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DIET QUALITY OF COLLEGIATE ATHLETES

K elly W ebber, PhD, RD, LD University o f Kentucky

A manda Ireland Stoess, M .S ., RD, LD University o f Kentucky

H azel F orsythe, PhD,RD University o f Kentucky

Janet K urzynske, PhD, RD University o f Kentucky

C orresponding A uthors: Joy Ann Vaught, M S , R D , LD University o f Kentucky

Bailey Adams, M S, R D , L D University o f Kentucky

Abstract Background/Objectives: Collegiate athletes generally appear healthy according to weight for height and body fat standards. Despite the fact that there are well known connections between

athletic performance and nutrition, little is known about the diets o f collegiate athletes. The objective o f this study was to determine the diet quality o f 138 collegiate athletes.

Subjects and Methods: Data were collected in the laboratory and via survey. Anthropometries were assessed using a free standing sta- diometer and the BodPod® for body fat assessment. The Block 2005 Food Frequency Questionnaire© was used to assess diet. The Healthy Eating Index (HEI) 2005 was used to calculate diet quality scores.

Results: The average BM1 was 23.2 + 2.3 kg/m2 and the average body fat was 17.8 % ± 6.5. The average HEI score was 51.2 + 8.8 out o f 100 possible. Higher HEI scores were correlated with higher body fat percentages in this sample. Diets were adequate in calcium, iron, and vitamin C. Diets were inadequate in fiber, fruits and vegetables. The athletes had excessive intakes o f sodium and percent fat.

Conclusion: These findings demonstrate the need for and potential benefit o f nutrition education for collegiate athletes.

Keywords: Diet quality, collegiate athletes, Healthy Eating Index 2005, Block 2005 Food Frequency Questionnaire, Nutrition Knowledge

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Introduction

College athletes spend hours a day train­ ing for their sport. While physical achieve­ ments require training, more emphasis may be needed on the diet quality of these athletes. An athletes’ macronutrient and mi­ cronutrient intake have an influence on the athletes physical output (Bonci, 2011). Nu­ tritional needs for athletes vary based on the type of sport, hours spent training, season, weather conditions, gender, and body mass index. Nutritional needs also vary between training days and competition days. Athletes who consume a balanced diet tend to per­ form better than those who have poor diet quality (Bonci, 2011).

Depending on the sport, physical appear­ ance is often important to the coach and the athlete. Some athletes and coaches tend to be more concerned about physical appear­ ance than nutritional intake. Collegiate ath­ letes may be pressured by their coaches and strength staff to have a specific body size because of performance expectations and comparison with other competitors (Hoogen- boom et al 2009). While body size can play an important role in performance, the nutritional status of an athlete also plays an important role (Rodriguez, DiMarco, & Langley, 2009).

Athletes receive most of their nutrition knowledge from the coaches, strength and conditioning staff, and athletic training staff; however, the accuracy of the information they receive may be questionable (Torres-McGe- hee et al 2012). These athletic professionals may have some general knowledge of nutri­ tion; however, they are not licensed nutrition professionals. Some colleges provide their athletes with access to nutrition professionals but many do not.

It is important for athletes to consume adequate nutrients for both short-term per­ formance goals and long-term health. Many athletes have health issues after their careers are concluded because nutritional care of

their bodies’ was not a priority during their athletic careers. Some of the health concerns that female athletes face later in life are high risks of arthritis, infertility and obesi­ ty (Manore 1999) while male athletes face risks for orthopedic problems in addition to arthritis and obesity. Athletes have also been found to have more degenerative joint and spine problems compared to a control popu­ lation (Kujala et al 2003).

The purpose of this study was to assess the diet quality and body composition of male and female collegiate athletes. Overall diet quality, as well as food groups, macro and micronutrients, and total calories were assessed. Body composition was assessed using body mass index and body fat percent­ age. The relationship between diet quality and body composition was also assessed. This is one of the few studies to assess colle­ giate athlete diet quality and its’ relationship to body composition.

Subjects and Methods Study Design

The study was a cross-sectional study and data were collected between September 2010 and January 2012 on collegiate athletes who volunteered. This study was based at a university and approved by the university Institutional Review Board (IRB). All ath­ letes signed consent forms for participation. Data were taken from the first measurement of an individual athlete when more than one assessment was conducted during the study period. The athletes’ height and weight were measured and his/her body composition was determined using air displacement plethys­ mography with the BodPod® (Fields, Hunter and Goran, 2000). The athletes’ demographics were also collected by a questionnaire at the initial assessment. The athletes completed a Block 2005 Food Frequency Questionnaire© and a diet quality score was calculated using the Healthy Eating Index 2005.

Diet Quality Of Collegiate Athletes / 253

Participants

Participants were drawn from college ath­ letes involved in various sports. A total o f 138 male and female athletes signed consent forms and completed data at the time of data analy­ sis. All participants were 18+ years o f age and were on the active roster for their team.

Food Frequency Questionnaire

The Block 2005 Food Frequency Ques­ tionnaire© was used to assess the athletes’ diets (Block et al., 1986). The question­ naire contains questions on over 100 foods and includes portion size and frequency of consumption. The validity (r = 0.59) and reliability (r = 0.75) o f the Block FFQ was confirmed among a sample o f Canadian women (Boucher et al., 2006). The analysis o f the questionnaires was conducted at Nutri- tionQuest (Berkeley, CA, USA). The intake o f macronutrients, micronutrients and food group servings were obtained from the anal­ ysis. The intake from supplements was not included in the dietary data. All analyses were performed using SPSS, version 19.0 (SPSS Inc., Chicago, IL, USA).

The Healthy Eating Index 2005

The Flealthy Eating Index (HEI) 2005 was used to determine diet quality. This measure assesses diet quality that conforms to the United States (U.S.) federal dietary guidance and recommendations published in the 2005 Dietary Guidelines for Americans. The components on the HEI 2005 index and the scoring standards are shown in Table I (Guenther, Krebs-Smith, Reedy, Britten, Juan, Lino, Carlson, Hiza & Basiotis, 2005). The HEI is a valuable tool in that it meets the least restrictive o f food-group recommenda­ tions for diets expressed on a per 1000 kcal basis-and receives maximum scores for the nine adequacy components o f the index. Lesser amounts were prorated linearly. The

following three components measuring mod­ eration and population probability densities were examined when setting the standards for minimum and maximum scores for these components: (i) Saturated Fat, (ii) Sodium and (iii) Calories from Solid Fats, Alcoholic Beverages and Added Sugars (SoFFAS). SoFFAS is a proxy for the discretionary cal­ orie allowance (Guenther et al., 2008a). The HEI-2005 measure was previously shown to be valid for assessing diet quality (Guenther et al., 2008). The HEI-2005 score is highly associated with plasma biomarkers including: vitamin C (r = 0.41), a-carotene (r = 0.28), P-carotene (r = 0.28), P-cryptoxanthin (r = 0 .4 1 ) and lutein (r = 0.23) (Hann et al., 2001). See Table I.

Results There were a total o f 138 participants in

the study. The sample was 65.2% female and 89.1% Caucasian. The average age o f all the participants was 19.4 years old. There were five sports represented in this study. The lean sports included gymnastics, and swimmers and divers. The ball sports included soccer, basketball and volleyball. Those in their first year o f school made up 42.8% o f the study.

The mean body mass index for all o f the participants was 23.2 (2.3) kg/m2. The male participants had a mean body mass index of 23.6 (2.4) kg/m2. The females had a mean body mass index o f 22.9 (2.2) kg/m2 (P=0.07). All o f the participants had an average body fat o f 17.8 (6.5%). The male participants had a body fat o f 11.1(3.9%), females were 24.1 (4.5%) (PO.OOl).

The HEI scores for males and females differed significantly (Males= 47.7 + 7.9 and Females= 53.1 + 8.6, p<0.001). Calorie intakes were significantly different for males and females also (p<0.001). Females reported consuming fewer than recommended calories (1866.9 + 976.8) and males reported con­ suming more than the recommended calories

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(3615.8 ± 2238.4). See Table II for detailed dietary intake.

Overall, there was a positive correlation between diet score and percent body fat (r= 0.30; P<0.001) and no correlation between BMI and diet score, r=0.03; P=0.72. When grouping the participants by lean vs. ball sports, there was a significant difference in HEI scores in males (lean= 45.4, ball= 50.6, p=0.02). For females there was no difference in HEI score in lean vs. ball sports (lean= 54.7, ball= 52.0, p=0.14).

Discussion

The purpose o f this study was to determine the diet quality o f collegiate athletes and to determine which groups o f athletes might be most at risk for nutritional deficiencies. In this study, athletes with lower body fat had lower HEI scores. Females had better diet quality than males and males in the ball sports had better diet quality than males in sports that require a leaner body type. Cumulatively, the

participants had diets that were high in solid fats, alcohol, and added sugar (SoFAS). Their diets were also high in sodium and lacked in fiber and fruit.

Previous studies have found that diet qual­ ity in collegiate athletes affects performance. Both malnourishment and over-nourishment can have a negative impact on an athletes’ performance (Quatromoni, 2008). According to Quatromoni, there is a need for nutrition education for athletes because meal skipping, limited finances and limited cooking skills are common issues for athletes. It is also very common for athletes to have misconceptions about the types and amount o f food that they should be eating (Quatromoni, 2008).

Skinner, Kopeck, Seburg, Roth and Lew­ is developed a medical nutrition therapy protocol for female athletes because female athletes tend to be at the highest risk for suboptimal caloric intake, stress fractures, and eating disorders (Skinner et al, 2001). According to these authors, there needs to be

Table I. Healthy Eating Index 2005

Component Maximum

Points Standard for Maximum Score

Standard for minimum score of zero

Total Fruit (includes 100% juice) 5 >0.8 cups equiv. per 1,000 Calorie No Fruit

Whole Fruit (not juice) 5 >0.4 cups equiv. per 1,000 Calorie No Whole Fruit

Total Vegetables 5 >1.1 cups equiv. per 1,000 Calorie No Vegetables

Dark Green and Orange Vegeta­ bles and Legumes

5 >0.4 cups equiv. per 1,000 Calorie No Dark Green or Orange Vegetables or Legumes

Total Grains 5 >3.0 cups equiv. per 1,000 Calorie No Grains

Whole Grains 5 >1.5 cups equiv. per 1,000 Calorie No Whole Grains

Milk 10 >1.3 cups equiv. per 1,000 Calorie No Milk

Meat and beans 10 >2.5oz equiv. per 1,000 Calorie No Meat or Beans

Oils 10 >12 grams equiv. per 1,000 Calorie No Oil

Saturated Fat 10 <7% o f energy >15% o f energy

Sodium 10 >0.7 grams equiv. per 1,000Calorie >2.0 grams o f 1,000 Caloric

Calories from Solid Fats, Alcoholic beverages, and added sugars (SoFAS)

20 <20% o f energy >50% o f energy

Diet Quality Of Collegiate Athletes / 255

a consistent MNT for collegiate athletes in order to prevent health issues that are caused by inadequate nutrition. Four nutrition re­ lated issues were highlighted: amenorrhea, decreased bone density, hydration and iron status Nutrition education and intervention are key to preventing these health issues that can have long term negative effects (Skinner et al 2001).

In a study by Shriver, Betts, and Wol- lenberg, the diets of female college athletes were assessed using a 3-day food record, 24 hour dietary recall, a nutrition questionnaire and anthropometric data. The diets of these athletes were compared to minimum recom­ mendations for athletes. Only 9 percent of the athletes met their energy needs, 25% met their carbohydrate needs and 16% monitored their hydration status. This study speaks to the need for both nutrition intervention and nutrition education (Shriver, Betts and Wol- lenberg, 2013).

While female athletes have a higher rate of disordered eating than male athletes (Thrash and Anderson, 2003), male athletes are certainly not immune to disordered eating patterns that cause long term metabolic dis­ turbances (Chatterton and Petrie, 2013). In a survey of 732 male collegiate athletes the

most common form of weight control was dieting and males that participated in weight controlled sports had the highest rates of dieting (Chatterton and Petrie, 2013). While dieting can aid in weight loss, it is important that athletes consume all required nutrients to prevent long term health effects. If an athlete is not educated on proper nutrition than nutri­ tional deficiencies can be caused by dieting (Chatterton and Petrie, 2013).

The strengths and limitations of this study are related to variation in the types of sport. One limitation may be the composition of the pool of athletes studied. The small numbers of male and female athletes in each sport make it hard to generalize this to a larger popula­ tion. In order to gather a large enough pool of both male and female athletes in one sport would require a larger longitudinal study to build a statistically relevant pool. However, the study is strengthened by the diversity of participants. There was a large enough sample size to see differences in groups and start to pinpoint which athletes might be at greatest risk for malnutrition and benefit most of a nutritional intervention.

The practice implications of these find­ ings suggest that college athletic staff should include nutrition care for their athletes’ that

Table II. Dietary Intake

Fem ale In tak e Fem ale

Recom m endation M ale Intake

Male R ecom m endation

Calories 1867 2400 3616 3000

Fruits (cups/day)

1.6 2 1.8 2

Vegetables (cups/day)

2.0 2.5 3.1 2.5

Fiber (gm)

9 per 1000 calories 14 per 1000 calories

8 per 1000 calories 14 per 1000 calories

SoFAS Calories

965 per 2000 calorics 267 per 2000 calories 1020 per 2000 calorics 267 per 2000 calories

Sodium (mg)

2875 2300 5803 2300

256 / College Student Journal

supports the long term health o f the athlete. While arthritis, orthopedic disorders, and infertility may not be widespread disorders, they pose issues that cannot be ignored in terms o f individual wellbeing and health care costs. The serious nature o f nutrition care should be noted as obesity and nutrition relat­ ed diseases become more endemic in the pop­ ulation. Athletes’ risks for obesity and other health issues should not be ignored. Athletic staff should be proactive when considering the nutritional health o f their athletes for both athletic performance and future health.

References 1. B o n d LJ. Eating for performance: bringing science to

the training table. Clin Sports Med 2011; 30(3), 661. 2. Hoogenboom BJ, Morris J, Morris C, & Schaefer

K. Nutrition Knowledge and Eating Behaviors o f Female, Collegiate Swimmers. N Am J Sports Phys Ther 2009; 4(3), 139-148.

3. Rodriguez NR, DiMarco NM, & Langley S. Position o f the American Dietetics Association, Dietitians o f Canada, and the American College o f Sports Medi­ cine: Nutrition and Athletic Performance. J Am Diet Assoc 2009; 109(3), 509-527.

4. Torres-McGehee, TM., Pritchett KL, Zippel D, Minton DM., Cellamare A, & Sibilia M. Sports Nutrition Knowledge Among Collegiate Athletes, Coaches, Athletic Trainers, and Strength and Conditioning Specialists. J Athl Train 2012; 47(2), 205-211.

5. Manore M. Nutritional Needs o f the Female Athlete. Clin Sports M ed 1999; 18 (3) 549-563.

6. Kujala UM, Orava S, Parkkari J, Kaprio J, & Sama S. Sports Career Related Musculoskeletal Injuries: Long-Term Flealth Effects on Former Athletes. Or- thop J Sports Med 2003; 33(12).

7. Fields D, Hunter G, & Goran M. Validation o f the BOD POD with hydrostatic weighing: influence of body clothing. Int J Obes 2000; 24(2), 200

8. Assessment and analysis services: Question­ naires and screeners. (2013). Retrieved from h t t p : / /w w w . n u t r i t i o n q u e s t . c o m / a s s e s s m e n t / list-of-qucstionnaires-and-screeners/

9. Guenther PM, Krebs-Smith S, Reedy M, Britten P, Juan WY, Lino M, Carlson A, & Basiotis PP. Healthy eating index-2005. Retrieved from website: http:// w w w .c n p p .u sd a .g o v /P u b lic a tio n s/H E I/h e a lth y - catingindcx.2005factsheet.pdf

10. Guenther PM, Reedy J, & Krebs-Smith SM. Devel­ opment o f the Healthy Eating Index-2005. J Am Diet Assoc 2008; 108(11) 1896.

11. Quatronomi P. Clinical Observations from Nutrition Services in College Athletes. J Am Diet Assoc 2008; 108(4) 689-694

12. Skinner P, Kopecky L, Scburg S, Roth T, Eich J, Lew­ is NM. Development o f a Medical Nutrition Therapy Protocol for Female Collegiate Athletes. J Am Diet Assoc 2008; 101: 914-917.

13. Shrivcr LH, Betts NM, & Wollcnbetg G. Dietary Intakes and Eating Habits o f College Athletes: Are Female Col­ lege Athletes Following the Current Sports Nutrition Standards? Am J Health Stud 2012; 61(1) 10-16.

14. Thrash LE, Anderson JJB. The Female Athlete Triad: Nutrition, Menstrual Disturbances, and Low Bone Mass. Nutt Today Sep/Oct 2012; 168-174.

15. Chattcrton JM, Petrie TA. Prevalence o f disordered eating and pathogenic weight control behaviors among male collegiate athletes. J Eat Disord 2013; 21(4):328^tl.

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