Context: Nutrition education aims to enhance knowledge and improve dietary intake in athletes. Understanding athletes' nutrition knowledge and its influence on dietary intake will inform nutrition-education programs in this population. Purpose: To systematically review the level of nutrition knowledge in athletes, benchmark this against nonathlete comparison groups, and determine the impact of nutrition knowledge on dietary intake. Methods: An extensive literature search from the earliest record to March 2010 using the terms nutrition knowledge or diet knowledge and athlete or sport was conducted. Included studies recruited able or physically disabled, male or female, competitive (recreational or elite) athletes over the age of 13 yr. Quantitative assessment of knowledge and, if available, diet intake was required. Because of variability in the assessment of nutrition knowledge and dietary intake, meta-analysis was not conducted. Results: Twenty-nine studies (17 published before 2000) measuring nutrition knowledge (7 including a nonathlete comparison group) met inclusion criteria. Athletes' knowledge was equal to or better than that of nonathletes but lower than comparison groups including nutrition students. When found statistically significant, knowledge was greater in females than males. A weak (r < .44), positive association between knowledge and dietary intake was reported in 5 of 9 studies assessing this. Common flaws in articles included inadequate statistical reporting, instrument validation, and benchmarking. Conclusion: The nutrition knowledge of athletes and its impact on their dietary intake is equivocal. There is a need for high-quality, contemporary research using validated tools to measure nutrition knowledge and its impact on dietary intake.

This review demonstrates that literature describing the dietary intake practices of competitive bodybuilders is dated and often of poor quality. Intake reporting required better specificity and details of the rationale underpinning the use. The review suggests that high-quality contemporary research is needed in this area, with the potential to uncover dietary strategies worthy of scientific exploration.

Dietary assessment methods that are recognized as appropriate for the general population are usually applied in a similar manner to athletes, despite the knowledge that sport-specific factors can complicate assessment and impact accuracy in unique ways. As dietary assessment methods are used extensively within the field of sports nutrition, there is concern the validity of methodologies have not undergone more rigorous evaluation in this unique population sub-group. The purpose of this systematic review was to compare two or more methods of dietary assessment, including dietary intake measured against biomarkers or reference measures of energy expenditure, in athletes. Six electronic databases were searched for English-language, full-text articles published from January 1980 until June 2016. The search strategy combined the following keywords: diet, nutrition assessment, athlete, and validity; where the following outcomes are reported but not limited to: energy intake, macro and/or micronutrient intake, food intake, nutritional adequacy, diet quality, or nutritional status. Meta-analysis was performed on studies with sufficient methodological similarity, with between-group standardized mean differences (or effect size) and 95% confidence intervals (CI) being calculated. Of the 1624 studies identified, 18 were eligible for inclusion. Studies comparing self-reported energy intake (EI) to energy expenditure assessed via doubly labelled water were grouped for comparison (n = 11) and demonstrated mean EI was under-estimated by 19% (−2793 ± 1134 kJ/day). Meta-analysis revealed a large pooled effect size of −1.006 (95% CI: −1.3 to −0.7; p < 0.001). The remaining studies (n = 7) compared a new dietary tool or instrument to a reference method(s) (e.g., food record, 24-h dietary recall, biomarker) as part of a validation study. This systematic review revealed there are limited robust studies evaluating dietary assessment methods in athletes. Existing literature demonstrates the substantial variability between methods, with under- and misreporting of intake being frequently observed. There is a clear need for careful validation of dietary assessment methods, including emerging technical innovations, among athlete populations.

MD symptomatology was greater in BBs than in NBBRTs. Anxiety and social physique anxiety, depression, neuroticism, and perfectionism were positively associated with MD, while self-concept and self-esteem were negatively associated. It remains unclear whether these characteristics are exacerbated by bodybuilding, or whether individuals with these characteristics are attracted to the bodybuilding context.

The objective of this study was to describe barriers influencing dietary practices of elite-level athletes using a focus-group design involving discussions with elite-level athletes, coaches and sports dietitians. The participants were sixteen male and thirty female elite athletes from an Australian State Institute of Sport, representing diving, netball, basketball and lawn bowls; twelve elite coaches representing swimming, diving, soccer, sailing, cycling and golf; and sixteen sports dietitians who consulted to state institutes/academies of sport with various sports. Focus groups were audio-taped and transcribed with in-depth notes also recorded during the groups. Thematic coding of transcripts and notes were undertaken by the primary coder and these themes were subsequently evaluated by the research team. A number of barriers to healthy eating were described. Lack of time for food preparation was a significant barrier raised by all groups. Financial limitations, inadequate cooking skills and difficulty with living arrangements also rated high among all three groups. Coaches were concerned with excess body weight and fat levels and perceived an impact on sports performance. Athletes reported concern about body shape due to societal pressures. Sports dietitians and coaches were concerned with issues relating to optimal dietary provision surrounding travel to and from training and competition. A range of barriers influence the diet of athletes, in particular time and financial constraints in addition to specific physique requirements. Health professionals working with elite athletes need to be aware of these barriers when assessing dietary intake, or designing nutrition interventions. Dietitians may need to advocate on behalf of athletes to facilitate increased financial or professional support to assist athletes to choose and then maintain healthy diet practices.

The aim of the present study was to investigate and benchmark the level of general nutrition knowledge in elite Australian athletes (EA) against a similar aged community (CM) and criterion sample with dietetic training (DT). EA (n 175), CM (n 116) and DT (n 53) completed the General Nutrition Knowledge Questionnaire (GNKQ), which assesses four domains (sections A -D) of general nutrition knowledge (section A: dietary guidelines; section B: sources of nutrients; section C: choosing everyday foods; section D: diet -disease relationships). Age, sex and education level were collected in all groups, and athletic calibre and sport type (team or individual) in EA. Dietitians and nutrition scientists (n 53) re-examined the GNKQ for content validity, resulting in instrument revision (R-GNKQ; ninety-six items). Psychometric assessment (internal consistency: Cronbach-a; test-retest: Spearman rank correlation) was performed in a sub-sample (n 28). Independent t tests, ANOVA and ANCOVA (x 2 for categorical variables) were used to assess between-group differences. DT scored higher than EA and CM in all sub-sections and overall (P,0·005). EA scored lower than CM in GNKQ for section B (P, 0·005) and overall (P,0·005), and in R-GNKQ for section B (P, 0·005), section C (P,0·005), section D (P¼0·006) and overall (P,0·005). Overall score was influenced by age (P¼ 0·036 for GNKQ: P¼0·053 for R-GNKQ), sex (P¼ 0·016 for GNKQ: P¼ 0·003 for R-GNKQ) and athletic calibre (P¼0·029 for R-GNKQ only), but not level of education, living situation or ethnicity. EA and CM performed best on section A and worst on D. EA had lower overall general knowledge scores than CM. This was significantly influenced by age and sex.

Competitive bodybuilders undergo strict dietary and training practices to achieve an extremely lean and muscular physique. The purpose of this study was to identify and describe different dietary strategies used by bodybuilders, their rationale, and the sources of information from which these strategies are gathered. In-depth interviews were conducted with seven experienced (10.4 ± 3.4 years bodybuilding experience), male, natural bodybuilders. Participants were asked about training, dietary and supplement practices, and information resources for bodybuilding strategies. Interviews were transcribed verbatim and analyzed using qualitative content analysis. During the off-season, energy intake was higher and less restricted than during the in-season to aid in muscle hypertrophy. There was a focus on high protein intake with adequate carbohydrate to permit high training loads. To create an energy deficit and loss of fat mass, energy intake was gradually and progressively reduced during the in-season via a reduction in carbohydrate and fat intake. The rationale for weekly higher carbohydrate refeed days was to offset declines in metabolic rate and fatigue, while in the final “peak week” before competition, the reasoning for fluid and sodium manipulation and carbohydrate loading was to enhance the appearance of leanness and vascularity. Other bodybuilders, coaches and the internet were significant sources of information. Despite the common perception of extreme, non-evidence-based regimens, these bodybuilders reported predominantly using strategies which are recognized as evidence-based, developed over many years of experience. Additionally, novel strategies such as weekly refeed days to enhance fat loss, and sodium and fluid manipulation, warrant further investigation to evaluate their efficacy and safety.

Interpretation of dietary adequacy is complex and varies depending on whether the mean, proportion of participants below the relevant NRV, or statistical probability estimate of inadequacy is used. Further research on methods to determine dietary adequacy in athlete populations is required.