EVALUATION OF THE IMPACT OF NUTRITIONAL KNOWLEDGE ON

BODY MASS INDEX AND FOOD PREFERENCES AMONG ATHLETES IN

THE UNITED KINGDOM

ABSTRACT

Background

Sports nutrition is described as the application of nutrition knowledge in a realistic daily

menu with the goal of providing energy for physical exercise, promoting bodily regeneration,
optimising sports performance in competitions, and ensuring health and well-being

Objective: To evaluate the impact of nutritional knowledge on body mass index and food
preferences of athletes.

Methodology: the community based cross sectional study was carried out in different leisure time
and fitness centers. A total of 30 male athletes were enrolled in the study. Data regarding age,
source of nutrition information, nutritional knowledge, dietary intake, food preferences, height,
weight and BMI was collected with the help of pre planned questionnaire. The data was analyzed
with the help of SPSS, chi square test and one way ANOVA was applied to find the association
between the variables.

Results

The mean age of the athletes was 26.5 with standard deviation of 3.4 the mean weight of the
athletes was 67.5 kg with standard deviation of 13.3. the mean height of the athletes was 172.7 cm
with standard deviation of 6.0 whereas the mean body mass index was 22.5 with standard deviation
of 4.0. The mean carbohydrate intake of the subject was 279.96±87.6 (g). The mean protein Intake
of the subject was 58.49±27.2 (g) The mean fat intake of the subject was 40.70±23.18 (g). The
mean caloric intake of the subjects was 19222.1± 503.8 (kcal).. Majority of athletes (60.0%) were in
the normal category followed by overweight (23.3%) and underweight (10.0%) majority of the
athletes were having poor (50.0%) knowledge of nutrition followed by average knowledge (20.0%)
and good knowledge (16.7%) of nutrition The chi square test concluded with a significant relation
(p=0.018) between nutrition knowledge and body mass index. A significant association (p<0.05) for
nutritional knowledge with carbohydrate, protein, fats and energy intake. nutritional knowledge of
athletes has significant effect (p<0.05) on food preference of vegetables, fruits, meat/fish and dairy
intake vegetable intake, fruit intake, meat and fish, dairy, snacks and starches has significant effect
on body mass index of athletes. A significant difference (p<0.05) was seen for the intake of
carbohydrates, fat and energy whereas a non-significant difference (p>0.05) was observed for the
intake of protein.

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Conclusion:

The nutritional knowledge of athletes has significant effect on body mass index, dietary intake and
food preference of athletes whereas the body mass index was also greatly influenced by dietary
intake and food preferences among the athletes.

Keywords: Nutritional knowledge, body mass index, food preferences, dietary intake, athletes

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 Introduction:

Background

Sports nutrition is described as the application of nutrition knowledge in a realistic daily menu
with the goal of providing energy for physical exercise, promoting bodily regeneration,
optimising sports performance in competitions, and ensuring health and well-being (Contento,
2007). Because most sports have a high level of competitiveness, athletes are vulnerable to
the newest trends in nutrition or supplementation and may be eager to adjust their diet to
improve their performance. Bad eating habits not only have a negative impact on competitive
performance, but also on overall health (Rosenbloom et al., 2002). Wardle et al. (2000) found
that nutritional knowledge is connected with healthy food consumption. Female athletes with
nutrition knowledge have lower body fat and perform better (Rossi et al., 2007). Athletes
consume little nutrition on average; education and economic level influence knowledge level
(Saribay and Kirbas. 2019). Nutritional education, particularly among female athletes, has a
positive impact on the quality of food consumed (Spronk et al., 2015)

Nutrition affects human health and is regarded to have the greatest impact to influence chronic
disease and long-term health. (WHO, 2003) and that may be easily changed to enhance
physical activity (Burke, 2010). Sports performance is greatly influenced by nutrition, although
it is unclear how much nutritional awareness is linked to physical health. It makes sense to
believe that increased nutrition awareness might lead to better dietary decisions, which in turn
might improve several aspects of physical fitness (Nikolaidis, 2014). Several studies have
found that the diets of athletes are nutritionally deficient (Heaney, 2011, Spronk, 2014),
frequently resulting in a negative energy balance, micronutrient deficiencies, and/or making
poor macronutrient choices (Papadopoulou, 2015). Although the underlying factors of this are
currently unknown, they could include the athlete's knowledge about what to eat but not doing
so, inappropriate educational information given to the athlete, a lack of nutritional education, a
lack of belief that nutrition is a crucial factor in their performance, and a belief that their eating
practices are adequate. In addition, a variety of socioeconomic factors may affect dietary
preferences (Shepherd, 2009).

In epidemiological studies, body mass index (BMI), an indicator based on height in kg and
weight in meter square is widely used as a substitute for body fatness. Typically, there are
significant connections between BMI and more accurate assessments of body fatness. (Flegal,
2009; Ranasinghe, 2013; Ablove, 2015). Observational cross-sectional studies have shown
that those with lower BMIs are more physically active than those who had higher levels of
BMIs. (Besson, 2009; Flegal, 2009). The concept that as BMI rises, adiposity rises as well,
leading to a strong and substantial relationship between BMI & body fatness, is the foundation

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for the reliability of BMI in non-athletic populations as a degree of adiposity. (Buchholz, 2004;
Nevill, 2008; Pateyjohns, 2006). BMI is a significant determinant in healthcare and athletic
populations when evaluating, for instance, cardiovascular problems and performance,
respectively, because of this strong connection. Whereas more sophisticated body composition
methods, such as BIA and skinfold thicknesses, may be more accurate than BMI in athletic
populations, the complexity of the devices, the qualified operator needed, and the accessibility
of more than 100 equations for the estimation of adiposity make the study of body composition,
comparative between studies, and their correlation with multiple problematic results. In
these conditions, the benefits of BMI have made it the favored unit of measurement of
adiposity in healthcare epidemiologic studies due to its strong and easy measurement of
overweight compared to height. (Nevill, 2010)

A population-based cohort study was performed in which 500 UK Biobank young males and
females, for a given BMI. Results revealed that athletes have a lower body fat percentage than
non-athletes, (Ode, 2007; Nevill, 2006). However, it is ambiguous whether in the overall
population of middle-aged adults, after accounting for BMI, those who engage in more physical
activity have a lower body fat percentage than those who engage in the least amount of
physical activity.

Consuming the right amount of nourishment can improve athletic performance. The amount of
exercise a person performs determines how much nutrition they need. Most athletes are aware
that an effective training regimen requires good nutrition, optimal fueling, and adequate
knowledge of nutrition (Rosenbloom, 2002). Yet, most athletes are still uneducated about good
eating habits and untrained in making wise daily dietary decisions (Grete, 2011).
Understanding what led athletes to make poor dietary decisions may eventually lead to an
increase in nutrient consumption. It would be helpful to create a reliable and accurate tool to
assess nutrition knowledge that could either rule out a knowledge problem or support an
intervention to address a knowledge deficit. (Kline, 2013). The development of a legitimate and
trustworthy tool to evaluate general and sports dietary habits in a population of athletes may
deliver the precise data required to provide advice on improved dietary choices and improve
dietary intake. (Spendlove, 2012).

The majority of athletes still struggle to implement their understanding of proper nutrition into
suitable food decisions (Ruka, 2005). The importance of nutrition knowledge in sports nutrition
may be shown in how it influences dietary practices and food preferences (Cupisti, 2002). The
effect of athletes' nutrition education on their nutritional consumption is ambiguous, according
to the current state of knowledge. According to current comprehensive research, there is a
marginally favorable relationship between athletes' food intake and nutrition knowledge

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(Heaney, 2011). Another study revealed a large improvement in nutritional knowledge along
with a significant increase in total calorie, carbohydrate, and protein consumption. (Valliant,
2012).

At the tertiary levels of education, it has been shown that nutrition awareness enhances
athletes' use of adequate nutrition intake and knowledge. Interventions in nutrition education
have an impact on dietary patterns and eating habits (Ruka, 2005; Zawila, 2003). Yet, very few
athletes chose foods from a menu that represented the idea of adequate nutrition. It has been
suggested that having healthy eating habits is associated with having a great level of nutrition
education (Ruka, 2005). Another aspect of an athlete's nutrition expertise is where they get
their information from. The majority of research indicates that trainers, instead of nutritionists or
dietitians, are the people that provide athletes with dietary advice. In addition, the trainers
might not be adequately certified to offer such services (Jessri, 2010; Prentice, 2011). The
relationship between athletes' practice and knowledge of nutrition has been identified as
beneficial. (Grete, 2011; Cupisti, 2002; Jessri, 2010). But there was no discernible relationship
between knowledge and practice (Supriya, 2013).

According to reports, students and instructors in sports education do not prioritize their diet and
are unaware of the role that nutrition plays in athletic performance. Athletes who are aware of
the importance of a healthy diet and who act and eat accordingly as a result of this
understanding are more successful in sports (Ozdoğan, 2011). But, it's crucial to remember
that understanding nutrition does not always convert into dietary behavior (Cupisti, 2002).
Possibility of influencing the sports team's knowledge of appropriate and proper nutrition;
coaches and trainers will help athletes perform better (Torres-McGehee, 2012).

The right nutrition is essential for top sports performance and includes getting enough calories,
staying hydrated, and timing meals. Students who participate in sports and their coaches or
advisors are frequently misinformed or mistaken about the requirements of nutrition in sports
(Ruka, 2005; Zawila, 2003; Cotugna, 2005). Athletes are advised to consume at least three
meals in a day, with a protein composition of between 10% and 15% of total calories, a
carbohydrate level of 55.0%, and a fat consumption of no more than 30% daily. (Fahey, 2009).
Peak athletic performance is correlated with proper food intake, and nutrient deficiency may
result in poorer athletic performance (Grete, 2011; Potgieter, 2013). Athletic performance
suffers when energy intake is restricted and muscle and fat mass are lost (Manore, 2000.). For
optimum performance, athletes must maintain a healthy weight and fat mass. The goals of the
current study were to evaluate athletes' performance, athletes’ knowledge and practice of
nutrition, and factors influencing athletes' performance. Specific knowledge of sports nutrition,
such as fluid intake, and pre or post-event eating, would be expected to be less significantly

5
associated with total dietary consumption or quality than general nutrition knowledge, which
measures awareness of healthy eating principles. Athletes must understand how to eat a
nutritious, balanced diet and pair it with particular sports nutrition strategies suitable for their
competitive and training environment to maximize performance (Rodriguez, 2009).

The foods that a sportsperson picks have an impact on their fitness and health as well as their
performance on and off the pitch. Diet has a minor role in performance compared to other
elements like ability, coaching, passion, injury resistance, and so on. Healthy eating choices
won't make up for inadequate training or talent, however, they will help a talented and
motivated athlete achieve their peak performance. Poor eating choices prevent athletes from
performing as well as they could (Hawley, 2006). The ability of an athlete to sustain
continuously intensive training and performance without collapsing to chronic fatigue, injury, or
disease depends on the types, quantities, and timing of the food they consume. Many athletes
assume that a standard diet will not be sufficient for peak performance and turn to nutritional
supplements in an attempt to enhance their diet or obtain competitiveness. (Maughan, 2005)

Athletes and others who offer them advice are frequently under pressure from supplement
firms with competing products. Yet, an athlete should be able to get all the nutrients they
require through a balanced meal that includes a wide range of food items and is consumed in
quantities enough to fulfill the energy requirements of competition and training. Supplement
use shouldn't be considered a replacement for healthy eating (Hespel,2006)

Making ensuring that all athletes choose foods that are appropriate for their nutritional
objectives should be the first step. The majority of athletes require ongoing assistance in order
to make healthy eating decisions both at home and at competition and training locations.
Contradictory to common opinion, a variety of meals eaten in balanced amounts to fulfill energy
requirements is probable to provide adequate protein and most of the micronutrients in
sufficient amounts (Hawley, 2006). The marketing of plant-based protein products is one trend
that satisfies the growing customer need for a healthy diet (Formanski, 2019). Consumers
commonly consume goods high in protein because of the alleged health benefits, but they also
do so to maintain an active lifestyle, gain muscle, and manage their weight (Banovic et al.,
2018).

A high-carbohydrate diet should be prioritized between the duration of intense exercise,

particularly during rehab time is limited if most of the workout consists of tactical work, where
the need for energy requirement and carbohydrates possibly not as great. Water and
electrolyte requirements rise when the exercise intensity increases, particularly during hot
weather, thus it's crucial to drink enough fluids. Athletes who lose a lot of salt during exercise

6
shouldn't limit their salt intake for blood pressure reasons (Armstrong,2002). Sports beverages,
protein bars, and meal replacements that are properly prepared all have their place and time.

A few sports nutritionists or certified sports dieticians should be consulted before using any
supplements or sports meals that may provide particular advantages for some athletes in
certain situations. A broad-spectrum, minimal-dose of multivitamin and a dietary supplement
may assist assure that key nutrient demands are satisfied in situations when energy
consumption is limited to minimize adiposity or overweight. (Nieper, 2005). However, it must be
acknowledged that not all athletes make wise eating decisions. There may be a use of a daily
multivitamin supplement when athletes are unwilling to alter their eating practices to ensure
they consume a variety of meals, including enough portions of fruit and vegetables. Although
routine supplementation with iron is not advised because it may have negative health effects,
there are rare circumstances where it may be necessary.

Supplements should generally only be used when inadequate minerals/vitamins have been
identified through blood testing, and even then, only as a temporary fix under medical
supervision while dietary adjustments are being made (Baume, 2006). The athlete needs to be
aware that without an assessment of these items' efficacy, there will be no proof of their safety.
Also, it is becoming more widely acknowledged that different athletes will react differently to
certain products. This is clearly demonstrated in the instance of vitamin or mineral
supplements: whereas an athlete with a deficiency is likely to benefit from supplementing, an
athlete who is well-nourished is not likely to experience an enhancement to their health or
performance (Green, 2001). For instance, there is conflicting evidence about the effectiveness
of carnitine supplements, however, Stephens and colleagues have noted that greater levels of
circulating insulin improve the bioavailability of carnitine in humans. (Stephens, 2007) Clear
effects on glucose and fat metabolism are seen when muscle carnitine concentration is
increased by carnitine infusion in the presence of hyperinsulinemia (Stephens, 2006).
Therefore, a current study is designed to evaluate the impact of nutritional knowledge on the
body mass index and food preferences of athletes in the United Kingdom. Therefore the current
study is designed to evaluate the effect of Nutritional Knowledge on Body mass index and food
preferences among athletes in united Kingdom.

Research Questions

RQ1: What is the level of Nutritional knowledge among athletes in United Kingdom?

RQ2: What is the Body mass index of Athletes in United Kingdom?

RQ3: What is the food preference among Athletes in United Kingdom?

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 RQ4: What is the Impact of Nutritional Knowledge on Body Mass index and Food
Preferences among Athletes?

Aims and Objectives

1. Assessing the Nutritional knowledge among athletes in United Kingdom

2. Determining the Body mass index of Athletes in United Kingdom
3. Evaluating the food preference among Athletes in United Kingdom
4. Determining the impact of Nutritional Knowledge on Body Mass index and Food
Preferences among Athletes
Hypothesis

Alternate Hypothesis: Nutritional knowledge of athletes has significant effect on Body

mass index and their Food preferences.

Null Hypothesis: Nutritional knowledge of athletes has no effect on Body mass index
and their Food preferences.

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 MATERIALS AND METHOD

Study design:

A community based cross sectional study was designed to evaluate the impact of nutritional
knowledge on body mass index and food preference among the athletes in United kingdom.

Study type

A longitudinal study type was used to collect the data and complete the research

Study location

The entire research study and data collection was carried out in different leisure and
fitness centers in East London, United Kingdom.

Population:

Athletes actively involved in sports, most probably those working out in gyms and swimmers.

Samples:

A convenient sample of 30 athletes were enrolled in the study

Inclusion Criteria

 Male athletes
 Age between 20 to 35 years
 Participation in difference leisure and fitness centers from last 1 year
 Participant willing to take part in the study

Exclusion criteria

 Athletes suffering from chronic illness

 Athletes having some medication for health purpose
 Athletes who have never participated in any leisure time and fitness activities in the last
1 year

Research tool

A pre-planned reliable questionnaire was sorted out to collect data regarding nutritional
knowledge and food preferences among the athletes.

Ethical consideration and consent letter

A proper research proposal was presented to the supervisor in order to outline the
objectives of the study and after the approval permission was taken for data collection. In the

9
first instance participant willingness and satisfaction in the study was confirmed. Participants
were informed about the purpose and outcome of the study. A consent letter was signed by all
the participants regarding their willingness in the study. All the information of enrolled were kept
confidential and not shared with anyone. All the provided information was assessable to the
participants via emails.

Data collection

Data regarding age, source of nutrition information, height, Weight, Body mass index,
Nutritional knowledge, food preferences and dietary intake was collected from the participants

Weight measurement

The participants were asked to take off all the heavy clothes and shoes. After that the
participants were directed to stand straight on the weighing machine pointing the head any eye
in the linear position. After that the weight in kg was calculated to the nearest 0.1 kg. Three
consecutive reading was recorded and average of three reading was filled in the form.

Height measurement

The participants were asked to stand next to the stadiometer. Take off there shoes, remove
bulky clothes and all other accessories that may get in the way of acurate readings. The
participants were asked to stand with their feet flat making sure that the head, shoulder and
buttock is touching with the stadiometer. The height was recorded to the nearest 0.1 cm.

Body mass index

The body mass index was calculated by dividing weight in Kg by meter (Square). After
calculating the individual Body mass index, it was divided in to four categories. Underweight
(<18.5 kg/m2), Normal (18.5 to 24.9 kg/m 2), overweight (25.0 to 29.9 kg/m 2) and obese (equal
or greater than 30 kg/m2)

Nutritional Knowledge

The nutritional knowledge was assessed by standard Nutrition for Sports knowledge
questionnaire (Trakman et al., 2017). The questionnaire consists of six sub sections, Weight
management, Macronutrient, Micronutrient, Sport nutrition, Supplements and Alcohol use.
Weight management (n=12), Macronutrient (n=30), micronutrient (n=13), Sport nutrition (n=12),
Supplement (n=12) and alcohol use (n=8). The overall knowledge was assessed by right
answer and wrong answer. The right answer was given 1 score and 0 for wrong answer. The
questionnaire consists of total of 89 questions. The end score of individuals was converted to

1
percentages. Grade of 0-49% was considered as poor knowledge, (50- 65% average), (66 to
75% good) and (76 to 100% as excellent knowledge of nutrition education)

Dietary intake

Data regarding dietary intake was collected from the participants through 24 hours
dietary recall method. The participants were asked to enlist all the food item they have
consumed in the last 24 hours. The serving size and amount of food consumed in the last day
was recorded in the questionnaire. The food items were entered in to nutritic software to
calculate the amount of macronutrient in the listed food item.

Food preference

The food preference of the participants was assessed by food preference questionnaire
for adolescent and adults (Glabska et al., 2021). The questionnaire consists of 62 different food
item. All the 62 food item are divided into sub categories as (Vegetables= 18 foods), fruits (7
foods),(meat and fish= f2 food), (Dairy= 10 item), (Snacks= 9 items and (starches= 6 item).
Each group is scored on a likert scale of 5. Dislike a lot= 1, dislike a little= 2, neutral= 3, like a
little= 4 and like a lot = 5.

Statistical analysis

The entire data was collected and entered into SPSS (Statistical Package for Social
Science) version 28. Different statistical test were applied on the data to find the results. The
normality of the data was checked through Kolmogorov -Simirnov test whereas the reliability
was checked by applying Chronbach Alpha. Means and standard deviation were calculated for
continuous variables whereas frequency and percentages were calculated for categorical
variables. Chi square test was used to determine the association between variables. Microsoft
excel 2019 was used to plot the graphs of different variables.

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 RESULTS

The current study was carried out among athletes in different fitness and leisure time centers of
London to evaluate the effect of nutritional knowledge on body mass index and food preferences of
athletes. The study concluded with the following result

Table no 1: General characteristic of the subjects

Variables Means Standard deviation

Age (years) 26.5 3.4
Weight (kg) 67.5 13.1
Height (cm) 172.7 6.0
Body mass index (kg/m2) 22.5 4.0

Table no 1 shows the general characteristic of the athletes. Simple means test was applied on the
data to calculate the means of age, height, weight and body mass index. The mean age of the
athletes was 26.5 with standard deviation of 3.4. the mean weight of the athletes was 67.5 kg with
standard deviation of 13.3. the mean height of the athletes was 172.7 cm with standard deviation of
6.0 whereas the mean body mass index was 22.5 with standard deviation of 4.0.

1
Table no 2: Dietary intake of the subjects.

Variables N (%) Mean ± S.D

Energy intake (kcal/day) 2322.1±503.8
Carbohydrate (g/day) 279.96±87.6
Protein (g/day) 58.49±27.2
Fat (g/day) 40.70±23.18

Table no 2 shows the macro nutrient and caloric intake of the subjects. The mean caloric
intake of the subjects was 2322.1±503.8 (kcal). The mean carbohydrate intake of the subject was
279.96±87.6 (g). The mean protein Intake of the subject was 58.49±27.2 (g). The mean fat intake of
the subject was 40.70±23.18 (g).

The Kolmogorov smirov and shipirov-wilk test was applied on the height, weight, body mass index,
carbohydrate, protein, fats and energy. The Kolmogorov smirov and shipirov-wilk test showed that
all the height, weight, body mass index, carbohydrate, protein, fats and energy were normally
distributed.

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Table no 3; Source of information among the subjects

Variables Frequency (N) Percentage (%)

Coach 7 23.3
Source of Newspaper/magazine 5 16.7
information Registered dietitian 5 16.7
No one 13 43.3

Table no 3 shows the distribution of sources of nutrition knowledge among the athletes. Descriptive
statistics was applied was applied on the data to calculate the frequency and percentages of
variables. The descriptive statistics and frequency distribution concluded that coaches (23.3%)
were the main source of nutrition knowledge whereas athletes (43.3%) had no source of nutrition
knowledge.

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Table no 4: Body mass index distribution among the subjects

Variables Frequency (N) Percentage (%)

Underweight 3 10.0
Body mass index Normal 18 60.0
distribution Overweight 7 23.3
Obese 2 6.7

Table no 4 shows the body mass index distribution of the athletes. Descriptive statistics was applied
was applied on the data to calculate the frequency and percentages of variables. The descriptive
statistics and frequency distribution concluded that athletes (60.0%) were in the normal category
followed by overweight (23.3%) and underweight (10.0%)

Reliability test were applied on NSKQ to determine the reliability of the nutrition knowledge
questionnaire. The Chronbach alpha score of overall nutritional knowledge was 0.887. The
chrobach alpha of weight management, macronutrient, micronmutrient, sport nutrition, supplements
and alcohol intake was 0.799, 0.906, 0.875, 0.856, 0.843 and 0.795 respectively

Table no 5: Distribution of nutrition knowledge

Variables Frequency (N) Percentage (%)

(0-49% of nutrition
knowledge score)
15 50.0
Poor nutrition
knowledge
(50 to 65%) of total
NK score) 6 20.0
Nutrition considered average
Knowledge (66% to 75% of total
Nutritional 5 16.7
knowledge) Good
(75% to 100% of
nutritional
4 13.3
knowledge score)
Excellent

Table no 5 shows the distribution of nutrition knowledge among the athletes, Descriptive statistics
was applied was applied on the data to calculate the frequency and percentages of variables. Grade

1
of 0-49% was considered as poor knowledge, (50- 65% average),(66 to 75% good) and (76 to
100% as excellent knowledge of nutrition education) The descriptive statistics and frequency
distribution showed that majority of the athletes were having poor (50.0%) knowledge of nutrition
followed by average knowledge (20.0%) and good knowledge (16.7%) of nutrition

Table no 6: Food preference among the subjects

Variables Frequency (N) Percent (%)

(1) Dislike Alot 8 26.7

(2) Dislike a little 6 20.0
Vegetables (3) Neutral 4 13.3
(4) Like a little 7 23.3
(5) Like a lot 5 16.7
(1) Dislike Alot 7 23.3
(2) Dislike a little 6 20.0
Fruits (3) Neutral 4 13.3
(4) Like a little 10 33.3
(5) Like a lot 3 10.0
(1) Dislike Alot 6 20.0
(2) Dislike a little 5 16.7
Meat/fish (3) Neutral 5 16.7
(4) Like a little 6 20.0
(5) Like a lot 8 26.7
(1) Dislike Alot 6 20.0
(2) Dislike a little 7 23.3
Dairy (3) Neutral 6 20.0
(4) Like a little 8 26.7
(5) Like a lot 3 10.0
(1) Dislike Alot 4 13.3
(2) Dislike a little 7 23.3
Snacks (3) Neutral 6 20.0
(4) Like a little 8 26.7
(5) Like a lot 9 30.0
Starches (1) Dislike Alot 5 16.7
(2) Dislike a little 5 16.7
(3) Neutral 6 20.0
(4) Like a little 8 26.7

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 (5) Like a lot 6 20.0

Table no 6 shows the food preferences among the athletes. Descriptive statistics was applied was
applied on the data to calculate the frequency and percentages of variables. Each group is scored
on a likert scale of 5. Dislike a lot= 1, dislike a little= 2, neutral= 3, like a little= 4 and like a lot = 5.
The descriptive statistics and frequency distribution shows that vegetable were liked a little by
athletes (23.3%). Fruits were liked a lot by athletes (10.0%), Meat and fish were disliked a lot by
athletes (20.0%). Dairy product were disliked a little by athletes (23.3%). Snacks were liked a lot by
athletes (30.0%) and starches were disliked a lot by athletes (16.7%)

Table no 7: Association of Nutrition knowledge with Body mass index

Body mass index

Variables p-value
Underweight Normal Overweight Obese

0 6 0 0
Average
0.0% 33.3% 0.0% 0.0%
0 4 0 0
Excellent
Nutritional 0.0% 22.2% 0.0% 0.0%
0.018
knowledge 0 5 0 0
Good
0.0% 27.8% 0.0% 0.0%
3 3 7 2
Poor
100.0% 16.7% 100.0% 100.0%

Table no 7 shows the association nutritional knowledge with body mass index of the subjects.
Descriptive statistics was applied on the data to calculate the association of Nutritional knowledge
with body mass index of individuals. The chi square test concluded with a significant relation
(p=0.018) between nutrition knowledge and body mass index.

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Table no 8: Association of nutritional knowledge with dietary intake of the subjects.

Variable Nutritional Knowledge p-value

Poor Average Good Excellent
Carbohydrate 199.9±8.3 247.1±32.1 287.5±24.1 318.8±26.9 0.028
Protein 46.5±14.3 47.6±17.1 62.9±20.1 67.8±19.0 0.038
Fats 58.9±23.0 49.2±13.4 43.0±16.1 38.3±11.8 0.032
Energy 1497.8± 1690.8±195.
169.4 1567.2±172.2 2109.1±199.7 0.027
8

Table no 8 shows the association of nutritional knowledge with dietary intake of the subjects. One
sided Anova test was applied on dietary intake and nutritional knowledge to determine the effect of
Nutritional knowledge on dietary intake of the individuals. A significant association (p<0.05) for
nutritional knowledge with carbohydrate, protein, fats and energy intake.

Table no 9 shows the association of nutritional knowledge with food preferences of the athletes.
Descriptive statistics was applied on the data to calculate the association of food preferences with
nutritional knowledge of individuals. The chi square test showed that nutritional knowledge of
athletes has significant effect (p<0.05) on food preference of vegetables, fruits, meat/fish and dairy
intake.

Table no 10 shows the association of body mass index with food preferences of the athletes.
Descriptive statistics was applied on the data to calculate the association of food preferences with
body mass index of individuals. The chi square test concluded that vegetable intake, fruit intake,
meat and fish, dairy, snacks and starches has significant effect on body mass index of athletes.

Table no 11: Association of dietary intake with body mass index

Body mass index. P-

Variables
Underweight Normal Overweight Obese value
Carbohydrate
214.41±78.1 264.21±62.3 317.7±83.1 321.62±135.0 0.037
intake (g/day)
Protein
59.33±28.4 68.84±37.8 72.25±31.7 76.76±41.7 0.73
intake (g/day)
Fat intake
49.75±29.1 62.10±30.7 68.67±22.8 73.91±47.3 0.031
(g/day)
Energy intake
1881.7±509.2 2197.3±491.2 2236±499.7 2371±473.5 0.004
(kcal/day)

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Table no 11 shows the macro nutrient energy intake of the subjects in relation to their body mass
indexes. One sided Anova test was applied on dietary intake and body mass index to determine the
effect of dietary intake on body mass index of the individuals. A significant association (p<0.05) was
seen for the intake of carbohydrates, fat and energy whereas a non-significant difference (p>0.05)
was observed for the intake of protein.

1
 Discussion

The objective of this research was to determine how nutritional education affected
athletes' body mass index and food preferences. The study found that the average age
of athletes were 26.5 years, with a standard deviation of 3.4. The athletes' average
weight was 67.5 kg, with a standard deviation of 13.3 kg, and their average BMI was
22.5 kg, with a standard deviation of 4.0 kg. In the standard category,
60.0% athletes were pursued by about 23.3% overweight and
10.0% underweight people. The study's findings are similar to those of Walsh et al.
(2021), who looked at whether Master athletes had better clinical outcomes for body
mass index (BMI), an indirect health marker of obesity, when compared to controls
or the overall public. The studies examined were divided into the following
categories: individual sports (n = 5), World Masters Games (n = 2), orienteering (n =
2), endurance sports (n = 14), marathon (n = 14), mixed sports (n = 8), cycling (n =
4), football (n = 4), divers (n = 3), non-specific (n = 3). The significant value was
lower (p < 0.001) than controls ( −9.5%, 26.13 ± 1.7 kg/m2) when Body mass index
was provided for the group of Master athletes. The average BMI was 23.8 kg/m2 (±
1.1), with an array of 20.8 kg/m2 in endurance runners to 27.3 kg/m2 in football
players. When data on gender-specific BMI was available, the average for male
Master athletes was 23.6 kg/m2 (± 1.5) with the array of 22.4 kg/m2 in endurance to
26.4 kg/m2 in divers and the average for female Master athletes. was 22.4 kg/m2 (±
1.2) with the array: 20.8 kg/m2 mixed to 24.7 kg/m2. The body mass index of
student athletes was evaluated using (Yard and Comstork et al., 2011). 61.4%of these
severely wounded high school players had a BMI that was deemed to be within the
normal range. The rest were underweighted, overweight or obese of about 2.6%,
19.6%, 16.4% respectively. Sport-specific inequalities occurred, despite there being
little gender disparity in gender-comparable sports such as baseball/softball,
basketball, and football. Football players who were injured had a significantly
greater rate of overweight or obesity (54.4%) than athletes who participated in any
other sport. Baseball (28.6%), boys' basketball (19.3%), and wrestling (31.7%) all
had significant incidence of obesity and weight gain. In contrast, injured girls'
football players had the lowest incidence of being obesity and weight gain (13.5%).

The adequate nutritional awareness Chronbach alpha score was 0.887. Weight
control, macronutrient, multivitamin, athletic nutrition, supplementation, and alcohol

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intake all had chronbach alpha values that were, respectively, 0.799, 0.906, 0.875,
0.856, 0.843, and 0.795. The work of Trakman et al. (2017), who examined the
reliability and validity of the Nutrition for Athletic Awareness Survey, is similar to
these findings. The questionnaire's overall internal reliability is strong (KR (Kucher
Richardson) = 0.88), and the majority of its sub-sections attained a respectable level
of internal reliability. Construct validity has been verified, yielding a significant (p <
0.001) independent T-test result. Using the opinions of student-athletes and sports
nutritionists as a guide, the questionnaire has proven to have both face and content
validity. Unlike earlier instruments, a Content validity index (CVI) has been used to
quantitatively evaluate the content validity (Polit et al., 2007). With the exception of
alcohol, people who said they had studied nutritional science had higher scores
overall, demonstrating the questionnaire's strong internal consistency. The group
who had received nutrition instruction was younger, more likely to be a woman, and
had received tertiary education. Unlike earlier claims, there was no discernible
variation in performance depending on gender or age (Heaaney et al., 2011). As a
result, it is doubtful that participant characteristics played a role in the knowledge
discrepancies between groups. Based on the connection between the test results of
participants who took the questionnaire twice, test-retest reliability was evaluated.
This strategy has the drawback that motivated people could improve their skills in
between tries. For trial two, the average final score was greater. All sub-sections,
with the exception of "supplements," nevertheless, obtained or came close
to satisfactory test-retest reliability, and overall test-retest reliability was good. The
supplement area was where participants did the worst. It is therefore possible that the
supplement test-retest result was the consequence of individuals making educated
guesses. With the exception of alcohol, most sub-sections' internal dependability
attained or came close to the necessary 0.7 value, indicating a very high overall level
of internal reliability. As anticipated, it seems that (Kunder Richardson) KR-20 and
the quantity of objects were related. If the list contains more than 20 items, Streiner
(2003) advises that (Kunder Richardson) KR-20 should be read cautiously; both the
overall scale and the macronutrient sub-section included more than 20 items.

According to the study's findings, the majority of athletes had inadequate nutritional
awareness (50.0%), followed by basic knowledge (20.0%) and good knowledge
(16.7%). The study's findings are similar to those of (Mcghee et al., 2012) in that

2
they recognize the nutrition information sources used by athletes, coaches, Athletes
trainers, and Strength and conditioning specialist. evaluate nutritional awareness
among athletes, trainers, and Strength and conditioning specialist, and to determine
the level of confidence that each group has in the reliability of the nutrition
understanding survey. In all disciplines, averaged participants were 68.5%. The
highest mean rate was attained by the Athletes trainers. (77.8%) and Strength and
conditioning specialist (81.6%). Only 9% of athletes, 35.9% of coaches, 71.4% of
Athletes trainers, and 83.1% of Strength and conditioning specialist, were found to
have sufficient knowledge. Registered dietitians were the dietary sources that
trainers, Athletes trainers, and Strength and conditioning specialist used the most.
The Nutritional knowledge of athletes from the Fútbol Club Barcelona is evaluated,
and its potential associations with self-perceived levels of Nutritional knowledge,
attitudes towards nutrition, information resources, and various dietary practices are
investigated (Espino et al., 2022). Athletes had a poor median score of 25.1 points,
which was much lower than the athletics technical player's scores and was on par
with 19.5 high school students and university philosophy students. In fact, some
studies show that athletes have more dietary awareness than non-athletes, while
other studies show the contrary (Hwaney et al., 2011). Athletes' scores in the
macronutrients and micronutrients fell short of the 30% maximum. Compared to the
hydration and periodization portions, which had scores above the average, athletes'
results in the macronutrients and micronutrients portions were low. Our findings on
hydration are in accord with some research (Zinn et al., 2006), (Noor Azizam et al.,
2022), and (Davar. 2012), however they are not in agreement with others (Jessri et
al., 2010), (Mcgehee et al., 2012). Although it was comparable to that representing
groups of the community and significantly less than the knowledge displayed by
Sports training technology, athletes should definitely increase their Nutritional
knowledge, particularly in the areas of both micronutrients and macronutrients.

The awareness of sports nutrition among student-athletes is investigated by (Andrew

et al., 2016) taking into account gender, education level, team, and fulfillment of past
nutrition curriculum. The student-athletes' collective mean score for sports
nutritional information was 56.9%, which was deemed insufficient (mean < 75%).
Only 12 student-athletes received a score of 75% or better on the adequate sport’s
nutritional knowledge test. The great majority of student-athletes scored poorly on

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tests measuring their understanding of sports nutrition. Out of 123 participants, only
12 student-athletes achieved a score of more than 75% on the sports nutrition survey.
The overall lack of expertise in sports nutrition seems to be a reflection of the
athletic department's coaches, strength and conditioning experts, and athletic trainers'
disregard for nutrition. According to earlier research by Torres-McGehee et al.,
athletic instructors and fitness experts had appropriate understanding of sports
nutrition, scoring 81.6% and 77.8%, respectively, higher than team trainers 65.9%.
Student athletes in that study scored similarly to those in the present study, scoring
56.9%, with scores of 54.9%. However, Rockwell et al. discovered that athletic
instructors, strength and fitness experts, and coaches did not exhibit a high level of
sports nutrition expertise on their assessment (Rockwell et al., 2001). Torres-
McGehee et al. came to the conclusion that coaches, fitness experts, and athletic
instructors could incorporate sports nutrition into their ongoing training but should
refer to Registered Dietitians for topics outside of their area of expertise (Mcgehee et
al., 2012). Even though the present study did not test the teaching staff's knowledge
of sports nutrition, future research might, it is likely that student-athletes are not
obtaining this information. The student-athletes had no access to Registered
Dietitians or Sports Dietitians, not even on a consultation basis. Only about half of
the 58.2% of their sample who had some contact to a Registered Dietitian were full-
or part-time employees in their athletics department, according to Torres-McGehee
et al. The remaining treatments could be obtained from private off-campus
physicians or through student health care services (Mcgehee et al., 2012). It would
be easier for the coaching, fitness, and athletic training staff to concentrate on sport-
specific practice, endurance training, and ailments if the athletic department hired a
qualified sports dietitian to educate sports nutrition to the athletes’ student-. The
dietitian could offer one-on-one or small-group counselling, as well as assist in
creating nutrition programmes especially for athletes. The nutritional understanding
of elite young athletes from a normal local sports institutions is examined (Bird and
Rushton et al., 2020). All athletes had an average Nutritional knowledge
Questionnaire score of 43.8% (± 11.4). There were no differences between men and
women in the overall nutritional knowledge levels, but in the subgroup for nutrients,
female athletes scored higher (p = 0.02). With this subgroup having the lowest ratio
of "accurate" to "improper" responses (27.1% ± 2.3; p = 0.02), the majority of
athletes had trouble recognizing the proper Dietary Reference intakes. The subgroup

2
for supplements showed a lot of confusion, with substantially more "uncertain"
responses than "improper" responses (42.4% ± 20.3; p < 0.05). Among Direct
intelligence bureau athletes and trainers in Lebanon, (Boumosleh et al., 2021)
analyze the frequency of insufficient Nutritional knowledge, determine the
deficiencies in Nutritional knowledge, key sources of nutrition knowledge, attitudes
on sports nutrition, and significant determinants of insufficient Nutritional
knowledge. Over 80% and 54% of Direct intelligence bureau athletes and trainers,
respectively, had insufficient Nutritional knowledge. Inadequate of nutrition
knowledge in Direct intelligence bureau players was found to be significantly
correlated with insufficient Nutritional knowledge. (Elsahoryi et al., 2021) measure
the Nutritional knowledge of Jordanian athletes, and assess the association between
NK and different sociodemographic variables. The majority of participants (91.4%)
were athletes who performed high-intensity sports (59.6%), were women (68.0%),
had a normal range of BMI (50.6%). Poor Nutritional knowledge was present in
88.3% of subjects (50%). Depending on participant role (athlete vs. coach), age, sex,
BMI, citizenship, cigarette smoking, years of participation in sport, frequency of
sport, intensity of sport, and nutrition training, statistically significant variations in
Nutritional knowledge values were present. According to multivariate modelling, the
NK category was predicted by role participant, BMI, level of education, frequency
of sport, and nutrition training.

The results of the current study showed that 23.3% athletes did not like vegetables
very much. 10.0% Athletes enjoyed fruits a lot, but 20.0% disliked meat and fish a
lot. Athletes disliked dairy products only. Athletes preferred snacks over
carbohydrates and 30.0% preferred snack foods over meals. The study's findings are
similar to those of Gutierrez et al. (2008), who evaluated the impact of dietary
choices on nutrient status in a group of elite adolescent athletes by recruiting 22 male
football players between the ages of 14 and 16. Meat, chicken, and derivatives
(ranked 1–5 in 83% of people) and pasta (ranked 58% of people) were the top
preferences, while veggies (ranked 11–15 in 82% of people) and seafood (ranked
64%) were the least preferences. Wheat, Cookies, Candies, and Desserts
(3.0 portions/day), and Fruits and Fruit Drinks were among the most widely
consumed food groups (3.9 portions/day). the individuals who particularly loved
bread, had statistically greater energy and carbohydrate content, otherwise there

2
were no statistical variations in consumption of food between preference groups, and
there was no correlation between preferences and nutritional status. Teenager high-
level footballers' dietary habits and dietary choices were in general, unconnected.
Regarding the methods employed for the assessment of choices, in the current study,
participants were asked to rank food groups rather than individual food products, as
other writers have published (Cooke & Wardle, 2005; Drewnowski & Hann, 1999).
In spite of this, our findings on teenage athletes' dietary choices were comparable to
those found in research on juvenile populations, with pasta and meat ranking among
favorites and fish and vegetables ranking as the least preference (Cooke & Wardle,
2005; Perez-Rodrigo et al., 2003). Also, we employed a quantitative food frequency
survey, which gave us the choice of identifying not only the food's frequency but
also the amount of each food that was consumed, as well as a combination of the
two. In our perspective, expressing food consumption patterns as portions per day or
portions per week (rather than just times per day or times per week) better correctly
reflects how often a certain meal is consumed. By eliminating the confounding
influence of the food portion when findings are expressed only in terms of frequency
of intake, we would be able to obtain clear information about the individuals
examined' eating habits. For example, when assessing only the consumption
frequency, the impact of one food that is consumed frequently in small amounts is
overestimated to the detriment of another that is consumed rarely but in greater
quantities, even though their importance in the overall pattern of food consumption
may be very similar. Some studies contend that people's food preferences have an
effect on the reliability of the frequency response in the identification of a positive
correlation between preferences and frequency of consumption (Drewnowski &
Hann, 1999). Even if the true consumption rates were the same, people may be more
inclined to report consuming a favored dish more frequently than a non - preferred
one. When the food frequency surveys in our study were filled out by the
participants with the assistance of their families, the likelihood of erroneous
connections between recorded consumption frequencies and food preferences is
reduced. It is noteworthy to highlight that in the current study, participants were
evaluated while still residing in their families, whose impact on eating behaviors is
crucial (Gedrich, 2003). As previously stated, practically all participants consumed
their three main meals, which made up the majority of their daily caloric intake, at
home with their families. Since meals are typically prepared by their parents or other

2
adults, who chooses the daily menu taking into account a variety of factors other
than adolescents' food preferences, such as healthy food and beliefs, the cost of
foods, the flexibility of preparation, etc., while also keeping in mind the choices of
other family members, which need not necessarily correlate with their own, the
possibility of choosing foods based on their personal tastes is restricted in this
situation.

The current study found a significant relationship between body mass index and
nutritional knowledge (p=0.018). Knowledge about eating habits that affect
performance and nutritional health can differ. In order to understand the association
between nutrition knowledge and the nutritional health of learners at the Sport
Science Faculty of Universitas Negeri Medan, (Serigar et al., 2020) set out to collect
data. Regression study indicated r = 0.580 and p = 0.004 as results. The findings,
however, contrast with those of other studies, which found that body mass index was
not significantly influenced by players' and non-athletes' levels of knowledge (Sedek
et al., 2014). According to another study, female athletes' ingestion of vitamins C and
E had no appreciable impact on their performance, body composition, or muscle
injury (Taghiyar et al., 2013). Understanding nutrition can influence meal choices
made by athletes and lead to a decrease in body fat percentage (Rossi et al., 2017:
Delvin et al., 2016). The nutrition expertise of athletes is related to food
consumption, eating habits, and meal preference. They can choose foods with the
best nutrients since they are able to grasp the appropriate consumption depending on
their energy requirements. Football players that receive nutritional instruction can
better comprehend nutrition and alter their eating habits (Roves et al., 2014). The
degree of information has the potential to enhance one's understanding, perspective,
and behavior around protein and carbohydrate consumption. Also, it can enhance
nutrition intake, which should be in line with energy requirements and upcoming
workouts (Elias et al., 2018). (Egan. 2017). The dietary recommendations made to
athletes may cause them to gain weight. In order to maintain weight, guidelines
should be properly supplied (Jagger et al., 2017). (Merawati et al., 2019) examined
129 young female athletes from 27 different sports branches, ranging in age from 12
to 19 years, to learn more about their nutritional awareness, eating habits, nutrient
intake, and physical ability. According to the study's findings, young female athletes
typically encounter several nutritional issues, poor eating habits, and self-conflicts

2
connected to body image and performance. (Jagim et al., 2021) investigate the
connections between understanding of sport nutrition and body composition as well
as potential indicators of body weight objectives in collegiate athletes. In the
nutrition survey, athletes correctly answered 47.98 ± 11.29% of the items; there were
no gender differences (men: 49.52 11.76% vs. women: 47.03 11.04%; p = 0.40). For
all athletes, there was a negative association between sport nutrition awareness levels
and body fat percentage (Body fats %) (r = -0.330; p = 0.008) and fat mass (r = -
0.268; p = 0.032). Body mass index (BMI) (β = 0.421), body fat percentage (BF%)
(β = 0.217), and Fat mass (β = 0.224) were all significant (p < 0.05) predictors of
women's desired body weight. All athletes significantly (p < 0.001) underestimated
their daily requirements for fat, carbohydrates, and energy (-41.4 ± 34.5 g/day, -
301.6 ± 149.2 (g/day), -1360 ± 610.2 kcal/day respectively). College athletes in
Division III have a poor degree of sport nutrition awareness, which was linked to a
higher BF%. Weight loss was more frequently chosen as a body weight goal by
female athletes with higher body weight, BF%, and BMI. In addition, athletes
dramatically underestimated their needs for energy and carbohydrates based on the
needs of their sport, regardless of gender.

According to the results of the current study, athletes' food preferences for
vegetables, fruits, meat/fish, and dairy had a significant impact (p<0.05) on their
nutritional awareness. These results are comparable to the research conducted by
Jauhari et al. in 2020 to assess the nutritional health, eating patterns, and degree of
nutrition awareness of Jakarta water polo athletes competing in the 20th National
Sports Event (PON XX) in Papua Province, Indonesia. According to the spearman
correlation test between the variables measuring respondents' eating habits and
nutrition knowledge, there was no significant link between these two (p value =
0.045, r = 0.032). Research demonstrated that a respondent's good eating habits were
inevitably tied to their level of nutritional awareness. (Dunn et al., 2007) investigated
individuals' understanding of existing dietary guidelines, nutrient resources,
nutritious food options, and the connection between dietary patterns and disease
processes. There were notable disparities in general knowledge between collegiate
sports and genders of athletes. The majority of the university's athletes had positive
opinions towards their eating habits, but they scored poorly on knowledge tests. The
information required to decide which food items to choose is another issue.

2
According to recent studies, athletes' meal choices become more nutritious as their
knowledge grows (Kunkel, Bell, & Luccia, 2001). Children are taught about
nutrition through Nutritional Education and Training (NET) programmes in the
majority of public schools (Sizer & Whitney, 2000), but by the time they are college-
age, few students have even a basic understanding of nutrition (Cho &. Students who
are more knowledgeable about nutrition might learn tips to improve performances
and/or keep a healthy or competitive weights. Yet, athletes who compete in particular
sports have more difficulty meeting their fundamental nutritional requirements while
trying to reach or keep a competitive weight.

According to the study's findings, eating fruits and vegetables, meat and fish, dairy
products, snacks, and carbohydrates significantly affects athletes' body mass index.
Athletes of all levels are urged to use sports nutrition techniques that enhance their
cognitive and athletic abilities and promote excellent health (Maughan & Shirreff’s,
2011). To achieve ideal body mass (BM) and composition, implementing specific
nutritional techniques before, during, and after training to maximize performance,
and eating a healthy diet that provides enough energy to meet all of the
macronutrient and micronutrient demands of competition and training are some
examples of these strategies (Maughan & Shirreffs, 2011; Thomas et al., 2016).
When caloric intakes are reduced to decrease body mass/fat mass, choosing nutrient-
rich foods is crucial for lowering the chance of nutrient shortages that may harm
both performance and health. Despite the fact that athletes might benefits from a
sports dietitian's guidance on their particular energy, nutritional, and hydration
requirements as well as assistance with sport-specific nutrition regimens, advice on
the usage of supplements is also commonly requested. But, nutritional supplements
shouldn't be used to make up for bad eating habits and an improper nutrition, unless
they may be used as a temporary solution when dietary adjustments are problematic
(Maughan & Shirreffs, 2011). Instead, an appropriate diet is complemented by the
benefits of evidence-based supplements, whether they are used to promote health,
prevent tiredness, or increase performance. Athletes who, for instance, do not have
time for their protein intake in proportion for training or who have poor iron status
are unlikely to fully benefit from supplements designed to increase muscle mass or
improve endurance. The first step in counseling athletes on nutritional tactics or
supplement use is a nutritional evaluation. The "systematic approach for acquiring,

2
validating, and analyzing data required to determine nutrition-related diseases, their
causes, and their relevance" is known as nutrition evaluation (Academy of Nutrition
and Dietetics, 2015). In a perfect world, a comprehensive examination would also
include patient's medical history, anthropometric measurements and body
composition assessment, biochemical tests, dietary review, and clinical examination
with a nutrition focus (Academy of Nutrition and Dietetics, 2015; Driskell &
Wolinsky, 2010).

In the context of sports, nutritional evaluation in relation to nutritional supplements

use should to make sure the athlete (a) is following a well-chosen sports nutrition
diet planning which is sufficient in energy, carbohydrates protein, fats , minerals and
vitamins; (b) does not pose a risk for health problems, such as association with
prescribed medication or over-the-counter drugs; and (c) would actually benefit from
nutritional supplements and is aware of the recommended supplementation
guidelines. If not, the supplementation programme may not be as successful and
excessive mineral and vitamin consumption and drug-nutrient interactions may
result. The traditional "A-E" structure of anthropometric Measurements, biochemical
analysis, clinical evaluation, dietary choices, and environmental evaluation
(Boosalis, 2010) is summarized in this paper to analyze the requirement for
nutritional supplements rather than its more typical application to populations that
are severely undernourished or burdened with chronic illness. The report also
discusses the absence of reference norms that are adapted to athletes as well as
assumptions and potential errors in the gathering of anthropometric, biochemical,
and nutritional data that must be taken into account in the evaluation process.

2
 CONCLUSION

the current research was carried to evaluate the impact of nutritional knowledge on body mass
index and food preferences of the athletes. The study was carried out in different training and
fitness centers of London. The study concluded that some of the athletes were having good and
excellent knowledge of nutrition. Majority of the athletes were in the normal category of body mass
index. Coaches were main source of nutrition knowledge among the athletes. The nutritional
knowledge of athletes has significant effect on body mass index, dietary intake and food preference
of athletes whereas the body mass index was also greatly influenced by dietary intake and food
preferences among the athletes.

LIMITATION OF THE STUDY.

The current study also posses some limitation. First, the study was limited to sample size of 30
athletes, therefore further studies must be carried out to consider a large number of sample size.
The second limitation of the study is that it is limited to athletes involved in fitness and leisure time
centers, more study should be conducted among athletes involved in both outdoor and indoor
sports games. A similar study can be considered the evaluate the prevalence of nutritional
knowledge among athletes and non-athletes and its effect on individual body mass index.

The foremost limitation of the study was limitation of time for visit to fitness center and recording
data from the participant as the data collection period was limited to 2 weeks only which make it
difficult to contact the athletes. Another limitation of the study is that nutritional knowledge was
assessed by nutritional for sport knowledge questionnaire, more study should be conducted by
using other specifics knowledge related questionnaire to evaluate the prevalence of athletes.

STRENGTH OF THE STUDY

The current study posses the following strength.

1. First is assessing the nutritional knowledge of athletes as nutritional knowledge of certain

food and nutrient play as a vital role in the selection of diet for the better performance
2. Second strength of the study is the determination of dietary intake and food preference of
athletes as both of these can greatly influence the body mass index and performance of
individual
3. The 3rd and utmost strength of current research study is determination of the impact of
nutritional knowledge of body mass index and food preference of the athletes as the body
mass index is greatly influence by level of nutritional knowledge of individuals.

3
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3
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3
 APPENDIXES

GENERAL CHARACTERISTICS

Serial no. _____________

Name: _______________

Age: ________________

Source of nutrition knowledge:

1. Coach
2. Registered dietitian
3. Newspaper
4. Friends
5. None

Contact no: ____________

Email: _________________

Height: _____________________

Weight: _____________________

Body mass index : ______________

NUTRITIONAL KNOWLEDGE

3
Weight Management

Q1.1 Which nutrient do you think has the most energy (kilojoules/calories) per
100 grams (3.5 ounces)?

 Carbohydrate
 Protein
 Fat
 Not sure

Q1.2 Do you agree or disagree with the following statements about weight
loss?

Agre Disagre Not

e e Sur
e

1. Having
the lowest
weight
possible
benefits   
endurance
performanc
e in the
long term

2. Eating
more
protein is
the most
important
  
dietary
change if
you want to
have more
muscle

3. Eating   
more
energy

3
 from
protein
than you
need can
make you
put on fat

Q1.3 Do you think the diet changes below are good ways to lose weight?

Y N No
e o t
s Su
re

1. Swapping
carbohydrates/en
ergy dense foods   
for low-energy
foods like
vegetables (Yes)

2. Eating
  
margarine instead
of butter (No)

3. Eating protein
bars and shakes
instead of yogurts,   
muesli/granola
bars and fruits
(No)

4. Choosing lower
glycemic index
(GI)   
carbohydrates to
help regulate
appetite (Yes)

4
Q1.4 If they want to lose weight, athletes should:

 eat less than 50 grams (1.7 ounces) of carbohydrate per day

 eat less than 20 grams (0.7 ounces) of fat per day
 eat less calories/kilojoules than your body needs
 Not sure

Q1.5 To ensure they meet their energy (kilojoule/calorie) requirements, all

athletes should:

 plan their diet based on their age, gender, body size, sport and training program
 eat based on their natural hunger and fullness signals
 eat at least 8000 kilojoules (2000 calories) per day
 eat more foods that have lots of carbohydrate
 Not sure

Q1.6 Which is a better recovery meal option for an athlete who wants to put
on muscle?

 A 'mass gainer' protein shake and 3 - 4 scrambled eggs

 Pasta with lean beef and vegetable sauce, plus a dessert of fruit, yoghurt and
nuts
 A large piece of grilled chicken with a side salad (lettuce, cucumber, tomato)
 A large steak and fried eggs
 Not sure

Q1.7 Which is a better recovery meal option for an athlete who wants to lose
weight?

o A side salad with no dressing (lettuce, cucumber, tomato)

 A pure whey protein isolate (WPI) shake made on water
 A mixed meal that includes a small-moderate serving of meat and carbohydrate
(e.g. small bowl pasta with lean mincemeat and vegetable sauce) plus a large side
salad
 Not sure

4
4
Macronutrients

Q2.1 An athlete doing a moderate to high-intensity endurance training

program for about two hours should eat…

 1 - 3 g carbohydrate per kg (0.016 - 0.048 ounces per lb) body weight per day
 5-7 g, increasing up to 10 g/kg with intense training/competition loads 15 - 25%
of total daily kilojoule/calorie intake as carbohydrate
 75 - 85% of total daily kilojoule/calorie intake as carbohydrate
 Not sure

Q2.2 Which options have enough carbohydrate for recovery from about 1
hour of high intensity aerobic exercise? Assume the athlete weighs about
70kg and has an important training session again tomorrow.

Enough Not Not

enough Sure

1. 1
medium
  
banana
(NE)

2. 1 cup
cooked
quinoa
  
and 1 tin
tuna
(NE)

3. 1 cup
plain
  
yoghurt
(NE)

4. 1 cup   
baked
beans
on two
slices of
bread

4
(E)

4
Q2.3 Which food has the most carbohydrate?

 1 cup (168 g/5.6 ounces) boiled rice

 2 slices of white sandwich loaf bread
 1 medium (150 g/ 5 ounces) boiled potato
 1 medium (150 g/5 ounces) ripe banana
 Not sure

Q2.4 Do you agree or disagree with these statements about fat?

Agre Disagre Not

e e Sur
e

1. The
body
needs fat
to fight   
off
sickness
(A)

2.
Athletes
should
not eat
  
more
than 20g
of fat per
day (D)

3. When   
we
increase
the
intensity
of
exercise,
the % of
fat we

4
use as a
fuel also
increase
s (D)

4. When
we
exercise
at a low
intensity,
  
our body
mostly
uses fat
as a fuel
(A)

4
Q2.5 Do you think these foods are high in fat?

Yes N Not
o Sure

Cheddar cheese  

(Y)

 
Margarine (Y) 

 
Mixed nuts (Y) 

 
Honey (N) 

4
Q2.6 Do you agree or disagree with the statements about protein?

Agr Disagr No
ee ee t
Su
re

1. Protein is
the main fuel

that muscles  
use during
exercise (D)

2. Vegetarian
athletes can
meet their
protein

requirements  
without the
use of protein
supplements
(A)

3. An
experienced
athlete needs
more protein 
 
than a young
athlete who is
just starting
training (D)

4
4 .The body
has a limited
ability to use 
 
protein for
muscle protein
synthesis (A)

5. A balanced
diet with
enough
kilojoules/calor

ies (energy)  
has enough
protein for
most athletes
(A)

4
Q2.7 Which food has the most protein?

 2 eggs
 100g (3 ounces) raw skinless chicken breast
 30g (1 ounce) almonds
 Not sure

Q2.8 The protein needs of a 100 kg (220 lb) well trained resistance athlete are
closest to:

 100g (1g/kg)
 150g (1.5g/kg)
 500g (5g/kg)
 They should eat as much protein as possible
 Not sure

Q2.9 Which of these foods do you think have enough protein to promote
muscle growth after a bout of resistance exercise?

Enough Not Not

enough Sure

1.100g
(3
ounces)
  
chicken
breast
(E)

2. 300g
(1
ounce)
  
Yellow
cheese
(NE)

3. 1 cup   
baked
beans

5
(NE)

4. 1/2
cup
cooked   
quinoa
(NE)

5
Q2.10 Do you think these foods have all the essential amino acids needed by
the body?

Yes N Not
o Sure

 
Beef steak (Y) 

 
Eggs (Y) 

 
Lentils (N) 

 
Cow's Milk (Y) 

5
Q2.11 The amount of protein in skim milk compared to full cream milk is:

 much less
 about the same
 much more
 Not sure

Micronutrients

5
Q3.1 Do you agree or Agree Disagree Not Sure
disagree with these
statements on vitamins
and minerals?

1. Calcium is
the main 
 
component
of bone (A)

2. Vitamin C

is an anti-  
oxidant (A)

[Link]
(Vitamin B1)
is needed to 
 
take oxygen
to muscles
(D)

4. Iron is
needed to
turn food into
usable
energy (D)
5. Vitamin D
enhances
calcium
absorption
(A)
6. Meat,
chicken and
fish are good
sources of
zinc (A)
7.
Wholegrain
foods are
good
sources of
vitamin C (D)
8. Fruit and
vegetables
are good
sources of
calcium (D)
9. Fatty fish
is a good
5
source of
vitamin D (A) 
 
10. Women
5
Sports Nutrition
Q4.1 Athletes should drink water to:

 keep plasma (blood) volume stable

 stop dry mouth
 allow proper sweating
 All of the above
 Not sure
Q4.2 Experts think that athletes should:

 drink 50 - 100 ml (1.7 - 3.3 fluid ounces) every 15 - 20 minutes

 suck on ice cubes rather than drinking during practice
 drink sports drinks (e.g. powerade) rather than water when exercising
 drink to a plan, based on body weight changes during training sessions
performed in a similar climate
 Not sure
Q4.4 How much sodium (salt) should fluid consumed for hydration purposes
(during exercise) contain?

 At least 11 - 25 mmol/L (~ 250 - 575 mg/L)

 At least 4 - 8 mmol/L (~ 90 - 185 mg/L)
 None
 Not sure
Q4.5 Before competition, athletes should eat foods that are high in:

 fluids, fat and carbohydrate

 fluids, fibre and carbohydrate
 fluids and carbohydrate
 Not sure

5
Q4.6 Do you agree or disagree with the statements on carbohydrate?

Agre Disagre Not

e e Sur
e

1. Eating
carbohydrat
es when you
exercise

makes it  
harder to
build
strength and
muscles (D)

2. In events
lasting 60 -
90 minutes,
30- 60 g (1.0
- 2.0 
 
ounces) of
carbohydrat
es should be
eaten per
hour (A)

3. Eating
carbohydrat
es when you
exercise will 
 
help keep
blood sugar
levels stable
(A)

5
Q4.7 Some athletes get a sore stomach if they eat during exercise. What
might make stomach pain worse?

 Having energy gels rather than water or sports drinks

 Having small amounts of water at a time
 Having sports drinks with different types of carbohydrates (e.g. fructose and
sucrose)
 Not sure
Q4.8 During a competition, athletes should eat foods that are high in:

 Fluids, fibre and fat

 Fluids and protein
 Fluids and carbohydrate
 Not sure
Q4.9 Which is the best snack to have during an intense 90-minute training
session?

 A protein shake
 A ripe banana
 2 boiled eggs
 A handful of nuts
 Not sure
Q4.10 After a competition, athletes should eat foods that are high in?

 Protein, carbohydrate and fat

 Only protein
 Only carbohydrate
 Carbohydrate and protein
 Not sure
Q4.11 How much protein do you think experts say athletes should eat after
resistance exercise?

 0.3g/kg body weight (~ 15 - 25 g [0.53 - 0.88 ounces] for most athletes)

 1.0 g/kg body weight (~ 50 - 100 g [(1.9 - 2.3 ounces)] for most athletes)
 1.5g/kg body weight (~ 150 – 130 g [5.3 – 10.6 ounces] for most athletes)
 Not sure

5
5
Supplementation
Q5.1 Do you agree or disagree with the statements about vitamin and mineral
supplements?

6
 Agree Disagree Not
Sure

1.
Vitamin
C should
always
  
be taken
by
athletes
(D)

2. B
vitamins
should
be taken
  
if energy
levels
are low
(D)

3. Salt
tablets
should
be taken
by
athletes
  
that get
cramps
when
they
exercise
(D)

4. Iron
tablets
should
be taken
by all
  
athletes
who feel
tired and
are pale
(D)
6
Q5.2 All supplements are tested to make sure they are safe, don’t have any
contamination.

 Agree
 Disagree
 Not sure
Q5.3 Supplement labels may sometimes say things that are not true.

 Agree
 Disagree
 Not sure
Q5.4 Do you agree or disagree with the statements about supplements?

Agree Disagree Not

Sure

1. Creatine makes
the brain think that
  
exercise feels
easier (D)

2. Caffeine makes
muscles able to
work harder even   
without more
oxygen (D)

3. Beetroot juice
(nitrates) makes
muscles feel less   
sore after exercise
(D)

4. Beta-Alanine can
decrease how much
acid muscles make   
during intense
exercise (A)

6
Q5.5 Which supplement does not have enough evidence in relation to
improving body composition or sporting performance?

 caffeine
 ferulic acid
 bicarbonate
 leucine
 Not sure
Q5.6 WORLD ANTI-DOPING AGENCY (WADA) bans the use of….

 caffeine
 bicarbonate
 carnitine
 testosterone
 Not sure

Alcohol
Q6.1 How much ethanol (pure alcohol) is there in a standard drink?

 1 - 2 / 0.03 - 0.06 fluid ounces

 8 - 14 g/ 0.3 - 0.6 fluid ounces
 30 - 50 g /1.2 - 2.0 fluid ounces
 Not sure
Q6.2 Which is an example of a "Standard Drink"?

 30 - 45 ml/1 - 1.5 fluid ounces of pure spirits

 One quarter of a bottle (175 ml/ 6 fluid ounces) of red wine
 A pint (425 ml/ 14 fluid ounces) of full strength beer
 Not sure
Q6.3 Do you think alcohol can make you put on weight?

 Yes
 No
 Not sure
Q6.4 How many drinks do you think experts say are the most we should have
in one day?

 Two
 Three

6
  Four
 Not sure

Q6.5 Do you agree or disagree with the statements on alcohol?

Agree Disagre Not

e Sure

1. If someone does
not drink at all during
the week, it is okay
for them to have five   
or more drinks on a
Friday or Saturday
night

2. Drinking lots of
alcohol can make it
  
harder to recover
from injury

3. Alcohol makes you

  
urinate more

Q6.6 "Binge drinking" (also referred to as heavy episodic drinking) is defined

as:

 having two or more standard alcoholic drinks on the same occasion

 having four to five or more standard alcoholic drinks on the same occasion
 having seven to eight or more standard alcoholic drinks on the same occasion
 Not sure

FOOD PREFERENCES

The food preference questionnaire requires participants to rate their liking of 62

individual foods on a 5-point Likert scale, ranging from “not at all” to “a lot”.

6
Participants are instructed to select ‘not applicable’ if they are not familiar with, or
have no memory of having tried a food item.

Two additional questions about important food allergies or dietary requirements

which may influence habitual intake and liking of certain foods are included (Q1 and
Q2):

- Q1 asks whether subjects follow a pescetarian, vegetarian, or vegan dietary

regimen, and

- Q2 establishes the presence of food allergies via a self-completed food allergies

checklist of the 10 most frequent food allergens.

The food preference ratings can be grouped into six internally reliable categories:
vegetables, fruits, meat/fish, dairy, snacks and starches.

Scoring instructions are included at the end of the questionnaire (page 5).

6
6
 1. Do you identify as any of the following?
☐ Vegan
☐ Vegetarian

☐ Pescetarian (no meat, but eat fish and/or shellfish)

☐ None of the above

2. Are you allergic to any of the following food items? (please select all that apply)
☐ Peanuts
☐ Tree nuts

☐ Sesame
☐ Dairy

☐ Shellfish

☐ Fish
☐ Egg

☐ Wheat / Gluten
☐ Soya

☐ Celery
☐ Mustard

☐ Other (please specify):

3. Please read the following list of food items and tick the box which most
accurately reflects how much (on average) you like the specific item (not
necessarily how much you actually consume).
For any foods you don't know, or don't remember ever having tried, please select
“Not applicable”.

Dislike a Dislike Neithe Like Not

Food lot a r like a Like a applicabl
item little nor little lot e
dislike
Beef ☐ ☐ ☐ ☐ ☐ ☐
Beef burgers ☐ ☐ ☐ ☐ ☐ ☐
Lamb ☐ ☐ ☐ ☐ ☐ ☐
Chicken ☐ ☐ ☐ ☐ ☐ ☐
Bacon ☐ ☐ ☐ ☐ ☐ ☐
Ham ☐ ☐ ☐ ☐ ☐ ☐
Sausages ☐ ☐ ☐ ☐ ☐ ☐

6
White fish (e.g. cod, haddock) ☐ ☐ ☐ ☐ ☐ ☐
Oily fish (e.g. mackerel, ☐ ☐ ☐ ☐ ☐ ☐
kippers)
Smoked salmon ☐ ☐ ☐ ☐ ☐ ☐
Tinned Tuna ☐ ☐ ☐ ☐ ☐ ☐
Eggs (boiled, scrambled or ☐ ☐ ☐ ☐ ☐ ☐
fried)
Baked beans ☐ ☐ ☐ ☐ ☐ ☐
Bread or Bread rolls ☐ ☐ ☐ ☐ ☐ ☐

Scoring of the food preference questionnaire for adults

Responses are scored 1-5, with a higher score indicative of greater liking of a food.
“Not applicable” is coded as missing.

Dislike a lot = 1 Dislike a little = 2

Neither like nor dislike = 3 Like a little = 4
Like a lot = 5

Food preference scale scores for the six food categories are obtained by summing
the single food preference item scores within each food category and dividing this
sum by the number of items.

Food Number

preference of items Individual food

6
 included

category in mean items

score (n)
Spinach, Carrots, Green beans,
Cucumber, Celery, Mushrooms,
Brussels sprouts, Parsnips,
Peas, Sweet corn, Broccoli,
Vegetables 18
Salad, Red peppers, Raw
tomatoes, Avocados,
Potatoes, Baked beans,
Beetroot
Oranges, Grapes, Apples,
Fruit 7 Melon, Peaches,
Apricots, Strawberries
Beef, Beef burgers, Lamb,
Chicken, Bacon, Ham,
Sausages, White fish, Canned
Meat/Fish 12
tuna,
Oily fish, Smoked salmon,
Hummus
Soft cheese, Hard cheese,
Eggs, Butter, Cream, Yogurt,
Dairy 10
Cottage cheese, Butter-like
spread, Mayonnaise, Custard
Chips, Plain biscuits, Chocolate
biscuits, Cake, Ice cream,
Snacks 9
Chocolate, Crisps, Gummy
sweets, Sugared cereal
Bread, Bran cereal, Porridge,
Starches 6 Rice, Wheat
cereal, Rice or corn cereal

6
Table no 9: Association of nutrition knowledge with food preferences

Nutrition Knowledge
Variables p-value
Average excellent good Poor
0 0 0 8
dislike alot
0.0% 0.0% 0.0% 53.3%
dislike a 0 0 0 6
little 0.0% 0.0% 0.0% 40.0%
1 0 2 1
Vegetable Neutral 0.000
16.7% 0.0% 40.0% 6.7%
4 0 3 0
like a little
66.7% 0.0% 60.0% 0.0%
1 4 0 0
like alot
16.7% 100.0% 0.0% 0.0%
0 0 0 7
dislike alot
0.0% 0.0% 0.0% 46.7%
dislike a 0 0 0 6
little 0.0% 0.0% 0.0% 40.0%
1 0 2 1
Fruits Neutral 0.002
16.7% 0.0% 40.0% 6.7%
4 4 2 0
like a little
66.7% 100.0% 40.0% 0.0%
1 0 1 1
like alot
16.7% 0.0% 20.0% 6.7%
0 1 0 5
dislike alot
0.0% 25.0% 0.0% 33.3%
dislike a 1 1 2 1
little 16.7% 25.0% 40.0% 6.7%
4 0 1 0
Meatfish Neutral 0.002
66.7% 0.0% 20.0% 0.0%
1 2 2 1
like a little
16.7% 50.0% 40.0% 6.7%
0 0 0 8
like alot
0.0% 0.0% 0.0% 53.3%
Dairy dislike alot 1 2 1 2 0.029
16.7% 50.0% 20.0% 13.3%

7
 dislike a 4 0 0 3
little 66.7% 0.0% 0.0% 20.0%
0 2 3 1
Neutral
0.0% 50.0% 60.0% 6.7%
1 0 1 6
like a little
16.7% 0.0% 20.0% 40.0%
0 0 0 3
like alot
0.0% 0.0% 0.0% 20.0%
1 1 0 1
dislike alot
16.7% 25.0% 0.0% 6.7%
dislike a 1 0 1 4
little 16.7% 0.0% 20.0% 26.7%
3 0 3 2
Snack Neutral 0.055
50.0% 0.0% 60.0% 13.3%
1 2 1 0
like a little
16.7% 50.0% 20.0% 0.0%
0 1 0 8
like alot
0.0% 25.0% 0.0% 53.3%
0 0 0 7
dislike alot
0.0% 0.0% 0.0% 46.7%
dislike a 1 0 0 2
little 16.7% 0.0% 0.0% 13.3%
1 2 3 1
Starches Neutral 0.091
16.7% 50.0% 60.0% 6.7%
2 2 2 2
like a little
33.3% 50.0% 40.0% 13.3%
2 0 0 3
like alot
33.3% 0.0% 0.0% 20.0%

Table no 10: Association of body mass index with food preferences

Body mass index

p-
Variables Overweigh
Underweight Normal Obese value
t
2 0 4 2
Vegetable dislike alot 0.028
66.7% 0.0% 57.1% 100.0%

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 1 3 2 0
dislike a little
33.3% 16.7% 28.6% 0.0%
0 3 1 0
Neutral
0.0% 16.7% 14.3% 0.0%
0 7 0 0
like a little
0.0% 38.9% 0.0% 0.0%
0 5 0 0
like alot
0.0% 27.8% 0.0% 0.0%
2 2 3 0
dislike alot
66.7% 11.1% 42.9% 0.0%
dislike a little 1 1 2 2
33.3% 5.6% 28.6% 100.0%
0 3 1 0
Fruits Neutral 0.038
0.0% 16.7% 14.3% 0.0%
0 10 0 0
like a little
0.0% 55.6% 0.0% 0.0%
0 2 1 0
like alot
0.0% 11.1% 14.3% 0.0%
3 3 0 0
dislike alot
100.0% 16.7% 0.0% 0.0%
0 5 0 0
dislike a little
0.0% 27.8% 0.0% 0.0%
0 5 0 0
Meat/fish Neutral 0.000
0.0% 27.8% 0.0% 0.0%
0 5 0 1
like a little
0.0% 27.8% 0.0% 50.0%
0 0 7 1
like alot
0.0% 0.0% 100.0% 50.0%
2 4 0 0
dislike alot
66.7% 22.2% 0.0% 0.0%
1 5 0 1
dislike a little
Dairy 33.3% 27.8% 0.0% 50.0% 0.006
0 6 0 0
Neutral
0.0% 33.3% 0.0% 0.0%
like a little 0 2 6 0

7
 0.0% 11.1% 85.7% 0.0%
0 1 1 1
like alot
0.0% 5.6% 14.3% 50.0%
1 2 0 0
dislike alot
33.3% 11.1% 0.0% 0.0%
dislike a little 1 4 1 0
33.3% 22.2% 14.3% 0.0%
1 7 0 0
Snack Neutral 0.017
33.3% 38.9% 0.0% 0.0%
0 4 0 0
like a little
0.0% 22.2% 0.0% 0.0%
0 1 6 2
like alot
0.0% 5.6% 85.7% 100.0%
0 0 5 2
dislike alot
0.0% 0.0% 71.4% 100.0%
dislike a little 0 1 2 0
0.0% 5.6% 28.6% 0.0%
0 7 0 0
Starches Neutral 0.000
0.0% 38.9% 0.0% 0.0%
0 8 0 0
like a little
0.0% 44.4% 0.0% 0.0%
3 2 0 0
like alot
100.0% 11.1% 0.0% 0.0%