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Beth Glace, Christine Murphy, and Malachy McHugh

The purpose of this study was to document eating strategies employed by runners during a 160-km race, and to identify eating patterns that predispose the runner to disturbed mental or gastrointestinal functioning. We monitored intake in 19 volunteers during the 12 hours pre-race. Intake was determined by interview with runners approximately every 12 km throughout the race. The mean finish time was 24.3 hours, with 4 runners not completing the race. Body mass decreased during the race, 75.9 ± 2.3 kg to 74.4 ± 2.2 kg (p < .001). Runners ingested 2643 kcals during the 12 hours prerace (68% carbohydrate) and 3.8 L of fluid. During the race 6047 kcal, 18 L of fluid, and 12 g of sodium were consumed. Gastrointestinal distress (GI) was experienced by half of the participants, but was unrelated to food or fluid intake. Upper GI symptoms were more prevalent than lower and occurred mainly after 88 km. Runners with GI distress tended to complete fewer training miles (p = .10) and to do shorter training runs (p = .08). Half of the volunteers reported mental status changes (MSC), such as confusion or dizziness. Runners with MSC had greater intake of total calories, carbohydrate, and fluid (p < .05) than runners without MSC. They also completed shorter training runs (p = .03). Caloric and moisture intake for all runners far exceeded intakes described previously. Although intake did not match energy expenditure, it may represent the upper limit for absorption during exercise, and very high food and/or fluid intake appears to lead to perturbed mental status.

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Salomé Aubert, Joel D. Barnes, Iryna Demchenko, Myranda Hawthorne, Chalchisa Abdeta, Patrick Abi Nader, José Carmelo Adsuar Sala, Nicolas Aguilar-Farias, Susana Aznar, Peter Bakalár, Jasmin Bhawra, Javier Brazo-Sayavera, Mikel Bringas, Jonathan Y. Cagas, Angela Carlin, Chen-Kang Chang, Bozhi Chen, Lars Breum Christiansen, Candice Jo-Anne Christie, Gabriela Fernanda De Roia, Christine Delisle Nyström, Yolanda Demetriou, Visnja Djordjic, Arunas Emeljanovas, Liri Findling Endy, Aleš Gába, Karla I. Galaviz, Silvia A. González, Kylie D. Hesketh, Wendy Yajun Huang, Omphile Hubona, Justin Y. Jeon, Danijel Jurakić, Jaak Jürimäe, Tarun Reddy Katapally, Piyawat Katewongsa, Peter T. Katzmarzyk, Yeon-Soo Kim, Estelle Victoria Lambert, Eun-Young Lee, Sharon Levi, Pablo Lobo, Marie Löf, Tom Loney, José Francisco López-Gil, Juan López-Taylor, Evelin Mäestu, Agus Mahendra, Daga Makaza, Marla Frances T. Mallari, Taru Manyanga, Bojan Masanovic, Shawnda A. Morrison, Jorge Mota, Falk Müller-Riemenschneider, Laura Muñoz Bermejo, Marie H. Murphy, Rowena Naidoo, Phuong Nguyen, Susan Paudel, Željko Pedišić, Jorge Pérez-Gómez, John J. Reilly, Anne Kerstin Reimers, Amie B. Richards, Diego Augusto Santos Silva, Pairoj Saonuam, Olga L. Sarmiento, Vedrana Sember, Mohd Razif Shahril, Melody Smith, Martyn Standage, Gareth Stratton, Narayan Subedi, Tuija H. Tammelin, Chiaki Tanaka, Riki Tesler, David Thivel, Dawn Mahube Tladi, Lenka Tlučáková, Leigh M. Vanderloo, Alun Williams, Stephen Heung Sang Wong, Ching-Lin Wu, Paweł Zembura, and Mark S. Tremblay

Background: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children’s and adolescents’ (5–17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. Methods: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders’ top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. Results: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. Conclusions: The Global Matrix 4.0 represents the largest compilation of children’s and adolescents’ PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation.