Nutrition Education Curriculum Promotes Adolescent Runners' Self-Efficacy, Knowledge, and Intake of Nutrient-Rich Carbohydrate Foods.

Background: Endurance runners exhibit an elevated prevalence of low bone mass and characteristics consistent with undernourishment.
Objective: This quasi-experimental, pretest-posttest design study evaluated the efficacy of a 4-week nutrition education curriculum to optimize nutrition knowledge, self-efficacy, and the intake of nutrient-rich carbohydrate foods.
Methods: Forty-eight adolescent endurance runners, age 15.7 ± 1.2 y, from two high schools in Southern California were recruited to complete four, weekly lessons addressing the quantity, quality, and timing of carbohydrate intake. Differences in pre- compared to post-intervention nutrition knowledge and self-efficacy to consume nutrient-rich carbohydrate foods were evaluated using paired samples t -tests. Qualitative coding of open-response questions explored changes in food intake behaviors reported by runners during the intervention.
Results: The percent of nutrition knowledge questions answered correctly increased after Lessons 1 and 2 (59.0% ± 20.0% pre- vs. 81.9% ± 22.8% post-Lesson 1; 44.7% ± 13.7% pre- vs. 74.5% ± 17.4% post-Lesson 2, P<.001 ) and the number of identified nutrient-rich carbohydrate foods (8.7 ± 2.7 vs. 12.4 ± 2.3, P  < 0.001). Self-efficacy scores improved after all lessons ( P<.001 ). After Lesson 2, 84% ( n  = 27/32) of runners increased the carbohydrate included in a snack or meal; after Lesson 4, 85% ( n  = 29/34) added a post-exercise snack. Frequent themes identified from questions addressing dietary changes included increasing quantity and quality of carbohydrates in snacks and meals and being more aware of food choices. Conclusions: Findings suggest that the curriculum enhanced nutrition knowledge, self-efficacy, and dietary behaviors related to intake of nutrient-dense carbohydrate foods in adolescent runners.