Several factors contribute to athletes’ sporting performance and diet is a key component. Higher levels of nutritional knowledge seem to correlate with a higher quality of diet, but this remains poorly explored and findings are still not conclusive. The aim of our study was to assess nutritional knowledge and dietary adequacy, detecting any potential association between these two factors in elite 24-hour ultramarathon runners, a sport which seems to have been increasing in popularity over the last decade. Nutritional knowledge and Mediterranean dietary adequacy scores were assessed by means of validated questionnaires given to 10 elite ultramarathon runners (six males and four females) from the Italian Ultramarathon and Trail Association (IUTA). The overall nutritional knowledge in the entire sample of athletes seemed to be good, especially in terms of “dietary recommendations” and “nutrient sources” knowledge. However, females had higher total nutritional knowledge scores when compared to males. Finally, linear regression analysis showed that greater nutritional knowledge was positively associated with an increase in Mediterranean dietary adequacy scores (β
= 1.27; 95% CI = 0.039–2.494; p
= 0.045) after adjusting for level of education. Our findings provide evidence that higher nutritional knowledge is associated with better dietary practice in elite 24-hour ultramarathon runners. Future studies are needed to assess the usefulness of educational programs as a strategy to improve the adequacy of dietary intake in this specific population.
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