Creative and talented athletes are an essential part of the wealth of a nation. It is considered to reflect the development of the nation in the field of sport. Therefore, all the elements of care and attention must be paid to all the relevant aspects of these elite athletes. This can be done in a variety of ways, such as holding special training programs and courses on all subjects related to their physical, nutritional, and psychological capabilities, and improving them all.
One of the most important foundations for maintaining physical, mental and psychological fitness; their commitment to a healthy and balanced diet, their knowledge of DS and their awareness of the limits of consumption. Proper and balanced healthy nutrition is also one of the most important foundations for the advancement and success of athletes.
The importance of this study stems from the fact that to the best of the researcher's knowledge, there has been no study assessing nutritional knowledge and attitudes regarding the use of DS among elite athletes and coaches in the Jordan Olympic Preparation Program and this is the first study to date in Jordan to report on the use of DS among elite athletes. This study assessed the perception of elite athletes and coaches towards DS and demonstrated the frequency of their use, which is an important area of ongoing clinical concern.
One of the main objectives of this research is also to assess and broaden the knowledge of elite athletes in Jordanian society about DS, to improve the nutritional attitudes, knowledge and practices of elite athletes, particularly in the field of DS, as this will lead to more athlete-conscious food and DS society and more healthy elite athletes.
This study showed that consumption of DS was common among elite athletes as 41.6% of athletes admitted to using DS and 46.5% of athletes believed that not using these supplements could impair their athletic performance. As noted in previous research by Sekulic et al. in 2019, elite athletes used DS because they believe it is an easy and quick way to build muscle and contribute to building a stronger physical structure.
Several other factors make a significant contribution to the spread of DS among athletes, such as rapid developments in the marketing of DS through media such as magazines, internet and television advertisements, attractive DS information, and ease of purchase from pharmacies and supermarkets, because there is no need for a prescription to purchase and therefore the product is called over the counter (OTC). In addition to the wide range of prices for each product, certain supplements are available at low prices and are affordable for most of them.
Also the majority of athletes who know that these DS are not safe for long-term use and over-consumption of DS may have negative health effects. The results of this study were consistent with those of previous studies that showed a high rate of consumption, such as a study in Southeast Europe of 912 elite athletes showing that 12.7% of athletes use DS equal to 116 athletes (Sekulic et al., 2019) and a Canadian study of 247 elite athletes found that 99 percent of elite athletes used DS at least once (Kristiansen et al., 2005).
In addition, there were statistical significant differences between the athlete's knowledge of athlete practice (P = 0.024), but their attitude did not affect the practice (P = 0.161) because they believed that nutritional supplementation was an essential component of improving their athletic performance (Maughan et al., 2007).
There are no statistical significant differences in nutritional knowledge and practice for DSs due to gender (P = 0.335, P = 0.490) While statistical significant differences in nutritional behavior for DS due to gender (P = 0.006).The proportion of attitudes for females was almost higher than for males because females have healthier beliefs than males in general. These results were similar to those of the Heikkinen et al. (2011) study conducted in elite Finnish athletes and showed no difference in the use of DS between male and female elite athletes either in the prospective study in 2002 or in the follow-up study in 2009.
In the same field, there are statistical significant differences in knowledge and attitude on DS due to sport type between athletes (P = 0.002, P = 0.000), Whereas 100% of taekwondo athletes use DS and are the most widely used, followed by football athletes with 58% also team sports athletes are more likely to use DS than individual sports athletes. Also in terms of practice and attitude, boxing and karate were superior parts of the questionnaire, but the highest degree of knowledge mostly belonged to Muaythai. These results were similar to a study conducted in elite Finnish athletes, which showed that speed and power athletes were the highest in DS use (Heikkinen et al., 2011). Also a study conducted on elite Lithuanian athletes showed that all DS use among athletes in team sports was higher than among athletes in individual sports (Baranauskas et al.,2020).
As for the difference between knowledge, attitude and practice of DS depending on the BMI, there was no significant statistical difference in practice (P = 0.623), knowledge (P = 0.323) and attitude (P = 0.070) between these groups due to the convergence of responses between all groups. These results were the opposite of the recently conducted study, which showed statistically significant differences in the use of DS due to BMI (P < 0001) (Barrack et al.,2020).
Also, 50% of underweight athletes use DS, while only 37% of overweight athletes take DS and 42% of normal weight athletes use DS. This could be an indication that underweight athletes are more likely to use DS to replace body weight loss and increase muscle mass.
On the other hand, the education level categories had statistically significant differences in the athlete's knowledge of DS (P = 0.006), where diploma athletes had the highest nutritional supplement knowledge, with approximately 55% having good knowledge, while 50.7% of graduate athletes and 42.3% of graduate athletes had good knowledge of DS. There were no statistically significant differences in attitudes (P = 0.499) and practices (P = 0.160) in the education level categories. They are due to their adherence to the consumption of DS as part of their concern to have good performance to improve recovery, to try to have an athletic and healthy body shape and to prevent any deficiency in vitamins and minerals (Barrack et al. ,2020).
In addition, the percentage of athletes holding a diploma was the least used for DS and about 14% followed by students holding a university degree by 40% and those holding a secondary degree by 42% and the highest in the use of supplements. It's the opposite of what's expected. 63% of university graduates say they have taken DS courses and workshops, while only 43% and 46% of graduates and high school graduates take DS courses and work. This can be explained by the fact that university students are having an impact on each other as they try to improve muscle mass and body appearance (Jawadi et al., 2017).
It has also been shown that there are no statistically significant differences between knowledge, attitudes, and DS practices among elite athletes that can be attributed to age, sleep duration, and experience variables among coaches, similar to those of Heikkinen et al. (2011) which showed that there are no statistical significant differences in age-related DS use. Our study showed that 50% of athletes between 31 and 36 years of age were the most frequent users of DS, although 56% had good knowledge of DS. As for athletes between the ages of 25 and 30, only 37% of them used DS and 42% of athletes under the age of 24 used DS supplements. In addition, long-sleep athletes had the least use of DS, with only about 29% of those using DS, while the average sleeper category was the largest user of DS, with about 50% and 44% of short-sleepers.
As far as income groups are concerned, there were statistical significant differences in DS utilization due to the purchasing power of athletes who have a job (P = 0.011), as 47% of athletes who have a job with DS compared to 29% of unemployed athletes did not use DS, but there were no significant differences in knowledge (P = 0.076) and attitude (P = 0.060) among elite athletes. There was a convergence between the percentage of athletes whose source of income was work and who had good knowledge of DS and athletes whose source of income was family and had good knowledge of DS, as follows: 49% and 42.7%.
One of the most important objectives of this research is to know the influence of coaches on elite athletes on the issue of DS. It was noted that 84.2% of the players considered the coach to be the most important source of information on DS, and this indicates that the coach had a massive impact on elite athletes in terms of DS, such as Parr et al. (1984) which showed that 36.3% of athletes were the source of their nutritional knowledge, and another study showed that 12% was the coach (Graham et al.,2015).
In general, only about 1% of all elite athletes have a knowledge score of 100%, and 53% have a knowledge score of less than 50%, while 47% have a knowledge score of more than 50%, indicating that knowledge of DS among elite athletes is inadequate. They must therefore be subject to courses and seminars on DS and limitations on the use.