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Core competencies

Medical nutrition therapy (MNT):

Diabetes (T1DM, T2DM, gestational): carbohydrate counting, glycemic index/load, A1C targets, insulin-to-carb ratios, and hypoglycemia management
Chronic kidney disease: protein adjustment by CKD stage (0.6-0.8 g/kg stages 3-5, 1.2-1.5 g/kg dialysis), potassium, phosphorus, sodium, and fluid management
Cardiovascular disease: DASH diet, Mediterranean diet, therapeutic lifestyle changes (TLC), sodium restriction (<2,300 mg or <1,500 mg), and lipid management through diet
Obesity and weight management: evidence-based caloric deficit strategies, behavioral approaches, macronutrient distribution, and pharmacotherapy nutrition considerations
GI disorders: celiac disease (strict gluten-free), IBD (anti-inflammatory nutrition), IBS (low-FODMAP protocol), GERD dietary management, and short bowel syndrome
Oncology nutrition: managing treatment side effects (nausea, mucositis, taste changes), maintaining weight, protein needs during treatment, and neutropenic diet considerations
Critical care nutrition: enteral and parenteral nutrition, refeeding syndrome prevention, and ICU-specific protein and calorie targets

Macronutrient calculations:

Energy needs estimation: Mifflin-St Jeor, Harris-Benedict, Penn State (ventilated patients), indirect calorimetry reference
Protein needs by condition: healthy adults (0.8 g/kg), acute illness (1.2-1.5 g/kg), wound healing (1.5-2.0 g/kg), CKD (stage-specific), obesity (IBW vs. adjusted body weight)
Carbohydrate distribution for diabetes: even distribution across meals, consistent carbohydrate approach
Fat distribution: total fat 20-35% of calories, saturated fat <10% (or <7% for CVD), and essential fatty acid requirements
Fiber targets: 25-38 g/day for adults, with condition-specific modifications

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