Nutritional indicators for gastrointestinal symptoms in female runners: the ‘Marikenloop study’

Haaf, Dominique S M Ten; Worp, Maarten P. van der; Groenewoud, Hans; Leij-Halfwerk, S.; Sanden, Maria W. G. Nijhuis-van der; Verbeek, A.L.M.; Staal, J. Bart

doi:10.1136/bmjopen-2014-005780

Cited by 21 publications

(16 citation statements)

References 31 publications

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“…One potential cause of GIS during marathon running is nutritional intake before and/or during the race. Carbohydrate (CHO) intake in both the days before and during endurance exercise has been shown to be beneficial to performance [ 8 , 9 ] yet there appears to be an association between carbohydrate intake during endurance exercise and GIS [ 10 , 11 , 12 ]. The mechanisms through which this may occur include potential malabsorption leading to luminal distension, delayed gastric emptying and gas production [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, Severity and Potential Nutritional Causes of Gastrointestinal Symptoms during a Marathon in Recreational Runners

et al. 2018

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The purpose of the present study was to investigate the prevalence of gastrointestinal symptoms (GIS) amongst recreational runners during a marathon race, and potential nutritional factors that may contribute. Recreational runners of the 2017 Liverpool (n = 66) and Dublin (n = 30) marathons were recruited. GIS were reported post-marathon and we considered GIS in the 7 days prior to the marathon and during the marathon using the Gastrointestinal Symptom Rating Scale (GSRS). Nutritional intake was recorded using food diaries for the day before the race, morning of the race, and during the race; 43% of participants reported moderate (≥4) GIS in the 7 days prior to the marathon and 27% reported moderate symptoms during the marathon with most common symptoms being flatulence (16%) during training, and nausea (8%) during the marathon race. Correlations between all nutritional intake and GIS were not statistically significant (p > 0.05). There were significant correlations between total GIS score (r = 0.510, p < 0.001), upper GIS score (r = 0.346, p = 0.001) and lower GIS score (r = 0.483, p < 0.001) in training and during the marathon. There appears to be a modest prevalence of GIS in recreational runners, in the week prior to a marathon and during marathon running, although there was no association with nutritional intake before or during the race.

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Section: Introductionmentioning

confidence: 99%

Prevalence, Severity and Potential Nutritional Causes of Gastrointestinal Symptoms during a Marathon in Recreational Runners

et al. 2018

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“…To date, an abundance of research has described the frequency and predictors of GI distress during endurance competition and training (Pfeiffer et al, 2012;Rehrer et al, 1992;ten Haaf et al, 2014;Wilson, 2016;Wilson et al, 2015). GI symptom questionnaires have been used extensively in this literature yet validation of these tools has yet to be conducted.…”

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confidence: 99%

“…GI symptom questionnaires have been used extensively in this literature yet validation of these tools has yet to be conducted. In some studies, GI symptoms were assessed days or even months after the exercise bout of interest (Pfeiffer et al, 2012;Rehrer et al, 1992;ten Haaf et al, 2014). In addition, most investigations evaluated GI symptoms during a single event or training session, and it would be useful to also quantify the frequency of GI symptoms experienced over a more prolonged period of time.…”

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confidence: 99%

Frequency of Chronic Gastrointestinal Distress in Runners: Validity and Reliability of a Retrospective Questionnaire

Wilson¹

2017

International Journal of Sport Nutrition and Exercise Metabolism

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Gastrointestinal (GI) symptoms may affect up to 90% of competitors during endurance races. Studies have typically assessed GI symptoms retrospectively or only over an acute timeframe, and information on the validity and reliability of the questionnaires employed is lacking. This investigation aimed to estimate the frequency of GI distress experienced by runners over 30 days and to establish the validity and reliability of a retrospective GI symptom questionnaire. Runners (70 men, 75 women) recorded GI symptoms with a prospective journal for 30 days. Retrospective GI symptom data were then collected after the 30-day period on two occasions within one week. GI symptoms were rated on a 0-10 scale. Descriptive statistics for GI symptoms are reported as medians (interquartile ranges) because of nonnormal distributions. Men and women experienced at least one GI symptom on 84.0% (59.8-95.1%) and 78.3% (50.0-95.2%) of runs, respectively. Moderate-to-severe GI symptoms (score of ≥5) were experienced on 13.8% (6.7-37.3%) and 21.7% (5.3-41.2%) of runs for men and women. Spearman's rho correlations between journal ratings and retrospective questionnaire ratings ranged from 0.47 to 0.82 (all p < .001), although they were highest when journal ratings were quantified as mean 30-day values (all rho ≥ 0.59). Reliability of the retrospective questionnaire ratings was high (rho = 0.78-0.92; p < .001). In comparison with tracking GI symptoms with a daily journal, retrospective questionnaires seem to offer a convenient and reasonably valid and reliable method of quantifying GI symptoms over 30 days.

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“…GI response questionnaire: Participants completed an overall monthly training GI response questionnaire, adapted from symptoms previously reported [4,9,38]. Participants were asked to subjectively rate their responses across four subsections (general training, endurance training (>3 h), acute (<24 h) and longer term (<72 h) recovery periods).…”

Section: Methodsmentioning

confidence: 99%

“…Symptoms associated with gastrointestinal (GI) distress (e.g., cramping, diarrhoea, nausea, and abdominal pain) are estimated to occur in 25%–90% of endurance athletes, and are often cited as reasons for non-completion [3,4,5]. In preparation for such events, exercise-related GI symptoms may go unreported, which could impact on training efficiency and race completion.…”

Section: Introductionmentioning

confidence: 99%

An Exploratory Investigation of Endotoxin Levels in Novice Long Distance Triathletes, and the Effects of a Multi-Strain Probiotic/Prebiotic, Antioxidant Intervention

et al. 2016

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Gastrointestinal (GI) ischemia during exercise is associated with luminal permeability and increased systemic lipopolysaccharides (LPS). This study aimed to assess the impact of a multistrain pro/prebiotic/antioxidant intervention on endotoxin unit levels and GI permeability in recreational athletes. Thirty healthy participants (25 males, 5 females) were randomly assigned either a multistrain pro/prebiotic/antioxidant (LAB4ANTI; 30 billion CFU·day−1 containing 10 billion CFU·day−1 Lactobacillus acidophilus CUL-60 (NCIMB 30157), 10 billion CFU·day−1 Lactobacillus acidophillus CUL-21 (NCIMB 30156), 9.5 billion CFU·day−1 Bifidobacterium bifidum CUL-20 (NCIMB 30172) and 0.5 billion CFU·day−1 Bifidobacterium animalis subspecies lactis CUL-34 (NCIMB 30153)/55.8 mg·day−1 fructooligosaccharides/ 400 mg·day−1 α-lipoic acid, 600 mg·day−1 N-acetyl-carnitine); matched pro/prebiotic (LAB4) or placebo (PL) for 12 weeks preceding a long-distance triathlon. Plasma endotoxin units (via Limulus amebocyte lysate chromogenic quantification) and GI permeability (via 5 h urinary lactulose (L): mannitol (M) recovery) were assessed at baseline, pre-race and six days post-race. Endotoxin unit levels were not significantly different between groups at baseline (LAB4ANTI: 8.20 ± 1.60 pg·mL−1; LAB4: 8.92 ± 1.20 pg·mL−1; PL: 9.72 ± 2.42 pg·mL−1). The use of a 12-week LAB4ANTI intervention significantly reduced endotoxin units both pre-race (4.37 ± 0.51 pg·mL−1) and six days post-race (5.18 ± 0.57 pg·mL−1; p = 0.03, ηp2 = 0.35), but only six days post-race with LAB4 (5.01 ± 0.28 pg·mL−1; p = 0.01, ηp2 = 0.43). In contrast, endotoxin units remained unchanged with PL. L:M significantly increased from 0.01 ± 0.01 at baseline to 0.06 ± 0.01 with PL only (p = 0.004, ηp2 = 0.51). Mean race times (h:min:s) were not statistically different between groups despite faster times with both pro/prebiotoic groups (LAB4ANTI: 13:17:07 ± 0:34:48; LAB4: 12:47:13 ± 0:25:06; PL: 14:12:51 ± 0:29:54; p > 0.05). Combined multistrain pro/prebiotic use may reduce endotoxin unit levels, with LAB4ANTI potentially conferring an additive effect via combined GI modulation and antioxidant protection.

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Nutritional indicators for gastrointestinal symptoms in female runners: the ‘Marikenloop study’

Cited by 21 publications

References 31 publications

Prevalence, Severity and Potential Nutritional Causes of Gastrointestinal Symptoms during a Marathon in Recreational Runners

Prevalence, Severity and Potential Nutritional Causes of Gastrointestinal Symptoms during a Marathon in Recreational Runners

Frequency of Chronic Gastrointestinal Distress in Runners: Validity and Reliability of a Retrospective Questionnaire

An Exploratory Investigation of Endotoxin Levels in Novice Long Distance Triathletes, and the Effects of a Multi-Strain Probiotic/Prebiotic, Antioxidant Intervention

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