1
|
Hulland SC, Trakman GL, Alcock RD. Adolescent athletes have better general than sports nutrition knowledge and lack awareness of supplement recommendations: a systematic literature review. Br J Nutr 2024; 131:1362-1376. [PMID: 38053387 PMCID: PMC10950453 DOI: 10.1017/s0007114523002799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/11/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023]
Abstract
Nutrition knowledge (NK) impacts food choices and may be improved through educational programmes. Identifying knowledge gaps related to NK among adolescent athletes may guide future nutrition education programmes. This review aimed to systematically review the level of NK in adolescent athletes based on the currently available published literature. The protocol for this review was registered with PROSPERO (CRD42022321765). A literature search was conducted in April 2022 using MEDLINE, CINAHL, SPORTDiscus, Web of Science and SCOPUS databases. The study design was not restricted, provided that a quantitative NK score was reported for adolescent athletes. Studies were limited to the English language and published between 2010 and April 2022. Studies were assessed for quality and risk of bias using the Academy of Nutrition and Dietetics Quality Appraisal Checklist. Data extracted included demographics, questionnaire name, number of items, validation status and mean total and subsection NK scores. Meta-analyses were inappropriate due to the heterogeneity of NK assessment tools; therefore, results were presented narratively. Thirty-two studies that assessed NK of 4553 adolescent athletes and 574 comparison participants were included. Critical appraisal of studies resulted in neutral rating 'moderate quality' for most (n 30) studies. Studies lacked justification for sample size and often used inadequately validated questionnaires. NK scores ranged from poor (33·3 %) to excellent (90·6 %). The level of NK across studies is difficult to determine due to heterogenous questionnaires often lacking appropriate validation. NK should be assessed using tools validated in the relevant population or revalidated tools previously used for other populations.
Collapse
Affiliation(s)
- Susan C. Hulland
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Gina L. Trakman
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
- Essendon Football Club, Fitzroy, VIC, Australia
| | - Rebekah D. Alcock
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
| |
Collapse
|
2
|
de Souza LC, Moris JM, Lee KM, Fant KH, Gallucci A, Funderburk LK. Dietary Intake and Menstrual Health among Acrobatics and Tumbling NCAA Division I Student-Athletes. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:101-109. [PMID: 37307023 DOI: 10.1080/27697061.2023.2218458] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/22/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Acrobatics & Tumbling (A&T) is an emerging sport in the National Collegiate Athletic Association that lacks research regarding the dietary intake and health of A&T student-athletes (A&Tsa). This study assessed the dietary intake adequacy, estimated energy availability (EA), self-reported menstrual health, and body composition of A&Tsa. METHODS Twenty-four female A&Tsa participated during week 8 of the preseason (11 top: Age= 20.1 ± 0.9 years; BMI= 22.1 ± 1.7 kg/m2; 13 base: Age= 19.5 ± 1.3 years; BMI= 26.2 ± 2.7 kg/m2). Total energy intake (TEI) and macronutrient intakes were assessed via a paper-based 3-day dietary recall. Resting Metabolic Rate [RMR = 500 + 22 * fat-free mass (FFM)] and energy availability [EA = (TEI - exercise energy expenditure)/FFM)] were estimated; and LEAF-Q assessed menstrual health. Body composition was measured using Dual-Energy X-Ray Absorptiometry. Macronutrient intakes and EA were compared to sports nutrition recommendations (carbohydrate: 6-10 g/kg; protein: 1.2-2.0 g/kg) and the Acceptable Macronutrient Distribution Range (carbohydrate: 45-65%; protein: 10-35%; fat: 20-35%). RESULTS TEI was 1753 ± 467 kcal (top) and 1980 ± 473.8 kcal (base). A total of 20.8% of A&Tsa failed to meet RMR with TEI, with a higher prevalence in the top (-266 ± 219.2 kcal, n = 3) vs. base (-414.3 ± 534.4 kcal, n = 2) A&Tsa. Top and base A&Tsa had both low EA (28.8 ± 13.4 kcals·FFM-1; 23.8 ± 9.5 kcals·FFM-1) and inadequate carbohydrate intake averages (4.2 ± 1.3 g/kg; 3.5 ± 1.1 g/kg, p < 0.001), respectively. A total of 17% of A&Tsa reported secondary amenorrhea, with a higher prevalence in the top (27.3%, n = 3) vs. the base (7.7%, n = 1). CONCLUSION TEI and carbohydrate intake of the majority of A&Tsa were below recommendations. Sports dietitians should encourage and educate A&Tsa about following an adequate diet that meets energy and sports-specific macronutrient needs.
Collapse
Affiliation(s)
- Leticia C de Souza
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Jose M Moris
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Katherine M Lee
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Kristin H Fant
- Performance Nutrition (Baylor Athletics), Baylor University, Waco, Texas, USA
| | - Andrew Gallucci
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - LesLee K Funderburk
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
- Department of Human Sciences and Design, Baylor University, Waco, Texas, USA
| |
Collapse
|
3
|
Fiorini S, Neri LDCL, Guglielmetti M, Pedrolini E, Tagliabue A, Quatromoni PA, Ferraris C. Nutritional counseling in athletes: a systematic review. Front Nutr 2023; 10:1250567. [PMID: 38053746 PMCID: PMC10694452 DOI: 10.3389/fnut.2023.1250567] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023] Open
Abstract
Many studies report poor adherence to sports nutrition guidelines, but there is a lack of research on the effectiveness of nutrition education and behavior change interventions in athletes. Some studies among athletes demonstrate that nutrition education (NE), often wrongly confused with nutritional counseling (NC), alone is insufficient to result in behavior change. For this reason, a clear distinction between NC and NE is of paramount importance, both in terms of definition and application. NE is considered a formal process to improve a client's knowledge about food and physical activity. NC is a supportive process delivered by a qualified professional who guides the client(s) to set priorities, establish goals, and create individualized action plans to facilitate behavior change. NC and NE can be delivered both to individuals and groups. To our knowledge, the efficacy of NC provided to athletes has not been comprehensively reviewed. The aim of this study was to investigate the current evidence on the use and efficacy of nutritional counseling within athletes. A systematic literature review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. The search was carried out in: PubMed, Scopus, Web of Science, Science Direct, Cochrane Library between November 2022 and February 2023. Inclusion criteria: recreational and elite athletes; all ages; all genders; NC strategies. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The quality of evidence checking was tested with the Mixed Methods Appraisal Tool system. From 2,438 records identified, 10 studies were included in this review, with athletes representing different levels of competition and type of sports. The most commonly applied behavior change theory was Cognitive Behavioral Theory. NC was delivered mainly by nutrition experts. The duration of the intervention ranged from 3 weeks to 5 years. Regarding the quality of the studies, the majority of articles reached more than 3 stars and lack of adequate randomization was the domain contributing to high risk of bias. NC interventions induced positive changes in nutrition knowledge and dietary intake consequently supporting individual performance. There is evidence of a positive behavioral impact when applying NC to athletes, with positive effects of NC also in athletes with eating disorders. Additional studies of sufficient rigor (i.e., randomized controlled trials) are needed to demonstrate the benefits of NC in athletes. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022374502.
Collapse
Affiliation(s)
- Simona Fiorini
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Lenycia De Cassya Lopes Neri
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Monica Guglielmetti
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Elisa Pedrolini
- Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Anna Tagliabue
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Paula A. Quatromoni
- Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Cinzia Ferraris
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| |
Collapse
|
4
|
Vicente F, Holanda M, Ramalho R, Mendes J, Marques-Vidal P, Pereira P. Lower calcium and iron intake in adolescent gymnasts: A case of concern for youth sports nutrition. Nutrition 2023; 110:112020. [PMID: 36963267 DOI: 10.1016/j.nut.2023.112020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/06/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES Diet is important for the appropriate development and maturation of young amateur athletes. The aim of this study was to determine whether young gymnasts were consuming adequate amounts of nutrients, particularly calcium and iron. METHODS This cross-sectional survey was conducted in Portugal's Almada and Lisbon regions in 2020. To determine if participants' diet was adequate, weight, height, and skinfold measurements were taken. Dietary consumption was examined using two 24-h recalls. We collected data from 66 participants (60% females, 12-18 y of age), of whom 82% had normal weight and 39% had ideal body fat. RESULTS The daily total energy intake (TEI) was1605 ± 601 kcal. Of the TEI, 19%, 31%, and 50% were comprised of protein, fat, and carbohydrates, respectively. The most often consumed protein sources were poultry and ultra-processed meat products (52% and 45%, respectively). The average daily consumption of calcium and iron was 626 ± 293 and 9 ± 3 mg, respectively. Only 2 of the 66 participants had calcium intake within recommended levels, and 1of 5 had iron intake within recommended levels, the percentage of which was lower in girls than boys (7.5% versus 38.5%, P < 0.05). CONCLUSIONS Despite having a sufficient macronutrient distribution, Portuguese gymnasts consume a high amount of ultra-processed items and a low amount of calcium and iron. The low proportion of female gymnasts with adequate iron consumption is cause for worry in sports nutrition.
Collapse
Affiliation(s)
- Filipa Vicente
- Instituto Universitário Egas Moniz (IUEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CIIEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal.
| | - Marcela Holanda
- Instituto Universitário Egas Moniz (IUEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal
| | - Renata Ramalho
- Instituto Universitário Egas Moniz (IUEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CIIEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal
| | - João Mendes
- Instituto Universitário Egas Moniz (IUEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CIIEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Paula Pereira
- Instituto Universitário Egas Moniz (IUEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CIIEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal
| |
Collapse
|
5
|
Villa M, Villa-Vicente JG, Seco-Calvo J, Mielgo-Ayuso J, Collado PS. Body Composition, Dietary Intake and the Risk of Low Energy Availability in Elite-Level Competitive Rhythmic Gymnasts. Nutrients 2021; 13:nu13062083. [PMID: 34207034 PMCID: PMC8233987 DOI: 10.3390/nu13062083] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to analyze dietary intake and body composition in a group of elite-level competitive rhythmic gymnasts from Spain. We undertook body composition and nutritional analysis of 30 elite gymnasts, divided into two groups by age: pre-teen (9-12 years) (n = 17) and teen (13-18 years) (n = 13). Measures of height, weight, and bioimpedance were used to calculate body mass index and percent body fat. Energy and nutrient intakes were assessed based on 7-day food records. The two groups had similar percentages of total body fat (pre-teen: 13.99 ± 3.83% vs. teen: 14.33 ± 5.57%; p > 0.05). The energy availability values for pre-teens were above the recommended values (>40 kcal/FFM/day) 69.38 ± 14.47 kcal/FFM/day, while those for the teens were much lower (34.7 ± 7.5 kcal/FFM/day). The distribution of the daily energy intake across the macronutrients indicates that both groups ingested less than the recommended level of carbohydrates and more than the recommended level of fat. Very low intakes of calcium and vitamin D among other micronutrients were also noted. The main finding is that teenage gymnasts do not consume as much energy as they need each day, which explains their weight and development. Moreover, they are at a high risk of developing low energy availability that could negatively impact their performance and future health.
Collapse
Affiliation(s)
- María Villa
- Department of Health Sciences, Faculty of Health Sciences, University Pontificia of Salamanca, 37002 Salamanca, Spain;
| | - José G. Villa-Vicente
- Institute of Biomedicine (IBIOMED), University of Leon, 24071 Leon, Spain; (J.G.V.-V.); (P.S.C.)
| | - Jesus Seco-Calvo
- Institute of Biomedicine (IBIOMED), University of Leon, 24071 Leon, Spain; (J.G.V.-V.); (P.S.C.)
- Department of Physiology, University of the Basque Country, 48940 Leioa, Spain
- Correspondence: or ; Tel.: +34-987-293-127
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain;
| | - Pilar S. Collado
- Institute of Biomedicine (IBIOMED), University of Leon, 24071 Leon, Spain; (J.G.V.-V.); (P.S.C.)
| |
Collapse
|