Oceania Highlights: The Sport Nutrition Edition

 

15 August 2016

Hello Oceania Sports Community,

Welcome to the seventh issue of Oceania Highlights with selected articles on sports nutrition.

Congratulations to Fiji for winning their first gold medal in Rugby. The Pacific's legacy of medal winners is starting to grow. In 2012, Iliesa Delana won a gold medal in the 2012 Paralympics and Paea Wolfgramm won a silver medal for Tonga in the 1996 Olympics. Woldfgramm has been the first Olympic medal winner for the region.

If you are interested in an article, send me an email and I will forward you the article. Please include title and author. Also, if you want us to focus on a specific topic, let us know.

You can always reach OSIC at osic@onoc.org.fj or osic@usp.ac.fj. Our phone number is +679-323-1958 or +679-722-4181(Digicel) or +679-834-8571(Vodafone).

Sincerely,
Martin V Burrows Jr.
Coordinator
Oceania Sport Information Centre (OSIC)
www.oceaniasportcentre.com



Sport Nutrition

Alaunyte, I., et al. (2015). "Nutritional knowledge and eating habits of professional rugby league players: does knowledge translate into practice?" Journal of the International Society of Sports Nutrition 12(1): 1-7.
    Background: Adequate nutrient intake is important to support training and to optimise performance of elite athletes. Nutritional knowledge has been shown to play an important role in adopting optimal nutrition practices. The aim of the present study was to investigate the relationship between the level of nutritional knowledge and dietary habits in elite English rugby league players using the eatwell plate food categories. Method: General nutritional knowledge questionnaires were collected during the Super League competitive season in the first team squad of 21 professional Rugby league players (mean age 25 ± 5 yrs, BMI 27 ± 2.4 kg/m<Sup>2</Sup>, experience in game 6 ± 4 yrs). According to their nutritional knowledge scores, the players were assigned to either good or poor nutritional knowledge group (n = 11, n = 10, respectively). Their dietary habits were assessment using a food frequency questionnaire. Results: The findings revealed that nutritional knowledge was adequate (mean 72.82%) in this group of athletes with the highest scores in dietary advice section (85.71%), followed by food groups (71.24%) and food choice (69.52%). The majority of athletes were not aware of current carbohydrate recommendations. This translated into their dietary habits as many starchy and fibrous foods were consumed only occasionally by poor nutritional knowledge group. In terms of their eating habits, the good nutritional knowledge group consumed significantly more fruit and vegetables, and starchy foods (p <.05). Nutritional knowledge was positively correlated to fruit and vegetables consumption (rs = .52, p <.05) but not to any other eatwell plate categories. Conclusions: The study identified adequate general nutritional knowledge in professional rugby league players with the exception of recommendation for starchy and fibrous foods. Players who scored higher in nutritional knowledge test were more likely to consume more fruits, vegetables and carbohydrate-rich foods.

Baranauskas, M., et al. (2013). "LITHUANIAN OLYMPIC BASKETBALL PLAYERS' NUTRITION DURING THE TRAINING MEZZO-CYCLES DESIGNED FOR STRENGTH TRAINING. Physical Training. Sport 90(3): 3-10.
    Research background and hypothesis. Unbalanced nutritional status, incorrect qualitative and quantitative content of nutritional and bioactive substances (nutrition value) for athletes in strength and speed sports can have a negative impact on acid-base homeostasis and physical working performance. Hypothesis - there is a dietary acidbase balance in the Lithuanian Olympic basketball team players' food rations. Research aim was to assess dietary acid-base balance in Lithuanian high-performance basketball players during the training mezzo-cycles designed for strength training. Research methods. In the general preparation period, Lithuanian Olympic Team basketball players (n = 52), aged 18.0 ± 1.9 years, training 197.9 ± 58.7 min a day, 6 days a week on average, were tested. Body composition analysis of athletes was performed using bioelectrical impedance analysis (BIA) method. Applying the survey method we investigated and assessed the nutritional status of basketball players, possible effect of their dietary intake on potential renal acid load (PRAL) and net endogenous acid production (NEAP). Research results. The dietary PRAL of more than half (67.3%) of subjects was positive (8.5 ± 49.0 mEq/day). Basketball players' protein intake was positively related to dietary PRAL (r = 0.408, p = 0.003). Protein intake of 20.5% of male basketball players on average was 2.6 ± 0.7 g/kg body weight, and their dietary PRAL was 75.5 ± 22.8 mEq/day, NEAP - 128.5 ± 23.7 mEq/day. Discussion and conclusions. If high-protein diet (protein intake meets 1.8-2.0 g/kg BW) is followed, basketball players' nutritional habits should be changed. Athletes are recommended to consume significantly more fresh fruits and vegetables and/or enrich the normal diet by sodium bicarbonate and/or beta-alanine dietary supplements.

Bird, S. (2010). "The travelling Orienteer: preventing Travel Fatigue and dealing with Jet-lag." Australian Orienteer(157): 23-25.
    The article focuses on how to prevent travel fatigue for traveling orienteers and to cope with the issues of jet-lags. It notes that traveling for several hours to attend in a sports event can be fatiguing. The author suggests tips to avoid travel fatigue, such as planning ahead, being attentive to ones eating, and having physical activity, which are all beneficial to the traveler. Also discussed are the causes and symptoms of jet-lags and how to resynchronize one's body clock.

Botsis, A. E. and S. L. Holden (2015). "Nutritional Knowledge of College Coaches." Sport Science Review 24(3/4): 193-200.
    Nutrition is recognized as an integral component to achieving optimal athletic performance. Even with the increase in sports nutrition research, athletes continually exhibit a lack of knowledge, which is cause for concern (Jacobson & Aldana, 1992; Jacobson, Sobonya, & Ransone, 2001; Rosenbloom, Jonnalagadda, & Skinner, 2002; Torres- McGehee et al., 2012). Moreover, coaches are a primary source of information to their athletes, but research is limited regarding the adequacy of their nutritional knowledge. Therefore, the purpose of this study was to investigate the nutritional knowledge of college coaches using the validated 88 item Sports Nutrition Questionnaire by Caryn Zinn. Twentyone coaches from a Division I National Collegiate Athletic Association (NCAA) institution in the southeastern United States participated. The sample consisted of 16 males and five females. Sports represented were basketball (n=5), cross country and track (n=5), football (n=6), soccer (n=2), softball (n=1), and volleyball (n=2). Results revealed college coaches do not have adequate nutritional knowledge. Only one participant obtained a score about 70% (M=55%). Results indicate coaches may not be an appropriate source of information to their athletes but more research needs to be conducted in the area to further assess collegiate coaches' nutritional knowledge.

Bradley, W. J., et al. (2015). "Energy intake and expenditure assessed ‘in-season’ in an elite European rugby union squad." European Journal of Sport Science 15(6): 469-479.
    Rugby union (RU) is a complex high-intensity intermittent collision sport with emphasis placed on players possessing high lean body mass and low body fat. After an 8 to 12-week pre-season focused on physiological adaptations, emphasis shifts towards competitive performance. However, there are no objective data on the physiological demands or energy intake (EI) and energy expenditure (EE) for elite players during this period. Accordingly, in-season training load using global positioning system and session rating of perceived exertion (sRPE), alongside six-day assessments of EE and EI were measured in 44 elite RU players. Mean weekly distance covered was 7827 ± 954 m and 9572 ± 1233 m with a total mean weekly sRPE of 1776 ± 355 and 1523 ± 434 AU for forwards and backs, respectively. Mean weekly EI was 16.6 ± 1.5 and 14.2 ± 1.2 megajoules (MJ) and EE was 15.9 ± 0.5 and 14 ± 0.5 MJ. Mean carbohydrate (CHO) intake was 3.5 ± 0.8 and 3.4 ± 0.7 g.kg−1body mass, protein intake was 2.7 ± 0.3 and 2.7 ± 0.5 g.kg−1body mass, and fat intake was 1.4 ± 0.2 and 1.4 ± 0.3 g.kg−1body mass. All players who completed the food diary self-selected a ‘low’ CHO ‘high’ protein diet during the early part of the week, with CHO intake increasing in the days leading up to a match, resulting in the mean EI matching EE. Based on EE and training load data, the EI and composition seems appropriate, although further research is required to evaluate if this diet is optimal for match day performance

Burke, L. M., et al. (2014). "Recovery Antagonized Training at the 2014 Meeting of the American College of Sports Medicine." Sportscience 18: 8-17.
    Nutrition Report with Louise Burke: GSSI symposium; PINES special event. Nutrition Reflections with Jeni Pearce. Performance Highlights with Dave Martin. Noteworthy Abstracts with Will Hopkins. Acute Effects: warm-ups. Correlates of Performance: genes. Nutrition and Drugs: acute supplementation with nitrate, dark chocolate, glucose+fructose, tyrosine, protein, L-alanine; mouth rinse with carbohydrate, quinine; ammonia inhalants; caffeine; recovery with an EAS product, cherry juice, chocolate milk; training with Rhodiola crenulata, naproxen. Training: resistance with cold-water immersion; interval; tapering; accommodation resistance; neuromuscular for injury risk; "sportomic" tracking; heart-rate variability for individual responses.

Carlsohn, A. (2016). "Recent Nutritional Guidelines for Endurance Athletes." Deutsche Zeitschrift für Sportmedizin 67(1): 7-12.
    Athletes may support health, training adaptations and performance by generally adequate diets and a prudent nutrient timing. However, for endurance athletes some obsolete recommendations and dietary myths are still widespread among recreational and elite athletes, coaches and health care professionals. This includes hydration strategies as well as nutrient intake before, during and after exercise. In addition, dietary recommendations for elite endurance athletes might differ in some aspects from nutrition recommendations for the general population including recreational athletes. Thus, this article aims to summarize the recent nutritional guidelines for endurance athletes during different training periods and to distinguish between elite and recreational endurance athletes where possible. Finally, some nutrition-associated clinical issues observed in endurance athletes are presented and dietary recommendations to reduce the risks are provided. To summarize, meeting the energy requirement is the major nutritional goal in endurance athletes. Energy availability should not fall below 30-45kcal/kg fat-free mass/d. Carbohydrate requirements vary from 3-5g/kg/d during low-intensity up to 8-12g/ kg/d in high-intensity, high-volume training periods. Protein requirements of elite athletes are approximately twice as high as those of sedentary people or recreational athletes, but not higher than the average protein intake of the general population in Germany (1.4-1.6g/kg/d). Health care professionals (e.g. nutritionists at the Olympic Sports Centers) may help endurance athletes to follow a healthy diet with prudent food choices and clever nutrient timing.

Clark, N. (2016). "ATHLETE'S KITCHEN. TRAVELING ATHLETES AND GAS STATION NUTRITION." Palaestra 30(1): 55-56.
    The article offers the author's insights on the well-balanced sports diet for traveling athletes and the healthful food options at gas stations. It discusses the well-balanced sports diet that includes foods from four groupings including fruits and vegetables, grain-based foods, and protein-rich foods.

Clark, N. (2016). "traveling Athletes and Gas Station Nutrition." American Fitness 34(2): 66-67.
    The article discusses the food intake of athletes, referees and coaches who are frequently travelling. The article also offers tips on how to eat reasonably of well-balanced sports diet such as fruits and vegetables, grain-based foods and protein-rich foods and bringing of food cooler that can stock sandwiches, beverages and wholesome sports foods.

Clénin, G. E., et al. (2016). "Iron Deficiency in sports - definition, influence on performance and therapy." Schweizerische Zeitschrift für Sportmedizin & Sporttraumatologie 64(1): 6-18.
    Iron deficiency is frequent among athletes. All types of iron deficiency may affect physical performance and should be treated. The main mechanisms by which sport leads to iron deficiency are an increased iron demand, an elevated iron loss and a blockage of iron absorption due to hepcidin bursts. As a baseline set of blood tests, haemoglobin, haematocrit, mean cellular volume (MCV), mean cellular haemoglobin (MCH) and serum ferritin levels are the important parameters to monitor iron deficiency. In healthy male and female athletes >15 years, ferritin values <15μg/l are equivalent to empty, values from 15 to 30μg/l to low iron stores. Therefore a cut-off of 30μg/l is appropriate. For children aged from 6 -12 years and younger adolescents from 12-15 years, cutoffs of 15 and 20μg/l, respectively are recommended. As an exception in adult elite sports, a ferritin value of 50μg/l should be attained in athletes prior to altitude training, as iron demands in these situations are increased. Treatment of iron deficiency consists of nutritional counselling and oral iron supplementation or, in specific cases, by intravenous injection. Athletes with repeatedly low ferritin values benefit from an intermittent oral substitution. It is important to follow up the athletes on an individual basis with the baseline blood tests listed above twice a year. A long-term daily oral iron intake or iv-supplementation in the presence of normal or even high ferritin values does not make sense and may be harmful.

Craddock, J. C., et al. (2016). "Vegetarian and Omnivorous Nutrition--Comparing Physical Performance." International Journal of Sport Nutrition & Exercise Metabolism 26(3): 212-220.
    Humans consuming vegetarian-based diets are observed to have reduced relative risk for many chronic diseases. Similarly, regular physical activity has also been shown to assist in preventing, and reducing the severity of these conditions. Many people, including athletes, acknowledge these findings and are adopting a vegetarian-based diet to improve their health status. Furthermore, athletes are incorporating this approach with the specific aim of optimizing physical performance. To examine the evidence for the relationship between consuming a predominately vegetarian-based diet and improved physical performance, a systematic literature review was performed using the SCOPUS database. No date parameters were set. The keywords vegetarian OR vegan AND sport OR athlete OR training OR performance OR endurance were used to identify relevant literature. Included studies (i) directly compared a vegetarian-based diet to an omnivorous/mixed diet, (ii) directly assessed physical performance, not biomarkers of physical performance, and (iii) did not use supplementation emulating a vegetarian diet. Reference lists were hand searched for additional studies. Seven randomized controlled trials and one cross-sectional study met the inclusion criteria. No distinguished differences between vegetarian-based diets and omnivorous mixed diets were identified when physical performance was compared. Consuming a predominately vegetarian-based diet did not improve nor hinder performance in athletes. However, with only 8 studies identified, with substantial variability among the studies' experimental designs, aims and outcomes, further research is warranted.

Devlin, B. L. and R. Belski (2015). "Exploring General and Sports Nutrition and Food Knowledge in Elite Male Australian Athletes." International Journal of Sport Nutrition & Exercise Metabolism 25(3): 225-232.
    Nutrition knowledge is believed to influence nutritional intake, which in turn influences performance in elite athletes. There is currently no published data on the nutrition knowledge of elite Australian Football (AF) players. The purpose of this study was to gain insight into the current level of general and sports nutrition knowledge in elite male AF athletes. Forty six elite male AF players (23.5 ± 2.8 years) answered 123 questions relating to five areas of nutrition knowledge: dietary recommendations, sources of nutrients, choosing everyday foods, alcohol and sports nutrition. Demographic details and perceptions of nutrition knowledge were collected for all participants. The mean nutrition knowledge score was 74.4 ± 10.9 (60.5%). The highest score was obtained in sports nutrition section (17.9 ± 3.0, 61.7%). The dietitian was selected as the first source of information by 98% of athletes, with club trainer and teammates as second choice for 45.7% and 23.9% of athletes, respectively. The majority of athletes correctly answered questions regarding recommendations to increase fruit and vegetable intake and decrease fat intake (95.6%, 91.1% and 93.3% correct respectively). While 80% of the athletes were aware fat intake should predominately be made up of unsaturated fat, they were less able to identify food sources of unsaturated fats (35.6% and 24.4% correct for statements regarding monounsaturated and polyunsaturated fats, respectively). Broad nutrition messages and recommendations appear to be well understood; however, gaps in nutrition knowledge are evident. A better understanding of nutrition knowledge in athletes will allow nutrition education interventions to target areas in need of improvement.

Dziedzic, C. E. and D. G. Higham (2014). "Performance Nutrition Guidelines for International Rugby Sevens Tournaments." International Journal of Sport Nutrition & Exercise Metabolism 24(3): 305-314.
    Rugby sevens is an abbreviated version of rugby union, played by teams of seven players over 7-min halves. International competitions are usually played in a tournament format. While shorter in duration, the movement demands of rugby sevens per min of match time are greater than rugby union, resulting in an accentuated load on players. This load can be repeated up to six times over a typical 2- or 3-day competition period. The potential cumulative effect of inadequate carbohydrate, protein and/or fluid intake over the course of a tournament is the greatest nutrition-related concern for players. Nutritional strategies before and during competition are suggested to replenish substrate stores, maintain fluid balance and promote recovery between matches. The use of ergogenic aids known to enhance intermittent, high-intensity activity and/or the execution of motor skills may be advantageous to rugby sevens performance and is discussed. This review provides a best-practice model of nutritional support for international rugby sevens competition based on our current understanding of the sport combined with pragmatic guidelines and considerations for the practitioner.

Esa, N. H., et al. (2015). "Knowledge, attitudes and behaviours regarding hydration and hydration status of Malaysian national weight category sports athletes." Journal of Physical Education & Sport 15(3): 452-459.
    Problem statement: Dehydration not only may decrease sports performance, it may also put athletes at risk of heat illness and injury. Heat illnesses such as heat cramp and heat stroke are life threatening. Weight category sports athletes are frequently in a state of dehydration as they restrict fluid intake to ensure their body weight within the weight division. Purpose: A cross-sectional study was conducted to ascertain the knowledge, attitudes, and behaviours regarding hydration and hydration status of Malaysian national weight category sports athletes. Approach: A total of 60 weight category sports athletes from the National Sports Institute of Malaysia, aged between 16 and 35 years, participated in this study. Results: This study demonstrated that the mean percentage score for knowledge, attitudes, and behaviours were 68.04±13.97%, 75.06±8.17%, and 75.78±13.79%, respectively. The mean value of urine specific gravity was 1.027±0.01 g/ml, which indicated significant dehydration. Gender was significantly associated with percentage of body weight changes (p=0.035), with all females in the hydrated category. The knowledge score was significantly correlated with the attitude score (r=0.459, p<0.001) and percentage of body weight changes (r=0.306, p=0.018). The knowledge score was significantly different between athletes from different types of sports (F=5.202, p=0.001), age groups (F=3.793, p=0.015), and education levels (F=3.319, p=0.043). Furthermore, the behaviours score was significantly different among athletes from different age groups (F=3.382, p=0.024). The mean percentage of body weight changes was significantly higher among males compared to females (t=3.187, p=0.002), and significantly different between athletes from different types of sports (F=12.096, p<0.001). Conclusions: The findings of this study identify the need for new learning strategies for athletes to improve their knowledge, attitudes, and behaviours with regards to hydration.

Halson, S. (2014). "Sleep in Elite Athletes and Nutritional Interventions to Enhance Sleep." Sports Medicine 44: 13-23.
    Sleep has numerous important physiological and cognitive functions that may be particularly important to elite athletes. Recent evidence, as well as anecdotal information, suggests that athletes may experience a reduced quality and/or quantity of sleep. Sleep deprivation can have significant effects on athletic performance, especially submaximal, prolonged exercise. Compromised sleep may also influence learning, memory, cognition, pain perception, immunity and inflammation. Furthermore, changes in glucose metabolism and neuroendocrine function as a result of chronic, partial sleep deprivation may result in alterations in carbohydrate metabolism, appetite, food intake and protein synthesis. These factors can ultimately have a negative influence on an athlete's nutritional, metabolic and endocrine status and hence potentially reduce athletic performance. Research has identified a number of neurotransmitters associated with the sleep-wake cycle. These include serotonin, gamma-aminobutyric acid, orexin, melanin-concentrating hormone, cholinergic, galanin, noradrenaline, and histamine. Therefore, nutritional interventions that may act on these neurotransmitters in the brain may also influence sleep. Carbohydrate, tryptophan, valerian, melatonin and other nutritional interventions have been investigated as possible sleep inducers and represent promising potential interventions. In this review, the factors influencing sleep quality and quantity in athletic populations are examined and the potential impact of nutritional interventions is considered. While there is some research investigating the effects of nutritional interventions on sleep, future research may highlight the importance of nutritional and dietary interventions to enhance sleep.

Heaney, S., et al. (2008). "Towards an Understanding of the Barriers to Good Nutrition for Elite Athletes." International Journal of Sports Science & Coaching 3(3): 391-401.
    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.

Hueglin, S. (2014). "Nutrition and the Female Athlete." Olympic Coach 25(4): 29-32.
    The article deals with the nutritional requirements of female athletes. Topics include the importance for female athletes to consume sufficient energy, symptoms that show female athletes consume too few total calories or individual nutrients and an example of training meals and snacks for a day designed to incorporate the critical macro and micronutrients for the female athlete.

Jones, B., et al. (2016). "Hydration strategies of professional elite rugby league referees during super league matches." International Journal of Sports Science & Coaching 11(1): 116-121.
    Due to the focus of research within athletic populations, little is known about the hydration strategies of rugby league referees. We observed all eight full-time professional referees, during 31 Super League matches to investigate the drinking strategies and magnitude of dehydration (body mass loss) experienced by referees during match play. Referees arrived and remained euhydrated (urine osmolality; pre and post-match 558±310 and 466±283 mOsmol⋅kg-1). Mean body mass change was -0.7±0.8%, fluid loss was 890±435 g and fluid intake was 444±167, 438±190, 254±108 and 471±221 g during pre-match, first half, half-time and second half. This study suggests that elite referees adopt appropriate hydration strategies during match-play to prevent large reductions in body mass, although individual variability was observed. Future research should investigate dehydration in referees from other sports and the effects on refereeing performance.

Keen, D. A., et al. (2016). "The impact of post-exercise hydration with deep-ocean mineral water on rehydration and exercise performance." Journal of the International Society of Sports Nutrition 13: 1-4.
    Background: Dehydration caused by prolonged exercise impairs thermoregulation, endurance and exercise performance. Evidence from animal and human studies validates the potential of desalinated deep-ocean mineral water to positively impact physiological and pathophysiological conditions. Here, we hypothesize that deep-ocean mineral water drawn from a depth of 915 m off the Kona, HI coast enhances recovery of hydration and exercise performance following a dehydrating exercise protocol compared to mountain spring water and a carbohydrate-based sports drink. Findings: Subjects (n = 8) were exposed to an exercise-dehydration protocol (stationary biking) under warm conditions (30 °C) to achieve a body mass loss of 3 % (93.4 ± 21.7 total exercise time). During the post-exercise recovery period, subjects received deep-ocean mineral water (Kona), mountain spring water (Spring) or a carbohydrate-based sports drink (Sports) at a volume (in L) equivalent to body mass loss (in Kg). Salivary samples were collected at regular intervals during exercise and post-exercise rehydration. Additionally, each participant performed peak torque knee extension as a measure of lower body muscle performance. Subjects who received Kona during the rehydrating period showed a significantly more rapid return to pre-exercise (baseline) hydration state, measured as the rate of decline in peak to baseline salivary osmolality, compared to Sports and Spring groups. In addition, subjects demonstrated significantly improved recovery of lower body muscle performance following rehydration with Kona versus Sports or Spring groups. Conclusions: Deep-ocean mineral water shows promise as an optimal rehydrating source over spring water and/or sports drink.

La Bounty, P. M., et al. (2011). "International Society of Sports Nutrition position stand: meal frequency." Journal of the International Society of Sports Nutrition 8(1): 4-15.
    Position Statement: Admittedly, research to date examining the physiological effects of meal frequency in humans is somewhat limited. More specifically, data that has specifically examined the impact of meal frequency on body composition, training adaptations, and performance in physically active individuals and athletes is scant. Until more research is available in the physically active and athletic populations, definitive conclusions cannot be made. However, within the confines of the current scientific literature, we assert that: 1. Increasing meal frequency does not appear to favorably change body composition in sedentary populations. 2. If protein levels are adequate, increasing meal frequency during periods of hypoenergetic dieting may preserve lean body mass in athletic populations. 3. Increased meal frequency appears to have a positive effect on various blood markers of health, particularly LDL cholesterol, total cholesterol, and insulin. 4. Increased meal frequency does not appear to significantly enhance diet induced thermogenesis, total energy expenditure or resting metabolic rate. 5. Increasing meal frequency appears to help decrease hunger and improve appetite control. The following literature review has been prepared by the authors in support of the aforementioned position statement.

Lockie, R. G., et al. (2015). "A PRELIMINARY ANALYSIS OF SUPPLEMENT HABITS, PERCEPTIONS, AND INFORMATION SOURCES FOR STATE REPRESENTATIVE YOUTH AMERICAN FOOTBALL PLAYERS FROM AUSTRALIA." Journal of Australian Strength & Conditioning 23(7): 16-24.
    American football typically features players that have high muscle mass and strength. Supplements can often be used as an ergogenic aid for youth athletes to assist with improvement in these areas, in addition to other aspects of performance. Little research has been conducted on supplementation habits, perceptions, and information sources of youth football players from countries other than the USA. The purpose of this research was to provide a preliminary analysis of supplement intake of youth football players from a representative state squad in Australia. Thirty-seven state representative players (age: 16.6 ± 0.8 years; mass: 81.8 ± 20.6 kilograms; height: 1.81 ± 0.07 metres) completed questionnaires regarding supplement intake, reasons for taking or not taking supplements, knowledge, general perceptions, and information sources. 13/37 (35%) subjects were taking supplements, and 11/13 (85%) were using protein. The primary reason for supplement use was to improve strength (10/13; 77%). The main reason for not taking supplements was the belief they were not required in a balanced diet. Subjects who used supplements believed that they were knowledgeable, although a majority of the sample did not associate supplementation with health risks (21/37; 57%) or positive doping violations (21/37; 57%). The primary information sources were family and friends, the athlete themselves, and their coach. It is important for people close to a youth football player to be knowledgeable about supplements, as they will invariably be an information source. The player should also have appropriate knowledge to avoid any improper supplement use. The sports' governing body in Australia should consider conducting education sessions facilitated by nutrition experts and sport scientists to assist with improving the knowledge base of players and coaches.

Madrigal, L., et al. (2016). "Nutritional Regrets and Knowledge in National Collegiate Athletic Association Division I Athletes: Establishing a Foundation for Educational Interventions." Journal of Issues in Intercollegiate Athletics 9: 1-16.
    The aim of this study was to describe the nutritional regrets and sport nutrition knowledge of Division I NCAA athletes and determine if higher knowledge would be related to fewer regrets. Additionally, we explored whether differences would emerge on nutrition knowledge or nutritional regrets based on gender or year in school. This was a cross-sectional, questionnaire-based study conducted during the spring and summer of 2015. A total of 196 Division I NCAA student-athletes (145 male and 51 female) from a single university completed a questionnaire at the end of their competitive season. Comparisons on nutrition-related regrets and sport nutrition knowledge were conducted using Mann-Whitney U and Kruskal-Wallis tests. A Spearman's rho correlation was used to examine the relationship between nutrition-related regrets and sports nutrition knowledge. Most student-athletes possessed regrets related to their eating habits, with few regretting weight management practices. Total nutritional regrets were higher in females than males, but did not differ significantly by school level. There was no significant association between nutritional knowledge and regrets. Interventions that incorporate education, strategies that increase dietary choice self-efficacy, and goal-setting may prove to be more efficacious in minimizing regrets in nutrition-related decision-making.

Omeragić, E., et al. (2015). "USE OF DIETARY SUPPLEMENTS AMONG ELITE ATHLETES." SportLogia 11(1): 49-56.
    Many athletes use supplements in their diet as part of regular training or competition, thus enabling more intense training by encouraging faster recovery between workouts, minimizing interference caused by disease or injury and increasing competitive performance. These supplements, unlike medications, are not subject to rigorous efficiency and safety checks and tests. There is a risk with regard to those supplements which include positive doping test result as a consequence of presence of the prohibited substances not listed in the declaration of the preparation. The aim of this study was to examine the use of supplements among elite athletes by analyzing the forms for doping control, issued by the Agency for Anti-doping control of Bosnia and Herzegovina, performed in the period from 2010 to 2012. The study includes supplements whose use was reported by athletes in the period of the last 7 days (prior testing). The study results indicate the frequency of dietary supplements use of 34.5%. The most dominant group among users of dietary supplements were men aged between 18 and 29 years. From 152 users of dietary supplements 62.3% of them have used more than one product. The number of used supplements was an average of 2.9±2.8 products. Amino acids and proteins are the most commonly used dietary supplements. This study confirmed excessive use of dietary supplements among elite athletes and pointed to the need of necessary education and ensuring the availability of scientific and unbiased information, about the benefits and risks of dietary supplements use, to athletes.

Outram, S. and B. Stewart (2015). "Doping Through Supplement Use: A Review of the Available Empirical Data." International Journal of Sport Nutrition & Exercise Metabolism 25(1): 54-59.
    The potential for supplement use to result in doping infringements is likely to be of concern for anyone involved in sports nutrition. The available data indicates that between 40-70% of athletes use supplements, and that between 10-15% of supplements may contain prohibited substances. Such data indicates that there is a considerable risk of accidental or inadvertent doping through using supplements. Accordingly, this paper sets out to provide an overview of the currently available empirical evidence of accidental doping by supplement use. In carrying out this task, the authors refer to press releases and proxy measures associated with nutritional supplement use, as well as statistical data on supplement contamination rates and doping infractions. A number of different indications as to the percentage of doping cases that might be attributed to supplement use are presented, ranging from 6.4% to 8.8%. Such percentages are not comparable; instead they are provided as indications as to how difficult it is to ascertain or estimate the scale of this problem. Although some forms of estimation can be made, it is suggested that it is currently not possible to quantify the scale of the problem. By way of conclusion, it is argued that antidoping regulators may wish to review current data gathering and information provision systems so that the problem of inadvertent doping can be more directly assessed as a factor in sports doping overall.

Pelly, F., et al. (2014). "Evaluation of Food Provision and Nutrition Support at the London 2012 Olympic Games: The Opinion of Sports Nutrition Experts." International Journal of Sport Nutrition & Exercise Metabolism 24(6): 674-683.
    The aim of this study was to evaluate the food provision and nutrition support at the London 2012 Olympic (OG) and Paralympic Games (PG) from the perspective of sports nutrition experts attending the event. Participants (n = 15) were asked to complete an online survey and rate on a Likert scale menu qualities, food safety, sustainability practices, nutrition labeling, and provision for cultural needs, dietary regimes and specific situations. Open-ended responses were incorporated to explore expert opinion and areas for improvement. Participants rated their overall experience of the food provision as 7.6 out of 10 (range 5 to 10), with the majority (n= 11) rating it greater than 7. The variety, accessibility, presentation, temperature, and freshness of menu items rated as average to good. A below average rating was received for recovery food and beverages, provision of food for traveling to other venues, taking suitable snacks out of the dining hall and provision of food at other venues. However, the variety and accessibility of choices for Ramadan, and provision of post-competition food were rated highly. A number of comments were received about the lack of gluten free and lower energy/fat items. The inclusion of allergens on nutrition labeling was considered more important than nutrient content. While dietetic review of the menu in advance of the OG and PG is clearly a valuable process that has resulted in improvements in the food supply, there are still areas that need to be addressed that are currently not implemented during the event.

Pelly, F. E., et al. (2011). "Evolution of food provision to athletes at the summer Olympic Games." Nutrition Reviews 69(6): 321-332.
    The history of food provision at the summer Olympic Games (OG) over the past century (1896-2008) provides insight into the evolution of sports nutrition research and the dietary strategies of athletes. Early research favoring protein as the main fuel for exercise was reflected in OG menus from 1932 to 1968. Despite conclusive research from the 1960s demonstrating the clear benefit of carbohydrate on exercise performance, a specific emphasis on carbohydrate-rich foods was not noted until the 1970s. Athlete food preferences and catering complexity evolved rapidly between 1970 and 2000, driven predominantly by a dramatic expansion of the OG and the emergence of systematic sports nutrition research. Nutritional advice by experts and sponsorship by food companies became increasingly important beginning with the 1984 Los Angeles OG. More recent developments include nutritional labeling of menu items and provision of a nutrition information desk (Barcelona 1992), demand for a 'high-starch, low-fat menu' (Atlanta 1996), the addition of a dedicated menu website and the systematic gathering of information on athletes' apparent consumption (Sydney 2000), and appointment of the first international dietetic review committee (Beijing 2008). The history of catering at the OG tracks the evolution of sports nutrition practice from anecdotes and myth towards an established specialty in nutrition and dietetics grounded in evidence-based science.

Popple, A. and K. Currell (2012). "Olympic nutrition support - Perspectives from British Swimming and British Triathlon." Sport & Exercise Scientist(32): 10-11.
    In this article the authors discuss the development of sport specific nutrition support for the Olympics for swimming and triathlon in Great Britain. According to the authors, performance nutrition to British Swimming is delivered at British Swimming's Intensive Training Centre Network, that offers coaching and sports medicine support to swimmers through two coaches, a physiotherapist, and a performance scientist. The authors also talk about beetroot juice supplementation for triathlon.

Reilly, T., et al. (2007). "Nutrition for travel." Journal of Sports Sciences 25: 125-134.
    The training and competitive programmes of elite athletes incorporate travel schedules, often long journeys, across multiple time zones. In such cases, travel causes both transient fatigue and a malaise known as "jet-lag" that persists for some days. Jet-lag is due to the disturbance of the body's circadian rhythms: diurnal and performance rhythms are displaced, depending on the direction of travel and the number of time zones crossed in flight. Attention to diet and hydration is relevant during the flight and following disembarkation until adjustment to the new meridian is complete. The consequences of jet-lag on rhythms in digestion may be compounded if food preparation and hygiene are inadequate in training camps or competitive venues overseas. The irony of travel is that it often places athletes at a greater risk of failing to meet their specific nutrition goals or succumbing to illness, at a time when the demands or outcomes of performance are of greatest importance. In addition, gastrointestinal infections related to travelling are frequent among athletes. Fastidious planning and organization among the support staff is recommended before the journey to prevent any such problems arising. Equally, athletes often need special education initiatives to assist them to cope with the challenges of a new and unusual food supply, or altered access to food.

Robson-Ansley, P. J., et al. (2009). "Fatigue management in the preparation of Olympic athletes." Journal of Sports Sciences 27(13): 1409-1420.
    Fatigue is often a consequence of physical training and the effective management of fatigue by the coach and athlete is essential in optimizing adaptation and performance. In this paper, we explore a range of practical and contemporary methods of fatigue management for Olympic athletes. We assesses the scientific merit of methods for monitoring fatigue, including self-assessment of training load, self-scored questionnaires, and the usefulness of saliva and blood diagnostic markers for indicating fatigued and under-recovered athletes, effective nutrition and hydration strategies for optimizing recovery and short-term recovery methods. We conclude that well-accepted methods such as sufficient nutrition, hydration, and rest appear to be the most effective strategies for optimizing recovery in Olympic athletes.

Shriver, L. H., et al. (2013). "Dietary Intakes and Eating Habits of College Athletes: Are Female College Athletes Following the Current Sports Nutrition Standards?" Journal of American College Health 61(1): 10-16.
    Objective: The objective of this study was to assess dietary intakes and eating habits of female college athletes and compared them with the minimum sports nutrition standards.Participants: Data were obtained from 52 female college athletes from a National Collegiate Athletic Association (NCAA) Division I university between January 2009 and May 2010.Methods: Participants completed anthropometric measurements and dietary assessment using a 3-day food record, a 24-hour recall, and a nutrition questionnaire.Results:ttests indicated the energy and carbohydrate intakes were below the minimum recommended amount (p< .001), with only 9% of the participants meeting their energy needs. Seventy-five percent of the participants failed to consume the minimum amount of carbohydrates that is required to support training. The majority of the participants reported no regular breakfast, 36% consumed < 5 meals/day, and only 16% monitored their hydration status.Conclusions: Effective nutrition interventions are needed to improve dietary intakes and eating habits of female college athletes.

Skolnik, H. (1999). "Sport Nutrition in a Fast-Food Society: Eating on the Road." Athletic Therapy Today 4(6): 22.
    Focuses on the importance of sports nutrition goals for team travel situations. List of fast food tips; Advantages of family style restaurants to athletes; Selection of foods with high fat content.

Spronk, I., et al. (2015). "Relationship Between General Nutrition Knowledge and Dietary Quality in Elite Athletes." International Journal of Sport Nutrition & Exercise Metabolism 25(3): 243-251.
    This study investigated the association between general nutrition knowledge and dietary quality in a convenience sample of athletes (≥ state level) recruited from four Australian State Sport Institutes. General nutrition knowledge was measured by the validated General Nutrition Knowledge Questionnaire and diet quality by an adapted version of the Australian Recommended Food Score (A-ARFS) calculated from food frequency questionnaire data. Analysis of variance and linear modeling were used to assess relationships between variables. Data: mean (Standard Deviation). A total of 101 athletes (Males: 37; Females: 64), 18.6 (4.6) years were recruited mainly from team sports (72.0%). Females scored higher than males for both nutrition knowledge (Females: 59.9%; Males: 55.6%; p = .017) and total A-ARFS (Females: 54.2% Males: 49.4%; p = .016). There was no significant influence of age, level of education, athletic caliber or team/individual sport participation on nutrition knowledge or total A-ARFS. However, athletes engaged in previous dietetic consultation had significantly higher nutrition knowledge (61.6% vs. 56.6%; p = .034) but not total A-ARFS (53.6% vs. 52.0%; p = .466). Nutrition knowledge was weakly but positively associated with total A-ARFS (r = .261, p= .008) and A-ARFS vegetable subgroup (r = .252, p = .024) independently explaining 6.8% and 5.1% of the variance respectively. Gender independently explained 5.6% of the variance in nutrition knowledge (p = .017) and 6.7% in total A-ARFS (p = .016). Higher nutrition knowledge and female gender were weakly but positively associated with better diet quality. Given the importance of nutrition to health and optimal sports performance, intervention to improve nutrition knowledge and healthy eating is recommended, especially for young male athletes.

Wagner, D. R. (2009). "Eating on the Road: Practical Nutrition Strategies for the Traveling Athlete." Athletic Therapy Today 14(5): 1-4.
    This article discusses nutrition strategies athletic trainers and coaches can utilize when working with athletes required to travel to and from sporting events. The author suggests travel can make it difficult for athletes to maintain good nutrition and that this can have a negative impact on their performance. Tips are offered on hydration, snacks, timing of meals and choosing healthy restaurant meals.

Ziegenfuss, T. N. P. D. (2015). "THE BEGINNER'S ESSENTIAL SUPPLEMENTS GUIDE." Muscle & Fitness Hers 16(6): 86-90.
    The article offers information on food supplements that can help boost energy in the body. Details on the health benefits and key components of these supplements are discussed which include protein powders, turmeric extract, and vitamin D. Also provided are tips on the factors to be considered for the safe and proper consumption of these products.

Zinn, C., et al. (2006). "Evaluation of Sports Nutrition Knowledge of New Zealand Premier Club Rugby Coaches." International Journal of Sport Nutrition & Exercise Metabolism 16(2): 214-225.
    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 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.

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