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

Jill A Parnell, Kim Wagner-Jones, Robyn F Madden, Kelly Anne Erdman, Jill A Parnell, Kim Wagner-Jones, Robyn F Madden, Kelly Anne Erdman

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.

Keywords: Dietary restrictions; Exercise-induced gastrointestinal symptoms; Food intolerances; Gastrointestinal tolerance; Pre-exercise meal; Runner’s gut; Running.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Pre-race food avoidances in runners to minimize exercise-induced GI symptoms. Percentage of endurance runners who avoid a food category pre-race to minimize GI symptoms
Fig. 2
Fig. 2
Symptoms experienced while racing. Symptoms that runners reported they would experience during a race if they consumed a food that they would typically avoid. Data is presented as percentage of all runners
Fig. 3
Fig. 3
Reasons for pre-race food avoidances in runners. Reasons endurance runners choose to avoid a food pre-race. Data is presented as percentage of all runners

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