Selecting and Specifying Target Behaviours to Enable Nutritional Adherence in Male Academy Footballers

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Therefore, this study, guided by the Behaviour Change Wheel, aimed to select and specify dietary behaviours to underpin a sport nutrition service within an English Football League Championship academy. Two Nominal Group Technique (NGT) workshops (mean duration = 2 h 20 min) with four experienced sport nutritionists, either currently (n = 3) or recently (n = 1) employed at the club, were conducted. Participants generated, ranked, and refined behaviours through structured group discussion, and a follow-up questionnaire. Audio data were descriptively analysed to provide context around behaviour selection and prioritisation. Results Twenty-six behaviours were generated, with a prioritised top 10 identified. The three most important were: 1) consuming ≥3 main meals (≥900 kcal or 13 kcal·kg⁻¹) and 2 snacks daily (≥350 kcal or 5 kcal·kg⁻¹); 2) consuming ≥3 carbohydrate portions (40–50g or 0.5–0.75 g·kg⁻¹) per main meal, and ≥1 per snack; and 3) consuming a protein portion (25–30g or 0.4 g·kg⁻¹) at ≥4 eating occasions daily. These behaviours collectively formed the “meal frequency and portion size guidance.” Other behaviours ranked in the top 10 included fruit and vegetable intake, attendance at club meals, hydration, and cooking from the club recipe app. Practitioners reported difficulty conceptualising behaviours, often defaulting to macronutrient prescriptions, and found prioritisation challenging given the number of valuable behaviours generated. Nonetheless, the iterative NGT process facilitated consensus and provided actionable, evidence-based nutritional guidance. Conclusion This study demonstrates the suitability of the NGT for co-producing and prioritising dietary behaviours, to enable in male academy footballers. This method proved effective in structuring practitioner insights, to inform priority areas in a sport nutrition service. However, working in behavioural terms proved time-intensive, highlighting the need for further behavioural science training for sport nutrition practitioners. Defining what athletes should do , not just what nutrients they should consume, is crucial for designing effective behavioural interventions. These findings will support the design and development of a targeted, theoretically informed intervention to support the health, wellbeing, and performance of male academy footballers. Nominal Group Technique Behaviour Change Wheel sport nutrition football academy adolescent athletes behaviour change athlete development Figures Figure 1 Introduction Adolescence is a nutritionally demanding phase of life, marked by increased energy requirements to support physical growth, biological maturation, and overall development (1,2). For youth athletes, meeting these elevated energy and nutrient needs is critical not only for maintaining health and wellbeing, but also for coping with the demands of training and competition, and for mitigating injury risk (3). Research has highlighted the substantial energy demands experienced by male academy footballers (4,5). For example, under-18 players in a category one Premier League academy have been reported to expend approximately 3500 kcal·day -1 , or 49 kcal·kg -1 ·day -1 (4). These values are comparable to, and in some cases exceed, those observed in adult male professional footballers, whose energy expenditures have been reported at 3566 ± 585 kcal·day -1 (6), and 3285 ± 354 kcal·day -1 (7). These findings underscore the importance of tailored nutritional strategies to support the unique demands of adolescent footballers engaged in training and competition. Despite these increased demands, male academy players consistently fall short of meeting recommended energy and carbohydrate intakes (5,8–11). The most substantial discrepancies between energy intake and expenditure have been observed on heavy training days (-2114 ± 2257 kJ) and match days (-2278 ± 2307 kJ) (8). Furthermore, inadequate carbohydrate consumption has been documented across key time points - before, during, and after training (11), as well as on the day preceding, the day of, and the day following matches among players in the Professional Development Phase (PDP), under-17 to under-23 years (12). These nutritional shortfalls are particularly concerning during congested fixture periods, when the cumulative demands of training and competition are heightened. Insufficient energy and carbohydrate intake during such times may compromise athletic performance, impair recovery, hinder growth and development, and negatively impact overall health. Sport nutritionists play an integral role in the design and delivery of dietary interventions that influence both staff and player behaviours. Historically, sport nutrition research has focused primarily on the physiological and nutritional demands of footballers, contributing to the development of evidence-based guidelines for fuelling strategies, and supplementation protocols (including micronutrients and ergogenic aids (e.g., 13–16)). However, the translation of these recommendations into practice remains underexplored. Bentley and colleagues (17) highlighted this gap, noting the absence of evidence-informed approaches underpinning the design and development of sport nutrition interventions (18). Therefore, there is a need for more robust, theory-driven approaches that support sustainable behaviour change among athletes and support staff in high-performance environments. Behavioural theories are important for understanding why specific actions occur and for identifying the key components, often referred to as the “active ingredients”, that drive behaviour change. These theories help clarify the relationships between behavioural components and the mechanisms through which they interact to influence the likelihood of a particular behaviour (19,20). Without a theoretical foundation, it becomes difficult to determine which aspects of an intervention contributed to change, or why certain components failed to do so (19). When designing interventions to address specific nutrition-related behaviour(s), it is recommended that practitioners adopt both a behaviour change framework and a detailed understanding of the targeted behaviour(s) (21). This dual approach is an integral step in both the design and evaluation of effective interventions (22). The Behaviour Change Wheel (BCW) provides a structured framework for designing behaviour change interventions, beginning with the identification of the specific behaviour to be changed. This ensures that the intervention is grounded in a clear understanding of the behavioural issue, which can then be effectively targeted and evaluated (21). To apply the BCW, intervention designers are guided through three key stages comprising of eight steps. The first stage (i.e., steps one to four) focuses on understanding the behaviour (23). Step one involves defining the problem in behavioural terms; in this case, male academy footballers failing to meet recommended energy and carbohydrate requirements (10,11). Steps two and three then guide researchers to select and specify the target behaviour(s). Recognising that behaviours occur within broader systems and contexts (21,24), designers are encouraged to list all potential behaviours that could lead to the desired outcome (i.e., male academy footballers meeting recommended energy and carbohydrate requirements), before evaluating each one based on its potential impact, likelihood of change, spillover effects, and ease of measurement (21). With growing recognition of the importance of behavioural theory in underpinning sport nutrition services, there has been an emerging shift toward behavioural approaches within male academy football (25–27). However, a critical first step in designing effective interventions is the identification of specific target dietary behaviours (21). The term ‘nutritional guidance’, as referenced in Bentley et al. (28,29), encompasses a wide array of dietary practices aimed at promoting nutritional adherence, yet lacks behavioural specificity. To address this gap, the present study aimed to generate, select, and specify target dietary behaviours to be enabled in male academy footballers. This research employed the Nominal Group Technique (NGT), a structured consensus method widely used across various health contexts (30–32), and previously applied alongside the BCW in areas such as pressure ulcer prevention (33), and diabetes management (34). Selecting and specifying target behaviours provides the foundation for behavioural analysis (i.e., step four of the BCW), helping to determine “what needs to change” to enable those behaviours (21), and forming the basis for a theoretically informed intervention that optimises health, wellbeing, growth, and performance in male academy footballers. Notably, this study represents the first application of the NGT to inform the development of a sport nutrition service, making an important step toward integrating behavioural science into youth football nutrition practice. Methodology and Methods Philosophical stance and biographical positioning This study was situated within an interpretive–pragmatist paradigm, reflecting its dual aim of understanding the lived experiences of delivering sport nutrition services in professional football (35), whilst employing methods deemed most appropriate for addressing the problem (35,36). Pragmatism does not adhere to a singular philosophical stance or ontological position, rather, it advocates for methodological flexibility, selecting approaches based on their suitability to the research context and questions (35,37). This paradigm supports the integration of both qualitative and quantitative methods, enabling researchers to draw on the strengths and assumptions of each, to generate a more comprehensive understanding of complex phenomena (36,38). Such an approach is particularly valuable in applied sport settings. As researcher-practitioners, we acknowledge that our beliefs, experiences and professional backgrounds may have influenced the research process (39). All authors are actively engaged in sport at various levels and share a common commitment to advancing the professional practice of sport and exercise nutrition, and protecting the health and wellbeing of adolescent athletes. Collectively, the team brings over 40 years of experience working with athletes and support personnel on issues related to dietary behaviour. The first author's five-year tenure as a researcher-practitioner within an academy football club directly informed the research question, facilitated rapport with participants, and enriched the depth of discussion throughout the study. Additional contributions included over nine years of researcher-practitioner experience in sport nutrition (XX), two seasons of applied sport nutrition experience within academy football and seven seasons within professional male football (XX), and over 20 years of practitioner–researcher experience in sport and exercise science (XX). This diverse and extensive practitioner insight strengthened the study’s relevance and practical applicability, while also supporting a reflexive approach to data analysis and interpretation. To enhance reflexivity, XX maintained a reflexive journal (40) to acknowledge personal subjectivity and the impact of their “position, perspective, and presence” (41, p. 16) on the research process. Regular reflection was important given the dual role as a researcher-practitioner, and for recognising their role in the co-construction of knowledge (39). Research context This research was based within an English Football League (EFL) Championship football club academy, hereafter referred to as the Academy Football Club (AFC). The AFC was ranked Category Four by the Elite Player Performance Plan (EPPP), operating with players from the PDP (under-17 to under-23 years). XX worked two days per week as lead academy nutritionist, providing support to approximately 30 players. This support encompassed both theoretical and practical nutrition education for players, staff, and caregivers (i.e., adults providing player support at home), as well as food provision and mealtime supervision. Additional responsibilities included individual player consultations, body composition assessments for players over 18 years, and body mass monitoring for those over 16 years. In responses to concerns regarding growth, maturation and energy availability among academy players (4,10), the AFC’s nutrition strategy prioritised achieving a positive energy balance amongst under-19 players and most B-Team players. Participants and recruitment A purposeful sampling approach was used to capture context-specific perspectives from experienced sport nutritionists, most familiar with the AFC environment (e.g. team schedule, canteen, and catering department), and the dietary behaviours of male academy footballers. Inclusion included practitioners with current, or recent (within two seasons) employment at the AFC, minimum one years’ experience as a sport nutritionist, minimum graduate accreditation with the Sport and Exercise Nutrition Register (SENR), and experience with PDP players. Four sport nutritionists (male = 3, female = 1) were recruited (mean age = 28 ± 2.9 years; range = 25 - 31 years).Two authors (XX and XX) participated due to their involvement in delivering nutrition services at the club. At the time of data collection, participants had an average of 5 ± 3 years’ experience as a sport nutritionist (range = 2 – 8 years), including 3 ± 1 years in football (range = 1 – 5 years). Study design Two NGT workshops (mean duration = 2 hour 20 minutes) were conducted to identify dietary behaviours that enable male academy players to meet nutritional recommendations. All participants were familiar with the AFC’s nutritional strategy. Prior to the workshops, participants were provided with the nutritional recommendations (13) and dietary intakes (10) relevant to adolescent male football players and were asked to familiarise themselves with this information. This ensured consistency in knowledge and understanding within the group. The workshops had two objectives, 1) identify dietary behaviours that enable male academy players to meet the nutritional recommendations, and 2) rank these behaviours by importance. Workshops were audio recorded and transcribed verbatim to capture participant perspectives. Identifying information (e.g., training locations, and competitions) were omitted, with pseudonyms used to protect participant identity. This study was approved by the XX Local Ethics Committee (reference: 127375). Nominal Group Technique This study applied the ten-stage NGT approach to collaboratively select and specify the dietary behaviours that sport nutritionists should target in their service to enable male academy football players to achieve nutritional recommendations. Figure 1 summarises the workshop stages and the data generated at each stage. [INSERT FIGURE 1 HERE] Stage 1: Introduce The Workshop The structure, and objectives of the workshop were outlined to participants, with an overview of the nutritional recommendations for male academy footballers (13), the AFC nutrition strategy, and the consensus definition of 'behaviour' (20). Behaviour was defined as: “Anything a person does in response to internal or external events. Actions may be overt (motor or verbal) and directly measurable or, covert (activities not viewable but involving voluntary muscles) and indirectly measurable; behaviours are physical events that occur in the body and are controlled by the brain” (20, p. 327). This stage ensured participants had a shared understanding of key concepts relevant to the research question, thereby enabling knowledge generation aligned with the aim of the present research. Stages 2-4: Identify and Clarify Dietary Behaviours. Participants were asked to identify and clarify dietary behaviours that enable male academy players to meet nutritional recommendations. When sharing individual behaviours, participants were asked to only clarify and promote understanding, rather than to challenge ideas. This ensured that participants had equal voice and contribution, and opportunity to share without challenge, modification or rejection (32,43). Whilst sharing, participants were encouraged to ‘hitch-hike’ onto other ideas to generate new thoughts, to contribute at their next turn (31,42). A total of 30 dietary behaviours were produced. Stages 5-6: Choosing and Prioritising Individual Top 10 Behaviours. Participants used a worksheet to select their individual top 10 behaviours, and to rank these according to their likelihood of impact for enabling male academy footballers to meet nutritional recommendations, from one (least important), to ten (most important). Stage 7: Collate Rankings and Comfort Break. During a short break, XX inputted participants’ scores into Excel (Version 16.86, Microsoft Corporation, 2019), to calculate the top 10 behaviours across the group, that will hereon be referred to as the grouped top 10. Given two behaviours received the same score, a total of 11 behaviours, rather than 10, advanced to the next stage. Stage 8: Discussion of Grouped Top 11 Behaviours. The grouped top 11 behaviours were presented on a whiteboard for participant discussion . As XX was both a facilitator and participant, they actively participated in discussion, rather than observing passively (44). To manage power dynamics between early-career and experienced participants, including herself, XX ensured all participants had equal opportunities to contribute, encouraging diverse perspectives, and input from quieter participants (45). Stage 9: Individual Ranking of Grouped Top 11 Behaviours. Participants were asked to individually rank the grouped top 11 behaviours by priority, based on their perceived likelihood of impact for enabling players to achieve nutritional recommendations. Using a worksheet, each behaviour was scored from 0 (least important), to 100 (most important). All data generated from each stage of the workshop is outlined in Figure 1. Stage 10: Conclusion and Close. Participants were thanked for their participation and informed that they would later be emailed a summary document outlining the top 10 behaviours and their descriptions. Following Workshop One Workshop one produced a list of 30 behaviours; however consensus was not achieved. Participants noted that some behaviours had been overlooked in the individual rankings (i.e., stages five to six). For example, recovery behaviours (e.g., “players consume the club-provided post-match recovery strategy” ) were omitted, whist sleep-related behaviours - such as “players maintain a consistent sleep routine,” and “players achieve 7–10 hours’ sleep per night” - were included, despite disagreement among participants regarding their relevance. To resolve this, a second workshop was conducted to repeat stages two to ten of the NGT process. Prior to workshop two, the research team critically reviewed the 30 behaviours generated in workshop one. Guided by behavioural science expertise (XX and XX), behaviours were revised, to ensure alignment with the agreed definition of behaviour (20). For example, “prioritise carbohydrate-based foods at each eating occasion” was amended to “players consume [number of portions to be agreed in workshop two] of carbohydrate at each main meal and [number to be agreed] portions per snack.” The list was also refined to remove duplication, reducing 30 behaviours to 26. For instance, “players prepare and consume their own snacks from the recipe app” and “players cook their own meals” were combined as “players routinely prepare, cook, and consume their own snacks and meals from the club recipe ap p .” Workshop Two During workshop two, stages two to ten of the NGT were repeated, to attempt consensus on the final top 10 dietary behaviours. The 26 behaviours refined from workshop one were presented for review, with participants given time to re-familiarise themselves, challenge amendments to terminology, and suggest additional behaviours (i.e., stages two to four). Participants subsequently selected their individual top 10 behaviours (i.e., stages five to six). Prioritisation had been expressed as a difficult task during workshop one, as Michael shared: “I struggled to get it down to the ten” . Therefore, the lead author emphasised ranking behaviours according to their likelihood of impact for enabling players to achieve nutritional recommendations. The remaining NGT stages were completed, as in workshop one. Questionnaire Following workshop two, participants received a summary of the target dietary behaviours and an electronic questionnaire (Microsoft Word, Version 16.99, Microsoft Corporation, 2019). The questionnaire sought participant reflections on the top 10 list, and encouraged participants to challenge rankings, and provide alternative viewpoints. To address power imbalances between participants and participant-researchers, this format offered time and space for individual reflection, allowing participants to share views they might not have voiced in a group setting. The questionnaire included five-point Likert scales to review: 1) participant agreement with the ranking of behaviours, and 2) the extent to which each behaviour would support male academy players in achieving nutritional recommendations. Open-ended questions invited participants to elaborate on their responses. Following Workshop Two After careful consideration, two further behaviours were removed by the research team, as they were not deemed dietary behaviours, and therefore did not meet the aims of the study. These behaviours included, “Players routinely brush and floss their teeth to maintain dental hygiene,” and “Players wash their hands before every meal.” Data Analysis The NGT workshops generated both quantitative and qualitative data. Quantitative Data Individual and grouped top 10 lists were produced during stages five and six, with grouped rankings generated from combined individual scores. After discussion (stage eight), participants re-scored the grouped top 10 behaviours on a 1–100 scale. Because totals varied, scores were weighted to reflect the relative importance of each behaviour (31,46). Without this, differences in total scores for each behaviour may have been overstated or missed (31). Weighting involved dividing each score by the participant’s total sum across all 10 behaviours, producing “individual weighted top 10 behaviours.” These were then aggregated to create the “grouped weighted top 10 behaviours,” ordered by total score to produce the final list of target dietary behaviours (Figure 1) (31). All quantitative data were analysed using Excel (Version 16.86, Microsoft Corporation, 2019). Qualitative Data Qualitative insights were captured during behaviour generation and clarification (stages two to four), group discussion (stage eight), and responses to open-ended questionnaire items. Audio recordings from both workshops were transcribed verbatim and descriptively reviewed. This approach was deemed most appropriate given the small sample size and provided depth to the quantitative rankings by contextualising participants’ reasoning (32). These data informed the development of grouped behaviours, by providing contextual insights, and offering justification for why specific behaviours were perceived as important, enhancing the interpretive depth and relevance of the final rankings. Subsequently, these data captured reasonings behind changes to individual priorities (stage nine). Questionnaire responses were also descriptively reviewed, informing amendments to terminology, or rankings, when suggested by at least half of participants. Meal Frequency and Portion Size Guidance During analysis, the research team produced “meal frequency and portion size guidance,” from the top three target dietary behaviours. This term reflected a system of interrelated behaviours, identified by participants as essential for male academy footballers to meet nutritional recommendations (47). When selecting and specifying these behaviours, the team considered impact, likelihood of change, spillover effects, and ease of measurement (21). Research Quality In alignment with our interpretive–pragmatist approach (36), we encourage readers to evaluate this research using the following criteria: (a) worthiness of the research, (b) rich rigour, (c) sincerity, (d) credibility, and (e) significant contribution (48,49). Worthiness is demonstrated through the study’s rationale, which addresses the timely and relevant issue of suboptimal energy and macronutrient intake among male academy footballers (10,11). Rich rigour was established by recruiting information-rich participants who provided context-specific insights into dietary behaviours and sport nutrition service delivery. Sincerity was pursued through researcher reflexivity, with positionality acknowledged throughout the design, data construction, and analysis phases. Credibility was enhanced through collaborative reflexive practice, with the research team acting as “critical friends” to challenge interpretations, and explore alternative perspectives (48). Member reflections, captured via post-workshop questionnaires, further contributed to a robust and enriched understanding of the findings. Significant contribution was realised through the novel application of the NGT within sport and behavioural sciences. This study offers a transferable method for selecting, specifying, and prioritising dietary behaviours within a sports nutrition service. Importantly, this process will inform subsequent behavioural analysis and intervention development of a sports nutrition intervention, aligned with the BCW (21). Findings The workshops co-produced a total of 24 behaviours, from which a top 10 list of target behaviours were identified to enable male academy footballers to meet nutritional recommendations (Table 1). From these, the research team synthesised the top three behaviours into meal frequency and portion size guidance. Practitioners reported difficulty with the concept of “behaviour” (as defined by (20)), being more accustomed to working with macronutrient quantities. They also found prioritising their individual top 10 behaviours challenging, due to the number of valuable behaviours generated. Workshop Two Findings Changes to the top 10 target behaviours between workshops, including grouped weightings, are shown in Table 2. During workshop two, “players consume club-provided drinks to hydrate during matches” replaced sleep-related behaviours (e.g., “players go to bed before midnight and achieve 7-10 hours of sleep per night” , originally titled “players have a consistent sleep routine” and “players achieve 7–10 hours’ sleep per night” ). The recovery behaviour “players consume the club-provided post-match recovery strategy” failed to reach the top 10, as participants considered it captured within “players attend and consume all club meals” (target behaviour six). When re-familiarising with behaviours (stages two to four), participants challenged changes to terminology made by the team following workshop one. The shift to “portions” was most contested, with practitioners preferring macronutrient recommendations expressed in grams per kilogram of body weight, as Michael expressed, “Could you put this in grams per kilo? Not in portions. Because I have no idea what a ‘portion’ of carbohydrate is”. One behaviour was also amended following participant discussion, from “players should consume nutritionist-prescribed supplements” to “players should only consume nutritionist-prescribed supplements.” No additional behaviours were generated at this stage. [INSERT TABLE 1 HERE] [INSERT TABLE 2 HERE] Questionnaire Findings Following the questionnaire, four behaviours changed ranking, and two behaviours received terminology changes (Table 2). The questionnaire led to four changes in ranking, and two changes in behavioural terminology (Table 2). “Players attend and consume all club meals” rose from sixth to fifth, and “players increase carbohydrate portion sizes on match days and heavy training days” moved from tenth to ninth. In turn, “players consume club-provided drinks to hydrate during training sessions and matches” dropped from fifth to sixth, and “players attend and consume all club meals” from ninth to tenth. Participants also suggested revising fruit and vegetable intake from “five to ten portions per day” to “at least five portions per day,” noting that higher intake would increase fibre and food volume, potentially suppressing appetite, and reducing overall energy intake. Finally, “players consume club-provided drinks to hydrate during training sessions” and “players consume club-provided drinks to hydrate during matches” were combined into a single behaviour. Meal Frequency and Portion Size Guidance The top three target dietary behaviours captured meal and snack frequency, alongside carbohydrate and protein portion sizes (Table 1). Consequently, the research team clustered these three behaviours together to produce the meal frequency and portion size guidelines for male academy football players, which included 1) players consume at least three meals and two snacks per day, 2) players consume at least one portion of carbohydrate per snack and at least three portions per main meal, and 3) players consume a portion of protein at four eating occasions. However, participants shared establishing energy or nutrient recommendations per portion was critical for supporting players to meet energy and macronutrient requirements. For instance, Michael noted: “If you can’t define from a calorie or a macronutrient perspective what a meal or a snack is, then you get back to the same problem [that players don’t consume enough energy at a main meal or snack occasion].” Therefore, the following target behaviours will outline the meal and snack frequency, and macronutrient portion sizes within these eating occasions. Target Behaviour One: Players consume at least three meals and two snacks per day The highest-ranked behaviour across both workshops was “players consume at least three meals and two snacks per day.” Participants agreed this behaviour was fundamental for achieving positive energy balance and enabling other behaviours (e.g., pre-training or pre-bed snacks), that did not reach the final top 10. As Mary noted: “I voted [for] it based on achieving energy balance,” while Michael added: “You can’t do anything else unless you do that […]. You can’t attend club meals, like that’s pointless if you don’t consume the three [meals and two snacks per day].” Participants highlighted the need to define energy and macronutrient targets for meals and snacks, given the high energy demands of academy footballers (4), which are often unmet (10,11). There was also a shared viewpoint that the definition of an “eating occasion” (i.e., ≥50 kcal and ≥15 minutes apart) according to Leech et al. (50), was inappropriate for athletes. As Jack explained: “Eating occasion is not clear, like main meal is clear. [...] 800 calories, for example. But eating occasion could be just fruit? That’s an eating occasion [as per the definition].” Consensus was reached within the workshops that meals should provide ≥900 kcal (≥13 kcal·kg⁻¹), and snacks ≥350 kcal (≥5 kcal·kg⁻¹). These values align with the estimated daily energy requirements of an under-18 male academy footballer (i.e., ~3500 kcal or ~49 kcal·kg⁻¹·day⁻¹) (4) when achieving the recommended meal frequency (i.e., three meals and two snacks). Target Behaviour Two: Players consume at least one portion* of carbohydrate per snack and at least three portions per main meal The second highest behaviour was “players consume at least one portion* of carbohydrate per snack and at least three portions* per main meal,” with all participants ranking it in their individual weighted top three during workshop two. However, using the term “portion size” was a challenge for participants, being more accustomed to numerical recommendations, rather than promoting dietary behaviours for players to perform. As Michael explained: “Could you put this in grams per kilo? Not in portions. Because I have no idea what a ‘portion’ of carbohydrate is.” Mary added: “We don’t have set portions of carbohydrate. We might have portions of carbohydrate that we give to the chef, such as 300 grams of pasta [...], but we wouldn't have a portion that we'd provide the players.” Consequently, consensus was reached within the workshops that a carbohydrate portion* for players is defined as 40–50 g, or 0.5–0.75 g·kg -1 , equating to 1.5–2.25 g·kg -1 per main meal and 0.5–0.75 g·kg -1 per snack (Table 3). Discussion also focused on behaviour nine: “players increase carbohydrate portion sizes on match days and heavy training days.” Whilst some practitioners opposed carbohydrate periodisation, others argued for youth-specific adaptations. Given male academy players are advised to follow senior guidelines (3–8 g·kg -1 ·day -1 ) (13), and face high energy demands (4), consensus was that intakes should remain high throughout the week, including rest days. As Peter noted: “Your rest day is your opportunity really as a youth player to get in a positive balance. Or they’re just not going to get there.” Accordingly, participants agreed that on match days and heavy training days, carbohydrate should be guided by the upper range of recommendations: 2.25 g·kg -1 per main meal and 0.75 g·kg -1 per snack (Table 1; Table 3). Michael summarised: “In the academy we should be coaching high [carbohydrate intake] and even higher. Because that’s technically periodisation, isn’t it.” Target Behaviour Three: Players consume a portion** of protein at four eating occasions The third target behaviour included “players should consume a portion** of protein at four eating occasions.” During discussion, participants agreed that sport nutritionists need to provide better guidance to players on what constitutes as a protein ‘portion’, noting that many players exceed their protein requirements, consequently impacting energy and carbohydrate intake. For instance, Michael observed: “So many players, they just have too much protein, and it makes them full for anything else,” and Peter added: “I bet if you asked 100 footballers, 98 of them would say a full chicken breast [is a portion of protein].” Consensus was reached within the workshops that a protein portion** for players is defined as 25-30 g or 0.4 g.kg -1 (Table 3). [INSERT TABLE 3 HERE] Discussion The aim of this study was to generate, select, and specify target dietary behaviours which will enable male academy footballers to meet nutritional recommendations, and in turn, adhere to the nutrition strategy of an EFL Championship club academy. Using the NGT, 24 context-specific behaviours were identified and prioritised into a top 10 list. Specifically, behaviours generated the meal frequency and portion size guidance to elicit in male academy footballers, to promote a positive energy balance, and to optimise growth, physical development, health and performance. In this study, practitioners reported difficulty conceptualising “behaviour,” being most accustomed to prescribing macronutrient quantities (i.e. grams per kilogram) than in behavioural terms (i.e., food consumption behaviours, including energy or nutrient recommendations per portion), emphasising the need for further support in behavioural science. Practitioners also found prioritisation challenging, given the number of valuable behaviours generated. The NGT showed potential as an effective prioritisation method in sport science, despite proving time intensive. This research developed a practical and behaviourally informed framework for engaging with elite youth male football players and collaborating with supporting stakeholders to deliver nutritional guidance that is both useful and usable. The three most important dietary behaviours identified were: 1) consuming at least three main meals and two snacks per day, 2) including at least three portions of carbohydrate per main meal and one per snack, and 3) consuming a portion of protein at four eating occasions daily. Together, these behaviours formed meal frequency and portion size guidelines, viewed as most impactful for achieving nutritional recommendations. Other behaviours in the top 10 included fruit and vegetable intake, attending club meals and workshops, preparing meals from the club recipe app, hydration strategies, and carbohydrate periodisation. In line with the BCW, there is a need to identify target behaviours to inform the design and development of behavioural interventions (21). “Nutritional adherence” encapsulates many dietary behaviours which seek to achieve nutrition recommendations and has previously been used to explore barriers and enablers in athletes and practitioners (25,28,29). However, defining the specific target behaviours which fall within this term will enable nutrition services to focus interventions where they are deemed most effective. Additionally, using a cluster of three related behaviours (i.e., the meal frequency and portion size guidance), rather than one singular behaviour in isolation, is anticipated to enhance player ability to meet nutrition recommendations, and replicates a constellation approach (i.e., using multiple, related behaviours), as applied within COVID-19 prevention (47). In this study, sport nutrition practitioners found it challenging to select a top 10 list of dietary behaviours, highlighting the importance of prioritisation and consensus before implementing a club academy nutrition strategy involving multiple interventions. Designing the NGT around a clear research question (31,32), and familiarising participants with nutritional recommendations, ensured context-specific behaviours, tailored to enhance health, wellbeing, growth, and performance outcomes (51,52). Yet, despite working together for several seasons and sharing a common vision (e.g., achieving a positive daily energy balance), practitioners lacked alignment on which dietary behaviours to target, or how to define them. To address this, practitioners should first invest time in clarifying and prioritising key target behaviours aligned with their nutrition strategy. This process can be guided by Michie et al. (21), who recommend evaluating potential behaviours based on impact, likelihood of change, and spillover effects. Sport nutrition practitioners reported challenges when working with behaviours, often preferring to focus on macronutrient targets (e.g., grams per kilogram of body weight) rather than framing recommendations in behavioural terms (e.g., specifying what players should do to achieve a given intake). This tendency frequently resulted in vague or non-actionable guidance (e.g., “players maintain hydration status”), without clearly defined behaviours (e.g., “players consume X mL of fluid per kilogram of body weight at each meal”). Similar difficulties were documented by Farrell et al. (53) in the application of the BCW within long-term care settings, where translating theoretical constructs into practical actions proved challenging. These issues likely stem from the traditional education of sport nutritionists, which has emphasised nutrition physiology and quantitative research methods (14–16), often at the expense of implementation science. This disciplinary focus may limit practitioners’ ability to conceptualise and facilitate behaviour change in applied settings. To address this gap, practitioners require support to strengthen their understanding of behavioural science (18), enabling them to translate evidence into clearly defined dietary behaviours that can be coached, monitored, and evaluated in daily practice, such as through the use of key performance behavioural dietary indicators. Whilst working in behavioural terms proved challenging and time consuming, the NGT showed potential as a transferrable and usable prioritisation tool within wider sport science. Applying the NGT to a sport nutrition service design generated a measurable framework aligned with the AFC nutrition strategy and centred on the top three consensus behaviours (i.e., the meal frequency and portion size guidance). These behaviours were specified for meals, snacks, and across contexts (rest, training, and match days), resulting in a practical framework for sports nutrition to communicate with players and support their nutritional adherence Developing this framework required an iterative process that allowed practitioners to reflect on applying behavioural science and prioritise behaviours most likely to influence adherence. However, the time-intensive nature of this work underlines the importance of establishing clear priorities before delivering interventions, through defining which behaviours are to be targeted before attempting change. This repeated-phase approach mirrors evidence-based programme development in other fields (e.g., (54)), and aims to support actionable, athlete-centred practices. Additionally, this research offers a behaviourally informed framework to support the professional practice of sports nutritionists, specifically in the design of nutritional services underpinned by a clearly defined behavioural problem and target behaviour. This clarity facilitates the effective targeting and evaluation of interventions to assess and understand the impact of sport nutrition service provision. Practical applications This study demonstrates how the NGT can serve as a practical tool for the design, development, and prioritisation of a sport nutrition service. By framing recommendations as behaviours, this study shows how nutrition recommendations can be translated into measurable actions, to inform player and staff education. For practitioners, this highlights the value of agreeing on specific behaviours in advance, ensuring clarity in high-performance sporting environments. Repeating the NGT process across seasons may help to adapt services to evolving squad needs and performance contexts, whilst including wider performance staff (e.g., coaches, chefs, medical, and management), may enhance collaboration in service design and development. Finally, the challenges practitioners faced in conceptualising “behaviour” highlight the need for professional development in behavioural science, equipping sport nutritionists with tools to bridge evidence and practice more effectively. Together, these insights provide a framework for building athlete-centred, behaviourally informed nutrition services in elite football academies. Strengths, limitations, and future directions This study recruited information-rich participants with significant contextual experience, enabling the generation of relevant and timely target dietary behaviours to enable male academy footballers to meet nutritional recommendations, and in turn the AFC nutrition strategy. The NGT supported balanced contributions through structured discussions and anonymous feedback, producing a practical list of behaviours deemed important for achieving nutritional recommendations. Furthermore, experience in behavioural science across the research team supported the alignment of behavioural terminology (i.e., (20)). Despite these strengths, the exclusion of key stakeholders, including management, performance and medical staff, players, chefs, and caregivers, may limit the adoption of behaviours in practice. Stakeholder inclusion may increase the impact of behaviour change research, through an enhanced sense of ownership, accountability, and buy in (55). Despite efforts to minimise power imbalances, less experienced practitioners may have found it challenging to fully contribute during discussions. In recognition of this, XX ensured all participants had equal opportunity for contribution, seeking opinions from quieter participants. Additionally, the questionnaire encouraged individual feedback, without fear of challenge. This process was conducted in a singular club environment, which may be perceived as a limitation of this research. However, this technique generated target behaviours, judged by participants as fundamental for achieving nutritional recommendations within the investigated environment. Readers are asked to consider naturalistic generalisability and if the findings resonate with them, their environment, or their experiences (56). Additionally, readers are encouraged to question if aspects of this approach can be transferable to their own environment (49), such as through applying the NGT elsewhere, or by considering athlete behaviours first, without skipping to solutions (i.e., intervention delivery). Typically, a behavioural analysis is centred around a singular target behaviour (57). However, using a cluster of three related behaviours (i.e., the meal frequency and portion size guidance) may enhance the ability for male academy footballers to meet nutritional recommendations (47). Future research should “identify what needs to change” for the target behaviours to occur (i.e., stage one, step four of the BCW), identify intervention options (i.e., stage two of the BCW), and identify content and implementation functions (i.e., stage three of the BCW) (23), to develop theoretically-informed solutions to elicit dietary behaviours in male academy footballers. Conclusion This study aimed to identify and specify dietary behaviours that support male academy footballers in meeting nutritional recommendations. Using the NGT, 24 dietary behaviours were generated and refined into a top 10 list, informing the development of the meal frequency and portion size guidelines. Whilst the NGT proved effective in structuring and prioritising insights, practitioners found working in behavioural terms challenging. This highlights the need for further training in behavioural science for sport nutrition practitioners, to translate nutritional recommendations into measurable actions. By focusing on a cluster of three target behaviours, this study provides a practical and transferable framework for nutrition service delivery in academy football. The next phase of this research programme will explore the barriers and enablers to following the meal frequency and portion size guidance (step four of the BCW), informing the design of interventions that improve dietary behaviours of male academy footballers, thereby supporting optimal health, wellbeing, growth, and performance. Abbreviations BCW Behaviour Change Wheel NGT Nominal Group Technique PDP Professional Development Phase EFL English Football League AFC Academy Football Club EPPP Elite Player Performance Plan SENR Sport and Exercise Nutrition Register Declarations Ethics approval and consent to participate Ethical approval for this study was obtained from XX Research Ethics Committee (approval ref: 127375). All participants provided informed consent to participate. Consent for publication All participants provided informed consent for their data to be published. Availability of data and materials The data generated and analysed during the current study are available from the corresponding author [XX], on reasonable request. Competing interests The authors declare no competing interests. Funding XX is supported by a PhD studentship sponsored by XX in collaboration with XX. Authors' contributions XX: Conceptualisation, Methodology, Data collection, Data analysis, Writing, Editing. XX, XX, XX: Conceptualisation, Methodology, Data analysis, Review, Editing, Supervision. Acknowledgements The authors would like to acknowledge all participants for taking the time to contribute to this research. Authors' information (optional) ORCiD: XX References Desbrow B. Youth Athlete Development and Nutrition. Sports Med. 2021 Sept;51(S1):3–12. Spear BA. Adolescent growth and development. J Am Diet Assoc. 2002;102(3 Suppl):S23-9. Petrie HJ, Stover EA, Horswill CA. Nutritional concerns for the child and adolescent competitor. Nutrition. 2004 July;20(7–8):620–31. Hannon MP, Parker LJF, Carney DJ, McKeown J, Speakman JR, Hambly C, et al. Energy Requirements of Male Academy Soccer Players from the English Premier League. Med Sci Sports Exerc. 2021 Jan;53(1):200–10. Russell M, Pennock A. Dietary Analysis of Young Professional Soccer Players for 1 Week During the Competitive Season. J Strength Cond Res. 2011 July;25(7):1816–23. 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The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement Sci [Internet]. 2011 Dec [cited 2023 Dec 4];6(42). Available from: http://www.implementationscience.com/content/6/1/42 National Health Service. nhs.uk. 2022 [cited 2024 July 4]. 5 A Day portion sizes. Available from: https://www.nhs.uk/live-well/eat-well/5-a-day/portion-sizes/ Tables Tables are available in the Supplementary Files section. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7792728","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":535014078,"identity":"f3696f6e-db0b-444e-804f-b18bc53b6392","order_by":0,"name":"Stephanie V 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For youth athletes, meeting these elevated energy and nutrient needs is critical not only for maintaining health and wellbeing, but also for coping with the demands of training and competition, and for mitigating injury risk (3). Research has highlighted the substantial energy demands experienced by male academy footballers (4,5). For example, under-18 players in a category one Premier League academy have been reported to expend approximately 3500 kcal\u0026middot;day\u003csup\u003e-1\u003c/sup\u003e, or 49 kcal\u0026middot;kg\u003csup\u003e-1\u003c/sup\u003e\u0026middot;day\u003csup\u003e-1\u0026nbsp;\u003c/sup\u003e(4). These values are comparable to, and in some cases exceed, those observed in adult male professional footballers, whose energy expenditures have been reported at 3566 \u0026plusmn; 585\u0026nbsp;kcal\u0026middot;day\u003csup\u003e-1\u0026nbsp;\u003c/sup\u003e(6), and 3285 \u0026plusmn; 354 kcal\u0026middot;day\u003csup\u003e-1\u0026nbsp;\u003c/sup\u003e(7). These findings underscore the importance of tailored nutritional strategies to support the unique demands of adolescent footballers engaged in training and competition.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDespite these increased demands, male academy players consistently fall short of meeting recommended energy and carbohydrate intakes\u0026nbsp;(5,8\u0026ndash;11). The most substantial discrepancies between energy intake and expenditure have been observed on heavy training days (-2114 \u0026plusmn; 2257 kJ) and match days (-2278 \u0026plusmn; 2307 kJ) (8). Furthermore, inadequate carbohydrate consumption has been documented across key time points - before, during, and after training (11), as well as on the day preceding, the day of, and the day following matches among players in the Professional Development Phase\u0026nbsp;(PDP), under-17 to under-23 years (12). These nutritional shortfalls are particularly concerning during congested fixture periods, when the cumulative demands of training and competition are heightened. Insufficient energy and carbohydrate intake during such times may compromise athletic performance, impair recovery, hinder growth and development, and negatively impact overall health.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSport nutritionists play an integral role in the design and delivery of dietary interventions\u0026nbsp;that influence both staff and player behaviours. Historically, sport nutrition research has focused primarily on the physiological and nutritional demands of footballers, contributing to the development of evidence-based guidelines for fuelling strategies, and supplementation protocols (including micronutrients and ergogenic aids (e.g.,\u0026nbsp;13\u0026ndash;16)). However, the translation of these recommendations into practice remains underexplored. Bentley and colleagues (17) highlighted this gap, noting the absence of evidence-informed approaches underpinning the design and development of sport nutrition interventions (18). Therefore, there is a need for more robust, theory-driven approaches that support sustainable behaviour change among athletes and support staff in high-performance environments.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBehavioural theories are important for understanding why specific actions occur and for identifying the key components, often referred to as the \u0026ldquo;active ingredients\u0026rdquo;, that drive behaviour change. These theories help clarify the relationships between behavioural components and the mechanisms through which they interact to influence the likelihood of a particular behaviour (19,20). Without a theoretical foundation, it becomes difficult to determine which aspects of an intervention contributed to change, or why certain components failed to do so (19). When designing interventions to address specific nutrition-related behaviour(s), it is recommended that practitioners adopt both a behaviour change framework and a detailed understanding of the targeted behaviour(s) (21). This dual approach is an integral step in both the design and evaluation of effective interventions (22).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Behaviour Change Wheel (BCW) provides a structured framework for designing behaviour change interventions, beginning with the identification of the specific behaviour to be changed. This ensures that the intervention is grounded in a clear understanding of the behavioural issue, which can then be effectively targeted and evaluated (21). To apply the BCW, intervention designers are guided through three key stages comprising of eight steps. The first stage (i.e., steps one to four) focuses on understanding the behaviour (23). Step one involves defining the problem in behavioural terms; in this case, male academy footballers failing to meet recommended energy and carbohydrate requirements (10,11). Steps two and three then guide researchers to select and specify the target behaviour(s). Recognising that\u0026nbsp;behaviours occur within broader systems and contexts (21,24),\u0026nbsp;designers are encouraged to list all potential behaviours that could lead to the desired outcome (i.e.,\u0026nbsp;male academy footballers meeting recommended energy and carbohydrate requirements), before evaluating each one based on its potential impact, likelihood of change, spillover effects, and ease of measurement (21).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWith growing recognition of the importance of behavioural theory in underpinning sport nutrition services, there has been an emerging shift toward behavioural approaches within male academy football (25\u0026ndash;27). However, a critical first step in designing effective interventions is the identification of specific target dietary behaviours (21). The term \u0026lsquo;nutritional guidance\u0026rsquo;, as referenced in Bentley et al. (28,29), encompasses a wide array of dietary practices aimed at promoting nutritional adherence, yet lacks behavioural specificity. To address this gap, the present study aimed to generate, select, and specify target dietary behaviours to be enabled in male academy footballers. This research employed the Nominal Group Technique (NGT), a structured consensus method widely used across various health contexts (30\u0026ndash;32), and previously applied alongside the BCW in areas such as pressure ulcer prevention (33), and diabetes management (34). Selecting and specifying target behaviours provides the foundation for behavioural analysis (i.e., step four of the BCW), helping to determine \u0026ldquo;what needs to change\u0026rdquo; to enable those behaviours (21), and forming the basis for a theoretically informed intervention that optimises health, wellbeing, growth, and performance in male academy footballers. Notably, this study represents the first application of the NGT to inform the development of a sport nutrition service, making an important step toward integrating behavioural science into youth football nutrition practice.\u0026nbsp;\u003c/p\u003e"},{"header":"Methodology and Methods","content":"\u003ch2\u003ePhilosophical stance and biographical positioning\u003c/h2\u003e\n\u003cp\u003eThis study was situated within an interpretive–pragmatist paradigm, reflecting its dual aim of understanding the lived experiences of delivering sport nutrition services in professional football (35), whilst employing methods deemed most appropriate for addressing the problem (35,36). Pragmatism does not adhere to a singular philosophical stance or ontological position, rather, it advocates for methodological flexibility, selecting approaches based on their suitability to the research context and questions (35,37). This paradigm supports the integration of both qualitative and quantitative methods, enabling researchers to draw on the strengths and assumptions of each, to generate a more comprehensive understanding of complex phenomena (36,38). Such an approach is particularly valuable in applied sport settings.\u003c/p\u003e\n\u003cp\u003eAs researcher-practitioners, we acknowledge that our beliefs, experiences and professional backgrounds may have influenced the research process (39). All authors are actively engaged in sport at various levels and share a common commitment to advancing the professional practice of sport and exercise nutrition, and protecting the health and wellbeing of adolescent athletes. Collectively, the team brings over 40 years of experience working with athletes and support personnel on issues related to dietary behaviour. The first author's five-year tenure as a researcher-practitioner within an academy football club directly informed the research question, facilitated rapport with participants, and enriched the depth of discussion throughout the study. Additional contributions included over nine years of researcher-practitioner experience in sport nutrition (XX), two seasons of applied sport nutrition experience within academy football and seven seasons within professional male football (XX), and over 20 years of practitioner–researcher experience in sport and exercise science (XX). This diverse and extensive practitioner insight strengthened the study’s relevance and practical applicability, while also supporting a reflexive approach to data analysis and interpretation. To enhance reflexivity, XX maintained a reflexive journal (40) to acknowledge personal subjectivity and the impact of their “position, perspective, and presence” (41, p. 16) on the research process. Regular reflection was important given the dual role as a researcher-practitioner, and for recognising their role in the co-construction of knowledge (39). \u003c/p\u003e\n\u003ch2\u003eResearch context \u003c/h2\u003e\n\u003cp\u003eThis research was based within an English Football League (EFL) Championship football club academy, hereafter referred to as the Academy Football Club (AFC). The AFC was ranked Category Four by the Elite Player Performance Plan (EPPP), operating with players from the PDP (under-17 to under-23 years). XX worked two days per week as lead academy nutritionist, providing support to approximately 30 players. This support encompassed both theoretical and practical nutrition education for players, staff, and caregivers (i.e., adults providing player support at home), as well as food provision and mealtime supervision. Additional responsibilities included individual player consultations, body composition assessments for players over 18 years, and body mass monitoring for those over 16 years. In responses to concerns regarding growth, maturation and energy availability among academy players (4,10), the AFC’s nutrition strategy prioritised achieving a positive energy balance amongst under-19 players and most B-Team players. \u003c/p\u003e\n\u003ch2\u003eParticipants and recruitment\u003c/h2\u003e\n\u003cp\u003eA purposeful sampling approach was used to capture context-specific perspectives from experienced sport nutritionists, most familiar with the AFC environment (e.g. team schedule, canteen, and catering department), and the dietary behaviours of male academy footballers. Inclusion included practitioners with current, or recent (within two seasons) employment at the AFC, minimum one years’ experience as a sport nutritionist, minimum graduate accreditation with the Sport and Exercise Nutrition Register (SENR), and experience with PDP players. Four sport nutritionists (male = 3, female = 1) were recruited (mean age = 28 ± 2.9 years; range = 25 - 31 years).Two authors (XX and XX) participated due to their involvement in delivering nutrition services at the club. At the time of data collection, participants had an average of 5 ± 3 years’ experience as a sport nutritionist (range = 2 – 8 years), including 3 ± 1 years in football (range = 1 – 5 years).\u003c/p\u003e\n\u003ch2\u003eStudy design\u003c/h2\u003e\n\u003cp\u003eTwo NGT workshops (mean duration = 2 hour 20 minutes) were conducted to identify dietary behaviours that enable male academy players to meet nutritional recommendations. All participants were familiar with the AFC’s nutritional strategy. Prior to the workshops, participants were provided with the nutritional recommendations (13) and dietary intakes (10) relevant to adolescent male football players and were asked to familiarise themselves with this information. This ensured consistency in knowledge and understanding within the group. The workshops had two objectives, 1) identify dietary behaviours that enable male academy players to meet the nutritional recommendations, and 2) rank these behaviours by importance. Workshops were audio recorded and transcribed verbatim to capture participant perspectives. Identifying information (e.g., training locations, and competitions) were omitted, with pseudonyms used to protect participant identity. This study was approved by the XX Local Ethics Committee (reference: 127375). \u003c/p\u003e\n\u003ch2\u003eNominal Group Technique\u003c/h2\u003e\n\u003cp\u003eThis study applied the ten-stage NGT approach to collaboratively select and specify the dietary behaviours that sport nutritionists should target in their service to enable male academy football players to achieve nutritional recommendations. Figure 1 summarises the workshop stages and the data generated at each stage. \u003c/p\u003e\n\u003cp\u003e[INSERT FIGURE 1 HERE]\u003c/p\u003e\n\u003ch3\u003eStage 1: Introduce The Workshop\u003c/h3\u003e\n\u003cp\u003eThe structure, and objectives of the workshop were outlined to participants, with an overview of the nutritional recommendations for male academy footballers (13), the AFC nutrition strategy, and the consensus definition of 'behaviour' (20). Behaviour was defined as: \u003c/p\u003e\n\u003cp\u003e\u003cem\u003e“Anything a person does in response to internal or external events. Actions may be overt (motor or verbal) and directly measurable or, covert (activities not viewable but involving voluntary muscles) and indirectly measurable; behaviours are physical events that occur in the body and are controlled by the brain” \u003c/em\u003e(20, p. 327). \u003c/p\u003e\n\u003cp\u003eThis stage ensured participants had a shared understanding of key concepts relevant to the research question, thereby enabling knowledge generation aligned with the aim of the present research.\u003c/p\u003e\n\u003ch3\u003eStages 2-4: Identify and Clarify Dietary Behaviours. \u003c/h3\u003e\n\u003cp\u003eParticipants were asked to identify and clarify dietary behaviours that enable male academy players to meet nutritional recommendations. When sharing individual behaviours, participants were asked to only clarify and promote understanding, rather than to challenge ideas. This ensured that participants had equal voice and contribution, and opportunity to share without challenge, modification or rejection (32,43). Whilst sharing, participants were encouraged to ‘hitch-hike’ onto other ideas to generate new thoughts, to contribute at their next turn (31,42). A total of 30 dietary behaviours were produced.\u003c/p\u003e\n\u003ch3\u003eStages 5-6: Choosing and Prioritising Individual Top 10 Behaviours. \u003c/h3\u003e\n\u003cp\u003eParticipants used a worksheet to select their individual top 10 behaviours, and to rank these according to their likelihood of impact for enabling male academy footballers to meet nutritional recommendations, from \u003cem\u003eone\u003c/em\u003e (least important), to \u003cem\u003eten\u003c/em\u003e (most important). \u003c/p\u003e\n\u003ch3\u003eStage 7: Collate Rankings and Comfort Break.\u003c/h3\u003e\n\u003cp\u003eDuring a short break, XX inputted participants’ scores into Excel (Version 16.86, Microsoft Corporation, 2019), to calculate the top 10 behaviours across the group, that will hereon be referred to as the grouped top 10. Given two behaviours received the same score, a total of 11 behaviours, rather than 10, advanced to the next stage.\u003c/p\u003e\n\u003ch3\u003eStage 8: Discussion of Grouped Top 11 Behaviours. \u003c/h3\u003e\n\u003cp\u003eThe grouped top 11 behaviours were presented on a whiteboard for participant discussion\u003cem\u003e.\u003c/em\u003e As XX was both a facilitator and participant, they actively participated in discussion, rather than observing passively (44). To manage power dynamics between early-career and experienced participants, including herself, XX ensured all participants had equal opportunities to contribute, encouraging diverse perspectives, and input from quieter participants (45).\u003c/p\u003e\n\u003ch3\u003eStage 9: Individual Ranking of Grouped Top 11 Behaviours.\u003c/h3\u003e\n\u003cp\u003eParticipants were asked to individually rank the grouped top 11 behaviours by priority, based on their perceived likelihood of impact for enabling players to achieve nutritional recommendations. Using a worksheet, each behaviour was scored from 0 (least important), to 100 (most important). All data generated from each stage of the workshop is outlined in Figure 1. \u003c/p\u003e\n\u003ch3\u003eStage 10: Conclusion and Close. \u003c/h3\u003e\n\u003cp\u003eParticipants were thanked for their participation and informed that they would later be emailed a summary document outlining the top 10 behaviours and their descriptions. \u003c/p\u003e\n\u003ch2\u003eFollowing Workshop One\u003c/h2\u003e\n\u003cp\u003eWorkshop one produced a list of 30 behaviours; however consensus was not achieved. Participants noted that some behaviours had been overlooked in the individual rankings (i.e., stages five to six). For example, recovery behaviours (e.g., \u003cem\u003e“players consume the club-provided post-match recovery strategy”\u003c/em\u003e) were omitted, whist sleep-related behaviours - such as \u003cem\u003e“players maintain a consistent sleep routine,”\u003c/em\u003e and \u003cem\u003e“players achieve 7–10 hours’ sleep per night”\u003c/em\u003e - were included, despite disagreement among participants regarding their relevance. To resolve this, a second workshop was conducted to repeat stages two to ten of the NGT process.\u003c/p\u003e\n\u003cp\u003ePrior to workshop two, the research team critically reviewed the 30 behaviours generated in workshop one. Guided by behavioural science expertise (XX and XX), behaviours were revised, to ensure alignment with the agreed definition of behaviour (20). For example, \u003cem\u003e“prioritise carbohydrate-based foods at each eating occasion”\u003c/em\u003e was amended to \u003cem\u003e“players consume [number of portions to be agreed in workshop two] of carbohydrate at each main meal and [number to be agreed] portions per snack.”\u003c/em\u003e The list was also refined to remove duplication, reducing 30 behaviours to 26. For instance, \u003cem\u003e“players prepare and consume their own snacks from the recipe app”\u003c/em\u003e and \u003cem\u003e“players cook their own meals”\u003c/em\u003e were combined as \u003cem\u003e“players routinely prepare, cook, and consume their own snacks and meals from the club recipe ap\u003c/em\u003e\u003cem\u003ep\u003c/em\u003e\u003cem\u003e.”\u003c/em\u003e\u003c/p\u003e\n\u003ch2\u003eWorkshop Two\u003c/h2\u003e\n\u003cp\u003eDuring workshop two, stages two to ten of the NGT were repeated, to attempt consensus on the final top 10 dietary behaviours. The 26 behaviours refined from workshop one were presented for review, with participants given time to re-familiarise themselves, challenge amendments to terminology, and suggest additional behaviours (i.e., stages two to four). Participants subsequently selected their individual top 10 behaviours (i.e., stages five to six). Prioritisation had been expressed as a difficult task during workshop one, as Michael shared: \u003cem\u003e“I struggled to get it down to the ten”\u003c/em\u003e. Therefore, the lead author emphasised ranking behaviours according to their likelihood of impact for enabling players to achieve nutritional recommendations. The remaining NGT stages were completed, as in workshop one.\u003c/p\u003e\n\u003ch2\u003eQuestionnaire\u003c/h2\u003e\n\u003cp\u003eFollowing workshop two, participants received a summary of the target dietary behaviours and an electronic questionnaire (Microsoft Word, Version 16.99, Microsoft Corporation, 2019). The questionnaire sought participant reflections on the top 10 list, and encouraged participants to challenge rankings, and provide alternative viewpoints. To address power imbalances between participants and participant-researchers, this format offered time and space for individual reflection, allowing participants to share views they might not have voiced in a group setting. The questionnaire included five-point Likert scales to review: 1) participant agreement with the ranking of behaviours, and 2) the extent to which each behaviour would support male academy players in achieving nutritional recommendations. Open-ended questions invited participants to elaborate on their responses.\u003c/p\u003e\n\u003ch2\u003eFollowing Workshop Two\u003c/h2\u003e\n\u003cp\u003eAfter careful consideration, two further behaviours were removed by the research team, as they were not deemed dietary behaviours, and therefore did not meet the aims of the study. These behaviours included, \u003cem\u003e“Players routinely brush and floss their teeth to maintain dental hygiene,”\u003c/em\u003e and \u003cem\u003e“Players wash their hands before every meal.” \u003c/em\u003e\u003c/p\u003e\n\u003ch2\u003eData Analysis\u003c/h2\u003e\n\u003cp\u003eThe NGT workshops generated both quantitative and qualitative data. \u003c/p\u003e\n\u003ch3\u003eQuantitative Data\u003c/h3\u003e\n\u003cp\u003eIndividual and grouped top 10 lists were produced during stages five and six, with grouped rankings generated from combined individual scores. After discussion (stage eight), participants re-scored the grouped top 10 behaviours on a 1–100 scale. Because totals varied, scores were weighted to reflect the relative importance of each behaviour (31,46). Without this, differences in total scores for each behaviour may have been overstated or missed (31). Weighting involved dividing each score by the participant’s total sum across all 10 behaviours, producing “individual weighted top 10 behaviours.” These were then aggregated to create the “grouped weighted top 10 behaviours,” ordered by total score to produce the final list of target dietary behaviours (Figure 1) (31). All quantitative data were analysed using Excel (Version 16.86, Microsoft Corporation, 2019).\u003c/p\u003e\n\u003ch3\u003eQualitative Data\u003c/h3\u003e\n\u003cp\u003eQualitative insights were captured during behaviour generation and clarification (stages two to four), group discussion (stage eight), and responses to open-ended questionnaire items. Audio recordings from both workshops were transcribed verbatim and descriptively reviewed. This approach was deemed most appropriate given the small sample size and provided depth to the quantitative rankings by contextualising participants’ reasoning (32). These data informed the development of grouped behaviours, by providing contextual insights, and offering justification for why specific behaviours were perceived as important, enhancing the interpretive depth and relevance of the final rankings. Subsequently, these data captured reasonings behind changes to individual priorities (stage nine). Questionnaire responses were also descriptively reviewed, informing amendments to terminology, or rankings, when suggested by at least half of participants.\u003c/p\u003e\n\u003ch3\u003eMeal Frequency and Portion Size Guidance\u003c/h3\u003e\n\u003cp\u003eDuring analysis, the research team produced “meal frequency and portion size guidance,” from the top three target dietary behaviours. This term reflected a system of interrelated behaviours, identified by participants as essential for male academy footballers to meet nutritional recommendations (47). When selecting and specifying these behaviours, the team considered impact, likelihood of change, spillover effects, and ease of measurement (21).\u003c/p\u003e\n\u003ch2\u003eResearch Quality \u003c/h2\u003e\n\u003cp\u003eIn alignment with our interpretive–pragmatist approach (36), we encourage readers to evaluate this research using the following criteria: (a) worthiness of the research, (b) rich rigour, (c) sincerity, (d) credibility, and (e) significant contribution (48,49). Worthiness is demonstrated through the study’s rationale, which addresses the timely and relevant issue of suboptimal energy and macronutrient intake among male academy footballers (10,11). Rich rigour was established by recruiting information-rich participants who provided context-specific insights into dietary behaviours and sport nutrition service delivery. Sincerity was pursued through researcher reflexivity, with positionality acknowledged throughout the design, data construction, and analysis phases. Credibility was enhanced through collaborative reflexive practice, with the research team acting as “critical friends” to challenge interpretations, and explore alternative perspectives (48). Member reflections, captured via post-workshop questionnaires, further contributed to a robust and enriched understanding of the findings. Significant contribution was realised through the novel application of the NGT within sport and behavioural sciences. This study offers a transferable method for selecting, specifying, and prioritising dietary behaviours within a sports nutrition service. Importantly, this process will inform subsequent behavioural analysis and intervention development of a sports nutrition intervention, aligned with the BCW (21).\u003c/p\u003e"},{"header":"Findings","content":"\u003cp\u003eThe workshops co-produced a total of 24 behaviours, from which a top 10 list of target behaviours were identified to enable male academy footballers to meet nutritional recommendations (Table 1). From these, the research team synthesised the top three behaviours into meal frequency and portion size guidance. Practitioners reported difficulty with the concept of “behaviour” (as defined by (20)), being more accustomed to working with macronutrient quantities. They also found prioritising their individual top 10 behaviours challenging, due to the number of valuable behaviours generated.\u003c/p\u003e\n\u003cp\u003eWorkshop Two Findings\u003c/p\u003e\n\u003cp\u003eChanges to the top 10 target behaviours between workshops, including grouped weightings, are shown in Table 2. During workshop two, \u003cem\u003e“players consume club-provided drinks to hydrate during matches”\u003c/em\u003e replaced sleep-related behaviours (e.g., \u003cem\u003e“players go to bed before midnight and achieve 7-10 hours of sleep per night”\u003c/em\u003e, originally\u003cem\u003e\u0026nbsp;\u003c/em\u003etitled\u003cem\u003e\u0026nbsp;“players have a consistent sleep routine”\u0026nbsp;\u003c/em\u003eand\u003cem\u003e\u0026nbsp;“players achieve 7–10 hours’ sleep per night”\u003c/em\u003e). The recovery behaviour \u003cem\u003e“players consume the club-provided post-match recovery strategy”\u003c/em\u003e failed to reach the top 10, as participants considered it captured within \u003cem\u003e“players attend and consume all club meals”\u003c/em\u003e (target behaviour six).\u003c/p\u003e\n\u003cp\u003eWhen re-familiarising with behaviours (stages two to four), participants challenged changes to terminology made by the team following workshop one. The shift to “portions” was most contested, with practitioners preferring macronutrient recommendations expressed in grams per kilogram of body weight, as Michael expressed,\u003cem\u003e\u0026nbsp;“Could you put this in grams per kilo? Not in portions. Because I have no idea what a ‘portion’ of carbohydrate is”.\u003c/em\u003e One behaviour was also amended following participant discussion, from \u003cem\u003e“players should consume nutritionist-prescribed supplements”\u003c/em\u003e to \u003cem\u003e“players should\u0026nbsp;\u003c/em\u003eonly\u003cem\u003e\u0026nbsp;consume nutritionist-prescribed supplements.”\u0026nbsp;\u003c/em\u003eNo additional behaviours were generated at this stage.\u003c/p\u003e\n\u003cp\u003e[INSERT TABLE 1 HERE]\u003c/p\u003e\n\u003cp\u003e[INSERT TABLE 2 HERE]\u003c/p\u003e\n\u003cp\u003eQuestionnaire Findings\u003c/p\u003e\n\u003cp\u003eFollowing the questionnaire, four behaviours changed ranking, and two behaviours received terminology changes (Table 2). The questionnaire led to four changes in ranking, and two changes in behavioural terminology (Table 2). \u003cem\u003e“Players attend and consume all club meals”\u003c/em\u003e rose from sixth to fifth, and \u003cem\u003e“players increase carbohydrate portion sizes on match days and heavy training days”\u003c/em\u003e moved from tenth to ninth. In turn, \u003cem\u003e“players consume club-provided drinks to hydrate during training sessions and matches”\u0026nbsp;\u003c/em\u003edropped from fifth to sixth, and \u003cem\u003e“players attend and consume all club meals”\u0026nbsp;\u003c/em\u003efrom ninth to tenth. Participants also suggested revising fruit and vegetable intake from \u003cem\u003e“five to ten portions per day”\u003c/em\u003e to \u003cem\u003e“at least five portions per day,”\u003c/em\u003e noting that higher intake would increase fibre and food volume, potentially suppressing appetite, and reducing overall energy intake. Finally, \u003cem\u003e“players consume club-provided drinks to hydrate during training sessions”\u003c/em\u003e and \u003cem\u003e“players consume club-provided drinks to hydrate during matches”\u003c/em\u003e were combined into a single behaviour.\u003c/p\u003e\n\u003cp\u003eMeal Frequency and Portion Size Guidance\u003c/p\u003e\n\u003cp\u003eThe top three target dietary behaviours captured meal and snack frequency, alongside carbohydrate and protein portion sizes (Table 1). Consequently, the research team clustered these three behaviours together to produce the meal frequency and portion size guidelines for male academy football players, which included 1) players consume at least three meals and two snacks per day, 2) players consume at least one portion of carbohydrate per snack and at least three portions per main meal, and 3) players consume a portion of protein at four eating occasions. However, participants shared establishing energy or nutrient recommendations per portion was critical for supporting players to meet energy and macronutrient requirements. For instance, Michael noted: “If you can’t define from a calorie or a macronutrient perspective what a meal or a snack is, then you get back to the same problem [that players don’t consume enough energy at a main meal or snack occasion].” Therefore, the following target behaviours will outline the meal and snack frequency, and macronutrient portion sizes within these eating occasions.\u003c/p\u003e\n\u003cp\u003eTarget Behaviour One: Players consume at least three meals and two snacks per day\u003c/p\u003e\n\u003cp\u003eThe highest-ranked behaviour across both workshops was \u003cem\u003e“players consume at least three meals and two snacks per day.”\u003c/em\u003e Participants agreed this behaviour was fundamental for achieving positive energy balance and enabling other behaviours (e.g., pre-training or pre-bed snacks), that did not reach the final top 10. As Mary noted: \u003cem\u003e“I voted [for] it based on achieving energy balance,”\u003c/em\u003e while Michael added: \u003cem\u003e“You can’t do anything else unless you do that […]. You can’t attend club meals, like that’s pointless if you don’t consume the three [meals and two snacks per day].”\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants highlighted the need to define energy and macronutrient targets for meals and snacks, given the high energy demands of academy footballers (4), which are often unmet (10,11). There was also a shared viewpoint that the definition of an “eating occasion” (i.e., ≥50 kcal and ≥15 minutes apart) according to Leech et al. (50), was inappropriate for athletes. As Jack explained: \u003cem\u003e“Eating occasion is not clear, like main meal is clear. [...] 800 calories, for example. But eating occasion could be just fruit? That’s an eating occasion [as per the definition].”\u003c/em\u003e Consensus was reached within the workshops that meals should provide ≥900 kcal (≥13 kcal·kg⁻¹), and snacks ≥350 kcal (≥5 kcal·kg⁻¹). These values align with the estimated daily energy requirements of an under-18 male academy footballer (i.e., ~3500 kcal or ~49 kcal·kg⁻¹·day⁻¹) (4) when achieving the recommended meal frequency (i.e., three meals and two snacks).\u003c/p\u003e\n\u003cp\u003eTarget Behaviour Two: \u003cem\u003ePlayers consume at least one portion* of carbohydrate per snack and at least three portions per main meal\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe second highest behaviour was \u003cem\u003e“players consume at least one portion* of carbohydrate per snack and at least three portions* per main meal,”\u003c/em\u003e with all participants ranking it in their individual weighted top three during workshop two. However, using the term “portion size” was a challenge for participants, being more accustomed to numerical recommendations, rather than promoting dietary behaviours for players to perform. As Michael explained: \u003cem\u003e“Could you put this in grams per kilo? Not in portions. Because I have no idea what a ‘portion’ of carbohydrate is.”\u003c/em\u003e Mary added: \u003cem\u003e“We don’t have set portions of carbohydrate. We might have portions of carbohydrate that we give to the chef, such as 300 grams of pasta [...], but we wouldn't have a portion that we'd provide the players.”\u003c/em\u003e Consequently, consensus was reached within the workshops that a carbohydrate portion* for players is defined as 40–50 g, or 0.5–0.75 g·kg\u003csup\u003e\u0026nbsp;-1\u003c/sup\u003e, equating to 1.5–2.25 g·kg\u003csup\u003e\u0026nbsp;-1\u0026nbsp;\u003c/sup\u003eper main meal and 0.5–0.75 g·kg\u003csup\u003e\u0026nbsp;-1\u0026nbsp;\u003c/sup\u003eper snack (Table 3).\u003c/p\u003e\n\u003cp\u003eDiscussion also focused on behaviour nine: \u003cem\u003e“players increase carbohydrate portion sizes on match days and heavy training days.”\u003c/em\u003e Whilst some practitioners opposed carbohydrate periodisation, others argued for youth-specific adaptations. Given male academy players are advised to follow senior guidelines (3–8 g·kg\u003csup\u003e\u0026nbsp;-1\u003c/sup\u003e·day\u003csup\u003e-1\u003c/sup\u003e) (13), and face high energy demands (4), consensus was that intakes should remain high throughout the week, including rest days. As Peter noted: \u003cem\u003e“Your rest day is your opportunity really as a youth player to get in a positive balance. Or they’re just not going to get there.”\u0026nbsp;\u003c/em\u003eAccordingly, participants agreed that on match days and heavy training days, carbohydrate should be guided by the upper range of recommendations: 2.25 g·kg\u003csup\u003e-1\u003c/sup\u003e per main meal and 0.75 g·kg\u003csup\u003e-1\u003c/sup\u003e per snack (Table 1; Table 3). Michael summarised: \u003cem\u003e“In the academy we should be coaching high [carbohydrate intake] and even higher. Because that’s technically periodisation, isn’t it.”\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTarget Behaviour Three: \u003cem\u003ePlayers consume a portion** of protein at four eating occasions\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe third target behaviour included\u003cem\u003e\u0026nbsp;“players should consume a portion** of protein at four eating occasions.”\u003c/em\u003e During discussion, participants agreed that sport nutritionists need to provide better guidance to players on what constitutes as a protein ‘portion’, noting that many players exceed their protein requirements, consequently impacting energy and carbohydrate intake. For instance, Michael observed: \u003cem\u003e“So many players, they just have too much protein, and it makes them full for anything else,”\u0026nbsp;\u003c/em\u003eand\u003cem\u003e\u0026nbsp;\u003c/em\u003ePeter added:\u003cem\u003e\u0026nbsp;“I bet if you asked 100 footballers, 98 of them would say a full chicken breast [is a portion of protein].”\u0026nbsp;\u003c/em\u003eConsensus was reached within the workshops that a protein portion** for players is defined as 25-30 g or 0.4 g.kg\u003csup\u003e-1\u0026nbsp;\u003c/sup\u003e(Table 3).\u003c/p\u003e\n\u003cp\u003e[INSERT TABLE 3 HERE]\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe aim of this study was to generate, select, and specify target dietary behaviours which will enable male academy footballers to meet nutritional recommendations, and in turn, adhere to the nutrition strategy of an EFL Championship club academy.\u0026nbsp;Using the NGT, 24 context-specific behaviours were identified and prioritised into a top 10 list. Specifically, behaviours generated the meal frequency and portion size guidance to elicit in male academy footballers, to promote a positive energy balance, and to optimise growth, physical development, health and performance. In this study, practitioners reported difficulty conceptualising \u0026ldquo;behaviour,\u0026rdquo; being most accustomed to prescribing macronutrient quantities (i.e. grams per kilogram) than in behavioural terms (i.e., food consumption behaviours, including\u0026nbsp;energy or nutrient recommendations per portion), emphasising the need for further support in behavioural science. Practitioners also found prioritisation challenging, given the number of valuable behaviours generated.\u0026nbsp;The NGT showed potential as an effective prioritisation method in sport science, despite proving time intensive. This research developed a practical and behaviourally informed framework for engaging with elite youth male football players and collaborating with supporting stakeholders to deliver nutritional guidance that is both useful and usable.\u003c/p\u003e\n\u003cp\u003eThe three most important dietary behaviours identified were: 1) consuming at least three main meals and two snacks per day, 2) including at least three portions of carbohydrate per main meal and one per snack, and 3) consuming a portion of protein at four eating occasions daily.\u0026nbsp;Together, these behaviours formed meal frequency and portion size guidelines, viewed as most impactful for achieving nutritional recommendations. Other behaviours in the top 10 included fruit and vegetable intake, attending club meals and workshops, preparing meals from the club recipe app, hydration strategies, and carbohydrate periodisation. In line with the BCW, there is a need to identify target behaviours to\u0026nbsp;inform the design and development of behavioural interventions (21).\u0026nbsp;\u0026ldquo;Nutritional adherence\u0026rdquo; encapsulates many dietary behaviours which seek to achieve nutrition recommendations and has previously been used to explore barriers and enablers in athletes and practitioners (25,28,29). However, defining the specific target behaviours which fall within this term will enable nutrition services to focus interventions where they are deemed most effective.\u0026nbsp;Additionally, using a cluster of three related behaviours (i.e., the meal frequency and portion size guidance), rather than one singular behaviour in isolation, is anticipated to enhance player ability to meet nutrition recommendations, and replicates a constellation approach (i.e., using multiple, related behaviours), as applied within COVID-19 prevention (47).\u003c/p\u003e\n\u003cp\u003eIn this study, sport nutrition practitioners found it challenging to select a top 10 list of dietary behaviours, highlighting the importance of prioritisation and consensus before implementing a club academy nutrition strategy involving multiple interventions. Designing the NGT around a clear research question (31,32), and familiarising participants with nutritional recommendations, ensured context-specific behaviours, tailored to enhance health, wellbeing, growth, and performance outcomes (51,52). Yet, despite working together for several seasons and sharing a common vision (e.g., achieving a positive daily energy balance), practitioners lacked alignment on which dietary behaviours to target, or how to define them. To address this, practitioners should first invest time in clarifying and prioritising key target behaviours aligned with their nutrition strategy. This process can be guided by Michie et al. (21), who recommend evaluating potential behaviours based on impact, likelihood of change, and spillover effects.\u003c/p\u003e\n\u003cp\u003eSport nutrition practitioners reported challenges when working with behaviours, often preferring to focus on macronutrient targets (e.g., grams per kilogram of body weight) rather than framing recommendations in behavioural terms (e.g., specifying what players should do to achieve a given intake). This tendency frequently resulted in vague or non-actionable guidance (e.g., \u0026ldquo;players maintain hydration status\u0026rdquo;), without clearly defined behaviours (e.g., \u0026ldquo;players consume X mL of fluid per kilogram of body weight at each meal\u0026rdquo;). \u0026nbsp;Similar difficulties were documented by Farrell et al. (53) in the application of the BCW within long-term care settings, where translating theoretical constructs into practical actions proved challenging. These issues likely stem from the traditional education of sport nutritionists, which has emphasised nutrition physiology and quantitative research methods (14\u0026ndash;16), often at the expense of implementation science. This disciplinary focus may limit practitioners\u0026rsquo; ability to conceptualise and facilitate behaviour change in applied settings. To address this gap, practitioners require support to strengthen their understanding of behavioural science (18), enabling them to translate evidence into clearly defined dietary behaviours that can be coached, monitored, and evaluated in daily practice, such as through the use of key performance behavioural dietary indicators.\u003c/p\u003e\n\u003cp\u003eWhilst working in behavioural terms proved challenging and time consuming, the NGT showed potential as a transferrable and usable prioritisation tool within wider sport science. Applying the NGT to a sport nutrition service design generated a measurable framework aligned with the AFC nutrition strategy and centred on the top three consensus behaviours (i.e., the meal frequency and portion size guidance). These behaviours were specified for meals, snacks, and across contexts (rest, training, and match days), resulting in a practical framework for sports nutrition to communicate with players and support their nutritional adherence Developing this framework required an iterative process that allowed practitioners to reflect on applying behavioural science and prioritise behaviours most likely to influence adherence. However, the time-intensive nature of this work underlines the importance of establishing clear priorities before delivering interventions, through defining which behaviours are to be targeted before attempting change. This repeated-phase approach mirrors evidence-based programme development in other fields (e.g., (54)), and aims to support actionable, athlete-centred practices. Additionally, this research offers a behaviourally informed framework to support the professional practice of sports nutritionists, specifically in the design of nutritional services underpinned by a clearly defined behavioural problem and target behaviour. This clarity facilitates the effective targeting and evaluation of interventions to assess and understand the impact of sport nutrition service provision. \u0026nbsp;\u003c/p\u003e\n\u003ch2\u003ePractical applications\u003c/h2\u003e\n\u003cp\u003eThis study demonstrates how the NGT can serve as a practical tool for the design, development, and prioritisation of a sport nutrition service. By framing recommendations as behaviours, this study shows how nutrition recommendations can be translated into measurable actions, to inform player and staff education. For practitioners, this highlights the value of agreeing on specific behaviours in advance, ensuring clarity in high-performance sporting environments. Repeating the NGT process across seasons may help to adapt services to evolving squad needs and performance contexts, whilst including wider performance staff (e.g., coaches, chefs, medical, and management), may enhance collaboration in service design and development. Finally, the challenges practitioners faced in conceptualising \u0026ldquo;behaviour\u0026rdquo; highlight the need for professional development in behavioural science, equipping sport nutritionists with tools to bridge evidence and practice more effectively. Together, these insights provide a framework for building athlete-centred, behaviourally informed nutrition services in elite football academies.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eStrengths, limitations, and future directions\u003c/h2\u003e\n\u003cp\u003eThis study recruited information-rich participants with significant contextual experience, enabling the generation of relevant and timely target dietary behaviours to enable male academy footballers to meet nutritional recommendations, and in turn the AFC nutrition strategy. The NGT supported balanced contributions through structured discussions and anonymous feedback, producing a practical list of behaviours deemed important for achieving nutritional recommendations. Furthermore, experience in behavioural science across the research team supported the alignment of behavioural terminology (i.e., (20)).\u003c/p\u003e\n\u003cp\u003eDespite these strengths, the exclusion of key stakeholders, including management, performance and medical staff, players, chefs, and caregivers, may limit the adoption of behaviours in practice. Stakeholder inclusion may increase the impact of behaviour change research, through an enhanced sense of ownership, accountability, and buy in (55). Despite efforts to minimise power imbalances, less experienced practitioners may have found it challenging to fully contribute during discussions.\u0026nbsp;In recognition of this, XX\u0026nbsp;ensured all participants had equal opportunity for contribution, seeking opinions from quieter participants. Additionally, the questionnaire encouraged individual feedback, without fear of challenge.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis process was conducted in a singular club environment, which may be perceived as a limitation of this research. However, this technique generated target behaviours, judged by participants as fundamental for achieving nutritional recommendations within the investigated environment. Readers are asked to consider naturalistic generalisability and if the findings resonate with them, their environment, or their experiences (56). Additionally, readers are encouraged to question if aspects of this approach can be transferable to their own environment (49), such as through applying the NGT elsewhere, or by considering athlete behaviours first, without skipping to solutions (i.e., intervention delivery).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTypically, a behavioural analysis is centred around a singular target behaviour (57). However, using a cluster of three related behaviours (i.e., the meal frequency and portion size guidance) may enhance the ability for male academy footballers to meet nutritional recommendations (47). Future research should \u0026ldquo;identify what needs to change\u0026rdquo; for the target behaviours to occur (i.e., stage one, step four of the BCW), identify intervention options (i.e., stage two of the BCW), and identify content and implementation functions (i.e., stage three of the BCW) (23), to develop theoretically-informed solutions to elicit dietary behaviours in male academy footballers.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study aimed to identify and specify dietary behaviours that support male academy footballers in meeting nutritional recommendations. Using the NGT, 24 dietary behaviours were generated and refined into a top 10 list, informing the development of the meal frequency and portion size guidelines. Whilst the NGT proved effective in structuring and prioritising insights, practitioners found working in behavioural terms challenging. This highlights the need for further training in behavioural science for sport nutrition practitioners, to translate nutritional recommendations into measurable actions. By focusing on a cluster of three target behaviours, this study provides a practical and transferable framework for nutrition service delivery in academy football. The next phase of this research programme will explore the barriers and enablers to following the meal frequency and portion size guidance (step four of the BCW), informing the design of interventions that improve dietary behaviours of male academy footballers, thereby supporting optimal health, wellbeing, growth, and performance.\u003c/p\u003e\n"},{"header":"Abbreviations","content":"\u003cp\u003eBCW Behaviour Change Wheel\u003c/p\u003e\n\u003cp\u003eNGT Nominal Group Technique\u003c/p\u003e\n\u003cp\u003ePDP Professional Development Phase\u003c/p\u003e\n\u003cp\u003eEFL English Football League\u003c/p\u003e\n\u003cp\u003eAFC Academy Football Club \u003c/p\u003e\n\u003cp\u003eEPPP Elite Player Performance Plan\u003c/p\u003e\n\u003cp\u003eSENR Sport and Exercise Nutrition Register\u003c/p\u003e\n"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from XX Research Ethics Committee (approval ref:\u0026nbsp;127375). All participants provided informed consent to participate.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eAll participants provided informed consent for their data to be published.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe data generated and analysed\u0026nbsp;during the current study are available from the corresponding author [XX], on reasonable request.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eXX is supported by a PhD studentship sponsored by XX in collaboration with XX.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions\u003c/p\u003e\n\u003cp\u003eXX: Conceptualisation, Methodology, Data collection, Data analysis, Writing, Editing. XX, XX, XX: Conceptualisation, Methodology, Data analysis, Review, Editing, Supervision.\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eThe authors would like to acknowledge all participants for taking the time to contribute to this research.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; information (optional)\u003c/p\u003e\n\u003cp\u003eORCiD: XX\u0026nbsp;\u003c/p\u003e\n"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDesbrow B. Youth Athlete Development and Nutrition. Sports Med. 2021 Sept;51(S1):3\u0026ndash;12. \u003c/li\u003e\n\u003cli\u003eSpear BA. Adolescent growth and development. J Am Diet Assoc. 2002;102(3 Suppl):S23-9. \u003c/li\u003e\n\u003cli\u003ePetrie HJ, Stover EA, Horswill CA. Nutritional concerns for the child and adolescent competitor. Nutrition. 2004 July;20(7\u0026ndash;8):620\u0026ndash;31. \u003c/li\u003e\n\u003cli\u003eHannon MP, Parker LJF, Carney DJ, McKeown J, Speakman JR, Hambly C, et al. 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Soc Sci. 2019 Sept 6;8(9):255. \u003c/li\u003e\n\u003cli\u003eCreswell JW, Creswell JD. Research design: qualitative, quantitative, and mixed methods approaches. Sixth edition. Thousand Oaks, California: SAGE Publications, Inc.; 2023. xxvii, 291 p. \u003c/li\u003e\n\u003cli\u003eSparkes AC, Smith B. Qualitative research methods in sport, exercise and health: from process to product [Internet]. New York: Routledge; 2014 [cited 2024 Jan 13]. Available from: http://site.ebrary.com/id/10783313\u003c/li\u003e\n\u003cli\u003eEtherington K. Becoming a reflexive researcher: using our selves in research [Internet]. London ; Jessica Kingsley Publishers; 2004 [cited 2024 Jan 13]. Available from: http://www.123library.org/book_details/?id=2049\u003c/li\u003e\n\u003cli\u003eFinlay L, Gough B. Reflexivity: a practical guide for researchers in health and social sciences [Internet]. Malden, MA: Blackwell Science; 2003 [cited 2024 July 4]. Available from: https://search.ebscohost.com/login.aspx?direct=true\u0026amp;scope=site\u0026amp;db=nlebk\u0026amp;db=nlabk\u0026amp;AN=231738\u003c/li\u003e\n\u003cli\u003eVan de Ven AH, Delbecq AL. The nominal group as a research instrument for exploratory health studies. Am J Public Health. 1972;62(3):337\u0026ndash;42. \u003c/li\u003e\n\u003cli\u003eHarvey N, Holmes CA. Nominal group technique: An effective method for obtaining group consensus. Int J Nurs Pract. 2012 Apr;18(2):188\u0026ndash;94. \u003c/li\u003e\n\u003cli\u003eKvale S, Brinkmann S. InterViews: learning the craft of qualitative research interviewing. Third edition. Los Angeles: Sage Publications; 2015. xviii, 405 p. \u003c/li\u003e\n\u003cli\u003eKornbluh M. Facilitation strategies for conducting focus groups attending to issues of power. Qual Res Psychol. 2023 Jan 2;20(1):1\u0026ndash;20. \u003c/li\u003e\n\u003cli\u003eClark A, Friedman MJ. The Relative Importance of Treatment Outcomes: A Delphi Group Weighting in Mental Health. Eval Rev. 1982 Feb;6(1):79\u0026ndash;93. \u003c/li\u003e\n\u003cli\u003eChater AM, Brook-Rowland P, Tolani F, Christopher E, Hart J, Byrne-Davis LMT, et al. Understanding a constellation of eight COVID-19 disease prevention behaviours using the COM-B model and the theoretical domains framework: a qualitative study using the behaviour change wheel. Front Public Health [Internet]. 2023 July 5 [cited 2025 Jan 10];11. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1130875/full\u003c/li\u003e\n\u003cli\u003eSmith B, McGannon KR. Developing rigor in qualitative research: problems and opportunities within sport and exercise psychology. Int Rev Sport Exerc Psychol. 2018 Jan;11(1):101\u0026ndash;21. \u003c/li\u003e\n\u003cli\u003eTracy SJ. Qualitative Quality: Eight \u0026ldquo;Big-Tent\u0026rdquo; Criteria for Excellent Qualitative Research. Qual Inq. 2010 Dec;16(10):837\u0026ndash;51. \u003c/li\u003e\n\u003cli\u003eLeech RM, Worsley A, Timperio A, McNaughton SA. Characterizing eating patterns: a comparison of eating occasion definitions. Am J Clin Nutr. 2015 Nov;102(5):1229\u0026ndash;37. \u003c/li\u003e\n\u003cli\u003eCoutts AJ. Challenges in Developing Evidence-Based Practice in High-Performance Sport. Int J Sports Physiol Perform. 2017 July;12(6):717\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eFullagar HHK, McCall A, Impellizzeri FM, Favero T, Coutts AJ. The Translation of Sport Science Research to the Field: A Current Opinion and Overview on the Perceptions of Practitioners, Researchers and Coaches. Sports Med. 2019 Dec;49(12):1817\u0026ndash;24. \u003c/li\u003e\n\u003cli\u003eFarrell B, Rousse-Grossman J, Santamaria C, McCarthy LM. Applying the Behaviour Change Wheel to support deprescribing in long-term care: Qualitative interviews with stakeholder participants. Explor Res Clin Soc Pharm [Internet]. 2023 Mar [cited 2024 Feb 10];9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2667276623000379\u003c/li\u003e\n\u003cli\u003eKohler P, Gothberg J, Andrews WD, Mahon AS, Seabrooks-Blackmore J. A Nominal Group Technique Study Identifying Evidence-Based and Promising Practices: Taxonomy for Postsecondary Comprehensive Transition Programs. J Incl Postsecond Educ. 2023 Feb 10;4(2):1\u0026ndash;27. \u003c/li\u003e\n\u003cli\u003eByrne M. Increasing the impact of behavior change intervention research: Is there a role for stakeholder engagement? Health Psychol. 2019 Apr;38(4):290\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eSmith B. Generalizability in qualitative research: misunderstandings, opportunities and recommendations for the sport and exercise sciences. Qual Res Sport Exerc Health. 2018 Jan;10(1):137\u0026ndash;49. \u003c/li\u003e\n\u003cli\u003eMichie S, Van Stralen MM, West R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement Sci [Internet]. 2011 Dec [cited 2023 Dec 4];6(42). Available from: http://www.implementationscience.com/content/6/1/42\u003c/li\u003e\n\u003cli\u003eNational Health Service. nhs.uk. 2022 [cited 2024 July 4]. 5 A Day portion sizes. Available from: https://www.nhs.uk/live-well/eat-well/5-a-day/portion-sizes/\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"performance-nutrition","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Performance Nutrition](https://performancenutrition.biomedcentral.com/)","snPcode":"44410","submissionUrl":"https://submission.springernature.com/new-submission/44410/3","title":"Performance Nutrition","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Nominal Group Technique, Behaviour Change Wheel, sport nutrition, football academy, adolescent athletes, behaviour change, athlete development","lastPublishedDoi":"10.21203/rs.3.rs-7792728/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7792728/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground\u003c/p\u003e\n\u003cp\u003eAdolescent male academy footballers often fail to meet nutritional recommendations, risking impaired growth, health, and performance. Therefore, this study, guided by the Behaviour Change Wheel, aimed to select and specify dietary behaviours to underpin a sport nutrition service within an English Football League Championship academy. Two Nominal Group Technique (NGT) workshops (mean duration = 2 h 20 min) with four experienced sport nutritionists, either currently (n = 3) or recently (n = 1) employed at the club, were conducted. Participants generated, ranked, and refined behaviours through structured group discussion, and a follow-up questionnaire. Audio data were descriptively analysed to provide context around behaviour selection and prioritisation.\u003c/p\u003e\n\u003cp\u003eResults\u003c/p\u003e\n\u003cp\u003eTwenty-six behaviours were generated, with a prioritised top 10 identified. The three most important were: 1) consuming ≥3 main meals (≥900 kcal or 13 kcal·kg⁻¹) and 2 snacks daily (≥350 kcal or 5 kcal·kg⁻¹); 2) consuming ≥3 carbohydrate portions (40–50g or 0.5–0.75 g·kg⁻¹) per main meal, and ≥1 per snack; and 3) consuming a protein portion (25–30g or 0.4 g·kg⁻¹) at ≥4 eating occasions daily. These behaviours collectively formed the “meal frequency and portion size guidance.” Other behaviours ranked in the top 10 included fruit and vegetable intake, attendance at club meals, hydration, and cooking from the club recipe app. Practitioners reported difficulty conceptualising behaviours, often defaulting to macronutrient prescriptions, and found prioritisation challenging given the number of valuable behaviours generated. Nonetheless, the iterative NGT process facilitated consensus and provided actionable, evidence-based nutritional guidance.\u003c/p\u003e\n\u003cp\u003eConclusion\u003c/p\u003e\n\u003cp\u003eThis study demonstrates the suitability of the NGT for co-producing and prioritising dietary behaviours, to enable in male academy footballers. This method proved effective in structuring practitioner insights, to inform priority areas in a sport nutrition service. However, working in behavioural terms proved time-intensive, highlighting the need for further behavioural science training for sport nutrition practitioners. Defining what athletes should \u003cem\u003edo\u003c/em\u003e, not just \u003cem\u003ewhat\u003c/em\u003e nutrients they should consume, is crucial for designing effective behavioural interventions. These findings will support the design and development of a targeted, theoretically informed intervention to support the health, wellbeing, and performance of male academy footballers.\u003c/p\u003e","manuscriptTitle":"Selecting and Specifying Target Behaviours to Enable Nutritional Adherence in Male Academy Footballers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-29 16:00:36","doi":"10.21203/rs.3.rs-7792728/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-23T14:08:11+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-08T16:35:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"274747538010775231288432145515405979856","date":"2025-11-21T13:40:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"46211879361241048541637350666507964670","date":"2025-10-18T07:38:37+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-16T05:46:03+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-11T16:40:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-09T05:39:40+00:00","index":"","fulltext":""},{"type":"submitted","content":"Performance Nutrition","date":"2025-10-06T15:27:38+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"performance-nutrition","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Performance Nutrition](https://performancenutrition.biomedcentral.com/)","snPcode":"44410","submissionUrl":"https://submission.springernature.com/new-submission/44410/3","title":"Performance Nutrition","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3b7a69d4-897e-4c20-8c24-2f236461b4d6","owner":[],"postedDate":"October 29th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-22T07:11:38+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-29 16:00:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7792728","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7792728","identity":"rs-7792728","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}