Recent Developments in the Assessment of Nutrition Knowledge in Athletes

PURPOSE OF REVIEW

Adequate nutrition knowledge may influence dietary behaviour, and the performance and health of athletes. Assessment of the nutrition knowledge of athletes can inform practice and provide a quantitative way to evaluate education interventions. This article aims to review nutrition knowledge questionnaires published in the last 5 years to identify advances, possible improvements in questionnaire development and design, and challenges that remain.

RECENT FINDINGS

Twelve new or modified questionnaires were identified. All had undergone validity and reliability testing. Advancements included quantitative measures of content validity and Rasch analysis. Online questionnaires were common, with at least seven using this format. Advances included use of images (n = 2), automated scored feedback (n = 1), and use of applied questions. While advancements have been made in validation and reliability testing and electronic delivery, new questionnaires would benefit from interactive and attractive features including images, provision of electronic feedback, and applied questions.

The Effect of Nutrition Education on Nutrition Knowledge and Macronutrition Intake in Muay Thai Athletes

BACKGROUND: Athletes’ achievements require the support of sports science and technology. One of the supporting sciences is sports nutrition services by fulfilling athlete nutrition through foodservice and nutrition education in nutrition counseling or nutrition counseling according to the needs and conditions of athletes. AIM: This study aims to determine the effect of nutrition education on nutritional knowledge and macronutrient intake in Muay Thai athletes in Cimahi city. METHODS: This type of research is a Quasi experiment by applying a one group pre- and post-test design: Nutrition education using leaflets. The sample is Muay Thai athletes in Cimahi city who are actively practicing at the Empire Muaythai Camp as many as ten people. Data were collected by filling in the respondent’s characteristics, knowledge of nutrition, and intake of macronutrients. RESULTS: Based on the Wilcoxon test, it was found that there was an effect of providing nutrition education using leaflets on nutritional knowledge (p = 0.005) and protein intake (p = 0.047). CONCLUSION: It is recommended that regular and periodic nutrition education be given to athletes and coaches as well as collaborate with nutritionists regarding nutritional fulfillment for athletes to increase macronutrient intake so that the performance of Muay Thai athletes in Cimahi city is optimal.

Carbohydrate for endurance athletes in competition questionnaire (CEAC-Q): validation of a practical and time-efficient tool for knowledge assessment

Purpose

Despite unequivocal evidence demonstrating high carbohydrate (CHO) availability improves endurance performance, athletes often report under-eating CHO during competition. Such findings may be related to a lack of knowledge though currently there are no practical or time-efficient tools to assess CHO knowledge in athletes. Accordingly, we aimed to validate a novel questionnaire to rapidly assess endurance athletes’ knowledge of competition CHO guidelines.

Methods

The Carbohydrate for Endurance Athletes in Competition Questionnaire (CEAC-Q) was created by research-active practitioners, based on contemporary guidelines. The CEAC-Q comprised 25 questions divided into 5 subsections (assessing CHO metabolism, CHO loading, pre-event meal, during-competition CHO and recovery) each worth 20 points for a total possible score of 100.

Results

A between-group analysis of variance compared scores in three different population groups to assess construct validity: general population (GenP; n = 68), endurance athletes (EA; n = 145), and sports dietitians/nutritionists (SDN; n = 60). Total scores were different (mean ± SD) in all pairwise comparisons of GenP (17 ± 20%), EA (46 ± 19%) and SDN (76 ± 10%, p < 0.001). Subsection scores were also significantly different between the groups, with mean subsection scores of 3.4 ± 4.7% (GenP), 9.2 ± 5.2% (EA) and 15.2 ± 3.5% (SDN, p < 0.001). Test–retest reliability of the total CEAC-Q was determined in EA (r = 0.742, p < 0.001).

Conclusion

Taking ~ 10 min to complete, the CEAC-Q is a new psychometrically valid, practical and time-efficient tool for practitioners to assess athletes’ knowledge of CHO for competition and guide subsequent nutrition intervention.

Sports nutrition knowledge and perceptions among professional basketball athletes and coaches in Lebanon-a cross-sectional study

BACKGROUND

Basketball is the most popular sport in Lebanon. Adequate nutrition has been established to be a key component of optimal athletic performance, recovery from exercise and exercise-induced injury and documented to be associated with adequate nutrition knowledge (NK). In Lebanon, nutrition education is not incorporated into the basketball player training program and there is no established position for sports nutritionists in basketball clubs. To our knowledge, the present study is the first to evaluate the NK status of Division I Basketball (D1B) players /coaches in Lebanon. The objectives of this study are to assess the prevalence of inadequate NK; identify the gaps in NK, main sources of nutrition information, perceptions on sports nutrition and independent predictors of inadequate NK among D1B players and coaches in Lebanon.

METHODS

All D1B players (n = 184) and coaches (n = 16) in Lebanon were invited to participate in the study. Study participants were asked to complete a questionnaire that included questions on NK, resources and perceptions. A percentage of ≥60% of NK questions answered correctly was used as indicative of having adequate NK. Descriptive statistics were used to summarize the sample characteristics. The T-test and chi square test were used for comparisons of means and proportions, respectively. Logistic regression was used to explore the predictors of inadequate NK in D1B players.

RESULTS

The sample consisted of 178 D1B players (nM = 126; nF = 52) and 11 male coaches, resulting in survey response rates of 97 and 69%, respectively. Inadequate NK was found among about 80 and 54% of D1B players and coaches, respectively. Inadequate NK was found to be independently associated with lack of nutrition education in D1B players.

CONCLUSIONS

Despite widespread lack of adequate NK among D1B players and coaches in Lebanon, our sports clubs do not have dietitians. Basketball sports clubs in Lebanon should start to budget for hiring a dietitian or carrying out nutrition education campaigns that are based on analyses of incorrect responses of our study participants. Findings of this study are of tremendous significance to D1B players in Lebanon in terms of improving the athletes' physical health and performance.

Pre-season dietary intake of professional soccer players

BACKGROUND

Despite the well-documented importance of nutrition in optimizing performance and health, the dietary intake of soccer players has attracted little attention.

AIM

We aimed to assess the pre-season dietary intake of professional soccer players and its adequacy in macro and micronutrients.

METHODS

The pre-season dietary intake of 19 male athletes was assessed using a semi-structured 3-day food record. To determine dietary adequacy and excess, energy and macronutrient intake were compared with the Brazilian dietary reference values for athletes, and micronutrients were compared with the Estimated Average Requirement - EAR (minimum recommendation) and Tolerable Upper Intake Level - UL (maximum recommendation).

RESULTS

Mean daily energy intake (40.74±12.81 kcal/kg) was adequate. However, there was a low carbohydrate intake (5.44±1.86 g/kg/day) and a high amount of protein and fat (1.91±0.75 and 1.27±0.50 g/kg/day, respectively). Sodium intake (3141.77±939.76 mg/day) was higher than UL (2300 mg/day), while the majority of players showed daily intake of vitamin A (74%), vitamin D (100%), folate (58%), calcium and magnesium (68%) below the EAR (625, 10 and 320 µg/day, 800 and 330 mg/day, respectively).

CONCLUSION

The dietary intake of professional soccer players was adequate in energy, but inadequate in macro and micronutrients, which suggests the need to improve nutritional practices to sustain the physical demands of soccer during pre-season.

Evaluation of Dietary Intakes, Body Composition, and Cardiometabolic Parameters in Adolescent Team Sports Elite Athletes: A Cross-sectional Study

Background:

Nutritional intake is an important issue in adolescent athletes. Proper athletes’ performance is a multifactorial outcome of good training, body composition, and nutritional status. The aim of the present study was to assess nutritional status, body composition, and cardiometabolic factors in adolescent elite athlete's province of Isfahan, Iran.

Materials and Methods:

In this cross-sectional study, 100 adolescent elite athletes from volleyball, basketball, and soccer teams were selected for the study. Demographic, anthropometric, and cardiometabolic parameters were assessed. Nutritional intakes of participants were recorded using three 24-h recall questioners.

Results:

Thirty-four female athletes and 66 male athletes participated in this study. Body mass index had not significantly different between the sexes. Energy, protein, carbohydrate, iron, and fat intakes were significantly higher in male athletes (P = 0.02), but calcium and folic acid intakes were not significantly different between the sexes, and Vitamin D intake was significantly higher in females (P = 0.01). Systolic and diastolic blood pressure was significantly higher in males (P = 0.04) and heart rate had not significantly different between the sexes (P = 0.09). Heart murmurs and heart sounds in the majority of participants were normal.

Conclusion:

All the evaluated anthropometric and cardiometabolic parameters were in normal range in the majority of participants. The results showed that dietary intake in these athletes is approximately normal but micronutrients intake status in these athletes needs to be investigated further and longer.

Role of nutrition in performance enhancement and postexercise recovery

A number of factors contribute to success in sport, and diet is a key component. An athlete's dietary requirements depend on several aspects, including the sport, the athlete's goals, the environment, and practical issues. The importance of individualized dietary advice has been increasingly recognized, including day-to-day dietary advice and specific advice before, during, and after training and/or competition. Athletes use a range of dietary strategies to improve performance, with maximizing glycogen stores a key strategy for many. Carbohydrate intake during exercise maintains high levels of carbohydrate oxidation, prevents hypoglycemia, and has a positive effect on the central nervous system. Recent research has focused on athletes training with low carbohydrate availability to enhance metabolic adaptations, but whether this leads to an improvement in performance is unclear. The benefits of protein intake throughout the day following exercise are now well recognized. Athletes should aim to maintain adequate levels of hydration, and they should minimize fluid losses during exercise to no more than 2% of their body weight. Supplement use is widespread in athletes, with recent interest in the beneficial effects of nitrate, beta-alanine, and vitamin D on performance. However, an unregulated supplement industry and inadvertent contamination of supplements with banned substances increases the risk of a positive doping result. Although the availability of nutrition information for athletes varies, athletes will benefit from the advice of a registered dietician or nutritionist.

Performance effects and metabolic consequences of caffeine and caffeinated energy drink consumption on glucose disposal

This review documents two opposing effects of caffeine and caffeine-containing energy drinks, i.e., their positive effects on athletic performance and their negative impacts on glucose tolerance in the sedentary state. Analysis of studies examining caffeine administration prior to performance-based exercise showed caffeine improved completion time by 3.6%. Similar analyses following consumption of caffeine-containing energy drinks yielded positive, but more varied, benefits, which were likely due to the diverse nature of the studies performed, the highly variable composition of the beverages consumed, and the range of caffeine doses administered. Conversely, analyses of studies administering caffeine prior to either an oral glucose tolerance test or insulin clamp showed a decline in whole-body glucose disposal of ~30%. The consequences of this resistance are unknown, but there may be implications for the development of a number of chronic diseases. Both caffeine-induced performance enhancement and insulin resistance converge with the primary actions of caffeine on skeletal muscle.

Contemporary nutrition approaches to optimize elite marathon performance

The professionalization of any sport must include an appreciation for how and where nutrition can positively affect training adaptation and/or competition performance. Furthermore, there is an ever-increasing importance of nutrition in sports that feature very high training volumes and are of a long enough duration that both glycogen and fluid balance can limit performance. Indeed, modern marathon training programs and racing satisfy these criteria and are uniquely suited to benefit from nutritional interventions. Given that muscle glycogen is limiting during a 2-h marathon, optimizing carbohydrate (CHO) intake and delivery is of maximal importance. Furthermore, the last 60 y of marathon performance have seen lighter and smaller marathoners, which enhances running economy and heat dissipation and increases CHO delivery per kg body mass. Finally, periodically training under conditions of low CHO availability (eg, low muscle glycogen) or periods of mild fluid restriction may actually further enhance the adaptive responses to training. Accordingly, this commentary highlights these key nutrition and hydration interventions that have emerged over the last several years and explores how they may assist in world-class marathon performance.