Abstract:
Research indicates that the nutritional knowledge of athletes is minimal. Dietary behaviors may hinder health status and athletic performance. The purpose of this study was to compare nutrition knowledge and attitudes of college athletes at a Southern university (N=190). Male and female athletes were surveyed from all sports. The study examined knowledge of current dietary recommendations, sources of nutrients, healthy food choices, and the relationship between diet and disease processes. Significant differences in overall knowledge were noted between athletes’ collegiate sports and genders. The majority of athletes at this university had healthy attitudes about eating behaviors, but low knowledge scores.
A problem facing America’s college youth today is the lack of available healthy fast foods or easily prepared foods. College students have little time and space when it comes to meal preparation within the confines of dorms, apartments, or shared housing. An additional concern is the knowledge needed to determine which food items to select. Current research indicates that as the athletes’ knowledge increases, nutritional quality of food choices improves (Kunkel, Bell, & Luccia, 2001).
Nutritional Education and Training (NET) programs are taught to children in most public schools (Sizer & Whitney, 2000), yet few college-age students understand even the basic concepts of nutrition by the time they reach a university setting (Cho & Fryer, 1974; Grandjean, Hursh, Manjure, & Hanley, 1981).
Student athletes with higher nutritional knowledge may obtain information to help increase performances and or maintain healthy or competitive weights (Barr, 1987). However, athletes participating in certain athletic sports have more problems obtaining basic nutrient needs (Beals & Manore, 1998) while attempting to attain or maintain a weight that allows them to stay competitive.
Some nutritional information obtained by athletes may be unreliable (Barr et al., 1997), contributing to the problem of athletes making poor dietary choices (Evans, Sawyer-Morse, & Betsinger, 2000). The purpose of this study was to examine nutrition knowledge and attitudes in a sample of athletes in a university setting.
Methods:
Data Collection Instruments
Nutritional knowledge was assessed using the Nutrition and Knowledge Questionnaire developed by Parameter and Wardle (2000). Permission for use of the questionnaire was obtained. The questionnaire included four sections covering (a) experts’ recommendations regarding increasing and decreasing intake of different food groups, (b) nutrient knowledge, (c) food choices (which ask people to choose between different options, e.g., to pick a healthy snack which is low in fat and high in fiber), and (d) the relationships between diet and disease. This last section addresses beliefs about which foods can cause particular diseases as well as knowledge of diseases associated with eating too much or too little of various foods.
Nutrition attitudes were measured using the Eating Attitudes Test (EAT 26) developed by Garner and Garfinkel (1979). Access to the questionnaire was obtained online with permission of the authors. The Eating Attitudes Test (EAT-26) is probably the most widely used standardized measure of symptoms and concerns characteristic of eating disorders (Garner, Olmstead, Bohr, & Garfinkel, 1982). Early identification of eating disorders is obtained by using the questionnaire as a screening tool to allow early treatment and prevention of long-term physical and psychological complications.
The demographic questions measured consisted of age, ethnic origin, year in school, and collegiate sport. Questions were asked about the student athletes’ frequency of working out, height, weight, supplement use, and previous nutrition classes.
Participants
After obtaining approval from the institution’s review board, participants were recruited from each of the athletic departments, including football, volleyball, basketball, softball, gymnastics, golf, tennis, swimming, cross-country/track and field, and soccer. One hundred and ninety participants aged 18-24 were surveyed. Coaches were initially informed of the study by e-mail. After the initial introduction by e-mail, another e-mail was sent to obtain consent from the coaches.
Procedure
All collegiate athletes were asked to voluntarily complete the knowledge and attitude survey. Surveys were disseminated before or after weight training sessions or before or after workouts. Each athlete was given the nine-page questionnaire to complete using as much time as necessary to answer all the questions. All athletes completed all sections of the study, with the exception of the gymnastic team. Coaches of the gymnastics team opted not to allow their athletes to complete the attitudes section of the survey because some of the gymnastic athletes were involved in counseling for problematic eating behaviors. The coaches were concerned that athletes would be put under more duress if challenged by a questionnaire assessing current nutritional habits.
Data Analyses
Statistical analyses were conducted using programs available in SPSS, version 11.0. Descriptive statistics were used to determine means and percentages of groups. Analysis of variance (ANOVA) was used to test for group mean differences in knowledge/attitudes and for relationships between knowledge scores and age, year in school, and collegiate sport. Gender differences in knowledge and attitudes were analyzed using an independent samples t test.
Results:
The mean age of female athletes was 19 years of age and the majority of respondents were white. The demographic characteristics are shown in Table 1.
The nutritional knowledge score had a mean of 51.49% (SD 13.57%). Of the maximum 11 points for the dietary recommendations section, the mean score was 6.52 (SD 2.02). Seventy-five percent of the respondents were aware of the recommendations to decrease fat, sugar, and salt intake, and 76.1% agreed that it was healthy to increase fiber, fruit, and vegetable intake. Only 32% of the surveyed population responded correctly to the number of fruits and vegetables recommended daily (collectively- five to six servings). Forty-five percent of the athletes stated that experts recommended that we needed four servings or less of fruits and vegetables or they were unsure. However, more than 66% of the students were aware of the recommendation to reduce saturated fat. When asked about carbohydrate and meat recommendations, 56% agreed that experts say we should eat the same amount of meat as Americans are currently consuming, and 53% of the respondents replied that experts recommend that carbohydrate intake should be less.
- Of a possible 67 points for the section on food groups, the mean score was 36.44 (SD 10.02 ). When asked to categorize various foods as either high or low in sugar, fat, starch, salt, protein, fiber, or saturated fats, a slight percentage were aware and no one scored higher than a 56.
Of a maximum of 6 points on the everyday food selections section, the mean score was 2.98 (SD 1.25). When athletes were asked to pick a low fat, high fiber snack, only 37% chose the correct answer (raisins). The most common incorrect response submitted was “nutragrain bar” (39%). Sixty-eight percent of the athletes agreed that the healthiest pasta-sauce combination should be a large amount of pasta with a small amount of sauce versus the reverse (large amount of sauce with small amount of pasta). When asked to choose the best choice for low fat, high fiber meal, 42% of the athletes correctly chose beans and rice. Twenty-eight percent chose grilled chicken and another 22% chose whole wheat with cheese.
In the diet and disease relationships section, athletes were asked if they were aware of links between eating more or less of a particular food and major health problems associated with each. The mean score was 5.57 (SD 2.99) out of a possible 17 points. The highest proportions of people (65%) were aware of a relationship between high fat intake and disease. Of the people who were aware of the fat-disease link, 58% also knew about the link to heart disease and obesity. Students therefore agreed that fat intake be decreased to reduce risk of heart disease.
Almost 70% of the athletes agreed that eating less salt would help decrease the risk for heart disease. Students were evenly divided (38% Yes; 38% No; 22% Unsure) as to whether eating less preservatives would decrease the risk for heart disease, indicating that more information should be provided for about food preservatives.
Only 35% were aware of a link between low intake of fruits and vegetables and health problems. Sixty-one percent of the athletes stated that consumption of more fruits and vegetables and fiber intake were methods to reducing the risk for development of cancer.
Slightly over one-third of the athletes (35%) knew of health risks associated with low fiber intake. The majority was unaware of a specific risk with cancer or any specific health problems associated with low fiber intake.
When asked to discuss diseases or health problems related to sugar, only one athlete out of 190 gave the correct response. The correct answer, teeth (in diseases of the teeth), was the most missed question. This information indicates that most students, though aware, may not stop to think of the association between sugar and the health of their teeth. Most students (54%) responded with the answer of diabetes which is also related to sugar intake although much later in life.
A t test between male (n = 92) and female (n = 97) athletes found significant differences in nutritional knowledge (P < .001). Female athletes scored slightly higher than the males on overall nutritional knowledge, as well as on each individual section of recommendations, food groups, choices, and diseases.
Eating attitudes were assessed using the 26-item Eating Attitudes Test (EAT-26). Mean scores for the 104 participants (gymnasts were excluded from this part of the survey) were 6.04 (SD = 5.96), with only 5.8% demonstrating a potential for having or acquiring an eating disorder (scores > 20).
Gender differences noted in the EAT-26 were not significant (equal variances assumed). Mean scores were just slightly lower for males (M = 5.41; SD = 5.85) than for females (M = 6.73; SD = 6.03). There were no significant differences between male and female athletes on the attitude sections.
Discussion:
The purpose of this study was to compare nutrition knowledge and attitudes of college athletes at a southern university. The results of this survey reveal a lack of nutritional knowledge among university athletes. As previous research has indicated (Barr, 1987; Jacobson, Sobonyna & Ransone, 2001), college athletes are lacking in nutritional knowledge.
Previous research in athletic programs shows that the time spent in the athletic program may improve nutritional awareness and positively influence eating behaviors (Clark, 1999). Athletes’ overall knowledge in the current study was fair. Just over half of the responses were answered correctly. Athletes’ knowledge about dietary recommendations was superior to their knowledge regarding other topics. Well over half of the athletes were generally aware that they should be eating more or less of particular types of foods. One topic area that needs improvement is regarding carbohydrate needs; most athletes incorrectly believed that carbohydrates should be decreased in the diet.
Athletes in the current study displayed impressive knowledge regarding fat content of specific foods. However, they lacked knowledge about types of fats. They were aware that whole grains contain more vitamins and minerals than do other grains. Knowledge about diet and disease relationships was poor. The most common known relationship was between heart disease and high fat foods.
Athletes had problems translating their knowledge into food choices. Only 50% percent of the survey questions regarding food choices were answered correctly. Marketing may be a contributing factor to the confusion of healthy food choices versus non-healthy food choices (Clark, 1999).
The eating attitudes of athletes were positive. Most athletes at this university were not at risk for eating disorders. However, scores might been different if the gymnasts participated in the study.
Recommendations:
Sports nutrition has grown over the past decade, linking how an athlete eats with how they perform during practice or competitive events (Clark, 1999). For this reason and given the results of this study, it would be beneficial to hire a nutritionist as part of the staff.
Coaches can help to enhance the performances of their athletes by promoting good nutrition (Turner & Bass, 2001; Witta, Stombaugh, & Buch, 1995); however, they need to have the nutritional knowledge in order to encourage healthy food choices (Corley, Demarest-Litchford, & Bazzarre, 1990; Wolf, Wirth, & Lohman, 1979). Providing athletes with a person knowledgeable in current dietary recommendations and aware of current eating disorders can perhaps prevent poor athletic performances and the potential problems with eating behaviors.
Nutritional knowledge is related to eating behavior (Burke, Cox, Cummings & Desbrow, 2001; Witta et al., 1995). Research shows that athletes who receive nutrition education have significantly higher knowledge and attitude scores, and as their knowledge increases, they are more prone to eat or avoid certain foods (Werblow, Fox, & Henneman, 1978).
Lifetime consequences from poor food choices may affect bone health and reproductive health (Turner & Bass, 2001). Positive attitudes toward nutrition are linked with accurate nutrition knowledge (Witta et al., 1995). It is necessary to inform college athletes about even the basic dietary concepts.
It is practical to consider that collegiate athletes are knowledgeable about the demands of their individual sports and the nutrients vital to maintain a healthy and competitive state. However, research in the past tells us different. Both athletes and non-athletes need guidance in selecting nutrient-dense foods (Tilgner & Schiller, 1989) necessary to sustain energy for activities of daily life or endurance sports. More research is needed regarding the effects of nutrition interventions on knowledge, attitudes, and food behavior.
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