EVALUATION OF SPORTS NUTRITION KNOWLEDGE BETWEEN NCAA
STUDENT-ATHLETES ACROSS DIVISIONS
A thesis submitted to the
Kent State University College
of Education, Health, and Human Services
in partial fulfillment of the requirements
for the degree Master of Science in Nutrition and Dietetics
By
Siera Jade Holley
May 2015
A thesis written by
Siera Jade Holley
B.S., The Ohio State University, 2013
M.S., Kent State University, 2015
Approved by
________________________, Director, Master’s Thesis Committee
Amy Miracle
________________________, Member, Master’s Thesis Committee
Natalie Caine-Bish
________________________, Member, Master’s Thesis Committee
Karen Lowry Gordon
Accepted by
________________________, Director, School of Health Sciences
Lynne E. Rowan
________________________, Dean, College of Education, Health, and Human Services
Daniel F. Mahony
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HOLLEY, SIERA JADE, M.S., May 2015
Nutrition and Dietetics
EVALUATION OF SPORTS NUTRITION KNOWLEDGE BETWEEN NCAA
STUDENT-ATHLETES ACROSS DIVISIONS (89 pp.)
Director of Thesis: Amy Miracle, Ph.D., R.D., C.S.S.D., L.D.
The purpose of this study was to evaluate sports nutrition knowledge and
experiences with registered dietitians amongst collegiate student-athletes across NCAA
Divisions I, II, and III. A total of 171 student-athletes from 13 academic institutions with
NCAA sanctioned varsity athletic programs participated. Five Division I, 5 Division II,
and 3 Division III institutions are represented. A questionnaire consisting of the
following components was administered: nutrition knowledge, feelings towards sports
nutrition statements, sources of nutrition information, participant characteristics and
demographics, and sports nutrition experience.
Overall, the sample achieved a mean Nutrition Knowledge Score (NKS) of
61.22% ± 12.57. There was no significant difference in knowledge scores across NCAA
Divisions (F = .385, p = .681), however, female participants scored significantly higher
than males (F = 6.313, p = .008). Approximately 82.4% (n = 141) of participants
indicated that having a dietitian/nutritionist on their team’s staff does or would help them
in achieving a healthy diet, and 81.8% (n = 140) responded that having a
dietitian/nutritionist on staff does or would help them in improving their athletic
performance. Collectively, participants responded they would be most likely to consult a
dietitian/nutritionist over other resources when obtaining current information regarding
nutrition.
Results indicate there is still a need for further sports nutrition education.
Additionally, participants’ perceive that having a dietitian on their athletic staff would be
advantageous for obtaining nutrition information and in achieving a healthier diet and
improved performance.
ACKNOWLEDGEMENTS
Praise God for the opportunities and challenges He has given me. His endless
love, comfort, and answered prayers have made this accomplishment attainable.
What once seemed like an intimidating process has been nothing but a positive
experience with the guidance of my advisor, Dr. Amy Miracle. She understood my
vision and was enthusiastic about helping me develop it into a meaningful study. I have
enjoyed being able to learn from someone with a passion for sports nutrition. The
constructive feedback and shared knowledge from Dr. Natalie Caine-Bish and Dr. Karen
Lowry Gordon have been instrumental in helping me take my ideas a step further.
Thank you to Dr. Jackie Buell for welcoming me into her sports nutrition lab as
an undergraduate student at The Ohio State University and introducing me to research. I
am grateful for her encouragement to pursue a graduate education.
Without my family, especially my Grandma and Grandpa Holley, Grandma D,
Grandpa P, mother and father, Nolan and Sarah, and Kyle, I could not begin to imagine
reaching the end of this project and graduate school. You are shining examples of the
commitment to hard work. Your prayers, positivity, humor, meals, cards and phone calls,
and most of all, love (including the tough love!), warm my heart. You are all true
blessings.
This project could not have been completed without the efforts of the coaching
staffs and student-athletes who participated. Thank you for contributing your time for the
betterment of my study. Also, your kind words were certainly appreciated.
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TABLE OF CONTENTS
ACKNOWLEDGEMENTS ........................................................................................... iii
LIST OF TABLES ........................................................................................................vii
CHAPTER
I.
INTRODUCTION.......................................................................................... 1
Statement of the Problem ............................................................................... 3
Purpose Statement .......................................................................................... 4
Hypotheses ..................................................................................................... 4
Operational Definitions .................................................................................. 5
II.
LITERATURE REVIEW ............................................................................... 7
NCAA Divisional Participation Rates ............................................................ 7
NCAA Collegiate Student-Athlete Health and Wellbeing ............................... 7
Student-Athletes’ Access To and Use of Resources ........................................ 9
Registered Dietitians ................................................................................... 9
Athletic Trainers, Strength and Conditioning Coaches, and Coaches ......... 11
Professional Sports Nutrition Organizations’ Resources ............................... 13
Athletes’ Nutrition Knowledge ..................................................................... 14
Nutrition Knowledge of Student-Athletes .................................................. 14
Descriptive studies ................................................................................. 14
Macronutrients and micronutrients....................................................... 14
Hydration ............................................................................................ 16
Athlete Nutrition Knowledge Contrast with Non-Athletes ......................... 17
Interventions to Increase Nutrition Knowledge .......................................... 20
Impact on dietary intake ......................................................................... 21
Nutrition Knowledge of Other Athletes ..................................................... 22
College Coursework in Nutrition ............................................................... 24
Resources’ Nutrition Knowledge .................................................................. 25
Registered Dietitians ................................................................................. 25
Certified Athletic Trainers ......................................................................... 28
Strength and Conditioning Coaches and Coaches ...................................... 30
Link in Literature between Nutrition Knowledge, NCAA Divisions, and
Access to Registered Dietitians .................................................................... 32
III.
METHODOLOGY ....................................................................................... 33
Study Design ................................................................................................ 33
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Setting .......................................................................................................... 33
Participants .................................................................................................. 34
Questionnaire ............................................................................................... 34
Questionnaire Components ........................................................................ 35
Nutrition knowledge ............................................................................... 35
Feelings towards sports nutrition statements ........................................... 35
Sources of nutrition information ............................................................. 35
Participant characteristics and demographics .......................................... 35
Sports nutrition experience ..................................................................... 36
Scoring Questionnaire ............................................................................... 36
Procedures.................................................................................................... 37
Statistical Analysis ....................................................................................... 37
IV.
JOURNAL ARTICLE .................................................................................. 39
Introduction.................................................................................................. 39
Methods ....................................................................................................... 40
Study Design ............................................................................................. 40
Setting ....................................................................................................... 41
Participants................................................................................................ 41
Measurement Instrument ........................................................................... 42
Nutrition knowledge ............................................................................... 42
Feelings towards sports nutrition statements ........................................... 42
Sources of nutrition information ............................................................. 42
Participant characteristics and demographics .......................................... 43
Sports nutrition experience ..................................................................... 43
Scoring Questionnaire ............................................................................... 44
Procedures................................................................................................. 44
Statistical Analysis .................................................................................... 45
Results ......................................................................................................... 45
Discussion .................................................................................................... 54
Nutrition Knowledge between NCAA Divisions ........................................ 54
Nutrition Knowledge between Genders ..................................................... 55
Sports Nutrition Experience ....................................................................... 56
Limitations ................................................................................................... 59
Applications ................................................................................................. 60
Recommendations for Future Research ........................................................ 62
Conclusion ................................................................................................... 62
APPENDICES ............................................................................................................... 64
APPENDIX A. SPORTS NUTRITION KNOWLEDGE QUESTIONNAIRE ........... 65
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APPENDIX B.
APPENDIX C.
APPENDIX D.
APPENDIX E.
RECRUITMENT E-MAIL ................................................................ 71
STUDY CONSENT FORM .............................................................. 73
PARTICIPATION BY ACADEMIC INSTITUTION TABLE .......... 76
NUTRITION KNOWLEDGE RESPONSES TABLE ........................ 78
REFERENCES .............................................................................................................. 82
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LIST OF TABLES
Table
Page
1. Demographic Characteristics of NCAA Division I, II, and III Student-Athletes
Completing Questionnaire (n = 171)………………………………………………...47
2. Summar of NKS Means and Standard Deviations
SD across NCAA
Divisions and Gender of Student-Athletes Responding to Sports Nutrition
Knowledge Questionnaire …………………………………………………………...48
3. Means and Standard Deviations
SD Representing NCAA Student-Athletes’
Feelings towards Sports Nutrition Statements ………………………………………49
4. Means and Standard Deviations
SD Representing NCAA Student-Athletes’
Likelihood to Utilize Resources to Obtain Current Nutrition Information ………….50
5. NCAA Student-Athletes’ Responses to Questions Regarding Sports Nutrition
Experience (n = 171) ………………………………………………………………...52
6. NCAA Student-Athletes’ Responses to Questions Regarding Impact of
Dietitian/Nutritionist on Diet and Performance (n = 171) …………………………..53
7. Participation Frequency of Academic Institutions Represented in Evaluation of
Sports Nutrition Knowledge between Student-Athletes across NCAA Divisions
Study (n = 171) ……………………………………………………………………...77
8. Frequency Distribution of NCAA Division I, II, and III Student-Athletes’ Correct
and Incorrect Responses to Nutrition Knowledge Statements ………………………79
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CHAPTER I
INTRODUCTION
The National Collegiate Athletic Association (NCAA) includes nutrition as a
health component that affects the overall wellness of its more than 463,000 studentathletes (NCAA Sports Sponsorship, 2013; NCAA Sports Medicine, 2013). Nutrition is
considered to be a vital factor in maintaining the health and wellbeing of student-athletes,
as well as assisting in the optimization of athletic performance (NCAA Sports Medicine,
2013). Injury risk, immune system function, and healing, to name a few, can all be
impacted b an athlete’s dietary intake and nutritional status (Steinmuller et al., 2014).
It is well documented that student-athletes obtain nutrition information from a
number of sources. Student-athletes in multiple studies have indicated they are likely to
seek out certified athletic trainers (ATCs), strength and conditioning coaches (SCCs), and
coaches when in need of nutrition information (Burns, Schiller, Merrick, & Wolf, 2004;
Jacobson, Sobonya, & Ransone, 2001; Shifflett, Timm, & Kahanov, 2002; TorresMcGehee et al., 2012). Unfortunately, many ATCs, SCCs, and coaches may not have a
clear understanding of basic nutrition. In one study, athletic trainers and strength and
conditioning coaches expressed confidence in their incorrect responses on a nutrition
knowledge questionnaire, creating concern that they may disseminate inappropriate
information to student-athletes (Torres-McGehee et al., 2012). Additionally, coaches
who have participated in studies examining their nutrition knowledge have underachieved
in comparison to ATCs and SCCs, indicating they could also be providing athletes with
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incorrect nutrition information (Shifflett et al., 2002; Torres-McGehee et al., 2012).
Athletic trainers, SCCs, and coaches have, however, indicated that they would
recommend student-athletes discuss nutrition with a registered dietitian (Torres-McGehee
et al., 2012).
Registered dietitians/registered dietitian nutritionists (RDs/RDNs), especially
those who are sports dietitians, possess the education necessary to evaluate the nutritional
needs associated with physical activity (Steinmuller et al., 2014). The education and
interventions sports RDs/RDNs offer can positivel influence athletes’ dietar behaviors
and athletic performance (Steinmuller et al., 2014). Some institutions’ athletic
departments, such as The Pennsylvania State University and the University of
Washington, value the potential benefits staffing a dietitian can provide and have allotted
funding and created positions for RDs/RDNs (Burns et al., 2004; Clark, 1999; Shattuck,
2001; Torres-McGehee et al., 2012; Vinci, 1998).
Many student-athletes do not have access to an RD/RDN at their academic
institutions or within their athletic departments (Torres-McGehee et al., 2012).
Furthermore, even if student-athletes do have access to an RD/RDN, they may not be
aware that one is available (Burns et al., 2004). A study that examined the role of ATCs
and RDs/RDNs in nutrition counseling discovered 27% of the student-athletes surveyed
knew whether a dietitian was available (Burns et al., 2004). Some student-athletes may
also feel uncomfortable pursuing registered dietitians for nutrition advice (TorresMcGehee et al., 2012). Student-athletes interact with ATCs, SCCs, and coaches
regularly, if not daily, which may be why some are more likely to reference them as
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resources for nutrition information rather than RDs/RDNs (Burns et al., 2004; TorresMcGehee et al., 2012).
Student-athletes have often been identified as having inadequate knowledge of
nutrition (Dunn et al., 2007). For example, multiple studies have discovered studentathletes do not understand the role of micronutrients in the body (Jacobson et al., 2001;
Rosenbloom, Jonnalagadda, & Skinner, 2002). Studies involving nutrition interventions
and education from a dietitian or other individuals within nutrition have successfully
improved student-athletes’ knowledge of nutrition from pretest to posttest (Abood, Black,
& Birnbaum, 2004; Kunkel, Bell, & Luccia, 2001; Valliant, Pittman Emplaincourt,
Kieckhaefer Wenzel, & Hilson Garner, 2012). Established sports nutrition programs,
such as the Husky Sport Nutrition Program at the University of Washington, offer
student-athletes numerous educational resources and opportunities to receive counseling
from a dietitian (Vinci, 1998). Despite the advantages of staffing an RD/RDN, many
NCAA Division II, III, and even smaller Division I, athletic departments may not have
the budgetary means to facilitate sports dietitians or sports nutrition programs. Karpinski
(2012) has also suggested that a nutrition course be offered at institutions for academic
credit, specifically for those students participating in intercollegiate athletics to aid in the
improvement of knowledge in athletes for optimal performance and overall health.
Statement of the Problem
Research has shown that NCAA student-athletes receive sports nutrition related
information from team personnel who work closely with them, such as coaches, athletic
trainers, and strength and conditioning coaches, who have little or no educational
4
background in nutrition (Burns et al., 2004; Jacobson et al., 2001; Shifflett et al., 2002;
Torres-McGehee et al., 2012). Differences in athletic funding and budgeting exist
between NCAA Divisions and institutions, potentially creating more or less accessibility
to staffing and resources for student-athletes. For example, some collegiate athletic
departments employ registered dietitians while others do not. Yet, research has shown
that athletes who do have access to registered dietitians do not always feel comfortable
seeking their expertise (Torres-McGehee et al., 2012).
Currently, there appears to be no information available regarding the nutrition
knowledge of student-athletes between NCAA Divisions I, II, and III and whether
knowledge differences exist between athletes across these Divisions (Torres-McGehee et
al., 2012). There is also limited information pertaining to student-athletes’ access to a
full-time registered dietitian and whether nutrition knowledge differs between athletes
that have an RD/RDN readily available to them and athletes who do not (TorresMcGehee et al., 2012). Further nutrition knowledge research focused on these areas
could be useful in determining student-athletes who may benefit from education and if
the lack of availability of resources put athletes in certain NCAA Divisions at a
disadvantage.
Purpose Statement
The purpose of this study was to evaluate sports nutrition knowledge and
experiences with registered dietitians amongst collegiate student-athletes across NCAA
Divisions I, II, and III.
Hypotheses
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H1: There will be a difference in sports nutrition knowledge between collegiate studentathletes across NCAA Divisions I, II, and III.
H0: There will not be a difference in sports nutrition knowledge between collegiate
student-athletes across NCAA Divisions I, II, and III.
H2: There will be a difference in sports nutrition knowledge between male collegiate
student-athletes and female collegiate student-athletes.
H0: There will not be a difference in sports nutrition knowledge between male collegiate
student-athletes and female collegiate student-athletes.
Operational Definitions
Collegiate athlete: any student-athlete participating in a National Collegiate
Athletic Association sanctioned sport within Divisions I, II, and III.
NCAA Division I: academic institutions that “sponsor at least seven sports for men
and seven for women (or six for men and eight for women) with two team sports for each
gender” “Divisional Differences,” 2015, para. 1 .
NCAA Division II: academic institutions that “sponsor at least five sports for men
and five for women, (or four for men and six for women), with two team sports for each
gender, and each pla ing season represented b each gender” “Divisional Differences,”
2015, para. 2).
NCAA Division III: academic institutions that “sponsor at least five sports for men
and five for women, with two team sports for each gender, and each playing season
represented b each gender” “Divisional Differences,” 2015, para. 3 .
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Sports nutrition knowledge: understanding of nutrition information specifically
related to sports and athletic performance.
CHAPTER II
LITERATURE REVIEW
NCAA Divisional Participation Rates
Student-athlete participation in National Collegiate Athletic Association (NCAA)
sponsored championship sports has grown over the past three decades (NCAA Sports
Sponsorship, 2013). In the most recent NCAA Sports Sponsorship and Participation
Report (2013), a record number of approximately 463,202 student-athletes were
documented for the 2012-2013 academic year for Divisions I, II, and III combined. The
NCAA reported that institutions averaged 424 total student-athletes with 240 being males
and 184 being females (NCAA Sports Sponsorship, 2013).
For the 2012-2013 academic year, 173,457 total student-athletes, 92,997 and
80,460 males and females, respectively, participated in NCAA Division I championship
sports (NCAA Sports Sponsorship, 2013). Division II consisted of 64,032 males and
44,786 females, totaling 108,818 athletes participating in NCAA championship athletics
(NCAA Sports Sponsorship, 2013). Lastly, with the largest number of student-athletes,
Division III had 105,220 males and 75,707 females for a total of 180,927 athletes
participating during the 2012-2013 academic year (NCAA Sports Sponsorship, 2013).
NCAA Collegiate Student-Athlete Health and Wellbeing
The NCAA publishes a Sports Medicine Handbook annually with guidelines and
recommendations to assist institutions with policy development to ensure student-athlete
health and safety (NCAA Sports Medicine, 2013). According to the most recent
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guidelines in the 2013-14 NCAA Sports Medicine Handbook (2013), the NCAA uses
what is termed an “applied sport science” approach as the foundation for performance
and long-term athlete development and achieving success as a student-athlete. The
approach is an interconnection of physiology, psychology, a safe environment, motor
learning, recovery and regeneration, medicine, nutrition, skill development, and
biomechanics focused around the student-athlete (NCAA Sports Medicine, 2013).
Quatromoni (2008) displayed that approaching student-athlete wellness and
health-promotion with a multidisciplinary Sports Medicine Wellness Team can be
effective. Quatromoni’s 2008 multidisciplinar model has a Wellness Coordinator at its
center. Academic counselors, athletic trainers, coaches, the strength and conditioning
team, and self-referred athletes identif “at-risk” athletes, specificall athletes displa ing
behaviors of disordered eating, and refer them to a Wellness Coordinator (Quatromoni,
2008). The Wellness Coordinator then makes the appropriate referrals to a therapeutic
support group consisting of sports psychology, sports nutrition, and sports medicine
departments (Quatromoni, 2008). The model, which was studied within a NCAA
Division I athletic program, contributed to serving 75 athletes in two years with a total of
254 nutrition consultations (Quatromoni, 2008). It was determined that health-promotion
benefited from the multidisciplinary model, especially because student-athletes sought
the services offered (Quatromoni, 2008).
Nutrition is discussed in multiple contexts regarding student-athlete health and
wellbeing within the NCAA’s 2013-14 NCAA Sports Medicine Handbook (2013). For
instance, the NCAA states that strength and conditioning coaches should understand
9
health-related factors that affect training, one of which is suboptimal nutrition (NCAA
Sports Medicine, 2013). Furthermore, the NCAA recognizes the impact nutrition has on
student-athlete health, training, and athletic performance and recovery and discusses
nutrition in greater detail within the Handbook (NCAA Sports Medicine, 2013) in a
section titled Nutrition and Athletic Performance. Macronutrient intake, vitamin and
mineral supplementation, hydration, energy intake, and ideal body weight are discussed
in relation to training, competition, and recovery phases (NCAA Sports Medicine, 2013).
The NCAA expands on the topic of body composition and weight, recommending
involvement of a sports dietitian, specifically a Certified Specialist in Sports Nutrition
(CSSD), medical staff, and coach in student-athlete weight loss (NCAA Sports Medicine,
2013). Lastly, a section separate from Nutrition and Athletic Performance exists for
Menstrual-Cycle Dysfunction in the 2013-14 NCAA Sports Medicine Handbook (2013).
Nutrition, particularly nutrition counseling and monitoring of diet, is involved in the
treatment of student-athletes experiencing menstrual-cycle irregularities. Nutrition
education is also recommended in discussing menstrual-cycle dysfunction with studentathletes (NCAA Sports Medicine, 2013).
Student-Athletes’ Access To and Use of Resources
Registered Dietitians
Literature discusses the establishment of positions for registered
dietitians/registered dietitian nutritionists (RDs/RDNs) within collegiate athletic
departments (Burns et al., 2004; Clark, 1999; Shattuck, 2001; Torres-McGehee et al.,
2012). Torres-McGehee et al. (2012) discussed that while some athletic departments
10
have a dietitian on staff, others have limited or no access to a dietitian. Many academic
institutions and athletic departments may not have the finances to allocate towards
staffing a sports dietitian (Hornstrom et al., 2011). Hornstrom and colleagues (2011)
have questioned if nutrition is viewed as an important component of the total training
experience in the same way practice and strength and conditioning are.
A study by Burns et al. (2004) demonstrated that student-athletes may not be
aware of the access they have to a registered dietitian, even when one is staffed and made
available by or through the athletic department. The study, conducted using data from
student-athletes at eight NCAA Division I institutions, found that 14.4% of the
participants stated they received nutrition information primarily from a dietitian;
however, 27% of the participants did not know if a dietitian was readily available to them
(Burns et al., 2004). Additionally, 23.5% of the student-athletes responded that there was
not a dietitian available on staff (Burns et al., 2004).
Research conducted by Torres-McGehee et al. (2012) across NCAA Divisions I,
II, and III found that 50.8% of the student-athletes surveyed stated they had access to a
registered dietitian. Of that percentage, student-athletes reported that 36.2% and 35.1%
were RDs/RDNs employed full or part-time within the athletic department, respectively
(Torres-McGehee et al., 2012). Student-athletes reported dietitians who were not in the
percentage of RDs that were employed through the athletic department were accessed
through student health or off-campus or private-practices (Torres-McGehee et al., 2012).
In the same study, 59.5 % of coaches, 63% of athletic trainers, and 62% of strength and
conditioning specialists responded they had access to a dietitian within athletics or
11
through student health or off-campus or private-practice (Torres-McGehee et al., 2012).
Overall, 50.1% of the institutions surveyed had athletic departments that employed an
RD/RDN, while the rest of the institutions (49.9%) had a dietitian available through
student-health, or off-campus or private-practices (Torres-McGehee et al., 2012).
Student-athlete experience consulting with a dietitian may be limited or nonexistent. In a study of Mid-American Conference softball players, only 21.6% of the
student-athletes responded that they had ever consulted with a dietitian (Hornstrom,
Friesen, Ellery, & Pike, 2011).
Athletic Trainers, Strength and Conditioning Coaches, and Coaches
Student-athletes are in contact with athletic trainers, strength and conditioning
coaches (SCCs), and coaches on a routine basis. Student-athletes participating within
institutions with larger athletic departments may have daily contact with an athletic
trainer in particular (Burns et al., 2004). For this reason, student-athletes may be more
comfortable seeking nutrition information from these professionals, specifically athletic
trainers and SCCs, than other resources, such as dietitians (Torres-McGehee et al., 2012).
Torres-McGehee et al. (2012) found that when asked who they were most comfortable
discussing nutritional needs with, student-athletes ranked SCCs and athletic trainers as
their main sources (Torres-McGehee et al., 2012). Similarly, student-athletes in Burns
and colleagues’ 2004 stud responded that certified athletic trainers 39.8% and SCCs
(23.7%) were their primary sources of nutrition information.
Student-athletes’ primar sources of nutrition information has shifted over the
years. An early study conducted by Jacobson and Gemmell (1991) that assessed sources
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of nutrition information in NCAA Division I student-athletes determined that trainers and
SCCs were ranked second and fifth, respectively, as primary sources of nutrition
information behind magazines, friends, and college courses. In a follow-up to that study,
Jacobson et al. (2001) asked student-athletes to rank their top three sources of nutrition
information. Strength and conditioning coaches (21.9%), athletic trainers (19.0%), and
university classes (12.5%) received the majority (Jacobson et al., 2001). In total, 53.4%
of nutrition information came from SCCs, athletic trainers, and university classes
(Jacobson et al., 2001). Additionally, men were significantly more likely to receive
nutrition information from athletic trainers and strength and condition coaches compared
to women whose significantly primary information sources were nutritionists and courses
at their institutions (Jacobson et al., 2001).
Research by Shifflett et al. 2002 that studied athletes’, coaches’, and athletic
trainers’ understanding of student-athlete nutritional needs found that student-athletes
most frequently reported parents (28%) and coaches (17%) as their sources of nutrition
information. In their study of NCAA Division I softball players, Hornstrom et al. (2011)
reported that the athletes indicated physicians were their preferred source of nutrition
information, followed by athletic trainers, college courses in nutrition or health, and
dietitians.
Studies examining female student-athletes indicate they may be less inclined to
consult with coaches or trainers for nutrition information. Coaches were one of the least
likely preferred sources of nutrition information by Division I softball players
(Hornstrom et al., 2011). A study by Zawila, Steib, and Hoogenboom (2003) studying
13
nutrition knowledge in collegiate female cross country runners found participants
obtained nutrition information from magazines and parents firstly, followed by coaches
and teammates. Only 17% of the participants cited athletic trainers as their source of
information (Zawila et al., 2003).
Professional Sports Nutrition Organizations’ Resources
Two popular professional organizations specializing in exercise, wellness, and
sports nutrition maintain Internet sites with educational resources that are accessible to
the general public. One of these organizations, the Collegiate and Professional Sports
Dietitian Association CPSDA , states that it “represents the vast majorit of advanced
practice registered dietitians in the United States who work full-time with athletes in
colleges, professional sports, Olympic training centers, the U.S. Military and in law
enforcement” “Mission and Strategic Goals,” 2014, para. 1 . The Sports,
Cardiovascular, and Wellness Nutrition (SCAN) dietetic practice group of the Academy
of Nutrition and Dietetics states “members are registered dietitians with nutrition
expertise in the areas of sports, physical activity, cardiovascular health, wellness, and the
prevention and treatment of disordered eating and eating disorders” “About SCAN,”
2015, para. 1).
Multiple sports nutrition educational fact sheets related to topics such as fueling
and hydration can be retrieved from the SCAN Internet site. SCAN describes these
resources as providing “timel , accurate, applied information and guidance authored and
edited b SCAN Registered Dietitians RDs ” “Sports Nutrition Fact,” 2015, para. 2 .
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CPSDA, in partnership with the NCAA and SCAN, also offers multiple sports nutrition
fact sheets and educational resources to the public “Sports Nutrition Resources,” 2015).
Athletes’ Nutrition Knowledge
Nutrition Knowledge of Student-Athletes
Descriptive studies. Nutrition status may impact athletic performance, and
nutrition knowledge in athletes is often inadequate (Dunn et al., 2007). For this reason,
many studies have been conducted to observe the nutritional knowledge of collegiate
student-athletes. Dunn and colleagues 2007 studied e perts’ recommendations of food
group intake, food choices, nutritional knowledge, and relationships between diet and
disease in collegiate student-athletes. There were significant differences between male
and female student-athletes, with females scoring higher on the overall nutrition
knowledge section, as well as recommendation of food group intake, food choices, and
diet and disease Dunn et al., 2007 . Dunn et al.’s 2007 finding that female athletes
have higher nutrition knowledge scores than male athletes differs from results of other
studies. Other studies have found no significant differences in nutrition knowledge
between male and female athletes (Nichols, Jonnalagadda, Rosenbloom, & Trinkaus,
2005; Rash, Malinauskas, Duffrin, Barber-Heidal, & Overton, 2008; Rosenbloom et al.,
2002).
Macronutrients and micronutrients. Research focusing on nutrition knowledge
in athletes often addresses participant responses that specifically assess knowledge of
macronutrients and micronutrients. Rash et al. (2008) assessed both nutrition knowledge
and dietary intake of NCAA Division I track athletes. The nutrition knowledge
15
questionnaire administered covered the areas of carbohydrates, protein, vitamins and
minerals, vitamin C, and vitamin E (Rash et al., 2008). Overall, the researchers
concluded that the student-athletes had fair knowledge of carbohydrates and vitamins and
minerals (Rash et al., 2008). Other student-athletes have indicated a belief that
carbohydrates should be decreased in the diet (Dunn et al., 2007). Student-athletes in
Torres-McGehee et al.’s 2012 stud scored low on a knowledge section regarding
macronutrients and micronutrients.
Student-athletes lacked knowledge about the roles of protein and vitamins C and
E in Rash and colleague’s 2008 stud . Rosenbloom et al. 2002 found similar findings
in NCAA Division I athletes of a misunderstanding in the role of protein. In that study,
47% of the men and 43% of the women participating believed protein was the main
energy source for the muscle (Rosenbloom et al., 2002). Additionally, 35% of the men
and 34% of the women participating believed that protein supplementation was necessary
(Rosenbloom et al., 2002). Jacobson et al. (2001) found that only 3% of the studentathletes in their study were able to correctly identify the percentage of total calories that
should come from protein.
Shifflett et al. (2002) also asked participants to identify the appropriate
percentages of total calories for each macronutrient. As a whole, 74% of the athletes
responded correctly for carbohydrates, while 41% responded correctly for protein, and
22% for fat (Shifflett et al., 2002). Another study determined that female cross country
collegiate athletes needed to be educated on fat’s role and needs in the bod
Zawila et
16
al., 2003). Student-athletes in Dunn et al.’s 2007 had a good understanding of the fat
content in some foods; however, they lacked knowledge about the specific types of fat.
Misconceptions about the roles of micronutrients are common among studentathletes. Some student-athletes believe that vitamins and minerals are a source of energy
(Jacobson et al., 2001; Rosenbloom et al., 2002). In a study examining nutritional
knowledge and attitudes of intercollegiate female cross country runners across NCAA
Divisions I, II, and III, participants displayed misconceptions about vitamin
supplementation, vitamins in natural foods versus enriched foods, and content of vitamins
in packaged foods, such as those that are frozen (Zawila et al., 2003). Additionally, male
student-athletes have indicated that they think vitamins are involved in weight gain and
can increase muscle strength (Jacobson et al., 2001). Rash et al. (2008) found many
student-athletes in their study believed it was necessary to supplement with vitamin C for
immune function and that vitamin E supplements were needed for purposes of the red
blood cells.
Zawila et al. (2003) found that participants scored greater than 70% on subscales
about iron and functional foods. In addition, athletes displayed understanding of the role
of calcium in the body but were not familiar with the amount of calcium needed per day
(Zawila et al., 2003).
Hydration. Prevention of dehydration through fluid replacement is important to
healthcare providers, such as athletic trainers, working with athletes (Nichols et al.,
2005 . There are few studies that have looked onl at athletes’ knowledge of h dration
and fluid replacement (Nichols et al., 2005). Some general nutrition knowledge studies
17
discussed student-athletes’ nutrition knowledge related to h dration needs. In some
studies, athletes have demonstrated a good understanding of hydration needs. Seventy
percent of participants in a Zawila et al.’s 2003 female cross country study answered
hydration-related questions correctly. Another study also displayed this, as greater than
90% of both men and women understood dehydration decreases performance, 96% of
men and 95% of women understood fluid replacement in relation to exercise, and 79% of
men and 80% of females understood that thirst is not adequate at indicating fluid needs
(Rosenbloom et al., 2002).
A study by Nichols and colleagues (2005) looked specifically at hydration and
fluid replacement in NCAA Division I athletes. The majority of the athletes understood
the importance in having fluids readily available at practices and competitions (Nichols et
al., 2005). Over half of the athletes did not know the duration of physical activity when
sports drinks should be consumed, and 10% of the athletes indicated they did not think
they would become dehydrated if they consumed two or more alcoholic beverages the
day before a practice or competition (Nichols et al., 2005). Researchers determined that
while athletes had adequate hydration and fluid replacement knowledge, they would
benefit from ongoing hydration and fluid replacement-specific education (Nichols et al.,
2005).
Athlete Nutrition Knowledge Contrast with Non-Athletes
Some sports nutrition research assessing athlete nutrition knowledge has used
comparison groups to determine if athletes have greater knowledge than non-athletes. A
review of articles by Heaney et al. (2011) examined research studies that have compared
18
nutritional knowledge in athletes versus non-athlete comparison groups. Determinations
of which group has greater nutrition knowledge, athletes or non-athletes, is variable
across studies.
Multiple studies found that athletes have greater nutrition knowledge than nonathletes. Cupisti, D’Alessandro, Castrogiovanni, Borale, and Morelli 2002 compared
nutrition knowledge in adolescent female high school athletes and non-athletes in Italy.
Athletes were determined to have a greater knowledge of nutrition than non-athletes
(Cupisti et al., 2002). Researchers speculated that perhaps athletes had more access to
nutrition information from being in contact with coaches and trainers whereas nonathletes had no access to nutrition education in their Italian school curriculum (Cupisti et
al., 2002). Another study compared nutrition knowledge between collegiate male
swimmers and a non-athlete group of university students (Heaney et al., 2011). The
comparison group of non-athletes was students in academic majors other than nutrition
and exercise science (Heaney et al., 2011). The swimmers were found to have more
nutrition knowledge than the comparison group of university students (Heaney et al.,
2011). Raymond-Barker, Petroczi, and Quested (2007) assessed general nutrition
knowledge in female athletes susceptible to the Female Athlete Triad Syndrome versus
non-athlete females. Females who were athletes had significantly greater nutrition
knowledge than their non-athlete counterparts (Raymond-Barker et al., 2007).
Triathletes participate in multiple athletic events and have interest in nutrition to
enhance their performance (Worme et al., 1990). For this reason, Worme et al. (1990)
analyzed nutrition knowledge in triathletes compared to a control group of individuals
19
employed in a medical school or a research institute who did not have degrees in nutrition
or experience with triathlons. A nutrition knowledge questionnaire consisting of general
and sports nutrition, health and disease, and micronutrients questions was administered.
There was no evidence of a significant difference in nutrition knowledge between
triathletes and the control group; however, there was a significant difference in correct
responses between males and females (Worme et al., 1990). The quantity of correct
answers was significantly higher among females (Worme et al., 1990). This is similar to
findings in Dunn, Turner, and Denn ’s 2007 stud of nutrition knowledge in the
collegiate athlete population. Because the control group was comprised of participants in
health professions and there was no significant difference in scores between them and the
triathletes, Worme and colleagues (1990) concluded that the triathletes had high nutrition
knowledge.
A number of other studies have found that athletes do not have greater knowledge
of nutrition than non-athletes. In a study of university athletes and non-athletes who were
university psychology majors, Barr (1987) found that both groups had relatively equal
amounts of nutrition knowledge. Athletes scored higher than non-athletes on sports
nutrition related questions but lower on general nutrition questions (Barr, 1987; Heaney
et al., 2011). Collison, Kuczmarski, and Vickery (1996) discovered that non-athletes
who were university students had greater nutrition knowledge than athletes; however, it
was noted that 28% of the non-athletes were classified as nutrition majors (Heaney et al.,
2011). Frederick and Hawkins (1992) also found that participants in the non-athlete
20
comparison group in their studies also had greater nutrition knowledge than athletes
(Heaney et al., 2011).
Interventions to Increase Nutrition Knowledge
Student-athletes’ knowledge of nutrition can be impacted b education and
intervention programs. Yet, academic institutions often lack the resources necessary to
make educational programming available to student-athletes (Kunkel et al., 2001). Many
researchers have been successful in providing evidence that education and interventions
can improve student-athletes’ nutrition knowledge. Much of the research studying the
implementation of nutrition education and interventions for collegiate student-athletes
seems to have been conducted focusing on the female athlete population.
Kunkel et al. (2001) study the effect female peer educators had on collegiate
female athletes’ nutrition knowledge. The athletes were given a general and sports
nutrition knowledge and sport attitude pretest prior to beginning the peer education
program and were then counseled on topics such as serving sizes, snacks, dining out, and
weight management (Kunkel et al., 2001). Following peer counseling, athletes were
given the same knowledge and attitude questions in a posttest (Kunkel et al., 2001). The
athletes significantly improved both their general and sports nutrition knowledge at the
conclusion of the program (Kunkel et al., 2001). The researchers concluded that peer
education programs are effective in increasing general and sports nutrition knowledge in
female student-athletes (Kunkel et al., 2001).
Abood and colleagues (2004) used a pretest-posttest control group design to
measure effectiveness of a nutrition education intervention program for female athletes.
21
The study, which consisted of NCAA Division I athletes, randomly assigned a soccer
team as the experimental group and a swimming team as the control group (Abood et al.,
2004). After eight, one hour educational sessions, the experimental group had
significantly increased their nutrition knowledge scores from pretest to posttest in
comparison to the control group (Abood et al., 2004).
Nutrition education provided by an RD/RDN was also effective in NCAA
Division I women’s volle ball athletes. Participants were given individualized nutrition
education by a dietitian, and sports nutrition knowledge was assessed with a test preeducation and post-education (Valliant et al., 2012). General nutrition questions were
included within the questionnaire (Valliant et al., 2012). Following four intervention
sessions with a dietitian, there was a significant improvement in posttest scores compared
to pretest scores (Valliant et al., 2012).
Impact on dietary intake. In addition to an enhancement in student-athlete
nutrition knowledge, the studies by Abood et al. (2004) and Valliant et al. (2012) both
resulted in improved dietary intake following intervention. Valliant and colleagues
2012 assessed the volle ball athletes’ 3-day food records gathered pre-intervention
during their offseason and post-intervention during their off season. During the preintervention session, food records were collected once at the beginning of the off season
and once at the end (Valliant et al., 2012). After the conclusion of the intervention, food
records were collected once per month for four months (Valliant et al., 2012). Following
the intervention, the researchers observed a significant improvement in the recommended
22
intake of total energy, carbohydrate, and protein (Valliant et al., 2012). A slight increase
in fat intake was also observed (Valliant et al., 2012).
The use of a control group allowed Abood and colleagues (2004) to study
differences in dietary intake between student-athletes following an intervention.
Utilization of 3-day food records pre and post-intervention indicated that the
e perimental group’s dietar intake was significantl healthier following intervention
when compared to the group (Abood et al., 2004).
Nutrition Knowledge of Other Athletes
Several studies have examined nutrition knowledge in athletes other than those
participating in NCAA athletic programs, such as elite and recreational athletes. Similar
to studies of collegiate athletes, nutrition knowledge has varied in elite and recreational
athletes.
For three years, Wiita and Stombaugh (1996) followed elite female adolescent
runners as they aged. The participants completed two knowledge tests during the course
of the three years and did not receive any nutrition education or intervention from the
researchers (Wiita & Stombaugh, 1996 . Overall, the athletes’ nutrition knowledge was
stable from the beginning to the conclusion of the study, although they improved their
knowledge in some areas and decreased in others (Wiita & Stombaugh, 1996). The
athletes increased their knowledge in the areas of caloric value, digestion of complex
carbohydrates and protein, and low cholesterol and saturated fat in relation to heart
disease (Wiita & Stombaugh, 1996). Unfortunately, knowledge involving hydration and
skipping meals to aid in weight loss were decreased (Wiita & Stombaugh, 1996).
23
In a study comparing nutrition knowledge between elite and non-elite athletes,
Harrison, Hopkins, MacFarlane, and Worsley (1991) found that elite athletes had greater
knowledge. There was no significant difference in knowledge between males and
females, but males were more likely to have less nutrition knowledge (Harrison et al.,
1991). The researchers also stated that while the elite athletes had better knowledge than
non-elite athletes, a large amount of them did not have an understanding of the benefits of
vitamins (Harrison et al., 1991).
A nutrition education intervention has been shown to be effective in improving
nutrition knowledge for athletes with physical disabilities (APDs). Rastmanesh, Azam
Taleban, Kimiagar, Mehrabi, and Salehi (2007) provided nutrition education to APDs in
an intervention group and compared their knowledge to APDs in a control group who
received no education. Prior to and following the conclusion of three, four-hour
education courses, nutrition knowledge was measured using two questionnaires. APDs in
the experimental had significantly greater nutrition knowledge after receiving education
than APDs in the control group (Rastmanesh et al., 2007). The researchers recognized
that there was a knowledge deficit concerning calcium, fiber, vitamin D, energy, and
heart disease, in addition to some basic health and nutrition questions (Rastmanesh et al.,
2007). In regards to sources of nutrition information, coaches, family members, and
dietitians were the top three choices of the ADPs as whole at baseline (Rastmanesh et al.,
2007). Interestingly, following the nutrition education, 50% of the intervention group
indicated they would rather receive nutrition information from a dietitian (Rastmanesh et
al., 2007). At baseline, 14.3% of the intervention group and 16.6% of the control group
24
indicated they would consult a dietitian for nutrition information (Rastmanesh et al.,
2007).
College Coursework in Nutrition
Student-athletes have indicated they obtain nutrition information from a variety of
sources. Many of these sources, such as coaches, have had limited or no prior training or
experience in nutrition (Karpinski, 2012). Multiple studies have discovered that studentathletes consider college coursework in nutrition or health and nutrition as a source of
their information (Hornstrom et al., 2011; Jacobson et al., 1991; Jacobson et al., 2001).
However, if an athlete is not pursuing a health-related or science-based major or does not
enroll in a nutrition course as an elective, they may not be exposed to nutrition
information in the classroom setting.
Because there seems to be limited information being delivered from sports
medicine teams and dietitians, Karpinski (2012) suggested institutions offer a college
course in nutrition specifically for student-athletes. The proposed course would be
tailored to discuss the personal nutrition needs of student-athletes (Karpinski, 2012).
Karpinski (2012) developed an outline of objectives for the hypothetical nutrition course.
Some of the objectives include developing personal nutrition and meal goals,
understanding water in relation to performance, describing nutrition’s role in fitness and
exercise, weight control, and understanding macronutrients and micronutrients and their
role in athletic performance Karpinski, 2012 . As described b Karpinski 2012 , “there
would be a focus on application of the content to identify each student-athlete’s nutrition
25
needs and explore ways in which the student-athlete could improve his or her diet to
optimize health and performance.” pp. 269 .
Karpinski (2012) noted that there are multiple benefits and barriers of a nutrition
course offered specifically to student-athletes. For example, a possible benefit is that if
athletes were to enroll in the course as a freshman the knowledge they acquire might
encourage positive dietary behaviors from the beginning of their collegiate careers
(Karpinski, 2012). Another benefit would be the duration that the course is offered
(Karpinski, 2012). Abood et al. (2004), Kunkel et al. (2001), and Valliant et al. (2012)
found providing education interventions were successful in increasing student-athletes’
nutrition knowledge. A student-athlete nutrition course would be similar to providing an
intervention, but for a greater duration than typical research studies implement
(Karpinski, 2012). On the contrary, student-athletes may not enroll in the course or have
interest in nutrition (Karpinski, 2012). Additionally, a sports dietitian would need to be
part of the institution’s facult to instruct the course Karpinski, 2012). In terms of
institutions that might already offer a course in nutrition for student-athletes, Karpinski
(2012) mentioned that there is no data to determine if any exist.
Resources’ Nutrition Knowledge
Registered Dietitians
According to the Academy of Nutrition and Dietetics 2014 , the world’s largest
organization of food and nutrition professionals, “registered dietitian nutritionists, or
RDNs, are the food and nutrition experts, translating the science of nutrition into practical
solutions for healthy living. The expertise, training and credentials that back a registered
26
dietitian nutritionist are vital for promoting positive lifest le choices” “What Is an
RDN?,” para. 1 . Shattuck 2001 discussed that some collegiate athletic departments
understand the importance of having the knowledge and skills of dietitians and have
developed positions for them on their staffs to “gain a competitive edge” p. 517 . For
instance, the University of Washington athletic department created the Husky Sport
Nutrition Program, staffed with a dietitian and graduate student in nutrition and exercise
physiology, to provide multiple educational services to student-athletes, including
counseling sessions and team presentations that discuss various topics such as
macronutrients, hydration, meal planning, and achieving a healthy weight (Vinci, 1998).
Furthermore, The Pennsylvania State University, the first institution to staff a full-time
sports dietitian, found that offering these types of services have even impacted the
recruitment of student-athletes to their athletic programs (Clark, 1999).
Sports dietitians have acquired the training and experience to assess nutritional
needs associated with physical activity (Steinmuller et al., 2014). Recently, the Sports,
Cardiovascular, and Wellness Nutrition Dietetic Practice Group and the Academy of
Nutrition and Dietetics released the Revised 2014 Standards of Practice and Standards of
Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient,
and Expert) in Sports Nutrition and Dietetics, written by a group of Certified Specialists
in Sports Dietetics (CSSDs) (Steinmuller et al., 2014). Within the article, the position of
a sports dietitian is discussed in detail. Steinmuller and colleagues (2014) explained the
role of a sports dietitian as follows:
27
Sports RDNs provide medical nutrition therapy (MNT) in direct care and design,
implement, and manage safe and effective nutrition strategies that enhance
lifelong health, fitness, and optimal physical performance. They assess, educate,
and counsel what, how much, and when to consume foods and fluids to maintain
health, appropriate body weight and composition, and how to properly fuel the
body for PA (physical activity) and exercise, training and conditioning, and
physical performance. Valued for their ability to positively impact behavior and
promote behavior change, sports RDNs assist individuals in implementing
nutrition plans that achieve their goals. In addition, sports RDNs generate and
analyze data to monitor and evaluate the effectiveness of their interventions. (pp.
633)
The impact nutrition has on athletes goes further than affecting just athletic
performance. Multiple aspects of an athlete’s health can be influenced b nutrition
practices and counsel. As stated by Steinmuller et al. (2014):
Sports nutrition guidance can enhance training capacity, improve physical
performance, reduce the risk of injury, enhance the healing process, strengthen the
immune system, enhance cognitive performance, and promote appropriate body
weight and composition in athletes. Evidence-based nutrition strategies facilitate
recovery from strenuous exercise by refueling and rehydrating the body,
providing nutrients to build and repair muscles, reducing stress, and preparing
athletes for the next training session or competition. (pp. 636)
28
To further their understanding of sports nutrition, dietitians can complete the
requirements to become a CSSD in addition to being a registered dietitian. Registered
dietitians earn the Board Certified credential by meeting practice requirements and
passing the CSSD examination (Steinmuller et al., 2014).
Certified Athletic Trainers
In previous literature involving the assessment of nutrition knowledge of certified
athletic trainers there has been indication that ATCs receive little to no formal training
and education in nutrition (Burns et al., 2004; Smith Rockwell et al., 2001). According to
the most recent National Athletic Trainers’ Association Athletic Training Education
Competencies document released in 2011, nutrition education is now integrated into the
requirements of the athletic training curriculum. The document, which discusses the
minimum competencies to be met by students in athletic training programs, states the
following in regards to nutrition:
Athletic trainers develop and implement strategies and programs to prevent the
incidence and/or severity of injuries and illnesses and optimize their
clients’/patients’ overall health and qualit of life. These strategies and programs
also incorporate the importance of nutrition and physical activity in maintaining a
healthy lifestyle and preventing chronic disease (eg, diabetes, obesity,
cardiovascular disease . National Athletic Trainers’ Association, 2011, pp. 13
Multiple studies have investigated nutrition knowledge in this population of
health professionals employed within NCAA athletics. Research by Shifflett et al. (2002)
found that athletic trainers had more nutrition knowledge than coaches when assessed
29
using a questionnaire. Additionally, Shifflett el al. (2002) concluded ATCs had more
familiarity with issues in sports nutrition than coaches. Smith Rockwell et al. (2001)
discovered the opposite; strength and conditioning coaches had more nutrition knowledge
than athletic trainers.
In general, it appears ATCs have varying levels of knowledge and understanding
of basic nutrition concepts. Torres-McGehee et al. (2012) assessed nutrition knowledge
within four domains: micronutrients and macronutrients, supplements and performance,
weight management and eating disorders, and hydration. When compared to coaches,
SCCs, and athletes, athletic trainers scored the highest in the hydration domain (TorresMcGehee et al., 2012). For each of the other domains, ATCs achieved the second highest
score behind SCCs (Torres-McGehee et al., 2012). However, because of the number of
participants included in the study, athletic trainers and SCCs were determined to have
equal nutrition knowledge (Torres-McGehee et al., 2012). These results differ from
findings of Smith Rockwell et al. (2001), where ATCs’ nutrition knowledge scores were
the lowest in the micronutrients and macronutrients categories.
Athletic trainers may be under the impression that they have a better
understanding of nutrition than they actually do. While assessing nutrition knowledge,
Torres-McGehee et al. (2012) also asked participants to indicate how confident they were
in their responses on the questionnaire. Athletic trainers, as well as SCCs, had the
highest confidence levels for both correct and incorrect responses (Torres-McGehee et
al., 2012). The researchers acknowledged that this finding is alarming, as these two
groups work closely to student-athletes and could perhaps be distributing incorrect
30
nutrition information (Torres-McGehee et al., 2012). Some collegiate student-athletes
have acknowledged athletic trainers as being their main contact source when seeking
nutrition information (Burns et al., 2004).
On a positive note, the majority of ATCs in Torres-McGehee and colleagues’
study (2012) responded that they would recommend student-athletes discuss nutrition
with a dietitian. When seeking nutrition information for themselves personally, the
majority of athletic trainers responded that they were most likely to reference an
academic journal firstly, followed by registered dietitian and lastly, a physician (TorresMcGehee et al., 2012). Shifflett et al. (2002) also reported ATCs reference academic
journals when locating nutrition information, followed by nutrition faculty.
Strength and Conditioning Coaches and Coaches
Both coaches and strength and conditioning coaches regularly interact with
student-athletes. Many NCAA collegiate student-athletes have indicated they are likely
to consult with coaches or strength and conditioning coaches when they are searching for
nutrition information (Burns et al., 2004; Jacobson et al., 2001; Shifflett et al., 2002;
Torres-McGehee et al., 2012; Zawila et al., 2003). As it is a position that was created
fairly recently, literature examining the nutrition knowledge of SCCs is limited (TorresMcGehee, 2012).
In nutrition knowledge studies that have included strength and conditioning
coaches, SCCs have possessed greater than or equal to the amount of knowledge of
athletic trainers, coaches, and athletes. For example, in a study by Torres-McGehee et al.
(2012), SCCs and ATCs had comparable knowledge of nutrition, and SCCs had greater
31
knowledge than coaches. When assessed using a questionnaire, strength and
conditioning coaches collectively scored the highest in the categories of micronutrients
and macronutrients, supplements and performance, and weight management and eating
disorders and scored equal to ATCs in hydration (Torres-McGehee et al., 2012).
Strength and conditioning coaches in another study provided significantly more correct
responses on a nutrition questionnaire in comparison to ATCs and coaches, and it was
determined SCCs have an understanding of basic nutrition concepts (Smith Rockwell et
al., 2001).
It seems as if coaches generally do not have a strong nutrition foundation.
Multiple studies in which coaches have participated have resulted in coaches scoring less
than ATCs and SCCs on nutrition knowledge questionnaires (Shifflett et al., 2002;
Torres-McGehee et al., 2012). However, coaches did slightly outscore athletic trainers in
a nutrition knowledge study by Smith Rockwell et al. (2001). Smith Rockwell et al.
(2001), as well as Torres-McGehee et al. (2012), found coaches scored low in the areas of
micronutrients and macronutrients. Coaches’ confidence levels in answering questions
was variable in Torres-McGehee et al.’s 2012 stud . The researchers implied this ma
be an indication that it could be advantageous for coaches to consult with a dietitian
(Torres-McGehee et al., 2012).
Like ATCs, SCCs in Torres-McGehee et al.’s 2012 stud were often confident
in their answer selections, even for responses that were incorrect. The majority of SCCs
indicated they would reference an academic journal when locating nutrition information
for themselves and recommend student-athletes consult an RD/RDN (Torres-McGehee et
32
al., 2012). Contrastingly, coaches were more likely to reference an athletic trainer for
nutrition information (Torres-McGehee et al., 2012). This is similar to a previous study
where coaches responded that both athletic trainers and nutrition faculty were equally
likely sources of nutrition information (Shifflett et al., 2002). They too, however, would
recommend student-athletes refer to a dietitian for nutrition information (TorresMcGehee et al., 2012).
Link in Literature between Nutrition Knowledge, NCAA Divisions, and Access to
Registered Dietitians
After a thorough review of literature, there does not appear to be a specific
connection in literature between student-athletes’ level of nutrition knowledge and the
NCAA Division they participate within and whether differences in knowledge exist
between Divisions I, II, and III. In addition, there does not seem to be any data related to
whether or not having access to a registered dietitian impacts the amount of knowledge
student-athletes have acquired and if knowledge differences exist between the studentathletes that have access to an RD/RDN and those who do not. Torres-McGehee and
colleagues (2012) acknowledged that future research should explore whether nutrition
knowledge differences exist between Divisions and if knowledge differences exist based
on access to a registered dietitian.
CHAPTER III
METHODOLOGY
Study Design
The purpose of this quantitative, cross-sectional study was to evaluate sports
nutrition knowledge and experiences with registered dietitians amongst collegiate
student-athletes across NCAA Divisions I, II, and III. It was hypothesized that there
would be a difference in sports nutrition knowledge between student-athletes across
NCAA Divisions, as well as between male and female student-athletes. The independent
variables in this study were NCAA Division and gender, and the dependent variable was
sports nutrition knowledge.
Setting
This study was conducted at fifteen Ohio college and university institutions with
NCAA sanctioned varsity athletics programs. Nonrandom sampling was used to select
five schools from each Division I, Division II, and Division III to participate. Ohio
college and university institutions with NCAA sanctioned varsity athletic programs were
selected purposively based on vicinity to the research institution.
The following institutions were selected from Division I: Kent State University,
University of Akron, Bowling Green State University, Cleveland State University, and
Youngstown State University. Ashland University, Lake Erie College, Malone
University, Notre Dame College, and Tiffin University were selected from Division II.
Institutions in Division III that were selected were Baldwin Wallace University, Case
33
34
Western Reserve University, Hiram College, John Carroll University, and the University
of Mount Union.
Participants
Participants in this study represent a convenience sample of NCAA Division I, II,
and III student-athletes. All varsity sports programs funded through the athletic
department of each institution qualified. Any student-athlete participating in a varsity
sport at each of the fifteen institutions qualified for the study. Student-athletes who
indicated their academic major as nutrition or nutrition-related (i.e. dietetics) were
excluded from the study. This study received approval from the Institutional Review
Board at Kent State University.
Questionnaire
The questionnaire (Appendix A) included the following components: basic
nutrition knowledge and sports nutrition knowledge, personal feelings towards sports
nutrition statements, sources used to obtain current nutrition information, characteristics
and demographics, and sports nutrition experience.
The questionnaire was adapted with permission from Hornstrom et al.’s 2011
nutrition knowledge, practices, attitudes, and information sources questionnaire used for
Mid-American Conference college softball players. The questionnaire is a combination
of sports nutrition surveys that have been utilized in other research studies by Bayless
(2006), Shifflett et al. (2002), Werblow, Fox, and Henneman (1978), and Zawila et al.
(2003).
35
Questionnaire Components
Nutrition knowledge. The questionnaire began with a section of a series of 35
basic nutrition and sports nutrition statements that may or may not be correct.
Participants indicated their responses to the statements b answering “True,” “False,” or
“Don’t Know” for each statement.
Feelings towards sports nutrition statements. The following section consisted
of a five-point Likert scale ranging from 1, “Strongl Agree” to 5, “Strongl Disagree”
that measured participants’ feelings towards four statements pertaining to sports nutrition.
Sources of nutrition information. A third section inquired about the likelihood
student-athletes would use the following sources to obtain current information regarding
nutrition from: athletic trainer, strength and conditioning coach, academic journals,
friends, parents, physicians, internet, coach, magazines, college nutrition/health courses,
dietitian, other. A five-point Likert scale ranging from the options of 1, “Ver Likel ” to
5, “Ver Unlikel ” was used to measure responses.
Participant characteristics and demographics. The fourth section of the
questionnaire included participant characteristics and demographics. It consisted of the
following items: (a) age; (b) gender; (c) institution attending; (d) sport participating in;
(e) current academic standing; (f) whether the student-athlete’s current residence is on or
off-campus (g) academic major; (h) number of courses in college in which nutrition was
included and how many, if applicable.
36
Sports nutrition experience. The following questions related to student-athletes’
previous sports nutrition experience were assessed: (a) consultations with a
dietitian/nutritionist; b if a dietitian/nutritionist has ever spoken to the athlete’s team; c
if the athlete has ever taken a grocery store tour led by a dietitian/nutritionist; (d) if the
athlete’s team offers training tables; e); if the athlete has received education on the
Female Athlete Triad; (f) if the athlete has received education on NCAA banned
substances; (g) if the student-athlete’s athletic department has a dietitian/nutritionist; (h)
if answers no or don’t know to g , if the athlete has access to a dietitian/nutritionist on
campus (through the student recreation center, student health center, dining services, or
other).
The following two statements were assessed using a five-point Likert scale
ranging from 1, “Strongl Agree” to 5, “Strongl Disagree:” a if the athlete thinks
having a dietitian/nutritionist on their team’s staff would help in achieving a healthy diet;
(b if the athlete thinks having a dietitian/nutritionist on their team’s staff would help in
improving athletic performance.
Scoring Questionnaire
The basic nutrition and sports nutrition statements were scored following the
system used by Hornstrom et al. (2011). Statements answered correctly were given a
score of 1, and statements answered incorrectl , including those with the answer “Don’t
Know,” were scored as 0. The overall score was referred to as the Nutrition Knowledge
Score (NKS) (Hornstrom et al., 2011).
37
Procedures
Participants were recruited for the study electronically. The e-mail addresses for
members of the coaching staff for every team were obtained from the staff directory
located on each academic institution’s athletic department website. Head coaches and
assistant coaches, as well as strength and conditioning coaches for those athletic
departments that staffed them, for each team were contacted by the researcher via e-mail.
An initial e-mail (Appendix B) describing the purpose and background of the
study, along with a hyperlink to a web-based questionnaire administered through the
online survey software Qualtrics, was sent to all the coaching staffs at the fifteen
institutions on January 20, 2015. Coaches were asked to forward the e-mail to the
student-athletes on their respective teams. The participants were provided with a webbased study consent form (Appendix C) with the option to decline participation. On
February 3, 2015, a reminder e-mail that provided the purpose and background of the
study, as well as the hyperlink to the questionnaire, was sent to the coaching staffs to
forward to their student-athletes. The questionnaire was accessible from January 20,
2015 through February 20, 2015.
Statistical Analysis
Statistical Package for the Social Sciences (SPSS) version 21.0 was utilized to
analyze the data gathered. The means of the NKS for each NCAA Division I, II, and III
group were calculated. A one-way analysis of variance (ANOVA) was conducted to
examine the NKS between each of the Divisions. A t-test determined whether any
38
knowledge differences existed between males and females. The Likert-scale statements
regarding feelings towards sports nutrition statements and the sources from which
participants indicated they currently receive nutrition information were assessed using
descriptive statistics, and a one-way ANOVA was done to compare the responses
between NCAA Divisions. Participant characteristics and demographics and questions
regarding experience with a dietitian were evaluated using frequencies and descriptive
statistics. A p value with a significance of < 0.05 was used for comparison.
CHAPTER IV
JOURNAL ARTICLE
Introduction
The National Collegiate Athletic Association (NCAA) includes nutrition as a
health component that affects the overall wellness of its more than 463,000 studentathletes (NCAA Sports Sponsorship, 2013; NCAA Sports Medicine, 2013). Nutrition is
considered to be a vital factor in maintaining the health and wellbeing of student-athletes,
as well as assisting in the optimization of athletic performance (NCAA Sports Medicine,
2013). Injury risk, immune system function, and healing, to name a few, can all be
impacted b an athlete’s dietar intake and nutritional status (Steinmuller et al., 2014).
It is well documented that student-athletes obtain nutrition information from a
number of sources, including certified athletic trainers (ATCs), strength and conditioning
coaches (SCCs), and coaches (Burns, Schiller, Merrick, & Wolf, 2004; Jacobson,
Sobonya, & Ransone, 2001; Shifflett, Timm, & Kahanov, 2002; Torres-McGehee et al.,
2012). Unfortunately, many ATCs, SCCs, and coaches may not have a clear
understanding of basic nutrition. Athletic trainers and strength and conditioning coaches
have expressed confidence in their incorrect responses on a nutrition knowledge
questionnaire, creating concern that they may disseminate inappropriate information to
student-athletes (Torres-McGehee et al., 2012). Additionally, coaches who have
participated in nutrition knowledge studies have underachieved in comparison to ATCs
and SCCs (Shifflett et al., 2002; Torres-McGehee et al., 2012).
39
40
Student-athletes have often been identified as having inadequate knowledge of
nutrition (Dunn et al., 2007). Established sports nutrition programs, such as the Husky
Sport Nutrition Program at the University of Washington, offer student-athletes
numerous educational resources and opportunities to receive counseling from a dietitian
(Vinci, 1998). Despite the advantages of staffing a registered dietitian/registered dietitian
nutritionist (RD/RDN), many NCAA Division II, III, and even smaller Division I, athletic
departments may not have the budgetary means to facilitate sports dietitians.
Currently, there appears to be no information available regarding the nutrition
knowledge of student-athletes between NCAA Divisions I, II, and III and whether
knowledge differences exist between athletes across these Divisions (Torres-McGehee et
al., 2012). The purpose of this study was to evaluate sports nutrition knowledge and
experiences with registered dietitians amongst collegiate student-athletes across NCAA
Divisions I, II, and III.
Methods
Study Design
The purpose of this quantitative, cross-sectional study was to evaluate sports
nutrition knowledge and experiences with registered dietitians amongst collegiate
student-athletes across NCAA Divisions I, II, and III. It was hypothesized that there
would be a difference in sports nutrition knowledge between student-athletes across
NCAA Divisions, as well as between male and female student-athletes. The independent
41
variables in this study were NCAA Division and gender, and the dependent variable was
sports nutrition knowledge.
Setting
This study was conducted at fifteen Ohio college and university institutions with
NCAA sanctioned varsity athletics programs. Nonrandom sampling was used to select
five schools from each Division I, Division II, and Division III to participate. Ohio
college and university institutions with NCAA sanctioned varsity athletic programs were
selected purposively based on vicinity to the research institution.
The following institutions were selected from Division I: Kent State University,
University of Akron, Bowling Green State University, Cleveland State University, and
Youngstown State University. Ashland University, Lake Erie College, Malone
University, Notre Dame College, and Tiffin University were selected from Division II.
Institutions in Division III that were selected were Baldwin Wallace University, Case
Western Reserve University, Hiram College, John Carroll University, and the University
of Mount Union.
Participants
Participants in this study represent a convenience sample of NCAA Division I, II,
and III student-athletes. All varsity sports programs funded through the athletic
department of each institution qualified. Any student-athlete participating in a varsity
sport at each of the fifteen institutions qualified for the study. Student-athletes who
indicated their academic major as nutrition or nutrition-related (i.e. dietetics) were
42
excluded from the study. This study received approval from the Institutional Review
Board at Kent State University.
Measurement Instrument
The participants’ sports nutrition knowledge and e periences with registered
dietitians were measured using a questionnaire (Appendix A) administered through the
online survey software Qualtrics. It was adapted with permission from Hornstrom et al.
(2011), and is a combination of sports nutrition surveys that have been utilized in other
research studies by Bayless (2006), Shifflett et al. (2002), Werblow, Fox, and Henneman
(1978), and Zawila et al. (2003). It consisted of the following components: basic
nutrition knowledge and sports nutrition knowledge, personal feelings towards four
sports nutrition statements, sources used to obtain current nutrition information,
characteristics and demographics, and sports nutrition experience.
Nutrition knowledge. The questionnaire began with a section of a series of 35
basic nutrition and sports nutrition statements that may or may not be correct.
Participants indicated their responses to the statements b answering “True,” “False,” or
“Don’t Know” for each statement.
Feelings towards sports nutrition statements. The following section consisted
of a five-point Likert scale ranging from 1, “Strongl Agree” to 5, “Strongl Disagree”
that measured participants’ feelings towards four statements pertaining to sports nutrition.
Sources of nutrition information. A third section inquired about the likelihood
student-athletes would use the following sources to obtain current information regarding
43
nutrition from: athletic trainer, strength and conditioning coach, academic journals,
friends, parents, physicians, internet, coach, magazines, college nutrition/health courses,
dietitian, other. A five-point Likert scale ranging from the options of 1, “Ver Likel ” to
5, “Ver Unlikel ” was used to measure responses.
Participant characteristics and demographics. The fourth section of the
questionnaire included participant characteristics and demographics. It consisted of the
following items: (a) age; (b) gender; (c) institution attending; (d) sport participating in;
(e) current academic standing; (f) whether the student-athlete’s current residence is on or
off-campus (g) academic major; (h) number of courses in college in which nutrition was
included and how many, if applicable.
Sports nutrition experience. The following questions related to student-athletes’
previous sports nutrition experience were assessed: (a) consultations with a
dietitian/nutritionist; b if a dietitian/nutritionist has ever spoken to the athlete’s team; c
if the athlete has ever taken a grocery store tour led by a dietitian/nutritionist; (d) if the
athlete’s team offers training tables; e ; if the athlete has received education on the
Female Athlete Triad; (f) if the athlete has received education on NCAA banned
substances; (g) if the student-athlete’s athletic department has a dietitian/nutritionist; (h)
if answers no or don’t know to g , if the athlete has access to a dietitian/nutritionist on
campus (through the student recreation center, student health center, dining services, or
other).
44
The following two statements were assessed using a five-point Likert scale
ranging from 1, “Strongl Agree” to 5, “Strongl Disagree:” a if the athlete thinks
having a dietitian/nutritionist on their team’s staff would help in achieving a healthy diet;
(b) if the athlete thinks having a dietitian/nutritionist on their team’s staff would help in
improving athletic performance.
Scoring Questionnaire
The basic nutrition and sports nutrition statements were scored following the
system used by Hornstrom et al. (2011). Statements answered correctly were given a
score of 1, and statements answered incorrectl , including those with the answer “Don’t
Know,” were scored as 0. The overall score was referred to as the Nutrition Knowledge
Score (NKS) (Hornstrom et al., 2011).
Procedures
Participants were recruited for the study electronically. The e-mail addresses for
members of the coaching staff for every team were obtained from the staff directory
located on each academic institution’s athletic department website. Head coaches and
assistant coaches, as well as strength and conditioning coaches for those athletic
departments that staffed them, for each team were contacted by the researcher via e-mail.
An initial e-mail (Appendix B) describing the purpose and background of the
study, along with a hyperlink to a web-based questionnaire administered through the
online survey software Qualtrics, was sent to all the coaching staffs at the fifteen
institutions on January 20, 2015. Coaches were asked to forward the e-mail to the
45
student-athletes on their respective teams. The participants were provided with a webbased study consent form (Appendix C) with the option to decline participation. On
February 3, 2015, a reminder e-mail that provided the purpose and background of the
study, as well as the hyperlink to the questionnaire, was sent to the coaching staffs to
forward to their student-athletes. The questionnaire was accessible from January 20,
2015 through February 20, 2015.
Statistical Analysis
Statistical Package for the Social Sciences (SPSS) version 21.0 was utilized to
analyze the data gathered. The means of the NKS for each NCAA Division I, II, and III
group were calculated. A one-way analysis of variance (ANOVA) was conducted to
examine the NKS between each of the Divisions. A t-test determined whether any
knowledge differences existed between males and females. The Likert-scale statements
regarding feelings towards sports nutrition statements and the sources from which
participants indicated they currently receive nutrition information were assessed using
descriptive statistics, and a one-way ANOVA was done to compare the responses
between NCAA Divisions. Participant characteristics and demographics and questions
regarding experience with a dietitian were evaluated using frequencies and descriptive
statistics. A p value with a significance of < 0.05 was used for comparison.
Results
One hundred and eighty-two questionnaires were completed. Of that total, 171
questionnaires were used in the study. Participants who indicated their academic major
46
as being within the nutritional sciences or who did not specify the academic institution in
which they attend were excluded. Additionally, one Division III academic institution
declined participation. Participation frequencies for each academic institution
represented in this study are displayed in Appendix D.
Had each coaching staff at the remaining fourteen institutions forwarded their
team the e-mail to participate, the questionnaire had the potential to reach approximately
6,200 student-athletes. Unfortunately, knowing how many coaches acknowledged the email and forwarded it to their student-athletes is undeterminable. Although 171 total
participants would suggest a 2.8% response rate, it is unknown how many studentathletes received the stud ’s e-mail to support this statistic.
Participants were an average of 19.60 years of age. Sixty-nine percent (n = 118)
of the participants were female, and 31.0% (n = 53) were male. National Collegiate
Athletic Association Division I student-athletes had the lowest participation rate as they
represented 28.1% (n = 48) of the sample. Division II student-athletes comprised 32.2%
(n = 55) of the participants. All Division I and Division II institutions contacted to
participate were represented in the study. The remaining 39.8% (n = 68) of participants
were representative of Division III. Three of the five Division III academic institutions
contacted participated in the study. Participant characteristics and demographics are
displayed in Table 1.
Although not every sport that was contacted is represented in the study, studentathletes from many teams participated. Sports represented in the data include the
47
following: baseball (n = 12 , women’s basketball n = 1 , men’s cross countr
women’s cross countr
n = 4),
n = 4 , women’s diving n = 2), football (n = 12 , men’s golf n =
2 , women’s golf n = 14), gymnastics (n = 2), women’s lacrosse n = 8 , men’s rifle n =
1 , women’s rifle n = 1 , men’s soccer n = 6 , women’s soccer n = 21), softball (n =
10 , men’s swimming n = 3 , women’s swimming (n = 15 , men’s tennis n = 1 , men’s
track and field (n = 15 , women’s track and field n = 14), and volleyball (n = 23).
Table 1
Demographic Characteristics of NCAA Division I, II, and III Student-Athletes Completing
Questionnaire (n = 171)
Characteristic
n
%
Male
Female
53
118
31.0
69.0
I
II
III
48
55
68
28.1
32.2
39.8
Freshman
Sophomore
Junior
Senior
Fifth-Year Senior
No response
58
55
24
30
2
2
33.9
32.2
14.0
17.5
1.2
1.2
On-campus
Off-campus
127
44
74.3
25.7
Gender
NCAA Division
Academic Standing
Current Residence
College Coursework with Nutrition
Component
Yes
68
39.8
No
102
59.6
No response
1
0.6
Note. Data represents student-athletes who completed sports nutrition knowledge questionnaire.
48
Overall, 63.7% (n = 109) of participants achieved an NKS of 60% or greater. The
remaining 36.3% (n = 62) of participants received an NKS of 60% or lower. The mean
NKS for the entire sample was 61.22 ± 12.57. A one-way ANOVA was conducted to
determine whether any differences in sports nutrition knowledge existed between studentathletes across Divisions I, II, and III. Using p < 0.05 for comparison, the sports nutrition
knowledge between student-athletes across Divisions was not significant (F = .385, p =
.681). It was found, however, that female student-athletes achieved significantly higher
Nutrition Knowledge Scores in comparison to their male counterparts (F = 6.313, p =
.008). The Nutrition Knowledge Score means and standard deviations across NCAA
Divisions and gender are displayed in Table 2. Frequencies of correct and incorrect
responses to the 35 nutrition knowledge statements for the entire sample are presented in
Appendix E.
Table 2
Summary of NKS Means and Standard Deviations ( ± SD) across NCAA Divisions and
Gender of Student-Athletes Responding to Sports Nutrition Knowledge Questionnaire
SD
NCAA Division
I
II
III
Total
62.26
60.10
61.39
61.22
11.38
12.03
13.84
12.57
Gender
Male
57.41
13.93
Female
62.93
11.57
Note. NKS = Nutrition Knowledge Score. Nutrition Knowledge Score calculated from
responses to 35 basic and sports nutrition knowledge statements.
49
Mean scores and standard deviations representing participants’ feelings towards
four statements pertaining to sports nutrition are displayed in Table 3. Most participants
agreed to the statements that the food an athlete consumes is likely to affect his or her
performance (1.30 ± .51) and that nutrition counseling would be important to the athlete
who is trying to change his or her weight (1.59 ± .72). Participants tended to remain
neutral towards the statement the caffeine has been shown to improve endurance
performance (3.22 ± 1.09). Many participants disagreed with the statement that learning
about nutrition is not important for athletes because they eat so much food they always
get the nutrients their bodies need (4.30 ± 1.03).
Table 3
Means and Standard Deviations ( ± SD) Representing NCAA Student-Athletes’ Feelings
towards Sports Nutrition Statements
Statement
n
± SD
Caffeine has been shown to improve
endurance performance
170
3.22 ± 1.09
The type of food an athlete eats affects
his or her performance
171
1.30 ± 0.51
Learning about nutrition is not important
for athletes because they eat so much
food they always get the nutrients their
bodies need
171
4.30 ± 1.03
Nutritional counseling would be
important to the athlete who is trying to
change his or her weight
171
1.59 ± 0.72
Note. Scoring ranged from 1, “Strongl Agree” to 5, “Strongl Disagree.” Data
represents student-athletes who completed sports nutrition knowledge questionnaire.
50
Displayed in Table 4 are the means and standard deviations corresponding to the
resources in which participants indicated they would be likely to use to obtain current
nutrition information.
Table 4
Means and Standard Deviations ( ± SD) Representing NCAA Student-Athletes’
Likelihood to Utilize Resources to Obtain Current Nutrition Information
Resource
n
± SD
Dietitian/Nutritionist
170
1.71 ± 1.01
Strength & Conditioning Coach
171
1.87 ± 1.04
College Nutrition/Health Courses
171
1.88 ± 0.97
Athletic Trainer
171
2.03 ± 1.03
Physicians
171
2.05 ± 1.00
Coach
171
2.32 ± 1.08
Internet
171
2.56 ± 1.08
Academic Journals
171
2.71 ± 1.07
Parents
170
2.76 ± 1.08
Friends
170
2.83 ± 0.99
Magazines
171
3.27 ± 1.08
Other
28
3.46 ± 1.29
Note. Scoring ranged from 1, “Ver Likel ” to 5, “Ver Unlikel .” Data represents
student-athletes who completed sports nutrition knowledge questionnaire.
As a group, participants selected dietitian/nutritionist as the resource they would
be most likely to consult, as represented by a mean of 1.71 ± 1.01. Strength and
conditioning coaches (1.87 ± 1.04), college nutrition/health courses (1.88 ± 0.97), athletic
trainers (2.03 ± 1.03), and physicians (2.05 ± 1.00) completed the top five resources.
Friends (2.83 ± 0.99) and magazines (3.27 ± 1.08) were less likely to be selected as
resources by participants. Participants who selected “Other” listed college nutrition
professors (n = 3), physical therapist (n = 1), television (n = 2), other student-athletes (n =
51
2), YouTube (n = 1), and doctor (n = 1) as resources they would likely utilize to obtain
nutrition information. Eighteen participants who selected “Other” did not specif a
resource.
Responses to the questions regarding sports nutrition experience are shown by
NCAA Division in Table 5. Most participants, regardless of NCAA Division, indicated
they have not consulted with a dietitian/nutritionist and have not taken a grocery store
tour led by a dietitian/nutritionist. More than half of the student-athletes in Division I (n
= 32) have had a dietitian/nutritionist speak to their team. Less than half of the
participants in Division III (n = 32) and approximately 14.5% of student-athletes in
Division II (n = 8) have had a dietitian/nutritionist speak to their team. Many studentathletes were not members of teams that offer training tables. Of the 118 female studentathletes who completed the study, 22.0% (n = 26) responded that they have been
educated on the female athlete triad with the majority of participants representing
Division III teams. Most participants (n = 161) indicated they have received education in
relation to NCAA banned substances.
When asked about whether their athletic department has a dietitian/nutritionist,
approximately 78.4% (n = 134) of the participants responded “No” or “Don’t Know.”
Approximately 67.6% (n = 46) of the participants in Division III responded that they did
not know. Over half of the participants in Division I (n = 27) indicated their athletic
departments have a dietitian/nutritionist. Fifty-seven student-athletes indicated they had
access to a dietitian/nutritionist elsewhere on campus.
52
Table 5
NCAA Student-Athletes’ Responses to Questions Regarding Sports Nutrition E perience (n = 171)
Division I,
(n = 48)(%)
Division II,
(n = 55)(%)
Division III,
(n = 68)(%)
Total,
(n = 171)(%)
Consulted with dietitian/nutritionist?
Yes
13(27.1)
6(10.9)
7(10.3)
26(15.2)
No
35(72.9)
49(89.1)
61(89.7)
145(84.8)
Dietitian/nutritionist spoken to
team?
Yes
32(66.7)
8(14.5)
32(47.1)
72(42.1)
No
16(33.3)
47(85.5)
36(52.9)
99(57.9)
Taken grocery store tour led by
dietitian/nutritionist?
Yes
2(4.2)
0(0.0)
0(0.0)
2(1.2)
No
46(95.8)
55(100.0)
68(100.0)
169(98.8)
Team offer training tables?
Yes
16(33.3)
7(12.7)
16(23.5)
39(22.8)
No
32(66.7)
47(85.5)
51(75.0)
130(76.0)
No Response
0(0.0)
1(1.8)
1(1.5)
2(1.2)
Received education on Female
Athlete Triad?a
Yes
9(25.0)
6(12.5)
11(32.4)
26(22.0)
No
27(75.0)
42(87.5)
23(67.6)
92(78.0)
Received education in relation to
NCAA banned substances?
Yes
44(91.7)
52(94.5)
65(95.6)
161(94.2)
No
4(8.3)
3(5.5)
3(4.4)
10(5.8)
Athletic department have
dietitian/nutritionist?
Yes
27(56.3)
5(9.1)
5(7.4)
37(21.6)
No
6(12.5)
23(41.8)
17(25.0)
46(26.9)
Don’t Know
15(31.3)
27(49.1)
46(67.6)
88(51.5)
If team does not have
dietitian/nutritionist, access to
dietitian/nutritionist on campus?
Yes
17(35.4)
17(30.9)
23(33.8)
57(33.3)
No
4(8.3)
33(60.0)
32(47.1)
69(40.4)
No Response
27(56.3)
5(9.1)
13(19.1)
45(26.3)
If have access to
dietitian/nutritionist on campus,
where located?
Student Recreation Center
7(14.6)
7(12.7)
5(7.4)
19(11.1)
Student Health Center
7(14.6)
1(1.8)
7(10.3)
15(8.8)
Dining Services
0(0.0)
0(0.0)
0(0.0)
0(0.0)
Other
3(6.3)
9(16.4)
12(17.6)
24(14.0)
No Response
31(64.6)
38(69.1)
44(64.7)
113(66.1)
Note. Data represents student-athletes who completed sports nutrition knowledge questionnaire.
a
Female participant responses only (Total, n = 118, Division I, n = 36, Division II, n = 48, Division III, n =
34).
53
Responses demonstrating participants’ agreement towards two statements
regarding the impact of a dietitian/nutritionist on their diet and performance are shown in
Table 6. Approximately 82.4% (n = 141) of participants indicated that the “Strongl
Agree” or “Agree” that having a dietitian/nutritionist on their team’s staff does or would
help them in achieving a healthy diet. Fourteen percent (n = 24) remained neutral or
disagreed with the statement. Three participants did not respond to the statement. In
response to the statement that a dietitian/nutritionist on staff would help them in
improving their athletic performance, 81.8% (n = 140) of participants were in agreement.
Twenty-six participants responded neutrally, 1 disagreed, and 4 did not respond.
Table 6
NCAA Student-Athletes’ Responses to Questions Regarding Impact of Dietitian/Nutritionist on Diet
and Performance (n = 171)
Division I, Division II, Division III,
Total,
(n = 48)(%) (n = 55)(%) (n = 68)(%) (n = 171)(%)
Having dietitian/nutritionist on team’s
staff does or would help achieve
healthy diet.
Strongly Agree
18(37.5)
29(52.7)
30(44.1)
77(45.0)
Agree
21(43.8)
14(25.5)
29(42.6)
64(37.4)
Neither Agree nor Disagree
6(12.5)
11(20.0)
7(10.3)
24(14.0)
Disagree
2(4.2)
0(0.0)
1(1.5)
3(1.8)
Strongly Disagree
0(0.0)
0(0.0)
0(0.0)
0(0.0)
No Response
1(2.1)
1(1.8)
1(1.5)
3(1.8)
Having dietitian/nutritionist on team’s
staff does or would help improve
athletic performance.
Strongly Agree
16(33.3)
28(50.9)
26(38.2)
70(40.9)
Agree
20(41.7)
18(32.7)
32(47.1)
70(40.9)
Neither Agree nor Disagree
10(20.8)
8(14.5)
8(11.8)
26(15.2)
Disagree
1(2.1)
0(0.0)
0(0.0)
1(0.6)
Strongly Disagree
0(0.0)
0(0.0)
0(0.0)
0(0.0)
No Response
1(2.1)
1(1.8)
2(2.9)
4(2.3)
Note. Data represents student-athletes who completed sports nutrition knowledge questionnaire.
54
Discussion
This study evaluated sports nutrition knowledge and experiences with registered
dietitians amongst collegiate student-athletes across NCAA Divisions I, II, and III. The
first hypothesis was that there would be a difference in sports nutrition knowledge
between collegiate student-athletes across NCAA Divisions I, II, and III. Secondly, it
was hypothesized that there would be a difference in sports nutrition knowledge between
male collegiate student-athletes and female collegiate student-athletes.
Nutrition Knowledge between NCAA Divisions
The hypothesis that there would be a difference in sports nutrition knowledge
between collegiate student-athletes across NCAA Divisions I, II, and III was rejected.
Using a sports nutrition knowledge questionnaire adapted from Hornstrom et al. (2011),
no significant difference in knowledge was observed between Divisions (F = .385, p =
.681). The majority of participants in the study (63.7%) achieved an NKS of 60% or
greater.
Determining what is considered to be adequate knowledge is difficult, as studies
measuring nutrition knowledge have used differing scoring criteria to define it. In
Hornstrom et al.’s stud
2011 , a Nutrition Knowledge Score of ≥60% was reflective of
having adequate nutrition knowledge. The sample of softball student-athletes responded
to 80 nutrition knowledge questions and averaged an NKS of 45.7 ± 4.7, indicating most
participants did not have adequate knowledge (Hornstrom et al., 2011). Torres-McGehee
et al. (2012) used a score of 75% or greater to determine adequate knowledge in their
55
study that included athletes, coaches, ATCs, and SCCs. In that study, a score equating to
adequate knowledge was achieved by only 9.0% of athletes (Torres-McGehee et al.,
2012). This is especially interesting because the student-athlete sample (n = 177) in
Torres-McGehee et al.’s 2012 stud was ver close to the student-athlete sample (n =
171) in the present study. Although questionnaires administered in research measuring
nutrition knowledge are not always the same, results should be expected to vary across
studies depending on the measurement scale utilized.
While each NCAA Division obtained an NKS ≥60% in this study, it would be
discomforting to suggest the majority of the sample has adequate nutrition knowledge. In
the academic setting, a score of 60% would not typically be considered as having an
adequate understanding of the knowledge being tested. Approximately 40% of the
nutrition knowledge statements in this stud ’s questionnaire were answered incorrectl
by participants, which is indicative of the need for further nutrition education in the
student-athlete population.
Nutrition Knowledge between Genders
The second hypothesis that there would be a difference in sports nutrition
knowledge between male collegiate student-athletes and female collegiate studentathletes was accepted. Nutrition knowledge scores amongst female student-athletes were
significantly greater than those of male student-athletes (F = 6.313, p = .008) in this
study. Previous nutrition knowledge studies by Dunn and colleagues (2007), as well as
Worme et al. (1990), involving both male and female athletes have also suggested
56
females have greater knowledge. This may be related to the thought that females are
more conscious of body image and perhaps have a greater likelihood to seek information
and education related to nutrition.
Sports Nutrition Experience
Results showed that the student-athletes in this study would be likely to consult a
dietitian if one was available to them. When asked about their likelihood to consult
certain sources for current information regarding nutrition, dietitian/nutritionist was the
most likely response (1.71 ± 1.01). When asked the same question in the study by
Hornstrom et al. (2011), softball athletes indicated they would be more likely to consult a
physician, athletic trainer, and college nutrition/health courses before a dietitian. Other
studies have found student-athletes preferred consulting primarily ATCs and SCCs for
nutrition information (Burns et al., 2004; Torres-McGehee et al., 2012). In this study,
SCCs were second behind dietitians and followed by college nutrition/health courses and
ATCs. With student-athletes ranking college courses so high, an athlete-specific
nutrition course, such as the one discussed by Karpinski (2012), should be considered by
academic institutions and their athletic departments. Unlike female cross country athletes
in Zawila et al.’s 2003 stud , magazines, parents, and coaches were less likel to be
selected as sources of nutrition information by student-athletes.
Certain responses to the “Other” resources student-athletes reported they consult
for nutrition information are concerning. Two student-athletes reported they consult the
television for information, and one reported they consult the video website YouTube.
57
Because the particular sources of nutrition information through these media outlets are
unknown, their credibility is questionable. It was encouraging to note, however, that
three student-athletes reported that they seek a nutrition professor when they have
questions regarding nutrition.
Over half of the student-athletes in this study (51.5%) did not know if their
athletic department has a dietitian available to them on staff. Unfortunately, these results
were not unexpected. Burns et al. (2004) reported 27% of the student-athletes in their
study did not know if they had a dietitian available. Thirty-seven student-athletes
responded that their athletic departments have a dietitian on staff. After a thorough
examination of the athletic department websites, it does not appear that any of the
academic institutions represented in the study have a full-time dietitian on staff.
Interestingly, student-athletes representing the same academic institution responded both
“Yes” and “No” to this statement. These responses bring about two questions: 1 who
do student-athletes perceive to be nutrition professionals, and (2) if these athletic
departments do have a dietitian available on staff, how visible are they to the studentathlete population. A positive finding was that 58 student-athletes who responded that
they do not have a dietitian on their athletic staff were aware of locations on campus with
an accessible dietitian.
In general, it appears student-athletes in this study have had minimal experience
with a dietitian. More than half (57.9%) of student-athletes have not had a dietitian speak
to their team. Only 1.2% of the participants (n = 2) reported to have gone on a grocery
58
store tour with a dietitian. Approximately 22.8% (n = 39) belong to teams that hold
training tables. It seems the participants have at least somewhat of an understanding of
NCAA banned substances; 94.2% (n = 161) reported they have received education in this
area.
An extremely troubling finding was that 78.0% (n = 92) of females reported to
have not received education on the female athlete triad. Moreover, this data is
representative of all female student-athletes in this study; over half of the females in each
Division responded that they have not been educated. This indicates that regardless of
NCAA Divisions, education on the female athlete triad is lacking in these academic
institutions’ athletic departments. Zawila et al. 2003 stated ATCs have “the opportunit
to serve as the first line of defense in preventing and identifying nutrition-related health
problems” p. 69 . Athletic trainers, especiall those employed at academic institutions
without a dietitian on staff in the athletic department, are crucial for educating athletes on
the dangers and precautions associated with athletic related life-altering syndromes, such
as the female athlete triad. Furthermore, if collegiate athletic departments mandated
annual physical evaluations for all student-athletes, female athletes could be screened and
educated specifically on the female athlete triad.
The NCAA student-athletes represented in this study indicated that they feel
having a dietitian on their athletic departments’ staffs would have a beneficial influence
on their diet and athletic performance. Approximately 82.4% (n = 141) of participants
were in agreement that a dietitian does or would help them achieve a healthy diet, while
59
81.8% (n = 140) were in agreement with the statement that a dietitian does or would help
them improve their athletic performance. Most participants also indicated they believe
that nutrition counseling would be important for an athlete trying to change their weight
(1.59 ± .725). Clearly, student-athletes in this study believe that proper nutrition can
positively impact their health and performance, and a dietitian can help them in achieving
this. There has been question of the importance placed on nutrition in comparison to
other aspects of student-athletes’ training Hornstrom et al., 2011 . Athletic departments
should take this data into consideration, as it is representative of the student-athlete
population. Student-athletes from all NCAA Divisions have indicated that staffing a
dietitian within athletic departments can translate into increased success for them, both
personally and athletically.
Limitations
Perhaps the largest limitation in this study is the small sample size. Only 2.8% of
the approximately 6,200 student-athletes combined across the fourteen academic
institutions are represented in this study. However, it is not possible to determine the
exact response rate as the number of coaches who forwarded the e-mail regarding
participation in the study to their student-athletes is unknown. National Collegiate
Athletic Association Division III was the most represented Division, and the sample
consisted primarily of females. The participants in this study also represented a
convenience sample of student-athletes from academic institutions specifically located
closely to the research institution within the state of Ohio.
60
The process in which student-athletes were recruited was a limitation. Because
the coaching staff of each team was the primary contact in order to reach the participants,
not all student-athletes may have received the recruitment e-mail. Collegiate coaching
staffs, especially those of teams at larger academic institutions, likely receive many emails each day that they are not able to attend to. Additionally, not all head coaches’ email addresses were available on their athletic departments’ websites. Another limitation
is that the student-athletes received the recruitment e-mail from their coaching staffs.
Student-athletes may have felt obligated to respond to the questionnaire due to the fact it
was forwarded from their coach(s).
Applications
Registered dietitians, especially those who are sports dietitians, possess the
education necessary to evaluate the nutritional needs associated with physical activity
(Steinmuller et al., 2014). The education and interventions sports RDs offer can
positivel influence athletes’ dietar behaviors and athletic performance Steinmuller et
al., 2014 . Some institutions’ athletic departments, such as The Penns lvania State
University and the University of Washington, value the potential benefits staffing a
dietitian can provide and have allotted funding and created positions for RDs (Burns et
al., 2004; Clark, 1999; Shattuck, 2001; Torres-McGehee et al., 2012; Vinci, 1998).
Larger athletic departments may even staff multiple dietitians. The University of
Alabama, for example, has a Director of Performance Nutrition in addition to three
61
nutrition interns listed in their athletic staff directory (University of Alabama Athletics,
2015).
Dietitians advocating for positions within collegiate athletic departments can use
these findings as a representation of student-athletes’ perception of the impact of the
nutrition profession. Over 80% of the student-athletes were in agreement that having a
dietitian in their athletic department would help them achieve healthier diets and improve
performance. With the recent flexibility given to athletic departments by the NCAA in
supplying student-athletes with food, registered dietitians can ensure training tables and
fueling stations are providing athletes with nourishing, nutritionally sound options to
support training, recovery, and overall health. Student-athletes also indicated they would
be more likely to consult a dietitian over other professionals, such as ATCs, SCCs, and
coaches, when inquiring about nutrition information. Athletic departments should be
operating in their student-athletes’ best interest in regards to academics, health, and
performance and take their responses from studies, such as the current one, into account.
Data collected in this study demonstrates that unrelated to NCAA Divisions, collegiate
student-athletes surveyed consider dietitians to be a valuable resource for their health,
athletic performance, and for nutrition information.
As Burns and colleagues (2004) mentioned previously, dietitians can market
themselves to athletic departments as being able to provide numerous services, such as
nutrition education. It was evident in this study that nutrition education concerning the
female athlete triad needs to be reinforced. While ATCs and SCCs can provide student-
62
athletes with basic nutrition education, it is unreasonable to expect them to fulfill the
tasks associated with their job and act as educators in areas they were not specifically
trained in. Registered dietitians can promote themselves as being the professionals who
have the ability to fill these knowledge gaps.
Recommendations for Future Research
This study is one of the first to examine student-athletes' sports nutrition
knowledge across NCAA Divisions. Future studies can involve comparing nutrition
knowledge between student-athletes within the same Division whose athletic departments
staff a registered dietitian versus those who do not and making evaluations across NCAA
Divisions. A large sample size spanning a wide geographical region should be
considered. Additionally, research specifically examining student-athletes' opinions and
feelings toward sports dietitians and sports nutrition programming in collegiate athletic
departments may be influential to the sports nutrition field. For example, inquiring
whether student-athletes feel having a registered dietitian on staff is or could be
beneficial in improving their nutrition knowledge.
Conclusion
An evaluation of sports nutrition knowledge between student-athletes across
NCAA Divisions I, II, and III revealed that there was no significant difference in
knowledge across Divisions. However, female student-athletes had significantly greater
sports nutrition knowledge than male student-athletes. Results indicated that there is still
a need for further sports nutrition education in the collegiate student-athlete population.
63
Lastly, student-athletes indicated that having a registered dietitian on their athletic staff
would be advantageous for obtaining nutrition information and in achieving a healthier
diet and improved performance.
APPENDICES
APPENDIX A
SPORTS NUTRITION KNOWLEDGE QUESTIONNAIRE
Appendix A
Sports Nutrition Knowledge Questionnaire
To respond to this section, please indicate your answer to each statement by selecting the
alternative that best corresponds to what YOU know about that statement.
T = True
F = False
DK = Don’t Know
T
F
Carbohydrates are not as easily and rapidly digested as protein and fat
□
Foods such as potatoes and honey are best eaten after exercise

Eggs and legumes are examples of protein sources other than meats

Protein is the primary source of muscular energy for the athlete
□
Protein is not stored in the body; therefore, it needs to be consumed
every day
Increasing protein in the diet is necessary in order to increase muscle
mass of the body
No more than 15% of calories in the diet should be provided by fat
Iron-deficiency anemia results in a decrease in the amount of oxygen that
can be carried in the blood
Vitamin supplementation is recommended for all physically active persons
□
□
□
□

 □
□
□


 □
□
Cheese is a good source of iron in the diet

□


Excess vitamin supplementation may harm the physically active person
 □
Vitamins are a good source of energy
□
Carrots are a good source of vitamin A
 □
Whole milk is a better source of vitamin D than skim or 2% milk
□
Fiber in the diet may help to decrease constipation, decrease blood
cholesterol levels, and prevent cancers

66
DK
□


□
□
□
□
□
□
□
□
□
□
□
□
□
67
Dehydration can impair physical performance
During activity, thirst is an adequate guide to the need for fluids
During exercise, mass ingestion of large amounts of fluid is preferred
over frequent ingestion of small amounts
Sports drinks are the best way to replace body fluids lost during exercise

□
□
□
Alcohol has more calories per gram than protein

Caffeine can increase the risk of dehydration

An athlete involved in endurance events (eg, distance running) should
follow a considerably different diet than one participating in events of short
duration (eg, sprinting)
A physically fit person eating a nutritionally adequate diet can improve his
or her performance by consuming great amounts of nutrients
A 200-pound person uses about twice as many calories to run a mile
as a 100-pound person
A person with a higher percentage of body fat may weigh less than a
person of the same size with a greater muscle mass
A sound nutritional practice for athletes is to eat a wide variety of
different food types from day to day
Skipping meals is justifiable if you need to lose weight quickly
When trying to lose weight, acidic foods such as grapefruit are
of special value because they burn fat
If trying to lose weight, carbohydrates should come from fruits and
vegetables rather than from breads and pastas
Nutrition is more important during the competitive season than during
the off-season for the athlete
A high fat meal, which is slowly digested, should be avoided before
athletic events
□
□



□


□

□



□
□
□
□
□
□
□


□
□
□
□
□
□
□
□

□
□
□
□
□

□
□
□
□
□
The pre-event meal should be eaten about 3-4 hours before competition

What the athlete eats is only important if the athlete is trying to gain
or lose weight
An athlete should drink no water during practice, but rather rinse out his or
her mouth or suck on ice cubes
□
A lack of iron in the diet can result in fatigue, injury, and illness
 □
□
□


□
□
□
68
To respond to this section, please indicate your reaction to each statement by selecting
the alternative that best corresponds with how YOU feel about that statement.
SA = Strongly Agree A = Agree N = Neutral D = Disagree SD = Strongly Disagree
Caffeine has been shown to improve endurance performance
The type of food an athlete eats affects his or her performance
Learning about nutrition is not important for athletes because
they eat so much food they always get the nutrients their bodies
need
Nutritional counseling would be important to the athlete who is
trying to change his or her weight
SA A N D
□ □ □ □
□ □ □ □
SD
□
□
□
□
□
□
□
□
□
□
□
□
To respond to this section, please check the appropriate response.
Please indicate your likelihood to use the following resources to obtain current
information regarding nutrition.
VL = Very Likely L = Likely N = Neutral U = Unlikely VU = Very Unlikely
Athletic Trainer
Coach
Strength & Conditioning Coach
Academic Journals
Magazines
Friends
College Nutrition/Health Courses
Parents
Dietitian/Nutritionist
Physicians
Internet
Other (Please indicate other source)
VL
□
□
□
□
□
□
□
□
□
□
□
L
□
□
□
□
□
□
□
□
□
□
□
N
□
□
□
□
□
□
□
□
□
□
□
U
□
□
□
□
□
□
□
□
□
□
□
VU
□
□
□
□
□
□
□
□
□
□
□
69
To respond to this section, please indicate the appropriate response.
What is your age?
______
What is your gender?
□ Male
□ Female
What academic institution are you currently attending?
__________________________
In which NCAA sport(s) do you participate in? You may select more than one if
applicable.
□ Baseball
□ Basketball - M
□ Basketball - W
□ Cross Country - M
□ Cross Country - W
□ Diving - M
□ Diving - W
□ Fencing - M
□ Fencing - W
□ Football
□ Golf - M
□ Golf - W
□ Gymnastics
□ Ice Hockey
□ Lacrosse - M
□ Lacrosse - W
□ Rifle - M
□ Rifle - W
□ Soccer - M
□ Soccer - W
□ Softball
□ Swimming - M
□ Swimming - W
□ Tennis - M
□ Tennis - W
□ Track & Field - M
□ Track & Field - W
□ Volleyball
□ Wrestling
What is your current academic standing?
□ Freshman □ Sophomore □ Junior □ Senior □ Fifth Year Senior
What is your current residence?
What is your major in college?
□ On-campus □ Off-campus
_____________________________________________
Have you ever taken a college course(s) in which nutrition was included as part of the
course(s)?
□ Yes (Please indicate how many) ______
□ No
Have you ever consulted with a dietitian/nutritionist concerning your diet? □ Yes □ No
Has a dietitian/nutritionist ever spoken to your team? □ Yes □ No
Have you ever taken a grocery store tour led by a dietitian/nutritionist? □ Yes □ No
Does your team offer training tables? □ Yes □ No
70
Have you received education on the Female Athlete Triad? □ Yes □ No
Have you received education in relation to NCAA banned substances? □ Yes □ No
Does your athletic department have a dietitian/nutritionist? □ Yes □ No □ Don’t Know
If your team does not have a dietitian/nutritionist, do you have access to a
dietitian/nutritionist on campus? □ Yes □ No
If you do have access to a dietitian/nutritionist on campus, where on campus is the
dietitian/nutritionist located?
□ Student Recreation Center
□ Student Health Center
□ Dining Services
□ Other (Please indicate other) ______________________________________________
To respond to this section, please indicate your reaction to each statement by selecting
the alternative that best corresponds to how YOU feel about that statement.
Having a
dietitian/nutritionist on my
team’s staff does or would
help me achieve a healthy
diet.
Having a
dietitian/nutritionist on my
team’s staff does or would
help me improve my
athletic performance.
Strongly
Agree
Agree
Neither Agree
nor Disagree
Disagree
Strongly
Disagree
□
□
□
□
□
□
□
□
□
□
APPENDIX B
RECRUITMENT E-MAIL
Appendix B
Recruitment E-Mail
Dear Coaching Staff,
I am a dietetic intern and graduate student in Nutrition & Dietetics at Kent State
University. As a component of my curriculum, I am conducting a research study titled
Evaluation of Sports Nutrition Knowledge between NCAA Student-Athletes across
Divisions. Through this research I would like to examine student-athletes’ level of
nutrition knowledge across academic institutions within NCAA Divisions I, II, and III. I
am writing to inquire if you would be willing to share a web-based questionnaire for
my study with your student-athletes by forwarding them this email.
Participation in the study typically takes 10-12 minutes and is strictly anonymous.
Participants begin by answering a series of statements about general nutrition and sports
nutrition. This is followed b a section inquiring about participants’ likelihood to use
certain resources to obtain nutrition information. The last section consists of participant
demographics and characteristics.
The questionnaire is accessible by this link:
https://kent.qualtrics.com/SE/?SI.D=SV_3DfS6Gli4IZUDS5
Your time and consideration is greatly appreciated. Your assistance is very conducive to
the completion of this study. Please feel free to contact me at sholley1@kent.edu or my
advisor, Dr. Amy Miracle, RD, CSSD, LD, at amiracle@kent.edu with any questions you
or your student-athletes may have.
Thank you,
Siera Holley
72
APPENDIX C
STUDY CONSENT FORM
Appendix C
Study Consent Form
Evaluation of Sports Nutrition Knowledge between NCAA Student-Athletes across
Divisions
Welcome to "Evaluation of Sports Nutrition Knowledge between NCAA StudentAthletes across Divisions," a web-based questionnaire that examines nutrition knowledge
of student-athletes and resources they use to obtain nutrition information. Before taking
part in this study, please read the consent form below and click on the "I Agree" button at
the bottom of the page if you understand the statements and freely consent to participate
in the study.
Consent Form
This consent form will provide you with information on the research project and what
you will need to do. Your participation is voluntary. Please read this form carefully. It is
important that you fully understand the research in order to make an informed decision.
You may print a copy of this document for your records.
This study involves a questionnaire designed to examine nutrition knowledge of studentathletes across NCAA Divisions I, II, and III. The study is being conducted by Dr. Amy
Miracle and Siera Holley of Kent State University, and it has been approved by the Kent
State University Institutional Review Board. No deception is involved, and the study
involves no more than minimal risk to participants (i.e., the level of risk encountered in
daily life).
Participation in the study typically takes 10-12 minutes and is strictly anonymous.
Participants begin by answering a series of statements about general and sports nutrition.
This is followed b a section inquiring about participants’ likelihood to use certain
resources to obtain nutrition information. The last section consists of participant
demographics and characteristics.
74
75
All responses are treated as confidential, and in no case will responses from individual
participants be identified. Rather, all data will be pooled and published in aggregate form
only. Participants should be aware, however, that the experiment is not being run from a
"secure" https server of the kind typically used to handle credit card transactions, so there
is a small possibility that responses could be viewed by unauthorized third parties (e.g.,
computer hackers).
Taking part in this research study is voluntary. You may choose not to participate or you
may discontinue your participation at any time.
If you have any questions or concerns about this research, you may contact the principal
investigator, Amy Miracle, Ph.D., RD, CSSD, LD, at 330-672-2649. This project has
been approved by the Kent State University Institutional Review Board. If you have any
questions about your rights as a research participant or complaints about the research, you
may call the IRB at 330-672-2704.
If you are 18 years of age or older, understand the statements above, and freely consent to
participate in the study, click on the "I Agree" button to begin the experiment.
I Agree
I Do Not Agree
APPENDIX D
PARTICIPATION BY ACADEMIC INSTITUTION TABLE
Table 7
Participation Frequency of Academic Institutions Represented in Evaluation of Sports
Nutrition Knowledge between Student-Athletes across NCAA Divisions Study (n = 171)
Institution
n
% Total
University of Akron
Ashland University
Bowling Green State University
Cleveland State University
Hiram College
John Carroll University
Kent State University
Lake Erie College
Malone University
University of Mount Union
Notre Dame College
Tiffin University
Youngstown State University
11
17
9
1
3
6
16
12
3
59
13
10
11
6.4
9.9
5.3
0.6
1.8
3.5
9.4
7.0
1.8
34.5
7.6
5.8
6.4
77
APPENDIX E
NUTRITION KNOWLEDGE RESPONSES TABLE
Table 8
Frequency Distribution of NCAA Division I, II, and III Student-Athletes’ Correct and
Incorrect Responses to Nutrition Knowledge Statements
n
Correct
n(%)
Incorrect
n(%)
Carbohydrates are not as easily and rapidly digested as
protein and fat
170
94(55.3)
76(44.7)
Foods such as potatoes and honey are best eaten after
exercise
170
43(25.3)
127(74.7)
Eggs and legumes are examples of protein sources
other than meats
170
169(99.4)
1(0.6)
Protein is the primary source of muscular energy for the
athlete
169
66(39.1)
103(60.9)
Protein is not stored in the body; therefore, it needs to
be consumed every day
170
55(32.4)
115(67.6)
Increasing protein in the diet is necessary in order to
increase muscle mass of the body
169
24(14.2)
145(85.8)
No more than 15% of calories in the diet should be
provided by fat
169
31(18.3)
138(81.7)
Iron-deficiency anemia results in a decrease in the
amount of oxygen that can be carried in the blood
170
117(68.8)
53(31.2)
Cheese is a good source of iron in the diet
170
105(61.8)
65(38.2)
Vitamin supplementation is recommended for all
physically active persons
171
71(41.5)
100(58.5)
Excess vitamin supplementation may harm the
physically active person
171
131(76.6)
40(23.4)
Vitamins are a good source of energy
171
87(50.9)
84(49.1)
Carrots are a good source of vitamin A
170
99(58.2)
71(41.8)
Statement
79
80
Whole milk is a better source of vitamin D than skim or
2% milk
170
61(35.9)
109(64.1)
Fiber in the diet may help to decrease constipation,
decrease blood cholesterol levels, and prevent cancers
171
148(86.5)
23(13.5)
Dehydration can impair physical performance
170
166(97.6)
4(2.4)
During activity, thirst is an adequate guide to the need
for fluids
171
41(24.0)
130(76.0)
During exercise, mass ingestion of large amounts of
fluid is preferred over frequent ingestion of small
amounts
171
136(78.9)
36(21.1)
Sports drinks are the best way to replace body fluids
lost during exercise
169
106(62.7)
63(37.3)
Alcohol has more calories per gram than protein
170
116(68.2)
54(31.8)
Caffeine can increase the risk of dehydration
170
163(95.9)
7(4.1)
An athlete involved in endurance events (eg, distance
running) should follow a considerably different diet
than one participating in events of short duration (eg,
sprinting)
170
23(13.5)
147(86.5)
A physically fit person eating a nutritionally adequate
diet can improve his or her performance by consuming
great amounts of nutrients
170
27(15.9)
143(84.1)
A 200-pound person uses about twice as many calories
to run a mile as a 100-pound person
170
64(37.6)
106(62.4)
A person with a higher percentage of body fat may
weigh less than a person of the same size with a greater
muscle mass
169
148(87.6)
21(12.4)
A sound nutritional practice for athletes is to eat a wide
variety of different food types from day to day
169
123(72.8)
46(27.2)
81
Skipping meals is justifiable if you need to lose weight
quickly
171
167(97.7)
4(2.3)
When trying to lose weight, acidic foods such as
grapefruit are of special value because they burn fat
170
71(41.8)
99(58.2)
If trying to lose weight, carbohydrates should come
from fruits and vegetables rather than from breads and
pastas
171
137(80.1)
34(19.9)
Nutrition is more important during the competitive
season than during the off-season for the athlete
171
141(82.5)
30(17.5)
A high fat meal, which is slowly digested, should be
avoided before athletic events
171
131(76.6)
40(23.4)
The pre-event meal should be eaten about 3-4 hours
before competition
171
135(78.9)
36(21.1)
What the athlete eats is only important if the athlete is
trying to gain or lose weight
171
157(91.8)
14(8.2)
An athlete should drink no water during practice, but
rather rinse out his or her mouth or suck on ice cubes
171
150(87.7)
21(12.3)
A lack of iron in the diet can result in fatigue, injury,
171
162(94.7)
9(5.3)
and illness
Note. Data represents student-athletes who completed sports nutrition knowledge
questionnaire.
REFERENCES
REFERENCES
Academy of Nutrition and Dietetics. (2014). What is an RDN? Retrieved from
http://www.eatright.org/Public/landing.aspx?TaxID=6442452104
Acosta, R. V. & Carpenter, L. J. (2008). Women in intercollegiate sport: A longitudinal,
national study thirty one year update. Retrieved from
http://www.acostacarpenter.org/
Barr, S. I. (1986). Nutrition knowledge and selected nutritional practices of female
recreational athletes. Journal of Nutrition Education, 18(4), 167-174.
Bayless, A. (2006). Effect of diet, physical activity, and lifestyle characteristics on body
weight of incoming freshmen at a Midwestern universit . Unpublished master’s
thesis). Ball State University, Muncie.
Burns, R. D., Schiller, M. R., Merrick, M. A., & Wolf, K. N. (2004). Intercollegiate
student athlete use of nutritional supplements and the role of athletic trainers and
dietitians in nutrition counseling. Journal of the American Dietetic Association,
104(2), 246-249.
Clark, K. S. (1999). Sports nutrition counseling: Documentation of performance. Topics
in Clinical Nutrition, 14(2), 34-40.
Collegiate and Professional Sports Dietitians Association. (2014, September 29). Mission
and strategic goals. Retrieved from http://www.sportsrd.org/?page_id=1311
Collegiate and Professional Sports Dietitians Association. (2015, January 5). Sports
nutrition resources. Retrieved from http://www.sportsrd.org/?page_id=1747
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