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.

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.

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.

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.

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.

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.

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.

Evaluation of an Environmental Nutrition Intervention at the 2018 Commonwealth Games.

There has been an increasing expectation that the food provided for athletes at major competition events meets the specific dietary and performance needs of athletes. The aim of this study was to map the range of food service nutrition schemes that were implemented prior to and during a major competition event (2018 Commonwealth Games) and evaluate these schemes through staff training satisfaction, athlete feedback, and quality assurance checks. This study followed a case study design with nutrition schemes as follows: informing (nutrition labelling), enabling (staff training, nutrition service), and engineering (modification to menus and recipes). Overall, participants reported that they easily found items on the menu that met their nutritional/dietary needs. When asked how useful the schemes were in helping them to identify items that meet their needs, the majority of participants found the nutrition cards (n = 227, 71%) and serving staff (n = 212, 66%) 'useful/very useful'. 'Good/very good' ratings were received by >90% of respondents for speed of service, staff politeness, and knowledge of the menu. Participants (n = 316) who rated the nutrition staff as 'useful/very useful' gave a higher median rating for the menu. Past events have focused on the impact of a single component in the food environment; however, taking a whole systems approach resulted in more suitable food provision to meet the dietary needs of athletes.

Food Provision at the Olympic Games in the New Millennium: A Meta-narrative Review.

BACKGROUND AND OBJECTIVE: The objective of this meta-narrative review was to identify, organise and map the literature on food provision and nutrition support at the summer and winter Olympic and Paralympic Games (OPG)  and similar major competition events over the past 21 years. This builds on a comprehensive update of a previous historical review of the evolution of food provision at the summer Olympic Games up until 2000 and considers contemporary issues such as the global pandemic and sustainability goals. METHODS: A range of sources included primary research and review articles, edited book chapters, theses, conference papers or abstracts, International Olympic Committee reports, Organising Committees' food vision and post-Games reports, independent professional reports, and media and periodicals including magazines and trade journals. The search strategy included four steps: a database search that complied with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews criteria, a search of the Olympic Studies Centre, a review of reference lists for unpublished sources, and a Google search for additional media reports. The researchers followed an iterative process where emerging narratives were discussed, recorded and refined as data were extracted. RESULTS: The data from 229 records were extracted into a spreadsheet and grouped according to the type of evidence and specific event, then presented chronologically to give a perspective on the development of food provision and nutrition support. Eleven narratives emerged from the data extraction: 'description of meals, menus and food', 'vision of the food provision', 'food safety', 'catering company involvement', 'sponsorship or contracts with food companies', 'athlete perspective', 'stakeholder perspective', 'athlete food intake,' 'nutrition input in food provision', 'food environment' and 'sustainability'. CONCLUSION: Results suggest that athletes' dining expectations, organising committee budgets, expert input and current global trends have led to food delivery changes. The OPG food environment has the capacity to positively influence the dietary choices of athletes and teams, while evolving to meet contemporary global challenges such as COVID-19 and sustainability targets.

Validation of a Turkish Version of the Athlete Food Choice Questionnaire.

There are multiple influences on food choice for athletes. The aim of this study was to assess the validity and reliability of a Turkish Athlete Food Choice Questionnaire (Turkish-AFCQ) and describe the main factors influencing food choices. A multi-step process of language and content validation, Explanatory Factor Analysis, Confirmatory Factor Analysis, and test-retest reliability were used to examine factorial structure and construct validity (convergent and discriminant) and reliability (internal and external). The translated Turkish-AFCQ was administered to 446 athletes (59% male, median age = 21 years) from a variety of sports. The original nine-factor structure was validated, external reliability was acceptable, and all factors achieved acceptable discriminate validity. Convergent validity and internal reliability received tenable-ideal ratings for seven and eight factors, respectively. Interpretation and future application are discussed for low-performing factors 'food and health awareness' and 'influence of others'. The factor most frequently (never 1-always 5) influencing choices was 'performance' (Md = 4.33) and the least was both the 'influence of others' and 'food values and beliefs' (Md = 2.67). The Turkish-AFCQ can be used to expand researchers' and practitioners' understanding of the relative influence multiple factors have on food choices, and this study provides a model for AFCQ linguistic translation and validation.

Reliability of the Athlete Food Choice Questionnaire in Diverse Settings.

Understanding the factors that influence an athletes' food choice is important to supporting optimal dietary intake. The Athlete Food Choice Questionnaire (AFCQ) is a new validated tool for assisting practitioners and researchers to understand athlete eating behaviours. However, the AFCQ previously has only been applied at international competition events. This observational study explored the online application of the AFCQ outside of the competition environment with detailed examination of factor reliability. The AFCQ factors include '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'. A total of 131 athletes, representing 19 countries and 36 sports, participated using an online questionnaire. Reliability via Cronbach's alpha (α) and item correlation scores were compared to those from previous competition events. Acceptable reliability was attained for seven of the nine factors (α ≥ 0.7, range 0.70-0.92). 'Food values and beliefs' and 'usual eating practices' (α = 0.60, 0.64) were tolerable and consistent against previous major competition samples, indicating that the setting is unlikely responsible for lower reliability scores. Three factors ('emotional influence'; 'nutritional attributes of the food'; 'influence of others') differed in reliability between the online sample compared to one or both major competition samples. The 'religious food beliefs' item within the 'food values and beliefs' factor may warrant removal due to recurrent low internal consistency. This study confirms the AFCQ's reliability regardless of competition phase and supports use of the AFCQ for understanding the eating behaviours of athletes.

Determinants of Food Choice in Athletes: A Systematic Scoping Review.

BACKGROUND: The individual determinants of food choice have been extensively investigated in the general population, but there have been limited studies in athletes. A better understanding of the food making decisions can help to target interventions that lead to optimal intake for athletes' health and performance. A scoping review will provide an understanding of the sports and settings that have been investigated, the methods and approaches to assessing food choice, as well as the factors influencing food choice. OBJECTIVE: The objective of this review was to map the available evidence on the multi-faceted determinants of food choice in athletes and describe key influences impacting their choices. ELIGIBILITY CRITERIA: Athletes 16 years and over from any country who engage in physical activity with the intent to be competitive. Studies were included if they reported the multi-faceted determinants of food choice as either a primary or secondary outcome. All study designs were considered. SOURCES OF EVIDENCE: This review followed the PRISMA extension for Scoping Reviews. Eleven databases including PubMed, Web of Science (Clarivate Analytics), SPORTDiscus (EBSCO), PsycNET (APA), Health Collection (Informit), CINAHL (EBSCO), the Cochrane Library, ProQuest Dissertations and Theses Global, Trove (National Library of Australia), JBI (Ovid), and Google scholar were searched between September-November 2020 and updated in March 2021. Charting of Data Search results were screened with selected studies extracted into a summary table established a priori by the authors. Study quality was assessed using standardised reporting tools for qualitative and quantitative research designs. The scope and quality of evidence was summarised and reported. RESULTS: A total of 15 studies were included. Qualitative research included one research thesis and six primary research studies using both focus groups and semi-structured interviews. Quantitative research included one research thesis and seven primary research studies with cross-sectional design using different validated and non-validated survey instruments. No longitudinal or intervention studies were found. The majority of studies have been published since 2018 and conducted across multiple countries with either mixed cohorts of athletes or focused on predominately endurance or team sports. The quality of reporting was variable, particularly for qualitative research. Outcomes suggested that performance and health were relevant to athlete food choice, with varying impact of competition season, the level of experience, the culture of the sport, the cultural background or nationality of the athlete, athlete sex and the food environment. CONCLUSION: More research is needed on the multi-faceted determinants of food choice in different cohorts of athletes, particularly females. Future research could explore the relationship between food choice, nutrition knowledge and diet quality or the change in food choice across the phase of the seasons and through injury and illness. Use of validated measurement tools and robust reporting will enable critical interpretation of the study methods and outcomes for use in practice. Registration OSF Registries: Open-ended registration 25th Sept 2020 https://doi.org/10.17605/OSF.IO/4PX2A.

Inclusion of Nutrition Expertise in Catering Operations at a Major Global Sporting Event: A Qualitative Case Study Using a Foodservice Systems Approach.

BACKGROUND: Major sporting event catering is a significant undertaking for foodservice providers, particularly with an increasing focus on sustainability, global health, and nutrition demands of athletes. Yet, the inclusion of nutrition expertise in catering varies significantly between events. Foodservice systems models are commonly used to evaluate foodservice operations but to date have not been applied to catering and nutrition at major sporting events. OBJECTIVE: The aim of this exploratory case study was to gain in-depth insights of key stakeholders (catering management, chefs, organizers, and dietitians) regarding the integration of nutrition into the catering operation of a major global sporting event, with a focus on future continuity, and map this to the foodservice systems model using a program logic model. SETTING: Semistructured interviews were conducted with 12 stakeholders during and after the 2018 Commonwealth Games, Gold Coast, Australia. RESULTS: The 8 themes that emerged were related to planning and preparation, refining processes, improvement of the menu, better technology, increase in food allergies/intolerances, organization controls, experience of the workforce, and increased client knowledge of nutrition. The logic model demonstrated that the system is driven by policy and budget at the level of control prior to and during the planning phase but modified by the environment during operation. CONCLUSIONS: Despite recognition by stakeholders on the importance of change, there are barriers to the provision of suitable food. Integration of nutrition expertise into tender documents and budgets in major event catering will help ensure nutritionally adequate, culturally suitable, and safe menus for future events.

The Athlete Food Choice Questionnaire (AFCQ): Validity and Reliability in a Sample of International High-Performance Athletes.

PURPOSE: The Athlete Food Choice Questionnaire (AFCQ) is a novel tool for understanding factors influencing athlete food selection and providing context to nutrition knowledge and diet quality data. Reliability, face, and content validity have been previously established during development. The aim of this study is to evaluate the AFCQ's factorial structure, reliability, and construct validity in an independent sample of international high-performance athletes. METHODS: The AFCQ contains 36 items within nine factors. Participants rate how frequently (1 never to 5 always) items influence their choices. Model consistency and construct validity was evaluated by confirmatory factor analysis. Measures included model fit incidences and duplicate methods examining reliability, convergent, and discriminant validity. RESULTS: Athletes (n = 232) at the 2018 Commonwealth Games, Gold Coast, Australia, completed the AFCQ. A modified 32-item model achieved discriminant validity for all factors and convergent validity for "emotional influence," "food and health awareness," "nutritional attributes of food," "performance," and "influence of others." Reliability measures of all constructs except "usual eating practice" and "food values and beliefs" were above acceptable thresholds, although "usual eating practice" was considered tolerable and conditionally accepted. CONCLUSION: The AFCQ was confirmed in its original nine-factor structure in an independent sample of high-performance athletes. This provides a detailed and transparent account of the construct validity of the AFCQ, adding to the foundation of evidence for this new instrument. The AFCQ captures the unique influences specific to athletes while being broad enough for application across diverse sporting and culturally mixed cohorts. This tool could assist sports science professionals in making more informed and effective decisions around strategies to support athletes, including the ability to triage for specific sports nutrition advice.

Outcomes of a nutrition service provided by dietitians at a major multi-cultural competition event: An observational study.

AIM: The nutrition service available for athletes competing at major events varies significantly and is dependent on advocacy for dietetic inclusion. The aim of this study was to describe the outcomes of a nutrition service designed and led by dietitians at a major international competition: the 2017 Taipei Universiade. METHODS: Athletes (university students aged 17-25 years) and officials that used the service were invited to participate. Occasions of service were recorded using standard pro formas and dietary analysis of consultations was conducted using Foodworks. RESULTS: The scope of the service included 242 enquiries, 884 weight checks, 25 skinfold measures and 37 consultations. A significantly higher proportion of females asked about food allergy/intolerance (26.2% vs 12.5%, P = .039) than males. Most athletes who sought a nutrition consultation had not received previous nutrition support (86.5%) and wanted performance-related meal plans and advice (81.1%). On average, their diets were adequate in micronutrients with the exception of calcium, and low in serves of vegetables and dairy products. The majority of athletes (72.9%) seeking a consultation reported that they did not follow a specific diet for their sport. Sports supplements, performance enhancers and vitamin-mineral supplements use was 45.9% (n = 17), 13.5% (n = 5) and 13.5% (n = 5), respectively. Most athletes were of a high international calibre, however, reported low confidence in their nutrition knowledge and did not consistently apply knowledge to practice. CONCLUSION: This demonstrates a need for nutrition services by dietitians at this and similar events to improve the dietary intake of young adult athletes.

Key concepts for dietetic curriculum: An observational study of Australian dietitians' perceptions.

AIM: A concept-based approach to dietetic curriculum design has been proposed to prevent content overload and promote critical thinking. Fifty-six concepts were identified in a previous study. The aim of the present study was to investigate whether the dietetic profession views these concepts as representative of current practice and key for nutrition and dietetics education, and identify any new or emerging concepts. METHODS: Accredited Practising Dietitians (APDs) were invited to participate in a self-administered online survey that included scale responses on the relevance of the 56 concepts and open-ended suggestions of additional concepts. Respondent characteristics were also collected. RESULTS: Ninety-eight APDs completed the survey. Greater than 65% of respondents agreed/strongly agreed that all 56 concepts were relevant. There was less agreement on the concepts of acid-base balance; leadership; management; physical activity, exercise and health; quality assurance and improvement; risk; safety; stakeholder; standards; sustainability; systems and technology and health informatics. Respondents working in regional, rural and remote areas were less likely to agree that leadership was a key concept (χ2 = 4.45, P = .035). Respondents working in teaching and education were more likely to agree that sustainability was a key concept (χ2 = 7.02, P = .008). No new concepts were identified. CONCLUSIONS: The existing 56 concepts were considered key for nutrition and dietetics education. Although the respondents to this survey view these concepts as relevant to current practice, this may not represent the entire profession. It is yet to be determined if the concepts will meet future priorities for the dietetic workforce.

Consumers' Perceptions of the Australian Health Star Rating Labelling Scheme.

The objective of this study was to explore consumers' use and perception of the Australian Health Star Rating (HSR). A purposive sample of fifteen Australian grocery shoppers was recruited into four focus groups using a supermarket intercept strategy. Focus group discussions were recorded, transcribed and analysed using an iterative approach to thematic analysis. Three key themes emerged from analysis. The HSR was seen as simple, uncluttered, easy to understand and useful for quick comparison across products. The nutrition information was viewed positively; however, there was little confidence in the HSR due to a perceived lack of transparency in the criteria used to determine the number of stars. Highly processed foods were generally seen as having inflated ratings and participants expressed concern that this would increase consumption of these products. Finally, there was a belief that the HSR had a lack of negative imagery limiting the dissuasive impact on consumers when presented with low-rated foods. Consumers saw benefits in the HSR but were sceptical about how the ratings were derived. Transparency about the development and education on the application may assist with consumers' perception of the HSR.