Nutritional Impact on Performance in Student-Athletes: Reality and

Merrimack College Merrimack College

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Nutritional Impact on Performance in Student-Athletes: Reality Nutritional Impact on Performance in Student-Athletes: Reality

and Perception and Perception

Sarah Sceery

Merrimack College

, [email protected]

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Running head: NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES:

REALITY AND PERCEPTION

Nutritional Impact on Performance in Student-Athletes: Reality and Perception

M.S. Health and Wellness Management

Sarah Sceery

Merrimack College

May 2017

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 2

Abstract

Context: The sports nutrition field is experiencing incredible growth and development. Athletes

are often epitomized for optimal health yet are susceptible to many nutrition related risks that can

have a profound impact on both positive and negative performance gains. The student-athlete

population is of particular interest based on their nutrition knowledge and where information is

obtained. Little is known about their perception on nutrition overall. Objective: The purpose of

this study was to examine student-athlete perceptions of nutrition and their attitudes about how

nutrition impacts performance. Design: Qualitative semi-structured interviews were facilitated

with the study population. Participants: A total of 10 Division II student-athletes enrolled in

this study. Data Analysis: Data was analyzed using a grounded theory approach. Credibility was

established through member checks and written notes served as triangulation. Results: Several

themes and subthemes emerged from the data. Accessibility, knowledge, time and physical

feelings all tie into how student-athletes perceive the nutritional impact on performance and were

the primary themes. The subthemes, which further broke down the student-athlete perspectives

and perceptions on how nutrition can impact performance, included the traveling, costs and

resources in relation to accessibility, understanding versus utilization of nutritional knowledge

and the performance or hunger effects students attribute to the physical feelings of nutrition.

Conclusions: Student-Athletes believe nutrition is important for their overall health and

wellbeing. They perceive that it has the potential to positively or negatively impact performance.

However they do not always have the resources or knowledge necessary to consume nutrition

properly balanced to improve performance, therefore additional nutritional education is

recommended.

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 3

Introduction

Background

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. Diet is simply what you

consume and the quantities of how much you consume, therefore fueling the body and

profoundly impacting how an individual functions physically, mentally and even socially.

Nutritional choices determine and greatly effect health status. Maintaining a healthy and well-

balanced diet is essential for the overall health and wellness of all populations and

individualizing those nutritional needs based on behaviors is critical.

Nutrition currently sits at the forefront of major public health concerns with many

nutritional choices trending toward poor decisions, developing unhealthy habits and the

associated effects. Obesity is one of the largest health concerns of Americans, accounting for

increased risk of disease, mortality, morbidity and billions of health care dollars spent each year.

While obesity is the most common indicator of poor nutrition, other main stream diseases

including diabetes, cardiovascular disease and stroke are all linked to nutritional factors as well.

In fact, 117 million individuals or close to one half of Americans have one or more chronic

diseases related to poor diet (U.S. Department of Health and Human Services and U.S.

Department of Agriculture, 2015, p.xi) therefore emphasizing the importance of intervention.

As these numbers are alarming, the general population are not the only population at risk

from poor nutritional habits. 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. In

the case of athletes across all levels, a quality well-balanced diet is essential for proper health

and achieving performance goals (Nutrition and Athletic Performance, 2016). The athlete

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 4

population spans a large range of nutritional needs. Performance goals vary immensely between

different types of athletes, therefore emphasizing the importance of individualism. Furthermore,

proper nutritional supplementation and emphasis on balance is important for all athletes. Current

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

positive impacts on performance (Moran, McClung, Kohen, & Lieberman, 2013). However,

education and awareness around sports nutrition is largely lagging behind. This is especially true

and concerning in the case of student-athletes (Torres-McGehee et al., 2012 & Webber et

al.,2015). This literature review will examine the perceptions of nutrition on performance,

student-athletes nutritional knowledge and the factors that influence these decisions.

Why does Nutrition Matter for Athletes?

Athletes at all levels from recreational to the international competitive scale place

incredible demands on their bodies. Through the combination of physical work, energy

expenditure, time and recovery periods, by nature they are pushing their bodies to further limits.

In doing so, athletes therefore require additional energy and fuel through nutrients and ultimately

their diet. According to renowned Sports Nutritionist, Nancy Clark and her Sports Nutrition

Guidebook (2013), eating for every day active people must be different than those who are more

sedentary. In this case, athletes are assumed to be much more active individuals. Furthermore,

just as a medication plan or physical training regimen, these eating patterns, needs and

requirements are unique to every individual athlete or “active person.”

This concept of individualism is one that is essential when considering sports nutrition.

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

Sports Medicine (2016) highlight that nutrition plans must be individualized for athletes to

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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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. The

differences are evident in the comparison of a 250lb offensive lineman versus a 115lb female

gymnast. Two incredibly unique individuals with different goals. One is not necessarily healthier

than the other or works any harder but what they put into their bodies to achieve those

individualized goals matters. Athletes walk a fine line between balancing to train hard enough to

reach those goals and avoiding the risk to injury. Nutrition and the benefits it can provide, fall

somewhere right in the middle (Nutrition and Athletic Performance, 2016). 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 (Moran et al., 2013). In addition, in order to maintain a balance and

modification the standard dietary guidelines of incorporating the micronutrients in fruits and

vegetables must not be forgotten (U.S. Department of Health and Human Services and U.S.

Department of Agriculture, 2015).

Nutrition in College Athletes

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

College of Sports Medicine (2016) 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. A study done by Webber et al. (2015) on the diet quality

of collegiate athletes demonstrated that on average student-athletes only scored a 51 out of a

possible 100 on the Healthy Eating Index (HEI). The HEI is a measure of diet quality that

assesses how closely individuals follow the dietary guidelines outlined and is one of the most

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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popular tools to monitor diet quality in the US. A diet score of 80 is considered “good” while

51-80 is considered “fair”. Therefore, this study emphasizes both the need for nutrition

intervention and nutritional education for student-athletes.

In taking it one step further and actually assessing diets, a dietary recall done by

researchers on the eating habits of female collegiate athletes specifically found that energy and

carbohydrate intakes were far below the recommended minimum amount with only 9% of

participants meeting their energy needs. 75% of these Division I athletes did not even consume

the minimum carbohydrate requirements (Shrivcr, Betts & Wollcnbetg, 2012). With

carbohydrates often serving as a main source of energy, this is concerning for the short term

performance impacts and long term sustainability of athletes.

Furthermore, disordered eating is a large concern for this population. According to the

Academy of Nutrition and Dietetics (2015), disordered eating is defined as “a wide range of

irregular eating behaviors…” It is categorized as a descriptive term, not necessarily a diagnosis

but the phrase can lead to serious conditions such as anorexia nervosa, bulimia nervosa, risks of

the female triad and even abuse of supplement usage. A recent study by Achiro and Theodore

(2015) highlighted the increased use and dangers associated with supplement usage, highlighting

the trend as the newest form of disordered eating. The authors found that men who were body

conscious used supplements in an excessive manner resulting in forms of disordered eating. 29%

of the group studied were concerned about their use of supplements while 22% stated they used

supplements to replace meals. The prevalence of disordered eating in this area expands the

overall categorization of eating disorders, putting a greater number of athletes at risk.

Disordered eating poses physical and mental health risks to athletes and the prevalence of

disordered eating is high among the specific student-athlete population. The NCAA, which

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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functions as the largest oversight board and governing institution for college athletes, identified

that 25% of female athletes and close to 20% of male athletes have disordered eating symptoms

(Voelker, 2012). Another study concluded that a significant number of female collegiate athletes

suffer from eating disorders and many used exercise as an outlet. The disorder was seen at the

symptom level and subclinical, not necessarily requiring specific treatment yet still incredibly

problematic (Greenleaf, Petrie, Carter, & Reel, 2009). Adams, Goldufsky and Schlaff (2015)

highlight the gender differences of disordered eating, dietary behavior and inherent risks among

both populations. As disordered eating continues to expand, the high prevalence among college

athletes is concerning.

The concern and risk of disordered eating scales well beyond college athletics both from

the early stages of development and post-college in professional athletics. Older literature found

team settings and group dynamics of peer pressure can include these risk factors on both a

positive and negative level for high school athletes. An article focused on the concepts of

reduced risk behavior and increasing positive behavior draws attention to the ATLAS (Athletes

Training and Learning to Avoid Steroids) and ATHENA (Athletes Targeting Healthy Exercise &

Nutrition Alternatives) programs. “The ATLAS and ATHENA programs’ positive findings

support strengthen sports’ health-engaging mission by incorporating harm reduction and health

promotion curriculum into the athletic team setting (Elliot et al., 2006)”, highlighting both the

important influences an athletic team can have as well as the risks that can be associated with

sport and competition to succeed. The accuracy of this data is limited however due to self-report

behaviors of high schoolers which has the potential to be subjective. However while information

no longer exist on these programs, the article demonstrates the importance of calling attention to

this area and idea of how health promotion can be tied to athletic teams in the areas of disordered

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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eating and nutrition. No similar programs or interventions were found for collegiate athletes.

Specific literature was not explored in depth for professional athletes, the general assumption can

be made that they do not always receive adequate nutrition guidance based on media outlets,

influential studies and personal affiliation of the increased steroid usage, nutrition discussion and

drive to succeed by professional athletes.

Nutrition Influencing Factors

What must be noted and emphasized in evaluating the nutritional risks for student-

athletes is the component of influence and identifying the specific factors that influence

nutritional decisions. An evaluation of how actual food choices are made by student-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 college students.

As Buckton and Combet (2015) highlight, healthy eating can be confused with diet and

weight management. This association between healthy eating and weight management is a

problem for the overall health population and relates back to the risk factors of disordered eating

for athletes. It is estimated that individuals make 220 food choices each and every day. These

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

(Birkenhead & Slater, 2015). New diet evidence and trends around gluten now play a role more

than ever for athletes. While specific benefits are unclear around gluten free diet benefits on

performance, when it comes to preference more and more endurance athletes are choosing to

take this route (Lis, Stellingwerff, Shing, Ahuja, & Fell, 2015). The research reported in this

study has a likelihood of bias based on the self-report information and possibility that subjects

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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adhere to a gluten free diet based on a number of other factors. However, it is interesting to

consider the current trends and new influencing factors in sports nutrition.

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

and sport decisions. As highlighted by Birkenhead and Slater (2015):

“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 (p.1515).”

The choice to physically be active and partake in sporting activities may alter student’s food

choices linking the two closely together. This can have a large impact on how student-athletes

feel about nutrition and food choices.

Psychological factors of body image and weight control along with social and cultural

factors all are incredibly essential in evaluating the nutrition of student-athletes. 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. Females were more preoccupied

with body weight factors and “…more likely to report a great level of agreement with statements

relating to performance declines attributed to weight gain…” (p.21) while “males have a positive

perception of performance enhancement directly associated with supplement utilization” (p.22).

Understanding the influences of nutritional perceptions is important and perceptions also extend

beyond psychological factors. As Ono, Kennedy, Reeves and Cronin (2012) point out, food

choice and perception is not traditional nutritional science instead it is more anthropology,

sociology or physiology (p.99). The authors are able to formulate stronger conclusions based on

a mixed methods approach of both nutritional intake assessment, determining what and when the

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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athletes are eating, followed by qualitative interviews allowing for a comprehensive

understanding of their attitudes and perceptions of food choices. This understanding could better

define the need for increased nutritional guidance.

For college students, food selections are often based on taste, time, convenience and cost

rather than nutritional value. 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 (Kicklighter, Koonce, Rosenbloom,

& Commander, 2010 and Long, Perry, Unruh, Lewis, & Stanek-Krogstand, 2011). The limitation

in this study, as well as several other pieces of literature found, is the narrow focus of the study

population on one specific sport. It can be assumed based on trends and general knowledge that

the idea of routine development is important but understanding that a sport like football may

have very different schedule routines or dynamics than other sports.

As demands on college athletes continue to increase and pressure surmounts to “be the

best” and “compete at the highest level” these routines become incredibly important and

structuring food into those routines matters. Socially, it is who you are eating with, who is

cooking and who you are around that impact food decisions. Often times, those social settings

are with teammates, coaches and athletic trainers, therefore playing an incredibly important role

in where nutritional information is obtained.

The role athletic trainers and coaches play in nutritional education is an essential one.

Athletic trainers and coaches have the significant ability to influence decisions (Torres-McGehee

et al., 2012 and Long et al., 2011). Based on multiple studies, it is evident that coaches, strength

and conditioning coaches and athletic trainers serve as a primary source of nutrition information

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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for student-athletes. These figures play a critical role in shaping an athlete on all aspects and

nutrition is part of that full package. Yet, there is a gap in knowledge of these sources that is

being provided. Torres-McGehee et al. (2012) also found that across Division I, II and III

schools, athletic trainers and strength and condition coaches have adequate knowledge but the

coaches do not. 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 (Ono et al., 2012). The lack of resources and lack of sports dietitians is evident at

the college and professional level.

The research about sports dietetics in a college setting is limited. While the full article

was unable to be located, a summary of an comparative assessment done on self-efficacy of

NCAA athletes found that athletes at schools who had a sports dietician were more likely to seek

out nutritional information, demonstrated more knowledge about nutrition and felt more

confident making decisions (Wallinga et al., 2013). 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 (Nutrition and Athletic Performance,

2016). Similar to the medical field, it is clear that obtaining information from experts is more

beneficial for student-athletes than peers, the internet or social media. Because information

delivery is still derived from a variety of areas, it leads to an incredible gap in knowledge of

nutrition for the athletes.

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Nutritional Knowledge

Where student-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. The Torres-

McGehee et al. (2012) study found that only 9% of student-athletes studied across Division I,

Division II and Division III institutions had adequate nutrition knowledge 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 (Jessri, Jessri, Rashidkhani, & Zinn, 2010). An older study which focused on

triathletes used the General Nutritional Knowledge Questionnaire (GNKQ) to identify there is a

gap and also highlighted that there are limited studies on knowledge (Birkenhead, 2013). A

variety of studies ranging from 1981-2002 were found that supported this point yet the literature

around current data was limited. Conclusions however could be drawn between knowledge and

beliefs. Both health and specifically nutrition can have difference meanings for individuals and

athletes are susceptible to this generalization. As Birkenhead and Slater (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 (p.1515).” 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 (Lis et al., 2015).

From a more general and broad perspective, further identifying what student-athletes know about

nutrition, how they feel it can impact their performance and the perceptions they have both

positively and negatively are important for educating this population.

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Nutritional Behaviors

Understanding nutritional influencing factors, motivators and nutritional knowledge are

essential for this population and consideration for any type of intervention. Taking it one step

further to understand how each of these components actually impacts their behavior is also

important. In a study looking at behavioral intentions, Karpinski and Milliner (2016) use the

underlying constructs of the Theory of Planned Behavior to help identify barriers to healthful

eating. The Theory of Planned Behavior has been explored across many health decisions with the

assumption that behavioral intention or intention to change, is the strongest predictor of actual

behavior, with a stronger intent resulting in a more likely behavior change. The three major

constructs that affect behavior intentions are attitude, subjective norms and perceived behavior

control. The authors tested this theory among Division II athletes examining female and male

student-athletes intentions of eating healthy and found that attitude had the greatest influence yet

further exploration of attitudes around nutrition were needed. Furthermore, questions in their

cross-sectional survey related to nutritional motivation included concepts of endurance,

concentration and impact on performance, therefore supporting ideas generated for the guided

interview questions of this proposed study. While this specific proposed study will not

investigate behavior change, this concept supports the idea that attitudes and perceptions effect

change and understanding those constructs is essential for athletes to make proper nutrition

decisions.

Rationale

Maintaining a healthy and well-balanced diet that is individualized is critical for student-

athletes. Diet can not only reduce the risk of disease but also increase health gains and improve

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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performance. The literature and evidence around nutritional impact on performance continues to

develop and exist as a popular topic in the health field. Student-athletes and the athletic

population are an important example of where diet can directly impact performance gains or

losses in addition to having positive or adverse health effects. While research identifies and

highlights the many internal and external factors that can impact or influence an athlete’s

nutritional choices, how those factors can be modified and the nutritional education gap for this

population needs further work, resources and time. As Adams et al. (2015) summarize, “research

conducted with a heavily qualitative focus may serve beneficial in exposing the roots of body

weight perceptions and dietary behaviors among athletes” (p.23). Therefore this study is aimed at

identifying how and what student-athletes perceive about nutrition, their attitudes about the

performance impact and nutritional motivations.

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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Research Objectives

The purpose of this study was to examine student-athlete perceptions of nutrition and their

attitudes about how nutrition impacts performance. The three main aims were to identify how

student-athletes feel about nutrition, their beliefs on the relationship between nutrition and

performance and their nutritional motivations.

Methodology

Research Design

This qualitative study was focused on exploring the knowledge, attitude and perception of

collegiate athletes about the nutritional impact on performance. Research was conducted through

voluntary interviews with Division II student-athletes at a Catholic College in the Northeast.

Comprehensive selection was used to recruit the entire student-athlete population. The sample

population was determined through non-random purposive selection based on the response

timeline.

Participants

A total of 10 participants enrolled in the study. Data analysis was ongoing and based on a

project timeline no further additional participants were recruited. There were 7 females and 3

males. Athletic team representation included Track and Field, Women’s Lacrosse, Crew,

Baseball, Basketball, Hockey and Men’s Lacrosse. Table 1 includes further information about

the student participants.

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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Table 1. Student-Athlete Participants

Student

Class Year

Athletic Team

Sophomore

Women’s Lacrosse

Sophomore

Crew

Freshman

Women’s Lacrosse

Junior

Track and Field

Senior

Track and Field

Junior

Baseball

Junior

Baseball

Senior

Women’s Basketball

Freshman

Hockey

D10

Sophomore

Men’s Lacrosse

Procedures

Institutional review board approval was obtained before data collection. The principal

investigator sent an email to all head coaches who served as the gate keepers in January 2017.

Coaches were asked to forward the email to all of their student-athletes with the principle

investigator’s contact information (See Appendix A). Several participants responded directly to

the email. A reminder email to coaches was sent during the first week of February, which was

followed by individual conversations with coaches requesting their athlete’s participation.

Once participants enrolled in the study, the researcher conducted semi structured

interviews that lasted approximately 20-30 minutes. The interviewer used a guided interview

process to ensure consistency among participants. Guided interview questions can be found in

Appendix B. The interview instrument was developed using predetermined, semi-structured,

open-ended questions designed to address the gap in literature around student-athletes

knowledge and perception of the impact it has on performance. The interviews were conducted

in person when possible or over the phone. All in person interviews were recorded on a lap top

microphone for transcription. Audio interviews were transcribed by the investigator.

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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Data Analysis

A grounded theory approach was used to determine themes from the data. Initially transcripts

were read in their entirety to gain a sense of the data and identify concepts regarding the

participants’ knowledge and perception. Transcripts were then reread and coded with categories

that were later organized into more specific themes. These themes were used to analyze

relationships, trends and commonalities among student-athlete responses.

Data Creditability

Before data analysis, member checks with the interview participants were used to enhance

credibility. Each participant was emailed his or her transcript with a request to review it for

accuracy. All participants replied and only minor changes were necessary. Written notes from

the interviews served as triangulation.

Results

An overview of major themes and subthemes is presented in Figure 1. These included

accessibility, knowledge, time and physical feeling in relation to student-athletes’ perception of

nutrition. In depth descriptions of each of these themes from the data are presented below.

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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Figure 1. Major Themes and Subthemes

Accessibility

Accessibility to proper nutrition plays a large role in determining student-athletes food choices.

Students define accessibility in different ways but the overall impact of access to proper nutrition

can positively or negatively affect what students believe.

Perception

Nutrition

Accessiblity

Traveling

Costs

Campus

Resources

Knowledge

Understanding

Utilization

Time

Physical

Feeling

Hunger Effects

Performance

Effects

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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Campus resources. As college students, many students do not have access to kitchens or

the ability to cook and store meals for themselves. They rely on the campus resources and dining

hall facilities. 80% of the student-athletes interviewed stated that they eat their primary meals in

the dining hall (Sparkys) while the other 20% was broken down between students who live at

home or off campus. The participants highlighted the benefits of eating in the dining hall as

always having consistency for nutrition. When asked about daily meals, J7 mentioned that he

knows “there is always at least salad, chicken and that is always a good go to option…” while R2

stated that “(Sparkys) is really good about always having some of the basics so I know I can

always get yogurt or take a banana or apple with me.” K1 was an outlier in this theme:

For a lot of people, going to the dining hall is easy. I wish I had a kitchen. When people

who have a kitchen are like ‘oh I don’t want to cook every night’, I wish I did because I

would make my own food and like that rather than go (to Sparkys) and have pasta again.

However while there is benefits to the dining hall, students also feel limited by the choices

offered on campus. As R2 later emphasized, “it is usually always the same thing…salad bar,

chicken, salad bar, chicken. Like, do I really want that again? Sometimes it is just a bin of apples

and I want more variety…” While many of the students discussed the availability of some

healthy choices, the lack of variety was prevalent. Furthermore, the availability of unhealthy

options was also discussed during the interviews “being here (at school), we don’t have that

many options. We have to resort to something else that is unhealthy to get a change” A3 noted.

Traveling. Regardless of sport, student-athletes spend a great deal of time traveling on

the road for practices, games and meets. They do not have a consistent living schedule on

campus each day. Athletes emphasized the impact that traveling can have on their daily

nutritional schedule. As L6 stated, “for away games we’ll get meal money and we’ll stop after

the game. A lot of times we don’t stop at the healthiest places which kind of sucks but we try to

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

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do the best.” Similarly, C5 emphasized “when we have meets that are further away, it is even

harder to stay in your routine.” C5 went on to describe the challenge of traveling in relation to

campus resources:

When we go to meets, they let us fill the green box but it’s the night before and it has to

be refrigerated. So it’s nasty because it’s sitting all day. Freshman year my coach used to

buy deli meet and bread so we’d have that. Then the last two years, Sparkys would make

sandwiches for us but they’d put oreos and chips in the bag with an apple. And I was like

all I’m eating is deli meet and an apple, it’s a waste.

S8 further elaborated on the modification of meals while on the road stating “it becomes a real

challenge to follow a specific diet in season when we are traveling at least two or three times a

week. I just kind of have to make due…”This concept of traveling and inconsistencies alters the

student-athletes’ perception of accessibility.

Costs. The expense related to healthy foods was also discussed by participants both on

the road, with limited meal money, and as college students. When asked about where they ate the

majority of their meals, several athletes discussed a desire to eat healthier or grocery shop but

were limited by cost. As a senior, S8 has had more experiences off campus but shared that the

benefit outweighs the cost in her mind:

Prices really deter people because healthy stuff is more expensive. Type of mindset I take

is you have your car even to get around. You have options to get around that are cheaper

but you chose your car no matter what gas prices are. So it’s like you have your body for

your whole life. There are cheaper options to eat but what are you going to do for you

that’s best in the long run. So this will cost me a pretty penny to eat but what will help me

in the long run. I see my body as a vehicle in life. Like even when gas prices go up, we

still drive so even with food that’s how I see it too.

T4 acknowledged that cost factor and the benefit of living off campus emphasizing that by living

at home she could use more quality ingredients and was not working on a “college food budget”

whereas her teammate C5 in contrast notes that she “splurges once a week eating off campus to

get more protein.”

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 21

Knowledge

Nutritional knowledge is a second factor that plays a large impact on food choices and how

students feel about nutrition. Each of the participants believed they had some form of nutritional

knowledge. Some went as far as to indicate that they were still learning. R9 mentioned, “as the

new guy on the team I pick up a lot from the older guys, kind of following their habits and I’m

learning more than I knew before coming to school.” R2 acknowledged “I’ve definitely come a

long way since high school but I know there is much more to know about what I should be

eating.” The interviews resulted in a clear distinction and common misalignment between the

understanding and the utilization of nutritional knowledge.

Understanding. Levels of athletes’ understanding of nutrition varied from participant to

participant. Some athletes discussed what they knew about proper nutrition as well as sports

nutrition directly while others alluded to their knowledge through describing their daily diet and

if they feel it is balanced. J5 used nutritional language such as calories, supplementation and

associating carbohydrates with energy from the beginning of the interview. When asked about

his knowledge, he replied:

I know the basics because I’ve worked with nutritionist…I know if I don’t eat enough or

put enough into my body and get the necessary nutrients, one I’m going to lose some

weight and two I’m not going to feel as healthy and two I’m going to lose some weight. I

think it’s important to know your body, knowing how much you need to maintain and

know your body to feel healthy.

Influences of family life and habits were common among students. J7 later when on to state that

“…My dad was a college athlete. He is a similar build to me, a little bulkier but similar. He had

an idea of, he played basketball so a little different, but between running, lifting, time

commitment the overall there isn’t always enough time.” Family influences on knowledge were

prevalent in 70% of the conversations and were brought up by students when asked the initial

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 22

question of “Is nutrition something that you think about in relation to your overall health?” S8

really pinpointed the relationship between nutritional knowledge and overall health in

referencing her own family health issues “its one of those things that could have been prevented

if we were more educated on the food choices and what we put into our bodies every day. I feel

like it starts young in developing your habits, your kids habits and your kids habits.”

Other influences and sources of nutritional knowledge discussed were coaches, both

directly and inadvertently, teammates and the internet. When asked about obtaining nutritional

information, S8 who is a vegan athlete said “The internet. For sure. I have other friends who

have gone vegan as well so like they send me stuff, I follow instagrams, I have a protein chart

that highlights which plants I should highlight every day” Several athletes shared that they

believed they had a good understanding of nutrition but went on to discuss imbalanced daily

diets for example, although discussing following a vegan diet and placing emphasis on eating

healthy, S8 described her daily meals with substantially low amounts of protein. R2 noted early

in the interview that she believed eating a balance of carbohydrates, proteins and fats was

important and that she “definitely worked to follow.” Yet later went on to discuss her daily diet,

citing “(only) apples at times for breakfast and then pre-race usually have apples followed by

granola for protein” which do not align as strong nutrition choices for her needs.

Utilization. While there were misconceptions about what constitutes as a healthy diet

present in the interview results, the data also found that students did acknowledge using that

nutrition knowledge. Several students emphasized “junk foods” and “cheat” or “reward” foods

while others discussed the importance of using nutrition to their advantage. For C5 who has seen

incredible athletic gains throughout her college career and hopes to one day run professionally,

the education and using that knowledge helps her gain an edge:

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 23

Really didn’t think about (nutrition) until second semester of sophomore year. My

coaches brought it up and said maybe you should eat better. I started to do my own

research on things going in my own body. Just started to change from there. I want to be

healthy and feel good. Once I started changing, I felt better. Better at practice and better

overall…my performance improved so much…now for the past three years I’ve kept it

very consistent on what I eat...” going on to state that “I know I have goals and that keeps

me going.

Time

Time was relative to almost every athlete both in the emphasis of time management and the

timing of meals. A3 mentioned that “lunch is hard because the middle of my day is lacrosse” and

teammate K1 noted time as the largest challenge of eating in the dining hall:

…biggest thing is the times when they do have food at the dining hall based on when

your practices are. If we have 5-7 practice, they put food out at 4:30 for dinner and at that

point not even everything is out yet. You have to give yourself enough time to eat and

then not throw it right up after and that is probably the biggest challenge.

L6 on the other hand related time and nutrition to snacking time management, “it’s obviously a

tough thing. Being on a balanced schedule for eating, especially with games and practices. A lot

of times it has to be quick. Stuff like that.” R9 went on to elaborate that “when I eat has been one

of the largest adjustments coming to school and playing Division I hockey. You really have to

focus on when you are going to eat and what your meals will be based on practice, games or

whatever else we’re doing.” Time emerged as one of the most common discussion points in

students’ perception of overall nutrition.

Physical Feeling

Athletes categorized nutrition into two classifications, eating out of hunger and eating for

performance. While correlations are drawn between the two, there were varying opinions and

attitudes toward meals, timing and overall nutrition.

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 24

Hunger Effects. “I am always hungry” or “I can eat or snack at any time” were common

statements throughout the interviews with participants acknowledging how important planning

out their meals were. A3 joked several times about having a snack at any point during the day.

R2 mentioned that after a race, she is “so hungry that I just eats anything to fill back up.”

Similarly, K1 said that protein helps to curb hunger “It definitely helps from a hunger standpoint.

After I work out, I’m starving. Like after two hour practice I’m starving. The other night I went

back to room, Saturday after the scrimmage my parents took me out to dinner at Bertuccis so the

other night I had left over pizza and a protein shake for dinner instead of going to Sparkys and

that was good.” While these athletes emphasized planning their nutrition around being hungry,

they also noted how the food impacts their body. R2 discussed this in relation to eating

unhealthy. “When I was younger I used to eat so much junk food and I never had as much energy

as I have now. When I eat a lot of junk food now, I can feel it.”

Performance Effects. It was evident that the more seasoned or experienced athletes

made direct correlations to nutrition and performance. As L6 acknowledged, “you’re always

lifting or at practice. It’s really hard for nutrition to not be a part of that because of the way you

live. What you’re doing.” C5 made a conscious decision to start eating healthy for performance,

“I want to be healthy and feel good. Once I started changing, I felt better.” She attributes

nutrition directly to her success. “It gives me and edge over other people. Because a lot of

people have more natural talent than me but it puts me over the edge that much more….when I

step up on the line sometimes in a race, I’m like I know that I did more than you and diet is a part

of that.”

Furthermore the timing of the nutrition impact on performance effects was also present.

As T4 discussed, “I only started caring recently because I got injured and was out the whole year

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 25

last year and it was mainly a result of overtraining and overuse. I needed to start maintaining my

body and caring more.” Taking ownership and considering nutrition as an important factor in

overall health was a reoccurring theme with athletes. Yet there are challenges associated with

this. As A3 stated, “I am my own motivator to choose a better balance diet and good nutrition as

much as my knowledge can give me. But also being college I know I don’t have access to the

things I want or I know I need.”

Discussion

Student-athletes feel strongly that nutrition is important for their overall health and wellbeing.

They believe it can have positive or adverse effects on their performance however they do not

always have the tools or proper resources to eat a well-balanced diet. Furthermore, nutritional

decision making factors or their motivation to eat healthier is influenced by a variety of factors

and in college has the risk of being negatively swayed. The variances in their perception about

the effect on performance aligns with the guidelines produced by the Dietitians of Canada, the

Academy of Nutrition and Dietetics and the American College of Sports Medicine (2016) and

Nancy Clark’s recommendations (2013), emphasizing individualistic needs and requirements.

Accessibility

Accessibility is a major theme for student-athletes, mirroring the challenges of healthy

eating as a college student (Kicklighter et al., 2010). Access to healthy, whole foods and a well-

balanced diet is a problem on college campuses with the lack of kitchens, dependency on dining

hall food and hours and cost. This becomes a barrier of limitation for students (Karpinski &

Milliner, 2016) with the perception that eating healthy foods can sometimes fall beyond their

control. Students feel strongly that nutrition is important but they cannot always get what they

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 26

need. While students expressed their desire to eat healthy, this was often difficult to accomplish.

This perceived barrier of control translates into two implications. The first is the necessity to

physically provide access to healthy foods or healthy food options for students. Through the

means of dining hall variety, meal times or increased travel meal budgets. The second is the

demonstrated need for overall education. Providing students with opportunities to learn how to

compose healthier meals in the dining hall where foods are accessible or how to maximize the

use of their kitchen or storage space at home. Removing this barrier of perceived control and

educating athletes on healthier could reduce negative beliefs about the dining hall food and their

lack of ability to consume proper nutrition.

Knowledge

Consistent with the themes identified by Torres et al. (2012) and Long et al. (2011),

student-athletes are under educated about proper nutrition, making healthy choices and how

nutrition impacts their performance. References to nutritional supplementation and well-balanced

meals demonstrated this gap in the knowledge. It was interesting to note that many of the

student-athletes did not actually site coaches, athletic trainers or strength and conditioning

coaches as a source of credible information and knowledge generation. While some sports were

stronger than others and later sited they obtained information from coaches, when first discussed

this group was not identified by students as an information source. In fact, several participants

noted they would never think to ask these resources. Instead, there were more references made to

family values, internet and teammates. While contrasting to the literature, both concepts illustrate

a further need for proper education around nutrition. Coaches were not included in this study

however if they do in fact have a greater baseline knowledge, student-athletes not only need to

know they can and should utilize their coaches as resources but coaches need to emphasize how

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 27

they can help. This open line of communication could amount to healthier athletes, increased

physical improvement and overall team strength.

In addition to the source of information, the utilization of nutritional knowledge varies. It

was not surprising to see how many students made references to poor nutritional choices,

identifying foods they considered “junk” or “bad”. This categorization demonstrates an

understanding of nutritional knowledge as a comparison to making food choices based on

psychological, anthropological, sociological and physiological factors (Ono et al., 2012 and

Adams et al., 2015). While there are certainly foods that could be and often are actually defined

by these terms, this categorization process has the risk to become more dangerous and lead to

disordered eating patterns (Academy of Nutrition and Dietetics, 2015 and Birkenhead & Slater,

2015 and Buckton, et al., 2015). When food becomes socialized, especially in team settings

(Elliot et al., 2006) it can lead to adverse risks for students emphasizing the need for further

guidance and specific education for this population.

The more experienced or competitive athletes have a likelihood of utilizing their

knowledge to make proper choices and therefore see results. (Ono et al., 2012 and Long et al.,

2011). This was evident in the conversations with both C5 and J7 who clearly identify that what

and how they eat makes a significant difference in how they look, feel and perform in their

respective sports. It was interesting to note that these student-athletes acknowledged nutrition as

a key component of their athletic success and simultaneously have seen performance gains. In

the case of C5, over the course of the last three years when she began to monitor and focus on

nutrition, her 400m time has improved by close to 20%, a significant decrease for a sprinter

resulting in one of the fastest times in the US. While it is likely that a combination of other

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 28

training aspects may also attribute to this success, more experienced athletes identify nutrition as

being a key training component to successful performance.

Time

Tied closely to accessibility, time is considered a major challenge for athletes. The

schedule of any college student is challenging to manage classes, activities, social aspects,

volunteering or work. Balancing a full practice and game schedule on top of those daily

undertakings can add immense stress and the necessity for careful navigation of time

management. In relation to nutrition as S8 stated “even finding the time to obtain and digest a

meal without getting sick running off to the next event is difficult.” Facing this challenge

impacts food choices and behavior patterns of healthy eating. As Kicklighter et al. (2010) found,

food selections are often based on time and establishing a routine is critical. While athletes

identify time as a significant challenge, references to routine and maintaining consistency prove

that it is not a challenge that cannot be overcome. Practice, games, lifting and classes cannot be

eliminated or lessened in most cases. Instead the focus must be placed on creating consistency

for athletes and how to link time and accessibility. Increased education in this area from coaches,

administration and teammates is important.

Physical Feeling

Athletes’ motivations for eating healthy are not uncommon from the literature which

discusses personal goals, physique goals and lifestyle factors (Birkenhead & Slater, 2015). It is

however interesting that the athletes motivations fall into the two categories of eating out of

hunger and eating for performance. This hunger component was not looked at in any of the

literature found yet it is a basic and common assumption. Nancy Clark (2013) and Moran et al.

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 29

(2013) do discuss why eating patterns and requirements for athletes are necessary but separate

these two ideas apart from one another. Considering the physical feelings of the impact food can

have on the body was not one of the components identified by Kicklighter et al. (2010) and Long

et al. (2011) in the food decision influences. This differentiation between eating for hunger and

eating for performance is important in identifying how to education student-athletes on proper

nutrition and making healthy choices around food consumption, quality and quantity. It is clear

that athletes can identify different physical feelings and this therefore translates into performance

effects.

As the demands on college athletes continue to rise and the landscape becomes more

competitive, how athletes perform is even more critical. No longer just based on talent, in order

to participate on college teams, remain free of injury and healthy and see time on the field, court

or ice, student-athletes must look to a variety of areas to be the best they can be. Sports nutrition

is a major component in maintaining overall health and achieving performance goals

physiologically. While student-athletes identify that nutrition is important, the lack of

accessibility, knowledge, time and how nutrition makes them feel hinders their ability to

maximize the nutritional benefits on performance. In order to further education student-athletes

on both short term and sustainable long term nutritional habits, additional education and

guidance is needed on campus in the form of sports nutritionists, facilitated sessions with

educators or coaches or an emphasis on the importance of proper nutrition.

Limitations

This study explored only a small sample of the student-athlete population utilizing subjects from

one school. Interviewing students-athletes who all share the same facilities and similar resources

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 30

(Hockey is Division I) may have limited the results with regards to challenges. Furthermore,

despite the fact that a diverse range of sports and gender diversity was substantial, the participant

pool did not reach data saturation. The questions in this study were specifically geared only

toward student-athletes and their perceptions. Future research may provide expanded findings by

analytically comparing physical performance standards or athletic achievements to the

perceptions and attitudes of nutrition. Additionally, including coaches, athletic trainers or

strength and conditioning coaches in future research could allow for important developments in

the area of sports nutrition for college athletes.

Conclusion

Student-athletes believe nutrition is an essential part of their overall health. Their desire to

perform better or improve physical feelings can influence how they make nutritional decisions. It

is evident that there are perceived challenges of both accessibility and time in making proper

nutritional decisions which could be identified independently or linked with one another. The

physical feeling that athletes receive from food and as a result of eating food weighs into their

decisions and beliefs. The theme of knowledge is quite possibly the most important theme that

emerged from this study in the comparison to existing literature. There are significant gaps in

both the nutritional knowledge of student-athletes and coaches but also gaps in how they apply

the knowledge that does exist to positively impact performance.

The findings from this study highlight the need to further educate this population on developing

healthy, sustainable and positive eating habits to improve individual and team performance.

Resources should be invested both in the education setting for student-athletes from sports

dietetics professionals as well as from an administrative perspective.

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 31

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Appendix A

Draft Recruitment Email

Good Afternoon Coaches,

As part of my graduate work at Merrimack I will be looking at nutrition and student-athlete

perceptions. Thank you in advance for forwarding the email below to your student-athletes.

Warmly,

Sarah Sceery

Hello Student-Athletes,

I am reaching out to request your participation in a research study. As part of my capstone for the

MS in Health and Wellness Management program, I will be conducting a study on Merrimack

student-athlete's perception of nutrition and their attitudes about how nutrition impacts

performance.

In order to gather the data, I will be doing 30-45 minutes interviews with student-athletes

focused on nutritional knowledge, perceptions about nutrition and attitudes toward the impact it

can have on performance.

This study may be of no direct benefit to you, but it will improve our knowledge of how student-

athletes perceive nutrition and the impact it can have on performance. The interviews will be

recorded for data accuracy but if you prefer to only do the interview with written notes, we can

accommodate. The interview may help you to be more aware of your nutritional habits,

knowledge and resources on campus. There are no inherent physical risks in the procedures

themselves, and it is not anticipated that you will experience risks in completing the interview.

Participants will not be exposed to any more risk of harm or discomfort than those ordinarily

encountered in daily life. If you are not comfortable answering any of the questions, you are free

to discontinue the interview at any time. A decision not to participate or discontinue will not

adversely affect any interactions with the investigator or any representative/employee of

Merrimack College or impact your standing on your current team. Information will be used for

research purposes only and responses will be kept confidential. In addition, your name will not

be used in any reports or publications of this study.

If you would like to participate, please contact me directly to set up the interviews at

[email protected] or 978-837-5554. We can set up an in person interview on campus or

phone call based on your availability.

By responding to this email and scheduling an interview, you are agreeing to the procedures

outlined above. Thank you in advance for your support and assistance!

Warmly,

Sarah

NUTRITIONAL IMPACT ON PERFORMANCE IN STUDENT-ATHLETES: REALITY AND

PERCEPTION 35

Appendix B

Guided Interview Questions

Male/Female

Sport:

Class Year:

1. Is nutrition something that you think about in relation to your overall health?

2. Do you feel nutrition is important? Why or Why not?

3. Do you think you eat a balanced diet? What does your diet on a normal day look like?

4. Do you feel you know the difference between proteins, carbohydrates and fats?

5. Do you use any nutritional supplements or vitamins? What do you know about them?

6. What influences your nutritional decisions?

a. For example timing of meals, teammates, schedules

7. Does what you know about nutrition impact what you actually eat?

8. What do you normally eat before a game or practice? How about after? Do you notice if

you feel differently during practice or a game based on what you eat?

a. For example, do you have more energy or feel sluggish?

9. What foods or nutritional categories do you feel have an effect on your performance?

a. How do those things (i.e. protein, carbs, fat) factor into your own routine?

10. Where would you go if you needed nutrition information? Why?

11. Do you have challenges related to your diet as an athlete?

12. Where do you typically eat your meals?

a. In the dining hall

b. At an on campus dining location (such as The Den, Zekes, MAC)

c. At apartment/house

d. As a restaurant/take out