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GI issues and sport nutrition

                                       A throwback to Kona '18 and Acai bowls - yum yum.


Wowzer - five weeks until IM 70.3 Haines City. I'm so excited to race I can hardly contain myself.
My training is slowly increasing in training volume - specifically bike and run. My typical swim distances are between 3800-4600 yards (~1-1:15hr swim) and I swim five times per week. I also bike about five times per week and there's never an easy bike workout. As for the run, I also run about 4-5 times per week and while I have some solid brick run sessions (my favorite - I love love love running off the bike), my other runs are all about efficiency right now (around 45-65 minutes). With a long season ahead (20 weeks until Ironman Canada and 30 weeks until IM Kona), I'm being patient with my run volume/intensity (per the methods of my coaches).

I'm lucky that I don't suffer from GI issues in training and on race day. Neither does Karel. I believe much of this relates to the daily diet, always fueling before our training sessions and always using sport nutrition during workouts. There's also a proper application to using sport nutrition products and I find that many athletes struggle with knowing what products to use (and when) and are very inconsistent with when/how products are consumed.

GI (gastrointestinal) problems are very common in athletes, specifically endurance athletes. It's probably one of the most common reasons why athletes reach out to me for sport nutrition help. Although many athletes suffer from GI issues in training, the prevalence for GI distress is amplified on race day, especially as racing duration continues and in hot environmental conditions.

GI issues may be due to several causes including physiological (reduced blood supply to the GI tract), nutritional (pre-race diet and race day fueling methods) and mechanical (ex. bike fit, jostling of organs while running, breathing issues).

From my professional experience, athletes describe many different types of GI issues that are bothersome in training/racing and many of which can disrupt the ability to train normally.
Flatulence or belching are two very mild lower and upper (respectively) abdominal symptoms that probably won't impair your physical performance. For most athletes who complain of gas and burping during racing, these symptoms are typically uncomfortable and annoying, but tolerable.  
However, heartburn, lower abdominal cramps, side stitches, diarrhea, nausea, vomiting, stomach pains, bloating and bloody stools will not only affect your race day effort (if you make it out of the port-o-potty) but are extremely health threatening. I've worked with several athletes who have experienced the above issues, only to end up in the medical tent or hospital after the race. It's certainly not the way you'd imagine finishing your race.

Keep in mind that GI symptoms during exercise are highly individualized and often circumstantial. However, the gut is an organ that can be trained, just like your muscles. 

Many athletes are predisposed to GI issues, relating to genetics, biomechanics, anatomy, age, diet and health issues (to name a few). For the athlete who has a long (or on and off) history of GI distress, it’s quite possible that you are not adapted to fluid/calorie ingestion during training, you do have an ideal formulation of carbohydrates, electrolytes and fluids for your fueling strategy, your fueling timing is off or you are racing at too high of an intensity to properly fuel and meet your planned (or perceived) effort. Menstruation, breathing issues and dehydration can also be blamed for GI distress.
To reduce the risk of GI issues on race day, do not wait until last minute to formulate your perfect concoction of liquids, electrolytes and carbohydrates to meet your race day effort needs.  Once you have the right fueling products (flavors taken into consideration for your taste buds), it can then take at least 4-6 weeks to feel "less full" when fueling and exercising and improve intestinal absorption - both of which correlate to improved tolerance of sport nutrition during training. This is why it's important to use sport nutrition products during training sessions, especially high intensity and longer distance sessions. 

As a reminder, a sport drink (or fueling strategy) is only effective if it is emptied from the stomach and can be quickly absorbed through the walls of the small intestine. Additionally, electrolytes (ex. sodium) are needed with water as they will encourage retention of fluids, reduce urine output and promote absorption from the intestine.

Happy fueling athletes!