Adolescent and young adult male hockey players: Nutrition knowledge and education

Abstract/Resume

Athletes often have inadequate nutrition knowledge and poor nutritional habits, which can have a negative impact on athletic performance. This study assessed the nutrition knowledge of competitive adolescent and young adult male hockey players, and examined the impact of a nutrition intervention program, Sport Nutrition for the Athletes of Canada (SNAC). Before the intervention, nutrition knowledge was tested in 175 adolescent and young adult male hockey players. The intervention was provided as part of a hockey camp curriculum and was based on the SNAC workbook, which emphasizes achieving a balanced diet with adequate energy and fluid intake. After the intervention, nutrition knowledge was assessed in a subgroup of 33 hockey players. The pre-intervention nutrition knowledge score was 45% (n = 175), which suggests this population had little sport nutrition knowledge. Nutrition knowledge scores two weeks after the intervention showed no meaningful improvement in the subgroup. The results of this study suggest that the SNAC nutrition intervention program offered under the conditions of this study, did not effectively improve nutrition knowledge in adolescent and young adult male hockey players. (Can J Diet Prac Res 1999; 60:166-169)

Les sportifs ont souvent des connaissances en nutrition insuffisantes et des habitudes nutritionnelles qui laissent a desirer, et leur performance peut en souffrir. Cette etude avait pour but d'evaluer les connaissances en nutrition de joueurs de hockey de competition et d'examiner les effets d'un programme d'intervention en nutrition, Sport et nutrition pour les athletes du Canada (SNAC). Les connaissances en nutrition ont ete testees avant l'intervention chez 175 adolescents et jeunes adultes de sexe masculin. L'intervention a ete appliquee chez les 175 joueurs au cours d'un camp de hockey. Elle etait basee sur le guide du programme SNAC avec une insistance particuliere sur la consommation d'une alimentation equilibree comportant un apport adequat en energie et en liquide. Les connaissances en nutrition ont ete evaluees apres l'intervention chez un sous-groupe de 33 joueurs. Le score de depart pour les connaissances en nutrition etait de 45% (n = 175), ce qui porte A croire que cette population possedait peu de connaissances en nutrition liees au sport avant l'intervention. Deux semaines apres l'intervention, les connaissances ne s'etaient pas ameliorees de facon significative dans le sous-groupe. Les resultats revelent que le programme d'intervention SNAC n'a pas ete efficace pour ameliorer les connaissances en nutrition chez des adolescents et de jeunes adultes joueurs de hockey. (Rev can prat rech dietet 1999; 60:166-169)

INTRODUCTION

Nutrition is one of many factors contributing to optimal athletic performance (1). However, many athletes lack nutrition knowledge and have poor nutrition habits (2-4). The impact of nutrition on sport performance has received considerable recognition. Because athletes are continually seeking a competitive edge, they may be likely to seek nutrition knowledge and adopt healthy eating behaviours (2, 3).

In 1991 the Sport Medicine and Science Council of Canada and the Beef Information Centre designed an interactive sport nutrition education program, Sport Nutrition for the Athletes of Canada (SNAC) (5). The purpose was to improve adolescent athletes' knowledge of basic nutrition and to help them use that information to attain and maintain peak performance. The first evaluation of SNAC showed that the program increased nutrition knowledge significantly, but did not change attitudes or behaviour over the short term (6).

Hockey places high physical demands on the players (1). Adult hockey players require 5,000 to 6,000 kcal a day during the season and can lose up to 4.54 kg (10 lb) of fluid during a game or workout if fluid replacement is inadequate (1). Children and adolescents have proportionately greater energy and nutrient requirements for support during periods of rapid growth and development (7). Dehydration is one of the most common factors that impairs athletic performance, and children and adolescents are even more susceptible to overheating because of their lower sweating capacity (8). Because of the physical demands of hockey, nutrition education may be important to improve young athletes' nutritional status and consequently enhance athletic performance. Currently there is minimal information on adolescent hockey players' nutrition knowledge.

The purpose of the present study was to assess SNAC's effectiveness at improving adolescent and young adult hockey players' nutrition knowledge. The SNAC program was to be deemed effective if knowledge improved meaningfully and significantly after intervention.

METHODS Subjects:

All participants in a summer hockey school were recruited. Nutrition education was part of the hockey school curriculum. Total enrollment consisted of 181 competitive male hockey players aged ten to 21.The University of Alberta Faculty of Agriculture, Forestry and Home Economics Human Ethics Review Committee approved the study protocol. Although 175 athletes participated in the nutrition education program and completed a pre-intervention nutrition knowledge questionnaire, unpredictable circumstances resulted in an extremely high attrition rate. Thus, only a subgroup (n = 33) were given both the pretest and a post-test to assess their nutrition knowledge after intervention. Nutrition education:

Nutrition intervention took the form of four modules provided to the athletes (n = 175) in two separate one-hour periods, one week apart. Each nutrition education session was administered to approximately 30-40 hockey players at a time. The modules comprised lectures, large-group discussions, video presentations, and group and individual activities. The modules focused on achieving a balanced diet with adequate energy, carbohydrate, and fluid intake before, during, and after intense exercise. All information was based on Sport Nutrition for the Athletes of Canada: Workbook forAthletes (5).

Nutrition knowledge: A modified version of the SNAC questionnaire was used to assess nutrition knowledge before and after the intervention. The pre-intervention knowledge test was administered before the first education module. The post-intervention knowledge test was administered one week after the last intervention module. The total intervention time was two weeks from the pretest to the post-test. The subjects' nutrition knowledge was assessed using the total scores of the test questionnaire: the highest possible score was 45.

Content validity of the original SNAC questionnaire knowledge section was established by experts in nutrition education, sport nutrition, and questionnaire design review, who reviewed and approved all questions (5). The original questionnaire was tested with 34 adolescent athletes to ensure comprehension. Also, this questionnaire has previously been shown to be reliable (r = 0.93) (5).

The nutrition knowledge questionnaire used to assess our subjects' nutrition knowledge was modified from the original; 45 of the original 62 questions were retained. Redundant questions were omitted because of time constraints. The reliability of the shorter, modified questionnaire was not evaluated. However, we assumed that its reliability would not differ from that of the original test, as only repetitive questions were omitted. The questionnaire consisted of true-or-false, multiple choice, and "choose all those that apply" questions (e.g., "Place a check beside all the foods that contain carbohydrates").

Demographic data: Age and the number of years playing hockey were determined by questionnaire before the pre-intervention questionnaire was administered. These variables were assessed because of their possible relation to nutrition knowledge test scores. For example, older and more experienced players may have had more nutrition education that could result in higher test scores. Data analysis: Data were analyzed with the Statistical Package for Social Sciences II (SPSS/PC+) software statistics program (version 4.0, SPSS Inc., Chicago, IL, 1990). Paired-difference t-tests were used to determine the mean difference of pre- and post-test scores. Pearson correlation analysis was used to examine the relationships between knowledge scores, and the number of years involved in the sport.

DISCUSSION

The low mean nutrition knowledge test score before any education (20.4 4.8 out of a possible score of 45 [n = 175]) demonstrates the athletes' limited nutrition knowledge before intervention. Although the mean scores increased in the subgroup's post-tests, knowledge did not improve meaningfully (scores were still < 50%) as a result of the intervention. This could have been a result of the large student-to-instructor ratio; limited time for questions, clarification, and review; and the physical and social environment, which was not conducive to learning. Previous research has shown that small-group education or individual counselling is ideal for delivering nutrition education (9).

Previous studies have shown that increasing age, educational level, and time in the sport were related to increased knowledge scores (2,3,10,11). This was not demonstrated in the current study. The low pre-intervention nutrition knowledge test scores revealed the need for an effective nutrition education program. These results are consistent with those of other studies of pre-intervention nutrition knowledge, although different test instruments were used. In a study of high school wrestlers, the mean nutrition knowledge test score before education was 58% (12). In the same study, 75 male college track, baseball, and football athletes scored below 50% on a nutrition knowledge test (12). Barr (2) compared the nutrition knowledge of female university students and varsity athletic team members. Female varsity athletes had low levels of general and sports-related nutrition knowledge, which were similar to those of female non-athletes. These findings suggest that:

athletes do not aspire to a higher level of nutrition knowl

edge to attain a competitive edge,

they are obtaining incorrect nutrition information from poor sources, or

nutrition education programs are limited and not widely available.

Limitations of the current study included lack of participants for both pre- and post-intervention testing, the shortterm nature of the assessment, lack of a control group, and the environment in which the intervention was delivered. The lack of a control group made it difficult to assess whether the improved post-evaluation test score was related to increased knowledge or whether the participants learned from the pre-intervention test. In conclusion, nutrition intervention based on the SNAC education program offered under the conditions of this study, was not an effective means of delivering sport nutrition information to large groups of adolescent and young adult male hockey players.

RELEVANCE TO PRACTICE

For nutrition education to be effective, it should be thoroughly planned and include a pre-assessment of the learner's knowledge and competencies. Small-group discussions are most effective for nutrition education because they provide less distraction and more time for questions, clarification, and review (13). The content and learning activities should be appropriate; programs for adolescent and young adult athletes should emphasize motivational, simple, and practical "how to" knowledge that can be applied to athletic performance (9). To facilitate learning, the social and physical environment should be bright, quiet, comfortable, and free of distractions (14).

Because the majority of athletes obtain sport nutrition information from their coaches and trainers (10,11), these people must have a good understanding of nutrition so that they can provide accurate information. Successful nutrition education programs should therefore include coaches and trainers.

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[Author Affiliation]

KAREN J. READING, BASc; LINDA J. McCARGAR, PhD, RD; BARBARA J. MARRIAGE, MSc, RD, Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB