Nutrition education by a registered dietitian improves dietary intake and nutrition knowledge of a NCAA female volleyball team

Development of a screener to assess athlete risk behavior of not using third-party tested nutritional supplements

Introduction

The aim of this cross-sectional study was to develop an algorithm to predict athletes use of third-party tested (TPT) supplements. Therefore, a nutritional supplement questionnaire was used with a section about self-reported TPT supplement use.

Methods

Outcomes were randomly assigned to a training dataset to identify predictors using logistic regression models, or a cross-validation dataset. Training data were used to develop an algorithm with a score from 0 to 100 predicting use or non-use of TPT nutritional supplements.

Results

A total of n = 410 NCAA Division I student-athletes (age: 21.4 ± 1.6 years, 53% female, from >20 sports) were included. Then n = 320 were randomly selected, of which 34% (n = 109) of users consistently reported that all supplements they used were TPT. Analyses resulted in a 10-item algorithm associated with use or non-use of TPT. Risk quadrants provided the best fit for classifying low vs. high risk toward inconsistent TPT-use resulting in a cut-off ≥60% (χ2(4) = 61.26, P < 0.001), with reasonable AUC 0.78. There was a significant association for TPT use (yes/no) and risk behavior (low vs. high) defined from the algorithm (χ2(1)=58.6, P < 0.001). The algorithm had a high sensitivity, classifying 89% of non-TPT users correctly, while having a low specificity, classifying 49% of TPT-users correctly. This was confirmed by cross-validation (n = 34), reporting a high sensitivity (83%), despite a lower AUC (0.61).

Discussion

The algorithm classifies high-risk inconsistent TPT-users with reasonable accuracy, but lacks the specificity to classify consistent users at low risk. This approach should be useful in identifying athletes that would benefit from additional counseling.

A systematic review of interventions targeting modifiable factors that impact dietary intake in athletes

Appropriate dietary intake has been found to positively impact athletes' performance, body composition and recovery from exercise. Strategies to optimise dietary intake often involve targeting one or more of the many factors that are known to influence dietary intake. This review aims to investigate the types and effectiveness of interventions used to impact modifiable factors of dietary intake in athletes. MEDLINE, CINAHL, SPORTDiscus and Web of Science were searched from inception to May 2022 for intervention studies that measured dietary intake with a quantitative tool and explored at least one factor thought to influence the dietary intake of adult athletes. Study quality was assessed using the ADA Quality Criteria Checklist: Primary Research. Twenty-four studies were included. The most common interventions focused on nutrition education (n 10), macronutrient adjustment (n 7) and physical activity (n 5). The three most common factors thought to influence dietary intake addressed were nutrition knowledge (n 12), hunger and appetite (n 8), and body composition (n 4). Significant changes in dietary intake were found in sixteen studies, with nutrition education interventions returning significant results in the largest proportion of studies (n 8). Study quality within this review was mostly average (n 4 < 50 %, n 19 50-80 %, n 1 > 80 %). As studies included were published between 1992 and 2021, interventions and factors explored in older studies may require up-to-date research to investigate possible differences in results due to time-related confounders.

Body fat of competitive volleyball players: a systematic review with meta-analysis

BACKGROUND

Reference values of body fat for competitive volleyball players are lacking, making it difficult to interpret measurement results. This review systematically summarized published data on the relative body fat of volleyball players and calculated potential differences between sex, measurement method, and competitive level.

METHODS

The protocol followed the Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines. The literature search was conducted using five electronic databases to retrieve all relevant publications from January 1, 2010, to July 1, 2021. The 63 studies including 2607 players that met the inclusion criteria were analyzed using random-effects models. Data were reported as pooled mean body fat with 95% confidence intervals.

RESULTS

Body fat for males and females was 12.8% (11.9-13.8%) and 22.8% (21.9-23.7%), respectively. Body fat was 18.3% (16.3-20.4%) measured via skinfolds, 18.4% (15.6-21.2%) via bioelectrical impedance analysis, 24.2% (20.4-28.0%) via dual-energy x-ray absorptiometry and 21.6% (17.4-25.8%) via densitometry. Regional, national, and international-level players had body fat values of 19.5% (17.8-21.2%), 20.3% (18.6-22.0%), and 17.9% (15.7-20.4%), respectively. When the meta-regression was adjusted for the variables sex, measurement method, and competitive level, a significant difference between sex (p < 0.001), dual-energy x-ray absorptiometry and skinfolds (p = 0.02), and national and international-level players (p = 0.02) was found. However, sensitivity analysis revealed that findings regarding measurement method and competitive level were not robust and should, therefore, be interpreted with caution.

CONCLUSIONS

Despite the limitations of published data, this meta-analysis provided pooled values for body fat of male and female volleyball players for different competitive levels and measurement methods.

Dietary Habits of Elite Soccer Players: Variations According to Competitive Level, Playing Position and Sex

Soccer is a sport practiced worldwide by both men and women, where nutrition plays a fundamental role in the performance of soccer players, providing them with the nutrients necessary for energy, muscle recovery and injury prevention. The aim of this study is to describe the dietary habits in elite soccer players and their association with their competitive level, playing position and sex. A descriptive and non-experimental comparative study was conducted during the 2021-2022 competitive season. A total of 105 players belonging to a Spanish elite soccer team completed a food frequency questionnaire (FCFQ). It was observed that male players presented a higher consumption of carbohydrate-rich foods (p < 0.05), fermented foods (p = 0.014), frozen foods (p = 0.049) and red meat (p = 0.012) compared to female players, with the exception of lean meats, which were higher in females (p = 0.012). Furthermore, the U16-15 categories stand out for consuming carbohydrate-rich foods such as pasta (p = 0.000), bread (p = 0.004) and sweets (p = 0.046), as well as frozen foods (p = 0.002). Finally, alcohol consumption is higher in the senior categories (42.9%), where men are more likely to drink mixed drinks (6.2%), and beer and wine by women (10.7%). Practically no differences were found between the playing positions. In conclusion, differences were found in FCFQ according to competitive level and sex.

Nutrition Knowledge Is Associated With Diet Quality Among US Army Soldiers

OBJECTIVE

Examine the relationship between nutrition knowledge, diet quality, and eating behavior among active-duty US Army Soldiers.

METHODS

Cross-sectional study with data collection in February 2018 via paper surveys during the validation of the Military Eating Behavior Survey.

RESULTS

Among 440 US Army Soldiers, nutrition knowledge was positively and significantly associated with diet quality (b = 0.29, P < 0.001). For every 1-point increase in nutrition knowledge, the Healthy Eating Index-2015 score was expected to increase by 0.29 points. Nutrition knowledge was not significantly associated with skipping breakfast (odds ratio, 1.01; 95% confidence interval, 0.98-1.04) or dining out (odds ratio, 1.01; 95% confidence interval, 0.98-1.03).

CONCLUSIONS AND IMPLICATIONS

The outcomes of this study warrant further investigation to determine what interventions provide the strongest outcomes for improving nutrition knowledge and diet quality, as well as create and support an environment that enhances healthy behaviors regarding nutrition that lead to improved diet quality among active-duty Soldiers.

Dietary Intake of Protein and Essential Amino Acids for Sustainable Muscle Development in Elite Male Athletes

Athletes need to develop a relatively high muscle mass and low body adipose tissue for the sake of better athletic performance. A full range of nine essential amino acids and eleven non-essential amino acids have to attend in appropriate amounts for protein biosynthesis. The aim of the observational comparative cross-sectional study was to assess the association between the diet quality profile and training-induced muscle mass estimated by bioelectrical impedance among elite male athletes. The research sample comprised 18.1 ± 3.1 year-old Lithuanian professional male athletes (n = 234). The study participants were enrolled to complete 24-h dietary recalls of three non-consecutive days. The body composition was assessed using the bioelectrical impedance analysis (BIA) method. The present study showed a significant insufficiency of the mean carbohydrate intake of 5.7 g/kg/day in a group of aerobic male athletes. The lower muscle mass of aerobic male athletes was related to the lower-carbohydrate diet (adjusted odd ratio (ORadj) 0.3; 95% confidence interval (CI): 0.1-0.7). The mean protein intake of 1.8 g/kg/day was optimal for anabolism in the samples of both anaerobic and aerobic male athletes. The protein intake in appropriate doses was potentially associated with an increase in muscle mass only in anaerobic male athletes (ORadj 2.2; 95% CI: 1.3-3.7). The positive relationship was revealed between the possible muscle mass gain and the increased intakes of amino acids such as isoleucine and histidine among anaerobic athletes (ORadj 2.9; 95% CI: 1.1-4.7 and ORadj 2.9; 95% CI: 1.0-4.3, respectively). An inverse feasible association was indicated between a higher intake of valine and lower muscle mass quantities among anaerobic male athletes (ORadj 0.1; 95% CI: 0.1-0.5). The recommendations for sports nutritionists should emphasize the necessity of advising professional athletes on dietary strategies on how to manipulate dietary amino acid composition with respect to achieving long-term body composition goals.

Cooking and food skills confidence of team sport athletes in Ireland

Nutritional support often focuses on cooking and food skills such as food selection, recipe planning and meal preparation. Individuals with greater cooking and food skills confidence have previously displayed higher diet quality scores and lower intakes of overall calories, saturated fat and sugar. Despite this, the cooking and food skills of team sport athletes have yet to be investigated. This study aimed to evaluate the relationship between cooking and food skills confidence and athletes' demographic characteristics. A validated measure for the assessment of cooking and food skills confidence was distributed via an online survey. Participants were required to rate their confidence on a Likert scale (1 "very poor" - 7 "very good") for 14 items related to cooking skills and 19 items for food skills. Food engagement, general health interest and self-reported fruit and vegetable consumption as a measure of diet quality were also measured. The survey was completed by 266 team sport athletes (male: 150, female: 116, age: 24.8 ± 6.1 years). Group differences were explored using t-tests and ANOVA and associations were evaluated using Spearman's correlation and hierarchical multiple regressions. Athletes' total cooking and food skills confidence was 62.7 ± 17.4 (64.0 ± 17.8%) and 83.8 ± 20.1 (63.0 ± 15.1%), respectively. Females reported greater confidence in both cooking (+20.3%, p < 0.01) and food skills (+9.2%, p < 0.01). Hierarchical multiple regressions explained 48.8% of the variance in cooking skills confidence and 44% of the variance in food skills confidence with gender, previous culinary training, cooking learning stage, general health interest and food engagement all remaining significant in the cooking skills confidence model and cooking frequency, previous culinary training, general health interest and food engagement remaining significant in the food skills confidence model. Male team sport athletes may benefit the most from educational interventions designed to increase cooking and food skills confidence.

The measurement of college athletes' knowledge and behavior on pre- and post-workout nutrition utilizing a text message intervention

Objective: The purpose of this study was to measure college student athletes' nutrition knowledge and behavior before and after a text message-based educational intervention. Participants: Athletes (n = 35) participated by completing a pre- and post-intervention survey. Methods: This survey gathered information on ability to identify carbohydrate and protein food sources, pre-and post-workout intake, and behavior. Text messages were sent during the 4-week intervention and included information regarding the importance of carbohydrate consumption before training, and a carbohydrate-protein mixture for recovery. Results: Dependent t-tests revealed a lack of statistically significant increases in total knowledge (p = 0.156) or behavior (p = 0.177), but an increase in the behavior questions regarding efficacy of carbohydrate before training (p = 0.026) and carbohydrate and protein after training (p = 0.016). Conclusion: This suggests the text message educational intervention did influence behavioral outcomes. Future research should focus on the effectiveness, length, and frequency of the text message intervention, and investigate the athletes' willingness to change dietary behaviors.

Body Composition, Energy Availability, Risk of Eating Disorder, and Sport Nutrition Knowledge in Young Athletes

Young athletes may be at risk for low energy availability (LEA) or dietary habits that are indicative of eating disorders. Thus, the purpose of the current study was to investigate the prevalence of LEA among high school athletes and examine those at risk for eating disorders. A secondary aim was to examine relationships between sport nutrition knowledge, body composition, and LEA.

METHODS

94 male (n = 42) and female (n = 52) mean ± SD age: 18.09 ± 2.44 y; height: 172.6 ± 9.8 cm; body mass: 68.7 ± 14.5 kg; BMI: 22.91 ± 3.3 kg·m^-2) athletes completed a body composition assessment and electronic versions of the abridged sports nutrition knowledge questionnaire (ASNK-Q), brief eating disorder in athletes questionnaire (BEDA-Q), and the low energy availability for females questionnaire (LEAF-Q; females only).

RESULTS

52.1% of female athletes were classified as being at risk for LEA. Moderate inverse relationships existed for computed LEAF-Q scores and BMI (r = -0.394; p < 0.01). A total of 42.9% of males (n = 18) and 68.6% of females (n = 35) were at risk for eating disorders, with females being at greater risk (p < 0.01). Body fat percentage was a predictor (β = -0.095; p = -0.01) for eating disorder risk status. For every 1 unit increase in body fat percentage, athletes were 0.909 (95% CI: 0.845-0.977) times less likely to be classified as at risk for an eating disorder. Male (46.5 ± 13.9) and female (46.9 ± 11.4) athletes scored poorly on the ASNK-Q, with no differences between sex (p = 0.895).

CONCLUSIONS

Female athletes were at a greater risk for eating disorders. No relationships existed between sport nutrition knowledge and %BF. Female athletes with a higher %BF had a lower risk for an eating disorder and risk for LEA.

The five most significant barriers to healthy eating in collegiate student-athletes

The objective of the present study was to elucidate what student-athletes believe are the most significant barriers to consuming a healthy diet. 418 student-athletes at an NCAA Division 1 university were invited to complete a survey on their nutritional habits and barriers to healthy eating. The survey was designed utilizing the current literature in student-athletes and young adults and underwent a professional review and pilot study before use in data collection. 169 student-athletes (40%) fully completed the survey. Responses indicate the five most significant barriers are lack of time, easy access to unhealthy foods, cost of healthy foods, lack of knowledge about what foods are healthy, and lack of knowledge and skills to cook healthy foods, respectively. Further, data show significant relationships between several variables and the rate of selection of various barriers. Overall, these findings lay the groundwork for future interventions while also presenting initial, usable information for professionals.

College students' attitude toward menu labeling differs by sex, BMI, weight management status, and athletic type

Objective Determine students' attitude toward menu labeling before and after menu labeling implementation at university dining facility. Participants: College students aged 18 years and older eating at campus dining facility. Methods: Survey on attitude toward menu labeling, weight management status, and athletic classification (NCAA, recreational, or non-athlete) was completed 30 days pre- and post-menu labeling implementation. Results: Females showed stronger positive attitude toward menu labeling. Students trying to lose or gain weight had stronger positive attitudes toward menu labeling than students maintaining weight, as did overweight students compared to normal weight students. NCAA athletes had lower attitude mean scores toward menu labeling than other athletic classifications. Conclusion: Attitude toward menu labeling varies by students' gender, body mass index (BMI), and weight management focus, with NCAA athletes having the least positive attitude. Focus future research on effective ways to inform students on menu labeling in university dining facilities in order to nutritionally engage young adults.

Energy and Macronutrients Intake in Indoor Sport Team Athletes: Systematic Review

Indoor team sports are characterized by matches that are shorter in duration and with frequent substitution (high-intensity intermittent). The main goal of teams is to best cover athletes' physiological demands, while meeting their dietary intake needs is critical. The aim of this study is to conduct a systematic review of the dietary intake of indoor team sports athletes and to analyze whether they comply with nutritional recommendations. A search of PubMed-MEDLINE, Web of Science, and Scopus databases from 2008 to July 2022 was conducted and 2727 documents were identified. The studies focused on adult professional or semi-professional volleyball, basketball, handball, or futsal athletes. Two independent researchers screened and extracted the data, with 20 documents included after they met the inclusion criteria. Most of the athletes, both men and women, did not meet the official recommendations based on under-consumption (energy and carbohydrates) or over-consumption (fats). In relation to protein, 28.6% of studies met the recommendations, with 50% of those who did not meet it being due to under-consumption. Although there are references on athletes' dietary intakes, there are no references considering sexes or types of sport. More adapted recommendations are needed in order to more precisely evaluate athletes' intake to know if they meet their real nutritional requirements.

RELATIONSHIP BETWEEN NUTRITION KNOWLEDGE AND AEROBIC FITNESS IN YOUNG GYMNASTS

This study aimed to analyze the nutrition knowledge, nutritional status, body composition, nutrient intake and physical fitness of young gymnasts. The study used a cross-sectional design with 20 subjects comprising rhythmic and artistic gymnasts in Raden Inten, Jakarta. Nutritional status and body composition were measured using anthropometric measurements, macronutrient and micronutrient intakes were measured with 3x24-h food recall, physical fitness was measured using the bleep test (20m shuttle run), and nutrition knowledge was assessed using questionnaires consisting of 30 questions on macronutrients, micronutrients and water. The results indicated that the gymnasts (n=20, 13.7±2.1 y.o, 37.8±8.2 kg and 147.3±10 cm) generally had a fairly good nutrition knowledge score (73.2%); i.e. 10 people in the good nutrition-knowledge group and 10 people in the poor nutrition-knowledge group. The majority of the macronutrient and micronutrient intakes were below the nutritional requirements, in both the good and poor nutrition-knowledge groups. The nutrition knowledge scores were low for hydration-related knowledge (66%), while the scores for macronutrient and micronutrient knowledge were 73.8% and 84.2%, respectively. This study found that nutrition knowledge had a positive correlation with physical fitness (p<0.05). A sports nutrition-related education intervention is needed for those gymnasts that still have poor nutrition knowledge. Sports nutrition knowledge needs to be provided for athletes and coaches so that athletes’ intakes meet their nutritional requirements in order to maximise their performance.

Runner's health choices questionnaire: female collegiate cross-country runners' perspectives on health and eating

OBJECTIVE

To assess female collegiate cross-country runners' perspectives regarding sport-related health and the factors impacting eating behaviors.

PARTICIPANTS/METHODS

The Runner's Health Choices Questionnaire, a previously validated survey, was electronically distributed to female collegiate cross-country runners. Quantitative descriptive analysis was performed on all questions.

RESULTS

A total of 353 female collegiate cross-country runners completed the survey. The most common intrinsic factors that impacted overall diet type were makes you feel healthy, enjoyment of food, and athletic performance enhancement. Extrinsic factors such as practice/race that day, creating a balanced diet, and choices in the cafeteria were the top factors influencing daily meal decisions. Seventy-seven percent of athletes reported that they would be likely to apply information from a healthcare professional if they had access.

CONCLUSION

Female cross-country runners appeared willing to apply nutritional information; therefore, it is important that generalized nutrition education with an emphasis on intrinsic and extrinsic factors for food choices be considered for female collegiate cross-country runners.

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.

Using Nutrition Knowledge and Diet Quality Questionnaires as Screening Tools to Identify Female Collegiate Athletes in Need of Dietitian Referral

The purpose of this study was to evaluate nutrition knowledge and diet quality in collegiate athletes to determine if referral to a sports registered dietitian (RD) is warranted. This cross-sectional study analyzed four sections of the Nutrition for Sport Knowledge Questionnaire and the Rapid Eating Assessment for Patients Questionnaire, both validated in athletic populations. The relationship between nutrition knowledge and diet quality was evaluated. Significance was set at P ≤ 0.05. One hundred and twenty athletes reported a median nutrition score of 52 (45-61), and a dietary quality score of 53 (46-58), with a weak, positive association between both (r = 0.28 (95% CI: 0.11-0.44), P < 0.01). Fifty-four percent were categorized as needing a referral to a sports RD. Diet quality scores differed between dietitian referral group with 49 (43-54) versus 58 (52-62) for the nonreferral group, respectively (P < 0.01, V = 0.71), with no difference in nutrition knowledge observed, P = 0.73. Overall, nutrition knowledge and diet quality in our sample of collegiate athletes was poor. College athletic departments with limited access to sports RD should use these questionnaires to evaluate knowledge and the need of dietitian referral separately.

Significant differences in dietary intake of NCAA Division III soccer players compared to recommended levels

Objective: This study evaluated dietary intake patterns of NCAA Division III soccer players compared to recommended levels. Participants: NCAA Division III soccer players (n = 75). Methods: Actual dietary intake was determined by the analysis of a 3-day food record. Results: Results indicate that total energy, carbohydrate, and dietary fiber intake was significantly below the recommended levels. In addition, added sugar and total fat consumption were significantly above recommended levels. Potassium, magnesium, and vitamin D levels were consumed in levels significantly below the recommended levels. Sodium, iron, and vitamin C were consumed in significantly higher levels than the recommended target. Female athletes had significantly higher intakes of added sugar, saturated fat and vitamin C compared to male athletes. Female athletes had significantly lower intakes of calcium, potassium, sodium, iron, magnesium and vitamin D compared to male athletes. Conclusion: Based on the results of the present study, increased efforts should be put into development of nutrition education programs for NCAA Division III athletes.

Eating Perception, Nutrition Knowledge and Body Image among Para-Athletes: Practical Challenges in Nutritional Support

Limited information exists on dietary practices in para-athletes. The aim of this study was to clarify the actual situation of para-athletes' dietary practice and to sort out the factors (i.e., eating perception, nutrition knowledge, and body image), that may hinder their dietary practices, and explored the practical challenges in nutritional support and improving nutrition knowledge for para-athletes. Thirty-two Japanese para-athletes (22 men) and 45 collegiate student athletes without disabilities (27 men) participated in the online survey. The questionnaire included demographic characteristics, eating perception, dietary practices, and nutrition knowledge. The Japanese version of the body appreciation scale was used to determine their body image. Para-athletes who answered that they knew their ideal amount and way of eating showed significantly higher body image scores (r = 0.604, p < 0.001). However, mean score for nutrition knowledge of para-athletes were significantly lower than collegiate student athletes (19.4 ± 6.8 vs. 24.2 ± 6.1 points, p = 0.001). Both groups did not identify a dietitian as the source of nutrition information or receiving their nutrition advice. The results indicate para-athletes have unique eating perceptions and inadequate nutrition knowledge. Future interventions are needed to examine nutritional supports and education in relation to the role of dietitians.

Assessment of Sport Nutrition Knowledge, Dietary Practices, and Sources of Nutrition Information in NCAA Division III Collegiate Athletes

Nutrition knowledge is a critical component of meeting sport nutrition guidelines. The present study aimed to evaluate the sport nutrition knowledge of National Collegiate Athletic Association (NCAA) Division III (DIII) athletes using a validated questionnaire, and to assess the dietary practices and sources of nutrition information in this population. A total of 331 student-athletes (n = 149 males, n = 181 females, n = 1 no sex indicated) completed the questionnaire. The mean score for total sport nutrition knowledge was 6.49 ± 8.9 (range −49 to 49) with a mean percent (%) correct score of 36.9 ± 19.1%. Athletes who had a previous college-level nutrition course (n = 62) had significantly higher (p < 0.05) total sport nutrition, carbohydrate, and hydration knowledge compared to those who did not (n = 268). Individual sport athletes (n = 90) scored significantly higher (p < 0.05) on hydration and micronutrients knowledge than team sport athletes (n = 237), while females scored higher than males for hydration knowledge (p < 0.05). The majority of athletes reported sensible dietary habits, such as not frequently skipping meals and eating carbohydrate and protein foods peri-workout. Athletes also reported their primary sources of nutrition information, the top three sources being social media, coaches, and athletic trainers, despite most frequently rating registered dietitians/nutritionists as “extremely knowledgeable”. Despite low sport nutrition knowledge, NCAA DIII collegiate athletes practiced seemingly prudent dietary habits but lacked exposure to high-quality sources of nutrition information.

Good Food, Good Mood: Perspectives on the Relationship Between Nutrition and Mental Health With Division I Collegiate Athletic Programs

Research has shown a strong relationship between nutrition and mental health. Packed schedules and little rest time may make student-athletes more susceptible to mental health issues than the general population, but few athletes are fully aware of the effects that nutrition can have on their mental health. While collegiate athletic programs are beginning to recognize the individual contributions of nutrition and mental health to performance and are hiring sport dietitians and psychologists for their athletes, it is unclear whether these topics are ever discussed within the same context. The goal of this study was to understand the perspectives of different athletic personnel on the relationship between nutrition and mental health. 17 athletic personnel (11 Female, 6 Male) from 6 NCAA Division I universities were recruited for a 30-45-min semi-structured WebEx interview. Participants included athletic trainers, coaches, dietitians, sport psychologists, strength and conditioning coaches, and sports medicine physicians. Participants were asked questions about their educational backgrounds, resources, and perspectives on the integration of nutrition and mental health in their programs. Transcribed responses were sorted into four themes: (1) Resources, (2) Education, (3) Department Integration or Collaboration, and (4) Student and Coach Engagement. All participants reported a need for greater monetary resources and staffing. Around 59% of the participants felt they had little more than general or personal interest-level knowledge on topics pertaining to nutrition or mental health, with the exception of sports dietitians or psychologists. Each school varied in the degree to which their athletic staff regularly communicated about their work and athlete health statuses. Athletes were reportedly more or less likely to utilize the resources provided depending on coach attitudes toward nutrition or mental health. Regardless of size, reputation and annual spending, each university was reported to be in the early stages of integrating nutrition and mental health programs into their existing athletic departments. Implications of this work may be to help schools plan for ways to reallocate funding for nutrition or mental health programming.

Dietary Macronutrient and Micronutrient Intake over a 7-Day Period in Female Varsity Ice Hockey Players

This study examined the energy, macronutrient, and micronutrient intakes of female ice hockey players over a 7-d period including game, practice, and rest days. Twenty-three female varsity players (19.0 ± 1.1 yr, 167.1 ± 6.5 cm, 67.0 ± 8.0 kg) volunteered for the study. Average total daily energy expenditure (TDEE) was estimated over the 7-day period. Average 7-day energy intake (EI) and TDEE were 2354 ± 353 and 2304 ± 204 kcal. The majority (n = 19) of athletes had an EI ≥ 90% of their estimated TDEE. Macronutrient intake was 52% carbohydrate (CHO), 32% fat, and 16% protein of total EI, although CHO intake was slightly below recommendations (5 g/kg BM/d) on game and practice (4.8 ± 1.4 and 4.5 g/kg BM/d) days. Game day EI was greater than practice and rest days. Recommended micronutrient intakes were not met by most athletes for iron, calcium, vitamin D, and potassium, and intakes were similar between game, practice, and rest days. In summary, the average EI for female varsity ice hockey players appeared adequate to meet their energy needs over a weekly cycle of game, practice, and rest days. However, these female athletes would benefit from increasing CHO intake on game and practice days and selecting foods that are rich in vitamins and minerals.

The Influence of Sport Nutrition Knowledge on Body Composition and Perceptions of Dietary Requirements in Collegiate Athletes

Sport nutrition knowledge has been shown to influence dietary habits of athletes. The purpose of the current study was to examine relationships between sport nutrition knowledge and body composition and examine potential predictors of body weight goals in collegiate athletes. Participants included National Collegiate Athletic Association Division III women (n = 42, height: 169.9 ± 6.9 cm; body mass: 67.1 ± 8.6 kg; fat-free mass: 51.3 ± 6.6 kg; body fat percent: 24.2 ± 5.3%) and men (n = 25, height: 180.8 ± 7.2 cm; body mass: 89.2 ± 20.5 kg; fat-free mass: 75.9 ± 12.2 kg; body fat percent: 13.5 ± 8.9%) athletes. Body composition was assessed via air displacement plethysmography. Athletes completed a validated questionnaire designed to assess sport nutrition knowledge and were asked questions about their perceived dietary energy and macronutrient requirements, as well as their body weight goal (i.e., lose, maintain, gain weight). Athletes answered 47.98 ± 11.29% of questions correctly on the nutrition questionnaire with no differences observed between sexes (men: 49.52 ± 11.76% vs. women: 47.03 ± 11.04%; p = 0.40). An inverse relationship between sport nutrition knowledge scores and body fat percentage (BF%) (r = −0.330; p = 0.008), and fat mass (r = −0.268; p = 0.032) was observed for all athletes. Fat mass (β = 0.224), BF% (β = 0.217), and body mass index (BMI) (β = 0.421) were all significant (p < 0.05) predictors of body weight goal in women. All athletes significantly (p < 0.001) underestimated daily energy (−1360 ± 610.2 kcal/day), carbohydrate (−301.6 ± 149.2 grams/day [g/day]), and fat (−41.4 ± 34.5 g/day) requirements. Division III collegiate athletes have a low level of sport nutrition knowledge, which was associated with a higher BF%. Women athletes with a higher body weight, BF% and BMI were more likely to select weight loss as a body weight goal. Athletes also significantly underestimated their energy and carbohydrate requirements based upon the demands of their sport, independent of sex.

The Relationship Habits of Through Breakfast and Physical Activity with Abdominal Obesity in Nutrition Students

Background : Abdominal obesity is obesity characterized by the accumulation of excess fat in the abdominal area. The risk of metabolic and cardiovascular disease may increase due to abdominal obesity. One of the factors associated with abdominal obesity is imbalance between energy intake and physical activity. Several studies have stated that skipping breakfast is associated with an increased risk of obesity with the tendency to consume high calorie foods to provide energy for activities.Objectives : The purpose of this study is to analyze the relationship between skipping breakfast, level of physical activity and obesity in nutrition students at Public Health Faculty, Airlangga University.Methods : This research is observational analytic with cross sectional design. The population in this study were nutrition students at Public Health Faculty, Airlangga University. The number of samples was 60 people which selected by proportional random sampling method. Data were collected include the measurements of waist circumference, interviews using respondent's identity questionnaire and physical activity recall 3 x 24 hours. Data were analyze with Spearman correlation test.Results : Based on the results, it was found that 33.3% of the respondents were obese. The results of statistical tests shows a negative correlation between skipping breakfast and abdominal obesity (p = 0.000). The results of this study also showed that there is no significant correlation between the level of physical activity and obesity (p = 0.618).Conclusions : Skipping breakfast was significantly associated with abdominal obesity in the young adult students group. Therefore, it is better if the habits of skipping breakfast can be replaced with breakfast habits to prevent abdominal obesity. 

Intensive Sports Nutrition Program Improving Body Composition and Energy Intake among Elite Combat Sport Athletes

ABSTRAK Latar Belakang :Gizi olahraga merupakan aspek penting dalam mengatur asupan makanan dan komposisi tubuh untuk mencapai performa yang optimal. Studi epidemiologis menunjukkan sebagian besar asupan atlet tidak adekuat dan dapat mempengaruhi komposisi tubuh yang ideal.Tujuan :Tujuan dari penelitian ini adalah untuk menganalisis pengaruh pendampingan gizi olahraga terhadap komposisi tubuh dan asupan energi atlet bela diri.Metode :Pendampingan gizi intensif dilakukan selama empat bulan (Juni- September 2019). Pengukuran komposisi tubuh  dilakukan 2 kali, yakni sebelum dan sesudah intervensi dengan menganalisis hasil pengukuran dari alat BIA (Bio Impadance Analyzer) tipe MBCA (Medical Body Compotiton Analyzer) 515/514 merk seca©. Variabel yang dianalisis diantaranya, total asupan kalori sehari diukur menggunakan instrumen Recall-24 jam, komposisi tubuh diukur dengan alat BIA yakni Fat Mass (FM), Fat Free Mass (FFM) dan Skeletal Muscle Mass (SMM). Pendampingan gizi dilakukan oleh ahli gizi olahraga yang mengunjungi 24 responden setiap bulan dan memberikan materi pendidikan gizi, memberikan makanan sehat dan memberikan konseling permasalahan gizi atlet.Hasil : Hasil penelitian ini menunjukkan adanya peningkatan secara signifikan pada asupan energi total (1496,2±654,4 menjadi 1688,5±679,8, p= 0,002). Pada komposisi tubuh terjadi peningkatan pada FFM dan SMM yakni (56,57 ± 9,91 kg vs 57,01 ± 9,53, p = 0,032) dan (27,49 ± 5,58 vs 27,75 ± 5,31, p = 0,005) dan tidak ada perbedaan signifikan dalam variabel  FM.Kesimpulan : Kesimpulan dari percobaan ini adalah pendampingan gizi secara intensif dapat meningkatkan asupan energi total, FFM dan SMM pada atlet bela diri. Kata Kunci : Komposisi tubuh, pendampingan gizi, asupan energiABSTRACTBackground :Sports nutrition is very urgent to improve nutrition knowledge, dietary intake and body composition to achieve an optimum athletic performance. Epidemiological studies showed most athletes lack of getting adequate intake and maintaining an ideal body composition.Objective :This study aims to analyze the effect of sport nutrition education on body composition and energy intake among elite combat sport athletes.Methods :Intensive sport nutrition was conducted for four months June until September 2019. Body composition was assessed  for 2 times, before and after intervention using bioelectric impedance analysis (BIA), with seca© brand 515/514 type of stainless steel electrodes.Measurement of energy intake with recall 24 hours before and after the intervention. The variables studied were Fat Mass (FM), Fat Free Mass (FFM), Skeletal Muscle Mass (SMM) and energy intake.The professional sport nutritionist and dietitians visited 24 subjects every month by teaching nutrition education, bringing the healthy food, and facilitating the counseling about sport nutrition.Result :Energy intake increased significantly (1496,2±654,4 to 1688,5±679,8, p= 0,002). FFM and SMM increased significantly pre to post (56.57±9.91 kg vs 57.01±9.53, p=0.032) and (27.49±5.58 vs 27.75±5.31, p=0.005) respectively, meanwhile no significant differences in FM variable.Conclusion : Our findings indicate that intensive sport nutritionimproved energy intake, FFM and SMM among elite combat sport athletes. Keywords : Body compotition, sport nutririon education, energy intake

Elite squash players nutrition knowledge and influencing factors

Background

There is a reported mismatch between macronutrient consumption and contemporary macronutrient guidelines in elite standard squash players. Suboptimal dietary practices could be due to a lack of nutrition knowledge among players. Subsequently, the purpose of this study was to assess the sports nutrition knowledge of elite squash players through the Nutrition for Sport Knowledge Questionnaire (NSKQ) and provide an indication of whether players require nutrition support to increase their nutrition knowledge.

Methods

This cross-sectional study assessed the nutrition knowledge of 77 elite squash players via the NSKQ over the period of June 2020 to August 2020.

Results

Players conveyed average nutrition knowledge with a mean NSKQ score of 48.78 ± 10.06 (56.07% ± 11.56%). There were no significant differences in NSKQ score between male and female players (p = .532). There was found to be a weak positive association between world ranking and NSKQ score (r = .208) and age and NSKQ score (r = .281). Players who had a relevant undergraduate degree (e.g. BSc Sport & Exercise Science) had significantly greater NSKQ score than players with no relevant qualifications (p = .022). Players who consulted a sports nutritionist to obtain their main source of nutrition information were shown to have significantly greater knowledge than those who acquired knowledge from a sports scientist (p = .01) or the internet / social media (p = .007).

Conclusions

Players should consult with a sports nutritionist to increase their sport nutrition knowledge. Future research should quantify the effectiveness of a nutritional education intervention at increasing nutrition knowledge in players.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12970-021-00443-3.

Nutrition Knowledge of Collegiate Athletes in the United States and the Impact of Sports Dietitians on Related Outcomes: A Narrative Review

In the last decade, the number of full-time registered dietitians (RDs) serving intercollegiate athletes in the United States has more than quadrupled. However, many student athletes may be at increased risk of nutrition-related problems that impact physical and academic performance, which include inadequate macronutrients, inadequate micronutrients, and excessive macronutrients. This narrative review reports the current literature to date on nutrition-related knowledge in collegiate athletes and the impact of sports RDs on student athletes’ nutrition knowledge and behaviors. To date, only observational and quasi-experimental studies have been published with regard to changes in nutrition knowledge and behaviors in NCAA athletes. While these studies report benefits of the RD as a member of the interdisciplinary student athlete support team, more well-designed randomized control trials are warranted to determine benefits related to health outcomes and sport-specific performance outcomes.

A Qualitative Investigation of Factors Influencing the Dietary Intakes of Professional Australian Football Players

(1) Background: Many professional Australian Football (AF) players do not meet recommended sports nutrition guidelines despite having access to nutrition advice. There are a range of factors that can influence players′ ability to meet their nutrition goals and awareness of the barriers players face is essential to ensure that dietary advice translates into practice. Therefore, this qualitative research study aimed to explore the factors influencing AF players’ dietary intakes and food choice. (2) Methods: Semi-structured interviews were conducted with twelve professional male AF players. (3) Results: Less experienced players restricted their carbohydrate intake to meet body composition goals, particularly during preseason and surrounding body composition assessment. During the competition season players had a greater focus on performance and placed more emphasis on carbohydrate intake in the lead up to matches. Players felt nutrition goals were easier to achieve when dietary choices were supported by their families and peers. One-on-one consultations provided by a sports dietitian were players′ preferred mode of nutrition intervention. Individualized nutrition advice is required for less experienced AF players who may be vulnerable to unsustainable dietary habits. Experienced AF players can support junior teammates by promoting positive team culture related to body composition, nutrition and performance.

How Does the Dietary Intake of Female Field-Based Team Sport Athletes Compare to Dietary Recommendations for Health and Performance? A Systematic Literature Review

Field-based team sports present large energetic demands given their intermittent high-intensity nature. Current evidence suggests that the dietary intake of female athletes may be insufficient to meet such demands, resulting in negative consequences for athletic performance and health. The primary aim of this review was to therefore assess the adequacy of dietary intake of female field-based team sport athletes when compared to dietary recommendations. A systematic search of databases, including PubMed, Web of Science, SPORTDiscus, and OpenGrey, was performed from the earliest record available until July 2020, obtaining an initial total of 2588 articles. To be included within the final review, articles were required to provide a quantitative assessment of baseline dietary intake specific to the target population. A total of 20 studies (n = 462) met the full eligibility criteria. A majority reported that the dietary intake of female field-based team sport athletes was insufficient in overall energy (2064 ± 309 kcal·day^-1), carbohydrate (4.3 ± 1.2 g·kg·day^-1), and iron intake (13.6 ± 6.2 mg·day^-1) when compared to recommendations. Future research is required to establish why female team sport athletes consistently demonstrate deficient dietary practices, and to explore the potential negative consequences of this.

Exploring Sports Nutrition Knowledge in Elite Gaelic Footballers

Nutrition intake plays a crucial role in improving athletic performance, enhancing adaptations to training, and augmenting recovery from exercise. However, research has reported that Gaelic footballers consistently fail to meet energy and carbohydrate recommendations. Sports nutrition knowledge (SNK) can influence the dietary intake of athletes, and therefore has the potential to have a significant impact on athletic performance. The aim of this study was to investigate the current level of SNK in elite Gaelic footballers (n = 100). An online version of the Nutrition for Sport Knowledge Questionnaire (NSKQ) was used to assess sports SNK. The overall mean SNK scores for Gaelic footballers and practitioners were 47.6 ± 12.3% and 78.1 ± 8.3%, respectively. There were no differences in knowledge between age groups, education level or divisional status. The top three sources of nutrition information identified by participants were team dietitian/nutritionists (84.0%), athletic trainers/strength and conditioning coaches (73%), and social media (37%). The results show that there is a major gap in the SNK of Gaelic footballers, while practitioners demonstrated a promising SNK, that could support Gaelic footballers. There is a need for development of interventions and knowledge transfer partnerships, including more effective methods of educating Gaelic footballers and translating sports nutrition principles to players. Developing appropriate nutritional education strategies using online resources and mobile applications could help to improve nutritional knowledge and practice of Gaelic footballers.

Diet Quality of Elite Australian Athletes Evaluated Using the Athlete Diet Index

While athletes’ nutrient intakes have been widely reported, few studies have assessed the diet quality of athletes. This is the first study to evaluate the diet quality of athletes using the purpose-built Athlete Diet Index (ADI). A convenience sample of 165 elite athletes from Australian sporting institutions completed the ADI online, with subsequent automated results provided to their respective accredited sports dietitians (ASDs). At the completion of athlete participation, ASDs (n = 12) responded to a range of survey items using a Likert scale (i.e., 1 = strongly agree to 5 = strongly disagree) to determine the suitability of the ADI in practice. Differences in ADI scores for demographics and sport-specific variables were investigated using independent t-tests, analysis of variance (ANOVA) and Bonferroni multiple comparisons. Spearman’s rank correlation was used to assess the association between total scores and demographics. The mean total ADI score was 91.4 ± 12.2 (range 53–117, out of a possible 125). While there was no difference in total scores based on demographics or sport-specific variables; team sport athletes scored higher than individual sport athletes (92.7 vs. 88.5, p < 0.05). Athletes training fewer hours (i.e., 0–11 h/week) scored higher on Dietary Habits sub-scores compared with athletes training more hours (≥12 h/week; p < 0.05), suggesting that athletes who train longer may be at risk of a compromised dietary pattern or less than optimal nutrition practices that support training. Most (75%) ASDs surveyed strongly agreed with the perceived utility of the ADI for screening athletes and identifying areas for nutrition support, confirming its suitability for use in practice.

Energy Availability with or without Eating Disorder Risk in Collegiate Female Athletes and Performing Artists

CONTEXT

Female athletes/performing artists can present with low energy availability (LEA) either through unintentional (e.g., inadvertent undereating) or intentional methods (e.g., eating disorder [ED]). While LEA and ED risk have been examined independently, little research has examined these simultaneously. Awareness of LEA with or without ED risk may provide clinicians with innovative prevention and intervention strategies.

OBJECTIVE

To examine LEA with or without ED risk (e.g., eating attitudes, pathogenic behaviors) in female collegiate athletes/performing artists.

DESIGN

Cross-sectional and descriptive.

SETTING

Free-living in sport-specific settings.

PARTICIPANTS

Collegiate female athletes/performing artist (n=121; age: 19.8±2.0 years; height: 168.9±7.7 cm; weight: 63.6±9.26 kg) in equestrian (n=28), volleyball (n=12), softball (n=17), beach volleyball (n=18), ballet (n=26) and soccer (n=20) participated in this study.

MAIN OUTCOME MEASURES

Anthropometric measurements (height, weight, body composition), resting metabolic rate, energy intake, total daily energy expenditure, exercise energy expenditure, Eating Disorder Inventory-3 (EDI-3), and EDI-3 Symptom Checklist were assessed. Chi-square analysis examined differences between LEA and sport type, LEA and ED risk, ED risk and sport type, and pathogenic behaviors and sport type.

RESULTS

Female athletes/performing artists (81%; n=98) displayed LEA and significant differences were found between LEA and sport type (χ25=43.8, P<.01). Female athletes/performing artists (76.0%; n=92) presented with ED risk with no significant difference between ED risk and sport. EDI-3 Symptom Checklist revealed 61.2% (n=74) engaged in pathogenic behaviors, with dieting the most common (51.2%; n=62). Athletes/performing artist displayed LEA with ED risk (76.0%; n=92). No significant differences were found between LEA with ED risk and sport. Softball was the highest with 82.4% (n=14) reporting LEA with ED risk followed by ballet (76%; n=19).

CONCLUSION

Our results suggest a large proportion of collegiate female athletes/performing artists are at risk for LEA with ED risk, thus warranting education, identification, prevention, and intervention strategies relative to fueling for performance.

Prevalence of Low Energy Availability in Collegiate Women Soccer Athletes

(1) Background: Limited information exists on the prevalence of low energy availability (LEA) in collegiate team sports. The purpose of this study was to examine the prevalence of LEA in collegiate women soccer players. (2) Methods: Collegiate women soccer athletes (n = 18, height: 1.67 ± 0.05 m; body mass: 65.3 ± 7.9 kg; body fat %: 24.9 ± 5.6%) had their body composition and sport nutrition knowledge assessed in the pre-season. Energy availability was assessed mid-season using a 4-day dietary log and activity energy expenditure values from a team-based monitoring system. A validated screening tool was used to screen for LEA. (3) Results: The screening tool classified 56.3% of athletes as at risk of LEA (<30 kcal/kg of FFM); however, the actual dietary intake identified 67% as LEA. Athletes identified as non-LEA consumed significantly more absolute (p = 0.040) and relative (p = 0.004) energy than LEA athletes. (4) Conclusions: There was a high prevalence of LEA among collegiate women soccer athletes. Although previously validated in women endurance athletes, the LEA screening tool was not effective in identifying those at risk of LEA in this sample of athletes.

Evaluation of Nutrition Knowledge in Female Gaelic Games Players

Improvements in nutrition knowledge have been associated with increased carbohydrate consumption and greater adherence to dietary recommendations among female athletes. In order to assess whether nutrition knowledge interventions in female Gaelic games players may be beneficial, it is necessary to first of all investigate current levels of nutrition knowledge in this population. Given that many demographic characteristics have been shown to influence nutrition knowledge, it is also important for these to be investigated. The aims of this study were to evaluate the nutrition knowledge of female Gaelic games players, compare knowledge by players’ characteristics and identify players’ preferences for information and support. A validated 35-item questionnaire was completed by 328 female Gaelic games players (Age: 23.7 ± 5.0 years). Players’ mean nutrition knowledge score was 46.0% ± 11.8% and classified as “poor”. Elite players scored greater (+4.5–5.9%, p < 0.05) than subelite players. Players with higher levels of general education, history of formal nutrition education and previous advice from a nutritionist also presented greater nutrition knowledge (+3.7–7.5%, p < 0.05). Future education interventions with female Gaelic games players may lead to beneficial changes in dietary behaviour and would likely benefit from stratifying content based on athletes’ demographic characteristics, given the differences observed.

Effects of Nutrition Education Interventions in Team Sport Players. A Systematic Review

Considering nutrition education interventions have been frequently implemented in team sport athletes and have shown promising results, this study aimed to summarize the effects of nutrition education interventions on eating habits, nutrition knowledge, body composition, and physical performance in team sport athletes. A systematic review was conducted using the following databases: PubMed/MEDLINE, Web of Science and SPORTDiscus. A total of 14 studies met the inclusion criteria for the review. The methodological quality of included studies was evaluated, and each study was assessed according to the analyzed variables (i.e., eating habits, nutrition knowledge, body composition, and physical performance). Most studies showed improvements in or maintenance of variables used to indicate eating habits, nutrition knowledge, and body composition. However, limited studies examined the effect of nutrition education interventions on physical performance, with existing studies demonstrating disparate results. These findings suggest implementation of nutrition education interventions in team sport athletes could be an effective strategy to improve their eating habits, nutrition knowledge, and body composition. Due to the heterogeneity across the included studies regarding sport modality, competition level, age, and sex of the athletes investigated, as well as the intervention type adopted (i.e., online or face-to-face), it is difficult to establish optimal nutrition education interventions for each analyzed variable.

The effectiveness of nutrition education programmes on improving dietary intake in athletes: a systematic review

Nutrition education programmes for athletes aim to enhance nutrition knowledge and more importantly support positive dietary change to enhance performance, health and well-being. This systematic review assessed changes in the dietary intakes of athletes in response to nutrition education programmes. A search was conducted which included studies providing quantitative dietary intake assessment of athletes of any calibre aged between 12 and 65 years in response to a nutrition education programme. Standardised differences (effect sizes) were calculated (when possible) for each dietary parameter. The search yielded 6285 papers with twenty-two studies (974 participants (71·9 % female)) eligible for inclusion. Studies described athletes competing at high school (n 3) through to college level or higher (n 19). Study designs were either single arm with an intervention-only group (twelve studies; n 241) or double arm including an intervention and control group (ten studies; n 689). No control groups received an alternative or ‘sham’ intervention. Face-to-face lectures (9/22) and individual nutrition counselling (6/22) were the most common education interventions. Non-weighed, 3-d diet records (10/22) were the most frequently utilised dietary assessment method. Although 14/22 studies (n 5 single and n 9 double) reported significant change in at least one nutrition parameter, dietary changes were inconsistent. Poor study quality and heterogeneity of methods prohibit firm conclusions regarding overall intervention success or superior types of educational modalities. Of note, carbohydrate intakes ‘post-intervention’ when assessed often failed to meet recommended guidelines (12/17 studies). Given the substantial investment made in nutrition education interventions with athletes, there is a need for well-designed and rigorous research to inform future best practice.

Third-Party Testing Nutritional Supplement Knowledge, Attitudes, and Use Among an NCAA I Collegiate Student-Athlete Population

Dietary supplements, sports foods, and ergogenic supplements are consumed to increase performance, recovery, and health, but risk contamination with illegal substances. Third-party testing programs may assist in regulating the purity and safety of supplements, yet athletes' attitudes and use of such programs are not widely reported. This study examined nutritional supplement knowledge, attitudes, and use, as well as the purchase of third-party tested supplements among university student-athletes (N = 138). Knowledge of nutritional supplements yielded a median and (IQR) score of 25% (17 to 42%). Sixteen percent of student-athletes said they were knowledgeable about supplements and their effects, p < 0.001. All athletes stated they used a dietary supplement or sports food at least once within the last 12 months, and 77% consumed at least one “claimed to be” ergogenic supplement. Sixty-six percent of student-athletes purchased nutritional supplements not provided by the athletic department. Females athletes were more likely to consume a combination of vitamins and single minerals, a larger variety of sports foods, exotic berries, herbs, maca root powder, ribose, ephedra, colostrum, and hydroxy-methyl-buterate (HMB) than males. Over 90% believed it was essential to know if a supplement was third-party tested. However, only 57% stated the supplements bought were third-party tested. No sex differences were found for nutritional supplement knowledge, attitudes, and use of third-party testing programs. Our results indicate a need to improve student-athletes' attitudes toward and knowledge of nutritional supplements, and the initiation of programs to assist in the choosing and consuming of third-party tested supplements.

Gym Members Show Lower Nutrition Knowledge than Youth Engaged in Competitive Sports

OBJECTIVE

Adolescents may be vulnerable to misleading nutritional information and adopt unhealthy food habits. In addition, specific features related to physical training, either aimed to improve fitness or to comply with sport demands, may influence food habits of the youth. This cross-sectional study was aimed to compare nutrition knowledge, food habits and adherence to Mediterranean diet in youth engaged in fitness training, competitive sports or inactive.

METHODS

Three questionnaires, the General and Sport Nutrition Knowledge (GeSNK) questionnaire, a food habit questionnaire and the KIDMED were administered to gym members, athletes engaged in volleyball, long-distance swimming, and gymnastics, and inactive adolescents.

RESULTS

The total sample included 211 youth (age 16.8 ± 1.7 years). Gym members, like the inactive youth, had lower general and sport-related nutrition knowledge compared to athletes (p = 0.001). In the whole sample, general nutrition knowledge was positively associated with healthy food habits (p < 0.01) and adherence to the Mediterranean diet pattern (p < 0.02).

CONCLUSIONS

Gym members had a level of nutrition knowledge lower than young athletes and similar to inactive youth. Healthy food habits were related with nutrition knowledge among adolescents. Specific nutritional education programs are needed to address food habits in fitness settings.

Diet Quality, Carotenoid Status, and Body Composition in NCAA Division I Athletes

Objectives: In this paper, we examined diet quality and associations between changes in skin carotenoids and body composition among selected NCAA Division I athletes. Methods: Athletes from women's (rowing, swimming, gymnastics) and men's (swimming, wrestling) teams at a large Midwest university (N = 129) completed one online food frequency questionnaire and 2 in-person visits, once in-season and once out-of-season, to assess skin carotenoids and body composition. Diet quality was assessed via Healthy Eating Index-2015 (HEI). Carotenoids were measured via resonance Raman spectroscopy and body composition via dual-energy x-ray absorptiometry. ANOVA and Pearson correlations were used to test differences between teams and determine association between changes from in-season to out-of-season. Results: Mean HEI score for all athletes was 71.0. Women's rowing reported the highest diet quality (73.5), men's wrestling lowest (56.5). Skin carotenoids decreased for all teams, except men's wrestling, from in-season to out-of-season. Body fat percentage increased for women and decreased for men. There was a moderate inverse association between changes in skin carotenoids and body fat percentage (r = -.334, p = .001). Conclusions: Suboptimal diet quality coupled with decreases in skin carotenoids and increases in body fat percentage from in-season to out-of-season may justify dietitian-led interventions year-round to improve dietary patterns in collegiate athletes.

Effectiveness of Education Interventions Designed to Improve Nutrition Knowledge in Athletes: A Systematic Review

BACKGROUND

A range of nutrition education strategies are used to assist athletes to improve nutrition knowledge. Evaluation of nutrition education interventions guides the delivery of efficacious nutrition education for athletes.

AIM

Our aim was to systematically review sport/general nutrition education interventions delivered to athletes, and to evaluate their effectiveness.

METHODS

A search was conducted using terms related to nutrition knowledge, athletes, education, and intervention. Included studies had to be conducted in athletes (all calibres), use a scored nutrition knowledge assessment tool, and measure knowledge before and after a nutrition education intervention. Peer-reviewed and unpublished theses were included.

RESULTS

Thirty-two manuscripts (randomised controlled trial, n = 13; single-arm pre/post design, n = 19) met the inclusion criteria. Participants (n = 2180; mean age 17.4 ± 1.7 years) were mostly female (66.1%), university-level (56.3%) athletes based in the US (75%). Comparison of different education methods was limited since the majority of interventions (n = 28/36, 77.8%) used face-to-face education. Most intervention conditions (n = 19) had a total contact time of < 300 min (5 h). The majority of interventions (n = 30, 85.7%) reported significant knowledge improvement, with a mean increase of 16.1 ± 0.7% (mean effect size 1.72; range 0.4-17.1). Only 15.6% of studies used well-validated knowledge assessment tools (more than three types of validity or reliability testing).

CONCLUSIONS

Most interventions reported a significant improvement in nutrition knowledge. Unfortunately, the wide range of knowledge assessment tools with limited validation, and the predominant use of face-to-face interventions, prohibits identification of the most effective modality and dose for nutrition education in athletes.

Sports nutrition interventions: A systematic review of behavioural strategies used to promote dietary behaviour change in athletes

Designing and implementing successful dietary interventions is integral to the role of sports nutrition professionals. Despite this, no review has evaluated sports nutrition interventions and consequently their active ingredients are not defined. This systematic review aimed to identify the behavioural strategies used in sports nutrition interventions and to explore any relationship between the strategies employed and intervention effects. SPORTDiscus, MEDLINE, CINAHL, PubMed, and SCOPUS were searched for behavioural interventions that aimed to change athletes' dietary behaviour. Behavioural interventions were eligible for inclusion provided pre and post-measures of dietary intake were reported. The protocol adheres to Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols (PRISMA-P). Each study was coded against the "Template for Intervention Description and Replication" (TIDieR) checklist and the Behaviour change technique (BCT) taxonomy v1. Only 19 BCTs are currently employed within sports nutrition interventions suggesting that 80% of the available BCTs are not being used. Only three studies were theory informed and the standard of reporting across all studies requires substantial improvement. However, the majority of studies reported changes in athletes' dietary behaviour post-intervention. This review highlights an absence of evidence-informed approaches defining the professional practice of sports nutrition and illuminates a limited application of BCTs within the sports nutrition field. Consequently, the authors provide a framework and guide for intervention development to increase rigour and effectiveness of future sports nutrition interventions. PROSPERO registration number: CRD42018072283.

Dietary intakes of professional Australian football league women's (AFLW) athletes during a preseason training week

OBJECTIVES

In 2016 the Australian football league introduced the first women's league, integrating part-time female athletes into the professional sporting environment. This study aims to assess the dietary intakes of professional Australian football league women's (AFLW) athletes to highlight key focus areas for nutrition and additionally provide nutrition recommendations for dietitians working with these athletes.

DESIGN

Cross-sectional study.

METHODS

Dietary intake data was collected from 23 players from the same club competing in the Australian football league women's, during a preseason week. Dietary intakes were assessed using three day estimated food records.

RESULTS

Majority of athletes did not meet recommendations for carbohydrate (96%, n=22), iron (87%, n=20) and calcium (61%, n=14). In comparison, majority of athletes met protein (74%, n=17) and fat (78%, n=18) recommendations. No significant difference was found in energy intake on main training, light training and recovery days (p>0.05). Energy and carbohydrate intakes reported by AFLW athletes (1884±457kcalday-1 and 2.7±0.7gkg-1day-1) were consistent with values reported in previous studies that included professional female athletes.

CONCLUSIONS

This research highlights that further exploration of the factors that influence dietary intake is required to support athletes to meet energy and carbohydrate recommendations required for desired training and performance outcomes.

Nutrient Status and perceptions of energy and macronutrient intake in a Group of Collegiate Female Lacrosse Athletes

Background

The purpose of this study was to compare nutritional intakes against recommended values as well as between the perceived intake and needs of female lacrosse players.

Methods

Twenty female NCAA Division II lacrosse players (20.0 ± 1.7 yrs., 169.7 ± 6.4 cm; 69.9 ± 10.7 kg; 27.5 ± 3.3% fat) completed a four-day monitoring period during in-season. Athletes were outfitted with an activity monitor over four consecutive days and completed four-day food records to assess total daily energy expenditure (TDEE) and dietary intake. Body composition was assessed and used to calculate recommended dietary intakes. Actual intake was self-reported using a commercially available food tracking program (MyFitnessPal©, USA). Daily average values were calculated for total and relative energy, protein, carbohydrate, and fat intake. These values were then compared to published nutritional recommendations established by the International Society of Sports Nutrition. Appropriate pairwise comparisons were made depending on the normality of the distribution.

Results

Athletes ate significantly less than recommended values for energy, carbohydrates and protein. (p < 0.001). Significant discrepancies (p < 0.001) were also observed between perceptions of intake versus actual intake.

Conclusions

Athletes significantly underestimated perceived intake of dietary fat and carbohydrate when compared to perceived needs. Massive standard deviations and ranges were observed, suggesting that some athletes lack a basic understanding of their daily needs. Results from this data suggest that collegiate athletes lack appropriate understanding of basic nutrition needs and could benefit from basic nutrition education as it pertains to their health and performance.

The Impact of Nutrition Education Intervention with and Without a Mobile Phone Application on Nutrition Knowledge Among Young Endurance Athletes

Athletes often have significant gaps in their nutrition knowledge. Thus, the aim of this study was to investigate whether young Finnish endurance athletes' nutrition knowledge and dietary intake can be improved through an education intervention with or without a mobile food application. Seventy-nine endurance athletes, 18.0 years (SD: 1.4), participated in this randomized, controlled intervention. We compared the effects of participatory nutrition education sessions alone (group EDU) to those including the use of a mobile food application (group EDU + APP) for four days after each session. Both groups attended three 90-min education sessions fortnightly. The participants completed a validated nutrition knowledge questionnaire in Weeks 0, 5, and 17, and a three-day food diary in Weeks 0 and 17. The education plan was based on the Self-Determination Theory and the concept of meaningful learning process. The EDU group's nutrition knowledge scores were: 78 (week 0), 85 (week 5), and 84 (week 17) and the EDU + APP group's 78, 86, and 85, respectively. Nutrition knowledge increased significantly (main effect of time (p < 0.001)), but we observed no significant group × time interaction (p = 0.309). The changes in dietary intakes were minor (p > 0.05). The amount of carbohydrates was below endurance athletes' recommendations throughout the intervention. The reported energy intakes were also below the estimated energy expenditures. In conclusion, nutrition knowledge improved significantly after only three education sessions and food diary feedback, but the mobile app did not improve learning further. However, the nutrition education intervention alone was not enough to change dietary intake.

Australian team sports athletes prefer dietitians, the internet and nutritionists for sports nutrition information

AIM

To evaluate the information sources that are used and preferred by Australian athletes and to assess if preferences influence nutrition knowledge (NK).

METHODS

Elite and non-elite Australian team sport athletes, playing Australian football (AF), cricket, lawn bowls, soccer or hockey, were recruited via the sporting organisations' qualified sports dietitians or club presidents. Athletes completed one of two online, validated sports NK questionnaires. Frequency analysis on previous sources of advice, preferred sources of information and preferred type of support were assessed. Differences in NK scores (%) based on previous sources of dietary advice and preferences for obtaining information were assessed using t test or Mann-Whitney U test.

RESULTS

Demographic and information source questions were completed by 410 athletes; 331 also completed NK questions. Athletes were mostly non-elite (76%) and AF players (79%). Forty-four per cent of athletes reported having previously received advice from a dietitian. Twenty per cent, 19% and 16% of athletes chose "dietitian," "internet" and "nutritionist" as their preferred source of nutrition information, respectively. Athletes preferred information on sports nutrition (35%), individual consultations (33%), and information on general healthy eating (33%), over cooking classes (4%) and group presentations (3%). There were no significant associations between preferred and previous information sources and NK scores.

CONCLUSIONS

Australian athletes prefer dietitians, the internet and nutritionists for sports nutrition information. There is an interest in and need for access to a qualified sports dietitian and reputable internet-based nutrition information. Education programs and advice given to athletes need to be evaluated.