Table 1 Data extraction: Qualitative research design

Title

Personal food systems of male college hockey players

A comparison of pre-competition eating patterns in a group of non-elite triathletes

What should I eat next? Development of a theoretical model of how college-aged football players make food choices

Personal food systems of male collegiate football players: a grounded theory investigation

Perceptions and determinants of eating for health and performance in high-level male adolescent rugby union players

Food choice decisions of collegiate division I athletes: Qualitative interviews

Understanding food choices and eating practices of Brazilian and Spanish athletes in aesthetics and weight class sports

Study design

Grounded theory approach

Grounded theory approach

Grounded theory approach

Grounded theory approach

Thematic analysis of semi-structured interviews

(No theory reported)

Semi-structured phone interviews

(No theory reported)

Grounded theory—food choice process model

Study aim

To investigate how college athletes experienced and interpreted the multiple forces influencing their food choices

To investigate the reasons associated with the informed choices that triathletes make about their food consumption and specific eating patterns prior to competition

To understand the personal food choice process of collegiate football players

To develop a theoretical model explaining the personal food choice processes of collegiate football players

To explore perceptions and determinants of eating for health and performance in high-level male adolescent rugby union players

To improve understanding of athletes’ food-related beliefs and practices

To understand determinants of food choices and eating practices of aesthetics and weight class athletes from two countries

Population

Sample size

n = 10

n = 13

n = 15

n = 15

n = 20

n = 14

n = 33

Sex

Male 10

Male 7

Female 6

Male 15

Male 15

Male 20

Male 5

Female 9

Not specified

Age

(years)

18–23 (range)

31; 24–43

(mean; range)

Not specified

Not specified

17 ± 1; 16–18

(mean ± SD; range)

Not specified

15–42 (range)

Athlete level (as described by authors)

University –

2 freshmen, 4 sophomores, 3 juniors and 1 senior. Some with national or regional ranking

Non-elite

National Collegiate Athletic Association Division II. University –

4 sophomores, 9 juniors and 2 seniors

National Collegiate Athletic Association Division II. University –

4 sophomores, 9 juniors and 2 seniors

Highest representative -regional (60%), school (25%), national (10%), international/ age group (5%)

NCAA Division I

All competed in national and regional events

18 /33 involved in international competitions

Sport(s)

Ice hockey

Triathletes

American football

American football

Rugby union

Mixed—Swimming, track and field rowing, gymnastics, tennis, softball, volleyball

Gymnasts and martial arts

Athlete cultural background

Canada (n = 6), United States (n = 3), Eastern Europe (n = 1)

Not specified

Caucasian (n = 10), Hispanic (n = 3), African American (n = 2)

Caucasian (n = 10), Hispanic (n = 3), African American (n = 2)

New Zealand European (35%), Samoan (35%), Tongan (20%), Maori (10%)

Not specified

Brazil (n = 16)

Spain (n = 18)

Context

Country

Study; author

United States; American authors

England; United Kingdom authors

United States; American authors

United States; American authors

New Zealand; New Zealand and Australian authors

United States; American authors

Brazil and Spain; Brazilian author

Competition phase

Both in- and out-of-season

Pre-competition

During training and competition season

During training and competition season

Not specified

Not specified

Not specified

Food setting/ environment

Freshmen: dormitory, university meal plan. Other participants: off-campus housing. Athletes paid for own foods, except pre-game meals that coaches /trainers arranged and ate with the team

Not specified

Athletes were responsible for their own meals usually eating with roommates or significant others

Players had limited access to nutrition specialists

Athletes were responsible for their own meals usually eating with roommates or significant others

Players had limited access to nutrition specialists

Not specified

Not specified

Not specified (did not include those who were provided food in live-in centres)

Concept

Methods for reporting food choice

Interviews:

Semi-structured face-to-face

Factors that influence food choice

Changes in practices between home and college, and during the season

Participant observation of

daily activities and informal conversation

Focus groups:

Semi-structured face-to-face

The reasons for food choices prior to competition

7 themes to act as probe Themes were not explicitly specified

Interviews:

Semi-structured face-to-face

Food/drink preferences, traditions or superstitions related to training /games

Self-talk when making food selections

Changes to self-talk at home or college

Interviews:

Semi-structured face-to-face

Food/drink preferences, traditions or superstitions related to training or games

Self-talk when making food selections

Changes to self-talk at home or college

Interviews:

Semi-structured face-to-face

Perceptions of a healthy and unhealthy diet

Perceived impact of dietary intake on health and performance

Barrier and enablers to healthy eating

(Q: Is there anything we haven’t talked about that affects what you eat?)

Interviews:

Semi–structured via phone

Q: What food do you consume everyday? Why do you consume these foods? What foods do you avoid and why?

Also asked about definition of healthy eating, and supplement use

Interviews:

Semi-structured face-to-face

Q: How do you eat during training? How do you eat in the competition phase (both questions probed with reasons for these strategies)

Relative food environment

Current /past food environments

General food environment

General food environment

General food environment

General food environment

General food environment

General food environment

Outcome

Determinants of food choice

Before college: family/ home setting most influential

Freshman year: new eating influences, peer influence

Post freshman: independent food choice systems, beliefs about how eating related to hockey, less affected by peers

Personal food systems: changing priorities between hockey, health and taste

Health: ‘feeling good’, low body fat, good body image

Taste: preferences, indulgence and conflicted with health

Others: time, convenience, quality, quantity, variety, finances, peer influence

Seasonal cycles:

 Off season = taste

 Summer = taste

 Dry-land training = health

 In season = hockey and health

32 themes in five categories):

 Somatic (sickness, nervous, allergy, comfort)

Performance (energy, pressure, physiological need)

 Trust (advice, trust, nutrition knowledge, food marketing)

 Preferences (past experience, preferences taste, food, individual), health, convenience

 Routine (conditioning, routine, consistency, food planning, work-dominated eating pattern)

Experience:

Higher level athletes- maximizing performance, less evident with less experience

Choices based on past experience for more experienced athletes

The most common themes were:

 Healthy Food

 Eat Smarter /Right

 No greasy food

 Time

 Money value

Football players—more time planning, purchasing, and preparing meals

Primary concern was to eat to compete, focusing on macronutrients and healthful foods

Higher volumes of food freshman year, more college years- healthier choices

Social environment -

little influence from peers

Physical environment -

minimal influence, only the availability of choices when travelling

Theoretical model identified nine factors influencing food decisions:

Time was the central influence interacting with the following:

 Macronutrient

 Money

Meal themes

 Healthy food

 Food related decisions

 Routines

 Planned hydration

Key outcome of food choices was to overall maintain a comfortable playing weight and to feel healthier

Three broad themes:

General

 Influence of others (peers / family)—barriers or enablers dependent on situation

 Taste (barrier), cost, convenience, availability of food

 General/ sport-specific

 Mainstream and social media—barrier or enabler

 Physical appearance—healthy eating associated with feeling positive

Sport-specific

 Awareness of healthy eating (game days)

 Timing, type, volume of food (digestion before a game)

 Desire to enhance sport performance

 Reduced healthy eating motivation during off-season

 Team culture a motivator for healthy eating

Prominent factors:

 Benefits to health and performance

 Avoid “unhealthy” foods –

feel lethargic and inhibited ability to perform well

Other factors:

Cost, preference, nutrition knowledge

Little difference between in and off season. More relaxed in off season, consuming fast food or dessert. Alcohol avoided during season

Eat less healthy in season -when traveling, have to eat fast foods

Off season, making own food- healthier

Themes included:

 “Perceptions about the athletic body”, “everyday food practices”, and “eating to win”

 Male gymnasts concerned with muscles and weight control (fear of injury)

 Martial arts athletes concerned with reaching fight weight

 Higher level of competition = stronger weight awareness

 Brazilian gymnasts had greater body dissatisfaction compared to Spaniards—internal and external pressure, especially from coaches

 Body image/weight loss was constant concern

 When dietary restriction is relaxed—lack of control over food with feelings of guilt

 Participation in social occasions is hindered by food restrictions

Conclusion

Athletes use behavioural rules and routines to manage the multiple determinants and situational nature of food and eating

Food practices of athletes may be highly variable across the year of intake

Food choices and willingness for someone else to manipulate diet varied with experience/competitiveness. Food choices less important for less experienced; more experienced may have established knowledge of what works for them

Athletes have personal rules and routines informing their food choices which are based on influences from the social and physical environment

Collegiate athletes are in a highly dynamic period of life: They weigh and negotiate food choices in a new physical, social, and cultural environment

High-level male adolescent rugby players living in New Zealand have a good understanding of what eating for health and performance means

Food choices influenced by potential benefits to health and performance, availability of foods, and suggestions from sports dietitians

Sports nutritionists were trusted source of nutrition information

Idealised bodies are part of the sport’s culture- impacts on beliefs/ meanings associated with eating practices. Sports-related eating practices similar in both countries, suggesting a group identity and a “sports discipline's food culture”