The National Ribat University Faculty of Graduate Studies ...

The National Ribat University

Faculty of Graduate Studies & Scientific Research

Assessment of Nutrition Knowledge and Self–efficacy

of Male Athletes and their coaches At Sport Centers

in Khartoum State, Sudan

A dissertation Submitted in Partial Fulfillment of the

Requirements of the Degree of MSc in Human

Nutrition and Dietetics

By: Mohamed Siddig Abdelatef Rabeh

Supervised by: Dr. Siham Mohamed Osman Gritly

March 2018

بسم الله الرحمن الرحيم

الآية

:قوله تعالى

( اقْرَأْ وَرَبُّكَ 2( خَلَقَ الْْنِْسَانَ مِنْ عَلَقٍ )1الَّذِي خَلقََ ) اقْرَأْ باِسْمِ رَبِّكَ "

)" 5( عَلَّمَ الْْنِْسَانَ مَا لَمْ يَعْلَمْ )4( الَّذِي عَلَّمَ باِلْقَلَمِ )3الْْكَْرَمُ )

العلق{ سورة }

Dedication

I feel privileged to dedicate this work to the people in my

life, my late dad, Mr. Siddig Abdelatef

my lovely mother

Amalhasan Mohamed Alshayeb

my three brothers

Moataz

Maysam

Monzer

I thank them for all their support and encouragement

which saw me through in pursuing my dream to become

a Nutritionist

I also dedicate this dissertation to all the athletes,

coaches, trainers, and health professionals who are

passionate with knowledge.

Acknowledgments

I would first like to thank my god for the many blessings I have been given.

Without him none of this would be possible; He has guided every step I’ve taken,

every relationship I’ve formed, and every decision I’ve made. I have seen his

care in every opportunity He has given me. I stand in amazement of all He has

done and continues to do in my life.

I would also like to thank Dr. Siham Mohamed Osman Gritly for every

opportunity you have given me, especially the chance to be a part of this research

and to get to learn about something I am so passionate about. I cannot thank you

enough for your patience, encouragement, love, and support. You were there to

guide me and encourage me to have confidence in my abilities and my talents.

Also, thank you to Dr. Omer Mousi for serving on my thesis committee and

providing your guidance, expertise, and support.

I would like to thank my amazing sister Maysam for her continuous love,

support, encouragement, and listening ear. I seriously could not have done this

without you and everything you did to make this experience positive and as

smooth as possible. Also, thank you to my family, especially my parents, who

prayed for me, loved me, and supported me, reminding me every day that I am

blessed and can do anything I set my mind to.

Thank you also to everyone who worked extremely hard to make this research a

success, including the participants. I would also like to thank Mohamed Abdulah,

Hamdan Ali and Layal Hussein who were there from the beginning to encourage

me and were willing to do anything to help this research be successful. Your

friendship is appreciated more than you know. I’d especially like to thank Coach

Mahdi and Kamal and The National Ribat University and all sport centers that

participation in this study. Thank you!

Table of contents

Page Content

الآية 5

5 Dedication

5 Acknowledgments

5 Table of contents

5 List of tables

5 List of Figures

5 Abstract in English

5 Abstract in Arabic

1 Chapter one / Introduction

1 1.1Background

4 1.2 Statement of the problem

5 1.3 Justification

6 1.4 Objectives of the Study

7 Chapter two/ literature review

7 2.1 Introduction

7 2.2 The importance of nutrition for Athletes performance

8 2.3 Current sports nutrition guidelines for athletes

9 2.4 Sport Nutrition for Fitness, Bodybuilding, Body image

9 2.4.1 Sport Nutrition for Fitness

10 2.4.2 Sport Nutrition for Bodybuilding

10 2.4.3 Sport Nutrition for Body image

11 2.5 Nutritional supplements of Bodybuilding, Fitness, Body image

13 2.6 Sports nutrition recommendations for daily intake of Fitness,

Bodybuilding, Body image

14 2.6.1 Sports nutrition recommendations before, during or after exercise

15 2.7 Nutrition Influencing Factors and athletic performances

16 2.8 Nutrient intake behavior and athletic performances

18 2.9 Nutritional Knowledge and athletic performances

19 2.10 Nutrition Self-Efficacy and athletic performances

21 2.11 Importance of Sports Nutrition Departments

23 Chapter Three/ Methodology

23 3.1 Introduction

23 3.2 Research Design

23 3.3 Research Setting

24 3.3.1 The area of the study

24 3.4 The Study Population and Sample

26 3.5 Inclusion Criteria

26 3.6 Exclusion Criteria

26 3.7 Preliminary Study

26 3.8 Data Collection Techniques

27 3.8.1 Primary data and information

27 3.8.2 Interview questionnaire

28 3.8.2.1 Anthropometrics Measurements Techniques:

30 3.9 Statistical Analysis and Presentation

31 3.9 Limitation of the Study

31 3.10 Study Ethics

33 Chapter four/Results

33 Introduction

34 Section A

41 Section B

55 Chapter five/ Discussion

55 Introduction

66 Conclusions

67 Recommendations

69 Chapter Six/ References

84 Appendix

List of Tables

Page Table

34 Table (1): The Demographic Characteristics of Coaches

37 Table (2): Sources of Nutrition Information and Knowledge among

coaches

39 Table (3): Information on Supplements and counseling among coaches

40 Table (4): Nutrition Self Efficacy among coaches

41 Table (5): Demographic Information of Athletes

43 Table (6): Classification of BMI and Waist circumference among

Athletes

44 Table (7): Classification of BMI and Body Fat Percentage among

Athletes

45 Table (8): Access of Nutrition Counseling and Information among

Athletes

47 Table (9): Information on using Nutrition Supplementations and

Importance of Sport Nutritionist and Coach among Athletes

49 Table (10): Macro and Micro Nutrients Knowledge among athletes

52 Table (11): Macro and Micro Supplements Knowledge among athletes

54 Table (12): Nutrition Self Efficacy among Athletes

List of Figures

Page Table

35 Figure (1): The Sample Size of Coaches

35 Figure (2): Age of Coaches

36 Figure (3): The Sport Centers that are Included

42 Figure (4): Age of Athletes

List of Abbreviations

Full statement Abbreviation

Adequate Intake AI

American College of Sports Medicine ACSM

American Dietetic Association ADA

Body Mass Index BMI

Cardiovascular Diseases CVD

Certified Specialist in Sports Dietetics CSSD

Dietitians of Canada DC

Gastro-Intestinal GI

Gymnasium GYM

General Nutritional Knowledge Questionnaire GNKQ

International Olympic Committee IOC

National Collegiate Athletic Association NCAA

Registered Dietitian Nutritionist RDN

Registered Dietitian RD

Statistical Package for Social Sciences SPSS

Target Group Index TGI

United Sates Department of Agriculture USDA

Waist Hip Rate WHR

Waist Circumference WC

World Health Organization WHO

Abstract

Background Little data has been collected on the nutrition

knowledge and self efficacy of athletes and their coaches, and if Sports

Nutrition Departments at sport centers do positively affect on them. In

Sudan. The Objectives was to assess the nutrition knowledge and self-

efficacy among athletes and their caches as well as to evaluate nutritional

status of athletes. Methods It is a descriptive analytical and cross-sectional

study. Setting Participants completed a survey in person at their respective

nine sport centers, two with a sports nutrition department, and seven

without it. Participants Male athletes and their coaches, participating in

men’s (fitness, body builders and body image). The results Indicated a low

availability of registered dietician at the sport centers/ gyms in Khartoum

locality. Half of coaches at sport centers with registered dietitian got their

nutrition information from registered dietitian and had more self-efficacy

in making nutrition decisions, while coaches from sport centers without a

registered dietitian (47.6%) got their nutrition information from Internet.

Majority of the athletes in sport centers with RD were obese when using

BMI, but when using waist circumference and body fat percentage were

found within the normal range.

Conclusions The athletes and their coaches from the sport centers with

registered dietitian more often sought out nutrition information, saw more

importance in seeking out nutrition information, were more knowledgeable

about nutrition, and were more confident in making certain nutrition

decisions. Each sport center should have, a full time sports registered

dietitian.

ملخص الدراسة

القليل من البيانات جمعت بخصوص المعرفة الغذائية والفعالية الذاتية للرياضيين الخلفية

تقييمهداف ألأومدربيهم, وإذا كان قسم التغذية الرياضية يؤثر بصورة ايجابية عليها. في السودان .

نياضييالر المعرفة الغذائية والفعالية الذاتية للرياضيين ومدربيهم, وكذالك تقييم حالة التغذية في

كل من المشاركين أكمل الدراسة في تسع من المكان دراسة وصفية تحليلية عرضية. الطرق

مراكزهم الرياضية الخاصة, اثنان من المراكز لديها قسم تغذية للرياضيين, وسبع لا تمتلك قسم

الرياضيين الرجال ومدربيهم المشاركين في )اللياقة البدنية, بناء المشاركينالرياضيين. ةلتغذي

تشير إلي توفر القليل من أخصائي التغذية المسجلين في المراكز النتائجالأجسام وصورة الجسم(.

الرياضية في محلية الخرطوم. نصف المدربين في المراكز الرياضية التي تمتلك أخصائي التغذية

م الغذائية من أخصائي التغذية المسجل ولديهم فعالية ذاتية اكبر في اتخاذ يحصلون علي معلوماته

( 4..6القرارات الغذائية . بينما المدربين من المراكز الرياضية التي لا تمتلك أخصائي التغذية )%

يحصلون علي معلوماتهم الغذائية من الانترنت. معظم الرياضيين في المراكز الرياضية التي تمتلك

ي تغذية نجد أنهم يعانون من السمنة عند استخدامنا لمقياس مؤشر كتلة الجسم لكن عند أخصائ

لمقياسي محيط الخصر والنسبة المئوية لدهون الجسم نجد أنهم ضمن المدى الطبيعي. ااستخدامن

غالبا أكثر الرياضيين ومدربيهم من المراكز الرياضية التي لديها أخصائي تغذية مسجل الخاتمة

بحثا و اهتمام بخصوص المعلومات الغذائية و بالتالي أكثر معرفة عن التغذية وثقة في اتخاذ

قرارات غذائية معينة. يجب علي كل مركز رياضي إن يمتلك أخصائي تغذية رياضي مسجل بدوام

كامل.

Chapter One

1. Introduction

1.1 Background:

Sudan is considered one of developing countries where sport nutrition and

nutrition knowledge of athletes and their coaches and concept of sport dieticians and

nutritionists have been recently introduced, but in modern times the most popular sports

in this region of world is football as well as athletics track and field to be specific (1).

Other sports that are growing in popularity include basketball, handball, volleyball and

swimming, presently there is a wide range of sporting activities and facilities available

throughout the country (1). In Sudan the Ministry of Youth and Sports represents the

executive and legislative authority for each young athletes considering that youth are

corresponded to 40% of the state’s population (2008).

There are two sectors within the Ministry of Youth and Sports: the sport sector,

concerning: the sport federations, sport clubs, playgrounds and stadiums, football

subsidiary unions, volleyball local federations, squares and fields… etc. The second

one is the youth sector which involves the youth centers and organizations (2). In regard

to athletes, there are about 12 public centers and 120 private centers having athletes

activity the plan of the Ministry of Youth and Sports has affirmed the importance of

support to the sports activities and contribution of the youths to the social development,

peace, unity and national accord (2).

However, athletes have a unique set of nutritional needs to balance the needs for

growth and development and to optimize their performance, a large number of athletes

have little nutrition knowledge and believe that a normal diet will not be sufficient (3).

All information on sports nutrition and dietary practices would be important to help

formulate guidelines and support athletes in endeavoring towards improvement and

sustenance of good performance. The information will also help to foster the mission

of the ‘Ministry of Sports and Youth Affairs’ to empower and maximize full potential

of the youth by providing accurate information on sports and nutrition (3).

The Academy of Nutrition and Dietetics, Dietitians of Canada and the American

College of Sports Medicine, believe that “physical activity, athletic performance and

recovery from exercise are enhanced by optimal nutrition” (4). Implementing a nutrition

education program among athletes could improve nutrition knowledge and therefore

could improve the diet of these athletes, with an improved diet, these athletes will see

an improvement in perceived athletic performance. It is generally believed that

adequate nutrition is vital to overall health, peak performance, and recovery from

physical activity (4).

The joint position paper of the American College of Sports Medicine, Academy

of Nutrition and Dietetics, (formerly known as the American Dietetic Association) and

Dietitians of Canada (2009) recommended: “…appropriate selection of foods and

fluids, timing of intake, and supplement choices for optimal health and exercise

performance (5).

Furthermore International Society of Sports Nutrition suggests the first aspect of

maximizing performance and training through nutrition is to be sure athletes are

consuming enough calories to offset the amount of calories they are expending on a

daily basis (6). International Olympic Committee (IOC), the 2010 IOC Consensus Stated

that “Diet significantly influences athletic performance. A diet that provides adequate

energy from a wide range of commonly available foods can meet the carbohydrate, fat,

and, micronutrient requirements of training and competition (7). A key objective

identified in the global strategy on diet, physical activity and health was the increased

awareness and understanding of the role diet plays in personal health and physical

activity (8).

Sports nutrition refers to the specialized branch of nutrition that studies food with

significance to athletic performance. The importance of Sports Nutrition lies in the fact

that it has short-term and long-term effects on: body composition, metabolism, and

eventually the performance abilities of athletes. Also imperative in highlighting all the

following three areas: pre-training nutrition, nutrition during the event, and post-event

nutrition (9). Nutrition knowledge can be defined as the individual cognitive process

regarding diet, food and nutrition information (10). Short et al stated that: "There is no

area of nutrition where faddism, misconceptions and ignorance are more obvious than

in athletics." (11).

Nutrition knowledge likely leads to better nutrient intake decisions, and can

ultimately assist in optimizing athletic performance. The more an athlete knows, the

better informed decisions they can make, and the more ownership they have over their

diet and consequently athletic performance. It is important to keep athletes informed

and help them understand how nutrition plays a role in their performance and how to

make the most of their intake behaviors (12). Nutrition Knowledge can be delivered by

different providers including: coaches, athletic trainers, sport dieticians, nutritionists,

sport scientists, and medical practitioners. Athletes also obtain information from other

sources; such as: school or tertiary-education programs, books, sport-specific

magazines, the mass media, and, increasingly, the Internet. The problem often lies in

where athletes are receiving their nutrition knowledge (13,14,15).

Nutrition self-efficacy has been shown to be a significant predictor of physical,

social and self-evaluative outcome expectancies regarding healthy nutrition. Dieting,

weight control, and preventive nutrition can be governed by nutrition self-efficacy

beliefs. It has been found that nutrition self-efficacy operates best in concert with

general changes in lifestyle, including physical exercise and provision of social support

(16). The end result being improved athletic performance and recovery from training and

competitions, improved focus and cognitive performance, improved resistance to

injury, and better overall health and well-being (17,18).

1.2 Statement of the Problem:

Sport nutrition and performance in relation to knowledge and self-efficiency had

received little attention in Sudan, nutrition knowledge among athletes and coaches

becomes vital, despite improvements, athletes across the country remain unaware of the

effect their diets may have on present and future health and performance. Few studies

identify the nutrition knowledge and self–efficacy of athletes and coaches, despite the

growth of scientific knowledge, athletes’ diets often do not meet recommendations

from researchers and sporting organizations (19). While intercollegiate student-athletes

may be aware of the benefits of maintaining proper nutrition (e.g., consuming proper

amounts of carbohydrates to optimize training), their actions often prove otherwise

(20,19,21).

The researcher has selected this area of nutrition due to the reasons that;- Its

unique features, including demographic factors, socio-economic settings and type of

sport. It is economically, politically and culturally important to all of Sudan. Also he

attracted to this area of nutrition because many friends indented sport centers ask him

about nutrition and when he go to many different sport center found almost of centers

don’t have a sport nutritionist or registered dietitian to help athletes to achieve their

goals, when he sit with athletes, coaches and responsible people found there is poor

food choices and a lack of nutrition knowledge that where lead to negatively impact on

performance and health of athletes. Thus, there is gap between nutrition knowledge and

eating behavior exists in athletes (including their coaches).

However the scarcity of studies and lack of information on the area of sports

nutrition in Sudan lead to a great need to carry out in-depth studies including qualitative

and quantitative information to assess the nutrition knowledge and self–efficacy of

athletes and their coaches at deferent sport center in Khartoum state, Sudan. To identify

where deficits in nutrition is knowledge and self –efficacy of this target group. This

research will hopefully provide useful information to assist in future baseline

information for future research and planning. It will also draw the necessary attention

of the assigned bodies working in the fields of health and nutrition to help athletes meet

their unique set of nutritional needs to balance the needs for growth and development,

and to optimize their performance. Furthermore alleviate and reduce the problems

facing athletes by identifying the area of deficits in nutrition knowledge and self –

efficacy and to make the most appropriate intervention.

1.3 Justification:

Over the past half century, the proliferation of scientific knowledge related to

nutrition and its effects on athletic performance has been dramatic. A simple PubMed

search using sport nutrition terminology illustrates the prolific increase in publications.

For example, annual articles published on sport carbohydrate and sport protein

increased from 20 to 477 and 26 to 1426, respectively, from 1969 to 2014. This

expanding body of research has contributed, in part, to an increased focus on nutrition

as a means to augment athletic performance (22).

1.4 Objectives of the Study:

1.4.1 General Objective:

To assess nutrition knowledge and self-efficacy of male athletes and their

coaches at sport centers in Khartoum state. Sudan.

1.4.2 Specific Objective:

1. To assess deficits in the nutrition knowledge of athletes participating in men’s

(fitness, body builders and body image) and their coaches at different sport centers in

Khartoum state.

2. To identify general trends in self-efficacy of athletes participating in men’s (fitness,

body builders and body image) and their coach at different sport centers in Khartoum

state.

3. To evaluate nutritional status of athletes participating in men’s (fitness, body

builders and body image) at different sport centers in Khartoum state by using

anthropometric techniques.

4. To help formulate guidelines and support athletes in endeavoring towards

improvement and sustenance of good health and performance.

Chapter Two

2. Literature Review

2.1 Introduction:

Athletes differ from the general population in being considerably more physically

active and by other lifestyle characteristics including intensive training routines and

periodization (23). According to renowned Sports Nutritionist, Nancy Clark and her

Sports Nutrition Guidebook, eating for every day active people must be different than

those who are more sedentary (24). Hence, adequate intake (AI) of energy and nutrients

is of great importance for this population to ensure optimal performance, adaptation

and recovery during training or competition, and also to minimize health risks (25,17).

Aside from heredity and training, it has been acknowledged that no single factor plays

a greater role in optimizing performance than diet (26).

Young athletes have more nutritional needs because of physical activity and

physical development. Optimal athletic performance results from a combination of

factors including training, body composition, and nutrition (27). The Dietitians of

Canada, the Academy of Nutrition and Dietetics and the American College of Sports

Medicine highlight that nutrition plans must be individualized for athletes to account

for their own specific goals and uniqueness of the event, performance goals, practical

challenges, food preferences and responses to what works and ultimately what does not

(28).

2.2 The Importance of Nutrition for Athletes Performance:

The explosion of research interest in nutrition and physical activity (sports

nutrition) over the past two decades is still predicated on the desire to advance health

and work performance. Together with a well planned diet, physical exercises corrects

the energy balance in favor of increased energy output (29). In recent years, there has

been an increasing interest in nutrition as it relates to athletic performance. It is believed

by many that athletes' diets provide an adequate nutrient content simply because of the

greater amount of food consumed. However, there is no evidence that athletes select

healthier diets than less active people (11).

Nutrition plays an important role for attaining high level of achievement in sports

and athletics. Physical fitness and training are very much depended on nutritional status

of sports personnel. Diet significantly influences the performance of athletes (30). This

is not only important to help to improve performance but also to promote healthy

dietary practices in the long term (31). Nutrition and the benefits it can provide, fall

somewhere right in the middle (28).

There is evidence to support the fact that an increase in energy (calories) is

important for maintaining a balance and appropriate consumption of the right protein

sources can have a profound impact on muscle recovery, stimulation and synthesis and

that caffeine may have a positive stimulus effect on sustaining endurance (32). Current

evidence supports the idea that nutrients such as protein, calcium, and iron can have

significant positive impacts on performance (32).

2.3 Current sports nutrition guidelines for athletes

Nutritional interest in special populations is the very basis of modern dietary

guidelines and nutrient standards. Adequate energy should derive from a variety of

foods that provide carbohydrates, proteins, fat and micronutrients (33). In order to

maintain a balance and modification the standard dietary guidelines of incorporating

the micronutrients in fruits and vegetables must not be forgotten (34). These Guidelines

and recommendations consist of a mix of practical experiences and expertise, data from

observational studies, physiological knowledge and experimental data from laboratory

studies and, if available, intervention studies (35).

In 2011, the United Sates Department of Agriculture (USDA) introduced a new

food guide for the American population, using a circle to characterize a plate of food

and government offers updated nutrition recommendations every five years (36). Sports

nutrition guidelines can be seen as a valuable addition. These guidelines focus on

quantity, structure and timing of food intake of single nutrients and also include advice

for types or categories of exercise, i.e. for endurance, team and strength sports (37).

Led by Dietitians of Canada, the Academy of Nutrition and Dietetics and the

American College of Sports Medicine these guidelines and research continue to

improve and expand in this area of health but there is room for growth for the athletes’

overall understanding and implementation of these guidelines (28).

2.4 Sport Nutrition for Fitness, Bodybuilding, Body image:

2.4.1 Sport Nutrition for Fitness:

Fitness is more important for health than is fatness many athletes who are now

responsible for their own nutritional health may lack the knowledge to maintain a

healthy lifestyle. Lifestyle and dietary factors determine health status. Although some

weight is desirable (muscle weight), some is less desirable (fat weight) (38). Measuring

body fat rather than rely on scales of height and weight charts can offer a helpful

perspective about where a person is in the scheme of fatness. Body-fat measurement

allows you to quantify loss of body fat or gain of muscle as you embark on your diet

and exercise program (39). Keep in mind, no one best percentage of body fat exists for

athletes. The best percentage is the one that allows you to feel good, perform well, and

eat appropriately (39).

Exercise and physical activity is better used as a tool to prevent weight gain,

maintain weight loss, and improve health and research shows that adolescents

frequently relate fitness to appearance and to “looking good” (40) . Low physical activity

among athletes is related to unbeneficial changes in dietary-related factors such as BMI,

waist to hip ratio (WHR) or waist circumference (WC) that may be useful in identifying

athletes at risk of suffering from cardiovascular diseases (CVD) at a later stage (40). In

2015, researchers found that people who exercise for functional reasons, in order to be

fit, tend to have a more positive body image. Those who exercise to improve their

appearance feel less positive about their bodies (41).

2.4.2 Sport Nutrition for Bodybuilding

Bodybuilding is a sport aimed at increasing muscle mass and decreasing body fat

percentage. These changes in body composition occur due to an association of

resistance and aerobic training with a strict nutritional diet (42). Total energy and

macronutrient intakes of strength-power athletes are generally high but intakes tend to

be unremarkable when expressed relative to body mass (43). To optimization of dietary

intake to achieve nutrition-related goals would be achieved from assessment of nutrient

distribution over the day, especially intake before, during, and after exercise (44).

Adequate energy should be obtained from a wide variety of available foods to provide

adequate carbohydrates, proteins, fat and micronutrients (45).

Bodybuilding is usually planned in two phases: The preparatory phase usually

consists of combining resistance training with a high caloric and protein intake, with

the purpose of increasing muscle mass. The pre-competitive phase is mainly

characterized by an increased volume of aerobic exercise, caloric restriction and

dehydration in order to potentiate muscle definition (46).

Nutrient targets include eating about 0.7 to 1.0 gram of protein

per pound of body weight (1.4 to 2. g/kg), about 2 to 3 grams of carbohydrate per pound

of body weight (4. to 6. g/kg), and 15 to 20 percent of calories from fat(47).Eating three

to six meals per day with a meal containing 0.4-0.5 g/kg bodyweight of protein prior

and subsequent to resistance training likely maximizes any theoretical benefits of

nutrient timing and frequency (48).

2.4.3 Sport Nutrition for Body Image

Body image refers to one’s perceptions and feelings about the body and the

related actions to obtain that perception (49). Because adolescence is a period

characterized by great emotional, social, and physical change, body image disturbance

is among the most widespread disorders associated with the onset of adolescence (49).

Data from many countries show positive changes in nutritional habits of adolescents

(50). However, high consumption of animal fat, meat and food rich in sugar is also

observed (51,52). Physical activity is one of the environmental factors that contribute to

overweight and obesity because level of physical activity has an impact on energy

balance (53).

The best way to gain or lose weight is to seek professional advice that is tailored

to your lifestyle and food preferences. The advice to meet with a registered dietitian

(RD) or registered dietitian nutritionist (RDN), preferably one who is a board-certified

specialist in sports dietetics (CSSD)(38). Anthropometric parameters provide a lot of

information about body composition and nutritional status, regardless of the fact

whether they relate to obesity or malnutrition. The male ideal is a (V) shaped figure

with emphasis placed on large biceps, chest, and shoulders (38).

To gain 1 pound (0.5 kg) of body weight per week, consume an additional 500

calories per day above your typical intake (39). Weight loss is far more complex than the

simple recommendation to “just eat less and exercise more.” Both serious athletes and

fitness exercisers struggle to either lose weight or keep off the weight they have lost.

To lose weight eat 500 fewer calories per day below your typical intake (39).

2.5 Nutritional Supplements For Fitness Bodybuilding and

Body image:

Nutritional supplements are food components, for example protein, and not foods,

or pharmaceutical preparations, for example vitamins and minerals capsule or tablet,

supplying one or more nutrients in a concentrated form including proteins, minerals,

vitamins, trace elements, and other components that are theoretically present in a

normal and balanced diet (54). Nutritional supplements can be classified as dietary

supplements, sport nutrition products and ergogenic supplements (55). Nutritional

supplements are frequently used by athletes, although use can be irregular and varying

over time for sports purpose (56).

There is enough evidence that physically active people do not require additional

nutrients apart from those obtained from a balanced diet (57). The American Dietetic

Association, the Dietitians of Canada, and the American College of Sports Medicine

stated that only those persons who restrict their energy intake, use severe weight-loss

practices, eliminate one or more food groups from their diets or consume high

carbohydrate diets with low micronutrient density may require dietary supplementation

(58). Also the International Society of Sports Nutrition recommends obtaining protein

from whole foods before supplementation is explored. Guidance is important for an

athlete, especially regarding protein, so they are first meeting their protein needs

through food, not consuming it in excess amounts, and so they are consuming enough

to meet the demands of increasing muscle mass (59).

Supplements use among athletes is well documented in one study it was

estimated to range from 40 to as high as 88% and was found to vary according to types

of sports, cultural aspects, age groups, and gender (60). However, the exact benefits of

nutritional supplements are still not well established and various potential risks were

described when using nutritional supplements in high doses or without medical

supervision (59). In contrast to what is sometimes believed by the public, there is

common scientific consensus that “more” does not mean “better” (61).

Internationally, the prevalence of supplement usage among athletes has been

estimated at 37% to 89%, with greater frequencies among elite and old athletes (28).

Also supplement use is more common in strength and power sports in particular.

According to TGI (Target Group Index, 2012 Product Book) survey, supplement use

differs between countries. The lowest use appears in Thailand (3%), Argentina (8%)

and Spain (9%), while there is a moderate use in France (28%), Germany (32%),Great

Britain (34%) and Russia (38%), and the highest use is in USA (56%), Serbia (56%)

and Denmark (72%) (62).

In cross-sectional study, 512 exercisers, aged between 20 and 50 years, were

randomly selected from gyms. The intake of nutritional supplements was reported

among 36.3% of participants, with a weak presence of medical supervision. A meta-

analysis of 51 studies on supplements, that involves more than 10,000 athletes at all

levels and covers 15 sports, found that the mean prevalence of supplement use among

all subjects was 46%, with a large variance between individual sports which ranged

from 6% to 100% (63).

2.6 Sports nutrition recommendations for daily intake of

Fitness, Bodybuilding and Body image:

The American College of Sports Medicine, the American Dietetic Association,

and Dietitians of Canada have put forth carbohydrate, fat, and protein recommendations

for athletes. It is important to note that the following recommendations should be

specialized for each athlete and this can be done by a Sports Registered Dietitian(64).

Maintaining a balanced and varied diet is also vital for an athlete; they should follow

My-Pyramid (My-Plate) recommendations and be sure to consume enough fruits and

vegetables along with meats and grains. Total energy intake is an important aspect of

nutrition for athletes, but unfortunately this concept is often misunderstood (65).

The main focus is on carbohydrate and protein intake in relation to sport nutrition

recommendations (66). Current recommendations for carbohydrate and protein intake

for athletes do show a considerable degree of variation (67), with carbohydrate intake

recommendations ranging from 3 to12 g/kg/bw per day, and protein recommendations

from 1.2 to 2.0 g/kg/bw.5, 6 (consumed as 3-4 equally divided protein-rich meals,) to

optimize muscle protein synthesis or to prevent lean mass losses (68). The fat

requirements of athletes are similar or somewhat higher than those recommended for

the general population. Fat is a necessary component of a healthy diet, providing

energy, essential elements of cell membranes and other biochemical processes, and

facilitating the absorption of fat soluble vitamins (45).

Macronutrients are most often the focus of diets but micronutrients, vitamins and

minerals, are also an important aspect of an athlete’s diet. Vitamins and minerals are

needed to ensure optimal body functions (61). In relation to exercise, it is sometimes

suggested that micronutrients are performance enhancing. Micronutrients in general are

vital in the repair of muscle tissue during recovery, which is especially important for

athletes (64).

Good hydration status is seen as desirable with normal plasma electrolyte levels

based on the consumption of normal meals and standard fluid intake (69). Fluid intake is

vital as optimal hydration reduces the risk of heat injuries that are potentially life-

threatening (58). When an athlete sweats they lose valuable fluids, which include

electrolytes that are needed in order to maintain performance, exercising, evaporation

of sweat is the body’s way of regulating core temperature (70).

2.7 Sports Nutrition Recommendations Before, During or

After Exercise:

Nutrient timing has been identified as a very important aspect of proper nutrition

to optimizing performance, training adaptations, and preventing overtraining (71). The

general recommendations, as made by the International Society of Sports Nutrition

include; pre-exercise meals 4-6 hours before exercise, a light snack (high in protein and

carbohydrate and low in fat) 30- 60 minutes prior to exercise, snacks high in

carbohydrates every 15-20 minutes during performance lasting longer than an hour

(usually a carbohydrate/electrolyte solution) and a snack high in carbohydrate and

protein within 30 minutes after exercise (58).

An advice to take food shortly before exercise is mainly given to pre-fuel the

athlete, but should not lead to gastro-intestinal (GI) complaints during exercise (72).

Some athletes, despite following these recommendations experience GI complaints (73).

Regular carbohydrate intake is essential for physically active individuals and should be

timed according to training sessions to ensure optimal pre-, during, and post-workout

nutrition (45), especially during exercise lasting longer than 45 minutes. The

recommendations for fluid intake range from 150-350 ml per 15 minutes and for

carbohydrate intake from 30-90 grams per hour (69). After exercise, the nutritional goal

is to replace any fluid electrolyte deficit lost during exercise and to promote glycogen

syntheses and muscle protein syntheses for recovery and adaptation (68). The combined

intake of an insufficient amount of carbohydrate and 10-20 grams of protein can

enhance muscle glycogen by optimizing efficiency of carbohydrate uptake and

therefore results in both muscle protein syntheses as muscle glycogen recovery (74).

National Athletic Trainer’s Association stated that, athletes should properly

hydrate before, during, and after exercise in order for the body’s temperature to remain

regulated and to avoid heat illness. Proper hydration can also help to reduce fatigue

during athletic performance (75). The general recommendation is to consume sports

drinks when exercise or performance lasts longer than 60 minutes, and water for

performance lasting less than 60 minutes. Sports drinks, with a 6-8% carbohydrate

solution (608 grams per 100 mL) are also a good source of carbohydrates for the body

during prolonged exercise (76).

2.8 Nutrition Influencing Factors and athletic Performances:

There are many factors that influence health status and greatly impact everyday

life. One of the most modifiable and controllable areas is diet and nutrition, therefore

fueling the body and profoundly impacting how an individual functions physically,

mentally and even socially (77). Athletes are a sub-population that are particularly

affected by poor nutrition which can have a substantial impact on both their health and

physical performance. An evaluation of how actual food choices are made by athletes

and those things that influence their decisions play a key role in how they fuel their

bodies, where they obtain their nutritional information and personal perceptions as

athletes (28).

It is estimated that individuals make 220 food choices each and every day,

nutritional choices determine and greatly affect health status and performance (78). As

Ono et al (2012) point out, food choice and perception is not traditional nutritional

science instead it is more anthropology, sociology or physiology (79). Two qualitative

surveys looking specifically at collegiate football players highlighted the fact that not

only is time essential, and often what your meals are structured around but it is also part

of establishing a routine (80,81).

The relation between healthy eating and weight management is a problem that

relates back to the risk factors of disordered eating for athletes. Buckton et al (2015)

highlight, healthy eating can be confused with diet and weight management. The

choices are impacted by a substantial amount of internal and external factors

highlighted by physiological factors such as hunger, food and taste preferences and

gastronomical discomfort (82).

Lifestyle and knowledge factors also play a role in decision making of both

nutritional and sport decisions. As highlighted by Birkenhead et al (2015) stated that:

“Motives for participating in sport may influence the importance placed on food choice

as personal goals may differ from an athlete with physique goals to another who enjoys

the freedom of eating whatever they desire…motivation to participate in sport may be

based on a lifestyle choice that influences food choice’ (82). One of the few studies that

actually examines the perceptions associated with nutrition for college athletes focused

on the concept of psychological factors. As Adams et al (2015) highlighted, gender

differences of dietary behaviors occur, influencing nutrition: found that males have a

positive perception of performance enhancement directly associated with supplement

utilization (83).

Athletic trainers and coaches have the significant ability to influence decisions.

Based on multiple studies, it is evident that coaches, strength and conditioning coaches

and athletic trainers serve as a primary source of nutrition information for athletes. Yet,

there is a gap in knowledge of these sources that is being provided (81). Collegiate

athletes are expected to perform at a high competitive level and research supports a

relationship between the dietary practices and behaviors of collegiate athletes and their

health and competitiveness (84).

2.9 Nutrient intake behavior and athletic performances:

Understanding nutritional influencing factors, nutritional knowledge, lifestyle

and psychological factors are essential for this population and to understand how each

of these components actually impacts their behavior. Morse et al stated (2009), athletes

are largely unaware of their nutrition needs, the importance of meeting these needs, and

also how to meet these needs. This is a problem which needs to be addressed (85).

Hinton et al (2002) stated that, diets of athletes are generally low in carbohydrate

and protein and high in fat when compared to recommendations, it was also found that

males have a higher intake of fat than females and that they also consume less than

recommended total energy (86). In a study looking at behavioral intentions, Karpinski et

al (2016), use the Theory of Planned Behavior to help identify barriers to healthful

eating, the authors tested this theory among Division II athletes examining male

student-athletes intentions of eating healthy and found that behaviors had the greatest

influence yet further exploration of behaviors around nutrition were needed (87).

The data suggests that there are some significant issues regarding athlete’s intake

behaviors and there is room for improvement and also intervention. Additional studies

must be done to further the understanding of nutrient intake behaviors of college

athletes (88). One study done with NCAA football players identified time, specifically

academic and athletic schedules, and finances as the main factors affecting their nutrient

intake behaviors (84). The football players in same study discussed often buying based

on cost rather than on nutrient content. Based on their findings, the researchers

suggested athletes would benefit from education on what they should be eating and also

how to make this fit into busy schedule and tight finances (84).

Based on the literature, the focus on macronutrient intake can differ slightly

between training and competition. Slater et al (2011) found that, knowledge on energy

balance increased when individuals had more access to healthier food choices and

beverages. Also found mean cholesterol, fat, and protein intakes were above the

nutritional recommendations for most athletes’ while carbohydrate intake was low.

Mean fiber within recommended levels (89). Some recent studies mention athletes

meeting these recommendations. For example, Ono et al (2012), describe soccer players

with a mean CHO intake >7 g/kg·bw, (79) and Carlsohnet al (2012), describe a mean

intake of between 7.8 and 9.0 g/kg·bw by triathlon athletes (90).

Some studies report that many athletes would not meet micronutrient

recommendations, whereas others conclude the opposite (91). In cases of low energy

intake, such as are common in some athletes, micronutrient inadequacies can be

found(92). When vitamin and mineral intake is inadequate, not only will effectiveness of

recovery be reduced, but exercise capacity may also be reduced, making the athlete less

effective in both practice and game situation (64). One study found the Mean calcium

intake was found the highest in males involved with weight-related sports, however,

non-sport involved males did not meet the recommendations for calcium. Participating

in sports shows improved eating behaviors; however, nutrient intakes still did not meet

recommendation levels (93).

2.10 Nutritional Knowledge and athletic performances:

Interest in nutrition is a predictor of nutrition knowledge, as adults with an interest

in the topic will try to gather information in this area, with the degree of nutritional

knowledge tied not only to health outcomes, but also to health and nutritional literacy

(94). Individuals with high nutritional knowledge are likely to intend to make healthy

choices, however good intentions are different to behaviours (95).

Since nutrition is not the primary focus of the athletic staff and many do not

possess accurate knowledge, access to a professionally trained nutrition expert such as

a registered dietitian (RD) may be warranted (96). Diets of athletes are less than optimal

in certain areas such as low energy, carbohydrate, and micronutrient intake and high fat

intake, often due to a lack of knowledge and they often do not understand the benefits

of maintaining a healthy diet (97). An increased interest and availability of nutritional

information seems to be on the rise, but it is unclear if athletes are more knowledgeable

about the role of nutrition on athletic performance. Professionals can help athletes

recognize the role of nutrition in sports and help them choose the most appropriate

foods and fluids to attain peak performance (98).

It has been suggested that dietary regimes to support physical achievement and

athletic excellence require a level of nutrition knowledge and practice that may not be

present among the athletes, coaches or trainers (99). A variety of studies ranging from

1981-2002 were found that supported this point yet the literature around current data

was limited.

Athletes obtain their nutritional knowledge, their personal nutritional habits,

internal and external influence factors all play a critical role in baseline nutritional

knowledge and ultimately how the nutritional impact on performance is perceived.

Coaches and athletic trainers often assume responsibility for controlling and guiding

the dietary practices of athletes. They rarely have formal training in nutrition and

probably do not have the time or expertise needed to stay well-informed of

developments in nutrition (100). As Birkenhead et al (2015) summarizes “...beliefs about

nutrition and level of knowledge may determine the importance placed on food choices

as influenced by the athlete’s understanding of the role of nutrition on health and sport

performance.” For example, non-celiac athletes adopt the gluten free diet for perceived

health benefits even though there is no evidence based research to support this (78).

Other study which focused on tri-athletes used the General Nutritional

Knowledge Questionnaire (GNKQ) to identify there is a gap and also highlighted that

there are limited studies on knowledge (101). Because information delivery is still

derived from a variety of areas, it leads to an incredible gap in knowledge of nutrition

for the athletes (102).

Interestingly, Froiland et al (2004)found that athletes seldom seek information

from more informed sources, such as registered dietitians, strength coaches, athletic

trainers, or physicians, which can leave the competitive athlete vulnerable to

misinformation and inappropriate recommendations (103). One qualitative study using

focus groups of elite Australian athletes identified that the major challenge for eating

well came from applying (rather than possessing) nutrition knowledge (104).

2.11 Nutrition Self-Efficacy and athletic performances:

Self-efficacy is the belief in one’s capabilities to learn or perform motor skills to

obtain a certain outcome (105). Knowledge, attitudes and behaviours all influence, and

are influenced by, self-efficacy, with those demonstrating high levels of nutrition self-

efficacy more positive toward making healthy food choices and more able to employ

strategies which regulate their diet and lead to adequate nutritional balance (105).

Improvement in self-efficacy in relation to nutrition is important because having self-

efficacy toward nutrition means that an individual believes in both the influence that

nutrition has on a person, as well as the ability and attitude of an individual to apply

learned nutrition-related practices (106).

An example of improved self-efficacy leading to improved behaviour is the

development of skills in relation to reading food labels and grocery shopping; with

those with high levels of self-efficacy tending to attempt to use multiple levels of

information to inform purchasing behaviours (107). Similarly, increasing a person’s

nutrition self-efficacy has been shown to elicit positive results in health behaviors (108).

Self-efficacy was a predictor of nutrition behavior among shoppers. An example

of scale development is the following: have developed a self-efficacy measure for

eating low-fat diets in low-income women (109). Results of the treatment intervention

showed that the experimental group demonstrated significantly improved nutrition

knowledge, self-efficacy, and an increase in the overall number of positive dietary

changes and suggests that self-efficacy may impact attitudes in a positive way (110).

The measurement of this kind of self-efficacy aims at statements that include

control over the temptation to eat too much or to choose the wrong foods. Items can

include particular foods, such as “I am certain that I can eat five portions of fruits and

vegetables per day,” or can refer to self-regulatory efforts (111). Self-efficacy beliefs are

a vital part of motivation in youth sport and physical activity because they influence

task choice, effort, persistence, and resilience (112). A study using an objective measure

of nutrition behavior, namely grocery receipts, demonstrated that the effect of dietary

fiber self-efficacy on fat, fiber, fruit and vegetable intake was mediated by physical

outcome expectations. Nutrition goal setting was linked to higher dietary fiber self-

efficacy and actual fiber intake (113).

In a similar study, self-efficacy to eat more fruit and vegetables as well as

outcome expectancies in terms of fruit and vegetable intake predicted a 24-hour recall

of actual fruit and vegetable intake. Additionally, these fruit- and vegetable-specific

predictors were inversely related to an unhealthy diet, that is, high-fat cooking (114).

Other study say, where the authors emphasized self-efficacy as an integral component

of social cognitive theory, and efforts were made to increase nutrition related self-

efficacy through nutrition education as an intervention (115).

Quatromoni (2008), emphasized the role of a sports dietitian/nutrition consulting

service as being an integral part of a multidisciplinary health team to screen and assess

athletes, provide nutrition counseling and education, and enable athletes to build self-

efficacy towards healthful eating habits (116).

2.12 Importance of Sports Nutrition Departments

Sports Nutrition departments at Universities and sport centers are becoming more

prevalent and proving to be an important aspect of an athlete’s experience and

performance at the college level and all level. In terms of prevalence of sport dietitians,

although access to nutrition providers may be limited, those that do have access may

not be fully utilizing these resources (117). The American College of Sports Medicine

(ACSM), the American Dietetic Association (ADA), and Dietitians of Canada (DC)

discuss the importance of Sports Dietitians and their responsibilities (64). When

following the recommendations set by these professional organizations, Sports

Dietitians can be a vital aspect of an athlete’s optimal performance and overall health

(64).

Athletes need the help of knowledgeable health professionals in sports nutrition

to educate them toward better nutrition practices, safely, intelligently and effectively, it

is important for a Sports Dietitian to be available to assist athletes in setting nutritional

and performance goals which focus on consuming a balanced and varied diet in order

to improve health and performance (118). Communication with athletes and athletic

departments to work toward improved nutrition practices is a vital role for registered

dietitians. Their contribution in the area of nutrition education and dietary counseling

is indispensable (119). A Sports Dietitian is also someone who can screen athletes for the

disease, and is someone who should be on the treatment team for an athlete who has

been diagnosed (120).

Although there have not been studies specifically examining the effects of a

Sports Nutrition program on college athletes and sport centers, studies examining

nutrient intake and nutrition knowledge have identified the importance of these types

of programs (64, 120, 119, 121, 122). A survey involving student-athletes from eight NCAA

Division I universities found that half of the universities (49.6%) had a registered

dietitian on staff, and about half (47.5%) provided access to individual counseling (123).

The results of one study indicate that individuals involved in sports tend to have a

better understanding of nutrition than non-sport-involved peers (124).

Like many other aspects of nutrition Sports Nutrition departments, is an area that

deserves additional evaluation and research to be done, and it is important to understand

how these specialized departments make a difference in the athletes life skills plan for

responsible for their own meal planning, knowledgeable about eating a balanced and

promote healthy dietary behaviors that resulting in optimal performance and overall

health (125). As the evidence-based research field of nutritional impact on performance

continues to grow, the area of Sports Dietetics is continuing to become more popular

and there is a demonstrated need (126).

However, effectively translating this knowledge to relevant stakeholders in sport

(e.g., coaches, instructors) exposes a new set of challenges. For example, recent

research has begun to question the methods and effectiveness of existing coaching

education programs (127,128). Other research contend that researchers must accommodate

the needs and preferences of their audience before the effectiveness of coaching

education programs can be expected to improve (129).

Chapter Three

Research Methodology

3.1 Introduction:

This chapter gives an outline of research methods that were followed in the study

used to assess the nutrition knowledge and self-efficacy of athletes men’s (fitness, body

builders and body image) and their coaches at different sport centers, and will cover the

details explanation of methodology that is being used to make this project complete and

working well. It provides information on the participants, that is, the criteria for

inclusion and exclusion in the study, who the participants were and how they were

sampled. The researcher describes the research design that was chosen for the purpose

of this study and the reasons for this choice. The procedures that were followed to carry

out this study and instrument that was used for data collection. The researcher also

discusses the methods used to analyze the data. The limitations and ethical issues that

were followed in the process are also discussed.

3.2 Research Design:

The research designed is the researcher’s overall plan for obtaining answers to

the research questions guiding the study, used a quantitative descriptive design to

identify, analyses and describe the nutrition knowledge and self–efficacy of athletes ,

men’s (fitness, body builders and body image) and their coaches at different sport

centers.

3.3 Research Setting:

Khartoum is capital and largest city of Sudan. It is located at the confluence of

the White Nile and Blue Nile The location where the two Niles meet is known as AL-

Mogran, divided by the Niles, Khartoum is a tripartite metropolis with an estimated

overall population about 8 million people, Khartoum consists of three cities linked by

bridges to each other: Khartoum, Omdurman and Khartoum North. (130, 131).

The study was conducted at nine sport centers in Khartoum Locality two with

sport nutrition Department and seven without sport nutrition Department. The centers

that involved in this study were selected across the Khartoum Locality. Three centers

of regular forces, three centers with high-priced, three centers with middle to low

priced. The centers with a Sports Nutrition Department has contracts a Registered

Dietitian, who is not full time and is not on centers all day, to educate the athletes if

necessary. Centers without a Sports Nutrition Department, does contracts with a

Registered Dietitian.

3.3.1 The area of the study:

Khartoum is the capital city with a population of about 5129 person. It located

into the south of the Blue Nile (132, 131). The sport centers were included from Khartoum

locality included: Police House sport center, National Club sport center, Military Sports

Administration sport center, Afra Mall sport center, Muscle House sport center, O2

sport center, Golden sport center, Champions House Sport center, Romax sport center.

3.4 The Study Population and Sample:

A random sample was collected from nine public and privet sports centers across

the Khartoum locality. The centers were randomly selected using simple random

sampling and the men’s (fitness, body builders and body image) and their coaches were

selected by means of convenience sampling method during the period of the study. The

research included a sample of 108 men’s (fitness, body builders and body image) and

27 of their coaches age (18-50) year.

The sample size was determined using Slovin’s Formula:

[n= N/1+Ne2].

Where;

n = # of sample size

N = total population

e = confidence level

Given: for athletes

N = 950 residents

e = standard confidence level is 90% - 95%. The researcher used a confidence of 90%

for a better accuracy, which will give a margin error of 0.10

1. Computation for the Confidence Level:

e = 100% - 90%

= 10% = 0.10

2. Sample Size:

n= 950 / 1+950 (0.10)2

n=950 / 10.5

n= 90 respondents.

Given: for coaches

N = 27 residents

e = standard confidence level is 90% - 95%. The researcher used a confidence of 90%

for a better accuracy, which will give a margin error of 0.10

1. Computation for the Confidence Level:

e = 100% - 90%

= 10% = 0.10

2. Sample Size:

n= 27 / 1+27 (0.10)2

n=27 / 1.27

n= 21respondents.

Attributable to the scarcity of studies have done in the area of nutrition knowledge

and self-efficacy, and for the convenience and inducement of the results; the researcher

examined 108 from athletes men’s (fitness, body builders and body image) and 27 of

their coaches at different sport centers instead of 90 from athletes and 21 of coaches.

3.5 Inclusion Criteria:

The subjects is male athletes participating in men’s (fitness, body builders and

body image) and their coaches at two centers with a Sports Nutrition Program and seven

without Sports Nutrition Program were eligible to participate in this study.

3.6 Exclusion Criteria:

Females and athletes who are not participating in men’s (fitness. body builders

and body image) and their coaches were excluded.

3.7 Preliminary Study:

Initially, articles and researches in relation to the topic were extensively reviewed.

in October 2017, a pilot study had been performed in Khartoum state. The questionnaire

was developed concerning the objectives whereas about 12 from every sport (fitness,

bodybuilders-body image), were chosen randomly. Participants in the pilot study were

not included in the main study. Time for filling the questionnaire and the effectiveness

of the questions were identified to achieve the research goals. Some questions were

excluded and others were added.

3.8 Data Collection Techniques:

Collection of data was obtained during the working hours from 04:00 p.m. to

011:00 p.m. usually athletes men’s (Fitness, Body builders and body image) and their

coaches.

The first method of data collection was through preliminary information obtained

from previous researches, articles and official sectors. The second method was an

interview questionnaire was developed for the athletes and their coach to assess

nutrition knowledge and self efficacy (see Appendix )

The initial draft of the questionnaire was reviewed by two Registered Dietitians,

two Sports Nutritionists.

The questionnaire was then revised based on recommendations from the

reviewers. The questionnaire was then pilot-tested by athletes at centers not a part of

the study in order to establish reliability and validity. The athletes who tested the

questionnaire were similar to the athletes involved in the study; they were males and

their coach from the same sports being tested. The athletes completed the questionnaire

twice, with 2 weeks in-between each test. The correlation between the responses on the

initial test and post test of the questionnaire was above 0.908%, establishing that the

questionnaire is both reliable and valid.

3.8.1 Primary data and information:

The primary data was collected in Khartoum, provided by some personnel from

different institutions such as Ministry of Youth and Sport, Sudan University of Science

and Technology Faculty of Physical and Physical Education and Rafeef company for

dietary supplements. Other information was obtained through reviewing previous

articles, journal, researches and books

3.8.2 Interview questionnaire:

An interview questionnaire was developed for the athletes and their coach was

filled with 108 athletes men’s (Fitness, Body builders and body image) and 27 of their

coaches between the ages of 18 and 50 years from the previously mentioned centers to

assess nutrition knowledge and self efficacy (see Appendix).

The questionnaire which was given to each athlete consisted of 33 items to be

answered, divided into the three following sections.

A- The first section addressed personal information:

This included questions on the demographic information, The type of sport and duration

that participant in and their centers major.

B- The second section of the survey dealt with nutrition knowledge and addressed:

This included questions about macro- and micronutrients, hydration, nutrient timing,

supplement use, weight and calorie intake.

C- The third and final section of the survey dealt with self-efficacy addressed:

This included questions on self-efficacy of each athlete.

The questionnaire which was given to each coach consisted of 14 items to be

answered, divided into the three following sections.

A- The first section addressed personal information:

This included questions on the demographic information, The sport type that work in

and duration they work in, Their centers major center they work in.

B- The second section of the survey dealt with nutrition knowledge and addressed:

This included questions about macro- and micronutrients, hydration, nutrient timing,

supplement use, weight and calorie intake.

C- The third and final section of the survey addressed:

This included questions on self-efficacy of each coach

3.8.2.1 Anthropometrics Measurements Techniques:

Cross-sectional anthropometric measurements were taken from a total number

of 108 athletes. Those were weight, height, nick circumference and waist

circumference. The researcher has taken all the measurements. Weight and height were

used to calculate body mass index. Waist circumference were used to identify health

waist. Height, nick circumference and waist circumference were used to calculate body

fat percentage .

Weight:

The weight measurements have been taken during the interview by the researcher

using balance beam scales. Balance beam scale was placed in a hard and flat floor

surface. At the beginning of each examination the scale was balanced to zero, using

standardized weights to check up the scale and make any necessary corrections. athletes

were asked to remove their shoes, and to stand in the center of the platform and to look

straight.

Height:

Heights of the athletes were taking during the time of data collection using plastic

measurement. 150 centimeters marked on the wall and then the excess length measured,

this technique was used due to the lack of stadiometer. Athletes were asked to remove

their shoes and his head and buttocks to the wall. All heights were recorded in the

questionnaire sheet.

Waist circumference:

Measure the circumference of the athletes waist at a horizontal level around the

navel, ensure that the athletes dose not pull their stomach inwards to obtain accurate

measurements. Athletes were asked to remove their cloth. All measurements were

recorded in the questionnaire sheet.

Nick circumference:

Measure the circumference of the athletes neck starting below the larynx at

narrowest, with the top sloping downward to the front. The athletes asked to avoid

moving their neck outwards

BMI:

Body mass index was used as an indicator for assessing nutritional status of athletes.

Calculations have been done using the following formula: BMI= Weight

(kg)/Height(m2). Three measurements of weights and height that had been taken by the

researcher were registered during the field work. In adults a BMI of 18.5kg/m2 to 24.9

kg/m2 means that person is considered to be normal, BMI of 25kg/m2 to 29.9 kg/m2

means that person is considered to be overweight, and a BMI of 30kg/m2 or above

means that person is considered to be obese according to World Health Organization

Standards.

WC:

Waist circumference measure to estimate the potential disease risk. The waist

circumference of more than (94cm) shows increased risk and substantial risk if more

than (102cm) according to Nutrition and Healthy Foundation Standards .

BFP:

Body fat percentage, this method uses body circumference measurements to

estimate body fat percentages. Takes waist , nick and height circumference for men

according to the U.S Navy method. Calculations have been done using the following

formula:

BFP =

495/(.229579-.35004*log10(Waist – Neck)+0.22100*log10(Height) – 450

In adults a BFP of 2% to 5% means that person is considered to be have essential

fat percentage normal, BFP of 6% to 13% means that person is considered to be have

athletes fat percentage, BFP of 14% to 17% means that person is considered to be have

fitness fat percentage, BFP of 18% to 25% means that person is considered to be have

average fat percentage, according to Health Check Systems and American Council on

Exercise.

3.9 Statistical Analysis and Presentation

Statistical analyses were done using; the Statistical Package for the Social

Sciences program (SPSS) version 21. Then, the data were presented and formulated

into tables, charts and figures using Microsoft Office Excel 2007. The survey data was

entered into an excel spreadsheet. A statistical analysis was performed using JMP-SAS

software. The means and standard deviations for self-efficacy were analyzed using one-

way ANOVA and t-tests.

3.10 Limitation of the Study:

The researcher stumbled upon various following constrictions:

lack of similar published dissertations conducted on Sudan to reflect back on

and lack of documented information regarding nutrition knowledge of athletes

and their coaches in Sudan.

Because of the select nature of the participants, this study is not necessarily

generalizable to all athletes. Athletes had to be selected which were found at

each center. Also, only groups could be used if their coaches approved their

athletes’ participation. This made selection of groups limited and therefore not

all athletes at each center could be involved in the study.

Also, there was one question that could have been clearer to the athletes, this

question addressed where the athletes got their nutrition information especially

the term used in the survey was Registered Dietitian.

Another limitation is that the researchers do not know specifically how much

each athlete at centers with sport nutrition department corresponded with the

Registered Dietitian. The Registered Dietitian is contracted, therefore each

athlete utilizes this individual differently, and it is unknown which athlete utilize

them the most. The staff and athletes and their coach from centers with sport

nutrition department were much more compliant and cooperative with the study.

Their response rate was much higher and they spent a significant amount more

time going through the survey and considering ach question carefully.

3.11 Study Ethics:

In this dissertation, a documented permission slip was given to the institutions,

centers and gyms authorities. Verbal authorization was achieved concerning the

selected centers and gyms. Vocal consent was also obtained from athletes men’s

(fitness, body builders and body image) and their coaches in order to carry out the

interview questionnaire and do anthropometric measurements .

Chapter four

4. Results

Introduction:

The results of this descriptive, analytical and cross sectional study was to collect

nutrition knowledge and self-efficacy data from athletes and their coaches at sport

centers in Khartoum state, to assess knowledge and self-efficacy of the athletes and

their coaches who have access to a registered dietitian and those who do not. Results

from this study helped to reveal the need for interventions in certain areas of athlete’s

nutrition knowledge and self-efficacy and also the need for a Sports Nutrition program,

including a full-time registered dietitian, at all centers. It would be important to develop

the field of sports nutrition and promote appropriate nutritional standards and

understanding of this knowledge and practices by the athletes and coaches. Knowledge

on nutritional status of athletes will help in formulation of diets which help to improve

their stamina and endurance.

For more clarification and elucidation of the results, the researcher divided this

chapter into two major sections, section (A) present coaches and section (B) present

athletes, every sections contains three minor sections: section one describes the

personal information of the participants, section two displays the nutrition knowledge

of participants, section three demonstrated information about the self-efficacy among

participants. The yellow color indicates correct answer.

Section A

Table (1): The Demographic Characteristics of Coaches (N=27)

Coaches Sport centers with

Registered Dietitian

Sport centers without


Education

Frequency Percent Frequency Percent

University 6 100% 11 52.4%

Primary school 0 0% 1 4.8%

High school 0 0% 9 42.8%

Total 6 100% 21 100%

Type of

sports

Fitness 0 0% 3 14.3%

Body builder 0 0% 6 28.6%

Body image 0 0% 5 23.8%

All above 6 100.% 7 33.3%

Total 6 100% 21 100%

Years

of

Experience

s

Less than five

years

0 0% 7 33.3%

More than five

years

6 100% 14 66.7%

Total 6 100% 21 100%

Table (1) shows that all of coaches in sport centers with registered dietitian

(100%) received high education at University, all of them (100%) were work with all

type of sports including fitness, bodybuilder and body image, all of them (100%) have

more than five years of experiences. The table also shows that the coaches in sport

centers without registered dietitian (52.4%) received high education at University,

(33.3%) were work with all type of sports including fitness, bodybuilder and body

image, (66.7%) have more than five years of experiences .

Figure (1): The Sample Size (N=27)

Figure (1) shows that the coaches without access to registered dietitian (77.8%)

while coaches with access to registered dietitian found to be (22.2%) of the total sample.

78%

22%

Coaches without access

to RD (77.8%)

Coaches with access to

RD (22.2%)

Figure (2): Age of coaches (N=27)

Figure (2) represents the age of coaches ranged between 18 to 50, (58%) of them

age were between 29 – 38 years.

0%

10%

20%

30%

40%

50%

60%

28 - 1838 - 29

38<

38%

58%

4%

Figure (3): The Sport Centers that are Included

Figure (3) shows different sport centers that included in the study. The sport

centers without registered dietitian and had trained coaches by (10.3%). while there is

only two different sports centers with registered dietitian and coaches by (13.8%).

Military sports administration

club13.8%

Afraa mall sport center

13.8%

Police house sport center

10.3%

National club sport center

10.3%O2 gym

10.3%

Muscle house sport center

10.3%

Golden gym 10.3%

Champions house sport

center10.3%

Romax sport center10.3%

Table (2): Coaches Sources of Nutrition Information and Knowledge (N=27)

Coaches Sport centers with




Main sources

of

information on

nutrition


Doctors 0 0% 3 14.3%

RD 3 50% 0 0%

Colleagues at

work

2 33.3% 8 38.1%

Internet 1 16.7% 10 47.6%

Total 6 100% 21 100%

Do you have nutrition

plan

Yes 6 100.0% 21 100.0%

Total 6 100% 21 100%

The nutrition

plan for your

personal

physical activity

and

to your athletes

according to

what

Your personal

experience and

knowledge

0 0% 15 71.4%

Sport nutrition

guidelines

6 100.0% 3 14.3%

Doctors 0 0% 3 14.3%

Total 6 100% 21 100%

The main source

of muscular

energy for

athletes

Carbohydrates

and Fats

6 100.0% 15 71.4%

Protein 0% 0% 6 28.6%

Total 6 100% 21 100%

Dehydration can reduce

Performance

True 6 100.0% 18 85.7%

False 0 0% 3 14.3%

Total 6 100% 21 100%

Table (2) shows that, half of coaches in sport centers with registered dietitian

(50%) identified registered dietitian as main sources of information on nutrition, all of

them (100%) have nutrition plan and depend on sport nutrition guidelines in setting

nutrition plan for themselves and for their athletes, (100%) correctly identified

carbohydrates and fats are the main sources of energy, and stated that dehydration can

reduce performance.

The table also shows that, coaches in sport centers without registered dietitian

(47.6%) identified internet as main sources of information on nutrition, (100%) have

nutrition plan, (71.4%) depend on their personal experience and knowledge in setting

nutrition plan for themselves and for their athletes, (71.4%) correctly identified

carbohydrates and fats are the main sources of energy, most of them (85.7%) stated that

dehydration can reduce performance.

Table (3): Information on Supplements and counseling by Coaches (N=27)

Sport centers with




Recommend using

supplements


Yes 1 16.7% 19 90.5%

No 5 83.3% 2 9.5%

Total 6 100% 21 100%

Knowing the benefit

and harmful of

supplements

Yes 1 100% 9 47.4%

No 0 0% 10 52.6%

Total 1 100% 19 100%

Source of

supplements

available in center 0 0% 16 15.8%

supplements store 1 100% 3 15.8%

Total 2 100% 19 100%

Nutritional counseling

would be important to

everyone at sport centers

Yes

6

100.0%

17

80.5%

No 0 0% 4 19.5

Total 6 100% 21 100%

Table (3) shows that most of coaches in sport centers with registered dietitian

(83.3%) not recommend using dietary supplements. However, all of them (100%) stated

knowing the benefit and harmful of supplements, all of them (100%) obtain

supplements from supplements store, all of them (100%) clearly stated nutritional

counseling would be important to the coaches, athlete and all persons at sport centers.

The table also shows that most of coaches in sport centers with registered dietitian

(90.5%) recommend using dietary supplements. However, (52.6%) stated not knowing

the benefit and harmful of supplements, (68.4%) obtain supplements from the center,

most of them (80.5%) clearly stated nutritional counseling would be important to the

athlete, coaches and all persons at sport centers.

Table (4): Nutrition Self Efficacy among Coaches (N=27)

Sport centers with




Mean Std. Deviation Mean Std .Deviation

Eat a healthy snack

pre and post workout 8.7931 1.82011 7.7037 2.21827

Eat a nutritious

balanced diet 9.6552 1.00980 6.7870 2.41510

Eat the correct

amount of calories

each day

6.4907 2.45138 5.2130 2.80870

Maintain a healthy

weight with diet and

exercise

9.2870 9.2870 7.2414 2.08147

Keep hydrated before,

during and after

practice and

competition

8.7931 1.82011 7.7586 2.01167

Table (4) shows that the mean scores on 10 points scale showed that coaches in

sport centers with registered dietitian they were highly certain on eat a nutritious

balanced diet by (9.6) and lowest certain on eat the correct amount of calories each day

(6.4). The table also shows that coaches in sport centers without Registered Dietitian

they were highly certain on keep hydrated before, during, and after practice and

competition by (7.7) and lowest certain on eat the correct amount of calories each day

by (5.2).

Section (B)

Table (5): Demographic Information of Athletes (N=108)

Table (5) shows that, athletes in sport centers with registered dietitian (62.5%)

were students, most of them (95.8%) received high education at university, (33.3%)

Athletes Sport centers with


Sport centers

without Registered

Dietitian

Frequency Percent Frequency Percen

t

Occupation

Student 15 62.5% 40 47.6%

Employee 9 37.5% 44 52.4%

Total 24 100% 84 100%

Education

Primary school 0 0% 3 3.6%

High school 1 4.2% 7 8.3%

University 23 95.8% 74 88.1%

Total 24 100% 84 100%

Sport type

Body builder 8 33.3% 28 33.3%

Body image 8 33.3% 28 33.3%

Fitness 8 33.3% 28 33.3%

Total 24 100% 84 100%

Duration

of

regular

practice

of

Sport

Less than one

year

17 70.8% 14 16.6%

One year 0 0% 30 35.7%

More than one

year

7 29.2% 7 8.3%

More than two

years

0 0% 33 39.3%

Total 24 100% 84 100%

practice sports for (body builder, body image, fitness), (17.8%) practice sports for less

than one year.

The table also shows that, more than half of athletes in sport centers without

registered dietitian (52.4%) were employee, (88.1%) received high education at

university, (33.3%) practice sports for (fitness, body builder and body image,), (39.3%)

practice sports for more than two year.

Figure (4): Age of Athletes (N=108)

Figure (4) represents the age of athletes ranged between18 to 50 years, (69%)

were between18 -28 years

0%

10%

20%

30%

40%

50%

60%

70%

28 - 1838 - 29

38<

69%

27%

4%

Table (6): Classification of BMI and Waist circumference among Athletes

(N=108)

Sport centers with Registered Dietitian Sport centers without Registered

Dietitian

BMI % WC % BMI % WC %

Normal

weight

29.2

%

Normal 66.6% Normal

weight

21.4% Normal 16.6%

Over

Weight

12.5

%

At risk 12.5% Over

weight

29.8% At risk 50%

Obese

58.3

%

Greatly

increased

risk

20.8%

Obese

48.8%

Greatly

increase

d risk

33.3%

Total 100% Total 100% Total 100% Total 100%

Table (6): shows that, athletes in sport centers with registered dietitian (58.3%)

are obese when using BMI, but when using waist circumference (66.6%) are normal.

The table also shows that, athletes in sport centers without registered dietitian (48.8%)

are obese, but when using waist circumference half of them (50%) at risk diseases.

Classification of (BMI) according to World Health Organization Standard.

Classification of (WC) according to Nutrition and Healthy Foundation Standards .

Table (7): Classification of BMI and Body Fat Percentage among Athletes

(N=108)

Sport centers with Registered Dietitian Sport centers without Registered

Dietitian

BMI % BFP % BMI % BFP %

Normal

weight

29.2

%

Athletes 33.3% Normal

weight

21.4% Athletes 8.3%

Fitness 33.3% Fitness 8.3%

Over

Weight

12.5

%

Average 12.5% Over

weight

29.8% Average 50%

Obese 58.3

%

Obese 20.8% Obese 48.8% Obese 33.3%

100% 100% 100% 100%

Table (7): shows that, athletes in sport centers with registered dietitian (58.3%)

are obese when using BMI, but when using body fat percentage (66.6%) are athletes

and fit. The table also shows that, athletes in sport centers without registered dietitian

(48.8%) are obese, but when using body fat percentage half of them (50%) in average

body fat percentage. Classification of (BMI) according to World Health Organization

Standard. Classification of (BFP) according to Health Check Systems and American

Council on Exercise.

Table (8): Access of Nutrition Counseling and Information among

Athletes(N=96)

Sport centers with


Sport centers

without Registered

Dietitian

Frequency Percent Frequency Percen

t

Access to nutrition

counseling

Yes 20 83.3% 4 4.8%

No 4 16.6% 80 95.2%

Total 24 100.0% 84 100.0%

Having a nutritious

diet will improve

athletic performance

Yes 24 100% 77 91.6%

No 0 0% 6 7.1%

I don't

know

0 0% 1 1.2%

Total 24 100.0% 84 100.0%

aware of how many

calories need to

consume every day

Yes 7 29.2% 20 23.8%

No 17 70.8% 63 75%

I don't

know

0 0% 1 1.2%

Total 24 100.% 84 100.0%

Active seeking of

nutrition information

Yes 24 100% 76 90.5%

No 0 0% 8 9.5%

Total 24 100% 84 100%

Major source

of nutrition

information

Friends 1 5% 4 5.3%

Strength and

conditioning

coach

10 50% 45 59.2%

Internet 6 30% 25 32.9%

Registered

dietitian

3 15% 2 2.6%

Total 20 100% 76 100%

Reason of not

seeking

information

on nutrition

(N=12)

No time 4 100% 4 62.5%

already have

enough nutrition

knowledge

0 0% 3 37.5%

Total 4 100% 8 100%

Table (8) shows that, athletes in sport centers with registered dietitian (83.3%)

reported having access to nutrition counseling, all of them (100%) correctly believe

having a nutritious diet is important and beneficial for their athlete performance,

(70.8%) not aware how many calories are needed every day for promotion of athletic

performance, most of them (83.8%) claimed active seeking of information on nutrition,

with strength and conditioning coach being the major source of information (50%), all

of them stated that reason for not seeking information on nutrition is no time (100%).

The table also shows that, majority of the athletes in sport centers without registered

dietitian (95.2%) reported having no access to nutrition counseling, most of them

(91.6%) correctly believe having a nutritious diet is important and beneficial for their

athlete performance, (75%) not aware how many calories are needed every day for

promotion of athletic performance, most of them (90.5%) claimed active seeking of

information on nutrition, with strength and conditioning coach being the major source

of information (59.2%), half of them stated that reason for not seeking information on

nutrition is no time (50%).

Table (9): Information on using Nutrition Supplementations and Importance of

Sport Registered Dietitian and Coach among Athletes (N=108)

Sport centers with


Sport centers

without RD

Frequency Percen

t

Frequenc

y

Percen

t

Using supplements

Ye

s

4 16.6% 20 23.8%

No 20 83.3% 64 76.2%

Total 24 100% 84 100%

Reasons for

using

supplements

(N=24)

Improve

performance

3 75% 4 20%

Increase muscle

mass

1 25% 16 80%

Total 4 100% 20 100%

Reasons for

not using

supplements

(N=84)

It is too money

consuming

0 0% 37 57.8%

I don't know what

type is safe

3 15% 14 21.9%

It is not important 17 85% 13 20.3%

Total 20 100% 64 100%

Types of

supplement

s

Creatine 1 25% 6 30%

(BCA.A) 0 0% 2 10%

Protein 0 0% 5 25%

Whey protein 3 75% 7 35%

Total 4 100% 20 100%

Yes 24 100% 76 90.5%

Having a sports

Registered Dietitian at

my centers is

or would be helpful

No 0 0% 7 8.3%

I don't

know

0 0% 1 1.2%

Total 24 100% 84 100%

My coaches have encouraged

me to either lose or gain

weight

Ye

s

12 50% 62 73.8%

No 12 50% 22 26.2%

Total 24 100% 84 100%

Table (9)shows that, most of athletes in sport centers with registered dietitian

(83.3%) mentioned they do not use nutrition supplements, use of supplements was

mainly (75%) used for improve performance, mostly (85%) not use because they

thought it is not important, the major types of supplements use is whey protein (75%),

all of them (100%) stated having a sports nutritionist at my centers is or would be

helpful to me as an athlete, half (50%) stated my coaches have encouraged me to either

lose or gain weight. The table also shows that, athletes in sport centers without

registered dietitian (76.2%) mentioned they do not use nutrition supplements, use of

supplements was mainly (80%) used for increase muscle mass, mostly (57.8%) not use

because they thought it is too money consuming, the major types of supplements use is

creatine (35%), most of them (90.5%) stated having a sports nutritionist at my centers

is or would be helpful to me as an athlete, (73.8%) stated my coaches have encouraged

me to either lose or gain weight.

Table (10): Macro and Micro Nutrients Knowledge among athletes (N=108)

Sport centers with


Sport centers

without RD


Carbohydrates and

fats are the main

sources of energy for

the muscle

Yes 20 83.3% 63 75%

No 3 12.5% 17 20.2%

I don't

know

1 4.2% 4 4.7%

Total 24 100% 84 100%

Protein is the primary

source of energy for

the muscles

Yes 3 12.5% 17 20.2%

No 20 83.3% 63 75%

I don't

know

1 4.2% 4 4.7%

Total 24 100% 84 100%

High-fat foods should

be reduced in my diet

Yes 24 100% 77 91.6%

No 0 0% 7 8.3%

Total 24 100% 84 100%

Consuming fruits and

vegetables every day

is important to get

necessary vitamins

and minerals

Yes 24 100% 83 98.8%

I don't

know

0 0% 1 1.2%

Total 24 100% 84 100%

During 2-a-days or

heavy practice days

should eat more

calories

Yes 24 100% 43 51.2%

No 0 0% 38 45.2%

I don't

know

0 0% 3 3.6%

Total 24 100% 84 100%

When I am inactive

my

calories needs do not

change(N=108)

Yes 0 0% 52 61.9%

No 24 100% 31 36.9%

I don't

know

0 0% 1 1.2%

Total 24 100% 84 100%

Eating within 45

minutes of a workout

is important(N=108)

Yes 24 100% 59 70.2%

No 0 0% 20 23.8%

I don't

know

0 0% 5 5.9%

Total 24 100% 84 100%

Milk is a good source

of calcium and

vitamin D (N=108)

Yes 24 100 78 92.8

No 0 0 4 4.8

I don't

know

0 0 2 2.3

Total 24 100% 84 100%

Whole grain breads

are

a good source of fiber

(N=108)

Yes 19 79.2 56 66.6

No 3 12.5 18 21.4

I don't

know

2 8.3 10 11.9

Total 24 100% 84 100%

water is better than

drinking sport

drinks and should

be consumed all

throughout the day.

Yes 22 91.7% 65 77.4%

No 2 8.3% 9 22.6%

Total 24 100% 84 100%

Table (10) shows that, most of athletes in sport centers with registered dietitian

(83.3%) correctly identified carbohydrates and fats are the main sources of energy and

identified protein is not the main sources of energy, all of them (100%) correctly

believe that regular consumption of fruits and vegetables is important and beneficial for

their athlete performance, all of them (100%) correctly believe that reduction of high-

fat in diet is important and beneficial for their athlete performance, all of them (100%)

stated during 2-a-days or heavy practice days I should eat more calories, all of them

(100%) stated when I am inactive my calories needs to change, all of them (100%)

stated eating within 45 minutes of a workout is important, all of them (100%) correctly

identified milk as good sources of calcium and vitamin D, (79.2%) correctly identified

whole grain as good sources of fiber, most of them (91.7%) stated that water is better

than drinking sport drinks.

The table also shows that, athletes in sport centers without registered dietitian

(75%) correctly identified carbohydrates and fats are the main sources of energy and

identified protein is not the main sources of energy, most of them (98.8%) correctly

believe that regular consumption of fruits and vegetables is important and beneficial for

their athlete performance, most of them (91.6%) correctly believe that reduction of

high-fat in diet is important and beneficial for their athlete performance, more than half

of them (51.2%) stated during 2-a-days or heavy practice days I should eat more

calories, more than half of them (61.9%) stated when I am inactive my calories needs

to change, (70.2%) stated eating within 45 minutes of a workout is important, most of

them (92.8%) correctly identified milk as good sources of calcium and vitamin D,

(66.6%) correctly identified whole grain as good sources of fiber, most of them (77.4%)

stated that water is better than drinking sport drinks.

Table (11): Macro and Micro Supplements Knowledge among athletes (N=108)

Sport centers with


Sport centers

without RD


Protein supplements

are needed in addition

to food for muscle

growth and

development (N=24)

Yes 0 0% 19 95%

No 4 100% 1 5%

Total 4 100% 20 100%

Vitamins and mineral

supplementation

provide energy to my

body(N=24)

Yes 2 50% 16 80%

No 2 50% 0 0%

I don't

know

0 0% 4 20%

Total 4 100% 20 100%

It is recommended to

consume sports drinks

during practices and

competitions lasting

longer than 1

hour(N=108)

Yes 3 75% 12 60%

No 0 0% 7 35%

I don't

know

1 25% 1 5%

Total 4 100% 20 100%

Yes 0 0% 13 65%

The vast majority of

supplements sold to

the general public

have been tested for

effectiveness or

safety(N=24)

No 2 50% 7 35%

I don't

know

2 50% 0 %0

Total 4 100% 20 100%

Table (11) shows that, all of athletes in sport centers with registered dietitian

(100%) stated that the protein supplements are not needed in addition to food for muscle

growth and development, Further, half of them (50%) were sure that the vast majority

of supplements sold to the general public have been not tested for effectiveness or

safety, half of them (50%) stated that no role of vitamins and mineral supplementation

in provision of energy to their bodies, (75%) believed that it is recommended to

consume sports drinks during practices and competitions lasting longer than 1 hour.

The table also shows that, most of athletes in sport centers without registered dietitian

(95%) stated that the protein supplements are needed in addition to food for muscle

growth and development, (65%) were sure that the vast majority of supplements sold

to the general public have been tested for effectiveness or safety, (80%) stated the role

of vitamins and mineral supplementation in provision of energy to their bodies, (60%)

believed that it is recommended to consume sports drinks during practices and

competitions lasting longer than 1 hour.

Table (12): Nutrition Self Efficacy among Athletes (N=108)

Sport centers with

Registered Dietitian (N=24)


RD (N=84)

Mean Std. Deviation Mean Std. Deviation

Eat a healthy snack pre

and post workout 7.7586 2.01167 6.7870 2.41510

Eat a nutritious balanced

diet 7.2414 2.08147 6.4907 2.45138

Eat the correct amount of

calories each day 6.6552 2.51106 5.2130 2.80870

Maintain a healthy

weight with diet and

exercise

8.7931 1.82011 7.7037 2.21827

Keep hydrated before,

during, and after practice

and competition

9.6552 1.00980 9.2870 9.2870

Table (12) represents nutrition self -efficacy among athletes. Data shows that the

mean scores on 10 points scale showed that athletes at sport centers with registered

dietitian they were highly certain on keep hydrated before, during, and after practice

and competition by (9.6) and lowest certain on Eat the correct amount of calories each

day (6.6). The table also showed that athletes at sport centers without registered dietitian

they were highly certain on Eat a nutritious balanced diet by (9.2) and lowest certain on

Eat the correct amount of calories each day by (5.2).

Chapter Five

Discussion

: Introductio

n

This study is designed to assess the nutrition knowledge and self–efficacy of

athletes and their coaches in Khartoum state using an interview questionnaire and

anthropometric techniques. The participants were randomly selected from nine sport

centers in Khartoum Locality. It has been suggested by many researchers that sports

nutrition departments, which include a sports registered dietitian, could be beneficial

for athletes and their coaches (12, 31, 64,65, 86, 92, 122). Some studies have been done

assessing the nutrition knowledge and intake behaviors of such athletes and their

coaches, but the majority of them are out-of-date or on such a specific group of athletes

it is difficult to generalize the results to athletes and their coaches at sport centers in

general.

The objectives of the study were to: collect nutrition knowledge and self-efficacy

data from athletes and their coaches attending sport centers/ gyms, in Khartoum state

to examine nutrition knowledge and self-efficacy of the athletes and their coaches who

have access to a registered dietitian and those who do not. Results from this study

helped to reveal the need for interventions in certain areas of athlete’s nutrition

knowledge and self-efficacy and also the need for a Sports Nutrition program, including

a full-time registered dietitian, at all centers. It would be important to develop the field

of sports nutrition and promote appropriate nutritional standards and understanding of

this knowledge and practices by the athletes and coaches. Knowledge on nutritional

status of athletes will help in formulation of diets which help to improve their stamina

and endurance.

Section (A):

Demographic Profiles of Coaches and Sources of Nutrition

Knowledge, Counseling and Information:

All coaches in sport centers with registered dietitian (100%) received high

education at University, and about (66.7%) were work with all type of sports including

fitness, bodybuilder and body image, and have more than five years of experiences in

sports center including fitness, bodybuilder and body image while (52.4%) coaches

working in sport center without registered dietitian have only secondary education this

might due to the reasons that the location and financial ability of sport centers to pay

suitable salary for the coaches. On the other hand coaches without access to registered

dietitian were found (77.8%) while coaches with access to registered dietitian found to

be (22.2%) of the total sample. The ages of all coaches ranges between 18 to 50, (58%)

of them age were between 29 – 38 years.

In the present study the sport centers without registered dietitian and had trained

coaches (10.3%). while there is only two different sports centers with nutritionists and

coaches by (13.8%). (50%) of coaches in sport centers with Registered Dietitian

identified registered dietitian as main sources of information on nutrition, all of them

have nutrition plan and depend on sport nutrition guidelines in setting nutrition plan for

themselves and for their athletes, (100%) correctly identified carbohydrates and fats are

the main sources of energy, and stated that dehydration can reduce performance. On the

other hand coaches in sport centers without registered dietitian (47.6%) identified

internet as main sources of information on nutrition, and have nutrition plan, (71.4%)

depend on their personal experience and knowledge in setting nutrition plan for

themselves and for their athletes, (71.4%) correctly identified carbohydrates and fats

are the main sources of energy, most of them (85.7%) stated that dehydration can reduce

performance. This result may indicated that registered dietitian play important roles in

providing scientific information to the coaches and their clients which is good

indicators that shows increase in nutrition knowledge among coaches working in sport

centers with a certified Registered Dietitian.

The finding of this study identified that most of coaches in sport centers with

registered dietitian (83.3%) not recommend using dietary supplements. However, all of

them (100%) stated knowing the benefit and harmful of supplements, all of them

(100%) obtain supplements from supplements store, stated nutritional counseling

would be important to the coaches, athlete and all persons at sport centers. However,

half of the participants (52.6%) stated that did not know the benefit and harmful of

supplements (68.4%) obtain supplements from the center, they stated nutritional

counseling would be important to the athlete, coaches and all persons at sport centers.

Coaches from sport centers without a registered dietitian identified Internet and

colleagues at work the two places they get most of their nutrition information while

coaches from sport centers with a registered dietitian in the study identified registered

dietitians, colleagues at work and the internet as their largest sources for nutrition

information. The results from this study agree with results from previous studies, were

shown that coaches receive most of their nutrition knowledge from health and sports

magazines, television and radio have been cited as the most frequent media-related

sources of information for both coaches and athletes (15). Research has also shown that

one of the places coaches get the least amount of nutrition information is registered

dietitians (65). Furthermore a study done on international football players supports this

idea emphasizing that coaches often follow their own traditions and health beliefs,

imparting that wisdom on the team. In some cases, outside information from

professionals is not even welcomed in (79).

Taking this into consideration, when a registered dietitian is on centers full-time,

a significant amount more coaches receive their nutrition information from this credible

source. Internet were consistently identified in this study, as in previous studies, as a

source a large number of coaches look to for nutrition information (65), but there is

inadequate nutrition information available through the internet, can lead to several

unhealthy nutrition behaviors affecting growth and sport performance of their self and

their athletes.

Interestingly, most strength and conditioning coaches, although they may be

interested in nutrition, do not have formal nutrition education, also coaches and athletic

trainers often assume responsibility for controlling and guiding the dietary practices of

athletes. They rarely have formal training in nutrition and probably do not have the time

or expertise needed to stay well-informed of developments in nutrition (100). Therefore,

this is not the most reliable source of nutrition information for athletes. Taking these

results into consideration, the biggest differences are seen where the greatest efforts are

placed. At sport centers with a Registered Dietitian, there is one part-time RD

dedicating the majority of their time specifically to coaches. Therefore, these coaches

receive the most one-on-one counseling and team education from reliable source of

nutrition information. When taking all coaches into consideration, a higher percentage

from sport centers with a registered dietitian indicated that they have nutrition plan

according sport nutrition guidelines.

Other study suggested that athletic trainers and strength and condition coaches

have adequate knowledge but the coaches do not (133). While extensive research has

proven that there is a deficiency in nutrition knowledge among coaches, parents and

trainers at the high school and collegiate level (134). Corley et al conducted a study on

the nutritional knowledge and dietary practices among college coaches and found that

poor knowledge and eating habits of coaches may significantly influence the eating

habits of their athletes (135). In the previously mentioned study by Burns et al (2004),

nutrition misconceptions among collegiate athletes were also thought to be linked to

poor information coming from members of the coaching or athletic training staff (123).

Majority of coaches from sport centers with a registered dietitian identified that

nutritional counseling would be important to the coach, athlete and all persons at sport

centers. The result also shows that coaches with access to the registered dietitian on a

daily basis have a better idea about supplements. It is interesting to note that the place

where the largest, most differences were seen in the nutrition knowledge of coaches as

a whole were regarding supplements and the basis of their nutrition plan for physical

activity to them and their athletes. Coaches from sport centers with a registered dietitian

were more educated on supplements, correctly identifying there is not recommended to

using supplement and their knowing the benefit and harmful or side effects of

supplements.

Self-Efficacy of the Coaches:

Nutrition and exercise self-efficacy were connected to the maintenance of diet

and physical activity, it has been found that nutrition self-efficacy operates best in

concert with general changes in lifestyle, including physical exercise. As a whole,

coaches from sport centers with a registered dietitian were more confident in making

certain nutrition decisions than the coaches from sport centers without a registered

dietitian. The coaches from sport centers with a registered dietitian were more confident

in their ability to eat a health snack pre and post workout, eat a nutritious, balanced diet,

eat the correct amount of calories each day, maintain a healthy weight, and keep

hydrated before, during, and after practice and competition. These coaches from sport

centers with a registered dietitian, got more of their nutrition information from

registered dietitian. A summary of an comparative assessment done on self-efficacy of

NCAA athletes found that athletes who had a sports dietician were more likely to seek

out nutritional information, demonstrated more knowledge about nutrition and felt

more confident making decisions (136). Other study show that, athletes from Universities

with full-time sports registered dietitians placed more value on seeking out nutrition

information, got their nutrition information from more reliable sources, had better

nutrition knowledge, and identified more self-efficacy in making nutrition decisions

(91). Anderson et al (2000) stated that, Self-efficacy may be influenced by levels of

knowledge, and in turn, affects attitudes and behaviors (16).

Section B

Demographic Profiles of Athletes and Sources of Nutrition

Knowledge , Counseling and Information:

The study found that the majority of athletes attending different sport centers with

registered dietitians under the study in Khartoum were students and almost all of them

(95.8%) received high education at university. About (33.3%) practicing sports for

(fitness, body builder, body image), (70.8%) practice sports for less than one year. On

the other hand half of athletes in sport centers without registered dietitians (52.4%) were

employee, most of them (88.1%) received high education at university, About (33.3%)

in practice sports for (fitness, body builder and body image), (39.3%) practice sports

for More than two years. Figure (1) represents that, most of all the athletes participant’s

age were between 18-28 years by (69%).

Athletes from sport centers without a registered dietitians in the current study,

(59.2%) responded that they get their nutrition information from a strength and

conditioning coach, and about (32.9%) got their information from internet. In

comparison, regarding sources of nutrition information, (50%) of athletes from sport

centers with a registered dietitians indicated strength and conditioning coaches as a

source of information, (30%) indicated the internet as a source, (15%) indicated

registered dietitian as a source and (5%) indicated Friends as a source. Athletes from

centers without a registered dietitians and from sport centers with a registered dietitians

in the study identified strength and conditioning coaches and the internet as the two

places they get most of their nutrition information. A study done by. Cole, CR,

Salvaterra, GF, Davis JE, et al. (2005) stated that male athletes receive most of their

nutrition knowledge from classes, family, magazines and newspapers, friends, and

strength and conditioning coaches and athletic trainers (65), it also shown that one of the

places athletes get the least amount of nutrition information is registered dietitians (65).

The research has shown that knowledge can be delivered by different providers

including: coaches, athletic trainers, sport dieticians, nutritionists, sport scientists, and

medical practitioners. Athletes also obtain information from other sources; such as:

school or tertiary-education programs, books, sport-specific magazines, the mass

media, and, increasingly, the Internet (123). Almost strength and conditioning coaches,

although they may be interested in nutrition, do not have formal nutrition education.

Therefore, this is not the most reliable source of nutrition information for athletes, in

addition to the inadequate nutrition information available through the internet, can lead

to several unhealthy nutrition behaviors affecting growth and sport performance. A

study specifically done with college football players found that (49.6%) of athletes

reported getting their information from strength and conditioning coaches or athletic

trainers as opposed to the (5.6%) which received their knowledge from a registered

dietitians (65).

At sport centers with a registered dietitians, there is one part-time registered

dietitians dedicating the majority of their time specifically to coaches. Therefore, these

athletes receive the most one-on-one counseling and team education from their coaches.

When taking all athletes into consideration, a higher percentage and all of athletes from

sport centers with a registered dietitians indicated that they actually seek out nutrition

information. Also from sport centers without a Registered Dietitians, have a high

percentage they actively seek out or read nutrition information.

Research has demonstrated the importance of accurate nutrition knowledge and

has shown that adequate nutrition knowledge can lead to better intake decisions,

ultimately assisting in optimal athletic performance (12). When an athlete is properly

informed to make good nutrition decisions, they can then take ownership over their diet,

during college, after leaving college and also in sport centers. A study suggested that

when an athlete’s diet is lacking in certain important nutrients or is not balanced, it is

usually due to the fact that they are not well-informed to make the correct nutrition

decisions (86).

Few studies assessed nutrition knowledge. Torres McGehee et al (2012), found

that only 9% of student-athletes studied across Division I, Division II and Division III

institutions had adequate nutrition knowledge also found that across Division I, II and

III schools (96), while the cross-sectional questionnaire used with Iranian College

Athletes found that although nutrient knowledge is prevalent, supplement knowledge

is not and there are gaps in overall baseline knowledge (133).

Other study found that many athletes have reported moderate levels of nutrition

knowledge but hold various misconceptions about certain food and nutrition issues

particularly surrounding protein, carbohydrate, and vitamin and mineral knowledge

(137). Common misconceptions of athletes in a number of studies included protein acting

as a primary energy source for muscle contraction (138), and vitamin and mineral

supplements delivering energy (139). Protein supplements and vitamin and mineral

supplements were often reported by athletes as being necessary to achieve peak

performance (31). Rosenbloom et al (2002), suggested that there may be misconceptions

regarding nutritional knowledge, as some athletes indicated that they believed vitamin

supplements are needed to improve performance and to provide energy, that protein

supplements are necessary to build muscle, and that protein is the primary energy

source for muscle (140). Other study also found very small percentages of the athletes

could properly identify the correct carbohydrate, protein, and fat intake (65).

Almost all the participants in this study identified that they believe having a

nutritious diet will improve their athletic performance. Athletes from sport centers with

a registered dietitians were more aware of how many calories they need per day in order

to promote their best athletic performance.

This research suggested that athletes with access to the registered dietitian on a

weekly basis have a better idea about how important nutrition is to their athletic

performance and also understand how important it is to have access to someone who

can assist them. It is interesting to note that the place where the largest, most differences

were seen in the nutrition knowledge of athletes as a whole were regarding supplements

and how many calories they should be eating. Athletes from sport centers with a

registered dietitians were more educated on supplements, correctly identifying there is

no need for protein supplement addition to food for muscle growth and development

and vitamins and mineral supplementation will not provide any energy to their body.

Also they have more knowledgeable about their calorie needs changing when they have

2-a-days or heavy practice days and when they inactive.

In general, majority of athletes from sport centers without a registered dietitians

identified that their coaches have encouraged them to either loss or gain weight. This is

also likely to occur when coaches and strength and conditioning coaches, who do not

have formal nutrition education, are doing the majority of the nutrition education. It is

likely coaches without access to a registered dietitians perceive certain athletes as

overweight or underweight when in fact they may not be. Most differences were

athletes from sport centers without a registered dietitians are less knowledgeable about

needing to eat more calories on days of heavy practices and when they inactive their

calories needs do not changes. In the end, a higher percentage of athletes from sport

centers with a registered dietitians answered each question correctly.

Anthropometric variables and indices among athletes:

Anthropometric measurements were used in this study to assess body

composition of athletes in Khartoum locality area. The anthropometric measurements

used in this study were; height, weight, waist circumference, neck circumference, BMI,

waist circumference, body fat percentage. All these variables were used as indicators

for athletes nutritional status. The athletes in sport centers with registered dietitians

(58.3%) were obese when using BMI, but when using waist circumference (66.6%)

were the normal ranges. Additional when using BFP (33.3%) have athletes and fitness

body fat percentage. The table also shows that, athletes in sport centers without

registered dietitian (48.8%) are obese when using BMI, but when using waist

circumference about (50%) were at risk for diseases, Additional when using BFP half

of them (50%) have average body fat percentage. Classification of (BMI) according to

World Health Organization Standard, classification of (WC) according to Nutrition and

Healthy Foundation Standards and classification of (BFP) according to Health Check

Systems and American Council on Exercise.

Although some people believe that determining body mass index (BMI) is a good

way to screen for over-fatness in athletes, it is actually a poor one because it is a ratio

of body weight to height; it accounts for body mass, not body fat. Hulky football

players, weightlifters, and other power athletes who have lots of muscle mass easily get

ranked as obese (BMI greater than 30); this is generally far from the truth. In a study of

28 collegiate hockey players, the average BMI was 26 (overweight), but the average

body fat was a lean 13 percent (69). waist circumference (WC) that may be useful in

identifying at risk of suffering from cardiovascular diseases (CVD) a (67). Many

researchers recommend the use of percent body fat as a more precise parameter in the

physically active population.

Researchers also suggested that Waist circumference (WC) is thoroughly

correlated to body fat percentage (BFP) in calculating of extra body fat deposition (141).

Waist circumference (WC) measurement and body fat percentage (BFP) are being used

as procedures for valuation of body fat accumulation for those are overweight and obese

with general obesity and abdominal obesity because they are simple, inexpensive and

reliable (142, 143).

Nutrition and Self-efficacy of the Athletes:

Nutrition and exercise self-efficacy were connected to the maintenance of diet

and physical activity, it has been found that nutrition self-efficacy operates best in

concert with general changes in lifestyle, including physical exercise. As a whole,

athletes from sport centers with a registered dietitian were more confident in making

certain nutrition decisions than the athletes from sport centers without a registered

dietitian. The athletes from sport centers with a registered dietitian were significantly

more confident in their ability to eat a health snack pre and post workout, eat a

nutritious, balanced diet, eat the correct amount of calories each day, maintain a healthy

weight, and keep hydrated before, during, and after practice and competition. These

athletes from sport centers with a registered dietitian, who in general sought out more

nutrition information, got more of their nutrition information from their coaches who

have access to registered dietitians that spends most of their time with them, and who

were more knowledgeable about nutrition were better prepared to make nutrition

decisions and felt more confident in doing so.

Wallinga, M., and colloquies (2013) done a research on the Assessment of

Nutrition Knowledge and Self-Efficacy of NCAA Athletes. They suggested that that

athletes who had a sports dietician were more likely to seek out nutritional information,

demonstrated more knowledge about nutrition and felt more confident making

decisions (136). Other study show that, athletes from Universities with full-time Sports

Registered Dietitians placed more value on seeking out nutrition information, got their

nutrition information from more reliable sources, had better nutrition knowledge, and

identified more self-efficacy in making nutrition decisions (91). Anderson et al (2000).

Such approaches lead to consumption of more fruit and vegetables, less fat and more

fiber, Self-efficacy may be influenced by levels of knowledge, and in turn, affects

attitudes and behaviors (16)

Conclusions and Recommendations

CONCLUSIONS:

The researcher concluded that;

Low availability of sport nutritionists/registered dieticians in the sport

centers/gyms by (27.6%).

Coaches from sport centers with a registered dietitian in the study (50%)

identified registered dietitians, as their largest sources for nutrition information.

Coaches from sport centers without a registered dietitian in the study (47.6%)

identified Internet as places they get most of their nutrition information.

Athletes from sport centers with a registered dietitian and from sport centers

without a registered dietitian in the study identified strength and conditioning

coaches as places they get most of their nutrition information.

Majority of the athletes in sport centers with registered dietitian are obese when

using BMI, but when using waist circumference and body fat percentage most

of them were found normal according to the reference values

Athletes in sport centers without registered dietitian are obese when using BMI,

but when using waist circumference most of them are at risk for diseases

additional when using body fat percentage most of them have average body fat

percentage.

When considering all athletes and coaches from sport centers with a registered

dietitian and sport centers without a registered dietitian found the majority of

athletes and coaches to be fairly knowledgeable.

Some differences were found showing that the athletes and coaches with access

to registered-dietitian, were more knowledgeable in specific areas than athletes

and coaches without access to such this reliable source.

The athletes and coaches from sport centers with a registered dietitian were

identified more self-efficacy in making nutrition decisions than coaches from

sport centers without a registered dietitian.

Recommendations:

The researcher recommended that;

Ministry of youth and sport should pay more attention regarding the sports

nutritionist or registered dieticians by:

Establishing a sport nutrition department at Sport Centers and Universities

contract with a full time Sports Registered Dietitian on staff, not simply in a

consulting role, but also important to educated on the importance of seeking out

nutrition information from a reliable source, specifically Registered Dietitian.

Making easy access to Registered Dietitians; when one is on-university or work

full-time they are more likely to seek them out for nutrition information to

ensure each athlete is receiving reliable nutrition information,

Because so many athletes identified strength and conditioning coaches as a

source of nutrition information, it would be beneficial to know what type of

nutrition education and knowledge strength and conditioning coaches at Sport

Centers and Universities have and also how much nutrition education they are

doing with their athletes. In this case, Sports Registered Dietitians are also more

available for the coaches to educate them on proper nutrition so good nutrition

practices are done as an entire team.

Ministries of Education/ higher education and scientific research should put

more effort with regards to the capacity building and training of dieticians/

nutritionists and coaches by initiating a national accredited programs

inconsistent with the international standards.

Athletes federation should establish a valid, up to date data base to

facilitate further studies in this area. In order to enrich the country’s data bases

should be supported by collaboration and coordination between different sectors

and authorities.

As Sports Nutrition at Sport Centers and Universities is a topic which has not

been heavily researched, it is very important that more research be done to

establish trends and deficits in nutrition knowledge and self-efficacy and also

the importance of Sports Registered Dietitians at Sport Centers and

Universities. It would be beneficial for a mixed methods study to be done using

focus groups and surveys to establish which parts of the nutrition departments

were the most beneficial.

Chapter Six

References

1. Embassy of the Republic of Sudan (2017), سفارة جمهورية السودان Available at:

http://www.sudanembassy.org/index.php/about-sudan-sp-942178989.

Ministry of youth and sports, (2016) .2الخرطوم –وزارة الشباب والرياضة –عن الوزارة

Available at: http://www.hcys-krt.net/?page_id=11084 [Accessed December 26,2017]

:National Center for Research, (2017) Available at .3الخرطوم -المركز القومي للبحوث عن

http://www.ncr.gov.sd/

4. Rodriquez, N. R., DiMarco, N. M., and Langley, S. (2009). Position of the American

dietetic association, dietitians of Canada & the American college of sports medicine.

Journal of the American Dietetic Association, 109(3), 509-527.

5. Paper of the American College of Sports Medicine, Academy of Nutrition and

Dietetics (p. 709).

6. Kreider, R.B, Wilborn, C.D, Taylor, L, et al (2010). ISSN exercise & sport nutrition

review: research and recommendations. Journal of the International Society of Sports

Nutrition.; 7(7): 1-43.

7. Cook, D., (2015). What is sports nutrition? | Nerd Rage News ®. Available at

:http://nerdragenews.com/what-is-sports-nutrition/ [Accessed December 16,2017].

8. World Health Organization. (2004). Global strategy on diet, physical activity and

health. Geneva: World Health Organization.

9. Penn Foster Inc, (2016). INTRODUCTION TO SPORTS NUTRITION.

https://l.facebook.com/l.php?u=http%3A%2F%2Fwww.sudanembassy.org%2Findex.php%2Fabout-sudan-sp-942178989&h=ATMlDUGzOo_ylu4yLdtttMc_v8smOrcbc1HlrJUTQx_-_INmksHUIBcBNd9lO14vJSx9bUtzW2KU78js0bMi4CGZpJmwobWPRshLfUWOhZACuDAhMQN7e3dD3xLUB8lf9flcGorkAbqd

http://www.ncr.gov.sd/

10. Axelson, M. L., and Brinberg, D. (1992). The measurement and conceptualization

of nutrition knowledge. Journal of Nutrition Education, 24(5), 239-246.

11. Short SH, Short WR. (1983). Four-year study of university athletes' dietary intake.

J Am Diet Assoc;82:632-645.

12. Quatromoni, P.A. (2008). Clinical observations from nutrition services in college

athletics. Journal of the American Dietetic Association.; 108: 689-694

13. Burns, Robert D, Schiller, M. Rosita, Merrick, Mark A, Wolf and Kay N.(2004).

Intercollegiate student athlete use of nutritional supplements and the role of

athletic trainers and dietitians in nutrition counseling. Journal of the American

Dietetic Association, 104(2), pp.246–249. Available at:

http://linkinghub.elsevier.com/retrieve/pii/S0002822303015438 [Accessed

December 16, 2017].

14. Jacobson, B.H., Sobonya, C. and Ransone, J., (2001). Nutrition practices and

knowledge of college varsity athletes: a follow-up. Journal of strength and

conditioning research, 15(1), pp.63–8. Available at:

http://www.ncbi.nlm.nih.gov/pubmed/11708709 [Accessed December 26,

2016].

15. Parr, R.B., Porter, M.A. and Hodgson, S.C., (1984). Nutrition Knowledge and

Practice of Coaches, Trainers, and Athletes. The Physician and Sports medicine,

12(3), pp.126–138. Available at:

http://www.tandfonline.com/doi/full/10.1080/00913847.1984.11701801

[Accessed December 26, 2016].

16. Anderson, E. S., Winett, R. A., and Wojcik, J. R. (2000). Social-cognitive

determinants of nutrition behavior among supermarket food shoppers: A structural

equation analysis. Health Psychology, 19(5), 479-486.

17. Rodriguez N.R, DiMarco N.M and Langley S. (2009) Position of the American

Dietetic Association, Dietitians of Canada, and the American College of Sports

Medicine: Nutrition and Athletic Performance. J Am Diet Assoc.; 109(3): 509-527.

18. Burke L. (2007) Practical Sports Nutrition. Champaign, IL: Human Kinetics;.

19. Mujika, I., and Burke, L. M. (2010). Nutrition in team sports. Annals of Nutrition

and Metabolism, 57, 26-35.

20. Kreider, R.B., Wilborn, C.D., Taylor, L., Campbell, B., Almada, A. L., Collins, R.

and Antonia, J. (2010). ISSN exercise and sport nutrition review: Research and

recommendations. Journal of the International Society of Sports Nutrition, 7, 1-43.

21. Shriver, L., Betts, N., and Wollenberg, G. (2013). Dietary intakes and eating habits

of college athletes: Are female college athletes following the current sports nutrition

standards? Journal of American College Health, 61, 10-16.

22. Rodriguez, N. R., Di Marco, N. M., and Langley, S. (2009). American Dietetic

Association; Dietitians of Canada; American College of Sports Medicine. American

College of Sports Medicine position stand. Nutrition and athletic performance.

Medicine and Science in Sports and Exercise, 41, 709-731.

23. Burke L. (2007). Practical sports nutrition. Champaign, IL: Human Kinetics.

24. Clark, N. (2008). Sports Nutrition Guidebook. Champain, IL: Human Kinetics.

25. Potgieter S. (2013). Sport nutrition: A review of the latest guidelines for exercise

and sport nutrition from the American College of Sport Nutrition, the International

Olympic Committee and the International Society for Sports Nutrition. S Afr J

ClinNutr.; 26: 6-16.

26. Zawila LG, Steib CM and Hoogenboom B. (2003) The Female Collegiate Cross-

Country Runner: Nutritional Knowledge and Attitudes. J Athl Train.;38(1):67-74.

27. Daneshvar P, Hariri M, Ghiasvand R, Askari G, Darvishi L and Iraj B, et al. (2013)

Dietary behaviors and nutritional assessment of young male isfahani wrestlers. Int J

Prev Med.; Apr;4(Suppl 1):S48-52.

28. Dietitians of Canada, the Academy of Nutrition and Dietetics and the American

College of Sports Medicine (2016). Nutrition and Athletic Performance, Position of

Dietitians of Canada, the Academy of Nutrition and Dietetics and the American College

of Sports Medicine

29. Henderson D. (1987) Nutrition and the athlete. FDA Consumer;87:2219.

30. Burke and L.M. (2001) Practical issues in nutrition for athletes. Journal of Sports

Science.; 13: s83-s90.

31.Jonnalagadda SS, Rosenbloom CA and Skinner R. (2001) Dietary practices,

attitudes, and physiological status of collegiate freshman football players. J Strength

Cond Res.;15:507–13.[PubMed]

32. Moran, D., McClung, J., Kohen, T., and Lieberman, H. (2013). Vitamin D and

Physical Performance. Sports Medicine, 43(7), 601-611.

33. Nix, (2009), Nutrition and physical fitness, 13 edition, Williams Basic Nutrition

and Diet Therapy. 43-49.

34. U.S. Department of Health and Human Services and U.S. Department of

Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December

2015. Retrieved from:http://health.gov/dietaryguidelines/2015/guidelines/

35. Maughan RJ and Shirreffs SM. (2011) IOC Consensus Conference on Nutrition in

Sport, 25-27 October 2010, International Olympic Committee, Lausanne, Switzerland.

J Sports Sci.; 29 Suppl 1: 2011; 29 Suppl 1: S17-27. S1.

36. UNITED STATE. DEPARTMENT OF AGRICULTURE (USDA). (2012) Choose

my plate. Disponívelem: <http://www.choosemyplate.gov/>. Accesso: 16 jan.

37. Nordic Council of Ministers. Nordic Nutrition Recommendations 2012: Integrating

nutrition and physical activity. 2012.

38. Freedman D.S.and Perry G., (2000). Body composition and health status among

children and adolescents. Prevent. Med. 31, 34-53.

39. Clark, N. (2014). Sports Nutrition Guidebook. Champain, IL: Human Kinetics.

40. Bronner Y.L., (1996). Nutritional status outcomes for children: Ethincs, cultural

and environmental context. J. Am. Diet. Assoc. 90, 891-903.

41. Ramirez-Lopez G., Gonzalez-Villalpando C., Sanchez-Corona J., Salmeron-Castro

J., GonzálezOrtíz M., Cellis-de la Rosa A. and Valles-Sánchez V., (2001). Weight,

physical activity and smoking as determinant of insulinemia in adolescents. Arch. Med.

Res. 32, 208-213.

http://health.gov/dietaryguidelines/2015/guidelines/

42. Helms, E.; Fitschen, P.; Aragon, A.; Cronin, J. and Schoenfeld, B. (2015)

Recommendations for natural bodybuilding contest preparation: Resistance and

cardiovascular training. J. Sports Med. Phys. Fitness., 55, 164–178. [PubMed]

43. Gradidge P, Coopoo Y and Constantinou D. (2010) Attitudes and perceptions

towards performance enhancing substance use in Johannesburg boys high school sport.

S Afr J Sports Med.;22:32–6.

44. Gary Slater and Stuart M. Phillips Pages S67-S77 | Accepted 21 Mar (2011),

Published online: 09 Jun 2011 Download citation

http://dx.doi.org/10.1080/02640414.2011.574722

45. Potgieter, S., (2013). Sport nutrition : A review of the latest guidelines for exercise

and sport nutrition from the American College of Sport Nutrition , the International

Olympic Committee and the International Society for Sports Nutrition. , 26(1), pp.6–

16.

46. Hackett, D.; Johnson, N. and Chow, C. (2013) Training practices and ergogenic

aids used by male bodybuilders. J. Cond. Strength Cond. Res., 27, 1609–1617.

[CrossRef] [PubMed

47. Sundgot-Borgen, J., and I. Garthe. (2011). Elite athletes in aesthetic and Olympic

weight-class sports and the challenge of body weight and body compositions.

J Sports Sci 29 (Suppl. 1): S101-114.

48. Journal of the International Society of Sports Nutrition (2014) 11:20

https://doi.org/10.1186/1550-2783-11-20© Helms et al.; licensee BioMed Central

Ltd. 2014

49. Grosick, T. L., Talbert-Johnson, C., Myers, M. J., & Angelo, R. (2013). Assessing

the landscape: Body image values and attitudes among middle school boys and girls.

American Journal of Health Education, 44(1), 41-52. doi:10.1080/19325037.

2012.749682

50. Brausch AM. and Muehlenkamp JJ. (2007) Body image and suicidal ideation in

adolescents. Body Image.;4(2):207-12.3.

https://doi.org/10.1186/1550-2783-11-20

51. Grigg D., (1995). The nutritional transition in Western Europe. J. Hist. Geogr. 22,

247-261. Hurson M., Corish C., 1997. Evaluation of lifestyle, food consumption and

nutrient intake patterns among Irish teenagers. Irish J. Med. Sci. 166, 225-230.

52. Srinivasan C.S., Irz X. and Shankar B., (2006). An assessment of the potential

consumption impacts of WHO dietary norms in OECD countries. Food Policy 31, 53-

77.

53. U.S. Department of Health and Human Services, (1996) Physical activity and

health: a report of the Surgeon General. Atlanta: U.S. Department of Health and

Human Services, Centers for Disease Control and Prevention National Center for

Chronic Disease Prevention and Health Promotion. [Homepage on the internet].

[Cited 2007 Nov 10]. From:

http://www.cdc.gov/nccdphp/dnpa/physical/terms/index.htm.

54. U. Schroder, “Health effects of nutritional supplements,” in Health and Doping

Risks of Nutritional Supplements and SocialDrugs, W. Schanzer, F. T. Delbeke, A.

Deligiannis, G. Gmeiner, R. Maughan, and J. Mester, Eds., pp. 11–15, Sport and

BuchStrauB, Cologne, Germany, 2002.

55. Westerterp KR. (2013) Physical activity and physical activity induced energy

expenditure in humans: measurement, determinants, and effects. Front Physiol.; 4: 90.

56. Stuempfle KJ, Hoffman MD and Hew-Butler T. (2013) Association of

gastrointestinal distress in ultramarathoners with race diet. Int J Sport

NutrExercMetab.; 23: 103-9.

57. M. S. Rockwell, S. M. Nickols-Richardson, and F.W. Thye. (2004). “Nutrition

knowledge, opinions, and practices of coaches and athletic trainers at a Division I

University,” International Journal of Sport Nutrition, vol. 11, no. 2, pp. 174–185,.

58. S. H. Huang, K. Johnson, and A. L. (2006) Pipe, “The use of dietary supplements

and medications by Canadian athletes at the Atlanta and Sydney olympic games,”

Clinical Journal of Sport Medicine, vol. 16, no. 1, pp. 27–33,.

58. Kreider, RB, Wilborn, CD and Taylor, L, et al. (2010) ISSN exercise & sport

nutrition review: research and recommendations. Journal of the International Society

of Sports Nutrition.; 7(7): 1-43.

60. R. J. Maughan, D. S. King, and T. Lea. (2004) “Dietary supplements,” Journal of

Sports Sciences, vol. 22, no. 1, pp. 95–113,.

61. Rodriguez NR. DN and Langley S. (2011) Nutrition and athletic performance.

American College of Sports Medicine..

62. Castell, L.M., Stear, S.J. and Burke, L.M., (2015). NutritioNalSupplemeNtSiN

Sport exerciSeaNdHealtH

63. Sobal, J. and Marquart, L.F., (1994). Vitamin/mineral supplement use among

athletes: a review of the literature. International journal of sport nutrition, 4(4), pp.320–

34. Available at: http://www.ncbi.nlm.nih.gov/pubmed/7874149.

64. American College of Sports Medicine (ACSM), the American Dietetic Association

(ADA), and Dietitians of Canada (DC). (2009) Medicine & Science in Sports &

Exercise.; 41(3): 709-731.

65. Cole, CR, Salvaterra, GF and Davis JE, et al. (2005) Evaluation of dietary practices

of national collegiate athletic association division I football players. J. Strength Cond.

Res.; 19(3): 490-494.

66. Thomas DT, Erdman KA and Burke LM. (2016) Position of the Academy of

Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports

Medicine: Nutrition and Athletic Performance. J AcadNutr Diet.; 116: 501-28.

67. Van Erp-Baart AM, Saris WM, Binkhorst RA, Vos JA and Elvers JW. (1989)

Nationwide survey on nutritional habits in elite athletes. Part II. Mineral and vitamin

intake. Int J Sports Med.; 10 Suppl 1: S11-6.

68. Phillips SM, Van Loon LJ. (2011) Dietary protein for athletes: from requirements

to optimum adaptation. J Sports Sci.; 29 Suppl 1: S29-38.

69. American College of Sports M, Sawka MN and Burke LM, et al. (2007) American

College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci

Sports Exerc.; 39: 377-90.

70. Casa, DJ, Armstrong, LE, Hillman and SK, et al. (2000) National athletic trainer’s

association position statement: fluid replacement for athletes. Journal of Athletic

Training.; 35(2): 212-224.

http://www.ncbi.nlm.nih.gov/pubmed/7874149

71. Kerksick, C, Harvey, T and Stout J, et al. (2008) International Society of Sports

Nutrition position stand: Nutrient timing. Journal of the International Society of Sports

Nutrition.; 5: 17-28.

72. Wardenaar FC, Maas T, Danen S, Pannekoek S. Richtlijn, Wedstrijdsport. Dieetbeh

and elingsrichtlijnen. Rotterdam: (2010) uitgevers, (2013).

73. Stuempfle KJ, Hoffman MD and Hew-Butler T. (2013) Association of

gastrointestinal distress in ultramarathoners with race diet. Int J Sport

NutrExercMetab.; 23: 103-9.

74. Jeukendrup A. (2014) A step towards personalized sports nutrition: carbohydrate

intake during exercise. Sports Med.; 44 Suppl 1: S25-33.

75. Casa, DJ, Armstrong, LE and Hillman, SK, et al. (2000) National athletic trainer’s

association position statement: fluid replacement for athletes. Journal of Athletic

Training.; 35(2): 212-224.

76. Burke, LM. (2010) Fueling Strategies to optimize performance: training high or

training low? Scandinavian Journal of Medicine and Science in Sports.; 20(2): 48- 58.

77. Moran, D., McClung, J., Kohen, T., and Lieberman, H. (2013). Vitamin D and

Physical Performance. Sports Medicine, 43(7), 601-611.

78. Birkenhead, K. L., and Slater, G. (2015). A review of factors influencing athletes'

food choices. Sports Medicine, 45(11), 1511-1522.

79. Ono, M., Kennedy, E., Reeves, S., and Cronin, L. (2012). Nutrition and culture in

professional football. A mixed method approach. Appetite, 58(1), 98-104.

80. Kicklighter, J. R., Koonce, V. J., Rosenbloom, C. A., and Commander, N. E. (2010).

College Freshmen Perceptions of Effective and Ineffective Aspects of Nutrition

Education. Journal of American College Health, 59(2), 98-104.

81. Long, D., Perry, C., Unruh, S. A., Lewis, N., and Stanek-Krogstrand, K. (2011).

Personal Food Systems of Male Collegiate Football Players: A Grounded Theory

Investigation. Journal of Athletic Training, 46(6), 688–695.

82. Birkenhead, K. L., and Slater, G. (2015). A review of factors influencing athletes'

food choices. Sports Medicine, 45(11), 1511-1522.

83. Webber, K., Stoess, A.I., Forsythe, H., Kurzyneske, J., Vaught, J.A., and Adams,

B. (2015). Diet Quality of Collegiate Athletes. College Student Journal, 49(2), 251-256.

84. 8. Bonci L. (2011) Eating for performance: bringing science to the training table.

Clin Sports Med. Jul; 33(3): 661-70.

85. Jonnalagadda, SS, Rosenbloom, CA and Skinner, R. (2001) Dietary practices,

attitudes, and physiological status of collegiate freshman football players. J. Strength

Cond. Res.; 15(4): 507-513.

86. Hinton, PS, Sanford, TC, Davidson, M, Yakushko, O.F, Beck and NC. (2004)

Nutrient intakes and dietary behaviors of male and female collegiate athletes.

International Journal of Sport Nutrition and Exercise Metabolism.; 14(4), 389-405.

87. Karpinski, C. A., and Milliner, K. (2016). Assessing Intentions to Eat a Healthful

Diet Among National Collegiate Athletic Association Division II Collegiate Athletes.

Journal of Athletic Training (Allen Press), 51(1), 89-96.

88. Institute of Medicine. (2001) Dietary reference intakes: applications in dietary

assessment. Washington D.C.: National Academy Press..

89. Slater, M.E., Sirard, J.R., Laska, M.N., Pereira, M.A. and Lytle, L.A. (2011).

Relationships between Energy Balance Knowledge and the Home Environment. J Am

Diet Assoc., 111, 556- 560.

90. Carlsohn A, Nippe S, Heydenreich J and Mayer F. (2012) Carbohydrate intake and

food sources of junior triathletes during a moderate and an intensive training period. Int

J Sport NutrExercMetab.; 22: 438-43.

91. U.S. Department of Agriculture, U.S. Department of Health and Human Services.

Dietary Guidelines for Americans 2010; 7.

92. Volpe, SL. (2007) Micronutrient requirements for athletes. Clinics in Sports

Medicine.; 26: 119-130.

93. Cupisiti, A., D’Alessandro, C., Castrogiovanni, S., Barale, A. and Morelli, E.

(2002). Nutrition Knowledge and Dietary Composition in Italian Adolescent Female

Athletes and NonAthletes. International Journal of Sports Nutrition and Exercise

Metabolism, 12, 207-219.

94. Miller, P.E., Alexander, D.D. and Perez, V., (2014). Effects of Whey Protein and

Resistance Exercise on Body Composition: A Meta-Analysis of Randomized

Controlled Trials. Journal of the American College of Nutrition, 33(2), pp.163–

175. Available at:

http://www.tandfonline.com/doi/abs/10.1080/07315724.2013.875365 [Accessed

January 11, 2017].

95. Contento, I. R. (2011). Nutrition education linking research, theory, and practice

(2nd ed.). Sudbury, Mass.: Jones and Bartlett.

96. Torres-McGehee, T. M., Pritchett, K. L., Zippel, D., Minton, D. M., Cellamare, A.,

and Sibilia, M. (2012). Sports nutrition knowledge among collegiate athletes, coaches,

athletic trainers, and strength and conditioning specialists. Journal of Athletic Training,

47(2), 205-211.

97. Hinton, PS, Sanford, TC, Davidson, M, Yakushko, O.F ,Beck and NC. (2004)

Nutrient intakes and dietary behaviors of male and female collegiate athletes.

International Journal of Sport Nutrition and Exercise Metabolism.; 14(4), 389-405

98. Mirkin G. Pre-race or pre-game meal. Available at:

www.DrMirkin.com/fitness/8494.html. Accessed September 9, 2004.

99. Pratt CA, Walberg JL. (1988) Nutrition knowledge and concerns of health and

physical education teachers. J Am Diet Assoc;88:840-841.

100. Wolf EMB, Wirth JC and Lohman TG. (1979) Nutrition practices of coaches in

the big ten. PhysSportsmed;7:113-124.

101. Birkenhead, K. (2013). Nutrition Knowledge, Food Choice Motives and Eating

Behaviors of Triathletes. Faculty of Science, Health, Education and Engineering,

University of Sunshine Coast 2013

102. Burns, Robert D.,Schiller, M.Rosita,Merrick, Mark A.,Wolf and Kay N.(2004).

Intercollegiate student athlete use of nutritional supplements and the role of

athletic trainers and dietitians in nutrition counseling. Journal of the American

Dietetic Association, 104(2), pp.246–249. Available at:

http://linkinghub.elsevier.com/retrieve/pii/S0002822303015438 [Accessed

December 26, 2016].

103. Froiland K, Koszewski W, Higst J and Kopecky L. (2004) Nutritional Supplement

use Among College Athletes and Their Sources of Information. Int J Sport

NutrExercMetab.;14(1):104-120.

104. Spendlove JK, Heaney SE, Gifford JA, Prvan T, Denyer GS and O'Connor HT.

(2012) Evaluation of general nutrition knowledge in elite Australian athletes. British

Journal of Nutrition.;107(12):1871.

105. Feltz, D., and Magyar, T. (2006). Self-efficacy and adolescents in sport and

physical activity. In F. Pajares& T. Urdan (Eds.), Self-efficacy beliefs of

adolescents(pp. 161 179). Greenwich, CT: Information Age Publishing.

106. Abood DA, Black DR and Birnbaum RD. (2004) Nutrition Education Intervention

for College Female Athletes. J NutrEducBehav.;36(3):135-139.

107.Rehrer NJ, Hellemans IJ, Rolleston AK, Rush E and Miller BF. (2010) Energy

intake and expenditure during a 6-day cycling stage race. Scand J Med Sci Sports.; 20:

609-18.

108. Carr, A.,Dawson, B.,Schneiker, K.,Goodman, C. and Lay, B., (2008). Effect of

caffeine supplementation on repeated sprint running performance. Journal of Sports

Medicine and Physical Fitness.

109. Chang, M., Nitzke, S., and Brown, R. L. (2003). Development and validation of a

self-efficacy measure for fat intake behaviors of low-income women. Journal of

Nutrition Education & Behavior, 35, 302-307.

110. Abood DA, Black DR, Birnbaum RD. (2004) Nutrition Education Intervention for

College Female Athletes. J NutrEducBehav.;36(3):135-139.

111. Bagozzi, R. P., and Edwards, E. A. (1998). Goal setting and goal pursuit in the

regulation of body weight. Psychology and Health, 13, 593-621.

112. Bandura, A. (2012). On the functional properties of perceived self-efficacy

revisited.Journal of Management, 1, 9-24.

113. Schnoll, R., and Zimmerman, B. J. (2001). Self-regulation training enhances

dietary selfefficacy and dietary fiber consumption. Journal of the American Dietetic

Association, 101, 1006-1011.

114. Resnicow, K., Wallace, D. S., Jackson, A., Digirolamo, A., Odom, E., Wang, T.,

Dudley, W. M., Davis, M., Mitchell, D., and Baranowski, T. (2000). Dietary change

through African American churches: Baseline results and program description of the

eat for life trial. Journal of Cancer Education, 15, 156-163.

115. Pawlak R, Malinauskas B and Rivera D. (2009) Predicting Intentions to Eat a

Healthful Diet by College Baseball Players: Applying the Theory of Planned Behavior.

J NutrEducBehav.;41(5):334-339.

116. Quatromoni, P. A. (2008). Clinical observations from nutrition services in college

athletics. Journal of the American Dietetic Association, 108(4), 689-694. doi:

10.1016/j.jada.2008.01.008; 10.1016/j.jada.2008.01.008.

117. Weeden, A. M., Olsen, J., Batacan, J. M., and Peterson, T. (2014). Differences in

collegiate athlete nutrition knowledge as determined by athlete characteristics. The

Sport Journal, 55, 1-13.

118. Parr RB, Porter MA and Hodgson SC. (1984) Nutrition knowledge and practice

of coaches, trainers, and athletes. PhysSportsmed;12:127-138.

119. Volpe, SL. (2007) Micronutrient requirements for athletes. Clinics in Sports

Medicine.; 26: 119-130.

120. Quatromoni, PA. Clinical observations from nutrition services in college

athletics.Journal of the American Dietetic Association. 2008; 108: 689-694.

121. Jonnalagadda, SS, Rosenbloom, CA and Skinner, R. (2001) Dietary practices,

attitudes, and physiological status of collegiate freshman football players. J. Strength

Cond. Res.; 15(4): 507-513.

122. Anderson, D. (2010) The impact of feedback on dietary intake and body

composition of college women volleyball players over a competitive season. J. Strength

Cond. Res.; 24(8): 2220-2226.

123. Burns, R. D., Schiller, M. R., Merrick, M. A., & Wolf and K. N. (2004).

Intercollegiate student athlete use of nutritional supplements and the role of athletic

trainers and dietitians in nutrition counseling. Journal of American Dietetic

Association, 104, 246-249

124. Torres-McGehee, T. M., Pritchett, K. L., Zippel, D., Minton, D. M., Cellamare,

A., and Sibilia, M. (2012). Sports nutrition knowledge among collegiate athletes,

coaches, athletic trainers, and strength and conditioning specialists. Journal of Athletic

Training, 47(2), 205-211.

125. Murray, D. W., Mahadevan, M., Gatto, K., O’Connor, K., Fissinger, A., Bailey,

D., and Cassara, E. (2015). Culinary efficacy: An exploratory study of skills,

confidence, and healthy cooking competencies among university students. Perspectives

in Public Health, Advance online publication doi:10.1177/1757913915600195.

126. Weeden, A. M., Olsen, J., Batacan, J. M., and Peterson, T. (2014). Differences in

collegiate athlete nutrition knowledge as determined by athlete characteristics. The

Sport Journal, 55, 1-13.

127. Nash, C., and Sproule, J. (2012). Coaches perceptions of their coach education

experiences. International Journal of Sport Psychology, 43, 33-52.

128. Vargas-Tonsing and T. M. (2007). Coaches' preferences for continuing coaching

education. International Journal of Sports Science and Coaching, 2, 25-35.

doi: 10.1260/174795407780367186.

129. Williams, S. J., and Kendall, L. (2007). Perceptions of elite coaches and sports

scientists of the research needs for elite coaching practice. Journal of

Sports Sciences, 25, 1577-1586. doi: 10.1080/02640410701245550.

130. Anon, 2016.(2016) .130 مركز معلومات ولاية الخرطوم Available at:

http://www.krt.gov.sd/portal/ [Accessed January 14, 2017].

http://www.krt.gov.sd/portal/

131. Central Bureau of Statistics Republic of Sudan, (2013). The total population

expected to States for the period 2009-2018. , pp.1–137.

132. Ati, Hassan A.,Pavanello, Sara,Jaspars, Susanne,Martin, Ellen,Mosel and Irina,

(2011). City limits : urbanisation and vulnerability in Sudan Juba case study.

Humanitarian Policy Group, (January).

133. Jessri, M., Jessri, M., RashidKhani, B., and Zinn, C. (2010). Evaluation of Iranian

College Athletes' Sport Nutrition Knowledge. International Journal of Sport Nutrition

& Exercise Metabolism, 20(3), 257-263.

134. Shifflett., et al. (2002). Understanding of Athletes’ Nutritional Needs Among

Athletes, Coaches, and Athletic Trainers. Research Quarterly for Exercise and Sport,

73(3), 357-362.

135. Corley G, Demarest-Litchford M and Bazzarre T. (1990) Nutrition knowledge and

dietary practice among college coaches. J Am Diet Assoc. May; 90(5): 705-9.

136. Wallinga, M., Takahashi, S., Kohnke, C., Koszewski, W., Hingst, J., and Socha,

T. (2013). Assessment of Nutrition Knowledge and Self-Efficacy of NCAA Athletes.

Journal of The Academy Of Nutrition & Dietetics, 113A87.

137. Heaney S, O'connor H, Michael S, Gifford I and Naughton G. (2011) Nutrition

knowledge in athletes: a systematic review. International Journal of Sport

Nutrition and!Exercise Metabolism.;21(3):248O61.

138. Condon EM, Dube KA and Herbold NH. (2007) The Influence of the Low

Carbohydrate Trend on Collegiate Athletes' Knowledge, Attitudes, and Dietary

Intake of Carbohydrates. Topics in Clinical Nutrition.;22(2):175.

140. 7 Maughan RJ and Shirreffs SM. (2010) IOC Consensus Conference on Nutrition

in Sport, 25-27 October, International Olympic Committee, Lausanne, Switzerland. J

Sports Sci. 2011; 29 Suppl 1: S1

161 . Lear SA, Humphries KH, Kohli S and Birminghan L. (2007) The use of BMI and

waist circumference as surrogates of body fat differs by ethnicity. Obesity; 15: 2817-2

142. Han TS, Sattar N and Lean M. Assessment of obesity and its clinical implication.

BMJ 2006; 333: 695-

143 Wang J, Thornton JC, Bari S et al. (2003) Comparisons of waist circumferences

measured at 4 sites. Am J ClinNutr; 77: 379-84

.

Assessment of Nutrition knowledge and self-efficacy of

coaches

The purpose of this research study is to assess the nutrition knowledge and self-

efficacy of athletes and their coaches at sport centers. All information obtained

throughout this study will be kept strictly confidential. Thank you for your participation

in this study.

Age= __________year Major center:_______________________ __

Education of level

___________Literacy

___________Primary School

___________high School

___________University

___________Other (Please list) ________________________

Sport type you working with

__________ Body Builders

__________ Body Image

__________ Fitness

___________All of the above

How long have you been working

______Less than five year ______More than five year

1) From where you get information on nutrition and supplements

______Doctors _______Colleagues at work

_______Internet _______ Registered Dietitian _______Books

________ Supplement Store

_______Others ________________________

2) Do you have nutrition plan for your personal physical activity and to your athletes

______Yes ________No ________ Not sure

2A) if you have, according to what (Check all that apply)

________Your personal experience and knowledge

________Sport nutrition guideline

________ doctor s

________Others __________________________

2B) if you don’t why (Check all that apply)

_______It is too much time consuming

_______ It is too much money consuming

_______ It is not a major concern

_______ I don’t have enough nutrition knowledge

_______ Other (please list) ___________________________________

3) The main energy source for the athlete is

_______Carbohydrates and Fat _______ Protein _______Not sure

4) Dehydration can reduce performance.

______ True _________ False ________Not sure

5) Do you recommend using supplements

_____Yes ________No ________ Not sure

6) Do you know the benefit and harmful or side effects of supplements

______Yes ________No ________ Not sure

7) From where do you get supplements

_________available in center/gym

_________supplements store

_________pharmacy

_________Other________________

8) Nutritional counseling would be important to coaches, athletes and everyone at

sport center

__________ True

__________ False

__________Not sure

Use a number from 1 to 10 on the following scale to tell how certain you are that

you can do the following things all or most of the

time:0_________________________5_____________________10

Certain I Can Not Somewhat certain I Can Certain I Can

How certain are you that you can… How certain (0-10)

Eat a healthy snack pre-and post-workout

Eat a nutritious, balanced diet

Eat the correct amount of calories each day

Maintain a healthy weight with diet and exercise

Keep hydrated before, during, and after practice and

competition

Assessment of Nutrition knowledge and

Self-efficacy of Athletes

The purpose of this research study is to assess the nutrition knowledge and self-efficacy

of athletes and their coaches at sport centers. All information obtained throughout this

study will be kept strictly confidential. Thank you for your participation in this study.

Age = _____ year Height = _______cm Weight = ______kg Neck

circumference = ______cm Waist circumference = _____cm

Occupation = ______ student _______ employee

Education of level

___________Literacy

___________Primary School

____________high School

____________University

____________Other (Please list) ______________________________________

Sport type

_____________Fitness

_____________ Body Builders

_____________ Body Image

How long have you been participant

______Less than five month

______More than one year

______More than two year

Major center: _________________________________________________

1. Do you have access to nutrition counseling

_________Yes __________ No ________I don’t know

2. Do you actively seek out or read nutrition information?

_________Yes __________ No ________I don’t know

2A. if you do, from where? (Check all that apply)

_______Friends _______Family _______Magazines

______Supplement Store _______Doctor _________Internet

______Sports Nutritionist ________Registered Dietitian

_______Strength and Conditioning Coach

________Other (Please list) _________________________________

2B. if you don’t, why not? (Check all that apply)

_______No time

_______It is not a major concern

_______You already have enough nutrition knowledge

_______Other (please list) ___________________________________

3. Do you use supplement

_____Yes _____NO _______I don’t know what is supplements

3A .if you do, why (Check all that apply)

______Improve the performance

______Increase muscle mass

_______Burn fat

_______All of the above

________Others_________________________________

3B. if you don’t, why (Check all that apply)

________It is too money consuming

________I don’t know what type is safe

________It is not important

________Other (please list) ________________________

4. What kind of supplements are you using

________ Creatine

_________Branch chain amino acids (BCAA)

_________Protein

_________whey protein

_________casein protein

_________Glutamine

5. Vitamin and mineral supplements provide energy to my body.

_________Yes __________ No ________I don’t know

6. Protein supplements are needed in addition to food for muscle growth and

development.

_________Yes __________ No ________I don’t know

7. The vast majority of supplements sold to the general public have been tested for

effectiveness or safety.

_________Yes __________ No ________I don’t know

8. Water is better than drinking sport drinks and should be consumed all throughout

the day.

_________Yes __________ No ________I don’t know

9. It is recommended to consume sports drinks during practices and competitions

lasting longer than 1 hour.

_________Yes __________ No ________I don’t know

10. Having a nutritious diet will improve my athletic performance.

_________Yes __________ No ________I don’t know

11. I am aware of how many calories I need to consume every day to promote my best

athletic

performance.

_________Yes __________ No ________I don’t know

12. Having a Sports Nutritionist at my centers is or would be helpful to me as an

athlete.

_________Yes __________ No ________I don’t know

13. Carbohydrates and fats are the main sources of energy for the muscles.

_________Yes __________ No ________I don’t know

14. Protein is the primary source of energy for the muscles.

_________Yes __________ No ________I don’t know

15. Consuming fruits and vegetables every day is important in order to get necessary

vitamins and

minerals.

_________Yes __________ No ________I don’t know

16. High-fat foods should be reduced in my diet.

_________Yes __________ No ________I don’t know

17. My coaches have encouraged me to either lose or gain weight..

_________Yes __________ No ________I don’t know

18. During 2-a-days or heavy practice days I should eat more calories.

_________Yes __________ No ________I don’t know

19 .When I am inactive my calorie needs do not change.

_________Yes __________ No ________I don’t know

20 Eating within 45 minutes of a workout is important

_________Yes __________ No ________I don’t know

21. Milk is a good source of Calcium and Vitamin D.

_________Yes __________ No ________I don’t know

22. Whole grain breads are a good source of fiber.

_________Yes __________ No ________I don’t know

Use a number from 1 to 10 on the following scale to tell how certain you are that

you can do the following things all or most of the time:

0 ___________________________5__________________________10

Certain I Can Not Somewhat certain I Can Certain I Can

How certain are you that you can… How certain (0-10)

Eat a healthy snack pre-and post-workout

Eat a nutritious, balanced diet

Eat the correct amount of calories each day

Maintain a healthy weight with diet and exercise

Keep hydrated before, during, and after practice and

competition

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