Rachael L. Thurecht

Pacific Island Countries and Territories experience disproportionately high rates of stillbirth, neonatal, and childhood deaths, yet the drivers of these o

Ensuring food safety and infection control in large‐scale foodservice operations is critical to protecting health in mass feeding environments, including athletes' dining halls and institutional dining settings. Athletes at major competitions are at risk of illness in overcrowded dining areas, especially where foodservice safety standards are inconsistent. Objectives: This study aimed to (1) develop and pilot‐test a Foodservice Provision Audit Tool for Sport (FPAT‐S) at two major sport competitions to evaluate compliance with infection control and food safety measures, and (2) determine its inter‐rater reliability. Methods: The FPAT‐S was tested by health professionals during the 2022 Canada Summer ( n = 12) and 2023 Winter Games ( n = 9). The tool included 19 questions with binary, multiple‐choice, and Likert scale responses. Compliance trends over time and inter‐rater reliability were analyzed. Results: Hand sanitizer availability exceeded 75% compliance and improved over time, whereas staff sanitation compliance declined by the end of both events. Physical distancing compliance remained below 50% throughout. Binary response questions showed moderate agreement (κ = 0.471, p = 0.028) between auditors compared to scale and multiple‐choice questions during the Summer phase, while agreement was lower and non‐significant for scale and multiple‐choice responses in both phases. Auditor variability was attributed to subjectivity and audit timing. Conclusion: The FPAT‐S provides a structured approach to assessing food safety and infection control in mass foodservice settings. With refinement, it can support dietitians and foodservice managers in maintaining compliance across a range of institutional and commercial operations, beyond sporting events, and inform future public health infection control strategies.

Background: Poor nutrition in childhood can have irreversible impacts on development and health, potentially resulting in cognitive impairments and an increased risk of chronic disease later in life. Aim: This study aimed to develop and validate the Parent Carer-Food Choice Questionnaire (PC-FCQ) to determine the key factors influencing the parental food choices of children aged between two and five years. Methods: A sample of 737 Australian parents and carers completed the questionnaire consisting of 98 items on a 10-point frequency of influence anchored at 1 never to 10 always. Principal component analysis (PCA) was employed to identify the key factors and refine the questionnaire. Results: The PCA extracted 65 items organized into 12 factors explaining 62.8% of the total variance. The factors were named ethical concerns, nutritional attributes, child preferences, child mood, awareness, parent sensory, convenience, situation, culture, professional advice, accessibility and weight control. The final Kaiser–Meyer–Olkin measure was 0.93, and the Bartlett test of sphericity was statistically significant X2(4753) = 39,643.87, p < 0.001. Moderate intercorrelations were detected between seven factors. Conclusions: This research resulted in a PC-FCQ that includes factors specifically relevant to parental food choice. The PC-FCQ will enable researchers and clinicians to more effectively provide nutrition education and dietary interventions to suit the parent and child. The next phase of this research will be to test the accuracy and reliability of the PC-FCQ in an independent sample via confirmatory factor analysis.

Background: Nutrition knowledge is positively associated with energy intake in athletes, and therefore, improving nutrition knowledge may offer a cost-effective approach to prevent negative performance and health outcomes associated with low energy availability (LEA) described in the Relative Energy Deficiency in Sports (REDs) syndrome model. The aim was to assess the short-term influence of a 60-min group-based nutrition education intervention on sports nutrition knowledge and dietary intake in elite athletes. Method: Twenty-five elite Canadian athletes were enrolled into a 3-week prospective single blinded randomized pragmatic trial. Participants were randomly assigned to 1 of 2 group-based nutrition education interventions. Education content was similar between both groups with 1 group assigned an additional 5-10 mins to review athlete testimonials on the negative impacts of REDs. Participants were assessed, before and about 10 days after the intervention, using anthropometry, Platform to Evaluate Athlete Knowledge of Sports Nutrition, Athlete Food Choice, Eating Disorder Examination 6.0, LEA/Triad, Athlete Diet Index questionnaires, and consecutive 5-day food record. Results: The education intervention that was supplemented with athlete testimonials performed similarly to the intervention without (p>0.05). Overall, nutrition knowledge (score from 69.8, to 72.8) and the intake of carbohydrate-rich foods (12.4 to 14.3) increased while disordered eating/eating symptoms decreased (0.788 to 0.642) after the education intervention (all p< 0.05). No changes in daily energy and carbohydrate intake were observed after the education intervention (p>0.05). Conclusion: The nutrition education sessions were associated with an in-crease in nutrition knowledge and other factors associated with food choice leading to increased consumption of carbohydrate-rich foods and reducing disordered eating/eating disorder symptoms. More research is required on methods to influence athlete eating behaviours to optimize energy intake to prevent associated negative health and performance outcomes.

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.

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.

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.

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

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.