Survey of knowledge, attitudes and behaviors of athletes related to sports drinks and electrolytes in hydration status
Subject Areas :
Nut
M. Asafari
1
,
M. Hozoori
2
,
Z. SheikhiZadeh
3
1 - 1- PhD Student of the Food Safety and Hygiene, Department of Food Science and Technology, Shahid Beheshti University of Medical Sciences, Tehran. Iran.
2 - \Associate Professor of Nutritional Sciences, Department of Family and Community Medicine, Qom University of Medical Sciences, Qom, Iran.
3 - BSc of the Department of Public Health, School of Health, Qom University of Medical Sciences, Qom, Iran.
Received: 2023-01-15
Accepted : 2023-04-30
Published : 2023-09-23
Keywords:
Attitude,
Exercise,
Hydration,
Knowledge,
Sport Drink,
Water,
Abstract :
Introduction: Replacement of fluids excreted during exercise play an important role in in the success of athletes. However, according to the studies, knowledge and attitude about fluid intake are insufficient, and sometimes this lack of awareness leads to death. Therefore, this study was conducted to investigate the knowledge and behavior of athletes about sport drinks.Materials and Methods: In a cross-sectional study, 18 sports clubs in Qom were randomly selected and 272 researcher-made questionnaires were distributed among the athletes. The questionnaire contained demographic questions and also included 14 questions about knowledge, 9 questions about attitude and 7 questions about practice. The validity and reliability of the questionnaire were determined by assessment experts and Cronbach's alpha (N=24, α=0.83). Data were analyzed by ANOVA test.Results: In this study, 48% of the people know thirst is the best index for drinking water during exercise and 63% were unaware of the positive effects of sugary drinks on athletic performance. The number of athletes that preferred water to other beverages was 75% and about 70% had no attitude about adding carbohydrates. Also, age and education did not have correlations with level of awareness.Conclusion: The findings of this study show that athletes had incorrect attitude about fluid intake and it has caused dangerous consequences such as death. Therefore, education and training for athletes and their coaches to increase their sport activity with respect to nutritional awareness is essential.
References:
Adams, W. M., Vandermark, L. W., Belval, L. N. & Casa, D. J. (2019). The utility of thirst as a measure of hydration status following exercise-induced dehydration. Nutrients, 11, 2689. https://doi.org/10.3390/nu11112689
Aljaloud, S. O. (2018). Knowledge and behavior of Saudi college athletes toward energy and sports drinks with an emphasis on microbial quality and safety. Sports, 6(3), 60. https://doi.org/10.3390/sports6030060
Arnaoutis, G., Kavouras, S. A., Angelopoulou, A., Skoulariki, C., Bismpikou, S., Mourtakos, S. & Sidossis, L. S. (2015). Fluid balance during training in elite young athletes of different sports. Journal of strength and conditioning research/National Strength & Conditioning Association, 29(12), 3447-3452. doi: 10.1519/JSC.0000000000000400
Ayotte, D. & Corcocan, M. P. (2018). Individualized hydration plans improve performance outcomes for collegiate athletes engaging in in-season training. Journal of the International Society of Sports Nutrition, 15(1), 27. https://doi.org/10.1186/s12970-018-0230-2
Bolter, N. D., Gao, Y., Conger, S. A., Spear, C. E., Radin, A. K. & Flint, H. 2020. Parents’ knowledge, attitudes and behaviours related to children’s beverage consumption in youth soccer: A qualitative analysis. Health Education Journal, 79(3), 290-302. https://doi.org/10.1177/0017896919880225
Brink-Elfegoun, T., Ratel, S., Lepretre, P.-M., Metz, L., Ennequin, G., Dore, E., Martin, V., Bishop, D., Aubineau, N. & Lescuyer, J. (2014). Effects of sports drinks on the maintenance of physical performance during 3 tennis matches: a randomized controlled study. Journal of the International Society of Sports Nutrition. 11(1), 46. https://doi.org/10.1186/s12970-014-0046-7
Brown, Alysa M. (2017). Nutritional Needs in Collegiate Female Soccer Athletes. Graduate Student Theses, Dissertations, & Professional Papers. 10973. https://scholarworks.umt.edu/etd/10973
Carvalho, P., Oliveira, B., Barros, R., Padrao, P., Moreira, P. & Teixeira, V. H. (2011)Impact of fluid restriction and ad libitum water intake or an 8% carbohydrate-electrolyte beverage on skill performance of elite adolescent basketball players. International journal of sport nutrition and exercise metabolism, 21(3), 214-221. https://doi.org/10.1123/ijsnem.21.3.214
Castro-Sepulveda, M., Astudillo, J., Letelier, P. & Zbinden-Foncea, H. (2016). Prevalence of dehydration before training sessions, friendly and official matches in elite female soccer players. Journal of human kinetics, 50(1), 79-84.
Chapelle, L., Tassignon, B., Rommers, N., Mertens, E., Mullie, P. & Clarys, P. (2020). Pre-exercise hypohydration prevalence in soccer players: A quantitative systematic review. European journal of sport science, 20(6), 744-755. https://doi.org/10.1080/17461391.2019.1669716
Cheuvronts, S. N. & Sawka, M. N. (2005). Hydration assessment of athletes. Sports Science Exchange, 18(2), 1-6.
Centers for Disease Control Prevention. (1998). Hyperthermia and dehydration-related deaths associated with intentional rapid weight loss in three collegiate wrestlers--North Carolina, Wisconsin, and Michigan, November-December 1997. Morbidity and mortality weekly report, 47, 105-108.
Costa Pereira, R., Pitarma, G. & Jardim, M. (2019). Evaluation of Portuguese athletes knowledge regarding nutrition and hydration in sports. Annals of Medicine, 51, 219-219. https://doi.org/10.1080/07853890.2018.1560731
Fortes, L. S., Nascimento-Junior, J. R., Mortatti, A. L., Lima-Junior, D. R. A. A. D. & Ferreira, M. E. (2018). Effect of dehydration on passing decision making in soccer athletes. Research quarterly for exercise and sport, 89(3), 332-339. https://doi.org/10.1080/02701367.2018.1488026
Gilchrist, J., Haileyesus, T., Murphy, M., Collins, C. & Mcilvain, N. (2010). Heat illness among high school athletes-United States, 2005-2009. Morbidity and Mortality Weekly Report, 59(32), 1009-1013.
Heishman, A. D., Daub, B. D., Miller, R. M., Freitas, E. D. & Bemben, M. G. (2018). Longitudinal hydration assessment in collegiate basketball players over various training phases. decision-making, 5(6), 11.
Holland, J. J., Skinner, T. L., Irwin, C. G., Leveritt, M. D. & Goulet, E. D. (2017). The influence of drinking fluid on endurance cycling performance: a meta-analysis. Sports Medicine, 47(11), 2269-2284. https://doi.org/10.1007/s40279-017-0739-6
Hozoori, M., djafarian, K., Sheikhi-zadeh, Z. & Asafari, M. (2020). Knowledge, attitudes and practices of athletes related to dietary supplements in gym club in Iran. Journal of Nutritional Sciences and Dietetics, 6(1), 47-54.
Hozoori, M., Ehteshami, M., Haghravan, S. & Azarpira, A. (2012). Prevalence, Reasons and Information about Dietary Supplement Consumption in Athletes in Tabriz (1389). Journal of Sport Biosciences, 4(12), 77-91. [In Persian]. https://doi.org/10.22059/jsb.2012.28979
Hozoori, M., Safaei-Motlagh, A. & Marzban, A. (2016). The epidemiology of dietary supplements consumption in the athletes of Karaj Iran. International Journal of Epidemiologic Research, 3(3), 222-231. [In Persian]
Joachim, B. E. (2020). Effect of energy drink consumption on cardiovascular responses during exercise and recovery. (Doctoral dissertation).
Judge, L. W., Kumley, R. F., Bellard, D. M., Pike, K. L., Pierson, E. E., Weidner, T., Pearson, D. & Friesen, C. A. (2016). Hydration and fluid replacement knowledge, attitudes, barriers, and behaviors of NCAA division 1 American football players. Journal of Strength and Conditioning Research, 30(11), 2972-2978. https://doi.org/10.1519/JSC.0000000000001397
Kavoura, S. A. (2019). Hydration, dehydration, underhydration, optimal hydration: are we barking up the wrong tree? European Journal of Nutrition, 58(2), 471-473. https://doi.org/10.1007/s00394-018-01889-z
Klimesova, I., Krejci, J., Botek, M., Neuls, F., Sladeckova, B., Valenta, M. & Panska, S. (2019). Hydration status and the differences between perceived beverage consumption and objective hydration status indicator in the Czech elite deaf athletes. Acta Gymnica, 49(4), 197-202. 5507/ag.2019.020
Kumstat, M. (2019). Fluid intake during endurance exercise–is drinking to thirst optimum? Studia sportiva, 12(2), 70-78.
Logan‐Sprenger, H. M., Heigenhauser, G. J., Jones, G. L. & Spriet, L. L. (2015). The effect of dehydration on muscle metabolism and time trial performance during prolonged cycling in males. Physiological reports, 3(8), e12483. https://doi.org/10.14814/phy2.12483
Mahan, L. K. & Raymond, J. L. (2016). Krause's Food & the Nutrition Care Process, Iranian Edition E-Book, Elsevier.
Mettler, S. & Mannhart, C. (2017). Hydration, drinking and exercise performance. Swiss Sports & Exercise Medicine, 65(1), 16-21.
Mueller, F. O. & Cologate, B. (2012). Annual survey of football injury research: 1931-2011. Chapel Hill: University of North Carolina.
Muth, T., Pritchett, R., Pritchett, K., Depaepe, J. & Blank, R. (2019). Hydration status and perception of fluid loss in male and female university rugby union players. International journal of exercise science.12(3), 859.
Nery Chagas, T. P., Vieira Souza, L. M., Dos Santos, T., De Jesus, B. O., Martins Dantas, E. H. & Seixas Prado, E. (2017). Impacto da reposicao hidrica com agua de coco sobre o estado de hidratacao e cardiovascular drift durante o exercicio. Journal of Physical Education (24482455), 28(1). https://doi.org/10.4025/jphyseduc.v28i1.2804
Oppliger, R. A. & Bartok, C. (2002). Hydration testing of athletes. Sports Medicine, 32(15), 959-971. https://doi.org/10.2165/00007256-200232150-00001
Ortiz, E. (2019). Hydration Knowledge and Intake in High School Student Athletes.
Parastaez, S., Pushkina, T., Kurashvili, V., Yashin, T., Vykhodets, I., Kupeev, M. & Didur, M. (2017). An update on dehydration in athletes. Bulletin of Russian State Medical University. (6), pp.12-17.
Periard, J. D., Eejsvogels, T., Daanen, H. A. & Racinais, S. (2021). Hydration for the Tokyo Olympics: to thirst or not to thirst? : BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine. 55(8):410-1.
Pettersson, S. & Berg, C. M. (2014). Hydration status in elite wrestlers, judokas, boxers, and taekwondo athletes on competition day. International journal of sport nutrition and exercise metabolism, 24(3), 267-275. http://dx.doi.org/10.1136/bjsports-2020-102803
Qin, L., Wong, S., Sun, F.-H., Huang, Y., Sheridan, S. & Sit, C. H. P. (2017). The effect of carbohydrate and protein co-ingestion on energy substrate metabolism, sense of effort, and affective responses during prolonged strenuous endurance exercise. Physiology & behavior, 174, 170-7. https://doi.org/10.1016/j.physbeh.2017.02.035
Sedek, R., Mohamad, M. M. & Kasim, Z. M. (2015). Knowledge, attitudes and practices on hydration and fluid replacement among endurance sports athletes in National University of Malaysia (UKM). Pakistan Journal of Nutrition, 14(10), 658-668.
Sobana, R. & Nirmala, M. J. (2014). Analysis of knowledge, attitudes and practices between male and female college athletes on hydration and fluid replacement. International Journal of Sports Sciences & Fitness, 4(2), 144-156 .
Veilleux, J. C., Caldwell, A. R., Johnson, E. C., Kavouras, S., Mcdermott, B. P. & Ganio, M. S. (2019). Examining the links between hydration knowledge, attitudes and behavior. European Journal of Nutrition, 1-10. https://doi.org/10.1007/s00394-019-01958-x
Wolstein, J. & Babey, S. (2018). Impact of Role Models on Teen Sugary Drink Consumption. In APHA's 2018 Annual Meeting & Expo (Nov. 10-Nov. 14). APHA.
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Adams, W. M., Vandermark, L. W., Belval, L. N. & Casa, D. J. (2019). The utility of thirst as a measure of hydration status following exercise-induced dehydration. Nutrients, 11, 2689. https://doi.org/10.3390/nu11112689
Aljaloud, S. O. (2018). Knowledge and behavior of Saudi college athletes toward energy and sports drinks with an emphasis on microbial quality and safety. Sports, 6(3), 60. https://doi.org/10.3390/sports6030060
Arnaoutis, G., Kavouras, S. A., Angelopoulou, A., Skoulariki, C., Bismpikou, S., Mourtakos, S. & Sidossis, L. S. (2015). Fluid balance during training in elite young athletes of different sports. Journal of strength and conditioning research/National Strength & Conditioning Association, 29(12), 3447-3452. doi: 10.1519/JSC.0000000000000400
Ayotte, D. & Corcocan, M. P. (2018). Individualized hydration plans improve performance outcomes for collegiate athletes engaging in in-season training. Journal of the International Society of Sports Nutrition, 15(1), 27. https://doi.org/10.1186/s12970-018-0230-2
Bolter, N. D., Gao, Y., Conger, S. A., Spear, C. E., Radin, A. K. & Flint, H. 2020. Parents’ knowledge, attitudes and behaviours related to children’s beverage consumption in youth soccer: A qualitative analysis. Health Education Journal, 79(3), 290-302. https://doi.org/10.1177/0017896919880225
Brink-Elfegoun, T., Ratel, S., Lepretre, P.-M., Metz, L., Ennequin, G., Dore, E., Martin, V., Bishop, D., Aubineau, N. & Lescuyer, J. (2014). Effects of sports drinks on the maintenance of physical performance during 3 tennis matches: a randomized controlled study. Journal of the International Society of Sports Nutrition. 11(1), 46. https://doi.org/10.1186/s12970-014-0046-7
Brown, Alysa M. (2017). Nutritional Needs in Collegiate Female Soccer Athletes. Graduate Student Theses, Dissertations, & Professional Papers. 10973. https://scholarworks.umt.edu/etd/10973
Carvalho, P., Oliveira, B., Barros, R., Padrao, P., Moreira, P. & Teixeira, V. H. (2011)Impact of fluid restriction and ad libitum water intake or an 8% carbohydrate-electrolyte beverage on skill performance of elite adolescent basketball players. International journal of sport nutrition and exercise metabolism, 21(3), 214-221. https://doi.org/10.1123/ijsnem.21.3.214
Castro-Sepulveda, M., Astudillo, J., Letelier, P. & Zbinden-Foncea, H. (2016). Prevalence of dehydration before training sessions, friendly and official matches in elite female soccer players. Journal of human kinetics, 50(1), 79-84.
Chapelle, L., Tassignon, B., Rommers, N., Mertens, E., Mullie, P. & Clarys, P. (2020). Pre-exercise hypohydration prevalence in soccer players: A quantitative systematic review. European journal of sport science, 20(6), 744-755. https://doi.org/10.1080/17461391.2019.1669716
Cheuvronts, S. N. & Sawka, M. N. (2005). Hydration assessment of athletes. Sports Science Exchange, 18(2), 1-6.
Centers for Disease Control Prevention. (1998). Hyperthermia and dehydration-related deaths associated with intentional rapid weight loss in three collegiate wrestlers--North Carolina, Wisconsin, and Michigan, November-December 1997. Morbidity and mortality weekly report, 47, 105-108.
Costa Pereira, R., Pitarma, G. & Jardim, M. (2019). Evaluation of Portuguese athletes knowledge regarding nutrition and hydration in sports. Annals of Medicine, 51, 219-219. https://doi.org/10.1080/07853890.2018.1560731
Fortes, L. S., Nascimento-Junior, J. R., Mortatti, A. L., Lima-Junior, D. R. A. A. D. & Ferreira, M. E. (2018). Effect of dehydration on passing decision making in soccer athletes. Research quarterly for exercise and sport, 89(3), 332-339. https://doi.org/10.1080/02701367.2018.1488026
Gilchrist, J., Haileyesus, T., Murphy, M., Collins, C. & Mcilvain, N. (2010). Heat illness among high school athletes-United States, 2005-2009. Morbidity and Mortality Weekly Report, 59(32), 1009-1013.
Heishman, A. D., Daub, B. D., Miller, R. M., Freitas, E. D. & Bemben, M. G. (2018). Longitudinal hydration assessment in collegiate basketball players over various training phases. decision-making, 5(6), 11.
Holland, J. J., Skinner, T. L., Irwin, C. G., Leveritt, M. D. & Goulet, E. D. (2017). The influence of drinking fluid on endurance cycling performance: a meta-analysis. Sports Medicine, 47(11), 2269-2284. https://doi.org/10.1007/s40279-017-0739-6
Hozoori, M., djafarian, K., Sheikhi-zadeh, Z. & Asafari, M. (2020). Knowledge, attitudes and practices of athletes related to dietary supplements in gym club in Iran. Journal of Nutritional Sciences and Dietetics, 6(1), 47-54.
Hozoori, M., Ehteshami, M., Haghravan, S. & Azarpira, A. (2012). Prevalence, Reasons and Information about Dietary Supplement Consumption in Athletes in Tabriz (1389). Journal of Sport Biosciences, 4(12), 77-91. [In Persian]. https://doi.org/10.22059/jsb.2012.28979
Hozoori, M., Safaei-Motlagh, A. & Marzban, A. (2016). The epidemiology of dietary supplements consumption in the athletes of Karaj Iran. International Journal of Epidemiologic Research, 3(3), 222-231. [In Persian]
Joachim, B. E. (2020). Effect of energy drink consumption on cardiovascular responses during exercise and recovery. (Doctoral dissertation).
Judge, L. W., Kumley, R. F., Bellard, D. M., Pike, K. L., Pierson, E. E., Weidner, T., Pearson, D. & Friesen, C. A. (2016). Hydration and fluid replacement knowledge, attitudes, barriers, and behaviors of NCAA division 1 American football players. Journal of Strength and Conditioning Research, 30(11), 2972-2978. https://doi.org/10.1519/JSC.0000000000001397
Kavoura, S. A. (2019). Hydration, dehydration, underhydration, optimal hydration: are we barking up the wrong tree? European Journal of Nutrition, 58(2), 471-473. https://doi.org/10.1007/s00394-018-01889-z
Klimesova, I., Krejci, J., Botek, M., Neuls, F., Sladeckova, B., Valenta, M. & Panska, S. (2019). Hydration status and the differences between perceived beverage consumption and objective hydration status indicator in the Czech elite deaf athletes. Acta Gymnica, 49(4), 197-202. 5507/ag.2019.020
Kumstat, M. (2019). Fluid intake during endurance exercise–is drinking to thirst optimum? Studia sportiva, 12(2), 70-78.
Logan‐Sprenger, H. M., Heigenhauser, G. J., Jones, G. L. & Spriet, L. L. (2015). The effect of dehydration on muscle metabolism and time trial performance during prolonged cycling in males. Physiological reports, 3(8), e12483. https://doi.org/10.14814/phy2.12483
Mahan, L. K. & Raymond, J. L. (2016). Krause's Food & the Nutrition Care Process, Iranian Edition E-Book, Elsevier.
Mettler, S. & Mannhart, C. (2017). Hydration, drinking and exercise performance. Swiss Sports & Exercise Medicine, 65(1), 16-21.
Mueller, F. O. & Cologate, B. (2012). Annual survey of football injury research: 1931-2011. Chapel Hill: University of North Carolina.
Muth, T., Pritchett, R., Pritchett, K., Depaepe, J. & Blank, R. (2019). Hydration status and perception of fluid loss in male and female university rugby union players. International journal of exercise science.12(3), 859.
Nery Chagas, T. P., Vieira Souza, L. M., Dos Santos, T., De Jesus, B. O., Martins Dantas, E. H. & Seixas Prado, E. (2017). Impacto da reposicao hidrica com agua de coco sobre o estado de hidratacao e cardiovascular drift durante o exercicio. Journal of Physical Education (24482455), 28(1). https://doi.org/10.4025/jphyseduc.v28i1.2804
Oppliger, R. A. & Bartok, C. (2002). Hydration testing of athletes. Sports Medicine, 32(15), 959-971. https://doi.org/10.2165/00007256-200232150-00001
Ortiz, E. (2019). Hydration Knowledge and Intake in High School Student Athletes.
Parastaez, S., Pushkina, T., Kurashvili, V., Yashin, T., Vykhodets, I., Kupeev, M. & Didur, M. (2017). An update on dehydration in athletes. Bulletin of Russian State Medical University. (6), pp.12-17.
Periard, J. D., Eejsvogels, T., Daanen, H. A. & Racinais, S. (2021). Hydration for the Tokyo Olympics: to thirst or not to thirst? : BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine. 55(8):410-1.
Pettersson, S. & Berg, C. M. (2014). Hydration status in elite wrestlers, judokas, boxers, and taekwondo athletes on competition day. International journal of sport nutrition and exercise metabolism, 24(3), 267-275. http://dx.doi.org/10.1136/bjsports-2020-102803
Qin, L., Wong, S., Sun, F.-H., Huang, Y., Sheridan, S. & Sit, C. H. P. (2017). The effect of carbohydrate and protein co-ingestion on energy substrate metabolism, sense of effort, and affective responses during prolonged strenuous endurance exercise. Physiology & behavior, 174, 170-7. https://doi.org/10.1016/j.physbeh.2017.02.035
Sedek, R., Mohamad, M. M. & Kasim, Z. M. (2015). Knowledge, attitudes and practices on hydration and fluid replacement among endurance sports athletes in National University of Malaysia (UKM). Pakistan Journal of Nutrition, 14(10), 658-668.
Sobana, R. & Nirmala, M. J. (2014). Analysis of knowledge, attitudes and practices between male and female college athletes on hydration and fluid replacement. International Journal of Sports Sciences & Fitness, 4(2), 144-156 .
Veilleux, J. C., Caldwell, A. R., Johnson, E. C., Kavouras, S., Mcdermott, B. P. & Ganio, M. S. (2019). Examining the links between hydration knowledge, attitudes and behavior. European Journal of Nutrition, 1-10. https://doi.org/10.1007/s00394-019-01958-x
Wolstein, J. & Babey, S. (2018). Impact of Role Models on Teen Sugary Drink Consumption. In APHA's 2018 Annual Meeting & Expo (Nov. 10-Nov. 14). APHA.