Ultramarathon running events and participation numbers have increased progressively over the past three decades. Besides the exertion of prolonged running with or without a loaded pack, such events are often associated with challenging topography, environmental conditions, acute transient lifestyle discomforts, and/or event-related health complications. These factors create a scenario for greater nutritional needs, while predisposing ultramarathon runners to multiple nutritional intake barriers. The current review aims to explore the physiological and nutritional demands of ultramarathon running and provide general guidance on nutritional requirements for ultramarathon training and competition, including aspects of race nutrition logistics. Research outcomes suggest that daily dietary carbohydrates (up to 12 g·kg−1·day−1) and multiple-transportable carbohydrate intake (∼90 g·hr−1 for running distances ≥3 hr) during exercise support endurance training adaptations and enhance real-time endurance performance. Whether these intake rates are tolerable during ultramarathon competition is questionable from a practical and gastrointestinal perspective. Dietary protocols, such as glycogen manipulation or low-carbohydrate high-fat diets, are currently popular among ultramarathon runners. Despite the latter dietary manipulation showing increased total fat oxidation rates during submaximal exercise, the role in enhancing ultramarathon running performance is currently not supported. Ultramarathon runners may develop varying degrees of both hypohydration and hyperhydration (with accompanying exercise-associated hyponatremia), dependent on event duration, and environmental conditions. To avoid these two extremes, euhydration can generally be maintained through “drinking to thirst.” A well practiced and individualized nutrition strategy is required to optimize training and competition performance in ultramarathon running events, whether they are single stage or multistage.
Ricardo J.S. Costa, Beat Knechtle, Mark Tarnopolsky, and Martin D. Hoffman
Martin D. Hoffman, Philip S. Clifford, Božo Bota, Michael Mandli, and Gregory M. Jones
A theoretical analysis was used to evaluate the effect of body mass on the mechanical power cost of cross-country skiing and roller skiing on flat terrain. The relationships between body mass and the power cost of overcoming friction were found to be different between cross-country skiing on snow and roller skiing. Nevertheless, it was predicted that the heavier skier should have a lower oxygen cost per unit of body mass for roller skiing, as is the case for snow skiing. To determine whether the theoretical analysis was supported by experimental data, oxygen consumption measurements were performed during roller skiing by six male cross-country ski racers who spanned a 17.3-kg range in body mass. The theoretical analysis was supported by the experimental findings of decreases in oxygen consumption for each kg increase in body mass of approximately 1.0% for the double pole technique, 1.8% for the kick double pole technique, and 0.6% for the VI skate technique.
Martin D. Hoffman, Kristin J. Stuempfle, Ian R. Rogers, Louise B. Weschler, and Tamara Hew-Butler
To determine the incidence of exercise-associated hyponatremia (EAH), the associated biochemical measurements and risk factors for EAH, and whether there is an association between postrace blood sodium concentration ([Na+]) and changes in body mass among participants in the 2009 Western States Endurance Run, a 161-km mountain trail run.
Change in body mass, postrace [Na+], and blood creatine phosphokinase (CPK) concentration, and selected runner characteristics were evaluated among consenting competitors.
Of the 47 study participants, 14 (30%) had EAH as defined by a postrace [Na+] <135 mmol/L. Postrace [Na+] and percent change in body mass were directly related (r = .30, P = .044), and 50% of those with EAH had body mass losses of 3–6%. EAH was unrelated to age, sex, finish time, or use of nonsteroidal anti-inflammatory drugs during the run, but those with EAH had completed a smaller (P = .03) number of 161-km ultramarathons. The relationship of CPK levels to postrace [Na+] did not reach statistical significance (r = –.25, P = .097).
EAH was common (30%) among finishers of this 161-km ultramarathon and it was not unusual for those with EAH to be dehydrated. As such, changes in body mass should not be relied upon in the assessment for EAH during 161-km ultramarathons.
James M. Winger, Martin D. Hoffman, Tamara D. Hew-Butler, Kristin J. Stuempfle, Jonathan P. Dugas, Kevin Fogard, and Lara R. Dugas
To determine if beliefs about physiology and rehydration affect ultramarathon runners’ hydration behaviors or if these beliefs increase the risk for exercise-associated hyponatremia (EAH).
Participants of the 2011 161-km Western States Endurance Run completed a prerace questionnaire, prerace and postrace body-mass measurements, and postrace assessment of serum sodium ([Na+]).
Of 310 finishers, 309 (99.7%) completed the prerace questionnaire and 207 (67%) underwent postrace blood studies. Twelve (5.8%) finishers had asymptomatic EAH ([Na+] range 131–134 mmol/L). The most common hydration plan (43.1%) was drinking according to schedule, and these runners did so to replace fluid lost when sweating (100%) and to avoid dehydration (81.2%). Prerace drinking plan was not associated with postrace [Na+] or the development of postrace hyponatremia. There also were no group differences between those with and those without EAH for any other variables including planned energy intake or knowledge of fluid balance. Runners not planning to drink to thirst trended toward more influence from advertisements (P = .056) and were significantly more influenced by scientific organizations (P = .043) than runners with other drinking plans. Finally, runners who believe that EAH is caused by excessive drinking adopted a lower-volume drinking plan (P = .005), while runners who believe that EAH is caused by sodium loss via sweating reported more common use of sodium supplementation during the race (P = .017).
Beliefs regarding the causes of EAH alter race behaviors including drinking plan and sodium supplementation but do not appear to affect the likelihood of developing EAH during a 161-km ultramarathon.