Focus on Fitness: Sports Nutrition in Collegiate Athletics

November/December 2024 Issue

Focus on Fitness: Sports Nutrition in Collegiate Athletics
By Dana Angelo White, MS, RDN, ATC
Today’s Dietitian
Vol. 26 No. 9 P. 42

The Value of the Interprofessional Team

In late 2022, a project nearly 10 years in the making was finally published in the Journal of Athletic Training. The Interassociation Consensus Statement on Sports Nutrition Models for the Provision of Nutrition Services From Registered Dietitian Nutritionists in Collegiate Athletics1 was the brainchild of a small group of sports dietitians that now aims to set the standards for care for sports nutrition services for college athletes and support staff.

This statement was the first of its kind and created an opportunity for all the important clinicians involved in college sports to collaborate, define their roles, and optimize care while simultaneously giving athletic departments tools to help structure programs big and small.

Victoria Lambert, MS, RD, lead author and member of the American Sports and Performance Dietitians Association (ASPDA), formerly named the Collegiate and Professional Sports Dietitian Association (CPSDA), shares what led to the need to convene on this topic.

“During the early part of my tenure as Princeton University’s sports and eating disorders dietitian, collegiate sports nutrition was experiencing a huge wave of growth and it was becoming clear that without a unified path forward, the specialty may not advance in ways I and others thought prioritized our roles as health care providers, clinical sports dietitians, and sports scientists. By 2013, I was serving as a board member for CPSDA and brought the idea to the leadership who responded with unanimous support. From there, a committee was formed that included myself as well as Jen Ketterly, MS, RD, CSSD, LDN, who was at Georgia at the time, and Amy Culp, RD, CSSD, CEDS-C, from the University of Texas at Austin. Our first meeting took place in Texas in 2014.”

In the years that followed, the writing team expanded to six authors. After years of drafts, edits, feedback, and eventually approval from partnering organizations, the paper was submitted and approved for publication by the Journal of Athletic Training. The organizational review panel included the ASPDA, the National Athletic Trainers’ Association, the Sports and Human Performance Nutrition (SHPN) subgroup of the Academy of Nutrition and Dietetics, the American Medical Society for Sports Medicine, and the Collegiate Strength and Conditioning Coaches Association.

The paper established evidence-based practice models for RDs specializing in sports dietetics (sports RDs) working in all ranges of capacities.1 It’s a document to share with members of the athletic medicine team as well as coaches and administrators to help build staffing that could range from a part-time consultant to a department with several full-time staff.

In addition, the paper demonstrates and explains the extensive training sports RDs have in medical nutrition therapy, education and behavioral counseling, food service management, exercise physiology, physical performance, and administration.

The Growth of Sports RDs
In 1994, one Division 1 university employed one full-time sports RD. To date, at least 30% of D1 programs have at least one fulltime sports RD on staff, and the numbers continue to grow.2 Katie Knappenberger, MS, RD, CSSD, ATC, president of ASPDA, recalls the amazing growth the field has experienced. “The number of sports and performance dietitian positions available within the collegiate setting has absolutely exploded over the last decade,” Knappenberger says. “In 2014, I can remember our organization celebrating the creation of each and every full-time dietitian position at Power 5 universities. Now, we have Collegiate Performance Nutrition programs with over eight RDs! We also see RDs supporting DII and DIII athletes! It’s incredible growth and I absolutely love the countless stories that pour into ASPDA about the impact that these RDs are having on athlete health, performance, and experience.”

With this growth comes the need for more organization and collaboration among the various clinicians who practice within athletic departments. Defining roles and knowing how other clinicians operate can help create more efficient protocols and better care for student athletes.

Defining Roles in College Sports
Sports RDs and credentialed board-certified specialists in sports dietetics (CSSDs) are the preferred nutrition providers at the college level due to the unique demands of the job.

Sports RDs often work alongside athletic trainers, strength and conditioning coaches, medical doctors, sports psychologists, physical therapists, and other medical professionals to provide comprehensive and collaborative interprofessional care. While all these practitioners play a crucial role in the health and safety of student athletes, sports RDs are specially trained in key areas. Lambert et al identify specific areas of expertise and demonstrate how they are commonly executed in college sports. Examples of these areas are summarized in the following1:

• Clinical sports nutrition practice includes identification and treatment of nutrient deficiencies, risks to cardiometabolic health, and eating disorders and disordered eating in an athletic population.

• Onsite delivery of nutrition education for teams, individual athletes, and support staff to help navigate the nutrition needs of a college athlete in and out of their competitive seasons.

• Food service management at the campus cafeteria, off-campus kitchen, training tables, locker rooms, and offsite events. There are various access points to food that benefit from sports RD management.

• Performance nutrition encompasses the management of dietary supplements and banned substances and the challenges of proper hydration and avoiding heat illness.

It’s also worthwhile for sports RDs to understand how to best communicate and delegate to other members of the health care team when appropriate. Scope of practice for athletic trainers, physical therapists, and strength and conditioning professionals does include some nutrition, therefore these providers can help support the efforts of the sports RD in their role.

Unique Challenges
College athletes face unique challenges. The demands of balancing athletic and academic responsibilities, NCAA regulations, team dynamics, and for many, a first experience away from home can be overwhelming. Furthermore, college campuses present a new food universe for athletes, and many struggle to meet their nutrient needs. These issues are often made more difficult with additional information athletes access via social media. Many athletes report seeking guidance on food choices and dietary supplements on social media, which can put them at greater risk for malnutrition.3,4

The recent NCAA Name, Image, and Likeness policy5 that allows athletes to monetize their personal branding has deepened social media connections where many athletes interact and endorse specific brands. While this is a wonderful opportunity for athletes to be compensated for their hard work, it also makes them more susceptible to scrutiny and exposes them to brands and products that may put their health and safety at risk. Having access to a qualified sports RD can help educate these athletes about the potential risks associated with partnering with and consuming some products.

Looking to the Future
No matter what the size or budget of the institution, there are opportunities for sports RDs to integrate their services. The consensus statement offers tangible data for clinicians to shape their protocols and for athletic department administrators to build their departments. Practicing sports RDs are encouraged to communicate and share their experiences and aspiring sports RDs can tap into resources, including ASPDA and SHPN to help build their case for more sports nutrition services.

When asked what the future holds, Lambert remains hopeful. “The knowledge and perception of our training and capabilities still varies and limits our effectiveness in the areas of athlete safety and welfare, in addition to human performance. It’s always been my hope that administrators, other sports medicine professionals, coaches, and athletes alike begin to value and utilize the qualifications and skill set of sports dietitians to their greatest potential. All the authors, reviewers, and organizations who supported this work share in that hope.”

— Dana Angelo White, MS, RDN, ATC, is a dual registered dietitian nutritionist and certified athletic trainer with over 20 years of clinical experience. She is a media dietitian, cookbook author and full-time professor and sports RDN at Quinnipiac University in Hamden, Connecticut.

References
1. Lambert V, Carbuhn A, Culp A, Ketterly J, Twombley B, White D. Interassociation consensus statement on sports nutrition models for the provision of nutrition services from registered dietitian nutritionists in collegiate athletics. J Athl Train. 2022;57(8):717-732.

2. Growth of the sports RD. SportsRD website. https://sportsrd.org/wp-content/uploads/2024/01/Sports-RD-Growth-Map-Updated-1.19.24-1.pdf. Accessed September 6, 2024.

3. Bourke BEP, Baker DF, Braakhuis AJ. Social media as a nutrition resource for athletes: a cross-sectional survey. Int J Sport Nutr Exerc Metab. 2019;29(4):364-370.

4. Nath S, Bhattacharya S, Golla VB, Kumar R. Effect of social media on diet, lifestyle, and performance of athletes: a review of current evidence. Curr Nutr Rep. 2024;13(2):240-250.

5. NCAA adopts interim name, image and likeness policy. NCAA website. https://www.ncaa.org/news/2021/6/30/ncaa-adopts-interim-name-image-and-likeness-policy.aspx. Published June 30, 2021. Accessed September 6, 2024.