BackgroundA food and fluid intake program is essential for ultra-endurance athletes to maximize performance and avoid possible gastrointestinal symptoms (GIS). However, the ability to respect such a program during a race has been under-assessed. We thus investigated the kinetics of food and fluid intake during the 24-h run World Championship of 12 elite athletes (6 men and 6 women; age: 46 ± 7 years, height: 170 ± 9 cm, weight: 61.1 ± 9.6 kg, total distance run: 193–272 km) and assessed their ability to follow their nutritional program.MethodsReal-time overall intake (fluids, energy, and macronutrients) were recorded and compared to that of their program. The temporal difference in absolute values and degree of divergence from their program were assessed divided into four 6-h periods. GIS were recorded during the race. A questionnaire identifying the details of their nutritional program and the self-assessed causes of their inability to follow it was completed by the participants. ResultsWater, total fluid, carbohydrate (CHO), and energy intake decreased during the last quarter of the 24-h ultramarathon relative to the first half (p < 0.031). However, the differences were no longer significant after these values were normalized by the number of passages in front of the supply tent. The participants increasingly diverged from their nutritional program (dropping to approximately 50% of their expected fluid, CHO, and energy intake during the last quarter) but this was adequately compensated with unplanned foods to match their expected targets. GIS, lack of appeal of the planned items, and attractivity of unplanned items were the main explanations given for their deviation from the program (64, 27, and 27%, respectively). ConclusionDespite evident difficulty in respecting their nutritional programs (mostly attributed to GIS), elite ultra-endurance runners managed to maintain high rates of fluid and food intake during a 24-h ultramarathon and therefore still met their planned elevated nutritional objectives.