NUTRITION KNOWLEDGE, DIET QUALITY, SUPPLEMENT INTAKE AND THE BARRIERS AND ENABLERS THAT INFLUENCE THESE IN AUSTRALIAN MILITARY PERSONNEL. WHAT CAN BE DONE?

Abstract

Sound nutrition knowledge (NK) and a balanced diet is fundamental for military operational readiness and optimal health. Dietary intakes in this population are often inadequate, dietary supplement (DS) use is high and little is known about levels of NK. This thesis aimed to evaluate general NK, diet quality (DQ), DS use, and barriers and motivators to healthy eating in Australian military personnel (MP); and to review the efficacy of nutrition interventions on DQ and NK in MP. Using a cross-sectional study design and convenience samples, NK of MP (n=673) and civilians (C) (n=622) was assessed via the General NK Questionnaire (GNKQ). DQ was assessed using a Food Frequency Questionnaire and the Australian Recommended Food Score (ARFS) in a subset of MP (n=211). DS use, barriers and motivators to healthy eating, and interest in future nutrition initiatives were explored via questionnaire. NK scores of C (64.7%), officers (62.8%) and physical training instructors (61.9%), were higher than soldiers (50.6%) and cooks (56.4%) (P<0.001). Overall, young men without tertiary education had the lowest GNKQ scores. Overall ARFS was 50·8% with officers scoring higher than soldiers (54·7 v. 50·3 %, P=0·040). Total GNKQ score had a weak positive association with total ARFS (r=0·179; P=0·009). Overall, 74.5% of MP reported using ≥1 DS/day, with ~26% using ≥5 types of DS at least once/wk. Common DS used daily were caffeine, vitamins, minerals and protein powders. Reasons most reported for use were ‘to provide energy’, ‘performance’, ‘general health’, ‘like it’. Lack of time, motivation, easy access to takeaway foods and frequent field deployment were the main factors challenging healthy eating. Key motivators included the desire to improve health, physique and enhance job performance. Face-to-face and technology approaches to nutrition education were most desired. The review found manipulation of the food service environment, and education-base programs were effective at improving NK and DQ, however the range of intervention approaches, assessment methodologies, and limited reporting between-group analysis made it difficult to draw conclusions. An ecological approach, using multicomponent programs are recommended to create supportive social and physical environments to positively influence NK, DQ and DS use in MP.