Association of gastrointestinal distress in ultramarathoners with race diet

Health Sciences Dept., Gettysburg College, Gettysburg, PA.
International Journal of Sport Nutrition and Exercise Metabolism (Impact Factor: 2.44). 04/2013; 23(2):103-9.
Source: PubMed


Context: Gastrointestinal (GI) distress is common during ultrarunning. Purpose: To determine if race diet is related to GI distress in a 161-km ultramarathon. Methods: Fifteen (10 male, 5 female) consenting runners in the Javelina Jundred (6.5 loops on a desert trail) participated. Body mass was measured immediately prerace and after each loop. Runners reported if they had nausea, vomiting, abdominal cramps, and/or diarrhea after each loop. Subjects were interviewed after each loop to record food, fluid, and electrolyte consumption. Race diets were analyzed using Nutritionist Pro. Results: Nine (8 male, 1 female) of 15 runners experienced GI distress including nausea (89%), abdominal cramps (44%), diarrhea (44%), and vomiting (22%). Fluid consumption rate was higher (p = .001) in runners without GI distress (10.9 ± 3.2 ml · kg-1 · hr-1) than in those with GI distress (5.9 ± 1.6 ml · kg-1 · hr-1). Runners without GI distress consumed a higher percentage fat (p = .03) than runners with GI distress (16.5 ± 2.6 vs. 11.1 ± 5.0). In addition, fat intake rate was higher (p = .01) in runners without GI distress (0.06 ± 0.03 g · kg-1 · hr-1) than in runners with GI distress (0.03 ± 0.01 g · kg-1 · hr-1). Lower fluid and fat intake rates were evident in those developing GI distress before the onset of symptoms. Conclusions: A race diet with higher percentage fat and higher intake rates of fat and fluid may protect ultramarathoners from GI distress. However, these associations do not indicate cause and effect, and factors other than race diet may have contributed to GI distress.

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    • "Severe GI symptoms were rare, maybe because of the distance and environmental conditions and, in this case, probably not having a notable impact on group results. GI complaints are more common during races over longer distances (Stuempfle et al. 2013). "
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    ABSTRACT: The objective of this study was to investigate whether ultramarathon runners were able to meet nutrition recommendations during a training period and on a competition day. In preparation for a 60 or 120 km ultramarathon covering a varied terrain, male and female ultramarathon runners (n=68, age 46.5±7.1 y) reported habitual dietary intake during three independent days using a web-based 24-hour recall and questionnaires. The diet was assessed using probability of inadequacy or by qualitative evaluation using reference dietary intakes or sports nutrition recommendations. A small group of 120 km runners (n=4) was observed continuously during the race. After the race, 60 km runners (n=41) received a questionnaire to assess dietary intake and gastrointestinal (GI) distress on the race day. Spearman rank correlation coefficients (r) were applied to investigate the association between intake and general GI distress symptoms. In men and women, habitual mean carbohydrate (CHO) intake was lower than recommended, as was mean protein intake by women. CHO intake during the race was <60 g/h in 75% of the athletes. A large variation of nutrient and fluid intake was seen. GI distress during the race was reported in 82% of the runners; severe GI distress was low. In general, moderate, mostly negative, correlations with nutrient intake were seen for GI distress. Sports nutrition recommendations for the habitual diet were not achieved. During a competition day, a large variation was found in nutrient intake; this may be related to a high incidence of GI distress.
    International Journal of Sport Nutrition and Exercise Metabolism 03/2015; 25(4). DOI:10.1123/ijsnem.2014-0199 · 2.44 Impact Factor
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    • "Nausea, vomiting, abdominal cramping, and diarrhea have been reported in 37–89 % of runners participating in races 67–161 km long [6–9], and fecal blood loss indicating gastrointestinal hemorrhage was reported in 85 % of participants in a 161 km ultra-marathon [6]. A recent study investigated gastrointestinal problems in a group of ultra-marathon runners, and observed that 9 of 15 runners experienced gastrointestinal distress, including nausea (89 %), abdominal cramps (44 %), diarrhea (44 %), and vomiting (22 %) [9]. "
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    ABSTRACT: Gastrointestinal problems are common, especially in endurance athletes, and often impair performance or subsequent recovery. Generally, studies suggest that 30-50 % of athletes experience such complaints. Most gastrointestinal symptoms during exercise are mild and of no risk to health, but hemorrhagic gastritis, hematochezia, and ischemic bowel can present serious medical challenges. Three main causes of gastrointestinal symptoms have been identified, and these are either physiological, mechanical, or nutritional in nature. During intense exercise, and especially when hypohydrated, mesenteric blood flow is reduced; this is believed to be one of the main contributors to the development of gastrointestinal symptoms. Reduced splanchnic perfusion could result in compromised gut permeability in athletes. However, although evidence exists that this might occur, this has not yet been definitively linked to the prevalence of gastrointestinal symptoms. Nutritional training and appropriate nutrition choices can reduce the risk of gastrointestinal discomfort during exercise by ensuring rapid gastric emptying and the absorption of water and nutrients, and by maintaining adequate perfusion of the splanchnic vasculature. A number of nutritional manipulations have been proposed to minimize gastrointestinal symptoms, including the use of multiple transportable carbohydrates, and potentially the use of nutrients that stimulate the production of nitric oxide in the intestine and thereby improve splanchnic perfusion. However, at this stage, evidence for beneficial effects of such interventions is lacking, and more research needs to be conducted to obtain a better understanding of the etiology of the problems and to improve the recommendations to athletes.
    05/2014; 44 Suppl 1(Suppl 1):79-85. DOI:10.1007/s40279-014-0153-2
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    ABSTRACT: Little is known about exercise habits of those who compete in foot races longer than the standard 42-km marathon distance. The purpose of this work was to describe the past-year and lifetime exercise patterns of a large cohort of ultramarathon runners. Information on exercise history was collected on 1,345 current and former ultramarathon runners as baseline data for participation in a longitudinal observational study. Median age at the first ultramarathon was 36 years, and the median number of years of regular running prior to the first ultramarathon was 7 (interquartile range 3-15). Age at first ultramarathon did not changed across the past several decades, but there was evidence of an inverse relationship (r=-0.13, p<0.0001) between number of years of regular running prior to the first ultramarathon and calendar year. The active ultramarathon runners (n=1,212) had a prior year median running distance of 3,347 km, which was minimally related to age (r=-0.068, p=0.018), but mostly related to their longest ultramarathon competition of the year (p<0.0001). Running injuries represented the most common reason for discontinuation of regular running, while work and family commitments were reported as the main reasons for not running an ultramarathon in the prior year among those who were regularly running and intending to run ultramarathons again. We conclude that runners tend to be well into adulthood and with several years of running experience before running their first ultramarathon, but 25% have only been regularly running for 3 years or less at the time of their first ultramarathon.
    The Journal of Strength and Conditioning Research 07/2013; 27(11). DOI:10.1519/JSC.0b013e3182a1f261 · 2.08 Impact Factor
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