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Key Facts: BTS Diététique Exam

Level 5

National qualification level under France Compétences and EQF framework

France Compétences RNCP 37375

No fixed fee

Any candidate charge depends on academy and enrolment route

Ministère de l'Éducation nationale / Cyclades

20 Weeks

Mandatory clinical and collective catering internships required for graduation

Arrêté du 9 septembre 1997

10 / 20

Minimum overall weighted average required to obtain the BTS diploma

Code de l'éducation (France)

6 Units

Core examination units, with E6 divided into written and practical sub-units

Référentiel BTS Diététique

The BTS Diététique is a French state credential for dietitians. The legacy framework has its final examination session in 2026 and combines five written or oral units with a two-part professional synthesis assessment; the replacement BTS Diététique et nutrition first examines in 2027. This bank covers biochemistry, nutrition science, clinical dietetics, and food-service regulation as an English-language MCQ study adaptation.

Sample BTS Diététique Practice Questions

Try these sample questions to review concepts for the BTS Diététique exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which enzyme catalyzes the primary committed and rate-limiting step of glycolysis, and how is it allosterically regulated by fructose-2,6-bisphosphate and intracellular ATP concentrations?

A.Hexokinase, which is stimulated by glucose-6-phosphate and inhibited by fructose-2,6-bisphosphate

B.Phosphofructokinase-1 (PFK-1), which is allosterically activated by fructose-2,6-bisphosphate and AMP, and allosterically inhibited by high levels of ATP and citrate

C.Pyruvate kinase, which is activated by glucagon phosphorylation and inhibited by fructose-1,6-bisphosphate

D.Glyceraldehyde-3-phosphate dehydrogenase, which is regulated directly by the cytoplasmic NAD+/NADH ratio independent of adenylate energy charge

Explanation: Phosphofructokinase-1 (PFK-1) catalyzes the irreversible conversion of fructose-6-phosphate to fructose-1,6-bisphosphate, representing the major flux-controlling checkpoint of glycolysis. High concentrations of ATP and cytosolic citrate act as allosteric inhibitors signaling an abundant cellular energy state, whereas AMP and fructose-2,6-bisphosphate (produced by PFK-2 in response to insulin) are potent allosteric activators that override ATP inhibition.

2During hepatic gluconeogenesis, which sequence of mitochondrial and cytoplasmic enzymatic reactions bypasses the irreversible reaction catalyzed by pyruvate kinase?

A.Pyruvate decarboxylase in the cytoplasm converts pyruvate directly to acetaldehyde, followed by oxidation to acetate

B.Pyruvate dehydrogenase decarboxylates pyruvate to acetyl-CoA, which is subsequently converted into malate by citrate synthase

C.Mitochondrial pyruvate carboxylase converts pyruvate to oxaloacetate, which is reduced to malate for cytosol export and converted to phosphoenolpyruvate by cytosolic PEPCK

D.Mitochondrial malate dehydrogenase converts pyruvate directly to fumarate, which diffuses into the cytosol and is phosphorylated by nucleoside diphosphate kinase

Explanation: The bypass of pyruvate kinase requires two distinct enzymatic steps: first, mitochondrial pyruvate carboxylase carboxilates pyruvate to oxaloacetate using biotin and ATP (allosterically activated by acetyl-CoA). Because oxaloacetate cannot cross the inner mitochondrial membrane, it is reduced to malate by mitochondrial malate dehydrogenase, transported via the malate-alpha-ketoglutarate carrier to the cytosol, re-oxidized to oxaloacetate, and converted to phosphoenolpyruvate (PEP) by cytosolic phosphoenolpyruvate carboxykinase (PEPCK) utilizing GTP.

3In the fasting state, through which molecular cascade does glucagon stimulate hepatic glycogenolysis?

A.Glucagon binds to a G-protein coupled receptor (Gs), activating adenylyl cyclase, elevating cAMP, activating protein kinase A (PKA), which phosphorylates and activates phosphorylase kinase, thereby activating glycogen phosphorylase b into phosphorylase a

B.Glucagon enters the hepatocyte nucleus to transcribe glycogen synthase kinase-3, which dephosphorylates glycogen synthase to increase glycogen branching

C.Glucagon binds to a receptor tyrosine kinase, stimulating the PI3K/Akt pathway, which activates protein phosphatase-1 (PP1) to hydrolyze alpha-1,6-glucosidic bonds

D.Glucagon stimulates phospholipase C, generating IP3 that releases endoplasmic calcium, causing allosteric inactivation of glycogen debranching enzyme

Explanation: Glucagon activates hepatic Gs-protein coupled receptors, stimulating adenylyl cyclase to synthesize cyclic AMP (cAMP). High cAMP activates Protein Kinase A (PKA), which phosphorylates phosphorylase kinase; active phosphorylase kinase then phosphorylates glycogen phosphorylase b (inactive) into glycogen phosphorylase a (active), accelerating the phosphorolysis of glycogen into glucose-1-phosphate.

4What is the physiological role of the oxidative phase of the pentose phosphate pathway (PPP), and which enzyme deficiency in this pathway causes hemolytic anemia upon oxidative stress?

A.Generation of NADH for ATP synthesis in the respiratory chain; pyruvate dehydrogenase deficiency

B.Synthesis of UDP-glucuronate for bilirubin conjugation; UDP-glucuronosyltransferase deficiency

C.Degradation of ribose sugars to produce lactate in erythrocytes; transketolase deficiency

D.Production of NADPH for reductive biosyntheses and glutathione reduction, alongside ribose-5-phosphate; glucose-6-phosphate dehydrogenase (G6PD) deficiency

Explanation: The irreversible oxidative phase of the pentose phosphate pathway converts glucose-6-phosphate to ribulose-5-phosphate, generating two moles of NADPH per mole of glucose oxidized. NADPH is crucial for maintaining reduced glutathione (GSH) via glutathione reductase to protect erythrocytes from reactive oxygen species; a deficiency in glucose-6-phosphate dehydrogenase (G6PD) impairs NADPH production, predisposing red blood cells to oxidative hemolysis.

5Which enzyme controls the rate-limiting entry of long-chain fatty acyl-CoA into the mitochondrial matrix for beta-oxidation, and by which metabolite is it physiologically inhibited during the fed state?

A.Fatty acid synthase, inhibited by free coenzyme A

B.Carnitine palmitoyltransferase-1 (CPT-1), inhibited by malonyl-CoA

C.Acyl-CoA dehydrogenase, inhibited by acetoacetate

D.Carnitine-acylcarnitine translocase, inhibited by citrate

Explanation: Carnitine palmitoyltransferase-1 (CPT-1), situated in the outer mitochondrial membrane, converts long-chain fatty acyl-CoA into fatty acylcarnitine, enabling mitochondrial entry. In the fed state, active acetyl-CoA carboxylase (ACC) produces malonyl-CoA, the first committed intermediate of de novo lipogenesis; malonyl-CoA allosterically inhibits CPT-1, preventing simultaneous fatty acid synthesis and mitochondrial beta-oxidation.

6Why is the liver unable to utilize ketone bodies (acetoacetate and beta-hydroxybutyrate) as an energy substrate despite being their exclusive site of synthesis?

A.Hepatocytes lack the enzyme beta-ketoacyl-CoA transferase (thiophorase / succinyl-CoA:3-ketoacid CoA transferase)

B.Hepatocytes lack 3-hydroxybutyrate dehydrogenase in their mitochondrial matrix

C.Hepatic mitochondria are impermeable to acetoacetate and beta-hydroxybutyrate

D.Glucagon irreversibly inhibits hepatic thiolase, preventing the cleavage of acetoacetyl-CoA into acetyl-CoA

Explanation: The liver synthesizes ketone bodies from excess acetyl-CoA derived from beta-oxidation during prolonged fasting or untreated diabetes, but it lacks the activating enzyme beta-ketoacyl-CoA transferase (thiophorase, or succinyl-CoA:3-ketoacid CoA transferase). This metabolic adaptation ensures that ketone bodies are exported into the circulation to serve as vital fuel for extrahepatic tissues such as the brain, skeletal muscle, and myocardium.

7Which statement accurately contrasts the physiological function and hormonal regulation of lipoprotein lipase (LPL) and hormone-sensitive lipase (HSL)?

A.LPL hydrolyzes stored intracellular triglycerides in adipocytes under epinephrine stimulation, while HSL clears circulating chylomicrons in the capillary endothelium

B.Both LPL and HSL are located within the inner mitochondrial membrane and are activated by thyroid-stimulating hormone

C.LPL acts at capillary endothelial surfaces to hydrolyze triglycerides in circulating lipoproteins, while adipocyte HSL participates in intracellular lipolysis stimulated mainly by catecholamines and opposed by insulin

D.LPL synthesizes cholesterol esters from HDL, while HSL packages free fatty acids into VLDL in the liver

Explanation: Lipoprotein lipase is presented on capillary endothelium and hydrolyzes triglycerides carried in chylomicrons and VLDL; apoC-II is an essential activator, and insulin promotes adipose lipid storage. Hormone-sensitive lipase works inside adipocytes as part of regulated lipid-droplet lipolysis. In humans, catecholamine-cAMP signalling is a major activator and insulin suppresses lipolysis; a direct glucagon effect on human adipose tissue should not be stated as the standard mechanism.

8Which structural apolipoprotein is obligatorily synthesized by intestinal enterocytes to assemble and secrete dietary chylomicrons into the mesenteric lymphatic system?

A.Apolipoprotein A-I

B.Apolipoprotein E

C.Apolipoprotein B-100

D.Apolipoprotein B-48

Explanation: Apolipoprotein B-48 (Apo B-48) is the structural backbone of chylomicrons, produced exclusively in human enterocytes through post-transcriptional RNA editing of the APOB gene transcript by cytidine deaminase (APOBEC-1), creating a premature stop codon that results in a truncated protein 48% the length of Apo B-100. In contrast, the liver synthesizes full-length Apo B-100 to package VLDL.

9Which vitamin-derived coenzyme is indispensably required by aminotransferases (such as AST and ALT) to transfer alpha-amino groups to alpha-ketoglutarate?

A.Thiamine pyrophosphate (TPP, vitamin B1)

B.Pyridoxal-5-phosphate (PLP, vitamin B6)

C.Flavin adenine dinucleotide (FAD, vitamin B2)

D.Nicotinamide adenine dinucleotide (NAD+, vitamin B3)

Explanation: Aminotransferases (transaminases) require pyridoxal-5-phosphate (PLP), the active coenzyme form of vitamin B6. PLP forms a Schiff base intermediate with the epsilon-amino group of a lysine residue in the enzyme's active site, which subsequently accepts an amino group from an amino acid to form pyridoxamine phosphate before transferring it to an alpha-keto acid such as alpha-ketoglutarate to yield glutamate.

10What is the initial, rate-limiting enzyme of the hepatic urea cycle, and what allosteric activator is strictly required for its catalytic activity?

A.Ornithine transcarbamylase, activated by citrulline

B.Argininosuccinate synthetase, activated by fumarate

C.Carbamoyl phosphate synthetase I (CPS-1), activated by N-acetylglutamate

D.Arginase-1, activated by ornithine

Explanation: Carbamoyl phosphate synthetase I (CPS-1) is located in the mitochondrial matrix of hepatocytes and catalyzes the condensation of ammonia (NH4+), bicarbonate (HCO3-), and two molecules of ATP to form carbamoyl phosphate. CPS-1 is catalytically inactive unless allosterically activated by N-acetylglutamate (NAG), whose synthesis by N-acetylglutamate synthase is stimulated by arginine, a signal of high protein catabolism.

About the BTS Diététique Exam

The Brevet de Technicien Supérieur Diététique (BTS Diététique) is France's premier Niveau 5 (EQF Level 5) paramedical diploma required to practice as a licensed dietitian (diététicien nutritionniste) under the French Public Health Code (Code de la santé publique, Article L4371-1 et suivants). Dietitians are clinical nutrition specialists trained to design personalized therapeutic diets, treat metabolic, renal, digestive, and cardiovascular disorders, supervise institutional food service catering according to GEMRCN and EGAlim standards, ensure HACCP food safety, and conduct public health prevention campaigns.

Exam sponsor: Ministère de l'Éducation nationale et de la Jeunesse (MENJ). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

For its final session in 2026, the legacy BTS Diététique remains governed by the 9 September 1997 framework: E1 Biochimie-physiologie (written, 3h, coef 2); E2 Connaissance des aliments (written, 4h, coef 2); E3 Bases physiopathologiques de la diététique (written, 4h, coef 3); E4 Économie et gestion (written, 3h, coef 2); E5 Présentation et soutenance de mémoire (oral, 1h, coef 3); and E6 Épreuve professionnelle de synthèse, split into a 3h30 case study (coef 2.5) and a 3h practical food-technology assessment (coef 2.5). The replacement BTS Diététique et nutrition created in 2024 has its first examination session in 2027.

Time Limit

E1 3h; E2 4h; E3 4h; E4 3h; E5 oral 1h; E6.1 written 3h30; E6.2 practical 3h

Passing Score

10.0 / 20 overall weighted average across all units

Exam / Certification Fees

No single national examination fee is published; any charges depend on academy and candidate route

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25%

Biochimie et Physiologie Humaines (E1/U1)

Cell biology, enzymatic kinetics, bioenergetics, carbohydrate glycolysis and gluconeogenesis, beta-oxidation and lipogenesis, nitrogen balance and urea cycle, digestive gastrointestinal secretions, endocrine regulation of blood glucose, and renal glomerular/tubular hemodynamics.

25%

Nutrition et Alimentation (E2/U2)

Nutrient requirements across life stages, ANSES nutritional reference values (RNP, AS, LSS), PNNS 5 public health guidelines, nutritional values of major food groups (Ciqual data), culinary transformation and processing, food microbiology, foodborne pathogens, and HACCP sanitary principles.

25%

Physiopathologie et Diététique (E3/U3)

Etiology, clinical signs, and medical nutrition therapy for type 1 and type 2 diabetes mellitus, cardiovascular disease, hypertension, dyslipidemias, chronic kidney disease stages 1-5, malabsorption syndromes (celiac, Crohn's, ulcerative colitis), acute/chronic pancreatitis, severe undernutrition (HAS guidelines), bariatric surgery, and enteral/parenteral nutrition.

25%

Économie, Gestion et Réglementation (E4/U4)

Food service production systems (cook-chill liaison froide, cook-warm liaison chaude), GEMRCN nutrition guidelines and meal service frequencies, EGAlim and Climat-Résilience environmental legislation, Sanitary Control Plans (PMS), public health prevention programs, dietetic deontological ethics, and hospital nutrition committees (CLAN).

Preparing for the BTS Diététique Exam

What You Need to Know

Passing score: 10.0 / 20 overall weighted average across all units
Assessment: For its final session in 2026, the legacy BTS Diététique remains governed by the 9 September 1997 framework: E1 Biochimie-physiologie (written, 3h, coef 2); E2 Connaissance des aliments (written, 4h, coef 2); E3 Bases physiopathologiques de la diététique (written, 4h, coef 3); E4 Économie et gestion (written, 3h, coef 2); E5 Présentation et soutenance de mémoire (oral, 1h, coef 3); and E6 Épreuve professionnelle de synthèse, split into a 3h30 case study (coef 2.5) and a 3h practical food-technology assessment (coef 2.5). The replacement BTS Diététique et nutrition created in 2024 has its first examination session in 2027.
Time limit: E1 3h; E2 4h; E3 4h; E4 3h; E5 oral 1h; E6.1 written 3h30; E6.2 practical 3h
Exam / certification fees: No single national examination fee is published; any charges depend on academy and candidate route Official sources

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BTS Diététique: Suggested Study Strategy

1Master metabolic pathways and their enzymatic rate-limiting checkpoints: glycolysis (PFK-1), gluconeogenesis (FBPase-1), glycogenolysis, Krebs cycle, and lipogenesis.

2Memorize the ANSES nutritional references: macronutrient energy distribution (30-40% lipids, 40-55% carbohydrates, 10-20% protein) and specific micronutrient targets (calcium, iron, folate, vitamin D).

3Practice clinical case studies: calculate basal metabolic rate (Black et al. formula), total energy expenditure (TEE), protein target (g/kg/day), and mineral constraints (sodium, potassium, phosphorus) for diabetic, renal, and undernourished patients.

4Thoroughly review GEMRCN portion grammages and 20-meal frequency grids for school, hospital, and geriatric catering.

5Understand the legislative framework: EGAlim 1 & 2 laws, Arrêté du 21 décembre 2009, European Regulation (EC) 852/2004, and the role of the Comité de Liaison Alimentation Nutrition (CLAN).

Frequently Asked Questions

What legal qualifications does the BTS Diététique confer in France?

Under Article L4371-2 of the French Code de la santé publique, the BTS Diététique is one of only two recognized state diplomas (alongside the Bachelor Universitaire de Technologie - BUT Génie Biologique parcours Diététique et Nutrition) that allow registration with the Agence Régionale de Santé (ARS) on the RPPS / ADELI register and legal practice with the title of Diététicien.

What is the passing requirement for the BTS Diététique?

Candidates must achieve a cumulative weighted average of at least 10.0 out of 20 across all units. Marks are compensated across units according to their coefficients, and candidates who score between 8.0 and 9.9 out of 20 can take oral makeup examinations (épreuves de contrôle).

What are the mandatory internship requirements for the BTS Diététique?

The legacy curriculum requires 20 weeks of supervised placements: 6 weeks in collective catering, 10 weeks in therapeutic dietetics, and 4 weeks in an optional setting. Those placements support the dissertation assessed orally.

What are the key differences between units E1, E2, and E3?

E1 tests human biochemistry and physiology, E2 tests food knowledge, and E3 tests the pathophysiological basis of dietetics. Professional application is also assessed in E6 through a written case study and a practical food-technology task.

How are GEMRCN and EGAlim standards applied in the exam?

In E2 and E4, candidates must demonstrate complete mastery of the GEMRCN recommendation grids (minimum and maximum frequencies of lipid-rich dishes, fried items, fresh fruits, and dairy products over 20 consecutive meals) and the EGAlim law requirements (minimum 50% sustainable/quality products including at least 20% certified organic, plus mandatory vegetarian meal options).