, lipids, proteins, and micronutrients
• Effect of microbiome on metabolism of macronutrients & micronutrients, including use of probiotics & prebiotics
• Nutritional biochemical pathways including energy production and detoxification
• Regulation of fluid, electrolyte, and acid-base balance
• Inflammatory pathways including insulin, oxidative stress, and fatty acid oxidation
• Chemistry of enzymes, co-factors, and organic acids
• Chemistry of enzymes, co-factors, and organic acids in genomic theory
• Epigenetics: methyl donor biochemistry, and hypo- and hyper-methylation
• Pathway genomics: one carbon, methylation, tetrahydrobiopterin, and transsulfuration
• Physiology of the digestive tract (motility, absorption, secretion, intestinal barrier function)
• Malabsorption and effects on macronutrients and micronutrient status
• Role of oxidative stress and detoxification pathways on health status
• Digestion, absorption, and transport of macronutrients and micronutrients
• Impact of nutrition on disease states of the GI tract
• Effects of macronutrients, vitamins, and minerals on health and disease states
   

B. Nutrients and Human Health (14% of exam)

• Lipid metabolism, including cytokine and eicosanoid pathways
• Structure and function of soluble and insoluble fiber and impacts on health
• Tolerable upper intake levels of nutrients
• Symptoms and treatment of nutrient toxicity
• Macronutrient and micronutrient food sources and impact on health
• Functional and medical foods and their impact on health
• Supplemental sources of nutrients
• Impact of agricultural methods and food processing, preparation, and storage on nutrient value
• Nutrients used in fortification and applicable food sources
• Dietary Guidelines and Dietary Reference Intakes for preventive and therapeutic interventions
• Appropriate use of nutrient supplementation
• Role of key phytochemicals and zoochemicals in health
• Nutrient deficiency and insufficiency: causes, symptoms, and treatment
   

C. Nutrition Assessment (14% of exam)

• Comprehensive medical nutrition health history
• Evaluation of laboratory data including identification of optimal value ranges
• Evaluation of functional testing (organic acid, stool, and saliva tests for adrenals and hormones)
• Evaluation of hormonal and neurotransmitter imbalances based on laboratory assessment
• Assessment of single nucleotide polymorphisms (SNPs)
• Nutritional inborn errors of metabolism
• Body composition analysis (skin fold, bioelectrical impedance, other)
• Waist-to-hip ratio measurements
• Computerized analysis of food intake
• Identification of symptoms that require medical referral
• Correlation of symptoms and lab findings for research and development of personalized Medical Nutrient Therapy (MNT) protocol
• Use of behavior change strategies such as Motivational Interviewing and Stage of Change theory
• Lifestyle factors which impact nutrient needs and compliance such as exercise, stress, and sleep

D. Clinical Intervention and Monitoring (35% of exam)

• Impact of nutritional genomics on health
• Drug/herb action, duration of action, purpose and dose of a client's current therapeutic regimen
• Nutrient depletions related to commonly used drugs
• Interactions between drugs and foods, alcohol, vitamins, minerals, herbs, phytochemicals, and zoochemicals
• Synergistic effects and antagonistic interactions of nutrients in foods and supplements
• Effectiveness and contraindications of popular diets
• Linking childhood behaviors to obesity and other chronic health issues in adults
• Gauging and optimizing client compliance
• Evidence-based dose and duration of nutraceutical use for common conditions
• Good manufacturing practices and other quality markers for nutritional supplements
• Effects of disordered eating patterns on nutrition status, body composition, and body functions
• Application of national guidelines, policies, consensus recommendations, and evidence-based research in the development of personalized therapeutic interventions
• Evidence-based use of common botanical supplements for health promotion and common conditions
• Safety, toxicity, and interactions of botanical supplements
• Consideration of client's personal and cultural beliefs when developing nutrition intervention plans
• MNT for obesity
• MNT for cardiovascular disease, dyslipidemias, and hypertension
• MNT for type 1 diabetes
• MNT for insulin resistance and type 2 diabetes
• MNT for endocrine disorders
• MNT for autoimmune disorders
• MNT for gastrointestinal disorders
• MNT for hematologic disorders
• MNT for bone disorders
• MNT for hepatic disorders
• MNT for pulmonary disorders
• MNT for renal disorders
• MNT for cognitive and neuro-cognitive disorders
• MNT for food allergies and intolerances
• MNT for cancer
• MNT for bariatric surgery
• MNT for surgical procedures
• MNT for mastication, swallowing, and nutrient absorption disorders
• MNT for HIV-AIDS
• MNT for dermatological disorders
• MNT for mental health/mood disorders
   

E. Public Health (6% of exam)

• Nutritional epidemiology and translation of research studies into practice
• Disease risk and prevalence related to socioeconomic status, geographic residency, ethnicity, and life cycle stage
• Causes and preventative measures for common food borne illnesses
• Tracking current outbreaks of food borne illness and communication with clients
• Identification of populations at risk for food safety issues
• Factors that negatively affect food quality and safety
• Impact of environmental toxicity on health
   

F. Practice Management (6% of exam)

• HIPAA compliance requirements
• Working within scope of practice and in collaboration with other healthcare professionals as needed
• Compliance with ethical standards
• Licensure and certification
• Insurance coverage and reimbursement