Many of the athletes in your race may be at the top of their physical game, at their peak fitness level, but if GI distress crops up, it can be a show stopper. What causes GI issues and how can you help athletes who experience this during your race?
Numerous factors including diet, stress, hydration, and effort-intensity are responsible for GI problems during physical activity. Some of which are preventable. In rare instances, athletes experience pathological conditions that may require medical advice (irritable bowel disease, celiac disease). Incredibly, roughly 50% of endurance athletes report some form of GI problems during competitions and training. It is essential to recognize the factors that affect the digestive system and plan accordingly to limit potential problems.
Prolonged physical activity creates unfavorable conditions for the digestive system. In response to exercise, our bodies shunt blood away from the digestive system and to the skeletomuscular system. As a result, our muscles can continue powering our efforts, but the GI system now has limited ability to process food and absorb nutrients. Efforts of higher intensity or longer duration further inhibit the GI system from being able to ingest nutrients and redistribute those calories into much-needed energy. The best solution to address GI issues during efforts of high intensity is to slow down. However, bouts of higher intensity typically take place on race day, which is when athletes don't want to slow down! It is crucial for athletes to arrive at the starting line as fit as possible so they can put forth their best effort. Peak fitness and proper pacing can go a long way in eliminating GI issues.
So what can you do? The first step is obvious: encourage athletes to arrive at your event as fit as possible. The next critical step is for them to have a tried and true fueling strategy that has been practiced in their training. When looking at the potential digestive system problems (nausea, vomiting, diarrhea) that can occur during training or racing, there is one common denominator that binds all of these issues together. It is when the osmolality of the GI system becomes too high. High osmolality is responsible for the majority of GI distress incidents related to ingesting food during exercise. Osmolality is determined by the concentration of active molecules (Na, K, Cl, glucose). High osmolality is created when there is high consumption of quickly released active molecules such as glucose, maltose, saccharose, maltodextrin, starch, or salt. High temperatures in the external environment and dehydration can worsen the condition (as these conditions increase the ratio of active molecules to water). Osmolality is recognized by osmoreceptors, which guard the body's homeostasis (internal order) to prevent rapid absorption of highly concentrated active molecules.
Our bodies makes an effort to dissolve highly concentrated content by pulling water into our digestive system, which frequently leads to dehydration. As a result, there is now a high volume of food and water in the GI tract creating discomfort, sloshing, and all the other unpleasant events that follow. To prevent GI distress caused by high osmolality in the digestive system, athletes should consume natural sources of carbohydrates that are slowly released, and limit eating highly processed and quickly released sugars. For race directors, this means: providing real food options at aid stations such as bananas and watermelon. Keep in mind that sodas, salt, and maltodextrin-rich products are heavily present at many races. Thus it is important to encourage athletes to select food at the aid station consciously! It is not uncommon to see athletes who regularly grab salt tabs and/or sugary drinks routinely experience GI problems. A quick drink of soda will deliver caffeine and sugar to your system and provide a quick energy kick. But the sugar-laden soda will inevitably lead to GI issues thanks to the concentrated shot of sugar being released quickly into the GI system.
In some cases, avoiding products rich in sugar and salt may not be sufficient to limit digestive system problems. Food additives and preservatives have been shown to trigger stomach pain and increased sensitivity. Warning participants to avoid preserved foods while running or cycling is a good idea anyway as some preservatives (sodium benzoate or sulfates), even though not considered toxic, may affect mitochondrial functions. We train to improve mitochondrial functions. There is nothing more counterproductive than voluntarily ingesting substances that undermine training effects!
GI issues result in athletes having bad experiences and ultimately not performing as well as they had hoped in your race. As race directors, to help athletes reach their full potential without GI distress, you can provide them with pre-race education on the subject, stock your aid stations with nutritious options, make sure porta potties are easily accessible, and educate aid station volunteers on how to help athletes overcome stomach problems mid-race. This will foster an overall positive experience for all of the athletes who take part in your event.
Contributed by Rafal Nazarewicz, PhD Sports Nutrition, Founder of Spring Energy.
About Spring Energy
Spring Energy products are designed with the knowledge that GI distress is one of the leading problems in endurance sports nutrition. By using various sources of energy, lowering sugar content, including fat and excluding preservatives, Spring products are able to overcome this problem. We hope you consider stocking your aid stations with Spring Energy and give your participants a fighting chance against GI distress!