CHAPTER II

REVIEW OF RELATED LITERATURE

A careful study and exploration of the selected literature for present

study is essential to have an insight in to the work already done. In India very

little research has been done as compared to other countries in this area. The

scholar has given a deep thinking to those studies and has gained valuable

methodological hints from their procedure and findings that were of great

importance in the formulation of this study. A brief review of related studies

on nutrition knowledge assessment is presented in this chapter.

Dvorak et.al., (2008) have developed the Adolescent Sport Nutrition

(SN) Knowledge Questionnaire, over the past three decades, as adolescents

have become increasingly involved in athletics, nutrition education has

become an integral part of their training program. The purpose of this study

was to develop a valid and reliable SN knowledge questionnaire that could be

used to evaluate sport nutrition interventions in youth athletes. The

questionnaire consisted of 3 sections: 1) demographics and history of sport

participation; 2) nutrition attitudes and behaviors; 3) a 63-item true/false/

unknown test of SN knowledge with 5 varying subscales (energy sources and

balance and training meal; macronutrients; micronutrients; hydration;

supplements and steroids). A panel of 10 experts evaluated the questionnaire

Review 39

and established construct validity. A group of 42 university students

established predictive validity between themselves and the adolescent group

with distinct SN knowledge differences (r=0.78; p<0.05). To test reliability of

the questionnaire with youth athletes, 138 adolescent male and female athletes

(mean age: 15.6 ± 1.2 y) completed the questionnaire once, while 42

completed it a second time. The average SN knowledge score was 41.7 ±

7.8 (n=134). Internal consistency of the questionnaire was 0.86 with a narrow

95% confidence interval of 0.74-0.92, displaying a 'good' level of reliability,

although the individual subscales were not independently reliable. Stepwise

multiple regression revealed age (p=0.004) and 'parents as the primary source

of nutrition information' (p=0.002) as predictors of SN knowledge

(r2=0.16).These findings suggest that the Sport Nutrition Knowledge

Questionnaire is a valid and reliable tool to assess overall SN knowledge in

adolescent athletes. However, further development of the subscales would

need to be conducted to assess knowledge within these individual constructs.

Sports dietitians, coaches, and athletic trainers may utilize this questionnaire

to assess SN knowledge in adolescent athletes and to test the efficacy of SN

interventions among athletes and teams.

Sossin K et.al., (2007) evaluated Nutrition beliefs, attitudes, and

resource use of high school wrestling coaches Beliefs, attitudes, and nutrition

resource use among high school wrestling coaches were measured for weight

loss, weight class, dehydration, training diet, and eating disorders. Most

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coaches (82%) considered themselves very knowledgeable about wrestling

but less informed about sport nutrition, weight loss, and vitamin supplements.

They used a variety of nutrition resources, but only 36% had attended

nutrition workshops. Almost all coaches were interested in learning more

about specific nutrition topics. More experienced coaches attended nutrition

workshops and felt more informed about weight loss and sport nutrition. The

mean percentage of correct responses to questions about weight loss was

64%, training diets 59%, dehydration 57%, body composition 52%, and

eating disorders 80%; the mean score for healthy attitudes about weight loss

was 69%, training diets 34%, dehydration 29%, body composition 70%, and

eating disorders 69%. These results can be used to develop training seminars

and educational materials to promote greater knowledge and healthy attitudes

among wrestling coaches.

Zinn C- Schofield G Wall, (2006) have conducted a study on the

evaluation of sports nutrition knowledge of New Zealand premier club rugby

coaches. Little is known about if and how team coaches disseminate nutrition

information to athletes. In a census survey, New Zealand premier rugby

coaches (n = 168) completed a psychometrically validated questionnaire,

received by either Internet or standard mail (response rate, 46%), identifying

their nutrition advice dissemination practices to players, their level of

nutrition knowledge, and the factors determining this level of knowledge. The

majority of coaches provided advice to their players (83.8%). Coaches

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responded correctly to 55.6% of all knowledge questions. An independent t-

test showed coaches who imparted nutrition advice obtained a significantly

greater score, 56.8%, than those not imparting advice, 48.4% (P = 0.008).

One-way ANOVA showed significant relationships between total knowledge

score of all coaches and qualifications [F(1,166) = 5.28, P = 0.001], own

knowledge rating [F(3,164) = 6.88, P = 0.001] and nutrition training [F(1,166)

= 9.83, P = 0.002]. We conclude that these rugby coaches were inadequately

prepared to impart nutrition advice to athletes and could benefit from further

nutrition training.

Overdorf - Silgailis (2005) have investigated high school coach’s

perceptions of and actual knowledge about issues related to nutrition and

weight control. (Eating disorders) Psychologist’s narrations have identified

how difficult it is to treat individuals with eating disorders. Moreover, the

further the illness has progressed, the greater is the resistance to treatment.

Therefore, prevention is critical in reducing the prevalence of these disorders

among female athletes. The individuals having the most contact with athletes,

and thus constituting the first line of defense against this problem, are

coaches. Yet, information about nutrition and proper weight control and how

these topics should be properly communicated to athletes is frequently not

part of a coach's training, and consequently may not be part of a coach's

knowledge base. This study was designed to evaluate the perceived versus

actual knowledge about nutrition and weight control held by high school

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coaches of girls' teams (n = 42). Two questionnaires, designed by the

investigators, were administered sequentially. The first requested perceptions

on various nutritional and weight control issues. The second was a quiz on

actual knowledge of nutrition and weight control. Ninety-one percent of the

coaches rated their nutrition knowledge as average or above, while only 40

percent had taken any formal classes in nutrition. On the actual quiz, only 14

percent of the coaches knew what percentage of simple carbohydrates should

constitute athletes' diets, while less than half (40%) were able to identify

sources of complex carbohydrates. Eleven percent of the coaches thought

athletes should have a high protein diet, while almost all of them (80%)

believed that muscle is gained by eating proteins. Furthermore, only eight

percent were able to identify sources of low fat protein. In regard to issues of

weight control, 40 percent of the coaches thought athletes would improve

performance by losing weight, 33 percent had impressed on their team the

need to lose several times, and 28 percent had spoken to individual athletes

about the need to lose weight several times. The predominant method for

monitoring weight loss in athletes was visual inspection (37%) rather than

actual measurement. Moreover, 77 percent of the coaches thought weight loss

had to exceed 15 percent to reflect an anorectic condition, suggesting a

possible need for earlier intervention by coaches. Since 82 percent of the

coaches incorrectly thought body image distortions occur equally among male

and female adolescents, it seems they are unaware of the greater risk for

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eating disorders among female athletes. While this study represents a small

sampling of coaches, the observed lack of congruence between perceived and

actual knowledge regarding nutrition and weight control must be addressed if

prevention of eating disorders among is to be become a reality.

Research has indicated an inordinately high prevalence of eating

disordered behavior in athletes, especially women and girls, over the last two

decades (Halmi, Falk, & Schwartz, 1981; Johnson, Powers, & Dick, 1999;

Levenkron, 1982; Mitchell & Eckert, 1987; Sundgot-Borgen, 1994). In fact, a

1988 study (Burckes-Miller & Black) suggested that male athletes are up to

15 times and female athletes 40 times more likely to have an eating disorder

than the general American public. More recently, 48 percent of college

coaches reported coaching an athlete with an eating disorder in the past five

years (Heffner, Ogles, Gold, Marsden, & Johnson, 2003) while 26 percent of

college

Reza Rastmanesh et.al., (2005) have investigated Nutritional

Knowledge and Attitudes in Athletes With Physical Disabilities. Little is

known about sport nutritional problems and requirements of athletes with

physical disabilities. The Objective: To compare the nutritional knowledge

and attitudes of Iranian athletes with physical disabilities (APDs) after

nutrition education. Because proper nutrition is important for both

performance and injury healing, learning about the nutritional areas in which

Review 44

APDs are deficient may assist professionals in educating them. Patients or

Other Participants: Seventy-two APDs (42 APDs in the intervention group

and 30 age-matched and sex-matched control APDs) and 10 coaches

completed the study. Intervention(s): The APDs in the intervention group and

their coaches were given nutrition education, which included a booklet with a

simplified food guide pyramid, simple concepts about nutrition and weight

loss, and four 3-hour courses. The APDs in the control group and their

coaches were not given nutrition education. Main Outcome Measure(s):

Subjects completed 2 nutritional questionnaires with both quantitative and

qualitative components. Nutritional questionnaires were administered at 2

consecutive camps, 30 days apart, before and after nutrition education. Our

questionnaires included a demographics section; 88 Likert scale and true-false

questions; and 18 open-ended questions, 13 of which were specifically

designed for APDs. Each APD completed two 3-day food records. Results

The APDs in the intervention group scored significantly higher after nutrition

education and higher than the control group on the knowledge subscales and

interest in nutrition. Although the nutrition knowledge score in this study was

moderate, several specific areas of deficient nutritional knowledge were

identified that are critical for the health of APDs. Our model of nutrition

education was more effective than the usual instructions presented irregularly

by coaches. Conclusions part, our findings suggest that Iranian APDs lack

nutritional knowledge in areas critical to preventing nutrition-related health

Review 45

problems, especially components related to nutrition for athletes with

disabilities.

Jazayeri- Reza Amani, (2004) evaluated Nutritional Knowledge,

Attitudes and Practices of Bodybuilding Trainers in Ahwaz, Iran,This study

was conducted to determine the nutritional knowledge, attitudes and practices

(KAP) of male and female bodybuilding trainers in Ahwaz, one of the 7 major

cities of Iran. KAP questionnaires which contained information about

nutrients, food groups, using of supplements and ergogenic aids, were

completed by trainers. Sixty three certified male bodybuilding trainers (37.9 ±

2.7 y) and 30 certified female trainers (37.3 ± 8.1 y) were recruited from all

clubs of the city. All of the male and 47% of the female trainers have

prescribed diet program for their trainees (P<0.001) and it showed that there

was a significant (P<0.001) relationship between their diet prescription and

their educational degrees. None of the female trainers neither use nor advise

anabolic hormones such as Nandrolon; however 62% of the male trainers

have advised hormones to their trainees while only 50% of them use

hormones themselves. 96.8% of the trainers did not know that minerals and

88.2% did not know water are essential nutrients; and more than 90% did not

realize that fat and sugars are as food groups. The training courses and

educational levels of trainers are positively related to their practices. All of

the trainers need more theoretical and applied nutritional education.

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Subjects: Certified male (n=63) and female (n=30) bodybuilding

trainers were questioned from all clubs of the city. The mean age of male and

female subjects were 37.9 ± 2.7 years and 37.3 ± 8.1 years, respectively.

Subjects didn't compensate for their participation. The majority of subjects

(37.6%) had diploma degree, 30.2% held BA (Bachelor of Art) or BSc

(Bachelor of Science) and 32.2% didn't have even diploma degree. 32.3% of

the subjects have participated in training educational workshops and the

remainder 67.7%) have not participated. Letters requesting trainers' consent

were sent to their homes or clubs, resulting in a return rate ofabout 75%.

Procedure: A descriptive cross sectional study was designed so that the

subjects completed self administrated questionnaires. 3 well-known

bodybuilding trainers of the city had released the questionnaires to the

subjects. The questionnaires were completed at clubs or homes, anywhere the

trainers did prefer to complete. The responses of questions were excluded

from analysis if the subjects checked more than one response option for

multiple choice questions with one correct answer (62.5% of the questions

were multiple choice questions with one correct answer). Using these criteria

for exclusion, none of the responses were excluded. Questionnaire

Development: There were 45 questions with 122 response choices. The KAP

questionnaires contained questions about educational degree, dietprescription,

essential nutrients, food groups, calorie content of nutrients, using of

hormones, sport drinks, water recommendation and multi-vitamin

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supplementation.Statistical analyses Chi square and ANOVA were used for

analysis. P-value less than 0.05 regarded assignificant point. All statistical

analysis was performedwith the use of SPSS for WINDOWS (version 10;

SPSSInc, Chicago).ResultsKnowledge: The results showed that 63 and 65.6%

of the trainers realized protein and carbohydrates as essential nutrients,

respectively; but 96.8% of them did not know minerals and 88.2% did not

realize water as essential nutrients. Of the subjects, 64.5% recognized bread

and meat as food groups, in compared with 3.2% for sugar.

Wong et.al., (2004) have conducted study on Nutrition Knowledge and

Attitudes of Athletes and Coaches in Hong Kong, Beijing, and Shanghai, to

assess the knowledge and attitudes of the coaches and athletes of major cities

in China regarding training diets, dehydration, and the value of nutrition

education. METHODS: Participants included 2415 coaches and athletes in

total from Hong Kong (HK), Shanghai (SH), and Beijing (BJ). For coaches,

selection was based upon their formal coaching qualifications in at least one

sport recognized by the national governing body. Physical education teachers

without a proper coaching qualification were excluded. For athletes, only

those aged above 14 were included. Selection was based on their participation

in at least one target sport classified by the Hong Kong Sports Development

Board for at least 4 years. A four-page, 39-item questionnaire, based on

scientific literature and knowledge in sport nutrition, was developed. The

questionnaire was divided into three parts that included demographic

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information, sport nutritional knowledge, and sports drink usage and

nutritional practices. Reliability and factor analysis were performed to ensure

the quality of the questionnaire. Content and face validity, layout, format, and

readability of the questionnaire were also assessed by experts. Data collection

was carried out between July 2001 and December 2001. RESULTS: Results

show that in all three cities, more than 80% respondents agreed to the

importance of proper nutritional knowledge in improving athletic

performance (HK: 83.5%; SH: 86.8%; BJ: 90.2%). However, less than 30%

participants in all three places agreed that they had enough opportunities to

gain accurate sport nutritional knowledge (HK: 22.9%; SH: 26.0%; BJ:

14.5%). These results may have led to the low score of the questions about

nutrition knowledge (33.99%) obtained from these cities. However,

respondents from HK scored higher than those from SH and BJ (p<.05). Most

HK respondents consumed high carbohydrate diet after exercise (87.0%),

whereas the majority of respondents from SH and BJ ingested foods with high

protein or vitamin content after exercise (SH: 77.2% and BJ: 85.3%). Whilst

water remained the major beverage for fluid replacement after exercise, sports

drink was heavily used by respondents in these three cities. Athletes of the

three cities rated coaches as the most important source for nutrition

information. CONCLUSIONS: The results suggest that the majority of the

athletes and coaches surveyed in HK, SH and BJ recognized the importance

of proper sports nutrition on athletic performance, however, their nutritional

Review 49

knowledge was found inadequate and their dietary practice did not reflect

their belief.

Sue Murphy-Yvonne Jeanes, (2003) have conducted study on

Nutritional knowledge and dietary intakes of young professional football

players. The Purpose was to determine how nutritional knowledge and

residential status influences the diets of a group of young professional football

players and compare them to controls of the same age

Design/methodology/approach – Seven day dietary records and nutritional

knowledge questionnaires were analyzed and anthropometric measurements

were taken mid-way through the competitive season. The Findings, football

players, with a mean body mass index of 23.6 ± 1.2 kg m2 and body fat of

15.3 ± 3 per cent were significantly lighter than the controls. They also

consumed significantly fewer calories than the controls (10.26 + 1.8 v. 13.89

+ 0.7 MJ per day), and less than the recommended amounts for soccer

players. Both groups could benefit from increasing their carbohydrate intakes,

although fat and protein intakes were appropriate. Nutritional knowledge had

little impact on dietary intakes. However, players who resided in the soccer

club hostels had significantly greater energy intakes, consumed more

carbohydrate and less fat (p < 0.05) than players who lived in their parental

home. Originality value It was identified that youth players require assistance

in the implementation of their knowledge of nutrition to their own diets. In

particular they need to increase their nutritional intakes inline with

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recommendations, in order to optimize their playing ability and provide the

energy they need for growth. This is particularly true for those who live away

from the scrutiny of the football club.

Gilbert N (2003) studied on "Multidisciplinary approaches to

nutritional problems". Symposium on "Performance, exercise and health".

Practical aspects of nutrition in performance. The importance of nutrition in

sport has been recognised since the ancient Olympians and its role in

improving both health and sports performance has widespread acceptance.

However, in sporting circles nutritional knowledge, beliefs and practices are

extremely varied. Within any sporting organization the sports dietitian or

nutritionist must be able to work with athletes, their family, coaches and other

support staff to develop and monitor realistic and practical strategies that

work best for each performer, contributing to a positive and sustained

outcome on performance. The present review examines the practical

application of current key issues in performance nutrition, highlighting the

advantages of early intervention in youth development and comprehensive

and integrated nutrition services.

Matkovic B et.al., (2002) have assessed Sport nutrition knowledge of

coaches, the nutrition of athletes has been of interest to scientists for decades;

also, since the origins of sports competitions the questions about what to eat

and what to drink in order to improve performance have been raised. Today,

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there are scientific proofs that an adequate dietary habit influences in a large

extent the athlete's health, body composition, and energetic pathways during

activity, as well as during competition or recovery. Athletes should be well

informed about food groups, caloric intake and daily meal schedule. As

previous investigations have shown, athletes obtain most of their knowledge

about nutrition from coaches, especially from physical conditioning coaches.

The major aim of this study was to determine the level of knowledge of

coaches about nutrition. The sample consisted of 32 basketball and 24 skiing

coaches from Croatia. Knowledge about sports nutrition was tested by means

of a questionnaire which was constructed based on the results of previous

local and international studies. It comprised items determining the general

knowledge of coaches about nutrition and nutritional ingredients needed for

providing adequate energy level in sports and items about supplements, meal

schedule before training and competition and recovery; also, items testing the

knowledge of coaches about the importance of fluids and dehydration and

rehydration during and after training and competition were included. Surveys

were anonymous, and the data obtained were analyzed by statistical software

statistica for windows. According to the results obtained, we concluded that

the level of knowledge about nutrition of basketball and ski coaches is

generally satisfactory but inadequate in some areas, especially in the area of

nutritional supplements and energy sources. It also can be concluded that the

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sources of information for nutritional facts that coaches use are not always

scientifically justified

Conkle, et.al., (2002) have conducted Sports Nutrition Knowledge

Assessment of Physical Educators and Coaches. This study assessed the

sports nutrition knowledge of current and prospective physical

educators/coaches (HPEs) to determine the need for improved education in

this area and to compare the nutrition knowledge of HPEs with that of foods

and nutrition students (FNSs) and general college students (GENs). A

researcher-developed 4-point Likert-type scale, which contained 70

statements, was administered to 58 students representing a cross-section of

health and physical education majors enrolled in upper-level major courses,

27 students in 2 upper-level home economics foods and nutritions courses,

and a general group comprised of 20 students in non-health/physical

education classes. Statements on the scale assessed nutrition supplementation,

fluids and hydration, pre-event nutrition, nutrition composition, nutrition

terminology, general nutrition, and nutrition opinion. The dependent variable

was sports nutrition knowledge. Frequencies and percentages were computed

for all items on the scale. Group mean differences were computed and

compared by a one-way analysis of variance. The sports nutrition knowledge

of HPEs tested is inferior to standard competency levels. Significantly higher

means scores for FNSs were found. Education and information sources for

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HPEs are insufficient. Currently, interscholastic athletic coaches have little

direct control over the dietary behaviors of student-athletes.

Juzwiak, -Lopez, (2001) have evaluated nutrition knowledge and

dietary recommendations by coaches of adolescent Brazilian athletes. The

objectives of this study were to describe the dietary practices recommended

by coaches working with adolescent athletes and to assess their nutritional

knowledge. During a regional competition in the state of São Paulo, Brazil, 55

coaches were interviewed. These coaches represented 22 cities with athletes

enrolled in olympic gymnastics, tennis, swimming, and judo events. A 3-

section questionnaire was used to obtain data on demographic characteristics,

dietary recommendations, and nutrition knowledge. Results showed that all

coaches recommended general dietary practices during training, with no

specific strategies for pre-, during-, and post-training periods. The main

objectives of the recommendations for the training period were weight control

and muscle mass gain. Deleterious weight control practices were

recommended by 27% of the coaches. Specific dietary practices pre and post

competition were recommended by 93% and 46% of the coaches,

respectively. Participants responded correctly to 70% (SD=3.2) of the

nutrition knowledge questions, with no significant differences (P=0.61)

between sports. The knowledge test identified a tendency to overvalue

proteins, excessively low-fat diets, and food myths. These findings indicate

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the importance of developing strategies that will enhance the nutritional

training of coaches.

Smith et.al., (2001) studied Nutrition knowledge, opinions, and

practices of coaches and athletic trainers at a division 1 university. The

purpose of this investigation was to assess nutrition knowledge, opinions, and

practices of coaches and trainers at a Division I university. Participants (n =

53) completed questionnaires regarding nutrition knowledge, opinions, and

practices. Descriptive statistics and analysis of variance were used to analyze

data. Overall, participants responded correctly to 67% of nutrition knowledge

questions. Participants who coached/trained female athletes tended to score

better than respondents who coached/trained male athletes. Strength and

conditioning coaches and participants with greater than 15 years of experience

scored higher than other participants. Nutrition opinions/practices responses

revealed that nutritional supplements were provided for all but 6% of

participants' athletes. Participants rated body weight as more important than

body composition to athletes' performances. Over 30% of participants

perceived at least one case of disordered eating within the past year. Some

participants (53%) felt that athletes may consume more nutritious meals on

team-sponsored trips if given larger food allowances. Thirty percent of

participants reported dietitians were available to them; the same percentage

reported utilizing dietitians. Coaches and trainers are knowledgeable about

some appropriate nutritional recommendations, but registered dietitians or

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qualified sports nutrition professionals may complement the nutrition-related

education and counseling of athletes.

Corley et.al., (2001) have conducted a study on nutrition knowledge

and dietary practices of college coaches, Veterans Administration Medical

Center, Salisbury, North Carolina. The objectives of this study were to

measure nutrition knowledge of college coaches, to identify educational and

demographic factors that affect nutrition knowledge of college coaches, to

describe dietary practices recommended by these coaches, and to identify

major sources of nutrition information used by coaches. Questionnaires were

mailed to 296 coaches of senior and junior colleges in North Carolina using a

listing from the National Directory of College Athletics. Coaches of the

following sports were included: track and field, cross country, swimming,

tennis, basketball, gymnastics, golf, football, and wrestling. The response rate

was 36%. Seventy percent of the 15 nutrition knowledge test items were

answered correctly; however, only one-third of the coaches indicated a high

degree of certainty for the correctness of their responses. There were no

significant relationships between nutrition knowledge and sex, age, collegiate

conference, course work in nutrition, win/loss record, and years of coaching

experience. Major dietary problems of college athletes reported by coaches

were consumption of "junk food," poor eating habits, and consumption of an

unbalanced diet. The authors recommend an annual workshop for coaches,

trainers, and dietitians to develop criteria for nutrition assessment and body

Review 56

composition for college athletes and to develop training diets. Special

workshops for foodservice personnel are also recommended.

Kelkar, et.al., (2000) conducted research on nutrition knowledge,

attitude and practices of competitive Indian sportsmen.78 sportsmen aged 18-

25 years were selected by purposive sampling technique. The sportsmen

belonged to varied sports disciplines viz. runners (n=21), boxers (n=21),

weightlifters (n=21) and wrestlers (n=15). The nutrient intake showed

significant variation with respect to sports discipline and body weight. The

nutrient intake of the sportsmen was well comparable with recommended

daily allowances except for protein and iron. Elite athletes were generally

knowledgeable and sophisticated with regard to nutrition and effect on

performance. The attitudes reflected the poor information sportsmen had and

their practice to copy peers and coaches. The sportsmen took minimum effort

to gather information about nutrition. The sportsmen from the weight

category sports (boxing, weightlifting, wrestling) reported vague concepts

about weight loss. The sportsmen reported supplements were essential to meet

increased demands of training and to supplement nutrients lacking in foods.

The present study reveals that there is a paucity of nutrition education

intervention among Indian sportsmen.

Frederick – Hawkins (1998) studied Nutrition knowledge, attitudes,

and dietary practices of female college athletes (dancers and track team) and

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non athletes college women along with postmenopausal women were

measured. The nonathletic group earned a higher score on a knowledge test

than did dancers or track team members, and their score was slightly higher

than the postmenopausal women. All four groups showed no significant

difference in attitude scores. Non athletes took a college nutrition course. The

source of nutrition information reported the most frequently by the track team

was the media. Dancers relied on parents, no athletes learned most from their

college nutrition course, while postmenopausal women most frequently listed

friends, physicians, and media as nutrition information sources.

Marquart – Sobal (1998) have examined the beliefs and sources of

information regarding muscle development among 742 high school athletes.

A majority (73%) believed protein supplements were important in muscle

development, and many believed carbohydrates (71%) and vitamin

supplements (61%) were important. Most athletes (84%) believed that good

nutrition could prevent disease later in life. More than 40% believed that

steroids were more important than nutrition for muscle development. These

athletes believed that the following sources provide accurate information:

doctors (86%), coaches (76%), trainers (68%), parents (38%), teachers (33%),

and other athletes (33%).

Landry et. al., (1996) have conducted study on Nutrition knowledge

and weight control practices of 317 high school wrestlers and 81 national

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Junior Olympic boxing competitors were compared. These adolescent athletes

had similar nutrition knowledge and agreed fasting was dangerous and weight

should be lost by proper dieting and exercise. However more than 90% of

both groups were losing weight and many were using techniques such as

saunas, rubber suits, and vomiting. Both groups considered their coaches to be

the most important sources of nutrition information about weight control, with

their fellow team members rated second.

Cohen et. al., (1995) studied nutrition and hematologic assessment of

22 men and women who were American Ballet Theater dancers (mean age

25). All of the men and 10 of the 12 women completed a 6-d food diary.

Mean caloric intake was almost 3000 kcal (12,540 J) for men and nearly 1700

kcal (7106 J) for women. Protein intake averaged 122 g for men and 60 g for

women. Percent of calories from carbohydrate was 38% for men and 50% for

women. Intakes below 25% of the RDA were most frequently noted for

pyridoxine, folic acid, biotin, and vitamin D. For females, mean iron intake

was low (13.5 mg) as was calcium intake. All deficiencies were calculated to

be more severe and more frequent among women than men. Except for four

dancers, all took daily multiple megavitamin supplements. The dancers' diets

were judged to be monotonous and unbalanced. Factors contributing to low

nutrient intakes among these female dancers were low caloric intake, lack of

correct nutrition information, avoidance of red meat and milk, and low

carbohydrate intake as a percentage of total calories.

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Sossin et. al., (1995) examined beliefs and attitudes of 311 New York

state high School wrestling coaches and their use of nutrition resources. Most

coaches (82%) considered themselves very knowledgeable about wrestling

but less informed about sports nutrition, weight loss, and vitamin

supplements. Only 36% of coaches attended a nutrition workshop. More

experienced coaches attended nutrition workshops and felt more informed

about weight loss and sports nutrition. Mean scores for correct responses to

questions about weight loss were 64%, training diets 59%, dehydration 57%',

body composition 52%, eating disorders 80%, and mean scores for positive

attitudes about weight loss were 69%, training diets 34%, dehydration 29%,

body composition 70%, and eating disorders 69%. Most coaches believed that

rapid weight loss had an effect on endurance, strength, performance, and

health. About 91% of coaches believed wrestlers should not limit their intake

of bread, rice, and potatoes as opposed to fats. Most coaches (93%) believed

correctly that flushing, cramps, headaches, rapid pulse, weakness, and fainting

are signs of dehydration. Many coaches (67%) believed wrestlers used their

weight loss advice. Binge-eating is a concern among coaches (75%) while

95% believe it is unacceptable for wrestlers to use this practice during the

season.

Massad et. al., (1995) assessed knowledge and factors that influence

nutrition supplement use among 509 high school athletes. Mean knowledge

scores were higher for females> One-third of subjects believed protein drinks

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offered nutritional advantages over protein found in food. Contray to

scientific evidence, about 50% of athletes believed argentine increased human

growth hormone production. About one-third of athletes believed B-vitamins

were a source of energy while one-half of subjects believed animal glandular

material (bull testicles) provide significant amounts of testosterone, and

nutritional supplements sold at health food stores are scientifically tested and

safe for use. greater nutrition knowledge about supplements was associated

with less use.

Keller-Grubbs et. al., (1994) assessed changes in nutrition knowledge

and dietary intake among university female cross-country runners before and

after a nutrition education program. A small group format was used to

communicate the following topics through presentations, handouts, and group

discussions: carbohydrates, fat, protein, live food groups, iron status, fluids

and dehydration, amenorrhea, calcium intake and its effect on bone mass, and

pathogenic .weight control. Nutrition knowledge increased significantly

among the experimental group (n = 9) from amean pre-test score of 11.22 to

15.44 post-test compared to controls. No significant change occurred for 21

nutrients except thiamin, dietary fiber, and saturated fat.

Par. R.B et,al (1994) has conducted a study a nutrition knowledge

survey of 348 coaches, 179 athletic trainers, and 2977 athletes in high school

and college settings throughout the United States reported that more than 70%

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of athletic trainers certified by the National Athletic Trainers Association had

taken nutrition courses and felt they should provide athletes with nutrition

information. Despite the fact that only 27% of coaches had taken a formal

nutrition course, half of them stated that they should provide nutrition

education to athletes. Noncertified athletic trainers (81%) believed they

should counsel athletes on diet, although more than 25% had little nutrition

education. Coaches and certified and uncertified trainers all reported fluids as

the prime nutritional concern for athletes. On the other hand, athletes ranked

fluid intake third, after concerns about body weight and vitamins. Sources of

nutrition information reported by athletes were parents (ranked first or second

by 77%), followed by print or electronic media. Athletes were asked about

their familiarity with, and daily use of, three nutritional guidelines. Most

(68%) athletes were very familiar with daily food guides, and 71% used a

guide daily. Since athletes were not asked to define their nutritional guides, it

is difficult to judge if these guidelines were actually being used. Additionally,

these guidelines were not formulated for athletes. Athletes were not identified

by their event except to state that wrestlers and swimmers relied more on

coaches for nutrition information, while football and baseball players relied

on trainers.

Douglas – Douglas (1994) test on nutritional knowledge and food

practices of 943 male and female high school athletes have conducted a

showed a mean score of 55% on nutrition questions.41 Of the 18 different

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sports teams in this study, members of the cross-country team and track-and-

field participants scored higher on nutrition knowledge than the high school

athletes in other sports. Athletes who participated in their sport for a longer

period of time had higher nutrition knowledge scores. When asked to rate

their sources of nutrition information besides school, most ranked parents

first, then popular books and magazines. Only 10% ranked first medical

personnel first. At school, science courses and home economics classes were

ranked first as sources of nutrition information by 50% of students. Only 15%

of students ranked coaches as a major source of information about sports

nutrition.

Campbel – Mac Fadyen (1994) have surveyed nutrition knowledge of

101 competitive swimmers (age 13 to 20) in the areas of general and sports

nutrition found a low level of nutrition knowledge. The majority believed a

well-balanced meal was necessary at all times, a balanced diet without

supplements was adequate for top performance, eating steak did not provide

extra strength before competition, and not everyone should take iron

supplements (41%). Almost half, however, stated everyone should take

supplements, extra energy is derived from vitamin B supplements, vitamin E

supplements improve performance, drinking milk the day of the event

decreased performance, and protein supplements improved performance.

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Hornick et. al., (1994) evaluated the effects of a 2-month nutrition

education program on sports nutrition knowledge and ergogenic aid usage

among 68 male and female adolescents, 15-18 years of age, enrolled in a

physical education class. No significant changes occurred in nutrition

education. There was a significant decrease in use of vitamin/minerals,

muscle building products, protein and amino acid supplements, and salt

tablets after the sports nutrition education program. Family (35%) was the

most frequently reported source of nutrition information followed by

coach/teacher (24%) and friends (14%). the author concluded that there is a

need for more sports nutrition education strategies involving parents, teacher,

and coaches.

Steen - McKinney (1992) collected data from two college wrestling

teams (42 wrestlers age 18-23 years) using 24-h diet recall preseason, 4-d

food record midseason, and a l-d report three to four weeks after the last

match. Thirty-seven percent of wrestlers did not meet the RDA for calories

for an "average person" and 15% had low protein intakes. Including

supplements, 25% of men consumed less than two-thirds of the RDA for

vitamin C, thiamin, and iron. Almost half were low in vitamin A, while more

than half were below two-thirds of the RDA for pyridoxine, zinc, and

magnesium. Percentages of calories from protein and fat were higher than that

recommended for athletes while carbohydrate consumption was lower than

recommended. All but five percent of subjects used alcohol during the season.

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Food and fluid intake was low and sometimes nothing was taken by mouth for

two days before a match.

Hickson et. al., (1991) have investigated 18 members of a men's

intercollegiate soccer team during preseason conditioning and fall competition

season. The athletes' preseason intake was observed and recorded at the

university cafeteria training table over three consecutive weekdays. During

the competitive season, players kept food intake records over two to three

weekdays. Caloric intake for preseason was 4492 kcal (18,777 J)/d and 3346

kcal (13,986 J)/d during season. During preseason, percent of total calories

from protein was 14%, from fat 33%, and from carbohydrate 52%. During the

competitive season, caloric intake was divided 17% protein, 37% fat, and

46% carbohydrate. Mean intake of six vitamins and four minerals exceeded

the RDA during preseason and during competitive season except that zinc

was 97% of the RDA. The carbohydrate intake may have been below optimal

level recommended for sports performance. Since the team won the NCAA

Division I championships, the authors believe that a high carbohydrate intake

is not the only factor in winning soccer competitions.

Corely, G. et. al., (1990) surveyed more than 100 college coaches in

North Carolina to Measure nutrition knowledge, identify recommendations

for dietary practices ,and to Discover sources of coaches' nutrition

information. A true/false nutrition test was answered correctly by 70% of

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coaches, but only one-third of coaches were certain their answers were

correct. Most (82%) coaches never took a college nutrition course but 48%

planned pre-game meals. These coaches (80%) knew little about the amounts

of carbohydrate, fat, and protein appropriate for an athlete's diet. The majority

of coaches reported that eating "junk food" was the worst dietary problem.

Three coaches urged their athletes to enroll in a college nutrition course.

Coaches' recommendations of vitamin/mineral supplements (60%),

carbohydrate loading (40% of male coaches), protein supplements (20%),

fluid restriction (12% of male coaches), and milk restriction (24% of male

coaches) all indicated that more nutrition education was needed. Coaches

indicated that their nutrition information came from books, physician's advice,

professional journals, and the popular press. Dietitians or nutritionists were

consulted by only 2% of coaches. The authors recommended special nutrition

workshops to increase the depth of coaches' nutrition information.

Benson et. al., (1990) analyzed diets of 92 female adolescent ballet

dancers (age 12 to 17) enrolled in six different professional schools. Results

of 3-d diet records of dancers, analyzed with a data base program of 700

foods, indicated that many dancers were consuming less than two-thirds of the

RDA for folacin, calcium, iron, and zinc. About 50% of dancers had iron

intakes less than two-thirds of the RDA. Other low intake nutrients included

vitamin E, pyridoxine, and magnesium. Average caloric intake was 1890 kcal

(7900 J)/d, but 50% of dancers ate less than 1800 kcal (7524 J)/d, and 11%

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ate less than 1200 kcal (5016 J)/d. Caloric intake was 15.6% from protein,

34.6% from fat, and 49.8% from carbohydrate. Over half of these girls

derived more than 20% of their calories from protein and one-fourth derived

more than 40% of calories from fat. About 60% of subjects took mineral or

vitamin supplements but rarely did the supplement cover the dancers'

nutritional deficiencies. Many dancers took supplements providing more than

twice the RDA for vitamins A, B, and C when no deficiencies were evident.

Ellsworth et. al., (1990) have investigated the nutrient intake of 13

male (age 18-28 years) and 14 female (15-31 years) members of the U.S.

Nordic Ski Team. Four sets of 3-d records were collected at 3-4 month

intervals during a year of training and competition (cross-country skiing for

females and 9 men; and combined Nordic events for 4 men). Food intake,

weighed and measured at the third session, indicated they consumed a diet

high in fat, low in carbohydrate, and averaged more than the RDA for vitamin

C, thiamin, riboflavin, niacin, and calcium. Females had low iron intakes for

three out of the four recording sessions. Although the female skiers' mean

calcium intake met the RDA, 40% of skiers at the last session ate less than

800 mg calcium. Caloric intake was high (49-76 kcal [205-318 J]/kg BW) for

men and (42-71 kcal [176-297 J]/kg BW) for women. Caloric needs for skiers

have been calculated to be 90 kcal (376 J)/kg BW but only two men

consumed calories al that level. The percentage of calories from energy

nutrients ranged between 13 and 14% for protein for both men and women,

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34-43% calories from fat for men, and 34^11% for women, and 40-52% of

calories from carbohydrate for men and 42-50% for women. Alcohol

provided up to 3% of calories for men and 4.5% for women. Intake ranged

from 655 to 1210 mg cholesterol for men and from 369 to 736 mg cholesterol

for women which are far above any dietary guidelines. Fat consumption

increased and carbohydrate intake decreased at training table as compared to

at-home eating habits suggesting that training table menus need to be revised.

Campbell - Mac Fadyen (1990) have assessed the dietary practices of

101 Canadian adolescent male and female competitive swimmers. They

divided these swimmers into groups: 15- to 16-year-olds, 16- to 18-year-olds,

and 20-year-olds who could meet time standards set in two events of 100 m or

over and in one event of 50 m or greater. Three-day food records were

collected and compared to the 1975 Canadian Dietary Standard Committee

for revision of the Canadian Dietary Standard. The 3-d mean intake of

calories and nutrients met the Canadian Dietary Standard recommendations

for all ages and for both boys and girls, however some swimmers ate less than

recommended amounts of calories, iron, and vitamin A. A higher percentage

of calories and nutrients were consumed at home than away from home by all

age and sex groups. Evening snacks provided almost the same percentage of

calories and nutrients as breakfast. In some cases, this was also true of lunch.

About 40% or more of total calorie and nutrient intake was provided by

dinner and evening snack. More swimmers took supplements during training

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than before competition. These supplements included vitamin C, vitamin E,

iron, and the B-complex vitamins. The most frequently eaten foods for pre-

game meals were cereals and carbohydrate foods.

Burke - Read (1989) described the self-reported diets of 25 Australian

male triathletes (age 19-46). During training, diet histories, and food

frequency techniques were used to collect dietary intake information. Twenty

subjects completed 7-d food diaries. Skin fold and other anthropometric

measurements were performed and blood samples were taken to measure iron

status. Athletes indicated that foods they used during triathlons lasting from

an average of 3 h to completion to those events lasting 9-17 h to completion

(e.g., Ironman) were fresh and dried fruit, cookies, sandwiches, water,

electrolyte drinks, soft drinks, 2-5% glucose/fructosc-polymcr drinks during

the cycling phase, and cookies with the same liquids during the running

phase. Foods used during a training week included (per day): 18 servings of

breads/cereals, nine servings of fruit/starchy vegetables, five servings of high-

sugar foods, and from one to three servings from other food groups. More

than 80% of men reported carbohydrate loading 2-4 d before the race. Mean

energy intake of the training diet was 4095 kcal (17,117 J)/d (59 .^/kcal [247

J]/kg BW/d) with 59.5% from carbohydrate, 13% from protein (2 g/kg BW),

27% from fat, and 0.5% from alcohol. Intake of five vitamins and two

minerals was above the Australians' nutrient recommendations. Intake of iron

was calculated to be 30 nig (three times the recommendation), and all iron

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status measurements were normal. These triathletes had frequent snacks and

multiple meals to increase caloric intake. At the pre-event meal, all triathletes

reported drinking extra liquids and all but two men had high carbohydrate

meals. All subjects recognized the importance of fluids before and during

triathlons.