100+ Free CSSD Practice Questions

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Which of the following best describes nutrient timing around resistance exercise to maximize hypertrophy?

Only protein within 5 minutes post-exercise; nothing else matters

Pre/post resistance: 0.3-0.4 g/kg high-quality protein within ~2h surrounding training; total daily protein and energy availability are most important

Protein only on training days

Skip protein post-workout

to track

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2026 Statistics

Key Facts: CSSD Exam

150

Total Items

125 scored + 25 pretest

3 hrs

Time Limit

CDR

45%

Largest Domain Weight

Exercise & Performance Nutrition

2,000 hrs

Required Experience

Sports dietetics within 5 years

$350

US Exam Fee

$475 international

ACSM/AND/DC

Core Position Statement

2016 Nutrition and Athletic Performance

The CSSD (Board Certified Specialist in Sports Dietetics) exam is administered by CDR. The exam consists of 150 multiple-choice items (125 scored + 25 pretest) over 3 hours. The fee is $350 US / $475 international. Eligibility requires an active RD/RDN credential plus 2,000 hours of sports dietetics practice within the past 5 years. Exercise and Performance Nutrition is the largest domain at 45%, followed by Clinical Sports Nutrition (39%). Year-round PSI testing.

Sample CSSD Practice Questions

Try these sample questions to test your CSSD exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 24-year-old female collegiate distance runner presents with three stress fractures in 18 months, secondary amenorrhea for 9 months, and a body weight of 50 kg with 18% body fat. Her 7-day food/training log shows an average energy intake of 2,100 kcal/day and exercise energy expenditure of 1,500 kcal/day. Her fat-free mass is 41 kg. What is her energy availability (EA), and how should it be classified?

A.37 kcal/kg FFM/day; optimal EA

B.29 kcal/kg FFM/day; reduced EA

C.15 kcal/kg FFM/day; low EA with RED-S risk

D.42 kcal/kg FFM/day; optimal EA

Explanation: EA = (energy intake - exercise energy expenditure) / FFM in kg = (2,100 - 1,500) / 41 = 14.6 kcal/kg FFM/day. Values below 30 kcal/kg FFM/day are considered low EA and place the athlete at risk for Relative Energy Deficiency in Sport (RED-S), which explains the menstrual dysfunction and recurrent stress fractures. Optimal EA for athletic performance is generally considered approximately 45 kcal/kg FFM/day.

2According to the 2016 Joint Position Statement of the Academy of Nutrition and Dietetics, Dietitians of Canada, and ACSM, what is the recommended carbohydrate intake for an endurance athlete training moderately for 1-3 hours per day?

A.3-5 g/kg/day

B.5-7 g/kg/day

C.6-10 g/kg/day

D.8-12 g/kg/day

Explanation: The 2016 joint position statement recommends 6-10 g/kg/day of carbohydrate for athletes performing moderate to high-intensity training for 1-3 hours per day. This range supports glycogen storage adequate for endurance training demands. Lower-intensity or shorter training is associated with lower needs.

3A cyclist completing a 4-hour training ride wants to maximize carbohydrate oxidation during the event. Which fueling strategy reflects current evidence for sustained high-intensity endurance >2.5 hours?

A.30 g glucose per hour

B.60 g glucose per hour

C.90 g of multiple transportable carbohydrates (glucose:fructose 2:1) per hour

D.120 g pure fructose per hour

Explanation: For events lasting >2.5 hours, intakes up to 90 g/hour are recommended using multiple transportable carbohydrates (typically glucose:fructose in a 2:1 ratio) which use separate intestinal transporters (SGLT1 and GLUT5). This bypasses the ~60 g/hr ceiling imposed by SGLT1 saturation when only glucose is consumed.

4A 70-kg marathon runner finishes a long training run with depleted glycogen and trains again the next morning. What post-exercise carbohydrate intake during the first 4 hours best supports rapid glycogen resynthesis?

A.0.5 g/kg/hour

B.1.0-1.2 g/kg/hour

C.2.0 g/kg/hour

D.3.0 g/kg/hour

Explanation: When recovery time between training sessions is short (<8 hours), 1.0-1.2 g/kg/hour of carbohydrate during the first 4 hours post-exercise maximizes muscle glycogen resynthesis. For a 70 kg athlete this equals approximately 70-84 g/hour. Adding small amounts of protein may help when carbohydrate intake is suboptimal.

5Which of the following best describes the protein recommendation for athletes per current ACSM/AND/DC guidelines?

A.0.8 g/kg/day for all athletes

B.1.2-2.0 g/kg/day distributed across the day

C.3.0-4.0 g/kg/day to maximize hypertrophy

D.Only post-exercise; total daily intake is irrelevant

Explanation: Athletes require 1.2-2.0 g/kg/day, with the higher end favored during energy restriction or for muscle gain. Optimal MPS is achieved by spreading intake across 3-5 meals containing 0.3-0.4 g/kg of high-quality protein. This range covers endurance, strength, and team sport athletes.

6A 90 kg powerlifter wants to maximize muscle protein synthesis after a heavy resistance session. Which post-workout protein dose is best supported by the leucine-trigger hypothesis?

A.10 g whey protein

B.20 g pea protein

C.30-40 g whey protein providing ~2.5-3 g leucine

D.70 g casein

Explanation: Approximately 0.3-0.4 g/kg of high-quality protein per meal, with at least 2.5-3 g leucine, maximizes MPS. For a 90 kg athlete, 30-40 g whey is appropriate and reaches the leucine threshold. Whey is rapidly digested and leucine-rich.

7Which strategy is recommended to support overnight muscle protein synthesis in a strength athlete?

A.Skip evening protein to prioritize fat oxidation

B.30-40 g of casein 30 minutes before sleep

C.5 g BCAA supplement before sleep

D.Only carbohydrate before sleep to support glycogen

Explanation: Pre-sleep ingestion of 30-40 g casein has been shown to elevate amino acid availability and increase whole-body and muscle protein synthesis during overnight recovery. Casein's slow digestion provides a sustained amino acid release.

8A football lineman weighs 110 kg and loses 2.5 kg during a 90-minute summer practice. What is the most accurate estimate of his sweat rate, and how much fluid should he target post-practice for full rehydration?

A.1.0 L/hr; replace 2.5 L post-practice

B.1.7 L/hr; replace 3.1-3.75 L post-practice

C.2.5 L/hr; replace 5.0 L post-practice

D.Sweat rate cannot be calculated; replace ad libitum

Explanation: Sweat rate equals body weight loss adjusted for fluid intake, divided by time: 2.5 L over 1.5 hours = ~1.67 L/hr. To fully rehydrate, athletes should consume 1.25-1.5 L per kg lost (3.1-3.75 L for 2.5 kg loss) to account for ongoing urinary losses.

9Which of the following describes the recommended pre-exercise fluid intake?

A.1-2 mL/kg, 30 minutes prior

B.5-10 mL/kg, 2-4 hours prior

C.20 mL/kg, 1 hour prior

D.Hydrate to thirst only

Explanation: Current guidelines recommend 5-10 mL/kg of fluid 2-4 hours before exercise to allow for adequate hydration and urine output. If urine remains dark, an additional 3-5 mL/kg can be added 1-2 hours prior.

10A marathoner collapses at mile 22 and is found to have a serum sodium of 128 mmol/L. Which is the most likely cause?

A.Dehydration with hypernatremia

B.Exercise-associated hyponatremia from overdrinking hypotonic fluid

C.Heat stroke

D.Acute kidney injury

Explanation: Exercise-associated hyponatremia (EAH) is defined as serum sodium <135 mmol/L during or up to 24 hours after exercise. Overdrinking of hypotonic fluids during prolonged events, especially by smaller athletes and slower marathoners, is the most common cause. Inappropriate ADH release can also contribute.

About the CSSD Exam

Specialty certification for Registered Dietitians providing nutrition care to athletes and physically active individuals. The CSSD validates expertise across exercise and performance nutrition (carbohydrate periodization, protein timing, hydration, evidence-based supplements), clinical sports nutrition (energy availability and RED-S, special populations, eating disorders in athletes), and the operational/regulatory environment of sports nutrition (NCAA staffing models, WADA and NCAA anti-doping, third-party-tested supplement vetting).

Questions

150 scored questions

Time Limit

3 hours

Passing Score

Scaled

Exam Fee

$350 US / $475 international (CDR)

CSSD Exam Content Outline

45%

Exercise and Performance Nutrition

Energy metabolism, carb/protein/hydration periodization, evidence-based supplements

39%

Clinical Sports Nutrition

Energy availability, RED-S, special populations, eating disorders, micronutrients

16%

Nutrition Operations and Resource Management

Sports RD scope, billing, NCAA staffing, supplement vetting, anti-doping, ethics

How to Pass the CSSD Exam

What You Need to Know

Passing score: Scaled
Exam length: 150 questions
Time limit: 3 hours
Exam fee: $350 US / $475 international

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CSSD Study Tips from Top Performers

1Memorize ACSM/AND/DC 2016 carb periodization: 3-5 g/kg low-intensity training day, 5-7 moderate, 6-10 endurance, 8-12 ultra-endurance/glycogen restoration day before competition

2Know energy availability calculation: EA = (energy intake − exercise EE) / FFM kg/day; <30 = RED-S risk; assess via DXA + 7-day diet/training log; treat with energy intake increase + reduced exercise volume

3Master evidence-based supplement dosing: caffeine 3-6 mg/kg 60 min pre; creatine 3-5 g/d daily OR 20 g/d × 5-7 d loading; beta-alanine 3-6 g/d × 4-10 wk; sodium bicarbonate 0.3 g/kg 60-180 min pre; nitrates 300-600 mg 2-3 h pre

4Understand WADA Prohibited List structure: S0-S9 (substances), M1-M3 (methods), P1-P2 (monitored). Know substances always prohibited (S1 anabolic, S2 peptide hormones, S3 beta-2 agonists with exceptions like inhaled salbutamol within limits) vs in-competition only (S6 stimulants, S7 narcotics, S8 cannabinoids, S9 glucocorticoids by certain routes)

5Recommend ONLY third-party-tested supplements to athletes: NSF Certified for Sport or Informed Sport. The supplement industry is not FDA-regulated for ergogenic claims; contamination with banned substances is documented

Frequently Asked Questions

Who is eligible for the CSSD exam?

You need an active CDR Registered Dietitian (RD or RDN) credential held for at least 2 years plus a minimum of 2,000 hours of documented sports dietetics practice within the past 5 years. The exam is offered year-round through PSI test centers.

What is energy availability and why does it matter?

Energy Availability (EA) = (energy intake − exercise energy expenditure) / kg fat-free mass per day. EA <30 kcal/kg FFM/day = low EA, which triggers Relative Energy Deficiency in Sport (RED-S — IOC 2014/2018 framework). Low EA impacts bone health (low BMD, stress fractures), menstrual function (FHA in females), endocrine, GI, immune, CV, and performance. Assess via DXA + 7-day diet/training log.

What carbohydrate recommendations apply during competition?

Per ACSM/AND/DC 2016 joint position: pre-event 1-4 g/kg 1-4 hours prior; during events <1 hour, water + small amounts CHO if needed; 1-2 hours, 30 g/h CHO; 2-3 hours, 60 g/h single transportable carb (glucose/maltodextrin); >2.5 hours, up to 90 g/h with multiple transportable carbs (glucose:fructose 2:1 ratio uses both intestinal transporters); post-event glycogen restoration 1.0-1.2 g/kg/h × 4 hours.

Which supplements have strong evidence for athletes?

Per IOC and AIS evidence categorization: A category (strong) — caffeine (3-6 mg/kg 60 min pre, ergogenic for endurance and high-intensity), creatine monohydrate (3-5 g/d or 20 g/d × 5-7 d loading; lean mass + short-burst performance), beta-alanine (3-6 g/d × 4-10 wk for buffering 1-4 min sprints; paresthesia), sodium bicarbonate (0.3 g/kg 60-180 min pre; GI distress), nitrates/beetroot juice (300-600 mg nitrate 2-3 h pre). Iron, vit D only if deficient. Many other supplements lack strong evidence.

How should I study for the CSSD exam?

Plan 60-100 hours over 8-12 weeks. Focus heavily on Exercise and Performance Nutrition (45%) and Clinical Sports Nutrition (39%) — together 84% of exam. Master ACSM/AND/DC 2016 macronutrient periodization, IOC RED-S framework, supplement evidence categorization, anti-doping (WADA prohibited list structure S0-S9 + M1-M3, NCAA banned drug class), third-party testing programs (NSF Certified for Sport, Informed Sport), and special population considerations.