Prevention and management of exercise-associated gastrointestinal issues 😮‍💨

Your new go-to GI issue guide.

Apr 12, 2025

Study Details

This new joint position statement from Sports Dietitians Australia and Ultra Sports Science Foundation reviewed the current evidence to establish the following guidelines 📝

Key Findings

Here are the key action points ⬇️

First Line Actions 📋

💧 Start exercise hydrated and maintain hydration throughout

🥤 Identify and apply individual feeding tolerance to carbs during exercise (e.g. feeding challenge assessment or 1 g/kg/hr)

⏱️ Carbs and/or protein immediately before and frequently throughout exercise (within individual tolerance)

🧃 Gut training protocols (foods and/or fluids)

🧊 Cooling strategies aimed to limit substantial rises in core temperature (≥39.5°C)

⏰ 24 - 48hr high carb low FODMAP diet

⚠️ Avoidance of non-steroidal anti-inflammatory agents

Adjustment Strategies 📊

Supplementation strategies including…

🥤 Mixed amino acid formulations

💊 Citrulline

🧫 Prebiotics

🫚 Curcumin

🫐 Anthocyanins

Feeding tolerance adjustment considerations…

👉 Intake volume

👉 Nutrient concentration

👉 Dose and frequency

👉 Intake texture form (e.g. gel vs chew)

👉 Carbohydrate type

Strategies to Avoid / Unlikely to be Beneficial / Have No Impact 🚫

💧 Hyperhydration (incl. glycerol + sodium)

🌾 Gluten-free

🥑 Ketogenic diets

🪫 Short term low-energy availability

💊 Supplements (incl. glutamine, arginine, antioxidants, probiotics, synbiotics, colostrum, nitrate)

💊 Pharmaceutical administration (antiemetics / antacids)

🥤 Gut training using non-caloric sweeteners

🤲 Application of physical manoeuvres

Compression socks

Plus these dietary adjustments/strategies that are also unlikely to have any positive effects…

👉 Fructose tolerance

👉 Glucose molecular weight

👉 Modified starch

👉 Multiple transportable carbs

👉 Hydrogel

👉 Caffeine inclusion

👉 Coconut water

👉 Dairy

👉 High fibre diets

Conclusion

GI issues are highly individual, therefore working with a qualified nutrition practitioner is strongly recommended to help guide you through this process ✅

Reference

https://pubmed.ncbi.nlm.nih.gov/40195264/