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.

AimTo develop and validate a questionnaire investigating endurance athletes' carbohydrate beliefs, knowledge, information sources, and other dietary and non‐dietary practices related to exercise‐associated gastrointestinal symptoms.MethodsA questionnaire was developed by a review of relevant literature and sports‐related questionnaires, and input from five experienced sports dietitians. Item construct and format was adapted and modified from a previous questionnaire. The modified questionnaire sought information on demographics, nutrition knowledge, beliefs, intended practices, information sources and exercise‐associated gastrointestinal symptoms. A five‐phase validity process was conducted to determine content, face and construct validity, item difficulty and internal reliability of the questionnaire. The Delphi technique was applied with experts over three anonymous rounds. Items were reviewed to determine whether to keep, modify, or delete, rate the relevance of each item using a content validity index (CVI), and provide comments. A content analysis was conducted on all comments after each round. Online interviews were conducted with a pilot group of endurance athletes (n = 15) to assess item difficulty and feasibility. Nutrition knowledge was compared between pilot group of athletes and experts to determine construct validity and internal consistency. A test‐retest process was applied to a second pilot group (n = 8) to verify questionnaire reliability.ResultsHigh CVI (≥.83) and agreement scores were obtained through the Delphi technique. High reliability (r = .942) and acceptable internal consistency (α = .53‐.78) of the questionnaire were obtained.ConclusionsThe questionnaire was shown to be a valid and reliable tool that will be of use for clinicians and research purposes.

IT IS GENERALLY BELIEVED CONSUMING SPORTS DRINKS CONTAINING 6–8% CARBOHYDRATE AND ALSO CONTAINING 10–20 MMOL·L−1 OF SODIUM DURING ENDURANCE EVENTS LASTING LONGER THAN 60 MINUTES WILL BENEFIT PERFORMANCE. DURING EXERCISE IN THE HEAT, FLUID CONSUMPTION IS ALSO IMPORTANT FOR THERMOREGULATION. THEREFORE, THE AIM OF THIS REVIEW IS TO INVESTIGATE THE COMPONENTS OF A TYPICAL SPORTS DRINK, AND DETERMINE WHETHER THERE IS ANY EFFECT ON EXERCISE PERFORMANCE OR THERMOREGULATION IN THE HEAT. THE RESULTS SUGGEST THAT CARBOHYDRATE INGESTION DURING CONTINUOUS EXERCISE OVER 60 MINUTES IN THE HEAT CAN IMPROVE TIME TRIAL AND TIME TO EXHAUSTION PERFORMANCE.