Heat adaptation and nutrition practices: athlete and practitioner knowledge and use

Purpose: To survey elite athletes and practitioners to identify (1) knowledge and application of heat acclimation/acclimatization (HA) interventions, (2) barriers to HA application, and (3) nutritional practices supporting HA. Methods: Elite athletes (n = 55) and practitioners (n = 99) completed an online survey.Mann-Whitney U tests (effect size [ES; r]) assessed differences between ROLE (athletes vs practitioners) and CLIMATE (hot vs temperate). Logistic regression and Pearson chi-square (ES Phi [φ]) assessed relationships. Results: Practitioners were more likely to report measuring athletes' core temperature (training: practitioners 40% [athletes 15%]; P =.001, odds ratio = 4.0, 95% CI, 2%-9%; competition: practitioners 25% [athletes 9%]; P =.020, odds ratio = 3.4, 95%CI, 1%-10%). Practitioners (55%[15%athletes]) weremore likely to perceive rectal as the gold standard core temperature measurement site (P =.013, φ =.49, medium ES). Temperate (57% [22% hot]) CLIMATE dwellers ranked active HA effectiveness higher (P <.001, r =.30, medium ES). Practitioners commonly identified athletes' preference (48%), accessibility, and cost (both 47%) as barriers to HA. Increasing carbohydrate intake when training in the heat was more likely recommended by practitioners (49%) than adopted by athletes (26%; P =.006, 95% CI, 0.1%-1%). Practitioners (56% [28% athletes]) were more likely to plan athletes' daily fluid strategies, adopting a preplanned approach (P =.001; 95% CI, 0.1%-1%). Conclusions: Practitioners, and to a greater extent athletes, lacked self-reported key HA knowledge (eg, core temperature assessment/monitoring methods) yet demonstrated comparatively more appropriate nutritional practices (eg, hydration).