The Role of Diets and Dietitians for Para-Athletes: A Pilot Study Based on Interviews

Efforts to provide nutrition support to para-athletes have not been established to date, and are far behind those established for athletes without disabilities. In the present study, we attempted to clarify the actual situation regarding dietary challenges of para-athletes. The aim of this study was to obtain clues to effective intervention methods that encourage the practice of sports nutrition. Six active elite para-athletes (30–70 years, four males) and a female physical therapist without physical disability participated in semi-structured interviews. All para-athletes had lower-limb disabilities and participated in the international wheelchair sports competitions (tennis, softball, and table tennis, with 2–26 years of player history). The interview items were on the ideal diet for improving competitive performance, evaluation of their typical diets, and the role of the dietitian as support. Responses obtained from participants were analyzed using quantitative content analysis by language analysis software. There are differences in the ideal diet based on the characteristics of the sport, but most participants believed that a nutritionally well-balanced diet with abundant vegetables was ideal for improving competitive performance. Para-athletes who use a wheelchair daily pay attention to their total calorie intake, because gaining weight is a critical issue for operating their wheelchairs and transferring themselves to and from their wheelchairs. Despite their world-class competition levels, none of them received routine dietary advice from dietitians. Some para-athletes did not even feel the need to engage with dietitians. Even for these para-athletes at a high level of competition, the “ideal diet” they considered was not always the optimal diet for improving their competitive performance. In addition, there are various barriers to practicing their optimal diet due to disability characteristics. Dietitians need to understand these barriers, their concerns and conflicts, and how to help them plan the optimal diet to improve their performance and maintain overall health.     

Sports Nutrition and Food Knowledge among Malaysian University Athletes

Sports nutrition and food knowledge can influence athletes’ dietary intake, potentially affecting athletic performance. Limited studies have been conducted to identify sports nutrition and food knowledge among Malaysian university athletes. This study aimed to determine Malaysian university athletes’ knowledge of sports nutrition and food, and their reference sources and preferred sports nutrition education programme. Seventy athletes (52.9% females, mean weight = 61.8 kg; height = 1.66 m) aged 18.5–22.4 years responded to an online survey administered using a Google Form. A score of ≥60% was considered as adequate knowledge. The average overall knowledge score was 58.6%. The highest knowledge score was for sports nutrition, specifically food intake periodicity (84.8%), while the lowest was for general food knowledge on fat (44.6%). An analysis of specific questions revealed a lack of understanding about the recommended daily intake of fruits and vegetables (only 14.3% answered correctly), the roles of vitamins and minerals in energy production (21.4%), and good sources of unsaturated fat (37.2%). The academician was the primary reference source (81%), while magazines were the least referred to sources (36%). The university athletes preferred sports camps (33%) over the other nutrition education programme options. More initiatives are needed to improve Malaysian university athletes’ understanding and knowledge of sports nutrition and general food.     

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.     

新疆沙湾县哈萨克族居民营养健康状况调查

目的 了解新疆哈萨克族居民膳食营养与健康状况,为制定营养改善策略提供科学依据。方法 采用3 d 24 h膳食回顾法和称重法,对新疆沙湾地区牛圈子牧场1 628名≥18岁常住哈萨克族居民进行膳食调查和医学体检。结果 哈萨克族居民膳食构成以粮谷类为主,食盐摄入过多,蔬菜水果摄入不足,豆类、蛋类和鱼虾类等食物基本不吃;能量的日均摄入量为11 762.5 kJ,蛋白质为103.8 g,占供能的14.2%;脂肪为50.3 g,占供能的16.2%;碳水化合物为485.0 g,占供能的69%;膳食纤维和微量营养素低于参考摄入量;动物性食物提供的蛋白质占33.5%,提供的脂肪占54.2%;高血压患病率为39.7%,超重为26.2%,肥胖为27.7%。结论 膳食结构不合理、能量过剩、微量元素不足、高血压、超重和肥胖已成为影响哈萨克族居民健康的重要因素,应加强对居民的营养干预和健康教育,预防相关疾病的发生。     

Nutrition Support Team Oversight and Appropriateness of Parenteral Nutrition in Hospitalized Adults: A Systematic Review

Inappropriate parenteral nutrition (PN) administration often occurs in hospitalized patients, increasing the risk of complications. Nutrition support teams (NSTs) regulate and approve PN use in some hospitals. This systematic review examined whether appropriateness of PN use in hospitalized adult patients increased under NST oversight. Ten databases were searched systematically to select studies from 2004 to 2020 that analyzed appropriateness of PN use in adult hospitalized patients under NST oversight. Studies were included if appropriateness of PN was examined and NSTs were involved in PN orders or recommendations. Studies were evaluated using the Quality Criteria Checklist from the Academy of Nutrition and Dietetics Evidence Analysis Library. Nine studies were included in the final analysis. One received a positive rating on the quality checklist, whereas 8 received a neutral rating. Inappropriate PN use varied from 4.3% to 18%. Two studies compared PN use between multiple hospitals, both with and without NSTs. Two compared appropriateness before and after NST implementation, whereas another 2 studies compared it before and after NST restructuring. Three studies examined appropriateness of PN with NST oversight at a single facility with no control group. Overall, NSTs were associated with decreased incidence of inappropriate PN use. No studies were randomized, and several did not describe demographics between groups. Although NSTs appear to decrease inappropriate PN use, the results are limited because of study design or reporting. Future studies should monitor and evaluate clinical outcomes, such as mortality, and utilize more rigorous methodologies.     

Nutrition Knowledge of Caregivers Influences Feeding Practices and Nutritional Status of Children 2 to 5 Years Old in Sekhukhune District,South Africa

BackgroundThe aim of this study was to determine caregivers'' nutrition knowledge and its influence on feeding practices and nutritional status on young children.MethodsA cross-sectional survey was conducted in 120 caregiver-child pairs. A validated questionnaire was used to collect caregivers'' nutrition knowledge and feeding practices. Nutritional status was estimated using anthropometric measurements. Z-scores were computed using WHO Antro software. Chi-square test was used to determine the association between caregivers'' nutrition knowledge and feeding practices. Significance was set at p <0.05.ResultsForty three percent of caregivers reported health professionals as their source of nutrition information. Almost all children (94.2%) were breastfed at one stage in their lives, with 62.5% introduced to solid foods before six months. Maize meal porridge (87.5%) and bread (54.2%) were consumed daily by most of the children, while 48.3% consumed meat and meat products three to four times per week. One in eight children consumed fruits daily and 5.8% vegetables daily. Forty one percent of children were stunted. Family income showed positive correlation with the nutritional status of children (weight-for-age R = 0.207, p < .05; height-for-age R°=°0.203*, p°= .026). An association was observed between the duration of breastfeeding and alternative food, to milk (R = 0.302**, p = .001), amount of fruit consumed daily (R = 0.197*, p = .031) and number of meals consumed daily (R = 0.284**, p = .048). Conclusion: Nutrition knowledge and feeding practices of the caregivers were not satisfactory.     

Energy-Adjusted Dietary Intakes Are Associated with Perceived Barriers to Healthy Eating but Not Food Insecurity or Sports Nutrition Knowledge in a Pilot Study of ROTC Cadets

Military service is inherently demanding and, due to the nature of these demands, the term “tactical athlete” has been coined to capture the physical requirements of the profession. Reserve Officers’ Training Corps (ROTC) cadets are a unique subset of the military service community, and the complexity of their training and educational pursuits increases their susceptibility to unhealthy eating patterns. The purpose of this pilot study was to explore the relationship between the perceived barriers to healthy eating, food insecurity, sports nutrition knowledge, and dietary patterns among Army ROTC cadets. The usual dietary intake was gathered from (N = 37) cadets using the General Nutrition Assessment Food Frequency Questionnaire. The perceived barriers to healthy eating were measured using a set of scales consisting of social barriers (6 items, α = 0.86), access barriers (2 items, α = 0.95), and personal barriers (2 items, α = 0.67), with higher-scale scores indicating greater perceived barriers. Spearman correlation coefficients were used to measure the association between the energy-adjusted dietary intakes and the scores on the barriers scales. Energy-adjusted intakes of calcium (ρ = −0.47, p ≤ 0.01), fiber (ρ = −0.35, p = 0.03), vitamin A (ρ = −0.46, p ≤ 0.01), vitamin C (ρ = −0.43, p ≤ 0.01), fruit (ρ = −0.34, p = 0.04), and vegetables (ρ = −0.50, p ≤ 0.01) were negatively correlated with the perceived personal barrier scores. The energy-adjusted intakes of fiber (ρ = −0.36, p = 0.03), vitamin C (ρ = −0.37, p = 0.03), and vitamin E (ρ = −0.45, p ≤.01) were negatively correlated with perceived social barriers, while energy-adjusted vitamin C intake was negatively correlated with perceived access barriers (ρ = −0.40, p = 0.01). Although additional research is needed to better understand the dietary patterns of ROTC cadets, among the participants in this study, greater perceived personal, social, and access barriers were associated with less nutrient-dense eating patterns. Interventions aimed at addressing such barriers may prove beneficial for the improvement of diet quality among ROTC cadets.     

Consumer Knowledge and Attitudes Toward Nutritional Labels

ObjectiveTo determine Mauritian consumers' attitudes toward nutritional labels based on the Kano model and to identify determinants of the use and understanding of nutrition labels.DesignThe researchers also used a Kano model questionnaire to determine consumers' attitudes toward nutrition labeling.SettingFour hundred consumers residing in Mauritius.ParticipantsInformation was elicited via a questionnaire that assessed nutritional knowledge and information about the use and understanding of nutritional labels and demographic factors.Main Outcome MeasuresNutritional label use and understanding, nutrition knowledge, and association of demographic factors with label use.AnalysisStatistical tests performed included 1-way ANOVA and independent samples t tests.ResultsStatistically significant relationships (P < .05) were found for nutritional knowledge and nutritional label usage with demographic factors. All demographic factors with the exception of gender were significantly associated (P < .05) with nutritional label understanding. Based on the outcome of the Kano survey, calorie content, trans fat content, protein content, and cholesterol content were found to be must-be attributes: that is, attributes that, when not present, result in consumer dissatisfaction.Conclusions and ImplicationsAge, education, income, household size, and nutrition knowledge had an impact on nutritional label use. Health promoters should aim to increase the use of nutritional labels.     

Trends in Eating Habits and Body Weight Status,Perception Patterns and Management Practices among First-Year Students of Kaunas (Lithuania) Universities, 2000–2017

Students’ transition from high school to university is accompanied by lifestyle changes. This study aimed to assess trends in students’ body weight status, perception, management practices and eating habits from 2000 to 2017. Three cross-sectional surveys were carried out among the first-year students of five Kaunas (Lithuania) universities in 2000, 2010 and 2017. The self-administered questionnaires were filled in during lectures. Altogether, 3275 students aged 20.0 (1.5) years participated in the survey. The prevalence of self-reported overweight increased among male students from 11.3% in 2000 to 24.3% in 2017 and female students from 5.2 to 9.6%. The intake frequency of fruits, vegetables and cereals increased, and red meat decreased. At a normal BMI, more female than male students perceived themselves as being ‘too fat’ (19.4% and 8.8% in 2017), while more male than female students perceived themselves as being ‘too thin’ (37.2% and 4.5% in 2017). More females than males were dissatisfied with their weight, worried about gaining weight and tried to lose weight. Weight-management practices were associated with body weight, self-perception, dissatisfaction, worries about weight gain and eating behaviours. Our study highlights the need for interventions to increase the accuracy of weight perception and to promote the appropriate weight-management methods, addressing gender differences.     

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

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

The Relationship between Restrained Eating,Body Image,and Dietary Intake among University Students in China: A Cross-Sectional Study

This study aims to explore the association between restrained eating, body image, and dietary intake among Chinese college students. This cross-sectional study included 1301 college students at two universities in Hunan Province. Electronic questionnaires were used to collect information including students’ demographic characteristics, restrained eating, perception of body weight, body satisfaction, and dietary intake. Anthropometric measurements were collected to calculate body mass index (BMI). The prevalence of high restrained eating was 52.8%. Students who were dissatisfied with their bodies or overestimated their body weight showed a higher tendency toward high restrained eating (p < 0.05). Students with high restrained eating tended to eat fruits and eggs more frequently, while the frequency of eating domestic animals and poultry, sugar-sweetened beverages, and fast food were the opposite. Moreover, high restrained eating was a risk factor for low dietary diversity (odds ratio (OR) = 1.384, 95% confidence interval: 1.002~1.912). The high incidence of restrained eating among Chinese college students and its energy-restricted diets that may lead to possible health implications require attention. Further studies are needed to investigate the characteristics of college students’ restrained eating to tailor appropriate interventions for forming positive body images and promoting healthy eating behaviors, thus, improving dietary quality.     

贵阳市云岩区2010年居民营养与健康状况调查

目的了解贵州省贵阳市云岩区居民营养与健康状况,为制定健康促进策略提供依据。方法采取多阶段分层整群随机抽样方法,抽取云岩区6个社区(村)455户1 456人进行询问、膳食调查、医学体检和实验室检测。结果当地居民粮谷薯类食物消费量充足,为283 g;新鲜水果、鱼虾类、奶及其制品偏低,为34、4、51 g;畜禽肉类和食用油则偏高,为108 和44 g;当地居民每标准人日各种膳食营养素摄入量均低于2002年全国摄入量水平,其中视黄醇当量320.5 μgRE、钙352.7 mg,仅为中国居民膳食营养素参考摄入量(DRIs)推荐标准(RNI,AI)的40%、44%;谷类食物占食物来源45.9%,豆类及动物性食物占蛋白质来源的47.5%,动物性食物占脂类食物47.4%;≥18岁居民的营养不良率、超重率、肥胖率、高血压患病率、糖尿病患病率、高胆固醇血症和高甘油三酯血症患病率分别为4.6%、33.4%、11.8%、17.5%、6.4%、12.4%和29.6%。结论云岩区居民已摄入足够的食物,改善居民的膳食模式应以调整不平衡膳食结构为主,慢性病将成为当地居民面临的重要公共卫生问题。     

Benefits of Adding an Aquatic Resistance Interval Training to a Nutritional Education on Body Composition,Body Image Perception and Adherence to the Mediterranean Diet in Older Women

The human population is increasing due to lengthening life expectancy, but the quality of life and health of people is moving in the opposite direction. The purpose of this study is to evaluate how aquatic resistance interval training can influence body composition, body image perception and adherence to the Mediterranean diet (MD) in older women participants in a nutrition education program and to study the relation between these variables. Thirty-four participants aged 69 ± 4 years were randomly assigned into two groups: experimental (aquatic resistance interval training plus nutritional intervention) and control (nutritional intervention). The intervention consisted of resistance training in an aquatic environment carried out for 14 weeks (three sessions per week; 60 min each). Body composition, body image perception and adherence to MD diet were evaluated at baseline and 14 weeks. No significant differences were found between groups regarding body image perception and adherence to the MD. There was a significant increase in muscle mass (kg) (p < 0.001) and a significant decrease in fat mass (kg) (p < 0.001) in the intervention group when compared to the control group. The addition of aquatic resistance interval training to a nutritional intervention was not sufficient to change body image perception and adherence to MD but produced improvement in body composition (through an increase in muscle mass and decrease on fat mass) in older women.     

Impact of an Expansion of a Clinical Nutrition Curriculum on Pre-Clerkship Medical Students’ Perception of Their Knowledge and Skills Related to Performing a Nutritional Assessment

Learning how to provide nutritional counseling to patients should start early in undergraduate medical education to improve the knowledge, comfort, and confidence of physicians. Two nutrition workshops were developed for first-year medical students. The first workshop, co-led by physicians and registered dieticians, focused on obtaining nutrition assessments. The second workshop focused on the appropriate dietary counseling of patients with chronic kidney disease and cardiovascular risk. We surveyed students before workshop 1, after workshop 1, and after workshop 2 to assess their perceptions of the value of physician nutrition knowledge and counseling skills as well as their own comfort in the area of nutritional knowledge, assessment, and counseling. We found a significant improvement in their self-assessed level of knowledge regarding counseling patients, in their comfort in completing a nutritional assessment, and in their confidence in advising a patient about nutrition by the end of the first workshop. By the time of the second workshop five months later, students continued to report a high level of knowledge, comfort, and confidence. The implementation of clinical nutrition workshops with a focus on assessment, management, and counseling was found to be effective in increasing student’s self-assessed level of knowledge as well as their confidence and comfort in advising patients on nutrition. Our findings further support the previous assertion that clinical nutrition education can be successfully integrated into the pre-clerkship medical school curriculum.     

Knowledge and Practices of Digestive Surgeons concerning Specialized Nutritional Support in Cancer Patients: A Survey Study

A survey study based on a 21-item questionnaire was conducted to assess knowledge and practices of digestive surgeons focused on nutritional support in gastrointestinal cancer patients. At least 5 staff digestive surgeons from 25 tertiary care hospitals throughout Spain were invited to participate and 116 accepted. Malnutrition was correctly defined by 81.9% of participants. In patients undergoing major abdominal surgery, 55.2% considered that preoperative nutritional support is indicated in all patients with malnutrition for a period of 7–14 days. For the diagnosis of malnutrition, only 18.1% of participants selected unintentional weight loss together with a fasting or semi-fasting period of more than one week. Regarding the advantages of enteral infusion, 93.7% of participants considered preservation of the integrity of the intestinal mucosa and barrier function, and in relation to peripheral parenteral nutrition, 86.2% selected the definition of nutrient infusion through a peripheral vein and 81.9% its indication for less than 7 days. Digestive surgeons had a limited knowledge of basic aspects of clinical nutrition in cancer patients, but there was some variability regarding clinical practice in individual cases. These findings indicate the need to develop standardized clinical protocols as well as a national consensus on nutrition support in cancer patients.     

Impact of Community-Based Nutrition Education on Geophagic Behavior and Dietary Knowledge and Practices among Rural Women in Nakuru Town,Kenya: A Pilot Study

Objective

Geophagia, the deliberate consumption of rocks, soil, or clay, is prevalent in developing countries, particularly sub-Saharan Africa. Health risks associated with this behavior include parasitosis, heavy metal poisoning, nutrient deficiencies, and poor birth outcomes. This pilot study was designed to reduce geophagic practices and improve nutrition among rural Kenyan women.

1992年至2007年上海市黄浦区居民膳食营养状况变化趋势

[目的]了解黄浦区居民近15年的膳食营养状况变化趋势。[方法]采用多阶段整群抽样方法,于2007[年9月至11月抽取上海市黄浦区372名居民进行调查,采用连续3天24小时膳食回顾法进行膳食调查,用称重法调查家庭调味品消费量。并与1992年、2002年和2005年的营养调查资料进行比较。[结果]蛋白质的每日摄入量为92.9g,较1992年上升10.5g。能量的每日摄入量为9167.1kJ,较1992年降低1351.5kJ。85.8%的居民蛋白质每日摄入量≥推荐摄入量（RNI）的80%;70.7%的居民能量每日摄入量≥RNI的80%。79.8%的居民胆固醇每日摄入量超过300mg;90.9%的居民膳食纤维每日摄入量不到25g。脂肪供能比为35.1%,较1992年提高4.9%。70.7%居民的视黄醇、66.2%居民的硫胺素、76.0%居民的核黄素及70.4%居民的抗坏血酸的每日摄入量均未达到RNI。钙的每日摄入量为639.2mg,较1992年上升92.9mg;但仅24.9%的居民钙摄入量达到适宜摄入量（AI）。84.1%居民的铁摄入量达到AI;70.2%居民的硒摄入量达到RNI,均较1992年上升。[结论]与1992年相比,基本营养素摄入状况明显改善,但仍然存在营养素缺乏或过剩问题,有必要加强科学化引导和管理。     

Education Interventions to Improve Knowledge,Beliefs, Intentions and Practices with Respect to Dietary Supplements and Doping Substances: A Narrative Review

The misuse of dietary supplements and doping substances is commonly associated with toxicity, nutritional imbalances, and health and psychological consequences. This is alarming especially in light of the increasing prevalence of the use of dietary supplements and doping, particularly among young adults including athletes. There is evidence that education interventions can lead to improved knowledge, intentions, and practices. However, no review has summarized and evaluated the effectiveness of such interventions. The aim of this article is to review the characteristics, contents and effects of education interventions that were designed and implemented to improve knowledge, attitudes, beliefs and intentions with respect to the use of dietary supplements and doping agents in different populations. PubMed, Scopus, CINAHL, PsycInfo and Google Scholar were searched for English-language education interventions targeting dietary supplements and doping substances. A total of 20 articles were identified and have generally provided consistent findings. Most interventions reported a significant improvement in knowledge on dietary supplements and doping agents. Unfortunately, the heavy reliance on self-reported assessment tools limits the validity of these interventions, with almost all articles targeting athletes and adolescents.