Sport Nutrition Knowledge, Behaviors and Beliefs of High School Soccer Players

Nutritional perspectives in female soccer: a scoping review

BACKGROUND

The purpose of the review was to evaluate the literature exploring nutritional habits and practices in female soccer players.

METHODS

The PRISMA-ScR Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews were followed. Searches of Web of Science, PubMed and Scopus databases were conducted for studies exploring the nutritional habits and practices of female soccer players.

RESULTS

A total of 72 studies were included in the scoping review. Studies on female soccer players mainly focused on daily energy expenditure, daily energy and macronutrient intake and hydration status. A negative energy balance was consistent across studies, and the ingestion of CHO appears below the current recommendations. Female soccer players are predominately in negative energy balance, which may indicate that they are at risk of low energy availability. A high use of nutritional supplements is apparent in female soccer, whilst a large proportion of players commence training dehydrated.

CONCLUSIONS

The current findings have implications for practitioners relating to the planning, management, monitoring, and implementation of nutritional intake and training and competition schedules.

The relationship between lifestyle habits and obesity among students in the Eastern province of Saudi Arabia: using the Arab Teens Lifestyle (ATLS) questionnaire

BACKGROUND

The Arab Teens Lifestyle (ATLS) questionnaire was an initiative to assess the lifestyle habits influencing obesity rates in the Middle East and North Africa (MENA) region, including physical activity (PA) patterns, sedentary and eating behaviours. Since its implementation, the ATLS questionnaire has been used in several studies among different age groups and populations. This instrument has not previously been administered among the university students of the Eastern Province of Saudi Arabia, where the obesity rates are the highest in the country. This research was the first that aimed to identify lifestyle habits influencing the rates of obesity among 18-25-year-old university students in the Eastern Province of the Kingdom of Saudi Arabia (KSA) using the ATLS questionnaire.

METHODS

Quantitative cross-sectional research among n = 426 students of the Eastern Province of Saudi Arabia using the ATLS questionnaire.

RESULTS

Out of n = 426 participants, n = 200 (47%) were categorised (using body mass index) as normal weight; n = 113 (26.5%) were overweight, and n = 73 (17.1%) were obese. The findings showed that most of the nutritional, PA, and sedentary behavioural factors (e.g., screen time) in the questionnaire were not associated with obesity status amongst the participants. In the obese group, more of the males that consumed fruits, French fries, cakes, sweets and doughnuts more than three times per week were likely to be obese, which was not the case for females.

CONCLUSION

The reported lifestyles of the students could potentially lead to long-term negative health effects, which is of concern given the rising rates of overweight, obesity, and obesity-related non-communicable diseases (NCDs) among the Kingdom's adult and ageing population. Further studies are recommended to explore the knowledge, attitudes, and perceptions of Saudi students in the Eastern Province in relation to PA, sedentary behaviours, and dietary habits, along with their views on how these can be improved.

How can we better engage female athletes? A novel approach to health and performance education in adolescent athletes

Objectives

To evaluate the impact of a video series versus online pamphlets/blog posts on Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (REDs) knowledge in high school female runners.

Methods

Runners from 10 US schools were cluster-randomised into groups to either watch videos or read pamphlets on Triad/REDs, nutrition, menstrual cycle, bone health and mental health. Changes in knowledge and interest were assessed using generalised estimating equations.

Results

Forty-five runners were in the video intervention group (mean age=16.0) and 39 in the control (mean age=15.7). Both groups showed knowledge gains for all topics, except for mental health, where knowledge was already high. The intervention group's knowledge increase (means=75.7 and 93.3) was not significantly higher than the control's (means=77.9 and 93.6) (p=0.149). However, the intervention group had stronger scores on behavioural impact, information novelty and interest (means=3.77, 3.93 and 4.14) compared with the control's (means=3.36, 3.48 and 3.52) (p≤0.05, p≤0.05 and p≤0.001).

Conclusion

Both videos and pamphlets improved knowledge of Triad/REDs and female athlete science, however videos had a greater influence on athletes' engagement and behavioural intentions.

Trends in Nutrition-Related Risk Factors Identified Post-Operatively in Patients Treated for a Lower-Extremity Injury

This study investigated trends within a custom Sports Nutrition Assessment for Consultation (SNAC) survey designed to identify nutrition-related risk factors among post-operative lower-extremity youth athletes. Athletes aged 8-18 years who completed the SNAC at a sports medicine institution after lower-extremity surgery were reviewed for associations between SNAC questions and age/sex differences. Of 477 patients (15.0 ± 2.0 years; 47.8% female), 319 (66.9%) answered 'yes' to at least one question and were identified for a consult, though 216 (64.3%) declined. The most frequent questions to prompt a consult were a desire to better understand nutrition for recovery (41.5%) and regularly skipping at least one meal a day (29.8%). Inter-question responses were often significantly related, especially regarding appetite changes, weight changes, and/or meal-skipping. While consult acceptance was not significantly different between sex/age, males were more likely to report a desire to better understand nutrition (p = 0.004) and a weight change (p = 0.019), and females were more likely to report struggling with dizziness/fatigue (p < 0.001). Additionally, older athletes reported an appetite change (p = 0.022), meal-skipping (p = 0.002), a desire to better understand nutrition (p < 0.001), a weight change (p < 0.001), and an effort/recommendation to change their body composition/weight (p = 0.005). These findings demonstrate a link between risky nutrition behaviors and physical detriments.

Patterns of energy availability and carbohydrate intake differentiate between adaptable and problematic low energy availability in female athletes

Background

Problematic low energy availability (EA) is the underlying culprit of relative energy deficiency in sport (REDs), and its consequences have been suggested to be exacerbated when accompanied by low carbohydrate (CHO) intakes.

Objectives

This study compared dietary intake, nutrition status and occurrence of REDs symptoms in groups of female athletes, displaying different patterns of EA and CHO intake.

Methods

Female athletes (n = 41, median age 20.4 years) from various sports weighed and recorded their food intake and training for 7 consecutive days via a photo-assisted mobile application. Participants were divided into four groups based on patterns of EA and CHO intakes: sufficient to optimal EA and sufficient to optimal CHO intake (SEA + SCHO), SEA and low CHO intake (SEA + LCHO), low energy availability and SCHO (LEA + SCHO), and LEA and LCHO (LEA + LCHO). SEA patterns were characterised by EA ≥30 and LEA by EA <30 kcal/kg fat free mass, and SCHO patterns characterised by CHO intake ≥3.0 and LCHO <3.0 g/kg body weight for most of the registered days. Body composition was measured with dual energy x-ray absorptiometry, resting metabolic rate with indirect calorimetry and serum blood samples were collected for evaluation of nutrition status. Behavioural risk factors and self-reported symptoms of REDs were assessed with the Low Energy Availability in Females Questionnaire, Eating Disorder Examination Questionnaire Short (EDE-QS), Exercise Addiction Inventory, and Muscle Dysmorphic Disorder Inventory.

Results

In total, 36.6% were categorised as SEA + SCHO, of which 5/16 were ball sport, 7/10 endurance, 1/7 aesthetic, 2/5 weight-class, and 0/3 weight-class athletes. Of LEA + LCHO athletes (19.5% of all), 50% came from ball sports. Aesthetic and endurance athletes reported the greatest training demands, with weekly training hours higher for aesthetic compared to ball sports (13.1 ± 5.7 vs. 6.7 ± 3.4 h, p = 0.012). Two LEA + LCHO and one SEA + LCHO athlete exceeded the EDE-QS cutoff. LEA + LCHO evaluated their sleep and energy levels as worse, and both LEA groups rated their recovery as worse compared to SEA + SCHO.

Conclusion

Repeated exposures to LEA and LCHO are associated with a cluster of negative implications in female athletes. In terms of nutrition strategies, sufficient EA and CHO intakes appear to be pivotal in preventing REDs.

Adolescent athletes have better general than sports nutrition knowledge and lack awareness of supplement recommendations: a systematic literature review

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.

Supplement Consumption by Elite Soccer Players: Differences by Competitive Level, Playing Position, and Sex

Soccer is a sport practiced all over the world and whose practice begins in young athletes. Currently, the consumption of nutritional supplements is essential to achieve the maximum performance of players. The aim of this study was to describe the consumption of sports supplements (CSS) by elite soccer players and its association with their competitive level, playing position, and sex. A comparative descriptive and non-experimental study was performed during the 2021-2022 competitive season. A total of 70 elite players completed one online questionnaire about their CSS. We found that sports drinks (55.7%), sports bars (50.0%), whey protein (48.6%), caffeine (47.1%), and creatine (60.0%) were the most consumed supplements by the total sample. Relative to the categories, the CSS was higher in the senior teams for both men and women. Regarding playing positions, caffeine was more consumed by midfielders and forwards (p = 0.013). Finally, in relation to sex, significant differences were found in the consumption of sports confectionery (p = 0.036), whey protein (p = 0.002), β-alanine (p = 0.013), and melatonin (p = 0.016). Soccer club SS questionnaires gather data to understand patterns, assess effectiveness and risks, and aid research. In conclusion, differences were found in the CSS according to competitive level, sex, and playing position.

Investigating Nutrition and Hydration Knowledge and Practice among a Cohort of Age-Grade Rugby Union Players

Optimal athletic performance relies on meeting specific nutritional requirements, encompassing adequate calorie intake, macronutrient intake, and hydration. Misinformation or misconceptions about these necessities are prevalent among young athletes. This study investigated nutrition and hydration knowledge and practices among 28 male rugby union players aged 16 to 17, participating in Munster Rugby's 2023 Summer Age-Grade Development Programme, specifically the U18's Schools Squad. The Nutrition for Sport Knowledge Questionnaire assessed nutrition knowledge, while the Hydration Assessment Questionnaire evaluated hydration knowledge. Urinalysis for hydration status utilised urine specific gravity measurements pre-exercise on five separate days (1.018 ± 0.008 Usg). Dietary intake was recorded using a 3-day estimated food intake record on the Libro App, analysed with Nutritics software(Version 9.50). Suboptimal nutrition knowledge (49.6 ± 8.2%) and dietary practices were observed, with incongruent nutrient intakes compared to recommendations for adolescent athletes. While superior hydration knowledge (79.0 (77.3, 83.6) %) was evident, pre-exercise urine specific gravity readings indicated significant variation (p < 0.001) and signs of dehydration (USG > 1.020 Usg). No statistically significant correlations were found between knowledge and practices. The study highlights suboptimal nutrition and hydration knowledge and practices in youth athletes, suggesting the need for tailored support and educational interventions to enhance their overall health and performance. Further investigation into barriers and facilitators to dietary adherence is recommended for more effective interventions.

Energy and Macronutrient Intakes in Young Athletes: A Systematic Review and Meta-analysis

The aim of this study was to conduct a systematic review and meta-analysis of differences in energy and macronutrient intakes between young athletes and non-athletes, considering age, gender and sport characteristics. The study included original research articles that compared energy and macronutrient intakes of 8 to 18-year-old athletes to non-athletes. Mean difference (MD) meta-analyses were performed to quantify energy and macronutrient intake differences between athletes and non-athletes. Eighteen observational studies were included. Results revealed that the energy and carbohydrate consumption of athletes was higher than that of non-athletes (MD=4.65kcal/kg/d, p<0.01 and MD=1.65% of total energy intake, p<0.01, respectively). Subgroup analyses revealed a significant effect of total training time on the observed mean differences between athletes and non-athletes. As practice time increased, the differences between athletes and non-athletes increased for carbohydrate and decreased for protein. Sport type analysis revealed a higher protein intake by mixed sport athletes compared to endurance and power sports. Analyses also indicated an age effect: the older the athletes, the smaller the differences between athletes and non-athletes for energy intake. However, the methods used to match groups and estimate dietary intakes forced us to moderate the results. More rigorous research methods are needed to define the dietary intakes of athletes and non-athletes.

Assessment of General and Sports Nutrition Knowledge, Dietary Habits, and Nutrient Intake of Physical Activity Practitioners and Athletes in Riyadh, Saudi Arabia

Physical performance and overall health are crucial in the athletic population, and their improvement relies on specific dietary guidelines and practices. Athletes and physical activity practitioners who participate in physical activity for specific health reasons need nutritional knowledge to improve physical performance. This study aimed to understand nutrient intake and nutritional knowledge among physical activity practitioners and athletes in Riyadh, Saudi Arabia. This cross-sectional study sampled 263 individuals divided into two groups: athletes (n = 121) and practitioners (n = 142). Their nutritional knowledge and dietary intake were measured with validated questionnaires: the Arabic Abridged Nutrition for Sport Knowledge Questionnaire and the Saudi Food Frequency Questionnaire. The majority of the sample (77.2%) had poor nutritional knowledge. Highest scoring domains for the dietary intake were protein from meat, fish, chicken (65.6%), vegetarian protein (62.4%), grains (51.0%), and the lowest were vegetables (41.1%), dairy (36.3%), and fruits (27.9%). In conclusion, athletes and practitioners in Riyadh, Saudi Arabia, have poor nutritional knowledge and dietary intake and may benefit from nutritional education and training to improve their knowledge, dietary intake, and performance.

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.

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 Impact of Physical Activity at School on Eating Behaviour and Leisure Time of Early Adolescents

(1) Background: Diet and physical activity (PA) significantly impact health. The aim of this study was to evaluate the impact of long-term increase in organized PA level at school on the eating behaviour and leisure time of early adolescences in the period from the age of 10 to 12. (2) Methods: Children born in 2007 (n = 278) in groups with a standard (control group) and increased level of organized PA at school (4 and 10 h a week) were subjected to an anonymous follow-up survey. The questionnaire included 22 questions related to the eating behaviour and ways and frequency of leisure time PA. The study was conducted in the same groups in three assessment sessions in September 2017, 2018 and 2019. (3) Results: During the course of the study, it was shown improvement of eating behaviour in the increased PA group whereas decline in the standard PA one. The share of children with good and very good scores of eating behaviour decreased in the standard PA group from 56.89% to 54.54% and increased in the increased PA from 58.06% to 60.29%. In the increased PA group children more frequently than standard PA ate vegetables, fruits, fish, poultry meat, wholemeal bakery products, milk, dairy products and drinking tea without sugar, as well as ate breakfast. The standard PA children more frequently than increased PA ate high sugar and/or fat content food as sweets, savoury snacks and drank fizzy drinks as well as fast foods. The frequency of often undertaken leisure time PA increased in the increased PA group from 67% to 74%, while decreased in the standard PA from 58% to 52%. (4) Conclusions: Increase in organized PA at school beneficially influenced early adolescents' eating behaviour and frequency of leisure time PA during 2 years observation. It also increased early adolescents' awareness of healthy diet. Increased PA at school helps shaping healthy lifestyle among early adolescents.

Consumption of nutritive supplements during physical activities in Romania: A qualitative study

The consumption of nutritional supplements by the population that practices physical activities in a regular, organized manner represents a form of scientific interest for professionals interested in analyzing the somatic and biological changes that occur under the influence of the stimuli provided by nutritional supplements. In this context, based on a new statistical model proposed by the authors, we aimed at assessing nutritional supplement consumption efficiency and the effects felt by the consumers in relation to both the achievement of their health goals and the destructuring of the biological processes following the consumption of these supplements. The new model, created by the authors, can be applied to the population of any other state in the world. The methods used in this article are analytical and prospective, and they are based on a qualitative questionnaire applied to 310 Romanian people who practice sports regularly; the sample group being considered representative for the entire population of Romania by the Cochran W.G. test. The results of the study are useful to both the specialists and the people who take nutritional supplements, and they help in improving the perception regarding the efficiency of these products on various categories, as will be seen from the data provided in this study. Moreover, the results of this analysis are also interesting for the providers of products such as pharmacies and authorized distributors, which can scientifically quantify their supply in the market.

Comparison of the Effects of Different Forms of Nutrition Education on Adolescent Male Soccer Players

The purpose of this study was to compare the educational effects on nutrition knowledge of two teaching methods targeting adolescent male soccer players through learning online from WeChat account articles (WeChat group) or taking classroom courses (classroom group). The study investigates whether such teaching methods can improve self-efficacy and nutrition knowledge for athletes. A total of 41 U15 (age 15) youth male soccer players, 21 in the classroom group and 20 in the WeChat group, participated in the experiment by receiving the same nutrition education separately for 12 weeks. An athlete nutrition KAP questionnaire and self-efficacy questionnaire were conducted before the intervention, immediately after the intervention, and 6 weeks and 12 weeks after the intervention. As a result, the nutritional knowledge score and the total score of the athlete nutrition KAP questionnaire in the classroom group increased significantly and were notably higher than those in the WeChat group. Self-efficacy scores improved significantly in both groups. In conclusion, the study showed that the level of nutritional knowledge of U15 male soccer players was mediocre, and both forms of nutrition education can significantly improve the level of nutritional knowledge and self-efficacy of the players. In comparison, the educational effect of classroom teaching is significantly greater and more consistent than that of learning from WeChat public articles.

Effects of Dietary Intervention and Education on Selected Biochemical Parameters and Nutritional Habits of Young Soccer Players

In adolescence, the body requires sufficient amounts of adequate nutrients. This is especially important in the case of young athletes, for whom a nutrition plan should be as significant as a proper training plan. The aim of the study was a 17-week follow-up of the effects of individual and group nutrition intervention on changes in eating habits and selected biochemical parameters. 46 young soccer players aged 12–17 from the Soccer Academy in Northeastern Poland completed the study. One group received only individual recommendations, while the other additionally received group nutrition education. As a result of the dietary education, teenagers from the latter group consumed less saccharose (44 g vs. 39.2 g) in favor of digestible carbohydrates (266 g vs. 273 g) and dietary fiber (19.7 g vs. 22.2 g), further emphasizing the health-promoting profile of diets. The amount of fluid consumed (33% vs. 48% above 2 L of water a day) and the habits of the peri-workout hydration routine were also improved. Many of the participants (41%) reported faster regeneration while 26% experienced an overall better well-being. The short-term intervention produced positive results, but nevertheless it is the implementation of long-term dietary improvement schemes involving parents and coaches that should be the direction of future approaches.

Nutraceuticals and dietary supplements: Disparities in usage and potential for harm

Background: The use of nutraceuticals and dietary supplements has a complex history. Aim: This work seeks to discuss the current state of nutraceuticals and dietary supplements, with a particular focus on the ambiguity of these terms, their current usage, potential harms, roles within the healthcare system, and associated disparities. Methods: This work reviews recent literature spanning the history of nutraceuticals and expands upon recommendations made by previous authors. Results: While a substantial portion of the United States population consumes these substances, their safety profiles are rarely well characterized. Taking a broad definition of these terms paints a picture of harmless use by a population that is middle-aged, educated, and white. However, focusing on specific substances reveals concerning disparities in race, ethnicity, income, physical health, and health literacy. This is of particular concern when looking at the side effects of these supplements both in isolation and due to drug-supplement interactions. Conclusions: In this work, the authors build upon the recommendations of others to propose ways in which physicians and healthcare systems can work to reduce the disproportionate harms of these substances on historically marginalized groups.

Improved Physiological Markers of Omega-3 Status and Compliance With Omega-3 Supplementation in Division I Track and Field and Cross-Country Athletes: A Randomized Controlled Crossover Trial

A sufficient omega-3 index may enhance cardiovascular function, enhance performance, and decrease inflammation. However, most collegiate athletes are deficient in omega-3s, requiring supplementation. A new type of omega-3 (N3) supplement, Enhanced Recovery™ (ER), claims to improve N3 index while addressing the current issues with traditional supplementation. The purpose of this study was to determine if ER improves N3 status and enhances compliance compared with the current standard in collegiate Division I Track and Field and cross-country athletes during a competitive season. Twenty-five (male = 15 and female = 10) athletes completed this longitudinal, randomized controlled crossover trial. Measurements of N3 status were collected at baseline prior to supplementation, and every 2 weeks for 6 weeks with a 33- to 36-day washout period before crossing over. Supplement compliance and dietary intake of N3 rich foods were collected throughout. Visual analog scales and an exit survey asked questions regarding each treatment. Results showed that N3 index increases within 6 weeks (p < .001) for ER (+37.5%) and control (CON; +55.1%), with small differences between treatments at Weeks 4 (ER = 7.3 ± 1.0; CON = 7.7 ± 1.1; p = .043) and 6 (ER = 7.4 ± 1.2; CON = 7.9 ± 1.2; p = .043). Dietary intake of N3-rich foods and supplement compliance were significant drivers of improvements in N3 status (p < .050). Compliance was not different between treatments but was affected by sex (males = 90.0 ± 17.0% and females = 76.5 ± 21.0%; p = .040), likability (p = .001; r = .77, p < .001), ease (p = .023; r = .53, p = .006), and supplement preference (p = .004), which appeared to favor ER. We conclude that consumption of N3-rich foods and consistent supplementation should be implemented for improvements in N3 status in collegiate athletes, but taste tests/trial periods with ER or CON may help determine preference and improve compliance.

Contributing Factors to Low Energy Availability in Female Athletes: A Narrative Review of Energy Availability, Training Demands, Nutrition Barriers, Body Image, and Disordered Eating

Relative Energy Deficiency in sport is experiencing remarkable popularity of late, particularly among female athletes. This condition is underpinned by low energy availability, which is a byproduct of high energy expenditure, inadequate energy intake, or a combination of the two. Several contributing factors exist that may predispose an athlete to low energy availability, and therefore a holistic and comprehensive assessment may be required to identify the root causes. The focus of the current narrative review is to discuss the primary contributing factors as well as known risk factors for low energy availability among female athletes to help practitioners increase awareness on the topic and identify future areas of focus.

Assessment of nutrition knowledge in division I college athletes

OBJECTIVE

Assess nutrition knowledge of Division I college athletes.

PARTICIPANTS

128 student-athletes (n = 70 female) from eight sports completed the survey in June 2018. METHODS: The survey by Calella et al (2017) was used to assess both general and sport nutrition knowledge.

RESULTS

Cases with more than 20% of responses missing were excluded (n = 3). Overall average score was 57.6% ± 18.6%. Females scored significantly (p < 0.001) better than the males (66.5% ± 16.4% versus 46.2% ± 14.7%). Participants were divided into revenue (football, ice hockey, male's basketball, women's basketball; n = 63) and non-revenue sports (field hockey, golf, rowing, soccer; n = 62) to address differences in knowledge between sports with greater versus lesser nutrition resource access. Revenue sports scored significantly (p < 0.001) worse than non-revenue sports (45.7% ± 15.2% versus 69.7% ± 13.1%).

CONCLUSIONS

Athletes appear to have low nutrition knowledge, putting them at risk for inappropriate dietary choices that could decrease ability to optimally perform and increase risk of injury.

Applied nutritional investigation Determinants of undernutrition among private and public primary school children: A comparative cross-sectional study toward nutritional transition in northwest Ethiopia

OBJECTIVES

Undernutrition is a major public health concern, particularly in children. The burden is higher in developing countries. Undernutrition is considered when there is one or more of the following: stunting, underweight, or wasting. Childhood undernutrition can have numerous long-term effects: a lower physical capacity for work, lower intellectual quotients, greater risk for morbidity and mortality, and cognitive impairment. Undernourished children also can have poor cognitive scores, a high absenteeism rate, and high class repetition compared with non-undernourished children. The aim of this study was to assess undernutrition and its associated factors among public and private primary school children in Gondar town, northwest Ethiopia.

METHODS

A school-based, cross-sectional study was conducted from March 5 to April 9, 2019. A multistage sampling technique was applied to select study participants. A simple random (lottery) sampling method was used to select seven public schools and five private schools. Systematic random sampling was used to select 774 study participants. The data were collected through face-to-face interviews. Multivariable logistic regressions were conducted to identify factors associated with undernutrition. The World Health Organization (WHO) AnthroPlus software was used to determine the status of undernutrition. Participants with a Z-score less than -2 were considered to be undernourished. Statistical significance was declared at P < 0.05 and odds ratios (ORs) were reported with a 95% confidence interval (CI).

RESULTS

The prevalence of undernutrition was higher among public school children (37.1%) than those attending private schools (28.3%). Not having family car (adjusted OR [aOR], 0.28; 95% CI, 0.09-0.84), snack frequency no more than twice a day (aOR, 5.29; 95% CI, 1.37-20.37), and vigorous intensity sports (aOR, 0.53; 95% CI, 0.32-0.91) were significantly associated with undernutrition among public primary school students. Family income below the median (aOR, 2.12; 95% CI, 1.23-3.53), no preference for sweets (aOR, 0.59; 95% CI, 0.36-0.97), and not habits while reading (aOR, 0.42; 95% CI, 0.19-0.89) were the factors significantly associated with undernutrition among private primary school students.

CONCLUSION

The prevalence of undernutrition was high. Children in public schools were highly vulnerable to undernutrition compared with those in private schools. Not having a family car, snack frequency no more than twice daily, and vigorous intensity sports increase the risk for undernutrition among public school children. Family income below the median, not preferring sweets, and not having a habit of eating while reading increase the risk for undernutrition among private school children. It is better to give attention to healthy dietary habits and healthy lifestyles to reduce childhood undernutrition.

Meta-Analysis of Carbohydrate Solution Intake during Prolonged Exercise in Adults: From the Last 45+ Years' Perspective

Carbohydrate (CHO) supplementation during prolonged exercise postpones fatigue. However, the optimum administration timing, dosage, type of CHO intake, and possible interaction of the ergogenic effect with athletes' cardiorespiratory fitness (CRF) are not clear. Ninety-six studies (from relevant databases based on predefined eligibility criteria) were selected for meta-analysis to investigate the acute effect of ≤20% CHO solutions on prolonged exercise performance. The between-subject standardized mean difference [SMD = ([mean post-value treatment group-mean post-value control group]/pooled variance)] was assessed. Overall, SMD [95% CI] of 0.43 [0.35, 0.51] was significant (p < 0.001). Subgroup analysis showed that SMD was reduced as the subjects' CRF level increased, with a 6-8% CHO solution composed of GL:FRU improving performance (exercise: 1-4 h); administration during the event led to a superior performance compared to administration before the exercise, with a 6-8% single-source CHO solution increasing performance in intermittent and 'stop and start' sports and an ~6% CHO solution appearing beneficial for 45-60 min exercises, but there were no significant differences between subjects' gender and age groups, varied CHO concentrations, doses, or types in the effect measurement. The evidence found was sound enough to support the hypothesis that CHO solutions, when ingested during endurance exercise, have ergogenic action and a possible crossover interaction with the subject's CRF.

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.

Prevalence of Protein and Pre-Workout Supplement Use among High School Football Players and Potential Product Contamination

The purpose was to determine the prevalence of protein and pre-workout supplement usage in high school football players and how many products contained banned substances or dangerous ingredients. A national sample of 102 high school football players was recruited via Qualtrics Research Panels to complete a cross-sectional online questionnaire. Data were summarized as means with standard deviations (SDs) and frequencies with proportions (%). A majority (59.8%) of high school football players reported currently using a protein supplement. Just under one-third (29.4%) reported currently using pre-workout supplements. Five participants reported using a pre-workout product that contained a known NCAA banned substance. Many of the products used contain banned, regulated elsewhere, or unknown substances. Secondary school ATs must educate athletes regarding the use of nutritional supplements and the potential dangers of ingesting banned or unknown substances.

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.

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.

Dietary practices of soccer athletes registered at the University of Limpopo, Limpopo Province, South Africa

Background

There is a growing number of athletes participating in soccer sports within the higher institutions of learning. However, studies involving the dietary practices of these athletes remain relatively scarce.

Objective

To determine the dietary practices of soccer athletes registered at the University of Limpopo, Limpopo Province, South Africa.

Methodology

This was a descriptive quantitative study, which adopted a purposive sampling technique to obtain 31 out of 40 registered soccer athletes representing the University of Limpopo as a team. The approval was obtained from the Turfloop Research and Ethics Committee (TREC). Data were collected at the University of Limpopo sports grounds, in the afternoons before the commencement of the training. The demographic status which included the gender, weight, and duration of athletes involved in sports of soccer at the University were collected. The weights of the athletes were also measured using a digital scale from SECA to calculate the nutrient requirements. The dietary practices of athletes were collected using the modified 24-h recall questionnaire on three different days. Athletes were required to recall all food items consumed in the previous 24 h. The researchers used household measuring utensils and food models to assist athletes in estimating food quantities. Athletes were required to recall incidences that took place in the previous to associate with food items taken. Food Frequency Questionnaire was used to determine the regularity of consumption of different food items. The nutrient intake for the athletes was obtained from the average analysis of the three 24-h recall questionnaires through MRC Food Finder (version 3.0). The SPSS software (24.0) was then used to determine descriptive tests expressing variables as percentages, means, standard deviations (± SD), and minimum and maximum values. The obtained test results were then compared to the recommendations by the International Society of Sports Nutrition (2018).

Results

Majority (81.0%) of athletes engaged in soccer sport for ≤ 2 years while at University. Overall, 61% of athletes consumed three meals/day. Only 65% consumed meals 2–3 h before the training. Majority of the athletes (≥ 61%) consumed carbohydrates, protein, and fat below the International Society of Sports Nutrition (ISSN) recommendations. Additionally, more than 65% of the same athletes consumed vitamins and minerals below the recommendations. None of the athletes consumed any food immediately after training.

Conclusion

The dietary intakes were below the ISSN recommendations. The dietary practices of athletes involved in the sport of soccer at the University of Limpopo were not adhering to soccer nutritional guidelines. Therefore, athletes need to receive nutrition support through the appointment of nutrition experts or dietitians to assist in nutrition and dietary related practices of athletes. Involvement of other multidisciplinary members is also warranted in sports of soccer and other sports categories to improve athletes’ performance without compromising their health.

A Comparison in Physical Fitness Attributes, Physical Activity Behaviors, Nutritional Habits, and Nutritional Knowledge Between Elite Male and Female Youth Basketball Players

Background: Limited evidence exists comprehensively assessing physical fitness attributes, physical activity behaviors, nutritional habits, and nutritional knowledge according to sex in basketball players during early adolescence. Insight of this nature could be used to optimize the training process and lifestyles in young basketball players. Objective: To compare physical fitness attributes, physical activity levels, nutritional habits, and nutritional knowledge between elite male and female basketball players under 14 years of age (U-14). Methods: Twenty-three U-14 basketball players (male, n = 13 and female, n = 10) from the same elite basketball academy (Spanish Asociación de Clubes de Baloncesto [ACB] League) participated in this study. Physical fitness attributes were assessed using a basketball-specific test battery (countermovement jump, drop jump, linear sprint, Lane Agility Drill, 505 change-of-direction, and repeated-change-of-direction tests), while physical activity levels (Physical Activity Questionnaire for Adolescents, PAQ-A), nutritional habits (Turconi questionnaire), and nutritional knowledge (Turconi questionnaire) were assessed using questionnaires. Results: Male players exhibited better physical fitness in all tests (p <0.001 to 0.036, effect size = -0.44 to -0.76, intermediate to strong) compared to female players. Male players also performed more physical activity in their leisure time (p = 0.036) than females. No significant differences in nutritional habits and nutritional knowledge were evident between sexes (p > 0.05). Of note, a high proportion of players declared never or only sometimes eating fruit (males: 23%; females: 40%) and vegetables (males: 46%; females: 70%). In addition, relatively poor nutritional knowledge was evident in all players with the group correctly answering <50% of nutritional questions overall (4.57 ± 1.88 out of 11 points, 42%) and according to sex (males: 4.07 ± 2.10, 37%; females: 5.20 ± 1.40, 47%). Conclusion: These findings emphasize the necessity to perform individualized prescription of training stimuli across sexes to optimize the physical preparedness and development of youth basketball players. Additionally, strategies such as nutrition-focused education interventions may be necessary in this population given the low consumption of fruits and vegetables, as well as the poor nutritional knowledge observed in players.

Nutritional Concerns for the Artistic Athlete

Performing artists are similar to sports athletes, with repeated patterns of training and performing. This requires that artistic athletes manage the dynamic interaction between energy/nutrient/fluid utilization and provision to assure long, healthful, and successful careers. Although sports athletes have an abundance of science-based nutritional guidance available, there are few nutrition-focused resources available to artistic athletes, which can result in failure to optimally satisfy the artistic athlete's individual nutritional needs. The purpose of this article is to review common nutritional issues faced by artistic athletes and to present science-based nutrition strategies that can aid in lowering nutrition-associated health and performance risks.

UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research

Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.

Validation of a General and Sports Nutrition Knowledge Questionnaire in Italian Early Adolescents

To the best of our knowledge, no specific questionnaires on sports nutrition knowledge (NK) have been validated so far in Italian early adolescents. The aim of the present study was to validate a short (26-item) general and sports NK questionnaire in a group of Italian early adolescents. To this aim, the questionnaire was administered to 264 subjects for analysis of internal consistency, and in a subgroup (n = 39) for evaluating the reliability over time. The questionnaire revealed good overall internal consistency and reliability (Cronbach’s α = 0.684) and a highly significant correlation over time (r = 0.977, p < 0.001). Comparison with other validated questionnaires is tricky, because the previous questionnaires were validated in different populations, such as middle or late adolescents or adults, with a higher number of items compared to our questionnaire. Furthermore, data on adolescent NK in Italy are very limited. This study provides a brief, feasible, and validated questionnaire that can be used for investigating sports NK in young subjects. It could be used for evaluating the efficacy of education on general and sports nutrition in both the general population and athletes, and for investigating the relationship between NK and different sports in early adolescence.

The Environmental Impact of the Athlete's Plate Nutrition Education Tool

Periodized nutrition is necessary to optimize training and enhance performance through the season. The Athlete's Plate (AP) is a nutrition education tool developed to teach athletes how to design their plates depending on training load (e.g., volume × intensity), from easy (E), moderate (M) to hard (H). The AP was validated, confirming its recommendations according to international sports nutrition guidelines. However, the AP had significantly higher protein content than recommended (up to 2.9 ± 0.5 g·kg-1·d-1; p < 0.001 for H male). The aim of this study was to quantify the environmental impact (EnvI) of the AP and to evaluate the influence of meal type, training load, sex and registered dietitian (RD). The nutritional contents of 216 APs created by 12 sport RDs were evaluated using Computrition Software (Hospitality Suite, v. 18.1, Chatsworth, CA, USA). The EnvI of the AP was analyzed by life cycle assessment (LCA) expressed by the total amount of food on the AP, kg, and kcal, according to the Swiss Agricultural Life Cycle Assessment (SALCA) methodology. Higher EnvI is directly associated with higher training load when the total amount of food on the plate is considered for E (5.7 ± 2.9 kg CO2 eq/day); M (6.4 ± 1.5 kg CO2 eq/day); and H (8.0 ± 2.1 kg CO2 eq/day). Global warming potential, exergy and eutrophication are driven by animal protein and mainly beef, while ecotoxicity is influenced by vegetable content on the AP. The EnvI is influenced by the amount of food, training load and sex. This study is the first to report the degree of EnvI in sports nutrition. These results not only raise the need for sustainability education in sports nutrition in general, but also the urgency to modify the AP nutrition education tool to ensure sports nutrition recommendations are met, while not compromising the environment.

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.

The Effects of Low- and High-Glycemic Index Sport Nutrition Bars on Metabolism and Performance in Recreational Soccer Players

Consumption of low-glycemic index (GI) carbohydrates (CHO) may be superior to high-GI CHO before exercise by increasing fat oxidation and decreasing carbohydrate oxidation. We compared the effects of pre-exercise feeding of a low-GI lentil-based sports nutrition bar with a high-GI bar on metabolism and performance during a simulated soccer match. Using a randomized, double-blind, counterbalanced, crossover design, participants (n = 8) consumed 1.5 g/kg available CHO from a low-GI bar (GI = 45) or high-GI bar (GI = 101) two hours before a 90 min simulated soccer match, and 0.38 g/kg body mass during a 15 min half-time break. The test involved alternating 6 min intervals of paced jogging, running, walking, and sprinting, and 3 min intervals of soccer-specific skills (timed ball dribbling, agility running, heading, kicking accuracy). Carbohydrate oxidation rate was lower during the match after consuming the low-GI compared to high-GI bar (2.17 ± 0.6 vs. 2.72 ± 0.4 g/min; p < 0.05). Participants performed better during the low-GI versus high-GI bar condition on the agility test (5.7 ± 0.4 versus 6.1 ± 0.6 s; p < 0.01) and heading (i.e., jumping height 24.7 ± 4.3 versus 22.2 ± 4.5 cm; p < 0.01) late in the soccer match (72 min). A low-GI lentil-based sports nutrition bar provides a metabolic benefit (lower carbohydrate oxidation rate) and a modest improvement in agility running and jumping height (heading) late in the test.

Evaluation for the effects of nutritional education on Chinese elite male young soccer players: The application of adjusted dietary balance index (DBI)

OBJECTIVES

To evaluate the effect of nutrition education on Chinese elite male young soccer players through the knowledge, attitude, behavior (KAP) survey and an adjusted dietary balance index (DBI).

METHODS

30 Chinese elite male young soccer players were randomly divided into two groups: lecture group (N = 15, Age: 16.7 ± 1.8 years, Height: 173.9 ± 9.0 cm; Weight: 62.4 ± 13.0 kg; Training years: 5.6 ± 2.7 years) and non-lecture group (N = 15, Age: 16.8 ± 1.7 years, Height: 175.5 ± 7.9 cm; Weight: 62.5 ± 12.3 kg; Training years: 6.2 ± 3.3). The comics book was given to the non-lecture group, while the a four-week nutritional quality education along with comic books were given to the lecture group. Before and after 4 weeks nutritional education, dietary nutritional status of both groups was assessed. The main outcome measurements included the scores for each part of the KAP survey, diet status (food-weighing method) and the dietary index in the adjusted DBI-07 system (DBI-low bound score, LBS; DBI-high bound score, HBS; and DBI-diet quality distance, DQD).

RESULTS

In the lecture group, significant differences were found in the scores of general nutrition knowledge, sports nutrition knowledge and total scores of KAP dietary questionnaire after 4 weeks nutritional education (P < 0.01). However, there is no significant difference in dietary attitude and dietary behavior (P > 0.05) on both two groups. There is no significant change in the DBI-low bound score (LBS), DBI-high bound score (HBS) and DBI-diet quality distance (DQD) of dietary quality index (P > 0.05) in both two groups.

CONCLUSIONS

Four weeks nutritional quality education improved the understanding of dietary nutrition among Chinese elite male young soccer players.

Determinants of coaches' intentions to provide different recommendations on sports nutrition to their athletes

BACKGROUND

Coaches are considered as an important source of nutrition information by their athletes. However, their knowledge in this area is often insufficient for proper guidance and may lead to the dissemination of misinformation regarding sports nutrition. The aim of this study was to assess coaches' intentions as well as psychosocial determinants underlying their intentions to provide sports nutrition recommendations to their high school athletes.

METHODS

Coaches (n = 47) completed a Web-based questionnaire based on the theory of planned behaviour, to assess their intentions to provide three different sports nutrition recommendations and their determinants. Multiple regression analyses were used to identify the variables that were most strongly related to the intentions.

RESULTS

Forty-six, 44.7 and 91.9% of coaches had the intention to recommend a higher consumption of foods rich in carbohydrates, foods rich in proteins and an increase in hydration to their athletes, respectively. Subjective norm was the only significant determinant of coaches' intention to recommend a higher consumption of foods rich in carbohydrates (R2 = 53.7%, β = 0.73 ± 0.12, P < 0.0001). Subjective norm and perceived behavioural control were significantly associated with coaches' intentions to recommend a higher consumption of foods rich in proteins (R2 = 25.9%, β = 0.50 ± 0.16, P = 0.002 and R2 = 17.2%, β = 0.39 ± 0.17, P = 0.01, respectively) and an increase in hydration (R2 = 26.8%, β = 0.38 ± 0.13, P = 0.001 and R2 = 46.3%, β = 0.58 ± 0.11, P < 0.0001, respectively).

CONCLUSIONS

The results of this study suggest that subjective norm and perceived behavioural control represent important determinants of coaches' intentions to provide recommendations on sports nutrition. These findings should be considered in future interventions aimed at facilitating proper general sports nutrition recommendations provided by coaches to their athletes.

Validation of the Athlete's Plate Nutrition Educational Tool: Phase I

Nutrition education visual tools are designed to help the general population translate science into practice. The purpose of this study was to validate the Athlete's Plate (AP) to ensure that it meets the current sport nutrition recommendations for athletes. Twelve registered dietitians (RDs; 10 female and 2 male) volunteered for the study. Each registered dietitian was asked to create three real and virtual plates at three different times corresponding to breakfast, lunch, and dinner, and the three different AP training loads, easy (E), moderate (M), and hard (H), divided into two weight categories (male 75 kg and female 60 kg). Data of the real and virtual plates were evaluated using Computrition software (v. 18.1; Computrition, Chatsworth, CA). Statistical analyses were conducted by SPSS (version 23.0; IBM, Armonk, NY) to compare the difference between each training load category (E, M, and H) and the recommendations. No statistically significant differences were found among the created plates and the recommendations for energy, carbohydrates, fat, and fiber for E, M, and H. Protein relative to body mass (BM) was higher than recommended for E (1.9 ± 0.3 g·kg-1 BM·day-1, p = .003), M (2.3 ± 0.3 g·kg-1 BM·day-1, p < .001), and H (2.9+0.5 g·kg-1 BM·day-1, p < .001). No differences were found for the macronutrient distribution by gender when correcting for kilograms of body mass. The authors conclude that the AP meets the nutrition recommendations for athletes at different training intensities for energy, carbohydrates, fat, and fiber, but exceeds the recommendations for protein. Further research should consider this protein discrepancy and develop an AP model that meets, besides health and performance goals, contemporary guidelines for sustainability.

Knowledge Concerning Dietary Supplements among General Public

Introduction. Diet and physical activity are widely recognized in maintaining health and preventing diseases. Currently, dietary supplements are also commonly believed to play a role in health promotion. However, a dietary supplement lacks single uniform definition within the scope of legal or nutritional sciences. Data on the usage of dietary supplements in Europe are still limited. The aim of this study was to assess subjective and objective knowledge of the inhabitants of south-eastern Poland about diet and supplementation in sport. Materials and Methods. The research was conducted in the south-east of Poland between October 2017 and July 2018 during three events organized by the University of Rzeszów. Initially, the study covered 500 people. During the preliminary analysis, 90 people were excluded from the study because they did not meet the previously well-explained rules of conduct during the study or did not meet the eligibility criteria for the tests. Finally, 410 people were qualified for the study. The survey method was a questionnaire with single-answer option. Results. Our study revealed statistically significant subjective and objective level of knowledge about diet and supplementation in terms of sex. Also, a correlation was found between sex and the fact of being involved in physical activity, as well as the subjects' knowledge of diet and supplementation in sport. Conclusion. High prevalence of dietary supplement use was found in our study population, but still significant percentage of the study group demonstrate inaccurate information about these products. Hence, there is an urgent need to provide the community with education and access to scientific and unbiased information.

Changes in Sport Nutrition Knowledge, Attitudes/Beliefs and Behaviors Following a Two-Year Sport Nutrition Education and Life-Skills Intervention among High School Soccer Players

The purpose of this study was to examine the impact of a sport nutrition education and life-skills intervention on sport nutrition knowledge (SNK), attitudes/beliefs and dietary behaviors relevant to sport nutrition among high school (HS) soccer players. Three assessments were done over the 2-year intervention (baseline = time 1, end year 1 = time 2, end year 2 = time 3). Participants (n = 217; females = 64%; Latino = 47.5%; 14.9 ± 0.9-year; 46.5% National School Breakfast/Lunch Program) were assigned to an intervention group (IG, n = 153; 9 schools) or comparison group (CG, n = 64; 4 schools) based on geographical location. Differences over time were examined based on group, sex, socioeconomic status (SES) and race/ethnicity. The IG increased SNK scores by ~10% (time 1 = 51.6%; time 3 = 60.9%; p ≤ 0.001), with the greatest change in the female IG vs. CG and no differences in male IG vs. CG. Daily breakfast consumption was 53.7% in both groups. IG players were 3 times more likely (95%CI = 2.59, 7.77) to report trying to eat for performance (IG = 48.7% vs. CG = 30.2%). By time 3, IG players were less likely to report that 'diet met nutritional requirements' (31.6%) compared to CG (47.6%). For IG, the consumption of lunch (≥5-days/week) did not change (92.2⁻93.4%), but declined in the CG (90.6%) (p = 0.04). No other differences by sub-population (race/ethnicity, SES) were observed. Our findings indicate that HS athletes are motivated to learn and improve diet behaviors, and benefit from team-based nutrition interventions. Future interventions should consider delivery of curriculum/experiential learning during a defined training period, with messages reinforced with supports at home, school and athletic settings.

Attitudes toward Nutrition and Dietary Habits and Effectiveness of Nutrition Education in Active Adolescents in a Private School Setting: A Pilot Study

This study was designed to pilot a survey to investigate nutrition knowledge, attitudes, and beliefs toward nutrition, exercise, and dietary habits of active adolescents. Participants included 117 middle school and 40 high school students. General and sport nutrition knowledge, dietary habits, and attitudes toward nutrition education were collected via three electronic surveys. Among middle schoolers, 79.5% of students stated feeling they could benefit from advice about nutrition compared to 92.5% of high school students. The topic scoring the highest in both populations was hydration; the lowest scoring topic category was protein and exercise. Knowledge about healthy eating reportedly comes from parents and coaches most frequently for both high school and middle school students. Less than 40% of students stated their diet meets their nutritional needs. Both middle school and high school students stated a desire to learn more about nutrition, but most nutrition information currently received comes from non-nutrition-related professionals. There is a need for validation of a nutrition knowledge and behavior instrument for United States adolescents, and room for improvement in general and sport nutrition knowledge in active adolescents in all topic areas.

Promoting Healthy Diet, Physical Activity, and Life-Skills in High School Athletes: Results from the WAVE Ripples for Change Childhood Obesity Prevention Two-Year Intervention

The purpose of this study was to compare changes in diet and daily physical activity (PA) in high school (HS) soccer players who participated in either a two-year obesity prevention intervention or comparison group, while controlling for sex, race/ethnicity, and socioeconomic status. Participants (n = 388; females = 58%; Latino = 38%; 15.3 ± 1.1 years, 38% National School Breakfast/Lunch Program) were assigned to either an intervention (n = 278; 9 schools) or comparison group (n = 110; 4 schools) based on geographical location. Pre/post intervention assessment of diet was done using Block Fat/Sugar/Fruit/Vegetable Screener, and daily steps was done using the Fitbit-Zip. Groups were compared over-time for mean changes (post-pre) in fruit/vegetables (FV), saturated fat (SF), added sugar, and PA (daily steps, moderate-to-vigorous PA) using analysis of covariance. The two-year intervention decreased mean added sugar intake (-12.1 g/day, CI (7.4, 16.8), p = 0.02); there were no differences in groups for FV or SF intake (p = 0.89). For both groups, PA was significantly higher in-soccer (9937 steps/day) vs. out-of-soccer season (8117 steps/day), emphasizing the contribution of organized sports to youth daily PA. At baseline, Latino youth had significantly higher added sugar intake (+14 g/day, p < 0.01) than non-Latinos. Targeting active youth in a diet/PA intervention improves diet, but out of soccer season youth need engagement to maintain PA (200).

WAVE~Ripples for Change Obesity Two-Year Intervention in High School Soccer Players: Process Evaluation, Best Practices, and Youth Engagement

This paper reports the process data on program fidelity, best practices for intervention implementation, youth and coach engagement, and youth application of knowledge and skills for the two-year WAVE~Ripples for Change (WAVE) obesity prevention intervention program focused on healthy eating, physical activity, and life skills with high school (HS) soccer players aged 14⁻19 years. Internal (staff: n = 7; volunteers: n = 27) and external (youth: n = 100; coaches: n = 9) stakeholders were interviewed/ surveyed. Staff rated program fidelity as high (94%), as did volunteers (85%). Best practices included coach encouragement for athlete participation, use of on-line consent for enrollment, building relationships with HS staff to complete assessments, sending text reminders, and providing incentives. Study results showed an enrollment rate of 72%, completion of baseline assessments of 89⁻98%, attendance of sports nutrition lessons in Year 1 and Year 2 of 90% and 39%, respectively, and team-building workshop (TBW) attendance of 25⁻31%. Activities exceeding youth expectations (>90%) included, (1) activities with their soccer team; (2) the TBW-cooking; and (3) sports nutrition lessons. The obesity prevention skills most applied by youth were obtained from the TBW-gardening and harvesting (49%), the TBW-cooking (43%), and sports nutrition lessons (44%). Coaches also rated the sports nutrition lessons highly and reported increased awareness for hydration/fueling during sport by the athletes. Using sport teams/clubs to engage youth in obesity prevention is a feasible model for future study.

Prevalence of supplement use in recreationally active Kazakhstan university students

Background

Little is known about the supplements use and recreational sport practices in Kazakhstan university students. Therefore, the aim of this study was to ascertain supplements use prevalence and their predictors in this population.

Methods

Cross-sectional survey of both undergraduate and graduate level students was completed in 2017 et al.-Farabi Kazakh National University, the largest higher institution in the country, from almost all Schools. A 45-item questionnaire was used to record physical activity, supplements use, lifestyle attributes (smoking, alcohol, sleep, etc.) and eating habits, and adjusted regression models were used to verify predictors of supplements use.

Results

Of the entire sample of 889 students (70% females), 526 (59%) were practicing recreational physical activity (RPA), and walking, jogging and track and field was the most popular activity type (38%). N = 151 (29%) students reported the use of any supplement (31% in men and 27% in women), whereas the most popular supplement type were vitamins. Supplement use was most prevalent in swimmers (55%). Age (odds ratio (OR) 1.19 (95% confidence interval (CI) 1.04–1.37), use of fitness tracker (OR 6.26 (95% CI 3.90–10.03)) and low-fat diet (OR 1.95 (95% CI 1.23–3.10)), but not income predicted supplements use in adjusted models.

Conclusions

With more than half of students exercising regularly, only less than one-third use supplements with a very strong association with fitness tracker use.