Intercollegiate student athlete use of nutritional supplements and the role of athletic trainers and dietitians in nutrition counseling

A survey of university student athletes was conducted to determine supplement use, perceived efficacy of supplements, availability and use of nutrition services, and perceived nutrition knowledge of athletic trainers. Results from 236 athletes showed that 88% used one or more nutritional supplements, yet perceived efficacy was moderate (2.9 or less; 5-point scale). Classes (69.4%), brochures (75%), and individual counseling (47%) were available and were used by 29.9%, 33.2%, and 17.9% of athletes, respectively. Primary sources of nutrition information were athletic trainers (39.8%), strength and conditioning coaches (23.7%), and dietitians (14.4%). Athletes perceived athletic trainers to have strong nutrition knowledge (mean=3.8+/-0.9; 5-point scale). Many (23.5%) did not know whether a dietitian was available. Dietitians must accelerate their marketing efforts to student athletes, work closely with athletic trainers to provide sound nutrition information, and provide services that meet the needs of a diverse population of student athletes.     

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.     

Nutrition knowledge and dietary practices of college coaches

The objectives of this study were to measure nutrition knowledge of college coaches, to identify educational and demographic factors that affect nutrition knowledge of college coaches, to describe dietary practices recommended by these coaches, and to identify major sources of nutrition information used by coaches. Questionnaires were mailed to 296 coaches of senior and junior colleges in North Carolina using a listing from the National Directory of College Athletics. Coaches of the following sports were included: track and field, cross country, swimming, tennis, basketball, gymnastics, golf, football, and wrestling. The response rate was 36%. Seventy percent of the 15 nutrition knowledge test items were answered correctly; however, only one-third of the coaches indicated a high degree of certainty for the correctness of their responses. There were no significant relationships between nutrition knowledge and sex, age, collegiate conference, course work in nutrition, win/loss record, and years of coaching experience. Major dietary problems of college athletes reported by coaches were consumption of "junk food," poor eating habits, and consumption of an unbalanced diet. The authors recommend an annual workshop for coaches, trainers, and dietitians to develop criteria for nutrition assessment and body composition for college athletes and to develop training diets. Special workshops for foodservice personnel are also recommended.     

Evaluation of nutrition knowledge and dietary recommendations by coaches of adolescent Brazilian athletes

The objectives of this study were to describe the dietary practices recommended by coaches working with adolescent athletes and to assess their nutritional knowledge. During a regional competition in the state of Sao Paulo, Brazil, 55 coaches were interviewed. These coaches represented 22 cities with athletes enrolled in Olympic gymnastics, tennis, swimming, and judo events. A 3-section questionnaire was used to obtain data on demographic characteristics, dietary recommendations, and nutrition knowledge. Results showed that all coaches recommended general dietary practices during training, with no specific strategies for pre-, during-, and post-training periods. The main objectives of the recommendations for the training period were weight control and muscle mass gain. Deleterious weight control practices were recommended by 27% of the coaches. Specific dietary practices pre and post competition were recommended by 93% and 46% of the coaches, respectively. Participants responded correctly to 70% (SD = 3.2) of the nutrition knowledge questions, with no significant differences (p =.61) between sports. The knowledge test identified a tendency to over-value proteins, excessively low-fat diets, and food myths. These findings indicate the importance of developing strategies that will enhance the nutritional training of coaches.     

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.     

Nutrition training, attitudes, knowledge, recommendations, responsibility, and resource utilization of high school coaches and trainers

Because misconceptions about nutrition are prevalent in athletics, we assessed the knowledge of sports-related nutrition concepts of high school athletic personnel. A questionnaire was mailed to all athletic directors and teacher athletic trainers in North Carolina high schools. Of the 821 surveys sent, 303 were returned (a response rate of 37%). The sample was grouped into three categories on the basis of the perceived role of the respondent: coach (n = 152), trainer (n = 91), and dual coach-trainer (n = 29). Thirty-one individuals who indicated that they held administrative positions with little or no contact with students were omitted from the analysis. One-way analysis of variance or chi 2 was used to examine differences in questionnaire responses among the three groups. In comparison with high school coaches, trainers had taken more workshops or courses related to nutrition (2.9 compared with 1.8) and had more frequently used professional meetings (62% vs 39%), workshops (64% vs 41%), and textbooks (75% vs 50%) as sources of information. Trainers were more knowledgeable about nutrition (9.6 correct responses vs 8.9 for coaches) and recommended desirable nutrition practices more often than coaches (7 of 9 vs 6 of 9). There was some disagreement between coaches and trainers in their perceptions of who was more important in dispensing nutrition information. Future nutrition education efforts should take into account the differences among these groups.     

Evaluation of sports nutrition knowledge of New Zealand premier club rugby coaches

Little is known about if and how team coaches disseminate nutrition information to athletes. In a census survey, New Zealand premier rugby coaches (n = 168) completed a psychometrically validated questionnaire, received by either Internet or standard mail (response rate, 46%), identifying their nutrition advice dissemination practices to players, their level of nutrition knowledge, and the factors determining this level of knowledge. The majority of coaches provided advice to their players (83.8%). Coaches responded correctly to 55.6% of all knowledge questions. An independent t-test showed coaches who imparted nutrition advice obtained a significantly greater score, 56.8%, than those not imparting advice, 48.4% (P = 0.008). One-way ANOVA showed significant relationships between total knowledge score of all coaches and qualifications [F(1,166) = 5.28, P = 0.001], own knowledge rating [F(3,164) = 6.88, P = 0.001] and nutrition training [F(1,166) = 9.83, P = 0.002]. We conclude that these rugby coaches were inadequately prepared to impart nutrition advice to athletes and could benefit from further nutrition training.     

Doctors and nurses on wards with greater access to clinical dietitians have better focus on clinical nutrition

Background  According to the Council of Europe, clinical dietitians should assume a more central role in nutritional support. The aim of this study was to assess the opinions among doctors, nurses and clinical dietitians regarding the use of clinical dietitians' expertise in the hospital units and, further, to assess whether the presence of clinical dietitians in hospital departments influenced doctors and nurses focus on clinical nutrition.
Methods  A questionnaire about the use of clinical nutrition was mailed to 6000 doctors and 6000 nurses working in hospital units where undernutrition is documented to be common, as well as to 678 clinical dietitians working in Scandinavian hospitals.
Results  The response rate of clinical dietitians, nurses and doctors were 53%, 46% and 29%, respectively. Nurses and doctors who saw clinical dietitians often found it less difficult to identify undernourished patients and found that insight into the importance of adequate nutrition was better than those who saw clinical dietitians seldom. Clinical nutrition had a higher priority in units with frequent visits by clinical dietitians.
Conclusions  The present study shows that doctors and nurses on wards with greater access to clinical dietitians had better focus on clinical nutrition.     

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.     

Nutritional Knowledge of UK Coaches

Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC) level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163) completed a sports nutrition questionnaire to identify: (a) if they provided nutritional advice; (b) their level of sport nutrition knowledge; and (c) factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%), even though they were not competent to do so. Coaches responded correctly to 60.3 ± 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05). Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p < 0.05). In conclusion, UK sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice.     

成都市孕妇营养知识、态度及行为调查与分析

目的：了解成都市孕妇营养知识及饮食行为及其影响因素，为今后孕妇营养教育工作提供科学依据。方法：采用问卷调查法对成都329名孕妇进行调查。结果：成都市孕妇营养KAP水平较差，总合格率27．1％；营养态度普遍较好；营养行为中的主要问题是：孕妇特殊需要食物如奶类（74．5％）、蛋类（57．4％）、豆类（17．0％）、海产品（7．0％）、动物内脏（0．9％）和血（0．3％）、坚果类（15．2％）等摄入不足，主食（93．9％）、蔬菜（88．1％）水果类（80．2％）食物的摄人频率较合理；营养KAP之间有明显正相关性，孕妇的营养KAP水平与其文化程度和丈夫职业呈正相关关系；孕妇希望获得营养信息的来源主要是医护人员（79．9％）和营养师指导（43．2％）、专业书籍。结论：目前孕妇人群的营养知识和饮食行为有待改善，建议利用孕妇营养态度普遍较好的有利条件，提高医护人员的营养知识技能水平，加强孕妇及家人的营养教育，以促进母子健康。     

Nutritional knowledge, attitudes, and food patterns of women athletes

Nutritional knowledge, attitudes, and food patterns of women athletes at the University of Nebraska at Lincoln were studied. Mean test scores for nutritional knowledge were higher for questions relating to "nutrition for the athlete" than to "general nutrition." Attitudes toward nutrition were generally favorable, with a positive correlation between nutritional knowledge and attitudes. Athletes who had received some form of nutrition education had higher nutritional knowledge and attitude scores than those who had not. Respondents were especially concerned with diet as it relates to weight control; those with higher knowledge scores consistently followed food patterns for weight-control diets similar to those used in training and pre-event diets.     

广州市孕妇营养知识、态度及饮食行为调查

[目的]了解广州市孕妇的营养知识、态度与饮食行为现况及其影响因素,为今后孕妇营养教育工作提供科学依据。[方法]采用问卷调查方法对广州市两所医院的169名孕妇进行调查。[结果]广州市孕妇对营养知识缺乏全面深入的了解,营养态度普遍较好。90%以上的孕妇每天都摄入粮谷类、蔬菜、水果;一半以上的孕妇每天都摄入奶及制品、蛋类、禽畜肉类;对豆及制品、鱼贝类的摄取一个月大于20d的孕妇亦超过一半;对菌藻、坚果类食物的摄取频率则较低,一个月超过20d的仅占19.1%和18.0%,几乎不吃的人数分别占17.9%和18.6%。营养KAP之间有明显正相关性,孕妇的营养KAP水平与其文化程度和丈夫职业呈正相关关系,孕妇希望获得营养信息的来源主要是医护人员和营养师指导（53.6%）。[结论]目前孕妇人群的营养知识和饮食行为有待改善,建议利用孕妇营养态度普遍较好的有利条件,提高医护人员的营养知识技能水平,在利用公共传媒的基础上加强有医务人员参与的咨询和讲座的力度,营养教育的内容重点在大力宣讲食物的营养价值及推荐合理的膳食结构,通过加强孕妇及家人的营养教育促进母子健康。     

A report of vitamin and mineral supplement use among university athletes in a division I institution

The influences of gender, ethnicity, and sport of varsity athletes on their vitamin/mineral supplementation habits were examined. Subjects included 145 females and 266 males from 22 varsity teams; 80% were Caucasian; 12% African American; and 8% Combined-Other. Over half of the subjects took supplements. Males were more likely than females to give "too expensive" as a reason for not taking supplements, and "improve athletic performance" and "build muscle" as reasons for taking supplements. The most common supplement was multivitamins plus minerals. Females were more likely to take calcium and iron, and males vitamins B12 and A. African Americans were the most likely to take vitamin A. Males were more likely to get supplement information from nutritionists/dietitians and self, and females from family members or friends and physicians or pharmacists. Football players were more likely to get supplement information from nutritionists/dietitians, and males in other sports from coaches/trainers. There were some differences in vitamin/mineral supplement habits of the athletes by gender, ethnicity, and sport.     

Nutrition knowledge and selected nutritional practices of female recreational athletes

Female marathon runners and fitness-class participants took part in a study designed to assess the nutrition knowledge of these two groups of recreational athletes. I also evaluated selected nutritional practices and examined relationships between nutrition knowledge and several demographic and lifestyle variables, including physical activity. I mailed validated, pretested instruments to all female finishers of a recent marathon (n = 173) and to a 10% random sample of female members of a fitness club (n = 190). The average return rate was 64%. The distribution of the two groups by age and education was similar. Most respondents used vitamin/mineral supplements, and supplement use was significantly greater among semivegetarians than among those consuming meat. Runners scored significantly higher on the nutrition knowledge test than did fitness-class participants, a difference that was primarily due to runners' higher scores on questions related to nutrition and activity. I found significant, positive relationships between nutrition knowledge and years of education, the total number of sources of nutrition information, and the level of physical activity. In contrast, the total number of supplements used correlated negatively with scores on questions related to nutrition and physical activity.     

Case study: nutrition challenges of a marathon runner with a gastric bypass

A new type of athlete is appearing in the offices of sports dietitians: formerly obese people who have undergone gastric bypass surgery and now aspire to be marathoners, triathletes, and other types of endurance athletes. The standard nutrition advice offered to bypass patients is contrary to the standard sports advice given to athletes. Bypass athletes need to limit carbohydrates, fluids, and energy intake and consume a protein-based diet. This case study describes the sport nutrition concerns of a woman who, after having gastric bypass surgery, trained to run a marathon (42 km). Because of her limited ability to consume food and fluids, she experienced difficulty preventing fatigue and dehydration during her long training runs and the marathon itself. She learned through trial and error how to survive the nutritional challenges and complete the marathon. Health professionals need to be aware of the potential medical risks associated with endurance exercise in gastric bypass patients. Research is needed to determine the best sports nutrition practices for bypass patients. Only then can sport dietitians better educate this small but growing contingent of endurance athletes so the athletes can meet their training and performance goals and reduce their risk of experiencing serious health consequences.     

Parenteral nutrition. Do dietitians have a role? Results of the Parenteral and Enteral Nutrition Group survey

Aim: To examine the role of the nutrition support dietitian in parenteral nutrition (PN).
Methods: Two postal surveys were sent to members of the Parenteral and Enteral Nutrition Group (PENG) in 1993 and 1995. The questionnaires were designed to examine four key areas of dietetic practice in PN.
Results: Response rates of 73% in 1993 and 75% in 1995 were achieved. In 1993, a minority of dietitians, only 5%, assumed total responsibility for the formulation of parenteral nutrition regimens. In 1995 this figure had risen to 14%. However, 83% of nutrition support dietitians wanted to increase their involvement in PN. Results from the 1995 survey showed that 42% of dietitians felt that education at undergraduate level was inadequate, whilst 58% felt education at postgraduate level could be improved.
Conclusion: Both surveys raised a number of issues concerning present prescribing practices of PN in the UK. There appears to be little practical clinical nutrition education concerning PN either in the medical, dietetic or pharmaceutical curriculum. This may indicate that present prescribing practices are suboptimal. Because dietitians are involved in nutritional assessment and calculation of nutritional requirements it would seem sensible that dietitians should have a greater prescribing role in PN. In order to become competent advisors in this area, more must be done to improve education for dietitians at the undergraduate and postgraduate levels, otherwise the opportunity to be actively involved in this area may be lost.