Knowledge of low energy availability in biathlon: Why coaches need more targeted education. Results from a national, cross-sectional study

This study explores the knowledge of coaches working with adolescent biathletes regarding eating disorders (ED), low energy availability (LEA), and Relative Energy Deficiency in Sport (REDs). METHODS: Recruited coaches completed a questionnaire assessing self-reported knowledge (scale 0–10) of ED, LEA and REDs, and secondly by articulating their knowledge (scored by three experts, scale 0–2). RESULTS: Thirty-three coaches participated (mean age 40.6 ± 12.2 years), most without formal coach education (n = 25, 75.8%), and 13 (39.4%) were female. Self-reported knowledge of LEA/REDs was lower than ED knowledge (4.75 ± 2.9 vs. 5.74 ± 2.5; p = 0.02, g = 0.4), with a similar pattern in expert-rated scores (0.72 ± 0.6 vs. 1.12 ± 0.6; p < 0.01, g = 0.8). A regression model explained 45% of variance in self-reported LEA/REDs knowledge, with education level and course participation positively associated, while sex had no significant effect. For expert-rated scores, the model explained 33% of variance, with only course participation significant. For knowledge of guidelines on addressing LEA/REDs concerns self-reported scores were 3.6 ± 2.9, and 4.5 ± 2.9 for ED concerns (p = 0.04, g = 0.4); and expert-assessed scores were 0.7 ± 0.7 and 0.9 ± 0.8 (p = 0.11), respectively. Regression models did not significantly explain variability in these scores CONCLUSION: Biathlon coaches are less aware of LEA/REDs symptoms and less confident in addressing them than symptoms of ED. Importantly, education and course attendance raised knowledge scores, and preferred learning methods were virtual or physical courses with experts over scientific papers.