A COMPARISON OF NUTRITION HABITS AND KNOWLEDGE BETWEEN NCAA
DIVISION II ATHLETES AND NON-ATHLETES

A THESIS
Submitted to the Faculty of the School of Graduate Studies
and Research
of
California University of Pennsylvania in partial
fulfillment of the requirements for the degree of
Master of Science

by
Sarah Nicole Seabrook

Research Advisor, Dr. Rebecca Hess
California, Pennsylvania
2009

ii

iii

ACKNOWLEDGEMENTS
First and foremost I thank God because with Him, all
things are possible.

Next I would like to thank my

research advisor, Dr. Hess, for her patience and her
guidance throughout this whole process.

I would also like

to thank Dr. Lyles, Professor West, and Dr. West for all of
their help in making this document better.
My family is always behind me and they have supported
me my whole life and for that I am grateful.

Thank you for

your consistent love, support, and prayers.
Last I need to thank my classmates this year.

Not

only have you all made this a fantastic year but you have
also offered your help and support to me when I have needed
it.

iv
TABLE OF CONTENTS

Page
SIGNATURE PAGE

. . . . . . . . . . . . . . . ii

AKNOWLEDGEMENTS . . . . . . . . . . . . . . . iii
TABLE OF CONTENTS
LIST OF TABLES

. . . . . . . . . . . . . . . vii

LIST OF FIGURES .
INTRODUCTION
METHODS

. . . . . . . . . . . . . . iv

. . . . . . . . . . . . . . viii

. . . . . . . . . . . . . . . . 1

. . . . . . . . . . . . . . . . . . 7

RESEARCH DESIGN
SUBJECTS

. . . . . . . . . . . . . . 7

. . . . . . . . . . . . . . . . . 8

INSTRUMENTS . . . . . . . . . . . . . . . . 9
PROCEDURES

. . . . . . . . . . . . . . . . 12

HYPOTHESIS. . . . . . . . . . . . . . . . . 14
DATA ANALYSIS
RESULTS

. . . . . . . . . . . . . . . 14

. . . . . . . . . . . . . . . . . . 16

DEMOGRAPHIC DATA . . . . . . . . . . . . . . 16
HYPOTHESIS TESTING

. . . . . . . . . . . . . 17

ADDITIONAL FINDINGS . . . . . . . . . . . . . 19
DISCUSSION .

. . . . . . . . . . . . . . . . 21

DISCUSSION OF RESULTS . . . . . . . . . . . . 21
CONCLUSIONS .

. . . . . . . . . . . . . . . 27

RECOMMENDATIONS . . . . . . . . . . . . . . . 27

v
REFERENCES. . . . . . . . . . . . . . . . . . 30
APPENDICES .

. . . . . . . . . . . . . . . . 32

APPENDIX A: Review of Literature .

. . . . . . . 33

Introduction . . . . . . . . . . . . . . . . 34
Sports and General Nutrition Overview . . . . . . 35
Nutritional Considerations

. . . . . . . 35

Specific Considerations for Athletes

. . . 37

Pre and Post Game Meal . . . . . . . . . . 40
Supplement Use

. . . . . . . . . . . . . 42

Perception of Diet. . . . . . . . . . . . . . 44
Formation of Dietary Habits

. . . . . . . 45

Environmental Factors . . . . . . . . . . 47
Available Nutrition Resources

. . . . . . 49

Summary . . . . . . . . . . . . . . . . . . 53
APPENDIX B: The Problem . . . . . . . . . . . . 55
Definition of Terms . . . . . . . . . . . . . 57
Basic Assumptions . . . . . . . . . . . . . . 58
Limitations of the Study . . . . . . . . . . . 58
Significance of the Study

. . . . . . . . . . 58

APPENDIX C: Additional Methods . . . . . . . . . 61
Original Nutritional Knowledge and Eating Habits
Questionnaire (C1) . . . . . . . . . . . . . . 62
Revised Nutritional Knowledge and Eating Habits
Questionnaire (C2) . . . . . . . . . . . . . . 67

vi
Consent Form (C3) . . . . . . . . . . . . . . 71
Demographics (C4) . . . . . . . . . . . . . . 74
Scoring Key:

Revised Nutritional Knowledge and Eating

Habits Questionnaire . . . . . . . . . . . . . 76
Institutional Review Board . . . . . . . . . . 79
REFERENCES . . . . . . . . . . . . . . . . . 97
ABSTRACT

. . . . . . . . . . . . . . . . . 100

vii
LIST OF TABLES
Table

Title

Page

1

Exposure to Nutrition Information

2

Descriptive Statistics for Nutrition
Knowledge and Eating Behavior Scores . . . 18

3

Tests of Between-Subjects Effects
for MANOVA
. . . . . . . . . . . . . 18

. . . . 17

viii

LIST OF FIGURES
Figure

Title

Page

1

Nutrition Knowledge and Eating
Behavior Score for Groups (NCAA
Athlete and Non-Athlete) . . . . . . . . 19

1

INTRODUCTION

Nutrition is a key component to athletic performance
and a healthy lifestyle.

Good dietary habits are essential

in order to maintain lean tissue mass, healthy immune and
reproductive function, and best possible athletic
performance.1

For both athletes and non-athletes, leaving

home for the first time poses new challenges when it comes
to nutrition habits.

Though nutrition information is

readily available via the internet and peer health
education (PHE) is widely used on college campuses across
America, college students still seem to have less than
optimal diets.2

College students are typically shown to

possess unhealthy dietary behaviors such as skipping meals,
snacking frequently on energy-dense food, and taking part
in unhealthy weight loss plans.3

College students also tend

to have diets that are high in fat, saturated fat,
cholesterol, and sodium, and are low in fiber, vitamins,
and minerals.3
Planning for proper nutrition contributes to
sustaining healthy living habits, motivation, and higher
levels of productivity in the life of students.4

College

2
students are at an impressionable age in which lifestyle
attitudes and behaviors are created and characterize a
pattern for later years in life.

For this reason, it is

important to observe the trends in health behavior with
this age group.4
Contributing factors to the less than satisfactory
nutrition habits among college students include busy
schedules and the college environment.5,6 For athletes, busy
class and practice schedules may influence nutritional
choices.6

Environmental factors include buffet style

cafeterias and dormitory living.

Having a buffet may

increase the amount of food a student will eat and with the
variety of choices available may deter them from choosing
healthy whole grains, fruits, and vegetables.5

Dormitory

living limits the facilities for food preparation and
access to grocery stores.6

Students may not have the time

or resources to cook whole meals and may opt for food that
is fast, cheap, and unhealthy.6
In the college environment, group influences may also
be a factor in dietary choices.

Hausenblas et al7 examined

group influences, both positive and negative, on male and
female varsity athletes.

Results showed that most athletes

did not report a perceived group influence that dictated
personal dietary habits, revealing that although other

3
research may support a negative influence of groups on
individual dietary and eating behaviors, there are also
positive influences.

There are a variety of nutrition

resources that may be available to the college student and
athlete to assist them in making better dietary choices.
These resources include but are not limited to the
internet, peer health education, coaches and athletic
trainers.
The internet is a quick, easy way to obtain
information.

Especially for college students who have

access to and consistently use the internet to find
information. The internet can be a great tool for exploring
health information.8

However, according to a study by

Cousineau et al8, the internet may have limited information
that is specifically geared toward the nutritional needs of
college students.
Peer health education is another way students in a
college setting may obtain information about nutrition.
Peer health education (PHE) is used on college campuses
across the nation to encourage healthy behaviors among
students.2

The benefits of PHE as described in the

literature include easy access to the students and positive
effects.2

4
Another channel for nutrition information commonly
comes from the coaches as they are viewed as the “central
team member.”9

As athletes interact closely with their

coaches, the coach may often become a source of information
to the athletes.

In this case, coaches should be

knowledgeable about nutrition so they can provide the best
and most accurate advice to their athletes.9
It is very important that the sports medicine team
including dieticians and certified athletic trainers be
informed of current nutrition recommendations as they are
also sources of information to the athlete.10

National

Collegiate Athletic Association (NCAA) athletes often seek
the certified athletic trainers for nutrition advice. It is
the role and responsibility of the certified athletic
trainer to be aware of the behavioral trends that dictate
the nutritional choices of NCAA athletes so they are better
able to understand the root of nutrition choices.10,11

The

certified athletic trainer should have sports nutrition as
an undergraduate course which must teach them nutrition
knowledge and eating behavior.

Once they understand where

the cause of making poor nutrition decisions come from,
they will be able to make better recommendations concerning
nutrition advice or further counseling for their athletes.11

5
Population groups differ in eating knowledge and
habits concerning nutrition.

Research has been conducted

to observe trends among NCAA athletes and non-athletes
which includes explaining dietary changes that occur for
females during their freshman year of college, as well as
dietary habits among male and female athletes.

Butler et

al12 determined dietary, physical activity, and body weight
parameter changes that occur among college freshman women
during their first semester after leaving home.

Results

showed that the females did not meet the U.S. Department of
Agriculture (USDA) recommendations for daily intake of
vegetables, fruits, breads and pasta, and meats during the
pre or post test.

Results of a study by Hinton et al6

showed only 15% of Division I athletes had adequate
carbohydrate intake and 26% for recommended daily
allowances of protein.

These results indicate that even

Division I athletes that may have more exposure to good
food and dieticians may not be eating optimal diets.
Athletes are college students with a heavy exercise
schedule, so the challenge to consume a well balanced,
healthy diet is very important in maintaining energy levels
and general health.
NCAA athletes and non-athletes need to be more
knowledgeable about the importance of proper nutrition.

6
They need to be more conscientious because proper
nutritional habits are necessary in order to maintain lean
tissue mass, healthy immune and reproductive function, and
best possible athletic performance.1 Our study examined the
nutrition knowledge and eating habits of NCAA Division II
athletes and non-athletes.

7

METHODS

The purpose of this study was to examine similarities
and/or differences between the nutrition knowledge and
eating habits in NCAA Division II athletes and noncollegiate level varsity athletes.
are discussed:

The following sections

(1) Research Design, (2) Subjects, (3)

Instruments, (4), Procedures, (5)Hypothesis, and (6) Data
Analysis.

Research Design

A descriptive research design was used for this study.
Dependent variables were subjects’ nutritional knowledge
and eating habits.

The independent variable was group

(NCAA athletes/non-varsity athletes).

Demographic

information was collected at the beginning of the survey as
the first sheet.

These questions include academic year in

college, gender, whether or not the subject is an NCAA
athlete, living environment, and exposure to nutrition
information in college.

Nutritional knowledge and eating

behavior scores were assessed using a 32 item

8
questionnaire, originally developed by Marino13 in 2001
(APPENDIX C1) and revised by Shepard14 in 2007 called the
Revised Nutritional Knowledge and Eating Habits
Questionnaire.14

Results are limited to Division II

athletes and also non-athletes who attend California
University of Pennsylvania.

Subjects

Male and female NCAA Division II athletes and nonathletes from California University of Pennsylvania were
used for this study.

For the purpose of this study, NCAA

athletes (n = 54) were those who actively participate in a
varsity sport. At California University of Pennsylvania
there were 373 NCAA Division II athletes in the fall and
383 NCAA Division II athletes in the spring.

Permission to

access athletes during practice times were obtained from
the California University of Pennsylvania’s Athletic
Director.

The researcher then asked permission from

California University of Pennsylvania’s football,
men’s/women’s soccer, track and field, men’s and women’s
cross country, tennis, volleyball, baseball, softball,
swimming, cheerleading, and men’s/women’s basketball
coaches to have 15 minutes prior to or after practice to

9
talk with the athletes without the presence of the coach.
There were no consequences or rewards for completing the
survey.

It was also explained that participation may be

discontinued at any time without penalty and all data
discarded, and informed consent was obtained.

Students

deemed as non-athletes were also solicited for the study (n
= 232).

The non-athlete population sample was also

obtained through distributing the survey by hand.

The

researcher received permission from two faculty professors
at California University of Pennsylvania in the Department
of Health Science.

Upon receiving permission from these

professors, the researcher took the survey by hand to the
classroom and distributed it to those willing to volunteer.
Informed consent was obtained by the non-athlete volunteers
prior to completing the survey.

Instruments

The instruments included in this study were a
Demographic Sheet (APPENDIX C2) and the revised Nutritional
Knowledge and Eating Habits Questionnaire (APPENDIX C3).

A

demographic sheet was completed by each subject, which
included information on academic year in college, gender,
NCAA athlete/non-athlete, and living situation (dormitory,

10
on, or off campus apartment, living in a house with
relatives, or living in a house with non-relatives).

There

was also a section where the subjects were asked where
their sources of nutrition information came from and to
check all that apply.

These sources of nutrition

information include: academic class, guest lecture, peer
health education (PHE), internet, peer influence, coaches,
certified athletic trainer, sports nutritionist, strength
and conditioning coach, and dietician.
Nutritional knowledge and eating habits were measured
using a revised version of a two-part questionnaire
(APPENDIX C1) developed by Marino13 for her study on female
college gymnasts.

The questionnaire was then used by

Shepard14 for establishing Division II swimmers’ nutrition
profiles.

Following the pilot research completed by

Shepard,14 reliability coefficients of 0.88 and 0.81 were
established for both sections on the revised Nutritional
Knowledge and Eating Habits Questionnaire, respectively.
The first part of the questionnaire (22 questions) was
designed to evaluate the level of nutritional knowledge of
each subject.

Using a four-point Likert-type scale, the

subjects were asked to specify to what degree they agree
with each statement.

Answers range from strongly agree (4)

to strongly disagree (1).

Questions surveyed the subjects

11
on topics such as pre-event meals, breakfast habits,
individual nutrient effect on performance, vitamin
consumption, and food group choices consistent with USDA
MyPyramid(www.mypyramid.gov) guidelines.
scored to their value.

Questions were

For example, if the subject

answered with a 4, they were given 4 points for that
particular question.

The scores in the first knowledge

section ranged from 22-88 points.

By dividing a subject’s

score by 88, a percentage was appointed.

Nutritional

knowledge was scored as follows: excellent (85-100%), good
(70-84%), fair (55-69%), or poor (54% or below).

Higher

scores in this section indicate an individual subjects’
increased nutrition knowledge.10
The second section of the questionnaire, comprised of
10 questions, tested the quality of the eating habits of
individual subjects.

Using a four-point Likert-type scale,

subjects were asked to specify how frequently they consume
certain foods or take part in particular eating habits.
Answers included: Always (4), Often (3), Sometimes (2), and
Never (1).

Always (4) showed that a habit occurs 5-7 days

per week, Often (3) 3-4 days per week, Sometimes (2) 1-2
days per week, and Never did not occur at all.

Reverse

scoring was used for questions numbered 2, 3, and 6.
Reverse scoring means that when a question is answered as a

12
4, one point is given.

The other questions excluding 2, 3,

and 6 were scored according to their numerical value.

If

the subject answered with a 4, they were awarded 4 points.
In this section, scores ranged from 10-40 points.

After

adding up each subject’s score, the total was divided by
40.

Scores were awarded as follows: Excellent (85-100%),

Good (70-84%), Fair (55-69%), or Poor (54% or below).
Subjects with high scores in this section reflect more
positive eating habits.

Procedures

The researcher applied for and received approval from
the IRB of California University of Pennsylvania to perform
this study (APPENDIX C5).
California University of Pennsylvania NCAA Division II
and non-athletes were the desired subjects for this study.
For the purpose of this study, NCAA athletes were defined
as those who actively participate in a varsity sport.
Permission to access athletes during practice times was
obtained from the California University of Pennsylvania’s
Athletic Director.

The researcher then asked permission

from California University of Pennsylvania’s football,
men’s/women’s soccer, track, cross country, tennis,

13
volleyball, baseball, softball, swimming, cheerleading, and
men’s/women’s basketball coaches to have 15 minutes prior
or after practice to talk with the athletes without the
presence of the coach.

Upon the coach’s permission, the

researcher requested that the athletes take part in the
survey; however there were no consequences or rewards for
taking part in it.

It was also explained that

participation may be discontinued at any time without
penalty and all data discarded. First, a consent form was
distributed.

After the researcher collected the consent

forms, the surveys were distributed.

After completion of

the surveys, the subjects were instructed to turn them over
so a blank sheet of paper faced up for the researcher to
collect.

The surveys were numbered for data

collection/analysis.

After collecting the surveys, the

researcher placed them in a folder, which was stored in a
locked file cabinet in a secure office in which only the
researcher and the program director had a key.
Potential non-varsity athlete volunteers for this
study were gathered through the Health Science Department.
Two faculty professors were contacted via email to request
permission to enter the classroom at two separate times,
for two classes by each professor.

The researcher entered

the classroom and requested that student athletes (NCAA)

14
and/or non-athlete’s take the survey.

It was stressed that

participation was strictly voluntary and that there were no
rewards or consequences for taking, or not taking the
survey.

A consent form explaining the research project was

distributed to the subjects to be reviewed and then signed
before the surveys were distributed.

Surveys were

collected, coded, and stored in the same manner as those
obtained at athletes’ practices.

Hypothesis

The following hypothesis was based on previous
research and the researcher’s intuition.
NCAA athletes and non-athletes will not exhibit a
significant difference in nutrition knowledge and eating
habits.

Data Analysis

All data were analyzed by using SPSS version 17.0 for
Windows at an alpha level of ≤ 0.05.

The research

hypothesis was analyzed using a MANOVA for the dependent

15
variables (nutrition knowledge/eating behavior) by group
(NCAA athletes/non-athletes).

16

RESULTS

The purpose of this study was to examine similarities
and/or differences between the knowledge and eating habits
of nutrition among NCAA athletes and non-athletes.
Subjects were tested by completing a 32 item questionnaire,
originally developed by Marino13 (APPENDIX C1) and revised
by Shepard called the Revised Nutritional Knowledge and
Eating Habits Questionnaire.14

Demographic Information

A total of 286 subjects (54 NCAA athletes, 232 nonvarsity athletes) completed the survey.

All of the

respondents were volunteers and were students at California
University of Pennsylvania.
male and 157 were female.

Of these subjects, 129 were

Academic year in college

included 173 freshman (1 – 29 credits), 74 sophomores (30 –
59 credits), 21 juniors (60 – 89 credits), and 18 seniors
(90 or more credits).

When asked about type of housing,

159 subjects reported to living in a dorm room, 55 lived in
an apartment, 54 resided in a home (with family or

17
relatives), and 18 subjects lived in a house (with no
family or relatives).
The final portion of the demographic data included the
subjects’ exposure to nutrition information in college.

In

this section the subjects were instructed to check all of
the sources that applied (Table 1).

Table 1.

Exposure to Nutrition Information

Source
Athlete (N)
Academic
27
Guest*
10
Class
Peer
Health
7
Lecture
Internet
24
Education
Peer
22
Lecture
Coaches
34
Influence
ATC
31
Sports
4
CSCS
43
Nutritionis
Dietician
3
*Guest Lecture
t

%
50.0
18.5
13.0
44.4
40.7
63.0
57.4
7.4
79.6
5.6

Non Athlete (N)
204
119
44
114
78
14
21
4
18
6

%
87.9
51.3
19.0
49.1
33.6
6.0
9.1
1.7
7.8
2.6

Hypothesis Testing

Hypothesis testing was completed at an alpha level of
≤ 0.05.

Descriptive statistics for nutrition knowledge

(KScore) and eating behavior (BScore) are shown in Table 2.

18
Table 2. Descriptive Statistics for Nutrition Knowledge and
Eating Behavior Scores.

KScore
BScore

NCAA
Athlete
Athlete
NonTotal
Athlete
NonTotal
Athlete

Hypothesis:

N
54
232
286
54
232
286

Mean
83.7332
83.0182
83.1532
72.5000
69.3427
69.9388

SD
7.12169
8.51765
8.26525
8.82214
8.38560
8.54404

Classification
Good
RR
Good
Good
Good
Fair
Fair

NCAA athletes and non-athletes will not

exhibit a significant difference in nutrition knowledge and
eating habits.

A MANOVA was calculated examining

differences between group (NCAA athletes and non-athletes)
on nutrition knowledge and eating behavior.

A significant

effect was found (Lambda(2,283) = .979, P = 0.05).

Effect

size for the MANOVA was also reported.

Table 3.

Tests of Between-Subjects Effects for MANOVA

Source
NCAA Athlete

Dependent Variable
Kscore
Bscore
*P is significant at ≤ 0.05

Conclusion:

F
.327
6.089

Sig.
.568
.014*

Athletes exhibited significantly higher

(better) eating behavior than non-athletes but the groups
were not significantly different on knowledge of nutrition.

19
(Figure 1, Table 3).

The partial Eta Squared for effect

size was 0.001 (knowledge) and 0.021 (eating behavior)
which represented no true effect due to different sample
sizes.

Figure 1. Nutrition Knowledge and Eating Behavior Score for
Groups (NCAA Athlete and Non-Athlete).

Additional Findings

Differences due to type of housing, academic year in
college, and gender on the main significant variable,
eating behavior, were also analyzed using one-way ANOVAs.
Type of housing included dorm room, apartment, home (with
family and relatives), and house (no family or relatives).

20
No significance was found between nutrition behavior and
type of housing.

Academic year in college included

freshman (1 – 29 credits), sophomore (30 – 59 credits),
junior (60 – 89 credits), and senior (90 or more credits).
No significance was found between academic year in college
and nutrition behavior, as well as for gender and nutrition
behavior.

A Pearson Product Moment correlation between

knowledge and behavior regardless of group revealed a low
significant positive correlation (P = .001, r = .202).
This means that 20% of the time, increased (better)
nutritional knowledge scores will result in increased
(better) eating behavior scores.

21

DISCUSSION

Discussion of Results

The main finding was that there was no difference in
nutrition knowledge between NCAA athletes and non-athletes
but with significant difference in eating behavior scores
between the two groups.

Statistics from this study showed

that NCAA athletes scored better on eating behavior than
did the non-athletes as well.
Cupisti et al15 evaluated nutritional knowledge and
dietary composition among female athletes compared to nonathletes.

Subjects were 60 athlete and 59 non-athlete

Italian, adolescent females ages 14 – 18.

Body weight and

height were measured as well as energy requirements using
the Harris – Benedict equation.

Data were collected with a

three day diary and a food knowledge questionnaire.
Results showed that the females overall did not meet daily
estimated energy requirements.

Athletes showed a higher

intake of energy during breakfast than non-athletes.
athletes also showed a higher intake of carbohydrates,
fiber, and vitamin A and lower intake of lipids when

The

22
compared to the non-athletes.

Neither group met daily

requirements for calcium, iron, and zinc.

On the

nutritional knowledge questionnaire, the athletes scored
slightly higher than the non-athletes, showing more
nutritional knowledge although both groups exhibited some
dietary misconceptions and nutritional deficiencies.
Overall, the results of this study showed better
nutritional concepts and practices among athletes when
compared to the non-athletes, which support our findings.
Athletes who have access to certified athletic trainers and
strength and conditioning coaches, such as the NCAA
Division II athletes in our study, might exhibit better
behavior.
As for effects of year in school, Butler et al12
determined dietary, physical activity, and body weight
parameter changes that occur among college freshman women
during their first semester after leaving home.

Results

showed that the freshman females did not meet the USDA
recommendations for daily intake of vegetables, fruits,
breads and pasta, and meats during the pre or post-test.
The women did seem to have adequate daily intake of milk,
however.

Overall, body weight and fat mass increased after

the five months of the study.

Interestingly, dietary

energy intake actually decreased.

It is apparent that the

23
increase in body weight and mass in this group of
individuals is due to inactivity.

Our results found that

there was a slightly lower but not significant difference
between eating behavior and year in school.

Though not

significant, the eating behavior score mean slightly
increased as year in school increased.

Many students may

take health and wellness class as a freshman or sophomore
so it is possible that eating behavior scores increase
after having formal classes that discuss nutrition
concepts.
Hinton et al6 analyzed the dietary habits of male and
female collegiate athletes.

Subjects were 345 male and

female Division I athletes from various sports.

Results

showed only 15% of athletes had an adequate intake of
carbohydrates and 26% of the athletes reported recommended
daily allowances of protein.

Male athletes were more

likely to consume higher than recommended amounts of fat,
saturated fat, cholesterol, and sodium.

Females showed a

higher interest in losing five pounds and so less
macronutrient and calories were consumed.

These results

indicate that even Division I athletes may not be eating
optimal diets.

Athletes are college students and so the

challenge to consume a well balanced, healthy diet applies
to them.

Our findings showed that while there was a

24
significant difference between gender and nutrition
knowledge, there was no difference between gender and
eating behavior.

Eating behavior may not be different due

to both male and female NCAA Division II athletes receiving
similar channels of nutrition information.

As a result,

the athletes as a group are probably offered similar food
choices on campus and on the road.
Jelinic et al15 examined the dietary and physical
activity behaviors of students who live in family
environments as opposed to living alone or in student
housing.

Subjects were 496 students attending Medical

School University of Zagreb, Croatia.

The study showed

that the group that lived in a family environment practiced
better dietary and physical activity habits although it
should be noted that both groups displayed less than
desirable dietary and physical activity habits.

Our

findings showed no difference between housing and eating
behavior score.

The finding may be a result of busy

practice and academic schedules where an NCAA athlete
chooses to eat what is quick and available.
There are a variety of nutrition resources that may be
available to the college student and athlete to assist them
in making better dietary choices.

These resources include

but are not limited to the internet, peer health education,

25
and coaches.

Cousineau et al8 looked at the availability of

resources of nutrition to college students available online
and the elements of nutrition that were deemed most
important by students, educators, and counselors.

Results

revealed surprising information because of the lack of
nutrition information that was available specifically for
college students’ nutritional needs.

The results of our

study showed that while the non-athletes gained most of
their nutrition information from academic class, the
internet was the second largest source of information.
The goal of White et al2 was to determine effects of peer
health education on a college campus and the impact that it
made on health behaviors.

Subjects were 146 students at a

University in California.

The research instrument was a

survey that evaluated impacts of peer health education on
health behaviors.
period.

Data were collected over a three-year

Regarding eating and nutrition habits, the study

showed students to have engaged in unhealthy eating
practices during the first year but the negative habits
decreased by the third year.

The results of their study

emphasize the importance of PHE availability to college
students. A similar study researching nutrition information
for athletes sought to determine whether coaches give
information on nutrition to their athletes and how

26
knowledgeable they are in nutrition topics9.
168 male rugby coaches in New Zealand.
conducted using a survey tool.

Subjects were

The study was

Results showed that most of

the coaches do give nutritional advice to their athletes
and of the nutrition topics tested, coaches were the least
knowledgeable about supplements.
It is important that certified athletic trainers,
strength and conditioning coaches, and team coaches be
knowledgeable on evidence based research regarding
nutrition information because it is apparent in our study
that these are the primary sources for our NCAA Division II
athletes.

At the Division II level, dieticians may not be

readily available so, accurate nutrition information should
be available to them through the certified athletic
trainers, strength and conditioning coaches, and coaches.
Evidence based research will provide the appropriate
personnel with the most accurate and current nutrition
information.

Our findings showed that the NCAA Division II

athletes received most of their nutrition information from
strength and conditioning coaches.

Next to strength and

conditioning coaches, NCAA Division II athletes received
nutrition information from coaches, and then certified
athletic trainers compared to non-athletes who mostly
received nutrition information in academic classes.

27

Conclusions

While NCAA athletes and non-athletes do not differ in
their knowledge about nutrition (both groups scored
“good”), NCAA athletes reported better behavior regarding
eating habits (NCAA athletes scored “good” as opposed to
non-athletes who scored “fair”).

Additionally, type of

housing, academic year in college, nor gender affected the
eating behavior score.

This finding may be different from

previous research due to differences in methods.

Recommendations

Our findings suggest that although NCAA athletes
displayed better eating behavior, their knowledge base was
the same as non-athletes.

As the certified athletic

trainer works with NCAA athletes closely and on a daily
basis, they should serve as an active nutritional resource.
Certified athletic trainers have a responsibility to be
aware of the behavioral trends that dictate the nutritional
choices of NCAA athletes. The certified athletic trainer
can then understand why NCAA athletes make the nutrition
choices that they make.

While the certified athletic

28
trainer does not act as a counselor, they should be current
on nutrition knowledge and serve as an educational resource
to their athletes so that they may ultimately increase
energy levels, performance, and overall well being.
Certified athletic trainers should also be knowledgeable on
evidence-based research regarding nutrition, ensuring that
they are familiar with the most current and accurate
nutrition information.

At the Division II or III levels,

athletes may not have direct access to a dietician, so it
is important then that certified athletic trainer is
current on evidence based research to not only better
educate athletes but also strength and conditioning coaches
and coaches who also work directly with athletes and serve
as a channel of nutrition information.
Future research may gain insight on eating behavior
alone comparing Division I and Division II athletes as
access to nutrition information may be different.

Budgets

between the two levels may also be different which may
affect food choices when traveling.

Eating habits and

difference in sport were not considered in this study but
may be researched for future studies.

Regardless of

Division I or II level, each sport at a specific
institution may not have the same budget and so food
choices while traveling may be different.

Also, difference

29
in population should be considered, specifically between
individual and group team sports.

30

REFERENCES

1.

Ray TR, Fowler R. Current issues in sports nutrition
in athletes. Sout Med J. 2004;97(9):863-866.

2.

White S, Park YS, Israel T, Cordero ED. Longitudinal
evaluation of peer health education on a college
campus: impact on health behaviors. J Am Coll Health.
2009;57(5):497-505.

3.

Ha EJ, Caine-Bish N. Effect of nutrition intervention
using a general nutrition course for promoting fruit
and vegetable consumption among college students. J
Nutr Educ Behav. 2009;41(2):103-109.

4.

Boyle JR, LaRose NR. Personal beliefs, the environment
and college students’ exercise and eating behaviors.
American Journal of Health Studies. 2008;12(4):195200.

5.

Jelinic JD, Nola IA, Matanic D. Living at or away from
home – impact on student’s eating habits. Materia
Socio Medica. 2008;20(4):204-208.

6.

Hinton PS, Sanford TC, Davidson MM, Yakushko OF, Beck
NC. Nutrient intakes and dietary behaviors of male and
female collegiate athletes. Int J Sport Nutr Exe.
2004;4(4):389-405.

7.

Hausenblas HA, Carron AV. Group influences on eating
and dieting behaviors in male and female varsity
athletes. Journal of Sport Behavior. 2000;23(1):33-40.

8.

Cousineau TM, Goldstein M, Franko DL. A collaborative
approach to nutrition education for college students.
J Am Coll Health. 2004;53(2):79-84.

9.

Zinn C, Schofield G, Wall C. Evaluation of sports
nutrition knowledge of New Zealand premier club rugby
coaches. Int J Sport Nutr Exe. 2006;16:214-225.

10.

Burns RD, Schiller R, Merrick MA, Wolf KN.
Intercollegiate student athlete use of nutritional

31
supplements and the role of athletic trainers and
dieticians in nutrition counseling. J Am Diet Assoc.
2004;4(2):246-249.
11.

Clark K. Sports nutrition counseling: documentation of
performance. Topics in Clinical Nutrition.
1999;14(2):34-40.

12.

Butler SM, Black DR, Blue CL, Gretebeck RJ. Change in
diet, physical activity, and body weight in female
college freshman. Am J Health Behav. 2004;28(1):24-32.

13.

Marino SA. The Role Nutrition Plays in the Eating
Habits of Female College Gymnasts. [master’s thesis].
California, PA: California University of Pennsylvania;
2001.

14.

Shepard MW. A Nutritional Profile of Female NCAA
Division II Swimmers. [master’s thesis]. California,
PA: California University of Pennsylvania; 2007.

15.

Cupisti A, D’Alessandro C, Castrogiovanni S, Barale A,
Morelli E, Nutrition knowledge and dietary composition
in Italian adolescent female athletes and nonathletes. Int J Sport Nutr Exe. 2002;12:207-219.

32

APPENDICES

33

APPENDIX A
Review of Literature

34

In order for athletes to perform their best, adequate
nutrition is important.

Though many Division I athletes

may have access to nutritionists or dieticians, collegiate
athletes are typically at liberty to make their own dietary
decisions.

Relocating from home to a college campus poses

changes in both the social and physical environments of a
college student.1

These changes offer new experiences with

dietary habits such as a buffet style cafeteria which may
be a quick and easy meal method.2,3 It could also mean hours
of sitting, whether in class or in front of a computer or
television.2,3

These habits may lead to poor food choices

or inadequate nutrition.

Education is essential for this

population of athletes who may not be as knowledgeable
about proper nutrition.

Certified athletic trainers and

other members of the sports medicine team should be
informed about nutrition, hydration, and supplements so
they are best equipped to educate athletes about dietary
habits. The review of the literature will be divided into
two sections.

The first section is the nutrition overview

that will then discuss nutritional considerations, specific
considerations for athletes, pre and post game meal, and
supplement use.

The second section is general perception

35
of dietary habits, which is divided into formation of
dietary habits, environmental factors, and available
nutrition resources.

Sports and General Nutrition Overview

Athletes require a proper nutritional regime in order
to meet the demands their bodies require both on and off
the field.

Good dietary habits are essential in order to

maintain lean tissue mass, healthy immune and reproductive
function, and best possible athletic performance.4

Nutritional Considerations
Carbohydrates are important for the maintenance of
blood glucose levels while exercising and replacing muscle
glycogen.

Daily requirements for athletes depend on the

athlete’s age, gender, total daily energy expenditure, and
sport.5 For the general population, it is recommended that
at least 3 ounces of whole grains be eaten on a daily
basis.6
Protein should be consumed primarily from food
sources.

Caloric intake should be adequate to maintain

body weight and to promote optimal protein usage in the
body for optimal performance.5 The daily requirements for

36
meat and beans vary according to a person’s age, gender,
and physical activity level.

Current recommended dietary

allowance for protein is 0.8 g*kg-1.5
Fruits and vegetables are essential for optimal
vitamin intake.

A variety from each group is vital in

order to consume an assortment of nutrients.

For women

ages 19 and older, a daily recommendation of 2 ½ cups of
vegetables is suggested.

For men ages 19 and older, 3 cups

of vegetables is recommended for daily intake.6 Two cups of
fruit is the daily requirement for both males and female’s
ages 19 and older.6
Though diets high in fat are not recommended for
athletes, it is important that fat intake should be about
20-30% of total energy intake.5

Consuming the recommended

amount of fat is essential for energy and fat is also
necessary for a number of fat-soluble vitamins.5
It is the role and responsibility of the sports
medicine professional to be educated on the current
nutritional recommendations for athletes.

Assessment and

education of nutritional knowledge is imperative in
providing the best nutritional advice to athletes.5

37

Specific Considerations for Athletes
Since athletes are typically more physically active
than the general population and they require more energy,
assessments are necessary in order to monitor their
nutritional goals.

Using an adequate nutritional

assessment, the athletic trainer or other sports medicine
team member can develop a plan of action suited for the
individual athlete and target it to improve their
nutritional status.7
First a diet history is taken, including taking a 24hour recall of the athlete’s diet, a food frequency
checklist, food diary, and direct observation.7 A 24-hour
recall is a record of the athlete’s food intake for one
day.

It is quick and easy to acquire however, it is rarely

a true representation of a person’s actual diet.7 The food
frequency checklist is a list in which the athlete would
check off how often and in what quantity specific foods are
consumed.

The method is a better representation of one’s

diet, although several foods that are regularly consumed
may be left out of the checklist.7 A food diary is typically
a 7-day record of all foods and beverages consumed.

If

completed correctly, this is a more accurate representation
of a person’s diet.

The method however is difficult to

38
obtain due to monotony and underreporting.7 Direct
observation is actually seeing and recording what the
athlete has eaten.

Usually this is performed in a hospital

or in-patient setting and is usually not possible in other
settings.7
Depending on their sport, athletes need to maintain a
specific body type.

In certain activities, performance may

be affected by being either overweight or underweight.7 To
measure body weight, a calibrated scale should be used.
However, while a football lineman may have a higher
bodyweight than a ballerina, body composition might also
vary. There are several ways to determine body composition.
The use of body mass index (BMI) is used to determine a
range of weight that is acceptable for a specific height.7
Though body mass index does not take into consideration the
body’s proportional composition or the fat distribution, it
is a moderate association for body fat based on stature and
mass.8

For this reason it may not be valid for most

athletes but is commonly used.8

BMI is determined by taking

a person’s weight in kilograms and dividing it by the
square of the person’s height in meters.7

The measure is

important due to its curvilinear relationship to mortality
ratio, as BMI increases, so does the risk for hypertension,
stroke, type 2 diabetes, and renal disease.8 Again, however,

39
these measures of height and bodyweight may not be valid
measures in athletes with higher lean body mass.
Two practical and valid ways to assess body
composition are the skin fold technique and bioelectrical
impedance analysis.7,8

Skin fold measurements are taken in

conjunction with a tool that measures subcutaneous fat at
selected body sites; most commonly the triceps, subscapula,
suprailium, abdomen, and thigh.8

Bioelectrical impedance is

another common and practical method to determine body
composition.7

The tool is based on Ohm’s law which is that

voltage is created as a result of the product of current
and resistance.7 Athletes who take this test should be
hydrated, as hydration changes that occur with exercise may
influence the test and provide inaccurate values.8
An appropriate assessment of nutritional and weight
management status can point an athlete in the direction
that is most beneficial to their nutrition needs and that
is sport specific.

Determining an athlete’s current

dietary habits and body composition will allow the health
care provider to better assist the athlete in determining
what meal plan is best suited for them.

Further, this will

allow the athlete to perform their best at their sport. Not
only will a dietary assessment aide the health care
provider in providing optimal meal plan assistance but it

40
will also help them give the best advice regarding
competition day meals.

Pre and Post Game Meal
Nutrition during the day of competition is a vital
component to the athlete’s energy and performance needs.9
The meal prior to competition should supply enough
carbohydrate energy and guarantee optimal hydration.5,8
Fasting before competition will negatively effect the
athlete’s performance due to the rapid depletion of liver
and muscle glycogen.8

Foods that should be consumed during

the day of competition should be somewhat low in fat and
fiber to accommodate gastric emptying and decrease
gastrointestinal discomfort, high in carbohydrates in order
to sustain blood glucose levels and maximize glycogen
stores, moderate in protein, and familiar to the athlete.5
Carbohydrates not only restore liver and muscle glycogen
depletion but they are also more quickly digested and
absorbed than proteins and lipids.

They will ultimately

supply energy more quickly and will reduce the “feeling of
fullness” after a meal.8

Meals high in protein will elevate

the body’s resting metabolism, causing a greater energy
requirement for digestion, absorption, and assimilation.
The heat created by this process will in turn put a strain

41
on the body’s heating mechanisms and will impair its
performance in hot weather.8
Timing of the meals is an important factor for
competition day.

Athlete preference will vary, but most

athletes do not like to perform on a full stomach.5 Smaller
meals may be eaten throughout the day to allow for gastric
emptying, or a considerable meal may be eaten 2-4 hours
before competition.

Other athletes may rely on liquid

meals that close to competition.5 For meals 3-4 hours prior
to exercise, it has been shown that carbohydrates in the
amount of 200 to 300 g is beneficial to exercise.5

Though

the above recommendations are effective in competition day
performance, athletes should use practice days to try new
foods and beverages to evaluate what works best for them.5
The post game meal consumption and timing depend on
the length and intensity of the exercise session and
whether or not glycogen depletion occurred.

It also

depends on if and when the next exercise session will
occur.5

Glycogen stores begin to deplete after 90 minutes

of high intensity training.5 When sufficient carbohydrate
intake has taken place, glycogen stores will restore at
about 5 –7% per hour.8

When an exercise session has caused

glycogen depletion, it will take about 20 hours for
glycogen stores to return.8

Some foods to avoid when

42
restoring glycogen reserves include legumes, fructose, and
milk products due to their slower re absorption rates.8
Incorporating protein into the post exercise meal will
assist in re-instituting the necessary amino acids for
muscle protein restoration and will support a more anabolic
hormonal profile.5

Supplement Use
Supplement use is a common activity among athletes.
Though a proper diet is recommended for adequate nutrition
it is inevitable that a portion of athletes will look for
dietary supplements in order to enhance performance, assist
in injury recovery, or supplement a diet in which they may
be lacking nutrients.10 With the internet now a primary
source of information and distribution, it is important for
the sports medicine professional to be updated on the
current knowledge and concerns regarding over the counter
supplements.
Froiland et al11 concluded that 89% of the subjects who
were all Division I athletes had used supplements.

It also

showed that males were significantly more likely to use
energy and protein supplements and females were more likely
to use vitamins and minerals.

Most of the athletes

reported that they obtained supplement information from

43
family, fellow athletes, their strength and conditioning
coach, athletic trainer, registered dietician, friend, and
coach.

Males took supplements with the goals to improve

speed and agility, strength and power, or for weight and/or
muscle gain.

Females took supplements due to a sub optimal

diet or for overall health.
Malinauskas et al12 sought to identify the incidence of
sports injury in college athletes, to identify three
categories of supplement interest among athletes including
those supplements marketed to improve circulation, promote
joint and soft tissue repair, and reduce inflammation.

The

survey was also designed to determine whether there was a
sex difference for supplements of interest and to learn the
primary sources of supplement information as used by
athletes.

Subjects were collegiate athletes.

Results

showed that 91% of the athletes had experienced sport
related injury.

In the three categories, 34% of the

athletes showed an interest in supplements used for joint
and soft tissue repair.

Twenty two percent were interested

in reducing inflammation and 17% were interested in
improving circulation with the use of supplements.

No

significant gender difference in the three categories was
found.

Most athletes used athletic trainers, physicians,

and coaches as the primary source of information regarding

44
supplements.

Other popular sources included the internet,

magazines, and television.

Females were more likely to

refer to textbooks for information whereas males would rely
on strength coaches.
Injury is a common occurrence in athletics. If
athletes are interested in supplement use to promote
healing it is important that the sports medicine team be
knowledgeable on the various supplements and their role in
speedy recovery.

They should also be able to educate

athletes about legal supplements that may assist with
healing.

Perception of Diet

There are several reasons why NCAA athletes and nonathletes eat the way they do.

The formation of their

dietary habits, environmental factors, and available
resources are all factors that affect the nutritional
choices of this population.

Understanding these trends and

patterns will assist the certified athletic trainer and
health care professional in providing adequate care for
this population.

45
Formation of Dietary Habits
College students away from home for the first time
tend to develop poor eating and physical activity habits.
More time is spent sitting in front of a computer or
television and less time participating in sports or
physical activity.13

Even for those who are participating

in organized sports, it may be the first time they have had
to make their own eating choices as the college campus may
have buffet and fast food type establishments to choose
from.

Students may not have the time or resources to cook

whole meals and may opt for food that is fast and cheap.14
The transition from home life to college hosts a
variety of changes that may occur in one’s dietary habits.
Jelinic et al15 examined the dietary and physical activity
behaviors of students who live in family environments as
opposed to living alone or in student housing.

Subjects

were 496 students attending Medical School University of
Zagreb, Croatia.

The study showed that the group that

lived in a family environment practiced better dietary and
physical activity habits although it should be noted that
both groups displayed less than desirable dietary and
physical activity habits.

Lifestyle behaviors and

attitudes about health care are learned early in life and
will influence decisions made later on in life.

46
College students have the chance to make their own
decisions about eating once they have left home.

Whether

they are eating at campus provided buffets or fast food
establishments, or doing their own grocery shopping for the
Butler et al1 determined

first time the choices are vast.

dietary, physical activity, and body weight parameter
changes that occur among college freshman women during
their first semester after leaving home.

Results showed

that the females did not meet the USDA recommendations for
daily intake of vegetables, fruits, breads and pasta, and
meats during the pre or post test.

The women did seem to

have adequate daily intake of milk, however.

Overall, body

weight and fat mass increased after the five months of the
study.

Interestingly, dietary energy intake actually

decreased, showing that the increase in body weight and
mass in this group of individuals is due to inactivity.
When considering collegiate athlete nutrition habits,
it must be noted that they are college students and so
their eating habits may mirror those of a general college
student.

This is apparent according to Hinton et al14 where

dietary habits of male and female collegiate athletes were
analyzed.

Subjects were 345 male and female Division I

athletes from various sports.

Data were collected using

surveys to determine dietary behaviors of the athletes.

A

47
food frequency questionnaire and Dietary Reference Intakes,
Dietary Guidelines, and Recommended Dietary Allowances were
used to assess nutrient intakes.

Results showed only 15%

of athletes had an adequate intake of carbohydrates and 26%
of the athletes reported recommended daily allowances of
protein.

Male athletes were more likely to consume higher

than recommended amounts of fat, saturated fat,
cholesterol, and sodium.

Females showed a higher interest

in losing five pounds and so less macronutrient and
calories were consumed.
These results indicate that even Division I athletes
may not be eating optimal diets.

Athletes are college

students and so the challenge to consume a well balanced,
healthy diet applies to them.

Environmental Factors
There are several environmental factors that may apply
to college students, particularly athletes.

For college

students in general these factors may include increased
time spent sitting in class or in front of a computer or
television.

Other factors include available food choices

such as fast food or buffet style cafeteria food.13 For
athletes in particular, environmental factors that may

48
influence the way an athlete eats include group influences
and sport.
Hausenblas et al16 examined group influences, both
positive and negative, on male and female varsity athletes.
Subjects were 131 volunteer male and female collegiate
athletes.

Data were collected using an open-ended

questionnaire.

Results showed that most athletes did not

report a perceived group influence that dictated personal
dietary habits.

Overall, the group seemed to have a

greater influence on eating behaviors (quality and quantity
of food) than on dieting practices (weight and body shape).
About 30% of the athletes reported a positive influence on
eating and dietary behavior while about 10% reported a
negative influence on eating and dietary behavior. Although
other research may support a negative influence of groups
on individual dietary and eating behaviors, these results
show that there are also positive influences.
Athletes on a team spend a considerable amount of time
together.

This may cause them to begin to influence each

other’s eating and dietary behavior.16 It is important to
encourage healthy eating behaviors and dietary practices
both at the individual level and also as a group.
Depending on the sport, they may also have pressure
concerning weight and body type.

49
Schwarz et al3 wanted to determine the differences in
eating attitudes, body dissatisfaction, and perfectionism
among female collegiate athletes as compared to female nonathletes.

Subjects were 103 female, undergraduate

students.

Data were collected using a survey, which

measured eating attitudes, perfectionism, and demographics.
Body mass index was measured using self reported height and
weight.

Results did not indicate that athletes showed a

higher incidence of eating disorder symptoms.

The only

difference between the athletes and non-athletes in this
study was found in body dissatisfaction.

Though body sizes

were rather similar in both groups, non-athletes displayed
a higher dissatisfaction with their bodies.

The athletes

also exhibited a higher score of perfectionism as compared
with the non-athletes.

This may be especially true for

those athletes who may make dietary choices to account for
body appearance including dancers, gymnasts, and figure
skaters.17

Available Nutrition Resources
There are a variety of nutrition resources that may be
available to the college student and athlete to assist them
in making better dietary choices.

These resources include

50
but are not limited to the internet, peer health education,
and coaches.
The internet is a quick, easy way to obtain
information.

Especially for college students, who have

access to the internet and who consistently use the
internet to find information the internet seems like a
great tool for exploring health information.18 Cousineau et
al18 looked at the availability of resources of nutrition to
college students available online and the elements of
nutrition that were deemed most important by students,
educators, and counselors.

The first part of the study was

completed by conducting research on nutrition specific to
college students by using popular search engines such as
Google, yahoo, and lycos.

They also searched specific

sites such as www.colleges.com and www.dietician.com.

The

results of this part of the study revealed surprising
information to the authors because of the lack of nutrition
information that was tailored for college students.

The

finding suggests that the need for nutritional information
specific to college students should become available on the
internet.18
Peer health education is another way students in a
college setting may obtain information on nutrition.

Peer

health education is used on college campuses across the

51
nation to encourage healthy behaviors among students.19

The

benefits of PHE as described in the literature include easy
access to the students and positive effects.19

The goal of

White et al19 was to determine effects of PHE on a college
campus and the impact that it made on health behaviors.
Subjects were 146 students at a University in California.
The research instrument was a survey that evaluated impacts
of peer health education on health behaviors.
collected over a three-year period.

Data were

Regarding eating and

nutrition habits, the study showed students to have engaged
in unhealthy eating practices during the first year but the
negative habits decreased by the third year.

The results

of this study emphasize the importance of PHE availability
to college students.
Another channel of nutrition information is commonly
the coaches as they are the central team member.20 Athletes
interact closely with their coaches and so the coach may
often become a source of information to the athletes.

Zinn

et al20 sought to determine whether coaches give information
on nutrition to their athletes and how knowledgeable they
are in nutrition topics.
coaches in New Zealand.
survey tool.

Subjects were 168 male rugby
They study was conducted using a

Results showed that most of the coaches do

give nutritional advice to their athletes and of the

52
nutrition topics tested, coaches were the least
knowledgeable about supplements.

Most of the coaches had

never had formal nutrition education.

These results

indicate that coaches may benefit from some form of
nutrition education.

Athletes will often turn to a coach

for advice in nutrition and so coaches should be more
knowledgeable in nutrition so they can provide the best and
most accurate advice to athletes.21
At the high school, collegiate, and professional level
certified athletic trainers are often the first person an
athlete may turn to for medical advice.22 Therefore, an
athlete may look to the certified athletic trainer for
advice about nutrition.

Descriptive research conducted by

Burns et al23 showed that even though dieticians were
available in half of the athletic departments studied, the
certified athletic trainers were the primary information
source regarding nutritional concerns and students
perceived the athletic trainers as good resources in terms
of knowledge of nutrition.

In order to provide better

nutrition services to athletes, dieticians and certified
athletic trainers should join their nutritional expertise.23

53

Summary

Leaving home for the first time poses new challenges
when it comes to nutrition habits for college students
whether they are athletes or non-athletes.

Though

nutrition information may be available through the
internet, PHE, coaches, and certified athletic trainers,
college students still seem to have less than optimal
diets.19

College students are typically shown to possess

unhealthy dietary behaviors such as skipping meals,
snacking frequently on energy-dense food, and taking part
in unhealthy weight loss plans.24 Contributing factors to
the less than satisfactory nutrition habits among college
students include busy schedules and the college
environment.13,14

For athletes, busy class and practice

schedules may influence nutritional choices.14
Environmental factors include buffet style cafeteria’s and
dormitory living, which may hinder facilities for food
preparation or the opportunity and funds to go grocery
shopping.14
College students are at an impressionable age in
which lifestyle attitudes and behaviors are created and
characterize a pattern for later years in life.

For this

54
reason, it is important to observe the trends in health
behavior with this age group.15 Understanding these trends
and patterns will assist the certified athletic trainer and
health care professional in providing adequate care for
this population.

The certified athletic trainer should

become familiar with evidence based research regarding
nutrition so that they are not only able to educate the
athletes, but so that they are also able to educate coaches
and strength and conditioning coaches when necessary.

55

APPENDIX B
The Problem

56
THE PROBLEM

Leaving home for the first time poses new challenges
when it comes to nutrition habits for college students
whether they are athletes or non-athletes.

Though

nutrition information may be available, college students
still seem to have less than optimal diets.19 For this
reason, it is important to observe the trends in health
behavior with this age group.15 At the high
school,collegiate, and professional level certified
athletic trainers are often the first person an athlete may
turn to for medical advice.22

Therefore, an athlete may

look to the certified athletic trainer for advice about
nutrition.

Descriptive research conducted by Burns et al23

showed that even though dieticians were available in half
of the athletic departments studied, the certified athletic
trainers were the primary information source regarding
nutritional concerns and students perceived the athletic
trainers as good resources in terms of knowledge of
nutrition.

In order to provide better nutrition services

to athletes, dieticians and certified athletic trainers
should join their nutritional expertise.23 The purpose of
this study was to examine similarities and/or differences

57
between the nutrition knowledge and eating behavior among
NCAA Division II athletes and non-athletes.

Definition of Terms
The following terms were integrated throughout this
study and so are defined as they relate to this research:
1)

Kilocalorie (kcal) – a measurement of food energy.
One calorie expresses the amount of heat that is
required to elevate the temperature of 1 kg of water 1
degrees Celsius (more specifically from 14.5 to 15.5
degrees Celsius).8

2)

NCAA Athlete – for the purpose of this study, someone
who participates in a sport that is a part of the
National Collegiate Athletics Association.

3)

Non-Athlete – for the purpose of this study, someone
who does not participate in a sport that is part of
the National Collegiate Athletics Association.

4)

Nutritional Habits – a number that is reported as
percentage score which is used to evaluate the
apparent quality of eating habits adopted by each
subject (APPENDIX C3).25

5)

Glycogen – a polysaccharide that is found in the liver
and muscle of humans and animals.8

58
6)

Nutritional Knowledge – a number that is reported as a
percentage score which is used to evaluate the
apparent knowledge of each subject in the nutrition
field (APPENDIX C3).25

Basic Assumptions
The following assumptions may be made about this
study:
1)

All subjects participated voluntarily.

2)

All subjects answered honestly and to the best of
their ability.

3)

All instruments are valid and reliable assessments of
nutritional knowledge and eating habits.

Limitations of the Study
The following are possible limitations of the study:
1)

Results were limited to a subject sample of NCAA
Division II athletes at one university.

2)

Results were limited to a subject sample of general
college students at one university.

Significance of the Study
The college environment may be a challenge for
students who are trying to make good nutritional choices.

59
Though nutrition information is readily available via the
internet and peer health education is widely used on
college campuses across America, college students still
seem to have less than optimal diets.19

Relocation from

home life to a college situation poses changes in both the
social and physical environments of a college student –
whether they are an athlete or not.1
The study was a comparison between NCAA Division II
athletes and non-athletes and their nutrition knowledge and
eating behavior.

Since research already shows that

college students have less than optimal diets, this study
is important in that it revealed various knowledge and
behaviors that are apparent in college students and
athletes.

The more obvious that the knowledge and habits

are among this population, the better equipped sports
medicine professionals will be in order to decide what
strategies are best in making improvements.

Since

certified athletic trainers are often the first medical
professional with whom the athlete will seek out, they
should especially be able to answer questions and provide
knowledgeable advice regarding nutritional decisions that
will assist the athlete in athletic performance.22 Certified
athletic trainers should be knowledgeable on evidence based

60
research so that they are better educating athletes and
other appropriate personnel when necessary.

61

APPENDIX C
Additional Methods

62

APPENDIX C1
Original Nutritional Knowledge and Eating Habits
Questionnaire

63

Original Nutritional Knowledge and Eating Habits Questionnaire
SECTION 1: Please circle the number for each statement indicating to
what extent you agree or disagree with each of the following
statements.
4 – Strongly Agree
3 – Agree Somewhat
2 – Disagree Somewhat
Athlete # _____
1 – Strongly Disagree
1. Skipping breakfast can negatively affect athletic performance.
4
3
2
1
2. Proteins are the best and most efficient source of energy.
4
3
2
1
3. Nutrition affects mental performance.
4
3
2
1
4. The pre-event meal should be eaten 3-4 hours prior to competition.
4
3
2
1
5. Calcium excretion from the body increases with alcohol consumption.
4
3
2
1
6. According to mypyramid.gov, it is recommended that females, age 1825, who engage in more than 60 min. of exercise per day, should consume
8 daily ounce equivalents from the grains group.
4
3
2
1
7. According to mypyramid.gov, it is recommended that females, age 1825, who engage in more than 60 min. of exercise per day, should consume
2 cups of fruit daily.
4
3
2
1
8. According to mypyramid.gov, it is recommended that females, age 1825, who engage in more than 60 min. of exercise per day, should consume
3 servings from the dairy group daily.
4
3
2
1
9. According to mypyramid.gov, it is recommended that females, age 1825, who engage in more than 60 min. of exercise per day, should consume
6.5 ounce equivalents from the meat/bean group every day.
4
3
2
1
10. Eating breakfast can improve concentration.
4
3
2
1
11. Carbohydrates are less fattening than fatty foods.
4
3
2
1
12. At least 60% of total calories should come from carbohydrates.
4
3
2
1

64
13. Carbohydrates are easier to digest than fats or proteins.
4
3
2
1
14. Excess vitamin consumption can be toxic.
4
3
2
1
15. Anemia is a deficiency of iron.
4
3
2
1
16. Average percentage of body fat in females is 20-25%.
4
3
2
1
17. Cereal, bread, bagels, and pasta are good sources of carbohydrates.
4
3
2
1
18. Tofu, nuts, and beans are good sources of proteins.
4
3
2
1
19. Athletes tend to consume twice as much protein as recommended.
4
3
2
1
20. Over-consumption of protein is beneficial for athletes.
4
3
2
1
21. The best sources of iron come from animal products and fish.
4
3
2
1
22. Eating cereals or breads enriched with iron should be eaten with a
source of vitamin C to enhance the absorption of iron.
4
3
2
1
23. Proteins act to repair and build muscle tissue and make hormones to
boost the immune system.
4
3
2
1
24. Fats are essential in all diets.
4
3
2
1
25. If a diet is lacking in carbohydrates, proteins are then used for
energy.
4
3
2
1
26. Oatmeal, legumes, and fruits are sources of soluble fiber.
4
3
2
1
27. The recommended amount of iron for females is 18-23 milligrams per
day.
4
3
2
1
28. Vitamin C is also known as ascorbic acid.
4
3
2
1
29. If you are not thirsty, then you must not be dehydrated.
4
3
2
1
SECTION 2: Please circle the number that applies to the following
questions. Refer to the scale below to determine the number of days

65
per week defined in each rating. All of the results will be strictly
confidential. Thank you for your cooperation.
4 – Always: Occurs 5-7 days per week.
3 – Often: Occurs 3-4 days per week.
2 – Sometimes: Occurs 1-2 days per week.
1 – Never: Does not occur at all.
1. How often do you eat breakfast in the morning?
4
3
2
1
2. Based on three meals per day, how often do you skip at least one
meal per day?
4
3
2
1
3. How often do you take vitamin supplements?
4
3
2
1
4. How often do you take mineral supplements?
4
3
2
1
5. How often do you eat three meals per day?
4
3
2
1
6. How often do you record what you eat?
4
3
2
1
7. How often do you drink water?
4
3
2
1
8. How often do you drink carbonated beverages?
4
3
2
1
9. How often are you on a “diet”?
4
3
2
1
10. How often do you eat breads, cereals, pasta, potatoes or rice?
4
3
2
1
11. How often do you eat fruits, such as apples, bananas, or oranges?
4
3
2
1
12. How often do you eat vegetables, such as broccoli, carrots, or
salad?
4
3
2
1
13. How often do you eat dairy products such as milk, yogurt or cheese?
4
3
2
1
14. How often do you eat berry jams, cookies, candies, or other sweets?
4
3
2
1
15. How often do you snack on foods like potato chips, cakes, candies,
donuts, or soda?
4
3
2
1
16. How often do you snack on foods like bagels, yogurt, popcorn,
pretzels, or fruits?

66
4

3

2

1

17. How often do you eat fast foods?
4
3
2
1
18. How often do you seek out nutritional information?
4
3
2
1

67

APPENDIX C2
Revised Nutritional Knowledge and Eating Habits
Questionnaire

68
Revised Nutritional Knowledge and Eating Habits Questionnaire
Section 1: Please circle the number for each statement indicating to
what extent you agree or disagree with each of the following
statements.
4 – Strongly Agree
3 – Agree Somewhat
2 – Disagree Somewhat
1 – Strongly Disagree
1. Skipping breakfast can negatively affect athletic performance.
4
3
2
1
2. Nutrition can affect mental performance.
4
3
2
1
3. Calcium excretion from the body increases with alcohol consumption.
4
3
2
1
4. According to mypyramid.gov, it is recommended that females, age 1825, who engage in more than 60 minutes of exercise per day, should
consume 8 daily ounce equivalents from the grains group.
4
3
2
1
5. According to mypyramid.gov, females age 18-25, who engage in more
than 60 minutes of exercise per day, should consume 2 cups of fruit
daily.
4
3
2
1
6. According to mypyramid.gov, females age 18-25, who engage in more
than 60 minutes of exercise per day, should consume 3 servings from the
dairy group per day.
4
3
2
1
7. According to mypyramid.gov, females ages 18-25, who engage in more
than 60 minutes of exercise per day, should consume 6.5 ounce
equivalents from the meat/bean group every day.
4
3
2
1
8. Eating breakfast can improve concentration.
4
3
2
1
9. Excess vitamin consumption can be toxic.
4
3
2
1
10. Anemia is a deficiency of iron.
4
3
2
1
11. Average percent of body fat in females is 20-25%.
4
3
2
1
12. Cereal, bread, bagels, and pasta are good sources of carbohydrates.
4
3
2
1
13. Tofu, nuts, and beans are good sources of protein.
4
3
2
1

69
14. Athletes tend to consume twice as much protein as recommended.
4
3
2
1
15. The best sources of iron come from animal products and fish.
4
3
2
1
16. Eating cereals or breads enriched with iron should be eaten with a
source of vitamin C to enhance absorption of iron.
4
3
2
1
17. Proteins act to repair and build muscle tissue and make hormones to
boost the immune system.
4
3
2
1
18. Fats are essential in all diets.
4
3
2
1
19. If a diet is lacking in carbohydrates, proteins are then used for
energy.
4
3
2
1
20. Oatmeal, legumes, and fruits are sources of soluble fiber.
4
3
2
1
21. The recommended amount of iron for females is 18-32 milligrams per
day.
4
3
2
1
22. Vitamin C is also known as ascorbic acid.
4
3
2
1
Section 2: Please circle the number that applied to each of the
following questions. Refer to the scale below to determine the number
of days per week defined in each rating. All of the results will be
kept strictly confidential. Thank you for your cooperation.
4 – Always: Occurs 5-7 days per week
3 – Often: Occurs 3-4 days per week
2 - Sometimes: Occurs 1-2 days per week
1 – Never: Does not occur at all
1. How often do you eat breakfast in the morning?
4
3
2
1
2. How often do you take vitamin supplements?
4
3
2
1
3. How often do you take mineral supplements?
4
3
2
1
4. How often do you eat three base meals per day?
4
3
2
1
5. How often do you record what you eat?
4
3
2
1
6. How often are you on a “diet”?

70
4

3

2

1

7. How often do you eat fruits, such as apples, bananas, or oranges?
4
3
2
1
8. How often do you eat vegetables, such as broccoli, carrots or salad?
4
3
2
1
9. How often do you consume dairy products such as milk, yogurt or
cheese?
4
3
2
1
10. How often do you seek out nutritional information?
4
3
2
1

71

Appendix C3
Consent Form

72

Informed Consent Form
1. Sarah Seabrook, who is a Graduate Athletic Training Student at California University of Pennsylvania,
has requested my participation in a research study at California University of Pennsylvania. The title of the
research is A Comparison of Nutrition Habits and Knowledge Between NCAA Division II Athletes and NonAthletes.
2. I have been informed that the purpose of this study is to study the similarities and/or differences in
nutrition habits and knowledge between NCAA Division II athletes and non-athletes. I understand that I
must be 18 years of age or older to participate. I understand that I have been asked to participate along
with other individuals who are not NCAA Division II athletes.

3. I have been invited to participate in this research project. My participation is voluntary and I can choose
to discontinue my participation at any time without penalty or loss of benefits. My participation will
involve demographic information and completing a nutritional knowledge and eating habits questionnaire.

4. There are no foreseeable risks associated with this study.
5. There are no feasible alternative procedures available for this study.
6. I understand that the possible benefits of my participation in the research is sports medicine
professionals will be able to better understand the trends associated with eating knowledge and behavior
among NCAA Division II athletes. This will allow them to provide better nutritional advice to this
population.

7. I understand that the results of the research study may be published but my name or identity will not be
revealed. Only aggregate data will be reported. In order to maintain confidentially of my records, Sarah
Seabrook will maintain all documents in a secure location on campus and password protect all electronic
files so that only the student researcher and research advisor can access the data. Each subject will be given
a specific subject number to represent his or her name so as to protect the anonymity of each subject.
8. I have been informed that I will not be compensated for my participation.
9. I have been informed that any questions I have concerning the research study or my participation in it,
before or after my consent, will be answered by:
Sarah Seabrook, ATC
STUDENT/PRIMARY RESEARCHER
SEA4160@cup.edu
609-602-7618
Rebecca Hess, PhD
RESEARCH ADVISOR
hess ra@calu.edu
724/938-4359

73
10. I understand that written responses may be used in quotations for publication but my identity will
remain anonymous.
11. I have read the above information and am electing to participate in this study. The nature, demands,
risks, and benefits of the project have been explained to me. I knowingly assume the risks involved, and
understand that I may withdraw my consent and discontinue participation at any time without penalty or
loss of benefit to myself. In signing this consent form, I am not waiving any legal claims, rights, or
remedies. A copy of this consent form will be given to me upon request.
12. This study has been approved by the California University of Pennsylvania Institutional Review Board.
13. The IRB approval dates for this project are from: 03/05/10 to 03/05/11.

Subject's signature:___________________________________ Date:____________________

Witness signature:___________________________________ Date:____________________

74

Appendix C4
Demographics

75

Demographic Information
Please DO NOT write your name anywhere on this sheet.
Answer the following questions honestly and to the best of
your ability. All responses to the following survey will
be kept confidential and used only for data analysis by the
researcher. Thank you.

1.

Gender ___Male ___Female

2.

Academic year in college
___Freshman (1-29 credits)
___Sophomore (30-59 credits)
___Junior (60-89 credits)
___Senior (90 or more credits)

3.

Are you an NCAA athlete at California University of
Pennsylvania?
___Yes ___No

4.

What type of housing do you live in?
___Dorm room ___Apartment (on or off campus)
___Home (with family or relatives)___House (no
family or relatives)

5.

What is your exposure to nutrition information in
college? (check all that apply)
___Academic Class ___Guest Lecture
___Peer Health Education
___Peer Influence

___Internet

___Coaches

___Certified Athletic Trainer
___Sports Nutritionist
___Strength and Conditioning Coach
___Dietician

76

Appendix C5
Scoring Key: Revised Nutritional Knowledge and Eating
Habits Questionnaire

77
Revised Nutritional Knowledge and Eating Habits Questionnaire
Section 1: Please circle the number for each statement indicating to
what extent you agree or disagree with each of the following
statements.
4 – Strongly Agree
3 – Agree Somewhat
2 – Disagree Somewhat
1 – Strongly Disagree
1. Skipping breakfast can negatively affect athletic performance.
2. Nutrition can affect mental performance.

4

4

3. Calcium excretion from the body increases with alcohol consumption.
4
4. According to mypyramid.gov, it is recommended that females, age 1825, who engage in more than 60 minutes of exercise per day, should
consume 8 daily ounce equivalents from the grains group. 4
5. According to mypyramid.gov, females age 18-25, who engage in more
than 60 minutes of exercise per day, should consume 2 cups of fruit
daily. 4
6. According to mypyramid.gov, females age 18-25, who engage in more
than 60 minutes of exercise per day, should consume 3 servings from the
dairy group per day.
4
7. According to mypyramid.gov, females ages 18-25, who engage in more
than 60 minutes of exercise per day, should consume 6.5 ounce
equivalents from the meat/bean group every day. 4
8. Eating breakfast can improve concentration.
9. Excess vitamin consumption can be toxic.
10. Anemia is a deficiency of iron.

4

4

4

11. Average percent of body fat in females is 20-25%.

4

12. Cereal, bread, bagels, and pasta are good sources of carbohydrates.
4
13. Tofu, nuts, and beans are good sources of protein.

4

14. Athletes tend to consume twice as much protein as recommended.
15. The best sources of iron come from animal products and fish.

4

4

16. Eating cereals or breads enriched with iron should be eaten with a
source of vitamin C to enhance absorption of iron. 4
17. Proteins act to repair and build muscle tissue and make hormones to
boost the immune system. 4

78
18. Fats are essential in all diets.

4

19. If a diet is lacking in carbohydrates, proteins are then used for
energy. 4
20. Oatmeal, legumes, and fruits are sources of soluble fiber.

4

21. The recommended amount of iron for females is 18-32 milligrams per
day. 4
22. Vitamin C is also known as ascorbic acid.

4

RANGE OF SCORES: 22-88
Section 2: Please circle the number that applied to each of the
following questions. Refer to the scale below to determine the number
of days per week defined in each rating. All of the results will be
kept strictly confidential. Thank you for your cooperation.
4 – Always: Occurs 5-7 days per week
3 – Often: Occurs 3-4 days per week
2 - Sometimes: Occurs 1-2 days per week
1 – Never: Does not occur at all
1. How often do you eat breakfast in the morning?
2. How often do you take vitamin supplements?

1

3. How often do you take mineral supplements?

1

4. How often do you eat three base meals per day?
5. How often do you record what you eat?
6. How often are you on a “diet”?

4

4

4

1

7. How often do you eat fruits, such as apples, bananas, or oranges?

4

8. How often do you eat vegetables, such as broccoli, carrots or salad?
4
9. How often do you consume dairy products such as milk, yogurt or
cheese? 4
10. How often do you seek out nutritional information?
RANGE OF SCORES: 10-40
CLASSIFICATIONS:
Excellent = 85-100%
Good = 70-85%
Fair = 55-69%
Poor = 54% or below

4

79

Appendix C6
Institutional Review Board

80

Proposal Number
Date Received

PROTOCOL for Research
Involving Human Subjects

Institutional Review Board (IRB) approval is required before
beginning any research and/or data collection involving human subjects

(Reference IRB Policies and Procedures for clarification)

Project Title A Comparison of Nutrition Habits and Knowledge Between NCAA Division II Athletes and NonAthletes
Phone #

609-602-7618

Faculty Sponsor (if required)
Department

E-mail Address SEA4160@calu.edu
Dr. Rebecca Hess

Health Science

Project Dates January 2010

to

May 2010

Sponsoring Agent (if applicable)
Project to be Conducted at
Project Purpose:

Hamer Hall, California University of Pennsylvania

Thesis

Research

Class Project

Keep a copy of this form for your records.

Other

81

Required IRB Training
The training requirement can be satisfied by completing the online training session at http://cme.nci.nih.gov/ . A copy of
your certification of training must be attached to this IRB Protocol. If you have completed the training at an earlier date
and have already provided documentation to the California University of Pennsylvania Grants Office, please provide the
following:

Previous Project Title
Date of Previous IRB Protocol

82
Please attach a typed, detailed summary of your project AND complete items 2
through 6.
1. Provide an overview of your project-proposal describing what you plan to do and how you
will go about doing it. Include any hypothesis(ses)or research questions that might be
involved and explain how the information you gather will be analyzed. For a complete list of
what should be included in your summary, please refer to Appendix B of the IRB Policies and
Procedures Manual

The purpose of this study is to examine similarities and/or differences between the
knowledge and habits of nutrition among NCAA athletes and non-athletes. A descriptive
research design will be used for this study. Dependent variables are subjects’ nutritional
knowledge and eating habits. The independent variable is group (NCAA athletes/nonathletes). Male and female National Collegiate Athletic Association (NCAA) Division II
athletes (N ~ 50) from California University of Pennsylvania are desired for this study.
For the purpose of this study, NCAA athletes are defined as those who actively
participate in a varsity sport. NCAA non-athletes, those not participating in an NCAA
sport, who attend California University of Pennsylvania are also desired for the study (N
~ 50). All participation is voluntary for NCAA athletes and non-athletes. The subjects
will remain anonymous but will complete a consent form to participate in the study
(Appendix C4). The instruments included in this study are a Demographic Sheet
(Appendix C1) and the revised Nutritional Knowledge and Eating Habits Questionnaire (
Appendix C2). A demographic sheet will be completed by each subject, which includes
information on academic year in college, gender, whether they are an NCAA athlete, and
living situation (dormitory, on or off campus apartment, living in a house with relatives,
or living in a house with non-relatives). The first part of the questionnaire (22 questions)
is designed to evaluate the level of nutritional knowledge of each subject. Using a fourpoint Likert-type scale, the subjects will be asked to specify to what degree they agree
with each statement. Answers range from strongly agree (4) to strongly disagree (1).
Questions surveyed the subjects on topics such as pre-event meals, breakfast habits,
individual nutrient effect on performance, vitamin consumption, and food group choices
consistent with www.mypyramid.gov. Questions will be scored to their value using the
specified key (Appendix C3). For example, if the subject answers with a 4, they will be
given 4 points for that particular question. The scores in the first knowledge section
range from 22-88 points. By dividing a subject’s score by 88, a percentage will be
appointed. Nutritional knowledge will be scored as follows: excellent (85-100%), good
(70-84%), fair (55-69%), or poor (54% or below). The second section of the
questionnaire, comprised of 10 questions, is anticipated to test the quality of the eating
habits of individual subjects. Using a four-point Likert-type scale, subjects will be asked
to specify how frequently they consume certain foods or take part in particular eating
habits. Answers will include: Always (4), Often (3), Sometimes (2), and Never (1).
Always (4) shows that a habit occurs 5-7 days per week, Often (3) shows that a habit
occurs 3-4 days per week, Sometimes (2) shows that a habit occurs 1-2 days per weeks,
and Never shows a habit that does not occur at all. Reverse scoring will be used for
questions numbered 2, 3, and 6. Reverse scoring means that when a question is answered
as a 4, one point is given. The other questions excluding 2, 3, and 6 will be scored
according to their numerical value – if the subject answers with a 4, they were awarded 4
points. In this section, scores rage from 10-40 points. After adding up each subject’s

83
score, the total will be divided by 40. Scores will be awarded as follows: Excellent (85100%), Good (70-84%), Fair (55-69%), or Poor (54% or below). Permission to access
athletes during practice times will be obtained from the California University of
Pennsylvania’s Athletic Director. The researcher will then ask permission from
California University of Pennsylvania’s football, men’s/women’s soccer, track, cross
country, tennis, volleyball, baseball, softball, swimming, cheerleading, and
men’s/women’s basketball to have 15 minutes prior to or after practice in which the
survey may be taken by volunteer NCAA athletes without the presence of the coach.
There will be no consequences or rewards for taking part in this survey and the survey
may be discontinued at any time. The coaches’ role in this study is simply to obtain
permission to access athletes for 15 minutes prior to or after practice. They will not be
present while the survey is handed out and completed. The researcher will distribute the
surveys by hand. Potential non-athlete volunteers for this study will be gathered through
the Health Science Department. Two faculty professors will be contacted via email to
request permission to enter the classroom at two separate times; two classes for each
professor. These classes are general education classes comprised of the general student
population. The researcher will request for volunteers in the classrooms; student athletes
(NCAA) and/or non-athletes may take the survey. It will be stressed that participation is
strictly voluntary and there are no rewards or consequences for taking the survey. The
role of the two professors is simply to obtain permission to enter the classroom for 15
minutes prior to or after class. The professor’s will not be present during that time. The
researcher will distribute the survey’s by hand. It will also be explained that participation
may be discontinued at any time without penalty and all data discarded. A consent form
explaining the research project will be distributed to the subjects to be reviewed and then
signed before the surveys are handed out. After reading, understanding, and signing the
consent forms, the researcher will collect them and will keep them in a secured location.
Following collection of the consent form, each survey will be distributed to the subjects.
The survey is a typed questionnaire that will be distributed and collected by hand by the
researcher. After completion of the surveys, the subjects will be instructed to turn them
over so a blank sheet of paper will be faced up for the researcher to collect. The surveys
will only be numbered for data collection/analysis. The numbers will not link the subject
to his/her survey. After collecting the surveys, the researcher will place them in a folder,
which will be stored in a locked file cabinet in a secure office in which only the
researcher and the program director will have a key. The following hypothesis was based
on previous research and the researcher’s intuition based on a review of the literature.
NCAA athletes and non-athletes will not exhibit a significant difference in nutrition
knowledge and eating habits. All data will be analyzed by SPSS version 17.0 for
windows at an alpha level of < 0.05. The hypothesis will be tested by using a MANOVA
in order to compare the two dependent variables (nutrition knowledge and eating habits)
between the groups (NCAA athletes and non-athletes).
2. Section 46.11 of the Federal Regulations state that research proposals involving human
subjects must satisfy certain requirements before the IRB can grant approval. You should
describe in detail how the following requirements will be satisfied. Be sure to address each
area separately.

84
a. How will you insure that any risks to subjects are minimized? If there are potential
risks, describe what will be done to minimize these risks. If there are risks, describe
why the risks to participants are reasonable in relation to the anticipated benefits.
There is no physical risk and minimal emotional risk possibilities for this study as
subjects are serving as volunteers and may terminate the survey at any time without
penalty. All subject’s answers will be kept confidential and no research will be carried
out until approved by IRB.
b. How will you insure that the selection of subjects is equitable? Take into account
your purpose(s). Be sure you address research problems involving vulnerable
populations such as children, prisoners, pregnant women, mentally disabled persons,
and economically or educationally disadvantaged persons. If this is an in-class
project describe how you will minimize the possibility that students will feel coerced.
No subject will be forced or coerced into this study by anyone at anytime. Subjects will
be informed that they can withdraw from the study at any time without the possibility of
penalty or personal self loss.
c. How will you obtain informed consent from each participant or the subject’s legally
authorized representative and ensure that all consent forms are appropriately
documented? Be sure to attach a copy of your consent form to the project summary.
Informed consent forms will be read and completed by each potential volunteer prior to
this study.
d. Show that the research plan makes provisions to monitor the data collected to insure
the safety of all subjects. This includes the privacy of subjects’ responses and
provisions for maintaining the security and confidentiality of the data.
The researcher will administer forms and surveys either by hand or electronically for the
safety of all subjects and privacy of all responses. All forms will be kept in a secure location
on University premises – Hamer Hall 235 in which only the researcher, Sarah Seabrook, and
program director, Thomas West, can access information. The results of this study may be
published, but subjects’ identity will not be revealed.
3. Check the appropriate box(es) that describe the subjects you plan to use.

Adult volunteers

Mentally Disabled People

CAL University Students

Economically Disadvantaged People

Other Students

Educationally Disadvantaged People

Prisoners

Fetuses or fetal material

Pregnant Women

Children Under 18

Physically Handicapped People

Neonates

85
4. Is remuneration involved in your project?
5. Is this project part of a grant?

Yes or

Yes or
No

No. If yes, Explain here.

If yes, provide the following information:

Title of the Grant Proposal
Name of the Funding Agency
Dates of the Project Period
6.

Does your project involve the debriefing of those who participated?

Yes or

No

If Yes, explain the debriefing process here.
7. If your project involves a questionnaire interview, ensure that it meets the requirements of
Appendix __ in the Policies and Procedures Manual.

86
California University of Pennsylvania Institutional Review Board
Survey/Interview/Questionnaire Consent Checklist (v021209)
This form MUST accompany all IRB review requests
Does your research involve ONLY a survey, interview or questionnaire?
YES—Complete this form
NO—You MUST complete the ―Informed Consent Checklist‖—skip the remainder of
this form
Does your survey/interview/questionnaire cover letter or explanatory statement include:
[YES] (1) Statement about the general nature of the survey and how the data will be
used?
[YES] (2) Statement as to who the primary researcher is, including name, phone, and
email address?
[YES] (3) FOR ALL STUDENTS: Is the faculty advisor’s name and contact
information provided?
[YES] (4) Statement that participation is voluntary?
[YES] (5) Statement that participation may be discontinued at any time without
penalty and all data discarded?
[YES] (6) Statement that the results are confidential?
[YES] (7) Statement that results are anonymous?
[YES] (8) Statement as to level of risk anticipated or that minimal risk is anticipated?
(NOTE: If more than minimal risk is anticipated, a full consent form is required—and
the Informed Consent Checklist must be completed)
[YES] (9) Statement that returning the survey is an indication of consent to use the
data?
[YES] (10) Who to contact regarding the project and how to contact this person?
[YES] (11) Statement as to where the results will be housed and how maintained?
(unless otherwise approved by the IRB, must be a secure location on University
premises)
[YES] (12) Is there text equivalent to: ―Approved by the California University of
Pennsylvania Institutional Review Board. This approval is effective nn/nn/nn and
expires mm/mm/mm‖? (the actual dates will be specified in the approval notice from
the IRB)?

87

[ ] (13) FOR ELECTRONIC/WEBSITE SURVEYS: Does the text of the cover letter
or
explanatory statement appear before any data is requested from the participant?
[ ] (14) FOR ELECTONIC/WEBSITE SURVEYS: Can the participant discontinue
participation at any point in the process and all data is immediately discarded?

88
California University of Pennsylvania Institutional Review Board
Informed Consent Checklist (v021209)
This form MUST accompany all IRB review requests
Does your research involve ONLY a survey, interview, or questionnaire?
YES—DO NOT complete this form. You MUST complete the
―Survey/Interview/Questionnaire Consent Checklist‖ instead.
NO—Complete the remainder of this form.
1. Introduction (check each)
[_] (1.1) Is there a statement that the study involves research?
[_] (1.2) Is there an explanation of the purpose of the research?
2. Is the participant. (check each)
[_] (2.1) Given an invitation to participate?
[_] (2.2) Told why he/she was selected.
[_] (2.3) Told the expected duration of the participation.
[_] (2.4) Informed that participation is voluntary?
[_] (2.5) Informed that all records are confidential?
[_] (2.6) Told that he/she may withdraw from the research at any time without
penalty or loss of benefits?
[_] (2.7) 18 years of age or older? (if not, see Section #9, Special Considerations
below)
3. Procedures (check each).
[_] (3.1) Are the procedures identified and explained?
[_] (3.2) Are the procedures that are being investigated clearly identified?
[_] (3.3) Are treatment conditions identified?
4. Risks and discomforts. (check each)
[_] (4.1) Are foreseeable risks or discomforts identified?
[_] (4.2) Is the likelihood of any risks or discomforts identified?
[_] (4.3) Is there a description of the steps that will be taken to minimize any risks
or discomforts?
[_] (4.4) Is there an acknowledgement of potentially unforeseeable risks?
[_] (4.5) Is the participant informed about what treatment or follow up courses of
action are available should there be some physical, emotional, or psychological harm?
[_] (4.6) Is there a description of the benefits, if any, to the participant or to others
that may be reasonably expected from the research and an estimate of the likelihood
of these benefits?
[_] (4.7) Is there a disclosure of any appropriate alternative procedures or courses
of treatment that might be advantageous to the participant?
5. Records and documentation. (check each)

89
[_] (5.1) Is there a statement describing how records will be kept confidential?
[_] (5.2) Is there a statement as to where the records will be kept and that this is a
secure location?
[_] (5.3) Is there a statement as to who will have access to the records?
6. For research involving more than minimal risk (check each),
[_] (6.1) Is there an explanation and description of any compensation and other
medical or counseling treatments that are available if the participants are injured
through participation?
[_] (6.2) Is there a statement where further information can be obtained regarding
the treatments?
[_] (6.3) Is there information regarding who to contact in the event of researchrelated injury?
7. Contacts.(check each)
[_] (7.1) Is the participant given a list of contacts for answers to questions about the
research and the participant’s rights?
[_] (7.2) Is the principal researcher identified with name and phone number and
email address?
[_] (7.3) FOR ALL STUDENTS: Is the faculty advisor’s name and contact
information provided?
8. General Considerations (check each)
[_] (8.1) Is there a statement indicating that the participant is making a decision
whether or not to participate, and that his/her signature indicates that he/she has
decided to participate having read and discussed the information in the informed
consent?
[_] (8.2) Are all technical terms fully explained to the participant?
[_] (8.3) Is the informed consent written at a level that the participant can
understand?
[_] (8.4) Is there text equivalent to: ―Approved by the California University of
Pennsylvania Institutional Review Board. This approval is effective nn/nn/nn and
expires mm/mm/mm‖? (the actual dates will be specified in the approval notice from
the IRB)
9. Specific Considerations (check as appropriate)
[_] (9.1) If the participant is or may become pregnant is there a statement that the
particular treatment or procedure may involve risks, foreseeable or currently
unforeseeable, to the participant or to the embryo or fetus?
[_] (9.2) Is there a statement specifying the circumstances in which the
participation may be terminated by the investigator without the participant’s consent?
[_] (9.3) Are any costs to the participant clearly spelled out?
[_] (9.4) If the participant desires to withdraw from the research, are procedures for
orderly termination spelled out?

90
[_] (9.5) Is there a statement that the Principal Investigator will inform the
participant or any significant new findings developed during the research that may
affect them and influence their willingness to continue participation?
[_] (9.6) Is the participant is less than 18 years of age? If so, a parent or guardian
must sign the consent form and assent must be obtained from the child
[_] Is the consent form written in such a manner that it is clear that the
parent/guardian is giving permission for their child to participate?
[_] Is a child assent form being used?
[_] Does the assent form (if used) clearly indicate that the child can freely
refuse to participate or discontinue participation at any time without penalty or
coercion?
[_] (9.7) Are all consent and assent forms written at a level that the intended
participant can understand? (generally, 8th grade level for adults, age-appropriate for
children)

91
California University of Pennsylvania Institutional Review Board
Review Request Checklist (v021209)
This form MUST accompany all IRB review requests.
Unless otherwise specified, ALL items must be present in your review request.
Have you:
[YES] (1.0) FOR ALL STUDIES: Completed ALL items on the Review Request
Form?
Pay particular attention to:
[YES] (1.1) Names and email addresses of all investigators
[YES] (1.1.1) FOR ALL STUDENTS: use only your CalU email
address)
[YES] (1.1.2) FOR ALL STUDENTS: Name and email address of
your faculty research advisor
[YES] (1.2) Project dates (must be in the future—no studies will be approved
which have already begun or scheduled to begin before final IRB approval—
NO EXCEPTIONS)
[YES] (1.3) Answered completely and in detail, the questions in items 2a
through 2d?
[YES] 2a: NOTE: No studies can have zero risk, the lowest risk is
―minimal risk‖. If more than minimal risk is involved you MUST:
[YES] i. Delineate all anticipated risks in detail;
[YES] ii. Explain in detail how these risks will be minimized;
[YES] iii. Detail the procedures for dealing with adverse
outcomes due to these risks.
[ ] iv. Cite peer reviewed references in support of your
explanation.
[YES] 2b. Complete all items.
[YES] 2c. Describe informed consent procedures in detail.
[ YES] 2d. NOTE: to maintain security and confidentiality of data,
all study records must be housed in a secure (locked) location ON
UNIVERSITY PREMISES. The actual location (department, office,
etc.) must be specified in your explanation and be listed on any
consent forms or cover letters.
[YES] (1.4) Checked all appropriate boxes in Section 3? If participants under
the age of 18 years are to be included (regardless of what the study involves)
you MUST:
[_] (1.4.1) Obtain informed consent from the parent or guardian—
consent forms must be written so that it is clear that the
parent/guardian is giving permission for their child to participate.
[_] (1.4.2) Document how you will obtain assent from the child—
This must be done in an age-appropriate manner. Regardless of
whether the parent/guardian has given permission, a child is
completely free to refuse to participate, so the investigator must

92
document how the child indicated agreement to participate
(―assent‖).
[YES] (1.5) Included all grant information in section 5?
[YES] (1.6) Included ALL signatures?
[_] (2.0) FOR STUDIES INVOLVING MORE THAN JUST SURVEYS,
INTERVIEWS, OR QUESTIONNAIRES:
[_] (2.1) Attached a copy of all consent form(s)?
[_] (2.2) FOR STUDIES INVOLVING INDIVIDUALS LESS THAN 18
YEARS OF AGE: attached a copy of all assent forms (if such a form is used)?
[_] (2.3) Completed and attached a copy of the Consent Form Checklist? (as
appropriate—see that checklist for instructions)
[_] (3.0) FOR STUDIES INVOLVING ONLY SURVEYS, INTERVIEWS, OR
QUESTIONNAIRES:
[YES] (3.1) Attached a copy of the cover letter/information sheet?
[_] (3.2) Completed and attached a copy of the
Survey/Interview/Questionnaire Consent Checklist? (see that checklist for
instructions)
[_] (3.3) Attached a copy of the actual survey, interview, or questionnaire
questions in their final form?
[YES] (4.0) FOR ALL STUDENTS: Has your faculty research advisor:
[YES] (4.1) Thoroughly reviewed and approved your study?
[YES] (4.2) Thoroughly reviewed and approved your IRB paperwork?
including:
[YES] (4.2.1) Review request form,
[YES] (4.2.2) All consent forms, (if used)
[YES] (4.2.3) All assent forms (if used)
[YES] (4.2.4) All Survey/Interview/Questionnaire cover letters (if
used)
[YES] (4.2.5) All checklists
[YES] (4.3) IMPORTANT NOTE: Your advisor’s signature on the review
request form indicates that they have thoroughly reviewed your proposal and
verified that it meets all IRB and University requirements.
[YES] (5.0) Have you retained a copy of all submitted documentation for your
records?

93

Project Director’s Certification
Program Involving HUMAN SUBJECTS
The proposed investigation involves the use of human subjects and I am submitting the complete
application form and project description to the Institutional Review Board for Research Involving
Human Subjects.
I understand that Institutional Review Board (IRB) approval is
required before beginning any research and/or data collection
involving human subjects.

If the Board grants approval of this

application, I agree to:

1. Abide by any conditions or changes in the project required by the Board.
2. Report to the Board any change in the research plan that affects the method of using
human subjects before such change is instituted.
3. Report to the Board any problems that arise in connection with the use of human subjects.
4. Seek advice of the Board whenever I believe such advice is necessary or would be
helpful.
5. Secure the informed, written consent of all human subjects participating in the project.
6. Cooperate with the Board in its effort to provide a continuing review after investigations
have been initiated.
I have reviewed the Federal and State regulations concerning the use of human subjects in
research and training programs and the guidelines. I agree to abide by the regulations and
guidelines aforementioned and will adhere to policies and procedures described in my
application. I understand that changes to the research must be approved by the IRB before they
are implemented.

Professional Research
Project Director’s Signature

Department Chairperson’s Signature

Student or Class Research

Student Researcher’s Signature
Supervising Faculty Member’s
Signature if required

Department Chairperson’s Signature

94

ACTION OF REVIEW BOARD (IRB use only)

The Institutional Review Board for Research Involving Human Subjects has reviewed this application to
ascertain whether or not the proposed project:

1.
2.
3.
4.
5.

provides adequate safeguards of the rights and welfare of human subjects involved in the
investigations;
uses appropriate methods to obtain informed, written consent;
indicates that the potential benefits of the investigation substantially outweigh the risk involved.
provides adequate debriefing of human participants.
provides adequate follow-up services to participants who may have incurred physical, mental, or
emotional harm.

Approved[_________________________________]

Disapproved

___________________________________________
_________________________
Chairperson, Institutional Review Board

Date

95

Certificate of Completion
The National Institutes of Health (NIH) Office of Extramural Research certifies that Sarah
Seabrook successfully completed the NIH Web-based training course “Protecting Human
Research Participants”.
Date of completion: 06/11/2009
Certification Number: 243306

96
Institutional Review Board
California University of Pennsylvania
Psychology Department LRC, Room 310
250 University Avenue
California, PA 15419
instreviewboard@cup.edu
instreviewboard@calu.edu
Robert Skwarecki, Ph.D., CCC-SLP,Chair

Sarah Seabrook,
Please consider this email as official notification that your proposal titled “A
Comparison of Nutrition Habits Between NCAA Division II Athletes”
(Proposal #09-035) has been approved by the California University of
Pennsylvania Institutional Review Board as amended.
The effective date of the approval is 3-05-2010 and the expiration date is 305-2011. These dates must appear on the consent form .
Please note that Federal Policy requires that you notify the IRB promptly regarding
any of the following:
(1) Any additions or changes in procedures you might wish for your
study (additions or changes must be approved by the IRB before
they are implemented)
(2) Any events that affect the safety or well-being of subjects
(3) Any modifications of your study or other responses that are
necessitated by any events reported in (2).
(4) To continue your research beyond the approval expiration date of
3-05-2011 you must file additional information to be considered for
continuing review. Please contact instreviewboard@calu.edu
Please notify the Board when data collection is complete.
Regards,
Robert Skwarecki, Ph.D., CCC-SLP
Chair, Institutional Review Board

97
REFERENCES
1.

Butler SM, Black DR, Blue CL, Gretebeck RJ. Change
in diet, physical activity, and body weight in
female college freshman. Am J Health Behav.
2004;28(1):24-32.

2.

Conklin MT, Cranage DA, Lambert CU. College studens’
use of point of selection nutrition information.
Topics in Clinical Nutrition. 2005;20(2):97-108.

3.

Schwarz HC, Aruguete MS, Gold ES. Eating attitudes,
body dissatisfaction, and perfectionism in female
college athletes. North American Journal of
Psychology. 2005;7(3):345-352.

4.

Ray TR, Fowler R. Current issues in sports nutrition
in athletes. South Med J. 2004;97(9):863-866.

5.

American College of Sports Medicine, American
Dietetic Association, and Dieticians of Canada.
Joint Position Statement: Nutrition and Athletic
Performance. Med Sci Sport Exer. 2009.

6.

United States Department of Agriculture.
MyPyramid.gov. http://www.mypyramid.gov. Accessed
[October 1, 2009].

7.

Massad SJ, Headley S. Nutrition assessment:
considerations for athletes. Athlet Ther Today.
1999;4(6):6-11.

8.

McArdle WD, Katch FI, Katch VL. Sports & Exercise
Nutrition. 2nd ed. Baltimore, MD, Philadelphia, PA:
Lippincott Williams & Wilkins; 2005. Page 12,
Chapters 8 and 13.

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Houtkooper L, Maurer Abbot J, Nimmo M. Nutrition for
throwers, jumpers, and combined events athletes. J
Sport Sci. 2007;25(S1):39-47.

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Baume N, Hellemans M, Saugy M. Guide to over-thecounter sports supplements for athletes. Int
SportMed J. 2007;8(1):2-10.

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Froiland K, Koszewski W, Hingst J, Kopecky L.
Nutritional supplement use among college athletes

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and their sources of information. Int J Sport Nutr
Exe. 2004;14(1):104-120.
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Malinauskas BM, Overton RF, Carraway VG, Cash BC.
Supplements of interest for sport-related injury and
sources of supplement information among college
athletes. Adv Med Sci. 2007;52:50-54.

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Boyle JR, LaRose NR. Personal beliefs, the
environment and college students’ exercise and
eating behaviors. American Journal of Health
Studies. 2008;12(4):195-200.

14.

Hinton PS, Sanford TC, Davidson MM, Yakushko OF,
Beck NC. Nutrient intakes and dietary behaviors of
male and female collegiate athletes. Int J Sport
Nutr Exe. 2004;4(4):389-405.

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Jelinic JD, Nola IA, Matanic D. Living at or away
from home – impact on student’s eating habits.
Materia Socio Medica. 2008;20(4):204-208.

16.

Hausenblas HA, Carron AV. Group influences on eating
and dieting behaviors in male and female varsity
athletes. Journal of Sport Behavior. 2000;23(1):3340.

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Cupisti A, D’Alessandro C, Castrogiovanni S, Barale,
A, Morelli E. Nutrition knowledge and dietary
composition in Italian adolescent female athletes
and non-athletes. Int J Sport Nutr and Exe.
2002;12:207-219.

18.

Cousineau TM, Goldstein M, Franko DL. A
collaborative approach to nutrition education for
college students. Journal of American College
Health. 2004;53(2):79-84.

19.

White S, Park YS, Israel T, Cordero ED. Longitudinal
evaluation of peer health education on a college
campus: impact on health behaviors. J Am Coll
Health. 2009;57(5):497-505.

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Zinn C, Schofield G, Wall C. Evaluation of sports
nutrition knowledge of New Zealand premier club
rugby coaches. Int J Sport Nutr and Exe.
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Clark K. Sports nutrition counseling: documentation
of performance. Topics in Clinical Nutrition.
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Unruh S, Unruh N, Moorman M, Seshadri S. Collegiate
student athletes’ satisfaction with athletic
trainers. J Athl Training. 2005;40(1):52-55.

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Burns RD, Schiller R, Merrick MA, Wolf KN.
Intercollegiate student athlete use of nutritional
supplements and the role of athletic trainers and
dieticians in nutrition counseling. J Am Diet Assoc.
2004;4(2):246-249.

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Ha EJ, Caine-Bish N. Effect of nutrition
intervention using a general nutrition course for
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100
ABSTRACT
TITLE:

A COMPARISON OF NUTRITION HABITS AND
KNOWLEDGE BETWEEN NCAA DIVISION II ATHLETES
AND NON-ATHLETES

Researcher:

Sarah Nicole Seabrook

Advisor:

Dr. Rebecca Hess

Date:

April 2010

Research Type: Master’s Thesis
Context:

Current research indicates that athletes
exhibit slightly more knowledge and better
eating behavior practices than do nonathletes. However, previous studies have
not examined a comparison of nutrition
knowledge and eating behavior between NCAA
Division II athletes and non-athletes.

Objective:

The purpose of this study was to examine
similarities and/or differences between NCAA
athletes and non-athletes on the nutrition
knowledge and eating behavior.

Design:

Descriptive research using a reliable
survey.

Setting:

California University of Pennsylvania’s NCAA
Division II athletes were recruited prior to
practice times. Non-athletes and some
Division II athletes completed the study
prior to anatomy or health class.

Participants:

A total of 286 subjects (54 NCAA athletes,
232 non athletes) completed the survey. All
of the respondents were volunteers and
students at California University of
Pennsylvania.

Interventions: The researcher distributed surveys to NCAA
Division II athletes and non-athletes either
prior to sports practice or anatomy or
health class. It was clearly explained to
the participants that participation was

101
strictly voluntary and there would be no
rewards or consequences for taking part in
the study. Informed consent was read and
signed prior to completion of the survey.
Main Outcome
Measures:

Nutrition knowledge and eating behavior
scores were obtained through a two part
survey called the Revised Nutritional
Knowledge and Eating Habits Questionnaire.

Results:

Athletes exhibited significantly higher
(better) eating behavior than non-athletes
but the groups were not significantly
different on knowledge of nutrition.

Conclusion:

While NCAA athletes and non-athletes do not
differ in their knowledge about nutrition,
the NCAA athletes have better eating habits.
Other behaviors, such as gender, or year in
school are not associated with either
variable.

Word count:

301