Assessment of Dietary Under-Reporting in Italian College Team Sport Athletes

Nutritional counseling in athletes: a systematic review

Many studies report poor adherence to sports nutrition guidelines, but there is a lack of research on the effectiveness of nutrition education and behavior change interventions in athletes. Some studies among athletes demonstrate that nutrition education (NE), often wrongly confused with nutritional counseling (NC), alone is insufficient to result in behavior change. For this reason, a clear distinction between NC and NE is of paramount importance, both in terms of definition and application. NE is considered a formal process to improve a client's knowledge about food and physical activity. NC is a supportive process delivered by a qualified professional who guides the client(s) to set priorities, establish goals, and create individualized action plans to facilitate behavior change. NC and NE can be delivered both to individuals and groups. To our knowledge, the efficacy of NC provided to athletes has not been comprehensively reviewed. The aim of this study was to investigate the current evidence on the use and efficacy of nutritional counseling within athletes. A systematic literature review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. The search was carried out in: PubMed, Scopus, Web of Science, Science Direct, Cochrane Library between November 2022 and February 2023. Inclusion criteria: recreational and elite athletes; all ages; all genders; NC strategies. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The quality of evidence checking was tested with the Mixed Methods Appraisal Tool system. From 2,438 records identified, 10 studies were included in this review, with athletes representing different levels of competition and type of sports. The most commonly applied behavior change theory was Cognitive Behavioral Theory. NC was delivered mainly by nutrition experts. The duration of the intervention ranged from 3 weeks to 5 years. Regarding the quality of the studies, the majority of articles reached more than 3 stars and lack of adequate randomization was the domain contributing to high risk of bias. NC interventions induced positive changes in nutrition knowledge and dietary intake consequently supporting individual performance. There is evidence of a positive behavioral impact when applying NC to athletes, with positive effects of NC also in athletes with eating disorders. Additional studies of sufficient rigor (i.e., randomized controlled trials) are needed to demonstrate the benefits of NC in athletes.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42022374502.

Blood biomarkers for estimating energy intake in Japanese male collegiate athletes: a pilot study

BACKGROUND

Athletes should be informed of their required energy intake in preparation for sports competitions. However, the environment in which dietary surveys can be conducted to determine the required energy intake for sports competitions is limited, and such survey will require a substantial amount of time and effort from athletes and dietitians. If certain biomarkers for estimating the energy intake can be identified, they may compensate for the shortcomings of these dietary surveys. We aimed to identify the blood biomarkers to estimate the energy intake/basal metabolic rate ratio of male athletes.

METHODS

Twenty-six male athletes from a university physical education department were included and underwent measurements of height, weight, and body composition, as well as blood sampling. The dietary assessment included a 3-day dietary recall and collection of meal photographs. The basal metabolic rate was estimated using the lean body mass, while the daily energy intake/basal metabolic rate ratio was used as an index to determine the energy intake. From the 36 selected blood biomarkers, we identified the independent biomarkers for inclusion in the multiple regression analysis by assessing for pairwise correlations and multicollinearity. A formula for estimating the energy intake/basal metabolic rate was then developed using the stepwise method. A p-value of < 0.05 was considered significant.

RESULTS

Overall, 18 of the 36 blood biomarkers were selected, and multiple regression analysis revealed that triiodothyronine, white blood cell count, and triglyceride level were significant factors that can be used to estimate the energy intake/basal metabolic rate, accounting for 60.4% of the variance. No systematic errors were observed in the estimated values, calculated using the estimation formula and dietary assessment results.

CONCLUSIONS

A combination of free triiodothyronine level, white blood cell count, and triglyceride level can be used for estimating the energy intake/basal metabolic rate of male athletes, thus compensating for the shortcomings of dietary surveys.

How Do Male Football Players Meet Dietary Recommendations? A Systematic Literature Review

The aim of this review was to determine whether male football players meet dietary recommendations according to a UEFA expert group statement and to identify priority areas for dietetic intervention, including training periodization and field position. A database search of PubMed, Web of Science, EBSCO and Scopus was performed. To be included within the final review, articles were required to provide a dietary intake assessment of professional and semi-professional football players. A total of 17 studies met the full eligibility criteria. Several studies showed insufficient energy and carbohydrate intake compared to the recommendations. A majority of athletes consume adequate protein and fat intakes compared to the recommendations. In addition, several studies showed the insufficient intake of vitamins and minerals. This systematic review showed that football players do not meet the nutritional recommendations according to the UEFA expert group statement. Future research should be focused on how to apply nutritional recommendations specific for athletes in accordance with training periodization and positions on the field.

Contributing Factors to Low Energy Availability in Female Athletes: A Narrative Review of Energy Availability, Training Demands, Nutrition Barriers, Body Image, and Disordered Eating

Relative Energy Deficiency in sport is experiencing remarkable popularity of late, particularly among female athletes. This condition is underpinned by low energy availability, which is a byproduct of high energy expenditure, inadequate energy intake, or a combination of the two. Several contributing factors exist that may predispose an athlete to low energy availability, and therefore a holistic and comprehensive assessment may be required to identify the root causes. The focus of the current narrative review is to discuss the primary contributing factors as well as known risk factors for low energy availability among female athletes to help practitioners increase awareness on the topic and identify future areas of focus.

Validation of a General and Sports Nutrition Knowledge Questionnaire in Italian Early Adolescents

To the best of our knowledge, no specific questionnaires on sports nutrition knowledge (NK) have been validated so far in Italian early adolescents. The aim of the present study was to validate a short (26-item) general and sports NK questionnaire in a group of Italian early adolescents. To this aim, the questionnaire was administered to 264 subjects for analysis of internal consistency, and in a subgroup (n = 39) for evaluating the reliability over time. The questionnaire revealed good overall internal consistency and reliability (Cronbach’s α = 0.684) and a highly significant correlation over time (r = 0.977, p < 0.001). Comparison with other validated questionnaires is tricky, because the previous questionnaires were validated in different populations, such as middle or late adolescents or adults, with a higher number of items compared to our questionnaire. Furthermore, data on adolescent NK in Italy are very limited. This study provides a brief, feasible, and validated questionnaire that can be used for investigating sports NK in young subjects. It could be used for evaluating the efficacy of education on general and sports nutrition in both the general population and athletes, and for investigating the relationship between NK and different sports in early adolescence.