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R E S E A R C H A R T I C L E Open Access
Nutritional knowledge of youth academy
athletes
Stephen P. Bird
1,2*
and Benjamin D. Rushton
3
Abstract
Background: Youth athletes are under increasing pressures to excel in their chosen sport and many turn to
nutritional supplements in order to enhance sports performance. However, athletes may obtain their nutritional
information via illegitimate sources such as the internet, media, and other athletes, representing miscommunication
between sound scientific information and anecdotal experiences. The objective of this investigation was to examine
nutrition knowledge of elite youth athletes from a non-residential regional academy of sport.
Methods: A previously validated two-part nutrition knowledge questionnaire (NKQ) was administered to 101
(37 male and 64 female) non-residential regional Academy of Sport elite youth athletes at an annual training
camp. Part 1 of the NKQ presented demographic questions. Part 2 presented 90 sports nutrition knowledge
questions in seven knowledge subcategories (1) Nutrients; (2) Dietary reference intakes (DRI); (3) Fluids/
Hydration; (4) Recovery; (5) Weight gain; (6) Weight loss; and (7) Supplements.
Results: The mean NKQ score of all athletes was 43.8% (± 11.4). No gender differences observed between nutritional
knowledge total scores, however female athletes recorded more ‘correct’responses than males (p= 0.02) in the
Nutrients subcategory. Majority of athletes had difficulty identifying correct DRI with this subcategory featuring the
lowest percentage of ‘correct’to ‘incorrect’responses (27.1% ± 2.3; p= 0.02). Supplements subcategory displayed much
uncertainty with significantly more ‘unsure’than ‘incorrect’responses (42.4% ± 20.3; p<0.05).
Conclusions: In agreement with previous research, results of the current study indicate that elite youth athletes lack
fundamental nutritional knowledge, specifically related to DRI and supplementation. These data provide further
support of current recommendations that Academy of Sport youth athletes may benefit from integrated nutrition
education conducted by qualified nutrition professionals.
Keywords: Nutrition knowledge, Supplements, Youth athletes
Background
Adolescence is defined by the World Health Organization
[1] as a period of significant growth and maturation oc-
curring following childhood and prior to adulthood, with
adolescents considered as those between the ages of 10 to
19. It is well established that this period of significant
growth and physical development can be negatively
affected by malnutrition [2,3], as such proper nutrition is
of significant importance especially in the competitive
adolescent athlete with the added demands of training and
competition [4,5]. In recent times there has been a rise in
youth sports participation [6], however youth athletes may
be increasingly pressured to excel in their sport, whether
through parents, sporting coaches or intrinsic pressures
imposed by the athlete [7,8]. In an attempt to gain a com-
petitive edge and improve performance many youth ath-
letes turn to nutritional supplements [9–12]. However,
research indicates that youth athletes possess limited
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data made available in this article, unless otherwise stated in a credit line to the data.
* Correspondence: stephen.bird@usq.edu.au
1
School of Health and Wellbeing (Sport and Exercise Science), University of
Southern Queensland, Ipswich, QLD, Australia
2
School of Exercise Science, Sport and Health, Charles Sturt University,
Bathurst, NSW, Australia
Full list of author information is available at the end of the article
Bird and Rushton BMC Nutrition (2020) 6:35
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nutritional knowledge [13,14], with much of their nutri-
tional information obtained via illegitimate sources such
as the coach, teacher, other athletes, internet, and social
media [15]. Potentially, this may represent a miscommuni-
cation from non-qualified individuals providing nutritional
advice to athletes that leads to nutritional principles being
misunderstood and/or incorrectly applied [16].
Research suggests that collegiate athletes with greater
understanding of sound nutritional principles are more
likely to apply this knowledge and display positive nutri-
tional behaviors [17]. This is an extremely important
consideration, especially for athletes competing in
weight-restricted or aesthetic sports wherein youth
athletes may feel pressured to restrict caloric intake [18,
19]. Unknowingly, not only may this compromise the
athlete’s physical development, such nutritional habits
may predispose psychological behaviors towards disor-
dered eating traits. Smith-Rockwell et al. [20] revealed
that in Division I collegiate coaches/trainers 35% re-
ported at least one perceived eating disorder case per
year, while 10% reported more than three cases per year.
Although many coaches/trainers referred athletes with
eating disorder symptoms to physicians, almost one
third dealt with these cases themselves. Interestingly,
only 30% of collegiate athletes had access to a sports
dietitian, and the same percentage reported utilizing die-
titians for nutritional advice [20]. Collectively, this would
suggest that reliable sources of nutrition information
and education, as well as appropriate nutrition services
including counseling are required for collegiate athletes.
Within elite sporting environments there appears to
be an increasing trend of coaches and athletic trainers
providing nutritional advice [20–22], and this seems to
be common practice especially for strength and condi-
tioning coaches [20,23]. A survey of elite rugby union
coaches [16] reported that despite responding correctly
to only 55% of all questions on the Nutrition Knowledge
Questionnaire (NKQ) [24], 83% provided nutritional ad-
vice to their athletes. Studies assessing coach/athlete nu-
tritional knowledge reported a 67% correct response rate
[20]. Further research solely in athletic populations (age
range: 18–37 yrs) using the same or modified iterations
of the NKQ, found nutritional knowledge in elite Aus-
tralian rules footballers (61%) [25], professional (54%)
and semi-professional soccer players (56%) [26], is well
below the adequate sports nutrition knowledge overall
score of 75% as proposed by Torres-McGehee et al. [23]
This would suggest that both athletes and coaches lack
sports nutrition knowledge. Although concerning, the
apparent lack of nutritional services available to athletes
may be responsible, in part, for necessitating this trend.
While nutritional knowledge and source of nutritional
information has been extensively reported in collegiate
athletes and coaches/trainers [9,20,25–30], to date,
there are no published data on youth athletes from Re-
gional Academy of Sport programs. Recently, Spronk
et al. [14] reported that a substantial proportion of what
were predominantly youth athletes (16–18 yrs) failed to
meet basic dietary recommendations, especially dairy in-
take. Therefore, it is unclear whether youth athletes have
an appropriate level of general nutrition knowledge and
understanding of nutrition principles, as much of the lit-
erature has focused upon collegiate and semi- or profes-
sional athletes [13,16,20,25–28]. Given the potential
for a lack of exposure to high quality nutrition-related
education, nutrition counselling, and qualified sports nu-
trition professionals youth athletes may be ill-equipped
to make accurate decisions regarding their nutritional
requirements, and this in turn may negatively impact
their health status, physiological development and/or
sports performance.
The purpose of the current study was to examine and
describe general nutrition knowledge and nutrition-
related practices of youth athletes from a non-residential
Regional Academy of Sport in NSW Australia. Specific-
ally, this study shall quantify nutritional knowledge in
youth athletes across a range of academy sports, as well
as identifying athletes’primary sources of nutritional in-
formation. It was hypothesised that regional youth acad-
emy athletes would display limited nutrition knowledge,
and this would be related to their primary source of nu-
tritional information.
Methods
Participants
A total of 101 elite youth athletes (37 males, 64 females;
state and national competition level; 15.3 ± 1.4 years)
who were scholarship holders from a non-residential re-
gional Academy of Sport (Western Region Academy of
Sport, WRAS) in Australia were invited to participate in
this study. Athletes were representative of eight WRAS
sports (Netball, Officiating, Basketball, Softball, Hockey,
Tennis, Lawn bowls, and Triathlon). Descriptive data is
presented in Table 1(n= 101). After a full explanation
of all procedures and possible risks of the investigation,
written informed consent was obtained (for participants
< 18 years, a legal guardian also provided written con-
sent). All experimentation was approved by the Charles
Sturt University Ethics in Human Research Committee.
Nutrition knowledge questionnaire (NKQ)
Nutritional knowledge was measured using a previously
validated Nutrition Knowledge Questionnaire (NKQ)
[16,24]. Consultation with an expert panel consisting of
a Registered Nutritionist; Sports Dietitian; two Academy
Head Coaches; and an Academy Strength and Condi-
tioning coach, was held. Each question was read out
loud by the lead researcher and critiqued by the expert
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panel in a group discussion for comprehension, rele-
vance and accuracy. If required, the wording was modi-
fied slightly to engage the target demographic of this
survey (i.e., high school student-athletes; male and fe-
male; aged 13 to 18 years). The NKQ consisted of two
distinct sections; Section 1 presented demographic ques-
tions including age, level of competition, training load
expressed as hours of training per week, education level
and primary source of nutrition information. Section 2
presented 90 sports nutrition knowledge questions in
seven subcategories.
1. Nutrients
2. Dietary reference intake (DRI)
3. Fluids/Hydration
4. Recovery
5. Weight gain
6. Weight loss
7. Supplements
Each question had a potential answer of “yes”,“no”or
“unsure”, with a correct response was coded as + 1
whilst incorrect or unsure responses were coded as 0.
The rationale for the inclusion of an unsure response is
to deter subjects from guessing responses in the NKQ as
suggested by Zinn et al. [16] All athletes attended a nu-
trition research session in the same room at the annual
training camp. The NKQ was distributed to athletes in
hard copy format with the lead researcher providing spe-
cific instructions on how to complete the NKQ, which
took taking approximately 45 min to complete under the
supervision of the researchers.
Statistical analysis
Descriptive statistics were used to analyze the demo-
graphic information. Nutrition knowledge sub-scores for
each section and an overall nutrition knowledge total
score was calculated. Percentage of ‘correct’,‘unsure’,
and ‘incorrect’responses to each individual item was an-
alyzed. Independent t-tests were used to show mean cor-
rect, incorrect, and unsure score differences between the
two groups (male and female athletes). All data were
coded, entered numerically and analyzed using SPSS ver-
sion 21.0 (SPSS Inc., Chicago, IL, USA, 2012) with sig-
nificance set at p< .05. Data are presented as
percentages, means, and standard deviations.
Results
Nutritional knowledge
Figure 1presents the mean percentage of ‘correct’,‘in-
correct’, and ‘unsure’total scores obtained by youth ath-
letes on the NKQ. The mean overall score was 43.8 ±
11.4% (pooled data) with significantly more (p< 0.01)
‘correct’responses compared to ‘unsure’responses. No
significant gender differences were observed between
nutritional knowledge total scores, however subcategory
differences were evident.
Subcategory knowledge
Figure 2displays the subcategory knowledge mean per-
centage of ‘correct’,‘incorrect’, and ‘unsure’total scores
obtained by youth athletes on the NKQ.
Nutrients
Subjects correctly answered 51% of questions within this
section. There was a greater number of ‘correct’re-
sponses in this subcategory compared with ‘unsure’(p<
0.01).Interestingly, 72% of subjects incorrectly stated
‘avocados were low in fat’, while 51% incorrectly identi-
fied ‘chicken as a high carbohydrate food’. An independ-
ent t-test showed that females obtained more ‘correct’
responses than males (p= 0.02).
Dietary reference intakes
This subcategory was the most poorly answered of all
the subcategories and featured the lowest percentage
of ‘correct’to ‘incorrect’responses (27% vs. 43%, re-
spectively; p = 0.02). Notably, 37 and 38% of athletes
Table 1 Participant characteristics
Variable Youth Athletes
(n= 101)
Age (yrs) 15.3 ± 1.4 yrs
Gender
Male 37
Female 64
High School Level
Year 7 (13 yrs) 11
Year 8 (14 yrs) 19
Year 9 (15 yrs) 25
Year 10 (16 yrs) 21
Year 11 (17 yrs) 21
Year 12 (18 yrs) 4
Years competing at this level
< 1 yr 26
2–4 yrs 63
5–7 yrs 10
8 + yrs. 2
Training hours per week
4–6h 40
7–10 h 42
11–14 h 15
15 + hrs 4
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responded ‘unsure’and ‘incorrect’, respectively, to the
protein recommendations for youth athletes. Add-
itionally, carbohydrate recommendations were incor-
rectly identified by 45% of athletes.
Fluids/hydration
Less than half (46%) of the fluid/hydration questions
were answered correctly. Regarding fluid ingestion, 72%
of respondents were unable to correctly identify the fluid
requirements for an intense two-hour training session
and only 9% correctly identified the carbohydrate con-
tent range of a standard sports drink.
Recovery
Only half (54%) of the recovery questions were answered
correctly. Regarding carbohydrates and recovery, not
only was the definition of Glycemic Index a source of
confusion with 45% responding ‘unsure’but 64% of ath-
letes incorrectly identified green salad as containing
more carbohydrates than soft drink.
Fig. 1 Mean percentage score of correct, incorrect and unsure total scores obtained by subjects on the nutritional knowledge questionnaire.
* Significantly greater than ‘unsure’and ‘incorrect’
Fig. 2 Subcategory knowledge mean percentage score of correct, incorrect and unsure totals scores across the seven subcategories. ◆Significantly
greater than ‘incorrect’and ‘unsure’;■Significantly greater than ‘correct’;●Significantly greater than ‘unsure’; ^ Significantly greater than ‘incorrect’;#
Significantly more ‘correct’responses for females than males. Abbreviations: DRI = Dietary reference intakes, REC = Recovery, WG = Weight gain, WL =
Weight loss, SUPP = Supplements
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Weight gain and weight loss
A substantial variation in mean correct percentage
scores within this subcategory was evident with ‘correct’
responses ranging from 3 to 78%. More than half of the
athletes (54%) reported that consuming protein powder
is essential to increase muscle mass, while 67% were ‘un-
sure’what type of protein was most suitable for gaining
muscle mass. The weight loss section had significantly
more (56%; p< 0.05) ‘correct’responses compared to ‘in-
correct’and ‘unsure’.
Supplements
Collectively, the responses for this subcategory displayed
much uncertainty with significantly more ‘unsure’re-
sponses to these questions than ‘incorrect’responses
(42%; p < 0.05). One third of youth athletes reported pro-
tein supplement use over the previous 12 months (Fig. 3);
however, athletes lacked knowledge as to why you would
take this supplement with 45% of athletes responding
‘unsure’. Further questions pertaining to creatine supple-
mentation and hydroxy-methyl butyrate (HMB) resulted
in similar ‘unsure’responses of 63 and 70%, respectively.
Overall, there was a greater number of ‘unsure’re-
sponses in this subcategory compared with any other
subcategory (p= 0.02).
Source of nutritional information
Figure 4presents the reported sources of nutritional in-
formation of youth athletes. Notably, 45% of athletes re-
ported that the coach was the primary source of
nutrition information, followed by books/magazines
(27%). Dietitians were only reported for 16% of athletes
with minor sources of nutritional information including
the internet and other athletes (10%).
Discussion
Results from the current study indicate that youth ath-
letes lack nutritional knowledge in multiple areas, with
only two subcategories recording mean ‘correct’re-
sponses above 50%. Athletes’nutritional knowledge were
particularly lacking pertaining to the areas of nutrient
recommendations and supplementation, indicating the
need for further nutrition education. This may predis-
pose youth athletes to make inadequate nutrition and/or
supplementation choices based on misconceptions and/
or misinformation that may negatively impact growth,
physical development and performance [4].
The results of current study further support recom-
mendations for nutrition education programs for both
youth athletes [31] and coaches [23], as Little et al. [31]
has shown that as little as five nutrition education ses-
sions can be effective in improving nutrition and supple-
ment knowledge in youth athletes from low-income
communities. This may be reflective of the youth ath-
letes in the current study, with many of the geographical
locations (inland regional and rural towns) recognized as
low socioeconomic communities.
Our study revealed that the coach represented the
main source of nutritional information for athletes
(45%), whilst dietitians represented only 16%. Previous
research has demonstrated that professional coaches re-
corded mean nutritional knowledge scores ranging from
48 to 67% [16,20], as such it may be fair to assume that
coaches of youth athletes may likely have comparable or
Fig. 3 Protein supplementation. Percentage of youth athletes using a protein supplement in the last 12 months and the reason provided for usage
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lower levels of nutrition knowledge. However, this was
not measured in the current study. The low incidence of
dietitians being sourced to provide nutritional advice is
of concern, however these data are similar to other re-
ports [32]. Despite youth athletes in the current study
being classified as ‘elite’, with competition level ranging
from state, national and international, the rural location
of the academy and the added expense of dietetic con-
sultations likely presents barriers for athletes from re-
gional and rural areas to source expert services. Smith-
Rockwell et al. [20] reported that strength and condi-
tioning coaches/trainers with access to a dietitian made
full use of these services. Therefore, increased accessibil-
ity may result in greater usage of qualified sports nutri-
tion professionals as the primary source of nutrition
information and education. With greater access to nutri-
tion support services, one could expect that athletes
would exhibit higher nutritional knowledge [14,25,26].
Conversely, Burns and colleagues [32] found that even
with access to an available dietitian, collegiate athletes
preferred to source athletic trainers (39%), and strength
and conditioning coaches (23%) for nutrition informa-
tion more than dietitians (14%). This may suggest that
even with increased availability of dietitians, integration
and collaboration between qualified nutrition profes-
sionals, strength and conditioning coaches, and athletic
trainers may be required to refer athletes to the dietician
and thereby provide greater opportunities for athletes to
interact with nutrition support services. Such an inte-
grated approach is an important consideration as athletic
training staff are noted to be key influencers on nutrition
behavior and decisions, particularly in younger athletes
[33,34].
In the current study, the athletes’knowledge of DRI
was particularly lacking with majority of respondents in-
correctly identifying recommended DRI values for
carbohydrate, fat and protein, with mean correct scores
of 26, 26 and 30% respectively. The high percentage of
‘incorrect’and ‘unsure’responses clearly demonstrates
that regional youth athletes display a lack of DRI nutri-
tion knowledge. Interestingly, athletes displayed higher
knowledge in the subcategory of weight loss compared
to weight gain, with more correct (59% vs. 42%) and
fewer unsure (28% vs. 32%) responses, respectively. This
contrast may be reflective of increased exposure to
health promotion campaigns and social media targeted
at reducing obesity in the Australian population, as an
inundation of information regarding weight loss is
highlighted throughout all media outlets. This may lead
to youth athletes questioning whether it is healthy and/
or acceptable to increase their energy intake despite
well-established guidelines that youth athletes require
greater caloric intakes to support growth, development
and physical activity [3,4].
The supplementation subcategory displayed the sec-
ond least ‘correct’responses across all categories with
greatest number of ‘unsure’responses. This further sup-
ports the works of Little et al. [31] who highlight that
youth athletes have poor understanding of concepts re-
lated to nutrition supplements. Specifically, related to
protein supplementation, Petróczi and colleagues [35]
reported 21–44% of young elite UK athletes (12–21 yrs)
Fig. 4 Source of nutrition information. Mean percentage score of where youth athletes source nutrition information
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supplemented with whey protein. This is consistent with
the current investigation wherein 31% of youth athletes
reported protein supplement use. It should be noted that
while there was a high “unsure”response rate to creatine
and HMB (63 and 70%, respectively), these are quite
technical terms and potentially unknown to youth ath-
letes. More than reflecting their knowledge and therefore
the health hazard it might also convey the athletes are
unfamiliar with these kinds of supplements. Collectively,
these data indicate that not only do youth athletes use
dietary supplements, but perhaps more importantly, they
lack knowledge pertaining to the efficacy and risks of
protein supplements. Self-managed supplementation
strategies employed by youth athletes may partially ex-
plain the observed lack of congruence between reasons
and supplement used [35].
As with all research there are potential limitations that
should be acknowledged. Firstly, difference in the male
and female sample size are apparent and while signifi-
cant difference observed in the nutrition category may
be due to the unequal sample sizes the statistical analysis
and framework used in the manuscript is consistent with
publications in the area. Secondly, the NKQ used was
based on a questionnaire previously determined to have
construct validity [24], however some questions under-
went minor word changes to account for the specific
population studied, that of regional academy youth ath-
letes. While the overall questions remained the same,
some questions were rephrased to be in the second per-
son tense. As highlighted by Abbey and colleagues [36],
acknowledging that no questionnaire is completely ro-
bust, the chosen NKQ was deemed the easiest to assess
nutrition knowledge in regional academy youth athletes.
Conclusion
In agreement with previous research [13,14], it was evi-
dent that non-residential Academy of Sport youth athletes
from regional and rural areas displayed several misconcep-
tions regarding general nutrition. Specifically, DRI and
supplementation have been identified as key areas requir-
ing targeted education. Secondly, with the tendency for
athletes to source nutrition information from coaches/
trainers, general nutrition education for coaching staff is
highly recommended as this may offer a flow-on effect for
enhancing youth athlete nutrition knowledge via coaches’
reinforcement of sound nutrition principles [16,20,21,
37]. This is an important consideration given that few
youth athletes seek nutrition information from appropri-
ately qualified nutrition professional, especially in regional
Academy of Sport programs that may lack such resources.
A better understanding of nutrition knowledge in youth
athletes will allow nutrition education interventions to tar-
get areas in need of improvement. These data provide fur-
ther support to current recommendations that athletes
[31] and coaches [16,23]wouldbenefitfromnutrition
education integrated into Academy of Sport programs
conducted by qualified nutrition educators, especially for
young male athletes.
Abbreviations
DRI: Dietary reference intakes; HMB: hydroxy-methyl butyrate; NKQ: Nutrition
knowledge questionnaire; WRAS: Western Region Academy of Sport
Acknowledgments
The authors would like to thank the athletes and coaches from the Western
Region Academy of Sport.
Consent to publish
Not applicable.
Authors’contributions
SPB conceived and designed the study, coordinated the study and statistical
analysis, contributed to and reviewed the draft manuscript. BDR drafted the
manuscript and participated in the statistical analysis. Both authors read and
approved the final manuscript. The authors have read and approved the final
version of the manuscript and agree with the order of presentation of the
authors.
Funding
No funding was received for the project.
Availability of data and materials
Availability of dataset can be given upon reasonable request to the first and/
or corresponding author.
Ethics approval and consent to participate
The study was approved by the Charles Sturt University Ethics in Human
Research Committee, Approval/Protocol Number: 2007/057. All participants
provided written informed consent to participate in the study with written
informed consent provided by Parent/Guardian for participants under the
age of 18.
Competing interests
The authors declare that they have no competing interests.
Author details
1
School of Health and Wellbeing (Sport and Exercise Science), University of
Southern Queensland, Ipswich, QLD, Australia.
2
School of Exercise Science,
Sport and Health, Charles Sturt University, Bathurst, NSW, Australia.
3
School of
Exercise and Nutrition Sciences, Faculty of Health, Deakin University,
Melbourne, VIC, Australia.
Received: 3 November 2019 Accepted: 1 July 2020
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