Nutrition Knowledge, Disordered Eating, and Low Energy Availability Symptom Burden in Climbers

Introduction: Disordered eating (DE), low energy availability (LEA), psychological distress, and nutrition knowledge (NK) have been examined in climbers, but their relationships remain unclear in broader climbing populations. Methods: Adult climbers (n = 417; 56.2% female; 33.1 ± 9.9 years) completed an online survey assessing demographics, climbing characteristics, NK (A-NSKQ), DE (EDE-QS), LEA symptom burden (modified LEAM-Q composite; LEAF-Q female domains), and psychological distress (DASS-21). Hierarchical regression tested associations between NK and standardized LEA symptom burden after covariates; EDE-QS and DASS-21 anxiety/depression were entered in exploratory sensitivity models. Female-only logistic models examined LEAF-Q gastrointestinal and menstrual risk. Results: Total NK was low-average (52.1 ± 13.5%) with no sex or performance-level differences. Women reported higher EDE-QS scores than men (6.9 ± 6.1 vs 4.8 ± 5.4; p < 0.001). Covariates explained 9.4% of LEA symptom burden; NK did not improve model fit (ΔR² = 0.004, p = 0.225), whereas EDE-QS did (ΔR² = 0.103, p < 0.001). Anxiety and depression explained additional variance in parallel models. Most moderation terms were not significant; the EDE-QS × depression interaction was significant and exploratory. EDE-QS was associated with higher odds of gastrointestinal symptom risk among women. Conclusions: LEA symptom burden in climbers was more closely associated with DE and psychological distress than NK. Prospective studies should evaluate whether weight-neutral sport nutrition education that integrates fueling guidance and symptom awareness improves behavioral or clinical outcomes.