Exploring the adoption of concept-based curricula: insights from educators and implications for change.

Concept-based approaches to curriculum design have been proposed to solve content and curricula overload and promote conceptual learning. Few health professions have adopted this approach and little is known about how to support this educational change. We aimed to understand how nutrition and dietetics educators may navigate proposed education change towards concept-based curricula. We employed an interpretivist approach and in-depth interviews that explored the views of nutrition and dietetic educators towards using a concept-based approach to curriculum. Employing deductive thematic analysis based on the diffusion of innovation theory, data from twenty experienced dietetics educators were analysed. Three main themes were identified; the need for change champions, concerns about change, and the complexity of the education system. Diffusion of innovation theory highlighted that to enact change, the relative advantage and compatibility of the approach with current structures and systems, with evidence from trialling and observing the new approach in action, were needed. Developing education leaders and infiltrating the social system of education through existing communities of practice is critical to enacting educational change.

Commonly Used Indicators of Low Energy Availability Risk Fail to Identify Female Amateur Soccer Players With Measured Low Energy Availability During Preseason.

This study aimed to determine energy availability (EA) and within-day energy balance (WDEB) in female soccer players during preseason and also explored eating disorder risk and athlete food choice. We hypothesized commonly used indicators of low energy availability (LEA) risk would correlate with measured EA and WDEB variables, and that food choice determinants would differ according to EA. Eleven National Premier League female soccer players participated in this observational cross-sectional study over 3 weeks. Assessment of resting metabolic rate and physique traits, including bone mineral density, was conducted during Weeks 1 or 3. During Week 2, dietary intake, energy expenditure, and continuous monitor-derived glucose were measured for 5 days. EA was calculated daily and WDEB calculated hourly with deficits/surpluses carried continuously. Questionnaires were administered throughout the 3 weeks, including the Athlete Food Choice Questionnaire, the Eating Disorders Screen for Athletes, and the Low Energy Availability in Females Questionnaire. Resting metabolic rate ratio, bone mineral density, Low Energy Availability in Females Questionnaire, and Eating Disorders Screen for Athletes scores were used as indicators of LEA risk. EA averaged 30.7 ± 7.5 kcals·kg fat-free mass-1·day-1. Approximately one-third (36%) of athletes were at risk of an eating disorder, while approximately half (45%) were identified at risk of the female athlete triad via Low Energy Availability in Females Questionnaire, compared with approximately one-third (36%) of athletes identified with EA < 30 kcal·kg fat-free mass-1·day-1. No athlete achieved EA >45 kcal·kg fat-free mass-1·day-1, and no indicator of LEA risk was associated with calculated EA or WDEB. However, overnight glycemic variability was positively correlated with measured EA (r = .722, p = .012).

The implementation of interprofessional education: a scoping review.

INTRODUCTION: Implementation of interprofessional education (IPE) is recognised as challenging, and well-designed programs can have differing levels of success depending on implementation quality. The aim of this review was to summarise the evidence for implementation of IPE, and identify challenges and key lessons to guide faculty in IPE implementation. METHODS: Five stage scoping review of methodological characteristics, implementation components, challenges and key lessons in primary studies in IPE. Thematic analysis using a framework of micro (teaching), meso (institutional), and macro (systemic) level education factors was used to synthesise challenges and key lessons. RESULTS: Twenty-seven primary studies were included in this review. Studies were predominantly descriptive in design and implementation components inconsistently reported. IPE was mostly integrated into curricula, optional, involved group learning, and used combinations of interactive and didactic approaches. Micro level implementation factors (socialisation issues, learning context, and faculty development), meso level implementation factors (leadership and resources, administrative processes), and macro level implementation factors (education system, government policies, social and cultural values) were extrapolated. Sustainability was identified as an additional factor in IPE implementation. CONCLUSION: Lack of complete detailed reporting limits evidence of IPE implementation, however, this review highlighted challenges and yielded key lessons to guide faculty in the implementation of IPE.

The influence of current food and nutrition trends on dietitians' perceptions of the healthiness of packaged food.

OBJECTIVE: To investigate the influence of current food and nutrition trends on dietitians' perceptions of the healthiness of packaged foods. DESIGN: This observational study used a cross-sectional survey. Participants rated (strongly disagree to strongly agree) the extent to which a range of factors, independent of the energy, nutrient and ingredient content, influenced their perceptions of the healthiness of packaged foods. Two open-ended questions allowed for participants to list additional items they considered important. SETTING: Online survey. PARTICIPANTS: Australian dietitians (n 117). RESULTS: The greatest consensus was a positive influence of the fit within the core food groups and presence of seasonal ingredients, and a negative influence of an increasing number of additives. Mixed opinions were obtained for GM ingredients, locally sourced ingredients, labelling of animal welfare and organic certification. Nutritional indicators received a split where almost half of participants disagreed/strongly disagreed that they positively influenced their perception of healthiness. Content analysis of open-ended responses (n 53, 45 %) revealed four broad categories as important in considering healthiness: 'a whole food approach', 'marketing and labelling', 'product information' and 'context of diet'. A small number of responses (count of 6, 5 %) reported that packaging, advertising and features such as celebrity endorsement were a negative influence. CONCLUSIONS: Dietitians have a broad concept of the healthiness of packaged foods, which incorporates elements of food safety, wholeness of the ingredients and marketing. Providing unified messages to the consumer can help to build the public perception of dietitians as experts in nutrition advice and counselling.

Using document analysis to identify core concepts for dietetics: The first step in promoting conceptual learning.

Concept-based approaches to curriculum design have been proposed in nursing and health sciences education to address the issue of content overload in curricula but have not been described in dietetics. This study aimed to identify core concepts for the dietetics discipline in Australia and investigate the commonality and differences in these concepts across different dietetic organizations across the world. This study used document analysis of a purposive sample of international dietetics competency or proficiency standards identified from English-speaking dietetic organizations worldwide. Content analysis was applied to the performance criteria or equivalent from 10 documents (nine organizations) to identify the most common elements. A total of 1,007 statements were analyzed. Fifty-six concepts were developed. The four most frequent concepts coded across all statements were "critical thinking," "communication," "nutrition and dietetic service," and "quality assurance and improvement." There were 55 concepts common to all standards. The concept of "food security" was not present in one of the standards from the United States. The concepts that emerged from this study were common across different English-speaking dietetic organizations across the world. Small differences on the emphasis of concepts, between different competency standards may reflect the health needs; health, political, economic, and social systems; and the cultural context of a country. Identifying core concepts in dietetics is the first step to help to inform curriculum design, which may address overcrowded curricular and promote conceptual learning.

Diagnosis and management practices for gestational diabetes mellitus in Australia: Cross-sectional survey of the multidisciplinary team.

BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common pregnancy disorders; however, if well managed, women with GDM experience similar pregnancy outcomes to those without. Currently, there is limited evidence on actual management practices across Australia or how multidisciplinary teams interact to optimise care. AIMS: To examine the current screening, diagnostic, task and role perceptions and management practices, as reported by members of the GDM multidisciplinary team. METHODS: A 64-item electronic survey containing multiple choice, Likert scale and open-ended questions was developed for this cross-sectional observational study and advertised through health professional organisations and Queensland Health facilities in May and June, 2017. RESULTS: The 183 survey respondents included 45 diabetes educators, 43 dietitians, 21 endocrinologists/diabetes specialists, 14 obstetricians and 21 midwives. Although almost 90% reported using updated diagnostic guidelines, less than two-thirds used GDM management guidelines. While 68% reported using the same blood glucose targets for GDM management, there was variation to what criteria prompted the commencement of medication to control blood glucose levels. There was a good consensus concerning the health professional responsible for tasks such as medical nutrition therapy, gestational weight gain and self-blood glucose monitoring education and ultrasound use. Other tasks appeared to be the role of almost any member of the GDM multidisciplinary team. CONCLUSIONS: The survey results indicate there is a need for consistent evidence on how to best manage GDM and that role identity, access to specialist knowledge and best practice need to be clearly defined within GDM models of care.

Food Provision at the Rio 2016 Olympic Games: Expert Review and Future Recommendations.

Food provision at the Olympic Games has evolved considerably since the advent of a unified menu, but there are challenges in existing catering for the expanding cultural and sporting diversity. Continuity between events is difficult due to the changes in location, organizing committees, caterers, athletes, support staff, and volunteers. Independent review of the food provision by sports nutrition experts has been implemented to help establish some consistency between Olympic Games. The aim of this study was to compare an expert desk top and onsite review of the food provided at the Rio 2016 Olympic Games, and compare this with a similar review at the London 2012 Olympic Games. A previously developed survey was completed by sports nutrition experts 6 months prior to the opening of the Rio 2016 Olympic village and during the Olympic Games in September 2016. Questions about the food provision included both scaled and open-ended responses. There was a significantly lower rating for menu variety onsite (p = .025) versus the desk top review. All aspects of the menu and the ability to cater for specific situations rated as average or less. A significantly (p = .007) lower overall median rating was obtained for Rio (five out of 10) compared with London (eight out of 10), with hot gluten-free items rated as poor at both events. Comments from experts related to lack of variety, sports and recovery foods, absence of signage, and inaccurate nutrition labeling. An improved process for expert nutrition review at these events is warranted.

Development of a New Tool for Managing Performance Nutrition: The Athlete Food Choice Questionnaire.

This study aimed to develop and refine an Athlete Food Choice Questionnaire (AFCQ) to determine the key factors influencing food choice in an international cohort of athletes. A questionnaire that contained 84 items on a 5-point frequency scale was developed for this study. Athletes at the 2017 Universiade, in Taiwan, were invited to participate. Principal component analysis was utilized to identify key factors and to refine the questionnaire. Completed questionnaires were received from 156 athletes from 31 countries and 17 sports. The principal component analysis extracted 36 items organized into nine factors explaining 68.0% of variation. The nine factors were as follows: nutritional attributes of the food, emotional influences, food and health awareness, influence of others, usual eating practices, weight control, food values and beliefs, sensory appeal, and performance. The overall Kaiser-Meyer-Olkin measure was 0.75, the Bartlett test of sphericity was statistically significant, χ2(666) =2,536.50, p < .001, and all of the communalities remained >0.5. Intercorrelations were detected between performance and both nutritional attributes of the food and weight control. The price of food, convenience, and situational influences did not form part of the factorial structure. This research resulted in an AFCQ that includes factors specific to athletic performance and the sporting environment. The AFCQ will enable researchers and sports dietitians to better tailor nutrition education and dietary interventions to suit the individual or team. The next phase will test the accuracy and reliability of the AFCQ both during and outside of competition. The AFCQ is a useful tool to assist with management of performance nutrition for athletes.

Factors influencing food choice of athletes at international competition events.

Although the nutrient requirements and dietary intake of athletes have been thoroughly investigated, little is known about the influences on their food choice, particularly prior to and during competition. This study sought to investigate factors that influence food selection of athletes at two similar international competition events: the Melbourne 2006 and Delhi 2010 Commonwealth Games. A secondary aim was to explore differences in these factors between at each event given the culturally diverse locations. A survey developed for this study was distributed to athletes in the village dining hall at both events. Athletes scored a selection of factors influencing food choice on a scale of 1 (not important) to 5 (very important). A total of 769 individuals completed the questionnaire in total, with 351 (46%) from Delhi and 418 (54%) from Melbourne. Overall, athletes rated nutrient composition (M = 4.22), stage of competition (M = 4.09), time of day (M = 4.02) and familiarity of the food (M = 4.07) higher than sensory properties (smell M = 3.88; visual appearance M = 3.22) when making a food selection. Visual appearance (p = 0.01), stage of competition (p < 0.001) and time of day (p = 0.01) had greater influence in Delhi than Melbourne. Overall, a significantly higher proportion of female athletes rated smell (p < 0.001) and familiar food (p < 0.001) as important compared to males. The stage of competition and nutrition composition was rated as very important by the greatest proportion of athletes from weight category sports (61.9%) and endurance sports (57.9%) respectively. The influence of the coach and team mates was less of an influence than other factors, but more so for athletes from Non-Western regions. Further investigation of the various determinants and motives for food section of athletes from a range of sports and cultures is warranted.

Dietitians' perceptions of the healthiness of packaged food.

The aim of this cross-sectional study was to determine the factors that influence Australian dietitians' perceptions of the healthiness of a sample of packaged foods. Participant dietitians (n = 120) rated the healthiness (1, less healthy to 10, more healthy), of seven packaged foods (bread, confectionary, breakfast cereal, flavoured yoghurt, curry, spread and crumble) based on information obtained from an ingredient list and nutrient information panel (NIP). Influences on each food's rating were explored via Likert-scale and open-response questions. There was variation in the healthiness rating of all foods, however, least so for confectionary and crumble. Bread (M = 7.39 ± 1.44) and confectionary (M = 1.33 ± 0.69) were rated the most and least healthy foods respectively. Crumble was rated significantly (p = 0.03) healthier by those with more experience (≥6 vs. ≤5 years). No other differences were detected. Highly reported influences on healthiness were sugar, total fat, sodium and saturated fat values and the ingredient list. Content analysis identified 13 categories of information not provided on the NIP that influenced participants' ratings. References to the Australian Guide to Healthy Eating food groups, micronutrients not listed as ingredients, comparisons to other foods, and fibre were most common among the sample. These results have implications for research or public health policy where expert opinion of the healthiness of food is used as a reference measure.

Barriers and enablers to malnutrition screening of community-living older adults: a content analysis of survey data by Australian dietitians.

Many older adults living in their own homes are at nutrition risk which, left untreated, can lead to the state of malnutrition. To reduce the prevalence of malnutrition among community-living older adults (CLOAs), risk factors should be identified and addressed early via malnutrition screening. The aim of this study was to identify barriers and enablers to malnutrition screening of CLOAs from the perspective of dietitians. Ninety-two dietitians working for government, not-for-profit and private organisations in Australia provided written comments to open-ended survey questions. Textual data were analysed using content analysis, resulting in four key categories of organisational, staff, screening and CLOA factors. Insufficient time to screen and lack of knowledge by non-dietetic staff and CLOAs about malnutrition were identified as the strongest barriers. Organisational factors of screening policy and procedures and the provision of education and training emerged as the strongest enablers. The findings from this study can provide guidance to organisations and healthcare practitioners considering the implementation of routine malnutrition screening of CLOAs. Increased awareness about malnutrition and the associated outcomes may help to reduce nutrition risk among CLOAs.

Construct and criterion-related validation of nutrient profiling models: A systematic review of the literature.

Nutrient profiling (NP) is defined as the science of ranking foods according to their nutritional composition for the purpose of preventing disease or promoting health. The application of NP is ultimately to assist consumers to make healthier food choices, and thus provide a cost effective public health strategy to reduce the incidence of diet-related chronic disease. To our knowledge, no review has assessed the evidence to confirm the validity of NP models. We conducted a systematic review to investigate the construct and criterion-related validity of NP models in ranking food according to their nutritional composition for the purpose of preventing disease and promoting health. We searched peer-reviewed research published to 30 June 2015 and used PUBMED, Global Health (CABI), and SCOPUS databases. Within study bias was assessed using an adapted version of the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies -2) tool for all diagnostic studies and the Cochrane Collaboration's Risk of Bias tool for all non-diagnostic studies. The GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach was used to guide our judgement of the quality of the body of evidence for each outcome measure. From a total of 83 studies, 69 confirmed the construct validity of NP models; however most of these studies contained methodological weaknesses. Six studies used objective external measures to confirm the criterion-related validity of NP models; which inherently improved quality. The overall quality of evidence on the accuracy of NP models was judged to be very low to moderate using the GRADE approach. Many carefully designed studies to establish both construct and criterion-related validity are necessary to authenticate the application of NP models and provide the evidence to support the current definition of NP.

The relationship between dietary intake and energy availability, eating attitudes and cognitive restraint in students enrolled in undergraduate nutrition degrees.

The aim of this research was to explore the relationship of total energy and macronutrient intake, energy balance and energy availability to eating attitudes and cognitive restraint in students enrolled in undergraduate nutrition degrees. Energy and micronutrient intake was assessed in 63 students (n = 50 nutrition, and n = 13 occupation therapy degrees; n = 51 females, n = 12 males) using three 24-h dietary recalls. Energy requirements were calculated based on measured resting metabolic rate, estimated exercise energy expenditure, and dietary induced thermogenesis. Body composition was assessed using dual energy x-ray absorptiometry. Eating attitudes and cognitive restraint were measured using previously validated tools. Eighteen percent of nutrition students were classified as having low energy availability (<30 kcal kgFFM-1d-1) and 38% were in negative energy balance. Eating attitudes and cognitive restraint were not associated with total energy or macronutrient intake. However, female nutrition students with high cognitive restraint had greater exercise energy expenditure and thus lower energy availability than those with low cognitive restraint (371 (302) kcal d-1 compared to 145 (206) kcal d-1, P < 0.01, and 35 (7) kcal d-1 compared to 41 (10) kcal d-1 of fat free mass, P = 0.005). Additionally, in females, disordered eating attitudes and cognitive restraint negatively correlated with energy availability (rs = -0.37, P = 0.02 and rs = -0.51, P < 0.01 respectively). There were no differences in outcomes between nutrition and non-nutrition students. The current study suggests that those students with disordered eating attitudes and cognitive restraint may be controlling their energy balance through exercise, as opposed to restricting food intake.

The activities of a dietitian-led gastroenterology clinic using extended scope of practice.

BACKGROUND: Extending the scope of practice of allied health professionals has been a strategy adopted in the United Kingdom to address issues within the health system. Australia's health system is currently undermined by similar issues, heightening government interest in adopting the extended scope health care model. The aim of the current study was to describe the activities and outcomes of a dietitian-led gastroenterology clinic which operated under an extended scope of practice model in an outpatient gastroenterology department at a tertiary hospital in regional Queensland, Australia, and to assess patient satisfaction with the initiative. METHODS: A descriptive, cross-sectional case series undertaken over 50 clinics involving 82 category 2 and 3 patients with suspected/confirmed coeliac disease or inflammatory bowel disease; low haemoglobin; gastroesophageal reflux disease, or; malnutrition. Data was analysed using Microsoft Excel 2010, and presented as descriptive statistics. RESULTS: Sixty out of 82 selected patients (median age 51 years) attended an initial appointment with the dietitian. Twenty-four review appointments were attended. Average waiting period for an initial appointment was 148 days (range 31-308 days). A total of 149 management strategies were provided, and 94 (63 %) of these involved the dietitian utilising extended scope of practice. The dietitian managed 47 (78 %) patients without need for gastroenterologist referral, and 25 (42 %) were discharged after dietetic management. Patients reported high levels of satisfaction with the clinic. CONCLUSIONS: Seventy-eight percent of category 2 and 3 patients referred to the gastroenterologist could be managed exclusively in the dietitian-led clinic. This extended scope model of care could potentially benefit the efficiency and acceptability of Australia's public health system.

Dietary regimens of athletes competing at the Delhi 2010 Commonwealth Games.

The aim of this study was to investigate the dietary regimens reported by athletes competing at a major international competition and report whether these were based on nutrient composition, religious beliefs, cultural eating style, food intolerance or avoidance of certain ingredients. A questionnaire was randomly distributed to 351 athletes in the main dining hall of the athletes' village over the three main meal periods during the Delhi 2010 Commonwealth Games (23rd Sept-14th Oct, 2010). The majority (n = 218, 62%) of athletes reported following one or more dietary regimens, with 50% (n = 174) following a diet based on the nutrient composition of the food. Significantly more athletes from weight category and aesthetic sports (28%, p = .005) and from power/sprint sports (41%, p = .004) followed low fat and high protein regimens respectively. Other specialized dietary regimens were followed by 33% of participants, with avoidance of red meat (13%), vegetarian (7%), Halal (6%), and low lactose regimens (5%) reported most frequently. Significantly more athletes from non-Western regions followed a vegetarian diet (p < .001), while more vegetarians reported avoiding additives (p = .013) and wheat (p ≤ .001). A Western style of eating was the most commonly reported cultural regimen (72% of total with 23% from non-Western regions). Those following a Western diet were significantly more likely to report following a regimen based on nutrient composition (p = .02). As a high proportion of athletes from differing countries and sports follow specialized dietary regimens, caterers and organizers should ensure that adequate nutrition support and food items are available at similar events.

Evaluation of food provision and nutrition support at the London 2012 Olympic Games: the opinion of sports nutrition experts.

The aim of this study was to evaluate the food provision and nutrition support at the London 2012 Olympic (OG) and Paralympic Games (PG) from the perspective of sports nutrition experts attending the event. Participants (n = 15) were asked to complete an online survey and rate on a Likert scale menu qualities, food safety, sustainability practices, nutrition labeling, and provision for cultural needs, dietary regimes and specific situations. Open-ended responses were incorporated to explore expert opinion and areas for improvement. Participants rated their overall experience of the food provision as 7.6 out of 10 (range 5 to 10), with the majority (n = 11) rating it greater than 7. The variety, accessibility, presentation, temperature, and freshness of menu items rated as average to good. A below average rating was received for recovery food and beverages, provision of food for traveling to other venues, taking suitable snacks out of the dining hall and provision of food at other venues. However, the variety and accessibility of choices for Ramadan, and provision of post-competition food were rated highly. A number of comments were received about the lack of gluten free and lower energy/fat items. The inclusion of allergens on nutrition labeling was considered more important than nutrient content. While dietetic review of the menu in advance of the OG and PG is clearly a valuable process that has resulted in improvements in the food supply, there are still areas that need to be addressed that are currently not implemented during the event.

Foodservice strategies for reducing athlete illness at the Olympic and Paralympic Games.

AIM: In 2021, infection control guidelines, including those specific to feeding environments, were introduced by the International Olympic and Paralympic Committees to reduce virus transmission at the Tokyo 2020 Summer and Beijing 2022 Winter games. This observational cross-sectional study aimed to investigate caterers' compliance to these guidelines which included measures for personal hygiene, sanitisation, and physical distancing at these events. METHODS: Expert sport dietitians attending Tokyo (n = 15) and Beijing (n = 7) games were surveyed to rate 11 COVID-19 countermeasures as fully (100%), partially or non-compliant at nine dining locations across both events. Descriptive analysis of each countermeasure based on observed compliance and location was conducted and reported as a proportion of the total responses. To better understand participant perspectives of the factors influencing compliance, open responses were systematically coded into themes and sub-themes by researchers through content analysis. Themes generated from participant comments were categorised based on their relevance to specific countermeasures and locations to identify commonalities and disparities in participant experiences, perceptions, and observations. RESULTS: All main dining halls at both events were observed as 100% compliant to countermeasures on more occasions compared with Tokyo's venues and satellite villages. However, Beijing's three main dining halls, showed a greater compliance compared with Tokyo's main dining hall, likely due to overcrowding in Tokyo. Comments suggested that smaller dining spaces, with overcrowding, may have contributed to reduced compliance to physical distancing measures. Food safety concerns were raised about gastrointestinal distress in Beijing due to food cross-contamination. CONCLUSION: Findings suggest that the food service environment may influence caterers' abilities to comply with foodservice safety and infection control guidelines. In the post-pandemic era, enhanced quality control and standardised risk mitigation strategies are needed to improve athletes' health at international sporting events.

Public perceptions of dietetics services in Australia and New Zealand.

AIM: The aim of this study was to examine expectations, perceptions and attitudes about dietetics services among the Australian and New Zealand public, to provide insights for building a future dietetics workforce that will meet consumer needs. METHODS: A cross-sectional, anonymous, online survey was employed to gain perspectives of a representative sample of Australian and New Zealand adults. Questions were purposely designed to collect views regarding sources of dietary information, expectations of dietetics service providers and factors influencing choice of dietetics service provider. Data were analysed descriptively and using Pearson's chi-square test to assess relationships between categorical variables. Free-text responses were analysed using content analysis. RESULTS: Of 2601 respondents, approximately one third (32%) had seen a dietitian. Doctors were the most trusted sources of dietary information (87%), particularly with participants over 60 years (χ(1) = 44.168, V = 0.130, p < 0.001). Cost was the most frequently reported factor influencing choice of dietetics services (56%), with 88% of respondents interested in accessing a dietitian, preferably in-person (64%), if they could do so for no cost. Participants anticipated that dietitians would offer services like meal plans (59%) and nutritional analysis (48%) as well as weight and other body measurements (56%). Some expectations such as blood tests (54%) were outside the usual scope of dietetic practice. CONCLUSION: The results of this study have implications for practising dietitians, dietetics educators, and funders of dietetics services. Cost as a barrier suggests that advocacy to government for funding type, duration and number of visits to dietitians is still required.

Athlete use and opinion of point of choice nutrition labels at a major international competition.

Point of choice (POC) labels may assist individuals to choose food appropriate for their needs when dining away from home. However, limited research exists on the use and opinion of labels by athletes in a large dining hall environment. The aim of this study was to evaluate athletes' utilisation and opinion of POC nutrition labels provided in the athletes village main dining hall at a major competition event (the 2010 Commonwealth Games, New Delhi, India). A questionnaire was distributed to athletes from a range of cultural and sporting backgrounds (n=351) while present within the dining hall during main meal periods throughout the competition event (23rd September-14th October, 2010). While the majority of respondents (79%) reported that it was important/very important to provide POC information for menu items and 59% rated the POC labels as useful/very useful, only 14% of athletes reported using labels all of the time. Athletes from specific regions (India/Sri Lanka, Africa), sports (team and weight category), and those with less education reported using the labels more frequently. Although females rated the importance of providing nutrition information higher than males (p=0.008), there was no gender difference in reported use of POC labels. Athletes believed that POC labels could be improved with the addition of more information, better aesthetic properties, and better positioning in more convenient locations. Further research to identify the most effective POC label for use in this environment, and ultimately the development of a standardised label may assist a broader range of athletes at future competitions.

Athletes' opinions of food provision at the 2010 Delhi Commonwealth Games: the influence of culture and sport.

The aim of this study was to investigate whether athletes' opinion of food provision in the main dining hall of the athletes' village at the Delhi 2010 Commonwealth Games varied according to cultural background, sport, stage of competition, and previous experience at similar events. A previously developed questionnaire was distributed over 3 meal periods to 351 athletes dining in the main dining hall during the course of the games (Sept. 23 to Oct. 4, 2010). Despite the challenges of food provision in a non-Western region, the availability of food and beverage items was rated highly. However, athletes from Western regions tended to rate food-provision qualities lower than athletes from non-Western regions. Most athletes found it easy to find items to meet their nutrition needs; however, requests for sports foods, snacks, and culturally specific items were received. Power/sprint athletes were more critical of the food provision, whereas athletes from aesthetic sports tended to rate it more highly. Athletes farther from competition gave higher ratings for taste, while athletes who had more experience in this type of environment also tended to be more critical of the food provision. Overall daily mean opinion scores for taste and menu variety decreased over the games period. The results of this study can help organizers and caterers ensure that appropriate food and beverage are provided for athletes at major competition events.