Ch. 10

• Why nutritional consultation with athletes is important


  • Nutrition is key to optimal performance
  • Few athletes have educational exposure to nutrition
  • Misconceptions about nutrition abound
• 61% of athletes believed that protein is the main source of energy; only 3% knew correct daily recommendation
• 71% of athletes disagreed that sports drinks are better than water for replacing fluids
• 65% of athletes believed that vitamin/mineral supplements increase energy levels
• Less than 30% of athletes could give recommended dietary intake for carbohydrates and fats
• Where athletes get their nutritional information

  • Peers
  • Coaches
  • Strength and conditioning coaches
  • Athletic trainers
  • University classes
  • Fitness magazines
  • Dietitians
• The Consultation Process

  1. Information Gathering

  2. Diet history

  3. Health history questionnaire

  4. Food record

  5. Exercise log
• Diet history


  A tool for collecting dietary intake data
• Health history questionnaire


  A survey tool used to collect health-related information
• Information collected in health history questionnaire


  • Current health information
  • Family history
  • Current medications and/or supplements
  • Past medical history
  • Daily health/wellness issues
• Methods of Collecting Food Intake Data

  • Food record
  • 24-hour dietary recall
  • Food frequency questionnaire
• Sample 1-day food record

  • Completing a 1-, 3-, or 7-day food record provides information on specific foods athletes eat each day
• Sample food frequency questionnaire


  • A food frequency questionnaire captures long-term dietary patterns of intake
• Exercise/training log


  • Documents training activity
  • Provides information on energy expenditure
  • Helps assess total daily caloric needs
  • Helps to formulate a dietary plan
  • Time for food preparation
  • When to eat meals or snack
• Sample exercise log


  • Keeping track of the time, amount, and intensity level of exercise helps determine energy expenditure
• How food records are analyzed


  1. Athlete fills out food record

  2. At first consultation, sports nutritionist clarifies information regarding the foods recorded

  3. Sports nutritionist analyzes data using various publications and/or computer software

  4. Quick comparison: Use MyPlate food guidance system on ChooseMyPlate.gov
• The Most Common Omissions in food records


  • Actual portion sizes eaten
  • Condiments used
  • Restaurant or brand of item
  • Method of food preparation
  • Beverages consumed with meals or snacks
  • Snacks
• Dietary analysis report


  • Many computer programs are available that provide detailed dietary analyses of food records
• Purpose of the initial consultation


  • Gather information
  • Assess dietary intake
  • Develop goals
  • Provide nutrition goals
  • Develop a nutrition plan
• Steps for the Initial Consultation

  1. Establish rapport with athlete

  2. Clarify athlete's reason for nutrition consultation

  3. Complete nutrition assessment

  4. Assess athlete's readiness for change

  5. Determine nutrition goals

  6. Educate athlete relative to nutrition goals

  7. Summarize and schedule for next visit
• Step 1: Establishing Rapport


  • Address athlete by name
  • Ask general questions to begin
  • Project a positive, approachable demeanor
  • The consultation area, if possible, should project a feeling of "comfort"
• Step 2: Clarifying Reasons for Consult

  Purpose is to clearly establish the purpose of the visit and the athlete's goals
• Step 3: Complete Nutritional Assessment


  • Basic demographics
  • Diet history
  • Health history
  • Clarify food records
  • Complete training/exercise log
• Step 4: Assess Readiness for Change

  • Determine whether athlete is truly ready to take action and modify nutrition
  • Transtheoretical model (commonly used)
  • Stage 1: Precontemplation
  • Stage 2: Contemplation
  • Stage 3: Preparation
  • Stage 4: Action
  • Stage 5: Maintenance
  • Stage 6: Termination
• Step 5: Determine Nutrition Goals

  • Purpose is to help the athlete establish goals
  • Short-term (process-oriented) goals
  • Long-term (outcome-oriented) goals
  • Establish means for measuring and monitoring progress
• Step 6: Educate Athlete Relative to Nutrition Goals

  • Purpose is to provide an informational foundation as to why and how changes in nutrition will help achieve specific goals
  • Provide basic healthful eating tips
  • Provide: Sample meals, Meal/snacking patterns, Educational handouts, Other nutrition specifics
• Step 7: Summarize and Schedule Next Visit


  • Purpose is to reemphasize important points
  • Summarize established goals
  • Summarize any dietary intake changes
  • Allow athlete to ask clarifying questions
  • Schedule follow-up appointment
• The Follow-up Consultation


  • Ongoing consultation is critical to the athlete's continued success
  • The more changes there are, the more frequent follow-up visits should be
  • The follow-up is very similar to the initial visit, just shorter (~ 1/2 the time of initial visit)
  • Determine how the athlete is feeling and performing
  • Answer questions about barriers or implementation issues
• Walk-in Visits


  • Brief consulting visit
  • Usually no forewarning or previsit prep
  • These sessions usually involve: Very brief dietary history, Maybe a 24-hour dietary recall, Quick exercise/training history, Q&A session about specific sports nutrition topics
• Health and medical information is considered to be confidential
• HIPAA regulations should be followed
• Information on who must comply with HIPAA can be found on the HHS website