Dataset Information

Dietary restrictions in endurance runners to mitigate exercise-induced gastrointestinal symptoms.

ABSTRACT:

Background

Endurance runners frequently experience exercise-induced gastrointestinal (GI) symptoms, negatively impacting their performance. Food choices pre-exercise have a significant impact on the gut's tolerance to running, yet little information is available as to which foods runners restrict prior to exercise.

Methods

A questionnaire designed to assess dietary restrictions pre-racing and gastrointestinal symptoms was administered to 388 runners. Fisher's exact tests determined differences in gender, age, performance level, and distance with follow-up multivariable logistic regression modeling.

Results

Runners regularly avoided meat (32%), milk products (31%), fish/seafood (28%), poultry (24%), and high-fiber foods (23%). Caffeinated beverages were commonly avoided in events 10 km or less (p < .001); whereas in females, increased running distance was a predictor of avoiding high-fiber foods (OR = 6.7; 95% CI = 1.6-28.5). Rates of food avoidance were elevated in younger and more competitive runners. Common GI symptoms included stomach pain/cramps (42%), intestinal pain/discomfort (23%), side ache/stitch (22%), urge to defecate (22%), and bloating (20%). The prevalence of GI symptoms was higher in younger athletes, especially females, which may explain their propensity to avoid foods. Lower recreational athletes were the least likely to report GI symptoms. Diarrhea incidence increased with running distance.

Conclusions

Identification of voluntary food restrictions in the pre-running meal highlights trends that can direct further research.

SUBMITTER: Parnell JA

PROVIDER: S-EPMC7288429 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Dietary restrictions in endurance runners to mitigate exercise-induced gastrointestinal symptoms.

Parnell Jill A JA Wagner-Jones Kim K Madden Robyn F RF Erdman Kelly Anne KA

Journal of the International Society of Sports Nutrition 20200610 1

<h4>Background</h4>Endurance runners frequently experience exercise-induced gastrointestinal (GI) symptoms, negatively impacting their performance. Food choices pre-exercise have a significant impact on the gut's tolerance to running, yet little information is available as to which foods runners restrict prior to exercise.<h4>Methods</h4>A questionnaire designed to assess dietary restrictions pre-racing and gastrointestinal symptoms was administered to 388 runners. Fisher's exact tests determine ...[more]

PMID: 32522222

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Project description:BackgroundExercise induced gastrointestinal (GI) symptoms can plague athletes, especially runners. Sport nutrition recommendations are nutrient rather than foods focused and do not adequately address strategies to reduce GI symptoms. The objective was to develop a valid and reliable questionnaire to evaluate pre-training and pre-racing voluntary food restrictions/choices, reasons for avoiding foods, and gastrointestinal symptoms in endurance runners.MethodsValidity testing occurred through four Registered Dietitians, three of whom possess Master's degrees, and a dietetic trainee who provided initial feedback. Additionally, one Registered Dietitian is a Board Certified Specialist in Sports Dietetics (CSSD), and another has an International Olympic Committee Diploma in Sports Nutrition. The second version was sent out to nine different experts who rated each question using a Likert scale and provided additional comments. For reliability testing, the questionnaire was administered to 39 participants in a test re-test format. Kappa statistics and the prevalence-adjusted bias-adjusted kappa (PABAK) were used to assess the reliability.ResultsAll questions had an average Likert scale rating of 4/5 or greater. All test re-test results falling under basic information exhibited substantial agreement (kappa ≥0.61). All medical questions including food allergies and intolerances had moderate (kappa ≥0.41) or higher agreement. Responses were less consistent for food avoidances while training (5/28 outcomes) versus racing (0/28 outcomes) with a kappa below 0.41. All reasons for avoiding foods were deemed reliable. Regarding symptoms, side stitch while training and gas while racing were the only flagged categories.ConclusionsOverall, the questionnaire is a valid and reliable tool to evaluate voluntary dietary restrictions among endurance runners. Future studies can use the questionnaire to assess dietary strategies runners employ to reduce GI distress and optimize performance.

Project description:This exploratory study investigated endurance athletes self-reported exercise-associated gastrointestinal symptoms (Ex-GIS) and associated strategies to manage symptomology. Adult endurance athletes with a history of Ex-GIS (n = 137) participating in events ≥ 60 min completed an online validated questionnaire. Respondents included runners (55%, n = 75), triathletes (22%, n = 30), and non-running sports (23%, n = 32), participating at a recreationally competitive (37%, n = 51), recreationally non-competitive (32%, n = 44), and competitive regional/national/international (31%, n = 42) levels. Athletes identified when Ex-GIS developed most frequently either around training (AT), around competitions (AC), or equally around both training (ET) and competitions (EC). Athletes reported the severity of each symptom before, during, and after exercise. Athletes predominantly categorized Ex-GIS severity as mild (< 5/10) on a 0 (no symptoms) to 10 (extremely severe symptoms) visual analog symptomology scale. The Friedman test and post hoc analysis with Wilcoxon signed rank test was conducted with a Bonferroni correction applied to determine differences between repeated measures. The only severe symptom of significance was the urge to defecate during training in the ET group (Z = -0.536, p = 0.01). Ex-GIS incidence was significantly higher during training and competitions in all categories. A content review of self-reported strategies (n = 277) to reduce Ex-GIS indicated popular dietary strategies were dietary fiber reduction (15.2%, n = 42), dairy avoidance (5.8%, n = 16), and a low fermentable oligosaccharides, monosaccharides, and polyols (FODMAP) diet (5.4%, n = 15). In contrast, non-dietary strategies included the use of medications (4.7%, n = 13) and relaxation/meditation (4.0%, n = 11). On a Likert scale of 1-5, the most successful dietary strategies implemented were dietary fiber reduction (median = 4, IQR = 4, 5), low FODMAP diets (median = 4, IQR = 4, 5), dairy-free diets (median = 4, IQR = 4, 5), and increasing carbohydrates (median = 4, IQR = 3, 4). Accredited practicing dietitians were rated as the most important sources of information for Ex-GIS management (n = 29). Endurance athletes use a variety of strategies to manage their Ex-GIS, with dietary manipulation being the most common.

Project description:ObjectivesAmong runners the reported prevalence of exercise-induced gastrointestinal (GI) symptoms is high (25%-83%). We aimed to investigate the prevalence of GI symptoms in women during a 5-10 km run in general and to explore the association between nutritional intakes and GI symptoms.SettingAs part of the Marikenloop-study (a cohort study to identify predictor variables of running injuries), a cross-sectional questionnaire was distributed in interested runners of the '2013 Marikenloop'.Participants433 female runners filled in the questionnaire.Primary and secondary outcome measuresThe primary outcome measure was the frequency of running-related GI symptoms during running in general and during the last (training) run. Furthermore, dietary intake was determined before and during this run. Secondary outcome measures were several demographic and anthropometric variables.ResultsDuring running in general, 40% of the participants suffered from GI symptoms and during their last run, 49%. The GI symptoms side ache, flatulence, urge to defecate and regurgitation and/or belching were most commonly reported. Lower age (OR=0.98, 95% CI 0.96 to 1.00), minor running experience (OR=3.1, 95% CI 1.7 to 5.7), higher body mass index (OR=1.1, 95% CI 1.0 to 1.2), consuming carbohydrate-containing drinks during running (OR=10.5, 95% CI 1.4 to 80.3) and experiencing GI symptoms during running in general OR=5.0, 95% CI 3.2 to 7.8) significantly contributed to GI symptoms during the last run in the logistic regression analysis. In contrast, time of eating and carbohydrate-containing drinks consumed prior to the run were not related to GI symptoms.ConclusionsIn conclusion, the current study confirms the high prevalence of GI symptoms in female runners. Several predictor variables contributed to the GI symptoms but more research is needed to specify the effects of prerunning eating and carbohydrate-containing drinks on GI symptoms during running.Trial registration numberMarikenloop study 2013: 50-50310-98-156 (ZonMw).

Project description:An acute bout of exercise in the moments after learning benefits the retention of new memories. This finding can be explained, at least partly, through a consolidation account: exercise provides a physiological state that is conducive to the early stabilisation of labile new memories, which supports their retention and subsequent retrieval. The modification of consolidation through non-invasive exercise interventions offers great applied potential. However, it remains poorly understood whether effects of exercise translate from the laboratory to naturalistic settings and whether the intensity of exercise determines the effect in memory. To this end, adult endurance runners were recruited as participants and completed two study sessions spaced two weeks apart. In each session, participants were presented with a list of words and asked to recall them on three occasions: (i) immediately following their presentation, (ii) after a 30-minute retention interval, and (iii) after 24 hours. Crucially, the 30-minute retention interval comprised our experimental manipulation: higher intensity exercise (running) in the first session and lower intensity exercise (walking) in the second, both completed in a naturalistic setting around participants' existing physical activity training programmes. Exertion was recorded through heart rate and rate of perceived exertion data. Alertness, mood, and arousal ratings were also collected before and after the 30-minute retention interval. Immediate memory for the two wordlists was matched, but participants retained significantly more words after 30 minutes and 24 hours when encoding was followed by higher than lower intensity exercise. Exertion data revealed that participants experienced vigorous and light exercise in the higher and lower intensity conditions, respectively. Significant improvements in alertness, mood, and arousal were observed following both exercise conditions, but especially in the higher intensity condition. These outcomes reveal that experiencing higher intensity physical activity in the field is conducive to declarative memory retention, possibly because it encourages consolidation.

Project description:There have been recent calls for strategies to improve oral health in athletes. High carbohydrate diets, exercise induced dehydration and transient perturbations to immune function combine to increase oral disease risk in this group. We tested whether a single dose of nitrate (NO3-) would offset the reduction in salivary pH following carbohydrate ingestion before and after an exercise bout designed to cause mild dehydration. Eleven trained male runners ([Formula: see text] 53 ± 9 ml∙kg-1∙min-1, age 30 ± 7 years) completed a randomised placebo-controlled study comprising four experimental trials. Participants ingested the following fluids one hour before each trial: (a) 140 ml of water (negative-control), (b) 140 ml of water (positive-control), (c) 140 ml of NO3- rich beetroot juice (~12.4 mmol NO3-) (NO3- trial) or (d) 140 ml NO3- depleted beetroot juice (placebo-trial). During the negative-control trial, participants ingested 795 ml of water in three equal aliquots: before, during, and after 90 min of submaximal running. In the other trials they received 795 ml of carbohydrate supplements in the same fashion. Venous blood was collected before and after the exercise bout and saliva was sampled before and repeatedly over the 20 min following carbohydrate or water ingestion. As expected, nitrite (NO2-) and NO3- were higher in plasma and saliva during the NO3- trial than all other trials (all P<0.001). Compared to the negative-control, salivary-pH was significantly reduced following the ingestion of carbohydrate in the positive-control and placebo trials (both P <0.05). Salivary-pH was similar between the negative-control and NO3- trials before and after exercise despite ingestion of carbohydrate in the NO3- trial (both P≥0.221). Ingesting NO3- attenuates the expected reduction in salivary-pH following carbohydrate supplements and exercise-induced dehydration. NO3- should be considered by athletes as a novel nutritional strategy to reduce the risk of developing acidity related oral health conditions.

Dataset Information

Dietary restrictions in endurance runners to mitigate exercise-induced gastrointestinal symptoms.

Background

Methods

Results

Conclusions

Publications

Dietary restrictions in endurance runners to mitigate exercise-induced gastrointestinal symptoms.

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