Beyond knowledge: Unveiling the hidden link between body image and dietary intake in elite race walkers at risk of relative energy deficiency in sport

Abstract

Background: Nutritional knowledge and body image concerns are key factors influencing dietary intake and health among athletes, particularly in lean-type sports. This study investigates these variables among elite race walkers from the United Kingdom and Ireland, a cohort selected for the prominence of race walking in their national sports programmes and unique cultural contexts. Aim: The study aims to assess the relationship between nutritional knowledge, body image, and dietary intake in elite race walkers, and explore the potential risk of relative energy deficiency in sport (RED-S). Methods: Eight elite race walkers (seven males, one female) were assessed using the Body Image Avoidance Questionnaire (BIAQ) and the Abridged Nutrition for Sport Knowledge Questionnaire. Dietary intake was evaluated through detailed food diaries and analysed against established nutritional guidelines. The Goldberg cut-off method was employed to identify dietary misreporters. Results: Despite moderate nutritional knowledge (58.93 ± 8.68%), athletes displayed suboptimal dietary habits with prevalent over-reporting. Carbohydrate intake was below recommended levels (5.4 ± 1.0 g/kg/day), while protein intake exceeded guidelines (2.0 g/kg/day). Body image dissatisfaction was common, particularly in the single female athlete, who scored highest on both nutritional knowledge and body image avoidance (BIAQ score: 62). The findings suggest a possible link between body image concerns and inappropriate dietary behaviours, increasing the risk of RED-S. Conclusion: While the study highlights the complex interplay between nutritional knowledge, body image dissatisfaction, and dietary intake, the small sample size (N = 8), particularly the inclusion of only one female athlete, limits the generalizability of the findings and introduces a potential bias in sex-specific interpretations. Future research should include larger, more diverse populations.