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HLTH-150 • Nutrition for Sports & Exercise

Mod 13 Discussion: Spotting Disordered Eating & When to Refer

Trastornos Alimentarios, Señales de Alerta y Protocolos de Derivación
Estimated Time / Tiempo: 15–20 Minutes / Minutos
Deadlines / Fechas: Initial Post: Thu 11:59 PM MST • 1 Peer Reply: Sun 11:59 PM MST • Locks: Mon 11:59 PM MST
Mastery Scale / Dominio: 10 / 7 / 0 Scale (Pattern / Rule / Solve + Bilingual Summary)
Module 13 Key Clinical Terms in Plain English / Glosario Clínico del Módulo en Palabras Sencillas (Click to Expand / Presione para Abrir)
  • Energy Availability Formula (EA = (EI − EEE) ÷ kg Fat-Free Mass): The dietary energy left over for basic physiological functions after subtracting Exercise Energy Expenditure (EEE), expressed per kg of Fat-Free Mass (FFM).
    En palabras sencillas: La energía que le queda libre a tus órganos vitales después de descontar las calorías que quemaste entrenando.
  • Optimal vs. Low Energy Availability Thresholds (≥45 vs. <30 kcal/kg FFM/day): Healthy physiological function requires ~45 kcal/kg FFM/day; falling below 30 kcal/kg FFM/day triggers clinical Low Energy Availability (LEA).
    En palabras sencillas: Bajar de 30 calorías por kilo de masa libre de grasa pone al cuerpo en reserva de emergencia, apagando hormonas y debilitando los huesos.
  • Relative Energy Deficiency in Sport (RED-S) & Multidisciplinary Referral Gate: Syndrome of impaired bone density, menstrual/endocrine dysfunction, frequent illness, and declining performance requiring immediate caloric restoration and physician/RD referral.
    En palabras sencillas: Señales de alarma como fatiga crónica, fracturas por estrés o falta de periodo menstrual que exigen subir calorías reales y referir al médico y nutriólogo clínico (RD).

Recognizing RED-S Warning Signs, Behavioral Red Flags & Referral Standards

Identifying disordered eating and Relative Energy Deficiency in Sport (RED-S) in athletic and clinical populations requires compassion, acute observational skill, and strict adherence to professional boundaries. Exercise professionals must recognize behavioral warning signs and execute proper interdisciplinary referrals. Select your Build Your Own Journey Track below, audit a real-world clinical screening case using Google Gemini, and apply federal and sports nutrition standards (PAGA 2018 / IOC RED-S Consensus / ACSM Position Stands)!

 Discussion Schedule & Deadlines / Horario y Fechas Límite:
Bilingual Participation Welcome / Participación Bilingüe Bienvenida: You are warmly encouraged to post in English or Spanish according to your preference. Le animamos a publicar en inglés o en español, según su preferencia.

PAGA Physical Activity & Nutrition Tool Kit PWA ("PAGA" in Course Navigation • Open PAGA PWA): Click "PAGA" in your left Canvas navigation bar or open Nutrition Coach (DGA 2025–2030) • USOPC Athlete Plates • Activity Audit • My Dashboard → Paste your ### delimited case or weekly log to run a Pattern / Rule / Solve audit and build your 4-part Canvas submission.

Optional Experimental Biometric & FITT Calculator ("Toolkit" in Course Navigation • https://exwtoolkit.com): Follow Step 1: Biometrics Box → 3. Fuel Box (RMR, TDEE & Macronutrients) → 9. Solve Box ("Copy for Canvas Submission") (optional experimental tool — verify all outputs against our course SSoT and share any feedback with Coach Alan).

Herramientas Digitales en el Menú Izquierdo ("PAGA" y "Toolkit"): Abra "PAGA" (paga2018.dev → Nutrition Coach (DGA 2025–2030), Platos del Atleta USOPC y Activity Audit) para pegar su caso entre líneas ### y armar su entrega de 4 partes, o use "Toolkit" (https://exwtoolkit.com → Step 1: Biometrics Box → 3. Fuel Box (Tasa Metabólica y Macronutrientes) → 9. Solve Box) de forma experimental opcional verificando cada dato contra la Fuente de Verdad.

Phase 1: Select Your Clinical Simulation Case File #150-13

Choose ONE of the three career-aligned tracks below to copy into your AI query:

Track 1: Clinical & Rehabilitation Path / Ruta Clínica y Rehabilitación (Default Open — Click to Collapse/Expand)

Focus: Managing recurrent stress fractures, amenorrhea, and bone density suppression in clinical rehabilitation patients.

TRACK 1 SIMULATION CASE DATA • CLÍNICA
Click to Copy / Copiar (1 Clic)Copied! Highlighted Below (Ctrl+C / Cmd+C) • ¡Copiado!
###
[TRACK]: Track 1 - Clinical & Rehabilitation Path
[PATIENT INITIALS]: H.L. | [AGE]: 24 | [LOCATION]: Yuma Regional Outpatient Physical Therapy Clinic
[CLINICAL PRESENTATION]: Patient is a recreational long-distance runner presenting with a third recurrent tibial stress fracture in 18 months, secondary amenorrhea, and chronic fatigue.
[DIETARY RECALL & CLINICAL AUDIT]: Consumes restrictive low-calorie intake (<1,800 kcal/day) while running 60 miles/week. Energy availability is calculated at 22 kcal/kg FFM/day (well below the 30 kcal/kg threshold).
[METABOLIC DEFICIT]: Severe chronic low energy availability suppressing estrogen and bone remodeling; requires immediate multidisciplinary referral to sports medicine and registered dietitian.
###
Track 2: Community & Public Health Path / Ruta Comunitaria y Salud Pública (Click to Expand Track)

Focus: Community education initiatives in Yuma County promoting positive body image and youth sports wellness.

TRACK 2 SIMULATION CASE DATA • COMUNITARIA
Click to Copy / Copiar (1 Clic)Copied! Highlighted Below (Ctrl+C / Cmd+C) • ¡Copiado!
###
[TRACK]: Track 2 - Community & Public Health Path
[CLIENT INITIALS]: C.P. | [AGE]: 16 | [LOCATION]: Yuma County Youth Sports League, AZ
[OCCUPATION]: High school cross-country runner exhibiting extreme anxiety around team meals, drastic weight loss, and declining academic performance.
[NUTRITIONAL CHALLENGE]: Parents report rigid food avoidance and secret exercising. Coaches lack training to screen for early-stage eating disorders in teenage athletes.
[INTERVENTION GOAL]: Design a community-level screening and support protocol for high school coaches and parents, establishing safe referral pathways to pediatric adolescent medicine.
###
Track 3: Sports & Athletic Performance Path / Ruta de Rendimiento Deportivo (Click to Expand Track)

Focus: Screening collegiate athletes for RED-S, restoring energy availability, and return-to-play clearance protocols.

TRACK 3 SIMULATION CASE DATA • DEPORTIVA
Click to Copy / Copiar (1 Clic)Copied! Highlighted Below (Ctrl+C / Cmd+C) • ¡Copiado!
###
[TRACK]: Track 3 - Sports & Athletic Performance Path
[ATHLETE INITIALS]: B.W. | [AGE]: 19 | [SPORT]: Collegiate Distance Runner (AWC Matadors)
[TRAINING LOAD]: 70 miles/week heavy endurance training.
[METRICS & DIETARY AUDIT]: Experiencing decreased race times, chronic bradycardia, irritability, and frequent injuries. Energy availability is audited at 25 kcal/kg FFM/day.
[PERFORMANCE BOTTLENECK]: Classical RED-S presentation; requires structured energy availability restoration (increasing intake by 500 kcal/day) and medical clearance review before racing.
###

Phase 2: Gemini AI Clinical Simulation Consultation / Espacio de Simulación con IA

AI SIMULATION PROMPT TEMPLATE • PLANTILLA DE CONSULTA
Click to Copy / Copiar (1 Clic)Copied! Highlighted Below (Ctrl+C / Cmd+C) • ¡Copiado!
"Act as my HLTH-150 Sports Nutrition Preceptor. Based on the case data wrapped in triple-hashes (###) above, perform a clinical screening and RED-S audit for my selected track. First, analyze the PATTERN by evaluating behavioral red flags, stress fracture history, or energy availability deficits. Second, apply the RULE by evaluating these metrics against federal and IOC standards (PAGA 2018 / IOC RED-S Consensus), specifically addressing the critical EA threshold (<30 kcal/kg FFM/day), multidisciplinary referral standards, and return-to-play clearance. Third, SOLVE by designing a compassionate screening and energy restoration protocol, and drafting a 2-sentence bilingual client instruction card in English and Spanish. Keep all case data wrapped within triple-hash delimiters."

Discussion Tasks / Tareas de Discusión (Due Thursday / Jueves 11:59 PM MST):

  1. Identify Selected Track & RED-S Warning Signs / Ruta y Señales de Alerta: State your chosen track and report the client's clinical presentation, noting specific physiological indicators of low energy availability.
    Indique la ruta seleccionada y reporte la presentación clínica del cliente, señalando indicadores fisiológicos de baja disponibilidad energética.
  2. Clinical Framing Protocol (Pattern / Rule / Solve) Analysis (Pattern / Rule / Solve) / Análisis del Protocolo de Marco Clínico (Patrón / Regla / Solución): Explain why chronic energy restriction impairs bone density and endocrine health (Pattern), cite IOC RED-S and PAGA 2018 screening standards (Rule), and provide the multidisciplinary support protocol (Solve).
    Explique por qué la restricción crónica afecta la densidad ósea (Patrón), cite las normas de tamizaje RED-S (Regla) y detalle el protocolo de apoyo (Solución).
  3. Bilingual Client Instruction Card / Tarjeta de Instrucción Bilingüe: Provide a concise 2-sentence explanation of the recovery and support plan in both English and Spanish so your client can execute it easily.
    Proporcione una explicación concisa de 2 oraciones sobre el plan de recuperación en inglés y español para que su cliente la aplique fácilmente.
BLANK DISCUSSION POST & PEER REPLY SKELETON • PLANTILLA PARA EL FORO
Click to Highlight Template (1 Clic)Selected! Press Ctrl+C / Cmd+C to Copy • ¡Seleccionado!
[SELECTED TRACK & CLIENT]: Track [1 / 2 / 3] — Client [Initials] [1. PATTERN RECOGNITION / PATRÓN]: [Identify the client's physiological, biomechanical, or nutritional limitation and Yuma environmental heat stressors.] [2. RULE APPLICATION / REGLA (2025-2030 Dietary Guidelines for Americans (Real-Food Focus))]: [Cite the exact federal guideline threshold and safety gate for this case.] [3. SOLUTION FORMULATION / SOLUCIÓN (IN MY OWN VOICE)]: [Propose your adapted exercise or nutrition intervention in your own coaching voice.] [4. BILINGUAL SUMMARY / RESUMEN BILINGÜE (1 SENTENCE EACH)]: EN: "[1-sentence plain-English takeaway for your client.]" ES: "[Resumen práctico de 1 oración en español para su cliente.]"

Peer Engagement Requirement / Requisito de Interacción

By Sunday at 11:59 PM MST, respond to at least ONE (1) classmate who selected a different track than yours (Minimum 1 Reply Required). Evaluate their screening recommendations, compare interdisciplinary referral pathways, and discuss how RED-S protocols must adapt across clinical, community, and athletic settings.

Antes del domingo a las 11:59 PM MST, responda al menos a UN (1) compañero que haya elegido una ruta diferente a la suya (mínimo 1 respuesta). Evalúe sus recomendaciones de tamizaje.

10/10 High-Fidelity Student Exemplar / Modelo 10/10

Target Quality Benchmark for Track 3 (Sports Performance) Submission
View Full 10 / 10 Model Student Exemplar (Click to Expand Reference Example / Ver Ejemplo 10/10)
Selected Track: Track 3 (Sports Performance Path) - Athlete B.W.

Pattern Recognition: Collegiate distance runner B.W. exhibits classic RED-S indicators: chronic fatigue, declining race performance, frequent injuries, and an audited energy availability of 25 kcal/kg FFM/day—significantly below the 30 kcal/kg safety threshold.

Rule Application (IOC RED-S / PAGA 2018 Standards): According to IOC consensus statements, energy availability below 30 kcal/kg FFM/day disrupts endocrine signaling, suppresses bone formation, and impairs cardiovascular function. Immediate clinical intervention and temporary training reduction are mandatory.

Solve (Multidisciplinary Recovery Protocol): We establish a comprehensive recovery plan:

  • Energy Restoration: Increase daily caloric intake by 500 kcal/day through nutrient-dense whole foods to elevate EA above 40 kcal/kg FFM/day.
  • Interdisciplinary Referral: Coordinate immediate evaluation with a sports medicine physician and a registered sports dietitian specializing in RED-S.
  • Return-to-Play Clearance: Enforce supervised training reduction until hormonal normalization and bone density stabilization are confirmed.
Bilingual Client Instruction Card / Tarjeta de Instrucción Bilingüe:

EN: "Increase your daily food intake to support your training, and partner with our sports medicine team to restore your long-term health."

ES: "Aumente su consumo diario de alimentos para respaldar su entrenamiento y colabore con nuestro equipo médico para restaurar su salud."