Clinical Nutrition Research

The Korean Society of Clinical Nutrition (한국임상영양학회)
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5A's Behavior Change Model Improves Nutrition Knowledge and Intake Among Adolescent Athletes

  • Saningun Lee (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University) ;
  • Yeongtaek Hwang (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University) ;
  • Hyunjung Lim (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University)
  • Received : 2024.10.07
  • Accepted : 2024.10.24
  • Published : 2024.10.30
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Abstract

This study compared the effects of 12 weeks of intensive nutrition education (IE) using the 5A's behavioral change model and basic nutrition education (BE) on nutritional knowledge and nutrient intake among Korean adolescent athletes. This study included elite adolescent athletes (IE group: n = 65, BE group: n = 65) at a physical education high school in Seoul. In this prospective, randomized, controlled trial, the athletes' body composition, nutritional knowledge, nutrient intake, and self-management practices were evaluated at the beginning and end of the intervention. Both groups had increased levels of nutrition knowledge between pre- and post-test, but the change in total score for nutrition knowledge was significantly higher in the IE group than in the BE group (p < 0.001). Energy intake post-test increased significantly in the IE group (from 2,185 to 2,651 kcal/day, p < 0.001) but not in the BE group. The intake of carbohydrates, protein, and fat also increased significantly in the IE group (carbohydrates: from 298 to 352 g/day, protein: from 86 to 106 g/day, fat: from 71 to 88 g/day, all p < 0.001), but the change in the BE group was not significant. Additionally, the IE group showed a significant overall increase in vitamins and minerals compared to the BE group at post-test. Adolescent athletes in the IE group showed improved nutritional knowledge and intake compared to those in the BE group 12 weeks after the intervention.

Keywords

Acknowledgement

We thank all the adolescent athletes at the physical education high school in Seoul, Republic of Korea, who participated in this study.

References

  1. Thomas DT, Erdman KA, Burke LM. American College of Sports Medicine joint position statement. Nutrition and athletic performance. Med Sci Sports Exerc 2016;48:543-68. https://doi.org/10.1249/MSS.0000000000000852
  2. Desbrow B, McCormack J, Burke LM, Cox GR, Fallon K, et al. Sports Dietitians Australia position statement: sports nutrition for the adolescent athlete. Int J Sport Nutr Exerc Metab 2014;24:570-84. https://doi.org/10.1123/ijsnem.2014-0031
  3. Zuniga KE, Downey DL, McCluskey R, Rivers C. Need for and interest in a sports nutrition mobile device application among Division I collegiate athletes. Int J Sport Nutr Exerc Metab 2017;27:43-9. https://doi.org/10.1123/ijsnem.2015-0305
  4. Partida S, Marshall A, Henry R, Townsend J, Toy A. Attitudes toward nutrition and dietary habits and effectiveness of nutrition education in active adolescents in a private school setting: a pilot study. Nutrients 2018;10:1260. https://doi.org/10.3390/nu10091260
  5. Hornstrom GR, Friesen CA, Ellery JE, Pike K. Nutrition knowledge, practices, attitudes, and information sources of Mid-American Conference college softball players. Food Nutr Sci 2011;2:109-17. https://doi.org/10.4236/fns.2011.22015
  6. Trakman GL, Forsyth A, Devlin BL, Belski R. A systematic review of athletes' and coaches' nutrition knowledge and reflections on the quality of current nutrition knowledge measures. Nutrients 2016;8:570. https://doi.org/10.3390/nu8090570
  7. Mikkila V, Rasanen L, Raitakari OT, Pietinen P, Viikari J. Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young Finns Study. Br J Nutr 2005;93:923-31. https://doi.org/10.1079/BJN20051418
  8. American Dietetic Association; Dietitians of Canada; American College of Sports Medicine, Rodriguez NR, Di Marco NM, et al. American College of Sports Medicine position stand. Nutrition and athletic performance. Med Sci Sports Exerc 2009;41:709-31. https://doi.org/10.1249/MSS.0b013e31890eb86
  9. Spronk I, Heaney SE, Prvan T, O'Connor HT. Relationship between general nutrition knowledge and dietary quality in elite athletes. Int J Sport Nutr Exerc Metab 2015;25:243-51. https://doi.org/10.1123/ijsnem.2014-0034
  10. Carl RL, Johnson MD, Martin TJ; Council on Sports Medicine and Fitness. Promotion of healthy weight-control practices in young athletes. Pediatrics 2017;140:e20171871. https://doi.org/10.1542/peds.2017-1871
  11. Welzel FD, Stein J, Pabst A, Luppa M, Kersting A, et al. Five A's counseling in weight management of obese patients in primary care: a cluster-randomized controlled trial (INTERACT). BMC Fam Pract 2018;19:97. https://doi.org/10.1186/s12875-018-0785-7
  12. Manore MM, Patton-Lopez MM, Meng Y, Wong SS. Sport nutrition knowledge, behaviors and beliefs of high school soccer players. Nutrients 2017;9:350. https://doi.org/10.3390/nu9040350
  13. Parks RB, Helwig D, Dettmann J, Taggart T, Woodruff B, et al. Developing a performance nutrition curriculum for collegiate athletics. J Nutr Educ Behav 2016;48:419-424.e1. https://doi.org/10.1016/j.jneb.2016.03.002
  14. Van Voorhees BW, Fogel J, Reinecke MA, Gladstone T, Stuart S, et al. Randomized clinical trial of an Internet-based depression prevention program for adolescents (Project CATCH-IT) in primary care: 12- week outcomes. J Dev Behav Pediatr 2009;30:23-37. https://doi.org/10.1097/DBP.0b013e3181966c2a
  15. Nascimento M, Silva D, Ribeiro S, Nunes M, Almeida M, et al. Effect of a nutritional intervention in athlete's body composition, eating behaviour and nutritional knowledge: a comparison between adults and adolescents. Nutrients 2016;8:535. https://doi.org/10.3390/nu8090535
  16. Furber MJW, Roberts JD, Roberts MG. A valid and reliable nutrition knowledge questionnaire for track and field athletes. BMC Nutr 2017;3:36. https://doi.org/10.1186/s40795-017-0156-0
  17. Valliant MW, Emplaincourt HP, Wenzel RK, Garner BH. Nutrition education by a registered dietitian improves dietary intake and nutrition knowledge of a NCAA female volleyball team. Nutrients 2012;4:506-16. https://doi.org/10.3390/nu4060506
  18. Kim BJ. Measuring self-management practices in Korean athletes. Korean J Sport Sci 2003;14:125-40.
  19. Juzwiak CR, Ancona-Lopez F. Evaluation of nutrition knowledge and dietary recommendations by coaches of adolescent Brazilian athletes. Int J Sport Nutr Exerc Metab 2004;14:222-35. https://doi.org/10.1123/ijsnem.14.2.222
  20. Abood DA, Black DR, Birnbaum RD. Nutrition education intervention for college female athletes. J Nutr Educ Behav 2004;36:135-7. https://doi.org/10.1016/S1499-4046(06)60150-4
  21. Smith JW, Holmes ME, McAllister MJ. Nutritional considerations for performance in young athletes. J Sports Med (Hindawi Publ Corp) 2015;2015:734649. https://doi.org/10.1155/2015/734649
  22. Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, et al. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 2014;43:69-77. https://doi.org/10.1093/ije/dyt228
  23. Bass S, Inge K. Nutrition for special populations: children and young athletes. In: Burke LM, Deakin V, editors. Clinical sports nutrition. Sydney: McGraw-Hill; 2006. p. 589-632.
  24. Johnstone AM, Murison SD, Duncan JS, Rance KA, Speakman JR. Factors influencing variation in basal metabolic rate include fat-free mass, fat mass, age, and circulating thyroxine but not sex, circulating leptin, or triiodothyronine. Am J Clin Nutr 2005;82:941-8. https://doi.org/10.1093/ajcn/82.5.941
  25. Pesta DH, Samuel VT. A high-protein diet for reducing body fat: mechanisms and possible caveats. Nutr Metab (Lond) 2014;11:53.
  26. Jager R, Kerksick CM, Campbell BI, Cribb PJ, Wells SD, et al. International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr 2017;14:20. https://doi.org/10.1186/s12970-017-0177-8
  27. Baker LB, Heaton LE, Nuccio RP, Stein KW. Dietitian-observed macronutrient intakes of young skill and team-sport athletes: adequacy of pre, during, and postexercise nutrition. Int J Sport Nutr Exerc Metab 2014;24:166-76. https://doi.org/10.1123/ijsnem.2013-0132
  28. Nikic M, Pedisic Z, Satalic Z, Jakovljevic S, Venus D. Adequacy of nutrient intakes in elite junior basketball players. Int J Sport Nutr Exerc Metab 2014;24:516-23. https://doi.org/10.1123/ijsnem.2013-0186
  29. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. 2020 Dietary reference intakes for Koreans: vitamins. Seoul: Ministry of Health and Welfare; 2020.
  30. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. 2020 Dietary reference intakes for Koreans: minerals. Seoul: Ministry of Health and Welfare; 2020.
  31. Cherian KS, Gavaravarapu SM, Sainoji A, Yagnambhatt VR. Coaches' perceptions about food, appetite, and nutrition of adolescent Indian athletes - a qualitative study. Heliyon (Lond) 2020;6:e03354. https://doi.org/10.1016/j.heliyon.2020.e03354
  32. Diehl K, Yarmoliuk T, Mayer J, Zipfel S, Schnell A, et al. Eating patterns of elite adolescent athletes: results of a cross-sectional study of 51 Olympic sports. Dtsch Z Sportmed 2013;64:126-31. https://doi.org/10.5960/dzsm.2012.067
  33. Sherson EA, Yakes Jimenez E, Katalanos N. A review of the use of the 5 A's model for weight loss counselling: differences between physician practice and patient demand. Fam Pract 2014;31:389-98. https://doi.org/10.1093/fampra/cmu020
  34. Whitlock EP, Orleans CT, Pender N, Allan J. Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med 2002;22:267-84. https://doi.org/10.1016/S0749-3797(02)00415-4
  35. Trexler ET, Smith-Ryan AE, Norton LE. Metabolic adaptation to weight loss: implications for the athlete. J Int Soc Sports Nutr 2014;11:7. https://doi.org/10.1186/1550-2783-11-7
  36. Sturgiss E, van Weel C. The 5 As framework for obesity management: do we need a more intricate model? Can Fam Physician 2017;63:506-8. PUBMED
  37. Raut S, Kc D, Singh DR, Dhungana RR, Pradhan PM, et al. Effect of nutrition education intervention on nutrition knowledge, attitude, and diet quality among school-going adolescents: a quasi-experimental study. BMC Nutr 2024;10:35. https://doi.org/10.1186/s40795-024-00850-0
  38. Wang D, Stewart D, Chang C, Shi Y. Effect of a school-based nutrition education program on adolescents' nutrition-related knowledge, attitudes and behaviour in rural areas of China. Environ Health Prev Med 2015;20:271-8. https://doi.org/10.1007/s12199-015-0456-4
  39. Franciscato SJ, Janson G, Machado R, Lauris JR, Andrade SM, et al. Impact of the nutrition education program Nutriamigos® on levels of awareness on healthy eating habits in school-aged children. J Hum Growth Dev 2019;29:390-402.
  40. Nyma Z, Rahman M, Das S, Alam MA, Haque E, et al. Dietary diversity modification through school-based nutrition education among Bangladeshi adolescent girls: a cluster randomized controlled trial. PLoS One 2023;18:e0282407. https://doi.org/10.1371/journal.pone.0282407
  41. Nguyen T, de Brauw A, van den Berg M, Do HTP. Testing methods to increase consumption of healthy foods: evidence from a school-based field experiment in Viet Nam. Food Policy 2021;101:102047. https://doi.org/10.1016/j.foodpol.2021.102047
  42. Hackman RM, Aggarwal BB, Applebaum RS, deVere White RW, Dubick MA, et al. Forecasting nutrition research in 2020. J Am Coll Nutr 2014;33:340-6. https://doi.org/10.1080/07315724.2014.943113
  43. Hoevenaars FPM, Berendsen CMM, Pasman WJ, van den Broek TJ, Barrat E, et al. Evaluation of food-intake behavior in a healthy population: personalized vs. one-size-fits-all. Nutrients 2020;12:2819. https://doi.org/10.3390/nu12092819
  44. Celis-Morales C, Livingstone KM, Petermann-Rocha F, Navas-Carretero S, San-Cristobal R, et al. Frequent nutritional feedback, personalized advice, and behavioral changes: findings from the European Food4Me internet-based RCT. Am J Prev Med 2019;57:209-19. https://doi.org/10.1016/j.amepre.2019.03.024