INTRODUCTION: Heat acclimation/acclimatization (HA) is the principal and most effective intervention to protect athletes from heat-mediated performance decrements and provide some protection against heat illnesses when exercise is performed in thermally challenging environments. That said, relatively little is known regarding how centuries worth of data in these regards, penetrates the knowledge and practice of elite athletes and practitioners. With the ever-increasing globalization of sport on a consistently warming planet, elite sport, including mega events, are increasingly held in such thermally challenging environments (e.g., Tokyo 2020ne). Thus, practitioners and their athletes alongside policy makers have a responsibility to prepare their athletes appropriately and educate their members, respectively. Additionally, the events themselves require diligent infrastructural and logistical preparation to deliver evidence-informed performance-facing support and potentially life-saving medical services. Therefore, the purpose was to survey elite athletes and practitioners to identify: (i) knowledge and application of heat acclimation/acclimatization (HA) interventions; (ii) barriers to HA application; and (iii) nutritional practices supporting HA. METHODS: Practitioners (99) and elite athletes (55) completed an online survey. Pearson`s Chi-square [ES; Phi] and logistic regression determined relationships. Differences between ROLE (athletes vs. practitioners) and CLIMATE (hot vs. temperate) were determined by Mann Whitney-U tests [effect size (ES; r)]. RESULTS: Practitioners were more likely to report measuring athletes` core temperature (Tc) [training: practitioners 40% (athletes 15%); p=0.001, Odds Ratio (OR) = 4.0, 95% Confidence Interval (CI) 2 to 9%; competition: practitioners 25% (athletes 9%); p=0.020, OR=3.4, 95% CI 1 to 10%]. Practitioners [55% (15% athletes)] were more likely to perceive rectal as the gold standard Tc measurement-site (p=0.013, phi=0.49, medium ES). Temperate [57% (22% hot)] CLIMATE dwellers ranked active heat acclimatization effectiveness higher (p<0.001, r=0.30, medium ES). Practitioners commonly identified athlete`s preference (48%), accessibility and cost (both 47%) as barriers to HA. Increasing carbohydrate (CHO) intake when training in the heat was more likely recommended by practitioners (49%) than adopted by athletes (26%; p=0.006, 95% CI 0.1 to 1%). Practitioners [56% (28% athletes)] were more likely to plan athletes` daily fluid strategies, adopting a pre-planned approach (p=0.001, 95% CI 0.1 to 1%). CONCLUSION: Practitioners and to a greater extent athlete`s lacked self-reported key HA knowledge (e.g. Tc assessment/monitoring methods) yet demonstrated comparatively more appropriate nutritional practices (e.g. hydration). Concerningly, reported data included biologically implausible values and assertions, emphasizing the need for palatable educational resources from policy makers and/or stakeholders for their members.
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