Casuistic Reasoning, Standards of Evidence, and Expertise on Elite Athletes’ Nutrition

Jukola Jukola

doi:10.3390/philosophies4020019

Abstract

This paper assesses the epistemic challenges of giving nutrition advice to elite athletes in light of recent philosophical discussion concerning evidence-based practice. Our trust in experts largely depends on the assumption that their advice is based on reliable evidence. In many fields, the evaluation of the reliability of evidence is made on the basis of standards that originate from evidence-based medicine. I show that at the Olympic or professional level, implementing nutritional plans in real-world competitions requires contextualization of knowledge in a way that contravenes the tenets of evidence-based thinking. Nutrition experts need to be able to combine and apply evidence from multiple sources, including the previous successes and failures of particular athletes. I argue that in this sense, the practice of elite sport nutrition embodies casuistic reasoning.

Highlights

The right kind of nutrition programs are essential for the success of elite athletes [1].Athletes competing at the Olympic or professional level strive for optimal performance at physiological and biomechanical limits
I have shown that evidence-based medicine (EBM) standards of evidence, which emphasize the importance of basing decisions on population-level studies and especially randomized controlled trials (RCTs), are ill-suited for evaluating the practices in elite sport nutrition
Relevant RCT-level evidence is often not available for sport nutrition coaches, and even if there were RCTs, they are usually conducted on populations that differ in relevant ways from high-caliber athletes

Summary

Introduction

The right kind of nutrition programs are essential for the success of elite athletes [1]. This paper assesses the epistemic challenges of giving nutrition advice to elite athletes in light of recent philosophical discussion concerning evidence-based practice. In the context of elite sport, relevant evidence that would be ranked high according to the criteria of EBM is often not available or sometimes even impossible to acquire. Even if such evidence was available, it alone could not inform nutrition protocols of athletes. I want to argue that even if all published sport nutrition research was of impeccable quality, the use of so-called low-level evidence, such as small case and laboratory studies and expert opinion, in informing high-caliber athletes would still be necessary.

Evidence-Based Practice

Epistemic Challenges of Sport Nutrition Practice

Elite Sport Nutrition Advice as A Form of Casuistry

Conclusions