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

Aim To evaluate the information sources that are used and preferred by Australian athletes and to assess if preferences influence nutrition knowledge (NK). Methods Elite and non-elite Australian team sport athletes, playing Australian football (AF), cricket, lawn bowls, soccer or hockey, were recruited via the sporting organisations' qualified sports dietitians or club presidents. Athletes completed one of two online, validated sports NK questionnaires. Frequency analysis on previous sources of advice, preferred sources of information and preferred type of support were assessed. Differences in NK scores (%) based on previous sources of dietary advice and preferences for obtaining information were assessed using t test or Mann-Whitney U test. Results Demographic and information source questions were completed by 410 athletes; 331 also completed NK questions. Athletes were mostly non-elite (76%) and AF players (79%). Forty-four per cent of athletes reported having previously received advice from a dietitian. Twenty per cent, 19% and 16% of athletes chose “dietitian,” “internet” and “nutritionist” as their preferred source of nutrition information, respectively. Athletes preferred information on sports nutrition (35%), individual consultations (33%), and information on general healthy eating (33%), over cooking classes (4%) and group presentations (3%). There were no significant associations between preferred and previous information sources and NK scores. Conclusions Australian athletes prefer dietitians, the internet and nutritionists for sports nutrition information. There is an interest in and need for access to a qualified sports dietitian and reputable internet-based nutrition information. Education programs and advice given to athletes need to be evaluated

A systematic review of athletes' and coaches' nutrition knowledge and reflections on the quality of current nutrition knowledge measures

Nutrition knowledge can influence dietary choices and impact on athletic performance. Valid and reliable measures are needed to assess the nutrition knowledge of athletes and coaches. Objectives: (1) To systematically review the published literature on nutrition knowledge of adult athletes and coaches and (2) to assess the quality of measures used to assess nutrition knowledge. Data Sources: MEDLINE, CINAHL, SPORTDiscuss, Web of Science, and SCOPUS. Study Selection: 36 studies that provided a quantitative measure of nutrition knowledge and described the measurement tool that was used were included. Data extraction: Participant description, questionnaire description, results (mean correct and responses to individual items), study quality, and questionnaire quality. Data synthesis: All studies were of neutral quality. Tools used to measure knowledge did not consider health literacy, were outdated with regards to consensus recommendations, and lacked appropriate and adequate validation. The current status of nutrition knowledge in athletes and coaches is difficult to ascertain. Gaps in knowledge also remain unclear, but it is likely that energy density, the need for supplementation, and the role of protein are frequently misunderstood. Conclusions: Previous reports of nutrition knowledge need to be interpreted with caution. A new, universal, up-to-date, validated measure of general and sports nutrition knowledge is required to allow for assessment of nutrition knowledge

A systematic review update of athletes' nutrition knowledge and association with dietary intake

Athletes’ dietary intakes sometimes do not meet sports nutrition guidelines. Nutrition knowledge (NK) is one factor that may influence dietary intake, but NK measurement tools are often outdated or unvalidated, and results regarding athletes’ NK are equivocal. The aims of this systematic review were to update previous systematic reviews by examining athletes’ NK and to assess the relationship between athletes’ general NK, sport NK and dietary intake. MEDLINE, CINAHL, Scopus, SPORTDiscus, Web of Science and Cochrane were searched for studies published between November 2015 and November 2020 that provided a quantitative measure of NK and described the NK tool used. Twenty-eight studies were included, study quality was assessed using JBI checklists and data on NK score and diet intake was extracted. Eight studies utilised validated, up-to-date NK measurement tools. Mean general and sport NK% scores varied between 40·2% ± 12·4 and 70 % ± 9. Mean protein and carbohydrate consumption was 1·1–3·4 g/kg.bw/d and 2·4–4·6 g/kg.bw/d, respectively. Weak-to-moderate, positive associations were found between NK and positive dietary behaviours. Due to a wide variety of NK measurement tools used, it is difficult to synthesise results to determine overall NK in athletes. Overall, there appears to be a low standard of knowledge. Quality of measurement tools for NK has improved but remains an issue. Future studies should use relevant, current validated NK tools or validate tools in their study population. More research is needed into the relationship between NK and other modifiable factors influencing dietary intake

Australian football athletes lack awareness of current sport nutrition guidelines

Sports nutrition is an evolving field, but there is a lack of data on Australian athletes’ knowledge of current sports nutrition guidelines. Additionally, several tools used to assess nutrition knowledge (NK) have not undergone adequate validation. The purpose of this study was to assess and compare the sports NK of elite and nonelite Australian football (AF) athletes using a newly validated questionnaire—The Nutrition for Sport Knowledge Questionnaire. Elite AF players (n = 46) were recruited directly from their club dietitian and nonelite AF players (n = 53) were invited to participate via e-mail from their club president or secretary. The mean NK score of elite and nonelite AF players was 46 ± 16% and 51 ± 11%, respectively (p = .041). In both groups, knowledge of macronutrients, weight management, and alcohol was better than knowledge of supplements, micronutrients, and sports nutrition. Nonelite athletes achieved statistically significantly higher scores on the questionnaire subsections testing weight management (elite: 48 ± 18; nonelite: 57 ± 19, p = .019), micronutrients (elite: 39 ± 19; nonelite: 50 ± 16, p = .004), and alcohol (elite: 52 ± 13; nonelite: 71 ± 17, p = .002). While overall NK of Australian athletes was poor, scores varied greatly among individuals (range: 10–70%) and across the six subsections (topics) being assessed. Professionals working with athletes should undertake an assessment of the athletes’ NK so that they can provide targeted education programs

Attitudes and Opinions of Parents towards Water-Only Drink Policy at Junior Triathlon Events

Rates of childhood obesity within Australia continue to rise, with consumption of sugar-sweetened beverages one contributing factor. Community sport provides an opportunity to implement policies promoting water as the beverage of choice. However, the attitudes of parents toward a water-only policy are not known. This cross-sectional study aimed to investigate parents’ opinions towards beverage consumption and a water-only policy. Data were collected from participants (n = 159) using an investigator-designed questionnaire, administered using iPads, at a junior Triathlon Victoria event. Water was the most popular beverage provided before (75%), during (85%) and after (61%) sport. Parents were more likely to provide sports drinks to children older than 14 years (27%). Three-quarters (77%) of parents reported having received no information regarding hydration requirements. Parents rated the importance of hydration prior to, during and after a triathlon as high (9.08 ± 1.2, 8.76 ± 1.3 and 9.30 ± 0.4 out of 10, respectively). Parents were supportive of a water-only policy at all junior triathlon events and all junior sporting events (7.94 ± 1.3 and 7.86 ± 1.9, respectively). There was less support for a water-only policy for adult triathlons (6.40 ± 3.1). A water-only drink policy at junior sport is viewed positively by parents. This warrants further research and policy development to facilitate behaviour change

Development and validation of surveys to estimate food additive intake

Background: The Food Agricultural Organization/World Health Organization (FAO/WHO) International Food Standards Codex Alimentarius CXS 192e International Food Standards (hereafter, CODEX) declares additives non-toxic, but they have been associated with changes to the microbiota changes and thinning of the mucus layer of the gut. Their widespread use has occurred in parallel with increased inflammatory bowel disease (IBD) incidence. This paper reports on the development and validation of surveys to estimate additive intake. Methods: Dietitians created a food-additive database, with a focus on additives that have been associated with IBD. For each additive, information on the CODEX food-category they are permitted in and the associated maximum permissible levels (mg/kg) was recorded. Based on the database, questions to assess early life (part 1) and recent (part 2) additive intake were written. Forward-backward translation from English to Chinese was undertaken. Thirty-one individuals were evaluated to assess understandability. A further fifty-seven individuals completed the tool on two occasions, a fortnight apart; agreement was assessed using Cohen's kappa coefficient or the intra-class correlation coefficient (ICC). Results: The participants reported that it was difficult to remember food intake and estimate portion sizes. The participants also noted confusion around the term 'home-grown'. Instructions and definitions were added; after this, respondents judged the questionnaires as clear. The average kappa coefficient for part 1 and part 2 questions were 0.61 and 0.67, respectively. The average ICC ranged from 0.30 to 0.94; three food lists were removed due to low reliability. Conclusions: Two tools have been created and validated, in two languages, that reliably assess remote and recent food additive intake

Nutritional Knowledge and Eating Habits of the national Brazilian futsal team

Introduction: Futsal is a sport that requires nutritional support to support the high-energy expenditure and significant loss of fluids and electrolytes during training and matches. It is important that high-level athletes follow appropriate, evidence-based nutrition. To our knowledge, there is a lack of data on the eating habits and nutrition knowledge of Futsal players. Therefore, this study aims to describe the nutritional knowledge and eating habits of players of the national Brazilian Futsal Team. A secondary aim was to translate the Abridged Nutrition for Sport Questionnaire into Portuguese for use in Portuguese-speaking athletes. Material and methods: This is a cross-sectional and descriptive study. The evaluations were carried out during the preparation period of the Brazilian Futsal Team for the FIFA Futsal World Cup 2020 qualifiers. We evaluated anthropometry (weight, height, body mass index) nutritional knowledge (assessed using a translated version of the Abridged Nutrition for Sport Knowledge Questionnaire) and eating habits (assessed using a validated Brazilian FFQ), as well as supplement use. The translation of the ANSKQ was undertaken using previous validated forward-backward translation procedures. Results: The mean total correct score on the ANSKQ was 12 out of a possible 35 (34.45%). The mean total correct score on the ANSKQ was 12 out of a possible 35 (34.45%). Players had a statistically significantly higher score for “General Nutrition” knowledge than Sports Nutrition Knowledge (47.27% vs 28.53%, p<0.005). Futsal players had infrequent consumption of the food group "Milk and dairy products", and frequent consumption of "Snacks" as well as fruits. Regarding dietary supplements, 46% of athletes said they consume, or previously consumed, with WheyProtein being the most common supplement. Conclusions: There is room from improvement in athletes nutrition knowledge, especially sports specific knowledge. Futsal players may also require education on appropriate supplement use and dietary intake.Introducción: El fútbol sala es un deporte que requiere un apoyo nutricional para soportar el alto gasto energético y pérdida significativa de líquidos y electrolitos durante los entrenamientos y partidos. Por tanto, este estudio tiene como objetivo describir el conocimiento nutricional y los hábitos alimenticios de los jugadores de la Selección Brasileña de Fútbol Sala. Un objetivo secundario fue traducir el Cuestionario abreviado de conocimiento sobre Nutrición para el deporte (ANSKQ) para su uso en atletas que hablan portugués. Material y métodos: Se trata de un estudio descriptivo y transversal. Las evaluaciones ocurrieron durante el período de preparación de la Selección Brasileña de Fútbol Sala para las eliminatorias del Mundial de Fútbol Sala FIFA 2020. Evaluamos la antropometría (peso, altura, índice de masa corporal), el conocimiento nutricional (versión traducida del ANSKQ) y los hábitos alimentarios (FFQ brasileño validado), así como el uso de suplementos. La traducción del ANSKQ se llevó a cabo utilizando procedimientos de traducción previamente validados. Resultados: La puntuación media de aciertos en el ANSKQ fue de 12 (de 35) (34.45%). Los jugadores obtuvieron una puntuación estadísticamente significativa más alta en el conocimiento de “Nutrición general” que en el Conocimiento de nutrición deportiva (47,27% frente a 28,53%, p <0,005). Los jugadores de fútbol sala tenían un consumo poco frecuente del grupo "Leche y productos lácteos", y un consumo frecuente de "Snacks" y frutas. A respecto de los suplementos alimenticios, el 46% de los deportistas afirmaron consumir, o haber consumido, siendo la proteína de suero el suplemento más habitual. Conclusiones: Hay margen de mejora en el conocimiento nutricional de los atletas, especialmente en los conocimientos específicos de nutrición deportiva. Los jugadores de fútbol sala también pueden requerir orientación sobre el uso apropiado de suplementos y la ingesta dietética

Reply to V Gianfredi et al

Dear Editor: We thank Gianfredi et al. for their generous comments regarding the methodology used in our recent umbrella review and welcome their clear discussion of common queries regarding the scope and methods of umbrella reviews..

Practical application of the Crohn's disease exclusion diet as therapy in an adult Australian population

There is demand from patients and clinicians to use the Crohn's disease exclusion diet (CDED) with or without partial enteral nutrition (PEN). However, the therapeutic efficacy and nutritional adequacy of this therapy are rudimentary in an adult population. This review examines the evidence for the CDED in adults with active luminal Crohn's disease and aims to provide practical guidance on the use of the CDED in Australian adults. A working group of nine inflammatory bowel disease (IBD) dietitians of DECCAN (Dietitians Crohn's and Colitis Australian Network) and an IBD gastroenterologist was established. A literature review was undertaken to examine (1) clinical indications, (2) monitoring, (3) dietary adequacy, (4) guidance for remission phase, and (5) diet reintroduction after therapy. Each diet phase was compared with Australian reference ranges for food groups and micronutrients. CDED with PEN is nutritionally adequate for adults containing sufficient energy and protein and meeting > 80% of the recommended daily intake of key micronutrients. An optimal care pathway for the clinical use of the CDED in an adult population was developed with accompanying consensus statements, clinician toolkit, and patient education brochure. Recommendations for weaning from the CDED to the Australian dietary guidelines were developed. The CDED + PEN provides an alternate partial food-based therapy for remission induction of active luminal Crohn's disease in an adult population. The CDED + PEN should be prioritized over CDED alone and prescribed by a specialist IBD dietitian. DECCAN cautions against using the maintenance diet beyond 12 weeks until further evidence becomes available.</p