Study Details

This new study recruited 16 healthy young men to test whether acute ketone monoester ingestion (650 mg/kg x 2) could protect sustained attention and vigilance during severe hypoxia 😮‍💨

Participants completed a 15-min severe hypoxia exposure at 9.7% oxygen (equivalent to ~6,096 m altitude) 🏔️

Key Findings

🧠 Severe hypoxia impaired every measured component of psychomotor vigilance compared with normoxia

🧪 Ketones rapidly increased blood β-hydroxybutyrate above 3 mmol/L

⚡ Ketones significantly reduced the hypoxia-induced decline in mean reaction time

⏱️ Mean reaction time worsened by 38.7 ms with ketones compared with 64.2 ms with placebo

🚀 During hypoxia, reaction time was ~25.5 ms faster following ketone supplementation than placebo

⚠️ However, ketones did not significantly improve the number of major attentional lapses, slowest reaction times or total errors

Conclusion

These findings may be due to ketones supporting brain function by providing an alternative cerebral fuel when oxygen-dependent glucose metabolism is compromised 🧐

Acute ketone monoester ingestion partially preserved sustained attention during severe hypoxia, supporting its potential as a cognitive-resilience strategy under extreme environmental stress ✅

These findings may therefore be particularly relevant to rapid altitude exposure, aviation, rescue and military operations rather than normal endurance competition🏔️

Reference

https://pubmed.ncbi.nlm.nih.gov/42560222/

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Study Details

This new study examined whether 7-days of freeze-dried highbush blueberry supplementation could improve…

⏱️ performance

🫀 physiological responses

🔋 recovery

…from a 22.2 km simulated trail race in nine experienced runners 🔍

Here are the key findings ⬇️

Key Findings

🫐 Blueberry supplementation significantly improved 22.2 km trail-running performance compared with placebo

⏱️ Race completion time was significantly faster following blueberry supplementation

🫀 Faster performance occurred without an increase in average race heart rate

😮‍💨 RPE for both the legs and lungs were also unchanged despite the faster running performance

📉 Supine heart rate was lower following the blueberry condition

😴 Feelings of tiredness were lower with blueberry supplementation

🫁 Assessment of lung airflow were higher following blueberry supplementation, suggesting a favourable pulmonary response

⤴️ Drop-jump height declined 24 hours after the race with placebo but was preserved following blueberry supplementation

(suggesting that blueberries may have helped maintain explosive neuromuscular function during recovery)

Conclusion

Short-term blueberry supplementation may provide a practical food-based strategy for improving trail-running performance while supporting recovery from demanding downhill running ✅

Add this to the data on tart cherries and blackcurrant extract, it certainly does make a compelling case for polyphenols.

Reference

https://pubmed.ncbi.nlm.nih.gov/42521198/

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Study Details

This new review summarised the available evidence on REDs including the importance of nutrition, common red flags, intervention strategies (📝) and monitoring tools (🔍)

Here are the 8 key red flags ⬇️

Key Findings

Menstrual dysfunction, low libido, fatigue 🚩
📝 Increase EA by 300–600 kcal/day (330 kcal in REFUEL); add energy-dense snacks pre/post-training
🔍 LEAF-Q, CAT2, sex hormones

Frequent injuries/stress fractures 🚩
📝 Boost calcium/vitamin D (diet/supplements); prioritise bone health
🔍 DXA scan, vitamin D/ferritin

Performance plateau, GI issues 🚩
📝 Periodise carbs (1–4 g/kg pre-exercise, 30–60 g/h during, 1.0–1.2 g/kg post)
🔍 Training logs, glycogen markers

Elevated RMR suppression 🚩
📝 Reduce training loads; restore EA gradually
🔍 RMR testing, EA calculations

Immune suppression, frequent illness 🚩
📝 Avoid chronic “train-low”; ensure carb fuelling for endocrine/immune protection
🔍 Immune markers, infection logs

Muscle loss, poor recovery 🚩
📝 Protein 1.6–2.2 g/kg/day, distributed 0.3–0.4 g/kg/meal; collagen + vitamin C for tendons
🔍 FFM via DXA, injury history

Iron deficiency (esp. endurance/females) 🚩
📝 Screen ferritin/haemoglobin; nutrient-rich diet + targeted iron supplements
🔍 Ferritin, haemoglobin levels

Chronic low EA symptoms (e.g. skewed intake) 🚩
📝 Tailored plans: portion increases, sustainable snacks, education
🔍 EA questionnaire, weight trends

Reference

https://www.mdpi.com/2075-4663/14/8/314

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Study Details

Implementing low FODMAP diets are common practice in sport to reduce gastrointestinal (GI) symptoms, but should it be? 🧐

This new opinion article examined how FODMAP manipulation should be used to manage exercise-associated GI symptoms in endurance athletes 🔍

Here are the key takeaway messages ⬇️

Key Findings

🏃 Exercise-associated gastrointestinal symptoms can disrupt comfort, training quality and race execution

📊 Up to 80% of ultra-endurance runners report symptoms such as nausea, abdominal pain, bloating, urgency and diarrhoea

🥖 FODMAPs are poorly absorbed fermentable carbohydrates that increase intestinal water, gas production and luminal distension

📉 Five of the six studies examined generally reported less severe GI symptoms with a low-FODMAP approach

🤢 Low-FODMAP diets reduced gut discomfort, nausea, upper and lower GI symptoms and overall symptom severity

↔️ Low-FODMAP diets appear to reduce symptom severity rather than completely prevent symptoms from occurring

⏱️ A 24–48-hour low-FODMAP diet may be useful before key training sessions or competitions for athletes with frequent, severe or performance-limiting symptoms

🎯 FODMAP restriction should be symptom-driven and individualised rather than used routinely by all endurance athletes

🌱 Higher-FODMAP diets increase fermentation and short-chain fatty acid production, which may support intestinal epithelial health

🛡️ High-FODMAP intake may reduce exercise-induced intestinal injury by increasing nutrients and fermentation products within the gut

💨 However, higher FODMAP intake also increases carbohydrate malabsorption, gas production and the risk of more severe GI symptoms

🍞 High carbohydrate availability during exercise may protect intestinal integrity independently of FODMAP intake

🥤 Carb intake during prolonged exercise should therefore remain a priority alongside any FODMAP manipulation

🙂 Athletes with mild or infrequent symptoms may benefit from maintaining a more liberal FODMAP intake rather than unnecessarily restricting their diet

🔄 FODMAP-containing foods should be gradually reintroduced once acute symptoms are controlled

⚡ Any performance benefit is likely to result indirectly from improved symptom control rather than a direct ergogenic effect

⚠️ Long-term low-FODMAP diets may reduce dietary variety, compromise nutritional adequacy and reinforce restrictive eating behaviours

Conclusion

Low-FODMAP strategies should be short-term, practitioner-led and carefully monitored to maintain energy and carbohydrate availability ✅

Plus, FODMAP manipulation should form one part of a broader gut-management plan alongside hydration, gut training and individualised fuelling tolerance 🔋

Reference

https://pubmed.ncbi.nlm.nih.gov/42496856/

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Study Details

This new systematic review of 12 studies (446 participants) examined whether different Lactiplantibacillus plantarum strains including…

👉 TWK10

👉 PS128

👉 PL-02

…can improve exercise performance and recovery 🔍

Here are the key findings ⬇️

Key Findings

The effects of L. plantarum were highly strain-specific, meaning findings cannot be generalised across all probiotic products 🧬

TWK10 showed the most consistent evidence for improving aerobic endurance 🏃

⏱️ Four of five TWK10 trials reported longer time to exhaustion, with increases of approximately 1.24–1.58-fold versus placebo

📈 Higher TWK10 doses produced greater endurance benefits, with effective protocols generally providing at least 3 × 10¹⁰ CFU/day for 6-weeks

🧪 TWK10 accelerated the clearance of lactate and ammonia during exercise and recovery

🔥 TWK10 appeared to support metabolic recovery rather than directly reducing structural muscle damage or inflammation

💊 Heat-inactivated TWK10 retained many of the endurance and metabolic benefits of the live probiotic

🫀 However, improvements in time to exhaustion did not consistently coincide with increases in VO₂max

PS128 acted primarily as a recovery-focused strain rather than a consistent direct performance enhancer 🛡️

🦵 PS128 reduced post-exercise losses in knee strength and helped preserve countermovement-jump performance after a half-marathon

📉 PS128 reduced creatine kinase and myoglobin responses, suggesting less exercise-induced muscle damage

🔥 PS128 lowered TNF-α, IL-6 and IL-8 while increasing the anti-inflammatory cytokine IL-10 in triathletes

⚡ PS128 also preserved neuromuscular function after endurance exercise, including electromyographic activity and neural drive

🚴 PS128 improved aerobic and anaerobic performance in some competitive triathletes, but benefits were not replicated in recreational runners

PL-02 reduced creatine kinase and IL-6 after muscle-damaging exercise, but did not clearly improve endurance, power or strength 🧫

❌ Products using unspecified L. plantarum strains did not produce consistent performance or recovery benefits

🦠 TWK10, PS128 and PL-02 altered gut bacteria and increased several short-chain-fatty-acid-producing species, although these changes were only associated with (not proven to cause) the performance effects

Interesting findings however, evidence quality was moderate, with small samples, and varied protocols ⚠️

Conclusion

It’s a worthwhile consideration at this point that probiotic selection could be based on the exact strain and intended outcome…

🫁 TWK10 for endurance and metabolic recovery

💪 PS128 for muscle and neuromuscular recovery

🔍 PL-02 as an emerging option requiring more research

Reference

https://pubmed.ncbi.nlm.nih.gov/42528893/

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Study Details

This new meta-analysis compiled data from 14 studies (755 participants) to evaluate how effectively nutrition education improves athletes’ knowledge and which programme characteristics produce the best results 🔍

Here are the key findings ⬇️

Key Findings

📚 Nutrition education produced a large improvement in athletes’ nutrition knowledge

👥 Most participants were young athletes, with 73% at high-school age or younger

🗣️ Face-to-face education produced substantially larger improvements than online delivery

💻 Online interventions still improved knowledge, but their effect was smaller

⏱️ Programmes lasting 7-12 weeks produced the greatest improvements

📅 Interventions lasting one to six weeks were effective, but less so than longer programmes

🔄 Programmes extending beyond 13 weeks remained beneficial, although effects were slightly smaller than those lasting 7-12 weeks

🧑‍🏫 Lectures, mixed teaching methods and interventions without lectures all improved knowledge

↔️ No specific teaching type was clearly superior, suggesting programme quality may matter more than any single method

🎂 Intervention effectiveness did not significantly differ between younger and older athletes

🧪 Studies using validated nutrition-knowledge questionnaires reported more moderate and credible improvements

🎯 The certainty of evidence was moderate, meaning there is reasonable confidence that nutrition education improves athlete knowledge

Conclusion

Improved knowledge is important but does not necessarily guarantee improved eating behaviour, health or performance ⚠️

When designing effective programmes, these should ideally last at least seven weeks, include meaningful interaction and use validated tools to assess knowledge ✅

Reference

https://pubmed.ncbi.nlm.nih.gov/42516262/

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Study Details

This new editorial summarised the key messages from a special issue examining nutrition requirements, education, supplements and practical dietary strategies for young athletes 🔍

Here are the key messages ⬇️

Key Findings

🧒 Youth sports nutrition must account for growth, maturation, training, competition, recovery and school demands

Energy Demands

🔥 Adequate energy intake is essential for both athletic performance and healthy development

⚠️ Low energy availability can compromise growth, puberty, menstrual function, bone health, immunity, recovery and training adaptation

🍞 Carbohydrate restriction, ketogenic diets and aggressive carbohydrate periodisation are generally inappropriate for young athletes

🎒 Fuelling plans must consider school timetables, travel, appetite changes, family routines and access to suitable food

Education

📚 Nutrition education can improve knowledge, but greater knowledge does not automatically lead to lasting dietary change

🍳 Education should include meal planning, food preparation, label reading and evaluation of supplement claims

⚽ One nutrition intervention improved footballers’ knowledge without improving Mediterranean-diet adherence, highlighting the knowledge–behaviour gap

Support System

👨‍👩‍👧 Parents strongly influence food availability, meals and transport logistics

🏟️ Coaches and clubs shape beliefs around body weight, recovery, supplement use and acceptable eating behaviours

📱 Social media, peers and performance marketing can increase young athletes’ exposure to misleading supplement claims

Supplements

🥗 A food-first approach should prioritise energy intake, diet quality, hydration, meal timing, recovery and sleep

💊 Supplements should only be considered when there is a clear rationale, appropriate safety evidence, product-quality assurance and professional oversight

🌿 A Rhodiola rosea trial reported improvements in intermittent performance and decision-making, but findings should not override safety and dietary foundations

Conclusion

Recommendations for youth athletes must be simple, practical and achievable within real-world family, school and club environments 🛠️

Youth nutrition support must protect against restrictive eating, body dissatisfaction, unsafe weight-control practices and supplement misuse 🛡️

Effective support requires consistent messages from athletes, parents, coaches, practitioners and sporting organisations 🤝

Youth nutrition should support long-term health and development, not simply optimise the next training session or competition 🎯

Reference

https://pubmed.ncbi.nlm.nih.gov/42514396/

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Study Details

This new systematic review of 26 studies (380 participants) evaluated how exogenous ketone supplements affect performance, metabolism and physiological responses in trained or physically active people 🔍

Here are the key findings ⬇️

Key Findings

🧪 Ketone supplementation consistently increased circulating β-hydroxybutyrate concentrations

📉 Ketones commonly reduced blood glucose and altered lactate, substrate use and acid–base balance

🏁 Most acute studies found no improvement in time-trial performance, time to exhaustion or maximal workload

⚠️ Some studies reported impaired performance during sustained high-intensity endurance exercise

🧂 Ketone esters can induce metabolic acidosis by reducing blood pH and bicarbonate concentrations

🥄 Adding sodium bicarbonate can reduce this acidosis, but performance benefits remained inconsistent

🧠 Some studies reported improvements in vigilance, reaction time or cognitive function during fatiguing exercise

🏉 Team-sport and intermittent-exercise settings showed more promising effects than continuous endurance exercise

🏃 Ketone salts produced smaller increases in blood ketones and generally failed to improve performance

🔄 Repeated supplementation showed more promising effects on recovery and training adaptation than single acute doses

🩸 Three weeks of ketone ester use during endurance overload increased muscle capillarisation and pro-angiogenic signalling

🌙 Repeated ketone use around strenuous exercise improved sleep efficiency and helped preserve REM sleep in one study

🥾 Ketones maintained alertness and increased dopamine during a 100 km trail race without improving race performance

Conclusion

Ketones may be more useful for supporting adaptation, cognition or recovery than as a reliable race-day performance aid ✅

Current evidence remains low certainty because studies were small and protocols varied considerably ⚠️

Overall, ketones produce clear metabolic effects, but performance benefits depend heavily on dose, formulation, exercise intensity and co-ingestion strategy 🧐

Reference

https://pubmed.ncbi.nlm.nih.gov/42514217/

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Study Details

This new meta-analysis compiled data from 38 studies (703 participants) to establish the effects of beetroot juice supplementation on maximal oxygen uptake (VO₂max/VO₂peak) in healthy adults 📚

Key Findings

🫁 Beetroot juice produced small but significant improvements in both VO₂max/VO₂peak compared to placebo

🏃‍♂️ Effects were larger in active participants

🚴‍♂️ Effects in highly trained athletes were not clearly demonstrated

Doses of beetroot juice that were…

🔬 6.4-12.8 mmol (400 - 800 mg nitrate)

🗓️ At least 3 consecutive days

…showed the most consistent effects.

Conclusion

Beetroot juice can enhance maximal oxygen uptake during endurance exercise ✅

But effects may be greater in active individuals vs athletes 🧐

Either way, it’s a good source of carbohydrate so may well be worth implementing for those athletes seeking to optimise aerobic capacity 🫜🫁

Reference

https://pubmed.ncbi.nlm.nih.gov/42523624/

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Study Details

This new review paper summarised the available data on nutritional strategies to support connective tissue rehab and return-to-play after injury 🔍

Here are the key findings ⬇️

Key Findings

🦵 Progressive mechanical loading remains the primary driver of tendon and ligament recovery; nutrition should support, not replace, rehabilitation

Calorie Intake

🔥 Adequate energy availability is the first priority because tissue repair, collagen remodeling, immune function and rehabilitation loading all require energy

⚠️ Aggressive calorie restriction during injury may impair recovery, particularly when low energy availability or REDs risk is present

Protein Intake

🥩 ~1.6–2.2 g/kg/day can support muscle preservation and connective tissue repair

🍽️ Protein should be distributed across the day in doses of roughly 25–40 g or 0.3–0.4 g/kg per meal

🧬 Complete proteins support muscle recovery, while collagen-rich proteins provide more glycine, proline and hydroxyproline for connective tissue

Collagen

🥤 Around 10–15 g of collagen or gelatin with 50–100 mg vitamin C, taken 30–60 minutes before loading exercise, is a promising targeted strategy

🏋️ Collagen timing may be most relevant before heavy slow resistance, eccentric loading, isometrics or plyometric rehabilitation

⚠️ Collagen supplementation has not yet been shown conclusively to accelerate return to sport, reduce reinjury or improve long-term tissue outcomes

Additional Supplements

💪 Creatine monohydrate at 3–5 g/day may help preserve or rebuild muscle during reduced loading, although direct tendon and ligament evidence is limited

☀️ Vitamin D deficiency should be identified and corrected

🥛 Calcium intake should generally reach approximately 1000–1200 mg/day

🐟 Omega-3 intake may support inflammation resolution and muscle preservation, with 2–3 g/day of EPA and DHA suggested when dietary intake is low

🥗 Micronutrient needs should be addressed primarily through a varied, nutrient-dense diet rather than routine high-dose supplementation

Other considerations

📈 Energy and carbohydrate intake should rise alongside rehabilitation load to support strength, plyometric and sport-specific sessions

🎯 Nutritional strategies should be adjusted across the early healing, strengthening and return-to-sport phases

Conclusion

It should be noted that much of the evidence comes from mechanistic research, small studies and indirect injury models ☝️

So recommendations remain evidence-informed rather than definitive clinical guidelines ⚠️

However for any injured athlete, a “do no harm” approach and implementing some of these promising strategies is likely the best way to tackle injuries with nutrition ✅

Reference

https://pubmed.ncbi.nlm.nih.gov/42512652/

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Study Details

This new study recruited 17 active men to complete 8-weeks of resistance-training (2 - 4 sessions weekly) under fed conditions 🏋️‍♂️

During each training session participants consumed either…

1️⃣ Protein (0.17 g/kg) + Carbs (0.50 g/kg)

2️⃣ Carbs only (0.67 g/kg)

Muscle growth and fibre-type composition were assessed pre- and post-intervention 🔍

Key Findings

💪 Resistance training significantly increased whole-body, arm and leg lean mass

📈 Bench-press strength, leg-extension strength, VO₂max and fat-oxidation capacity all improved

However, compared to carbs alone, protein during training produced no additional improvements in…

❌ muscle fibre growth

❌ lean mass

❌ strength

❌ aerobic fitness

❌ fat oxidation

Conclusion

Lack of effects may have been due to total protein intake already being high enough (~1.6 - 1.8 g/kg/day)🥩

These results suggest that when athletes are fed, consume enough daily protein and take protein after training, intra-workout protein appears unlikely to add meaningful benefit ✅

Carbs may still be king for intraworkout.

Reference

https://pubmed.ncbi.nlm.nih.gov/42514376/

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Study Details

This new review examined the latest evidence on mechanisms linking gut microbiota composition and athletic recovery 🔍

Here are the key findings ⬇️

Key Findings

🦠 The gut microbiome may support recovery by influencing inflammation, oxidative stress, gut integrity, immunity and sleep

🔄 Exercise alters microbial composition, while microbial metabolites may influence recovery and adaptation

🧪 Short-chain fatty acids, particularly butyrate and propionate, are the best-characterised link between gut bacteria and recovery

🛡️ Butyrate may strengthen the intestinal barrier, regulate inflammation and help manage exercise-induced oxidative stress

🏃 Endurance athletes commonly show more Prevotella, Veillonella and other short-chain-fatty-acid-producing bacteria

🏋️ Strength athletes tend to show more protein-metabolising bacteria and amino-acid metabolism pathways

📈 Microbial profiles change across training, competition and recovery, suggesting possible future use in monitoring training stress

💊 Small athlete trials of Lactobacillus and Bifidobacterium formulations have reported improvements in inflammation, oxidative stress and sleep

⚠️ Probiotic effects are strain-specific, and no standard dose, combination or protocol has been established

Practical strategies include…

🌾 increasing fermentable fibre

🌱 eating diverse plant foods and protein sources

🥣 including fermented foods

🍟 limiting UPFs

😴 The gut–brain axis may influence sleep through GABA, serotonin, tryptophan metabolism and short-chain fatty acids, but direct athlete evidence remains limited

🎯 Athlete probiotic trials have generally used 10⁹–10¹¹ CFU for 2–12 weeks, but these are tested ranges rather than firm recommendations

Conclusion

Microbiome strategies should complement, not replace, adequate nutrition, sleep and appropriate training periodisation ✅

At present most evidence is small, heterogeneous, observational or preclinical, so it remains unclear whether microbial differences cause better recovery or simply reflect training and diet ⚠️

Reference

https://pubmed.ncbi.nlm.nih.gov/42514472/

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Study Details

This new (slightly odd) study, recruited 23 trained men to a crossover trial where they completed repeated resistance-exercise sets after smelling either…

1️⃣ 90% dark chocolate

2️⃣ 60% milk chocolate

3️⃣ Water-based control

Here is what they found ⬇️

Key Findings

Chocolate odours significantly affected…

📈 Total repetitions

📈 Total sets

👉 Total repetitions were greater with 90% dark chocolate than with control (+18 reps)

👉 Milk chocolate was also greater than control (+9 reps)

🧠 Before exercise, 90% dark chocolate reduced appetite-related ratings

👃 Whereas 60% milk chocolate increased odour pleasantness

Conclusion

Chocolate-related odours appear to modulate appetite and hedonic responses while increasing resistance-exercise volume 🧐

Probably more pleasant than smelling salts, but personally I’d end up eating it.

Reference

https://pubmed.ncbi.nlm.nih.gov/42495704/

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Study Details

This new meta-analysis compiled data from 13 cohorts (over 380,000 participants and 26,000 depression cases) to establish the associations between fruit and vegetable intake and depression 🔍

Here are the key findings ⬇️

Key Findings

🥗 High intakes of fruit and veg were associated with a 37% lower risk of depression than low intakes

📈 Each 200 g/day increase corresponded to a 16% risk reduction

🫐 Fruit intake reduced depression risk by 16%

🥦 Vegetable intake reduced depression risk by 12%

Conclusion

Higher consumption of fruit and veg isn’t just for physical health 🫀

It has a significant benefit to mental health throughout life 🧠

Incorporating fruit and/or veg at 3 meals per day and aiming for multiple colours of fruit and veg in those meals can go a long way to supporting your overall health and mental wellbeing ✅

Reference

https://pubmed.ncbi.nlm.nih.gov/42480719/

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I Missed a Day! 😖

First one since starting the newsletter and it ends the 641 day streak! Slightly annoying as the post was ready I just put in the wrong date for publishing.

Anyhow, as a wee apology this edition of Super Digestible is free to all subscribers. Please enjoy and thanks again for being a valued subscriber to Performance Nutrition Digest.

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What is Super Digestible?

Every day I post a research breakdown of the latest nutrition science related to human performance, health and the power of food. The daily 1-min reads are a great way to stay on top of the research. But, I want to make actionable summaries even more accessible 📝

Therefore, I started Super Digestible, a monthly newsletter containing a one-to-two sentence summary of each study I’ve reviewed that month. Focusing specifically on how you can apply these findings in your own practice ✅

Each study will be filtered into: DO, CONSIDER, DON’T. Based on the research findings, paired with my professional experience in the world of elite sport 🏆

This is your monthly research cheat sheet, so you can stay at the very pinnacle of science-based performance nutrition 🏔

A huge shoutout to who inspired this format. I highly recommend following Daniel’s Endurance: Ideas & Implementation Substack.

The Super Digestible newsletter is a paid subscriber special. If you’re not a paid subscriber yet but want to know more, check out the January 2025 edition for free!

Each item is linked to the original research breakdown. Just click on the DO, CONSIDER, DON’T 👈

Please note that paid subscribers have access to all previous research breakdowns via the Performance Archive 📚

✅ DO these things…

DO: Supplement with blackcurrant extract, acute doses of 300 - 600 mg can improve strength, power, lifting volume and cognitive performance 📈

DO: Utilise lower doses of caffeine (≤ 3 mg/kg) to enhance endurance performance, you don’t always need moderate to high-doses to see benefits, plus it’s less likely to disturb sleep ☕️

DO: Target higher carb intakes (60 - 90 g/hr +) and higher sodium intakes if you are aiming for a fast finish in ultramarathons, data from the Western States Endurance Run show that these priorities support higher intensity running and better finishing times ⛰️

DO: Supplement with polyphenols including tart cherries (for recovery), blackcurrant extract (for performance), pomegranate (for performance) and turmeric (for recovery) 🍒

DO: Manage the interaction between gut tolerance, appetite, heat stress, psychology and practicality alongside carbs, fluids and electrolyte intake for ultramarathons, it’s a multifaceted challenge as outlined in this paper on the Marathon des Sables 🏜️

DO: Prioritise whey protein as your primary source of supplemental protein, in addition to benefits in and around training sessions it appears to also improve sleep and recovery when compared to casein 💤

DO: Where possible, implement > 31 min naps into training and competition routines, evidence shows this has significant benefits to endurance and power performance 😴

DO: Utilise GI symptom management strategies for adult athletes with youth athletes, evidence suggests that pathways are similar and therefore these tools / approaches are transferable 😮‍💨

DO: Employ food-based antioxidant strategies to support adaptations to endurance training, recovery during heavy training blocks and in congested competition periods, during eccentric exercise blocks, during heat stress or environmental strain, during travel or tournament settings and when returning from illness 🫐

DO: Add vitamin C to l-arginine supplementation, this increases arginine bioavailability and has been shown to improve VO2max, body composition and testosterone levels in bodybuilders 📈

DO: Combine structured healthy nutrition interventions (e.g. breakfast clubs) and physical activity (including cognitive components) in the morning before school, it has significant benefits to cognitive performance, academic achievement and physical fitness 🎓

DO: Use fish oils (3000 mg/day) and creatine (3 - 5 g/day) to support recovery after concussion in contact sports, these are low risk and potentially high reward supplements which are typically already used routinely by many athletes 💥🧠

DO: Plan hydration and carbohydrate intake as equally important during endurance exercise, dehydration can reduce how effectively athletes use the carbs they consume by impairing carb oxidation 🥵🚨

DO: Use split or multi-day dosing protocols, enteric-coated products and carbohydrate-hydrogel mini-tablets to reduce GI distress when using sodium bicarbonate 🧂

DO: Use caffeine (3 mg/kg) to improve sprint performance, reduce RPE and improve passing performance in rugby 🏉

🤔 CONSIDER these things…

CONSIDER: A higher dose of creatine (> 5 g/day), results from this paper showed that 5 g/day was not sufficient to elicit changes in muscular adaptations, also timing of creatine probably doesn’t matter much 🙅‍♂️

CONSIDER: That you probably don’t need to add carbs to your post-workout protein shake to enhance resistance-training outcomes, it has little effect (if any at all), but if you are training later in the day then do add those carbs for performance purposes 💪

CONSIDER: Ashwagandha (500 - 600 mg/day) to support aerobic exercise performance, it may not be a game changer but could offer benefits, also it doesn’t appear beneficial for strength / power performance 🫚

CONSIDER: That beta-alanine may not be as effective for female athletes, evidence suggests only small benefits for time-to-exhaustion with limited to no evidence for any other performance outcome ‼️

CONSIDER: Dark chocolate, daily mindfullness yoga, cryotherapy and (when medically directed) acetaminophen to help manage menstrual cycle symptoms as a female athlete 🩸

CONSIDER: Turmeric / curcumin supplementation to support recovery during high training stress, repeated competition, or when reducing excessive soreness and oxidative stress is the priority 🫚

CONSIDER: Probiotic supplementation alongside intensive endurance training blocks to boost physical and psychological recovery 🦠

CONSIDER: That intermittent fasting does not appear to compromise chronic resistance-training adaptations (as long as total daily calorie and macronutrient intake is sufficient) ⏰

CONSIDER: Collagen supplementation (15 g/day) to enhance resistance-training induced adaptations including muscular type I collagen content which can provide structural support and transmit contractile force to tendons 💪

CONSIDER: That total fasting (e.g. water fasting, complete food deprivation) duration (> 3 days) may lead to greater weight loss but also comes at the expense of greater fat free mass loses 🩻

CONSIDER: HMB supplementation (90 mg/kgFFM/day) to optimise aerobic performance gains including VO2max, power output at anaerobic threshold and heart rate metrics 🫁

CONSIDER: Astaxanthin (12 mg/day) to support fat oxidation and potentially improve endurance performance in female athletes 🧐

CONSIDER: Ketone monoesters before and during exercise in the heat, it appears to improve both endurance and cognitive performance when combined with pre-exercise caffeine 🌡️

CONSIDER: 20-min power naps during multi-day ultramarathons to improve cognitive performance, lower risk of making mistakes and improve fatigue management without compromising your finishing time, data from the Ultra-Trail du Mont-Blanc 💤

🚨 DON’T do these things…

DON’T: Just use symptom reporting to analyse gastrointestinal symptoms in athletes, as it likely underestimates GI issues, it should therefore be paired with blood biomarker data (e.g. IL-6, IL-10, IL-1ra) 🩸

DON’T: Aim for (or provide) general body composition targets for football players, evidence from over 900 DEXA scans shows that pro football players are commonly over 10% body fat and targets should be based on playing position, competition level, ethnicity and seasonal phase, rather than just pulled out of thin air ⚽️

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