Health status and heat preparation at a UCI World Tour multistage cycling race

Objectives: To assess health status and heat preparation of cyclists at the 2019 Tour Down Under and determine the alignment of heat mitigation strategies with current recommendations. Design: Cohort study. Methods: Twenty-three (17 % participation rate) male World Tour cyclists from five teams and 10 countries completed a pre-competition questionnaire evaluating exertional heat illness (EHI) history, pre-race health status, and heat mitigation and recovery strategies use. Associations between arrival days pre-competition, years as professional, nationality, team, history of EHI symptoms and diagnosis on heat mitigation and recovery strategy utilisation were assessed. Results: 65 % of cyclists reported previously experiencing one or more EHI symptom (cramping: 48 %) and 22 % a diagnosis of heat stroke. In the 10 days preceding the race, 26 % experienced one or more illness symptoms. 65 % trained in the heat (acclimatisation 8–25 days; acclimation: 3–7 days), which was associated with team (P = 0.047, ϕ_c = 0.61), nationality (P = 0.009, ϕ_c = 0.86) and EHI symptoms history (P = 0.058, ϕ = 0.43). All cyclists had a hydration plan, with links to team (0.5–1.0 L·h⁻¹, P = 0.043, ϕ_c = 0.68) and EHI symptom history (1.0–1.5 L·h⁻¹, P = 0.048, ϕ = 0.476). Most had pre-cooling (87 %) and mid-cooling (83 %) strategies, most commonly cold beverages (75 %) and neck collars (78 %), respectively. All cyclists planned on using at least one recovery strategy (massage: 87 %). Conclusions: Our data indicate good alignment with current recommendations for competing in the heat, particularly for hydration, cooling and recovery strategies. Whilst the proportion of cyclists engaging in heat acclimation/acclimatisation is encouraging, greater awareness on adapting and implementing heat training is required.