Energy Balance, Nutrition & Fuel Utilization

ACSM-EP ACSM Certified Exercise Physiologist

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1 Introduction & Exam Overview

The ACSM-EP Credential & Current Exam Facts Exam Blueprint, Cognitive Levels & Study Strategy

2 Foundations of Exercise Physiology

Bioenergetics & Energy Systems Cardiorespiratory Responses & Adaptations to Exercise Neuromuscular Physiology

3 Functional Anatomy & Biomechanics

Musculoskeletal Anatomy & Movement Terminology Biomechanical Principles

4 Preparticipation Health Screening & Risk Assessment

The ACSM Preparticipation Screening Algorithm & Medical Clearance Informed Consent & Health-History Questionnaire CV, Pulmonary, Metabolic & Musculoskeletal Risk Factors Clinical Reference Values

5 Health & Fitness Assessments

Selecting, Sequencing & Terminating Fitness Assessments Cardiorespiratory Fitness Testing Muscular Fitness, Flexibility & Neuromotor Assessment Anthropometric & Body Composition Assessment

6 Exercise Prescription Foundations: FITT-VP & Programming

The FITT-VP Framework & Training Principles Session Structure, Warm-Up/Cool-Down & Recovery Program Design, Overtraining & Injury Recognition

7 Cardiorespiratory Exercise Prescription

Prescribing CR Exercise & Intensity Methods ACSM Metabolic Equations & Caloric Expenditure

8 Resistance, Flexibility & Neuromotor Prescription

Resistance Training Prescription Flexibility, Neuromotor & Plyometric Prescription

9 Progression, Nutrition & Weight Management

Exercise Progression & Modification Energy Balance, Nutrition & Fuel Utilization Body-Composition Modification, Ergogenic Aids & Weight-Management Programming

10 Clients with Controlled Disease & Special Populations

Exercise for Controlled Cardiovascular, Pulmonary & Metabolic Disease Exercise for Arthritis, Osteoporosis, Obesity & Low-Back Pain Older Adults Children, Adolescents & Pregnant Clients Environmental Considerations: Heat, Cold, Altitude & Air Quality

11 Exercise Counseling & Behavior Modification

Communication Techniques & Group Exercise Leadership Behavior-Change Models & Theories Motivational Interviewing, Goal Setting & Adherence Health Literacy, Educational Resources & Stress Management Professional Standards, Mental Health & Referral (Scope of Practice)

12 Risk Management & Emergency Procedures

Risk Management, Legal & Professional Responsibilities Emergency Procedures, First Aid & Basic Life Support

Energy Balance, Nutrition & Fuel Utilization

Key Takeaways Explain This Topic AI

The Acceptable Macronutrient Distribution Range for healthy adults is 45-65% of calories from carbohydrate, 20-35% from fat, and 10-35% from protein.

Active individuals engaged in regular exercise generally need 1.2-2.0 g of protein per kilogram of body weight per day, above the general RDA of 0.8 g/kg.

The crossover concept describes fat as the dominant fuel at rest and low intensity, with carbohydrate becoming dominant above roughly 50-65% VO2max.

Practical hydration guidance suggests about 5-7 mL/kg of fluid roughly 4 hours before exercise and about 1.5 L of fluid per kilogram of body weight lost after exercise.

Medical nutrition therapy for diagnosed conditions is outside an exercise physiologist's scope and must be referred to a registered dietitian or physician.

Last updated: July 2026

Energy Balance and Metabolism

Energy balance is the relationship between kilocalories consumed and kilocalories expended. A neutral balance maintains body weight; a sustained positive balance (intake greater than expenditure) produces weight gain; a sustained negative balance (expenditure greater than intake) produces weight loss. Total daily energy expenditure is driven mainly by resting metabolic rate (RMR) -- the energy required for basic physiological function at rest, typically 60-75% of total daily expenditure -- plus the thermic effect of food and physical activity. Fat-free mass (FFM) is the single strongest predictor of RMR: more metabolically active tissue (muscle, organs) burns more calories at rest, which is why resistance training and preserving lean mass matter for long-term weight management. During prolonged, aggressive caloric restriction, RMR can fall by more than would be predicted from FFM loss alone -- a phenomenon called adaptive thermogenesis -- which is one reason very restrictive diets often fail to produce sustained weight loss.

Estimating Total Daily Energy Needs

Total daily energy expenditure (TDEE) is commonly estimated by multiplying predicted RMR (from equations such as Mifflin-St Jeor) by a physical activity level (PAL) multiplier that accounts for occupational and exercise activity, then adding the thermic effect of food (TEF) , which represents roughly 8-10% of total intake and reflects the energy cost of digesting, absorbing, and metabolizing food. Protein has the highest TEF of the three macronutrients, which is one minor contributor (alongside satiety) to higher-protein diets performing well for weight management. These are population-level estimates, not diagnostic tools -- individually measured RMR (via indirect calorimetry) can vary meaningfully from predicted values, so an exercise physiologist should treat estimated calorie targets as a starting point to be adjusted based on the client's actual rate of weight change over several weeks, not a precise prescription.

Macronutrients and the Acceptable Macronutrient Distribution Range

U.S. Dietary Guidelines and Institute of Medicine reference values set the Acceptable Macronutrient Distribution Range (AMDR) for healthy adults as follows:

Macronutrient AMDR (% of total calories) kcal per gram
Carbohydrate 45-65% 4
Fat 20-35% 9
Protein 10-35% 4
Alcohol (not an AMDR macronutrient) -- 7

For clients who exercise regularly, protein needs run higher than the general-population Recommended Dietary Allowance of 0.8 g/kg/day: active adults engaged in regular endurance or resistance training generally need 1.2-2.0 g of protein per kilogram of body weight per day , with the higher end of that range appropriate for intense resistance training or energy-restricted periods where preserving lean mass is a priority. Protein intake within the AMDR and this activity-adjusted range, spread across meals, supports muscle repair and satiety without requiring supplementation for most clients.

Fuel Utilization During Exercise

The relative contribution of fat versus carbohydrate to energy production shifts predictably with exercise intensity -- a pattern described by the crossover concept . At rest and during low-intensity exercise, fat oxidation supplies most energy. As intensity rises toward roughly 50-65% of VO2max, carbohydrate use increases and becomes the dominant fuel; above about 85% VO2max, energy comes almost entirely from carbohydrate via anaerobic glycolysis, because fat oxidation cannot supply ATP fast enough to match demand at high intensities. Endurance training shifts this crossover point to the right, allowing a trained individual to rely on fat for energy at a higher relative intensity than an untrained person -- one metabolic benefit of consistent aerobic training.

Hydration Before, During, and After Exercise

Fluid balance affects both performance and safety. General, evidence-based guidelines include:

Timing Recommendation
Pre-exercise About 5-7 mL/kg body weight roughly 4 hours before exercise; more if urine remains dark or scant

During exercise Individualized to sweat rate, duration, and environment; goal is to prevent body-weight loss from exceeding about 2% (a threshold linked to impaired performance and heat-illness risk)

Post-exercise Approximately 1.5 L of fluid per kilogram of body weight lost, to account for continued fluid loss through urination during rehydration

A practical way to individualize during-exercise fluid needs is the sweat-rate technique : weigh the client before and after a representative training session in similar dry clothing, account for any fluid consumed during the session, and use the body-weight change to estimate sweat losses per hour for future sessions performed in similar conditions.

MyPlate, Dietary Guidelines, and Scope of Practice

The USDA's MyPlate and the Dietary Guidelines for Americans provide the general nutrition framework exercise physiologists should reinforce with clients: about half the plate as fruits and vegetables, an emphasis on whole grains, lean protein and dairy or dairy alternatives, and limits on added sugars, saturated fat, and sodium. Special populations -- women (iron, folate, calcium needs), children and adolescents (adequate calories and calcium/vitamin D for growth), older adults (protein and vitamin D to counter sarcopenia), and pregnant clients (increased caloric, folate, and iron needs) -- have distinct requirements that warrant individualized general guidance. Critically, an exercise physiologist's scope of practice is limited to general, healthy-population nutrition education consistent with published guidelines. Medical nutrition therapy -- individualized nutrition care for diabetes, renal disease, eating disorders, or other diagnosed medical conditions -- is outside scope and must be referred to a registered dietitian (RD/RDN) or physician.