Athlete’s Diets are Not Passing According to Healthy Eating Index

Diet quality of NCAA Division I athletes assessed by the Healthy Eating Index

Werner EN, Robinson CA, Kerver JM, Pivarnik JM. J Am Coll Health. 2022 May 27:1-7. doi: 10.1080/07448481.2022.2076102. Epub ahead of print. PMID: 35623046.

https://www.tandfonline.com/doi/abs/10.1080/

Take-Home Message

Division I collegiate athletes reported poor dietary quality.

Background

Collegiate athletes must balance a full course load and a rigorous training program. Therefore, promoting physical, cognitive, and mental wellness should be prioritized. One way of fostering academic and physical performance is by optimizing nutrition. However, we need a better understanding of their diet quality before we can offer nutrition education to collegiate athletes.

Study Goal

The authors evaluated a sample of NCAA Division I college athletes to determine their dietary intake and quality.

Methods

The investigators surveyed 94 college athletes (78% female, 19 different varsity teams) at one Division I University. The athletes completed the Automated Self-Administered 24-hour (ASA24) Dietary Assessment Tool between March-June 2020 – before they returned to campus after the initial COVID-19 outbreak. The athletes completed information on the ASA24 regarding foods consumed at each meal/snack, cooking methods, portion size, and ingredients. They also received prompts to review forgotten items. The athletes also answered a question regarding whether this day was usual intake, less than usual, or more than usual intake. The authors used these answers to calculate the Healthy Eating Index (HEI). The Healthy Eating Index is organized into 13 components to assess overall dietary quality, including the adequacy of necessary food (fruits, vegetables, protein, fatty acids) and moderation of other foods (refined grains, added sugars, saturated fats). A total possible score is 100 (Grade A > 90, Grade B = 80-89, Grade C = 70-79, Grade D = 60-69, and Grade G <50).

Results

Most athletes reported being lower classmen (59%), majoring in non-health fields (65%), and having some nutrition coursework from high school or college (59%). Athletes typically competed in crew (25%), cross country (19%), soccer (11%), or swim and diving (11%). Overall, males reported a higher calorie intake (3299) than females (~2224). The average Healthy Eating Index score was ~59 (range: 27-94). Only nine athletes (10%) scored 80 or better. The authors found no differences in dietary quality by sex, class, major, or sport.

Viewpoints

Overall, athletes reported poor diets. Only nine athletes reported diets that received a grade of a B or better. Hence, most athletes are not meeting the dietary quality standards set forth by the Dietary Guidelines, let alone dietary recommendations for athletes. However, it is critical to assess if these dietary patterns can be replicated in a larger sample of college athletes at various times during their collegiate career (e.g., before preseason, preseason, in-season, off-season). The authors focused in this study on dietary patterns when the athletes were off campus during a unique time because of the pandemic. It would also be helpful if future investigators explore individual dietary needs, autonomy over diet/cooking, and socioeconomic barriers, which could help to explain the poor diet quality. Despite the challenges in generalizing these findings to other athletic populations, this study should raise awareness that we need to take a closer look at our athletes’ diets.

Clinical Implications

Despite the challenges in applying these results to other athletic populations, clinicians should become more aware that we must take a closer look at our athletes’ diets. We may need to work with nutritionists to develop educational interventions that discuss the best strategies for proper nutrition at home and school to optimize health and performance inside and outside the classroom.

Questions for Discussion

Do you discuss and assess nutrition outcomes with your athletes? If so, what do you use to educate your athletes, and what metrics do you use to assess quality?

Written by: Jane McDevitt
Reviewed by: Jeffrey Driban