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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]) were more 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).
Alabdulwahed, Galán-López, Hill, James, Esh, and Taylor are with the School of Sport, Exercise and Health Sciences, Loughborough University, and the National Centre for Sport and Exercise Medicine (NCSEM), Loughborough, United Kingdom. Galán-López is also with the Occupational and Environmental Physiology Group, Coventry University, Centre for Sport Exercise and Life Sciences, Coventry, United Kingdom. Chrismas is with the Dept of Physical Education, College of Education, Qatar University, Doha, Qatar. Racinais, Chamari, and Esh are with Aspetar, Orthopedic and Sports Medicine Hospital, FIFA Medical Center of Excellence, Doha, Qatar. Stellingwerff is with the Canadian Sport Institute–Pacific, Victoria, BC, Canada, and the Dept of Exercise Science, Physical and Health Education, Inst of Sport and Physical Activity Research, University of Victoria, Victoria, BC, Canada. Leal is with the Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal. Hausen is with the Olympic Laboratory, Brazil Olympic Committee, Rio de Janeiro, Brazil. Fullagar and Taylor are with the Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Moore Park, NSW, Australia, and the Human Performance Research Centre, University of Technology Sydney (UTS), Sydney, Australia. Alabdulwahed and Galan-Lopez are joint first authors.