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Kristin J. Stuempfle, Martin D. Hoffman and Tamara Hew-Butler

Context:

Gastrointestinal (GI) distress is common during ultrarunning.

Purpose:

To determine if race diet is related to GI distress in a 161-km ultramarathon.

Methods:

Fifteen (10 male, 5 female) consenting runners in the Javelina Jundred (6.5 loops on a desert trail) participated. Body mass was measured immediately prerace and after each loop. Runners reported if they had nausea, vomiting, abdominal cramps, and/or diarrhea after each loop. Subjects were interviewed after each loop to record food, fluid, and electrolyte consumption. Race diets were analyzed using Nutritionist Pro.

Results:

Nine (8 male, 1 female) of 15 runners experienced GI distress including nausea (89%), abdominal cramps (44%), diarrhea (44%), and vomiting (22%). Fluid consumption rate was higher (p = .001) in runners without GI distress (10.9 ± 3.2 ml · kg−1 · hr−1) than in those with GI distress (5.9 ± 1.6 ml · kg−1 · hr−1). Runners without GI distress consumed a higher percentage fat (p = .03) than runners with GI distress (16.5 ± 2.6 vs. 11.1 ± 5.0). In addition, fat intake rate was higher (p = .01) in runners without GI distress (0.06 ± 0.03 g · kg−1 · hr−1) than in runners with GI distress (0.03 ± 0.01 g · kg−1 · hr−1). Lower fluid and fat intake rates were evident in those developing GI distress before the onset of symptoms.

Conclusions:

A race diet with higher percentage fat and higher intake rates of fat and fluid may protect ultramarathoners from GI distress. However, these associations do not indicate cause and effect, and factors other than race diet may have contributed to GI distress.

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Nancy J. Rehrer, Monique van Kemenade, Wineke Meester, Fred Brouns and Wim H.M. Saris

This study examined the relationship between gastrointestinal (GI) symptoms and dietary intake in triathletes. Fifty-five male triathletes (age 31 ±6 yrs) were surveyed regarding the most recently completed half Iron Man triathlon. Questions were asked regarding GI symptoms and dietary intake. Fifty-two percent complained of eructation and 48% of flatulence. Other symptoms were abdominal bloating, vomiting urge, vomiting, nausea, stomachache, intestinal cramps, and diarrhea. More symptoms occurred while running than at other times. All individuals who had eaten within 30 min of the start vomited while swimming. Fat and protein intake was greater in those who vomited or had the urge to vomit than in those without these symptoms. Of the former, 93% had consumed a hypertonic beverage. Forty percent of those who drank a hypertonic beverage and only 11% of those who drank an iso-or hypotonic beverage had severe complaints. Four of five individuals with stomachache had consumed a strongly hypertonic beverage. All subjects with intestinal cramps had eaten fiber-rich foods in the pre race meal; only 10% of those without cramps had done so.

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Ben-El Berkovich, Aliza H. Stark, Alon Eliakim, Dan Nemet and Tali Sinai

risk” included RWL methods that required immediate restriction of food and liquid intake in order to reduce weight within days. (c) Interventions considered “high risk” lead to RWL in a very short time period, with methods that resemble practices in the realm of eating disorders, such as vomiting and

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Martin D. Hoffman and Kevin Fogard

Purpose:

Despite increased 161-km ultramarathon participation in recent years, little is known about those who pursue such an activity. This study surveyed entrants in two of the largest 161-km trail ultramarathon runs in North America to explore demographic characteristics and issues that affected race performance.

Methods:

All entries of the 2009 Western States Endurance Run and the Vermont 100 Endurance Race were invited to complete a postrace questionnaire.

Results:

There were 500 respondents among the 701 race entries (71.3% response). Finish time was found to have a significant (P <.01) negative association with training volume and was generally directly associated with body mass index. Among nonfinishers, the primary reason for dropping out was nausea and/or vomiting (23.0%). Finishers compared with nonfinishers were more likely (P <.02) to report blisters (40.1% vs 17.3%), muscle pain (36.5% vs 20.1%), and exhaustion (23.1% vs 13.7%) as adversely affecting race performance, but nausea and/or vomiting was similar between groups (36.8% vs 39.6%). Nausea and/or vomiting was no more common among those using nonsteroidal anti-infammatory drugs (NS AIDs), those participating in the event with higher ambient temperatures, those with a lower training volume, or those with less experience at finishing 161-km races. Overall use of NSAIDs was high, and greater (P = .006) among finishers (60.5%) than nonfinishers (46.4%).

Conclusions:

From this study, we conclude that primary performance-limiting issues in 161 -km ultramarathons include nausea and/or vomiting, blisters, and muscle pain, and there is a disturbingly high use of NSAIDs in these events.

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Ellen Weissinger, Terry J. Housh, Glen O. Johnson and Sharon A. Evans

Self-reports of weight loss knowledge, attitudes, and methods in a sample of 125 high school wrestlers are described. These responses are compared to perceptions of 88 wrestlers’ parents regarding their son’s weight loss behaviors. Responses to survey questionnaires indicated that wrestlers were highly likely to deliberately lose weight for wrestling and that they most commonly used increased exercise, caloric restriction, and fluid restriction as weight loss techniques. Wrestlers reported use of extreme weight loss techniques (fasting, vomiting, diuretics) in higher proportions than the general adolescent male population, despite their reports of detrimental effects of such methods. Compared to their sons, parents significantly underestimated the use of extreme methods and were more realistic about the potential harmful effects of severe weight loss. Wrestlers and parents alike felt that weight loss is overemphasized in wrestling competition. These findings indicate a need for improved adult monitoring of high school wrestling programs.

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Heather Fahsl and Shannon David

During the fall preseason of 2013, a 19-year-old Division I linebacker (body mass = 104 kg; height = 189 cm) attending a college football camp developed severe throat pain, quickly followed by night sweats, fever, nausea, vomiting, shortness of breath, and generalized body weakness. The athletic trainer believed that the athlete had a cold. Because symptoms did not improve, the athlete was referred to several physicians with different specialties and underwent standard testing. The ears, nose, and throat (ENT) physician recognized the signs and symptoms of Lemierre’s syndrome based on a previous case seen only once in his career. A computed tomography (CT) scan confirmed the presence of a peritonsillar abscess and thrombosis of the left internal jugular vein, which justified further investigation for this rare syndrome. A positive blood culture for Fusobacterium necrophorum confirmed the diagnosis of Lemierre’s syndrome. Several antibiotics and anticoagulation medications were prescribed and the athlete was closely monitored. After two months, he was cleared to play football.

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Sonya L. Cameron, Rebecca T. McLay-Cooke, Rachel C. Brown, Andrew R. Gray and Kirsty A. Fairbairn

Purpose:

This study investigated the effect of ingesting 0.3 g/kg body weight (BW) of sodium bicarbonate (NaHCO3) on physiological responses, gastrointestinal (GI) tolerability, and sprint performance in elite rugby union players.

Methods:

Twenty-five male rugby players, age 21.6 (2.6) yr, participated in a randomized, double-blind, placebo-controlled crossover trial. Sixty-five minutes after consuming 0.3 g/kg BW of either NaHCO3 or placebo, participants completed a 25-min warm-up followed by 9 min of high-intensity rugby-specific training followed by a rugby-specific repeated-sprint test (RSRST). Whole-blood samples were collected to determine lactate and bicarbonate concentrations and pH at baseline, after supplement ingestion, and immediately after the RSRST. Acute GI discomfort was assessed by questionnaire throughout the trials, and chronic GI discomfort was assessed during the 24 hr postingestion.

Results:

After supplement ingestion and immediately after the RSRST, blood HCO3 concentration and pH were higher for the NaHCO3 condition than for the placebo condition (p < .001). After the RSRST, blood lactate concentrations were significantly higher for the NaHCO3 than for the placebo condition (p < .001). There was no difference in performance on the RSRST between the 2 conditions. The incidence of belching, stomachache, diarrhea, stomach bloating, and nausea was higher after ingestion of NaHCO3 than with placebo (all p < .050). The severity of stomach cramps, belching, stomachache, bowel urgency, diarrhea, vomiting, stomach bloating, and flatulence was rated worse after ingestion of NaHCO3 than with placebo (p < .050).

Conclusions:

NaHCO3 supplementation increased blood HCO3 concentration and attenuated the decline in blood pH compared with placebo during high-intensity exercise in well-trained rugby players but did not significantly improve exercise performance. The higher incidence and greater severity of GI symptoms after ingestion of NaHCO3 may negatively affect physical performance, and the authors strongly recommend testing this supplement during training before use in competitive situations.

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Robert A. Oppliger, Suzanne A. Nelson Steen and James R. Scott

Purpose: The purpose of this investigation was to examine the weight management (WM) behaviors of collegiate wrestlers after the implementation of the NCAA’s new weight control rules. Methods: In the fall of 1999, a survey was distributed to 47 college wrestling teams stratified by collegiate division (i.e., I, II, III) and competitive quality. Forty-three teams returned surveys for a total of 741 responses. Comparisons were made using the collegiate division, weight class, and the wrestler’s competitive winning percentage. Results: The most weight lost during the season was 5.3 kg ± 2.8 kg (mean ± SD) or 6.9% ± 4.7% of the wrestler’s weight; weekly weight lost averaged 2.9 kg ± 1.3 kg or 4.3% ± 2.3% of the wrestler’s weight; post-season, the average wrestler regained 5.5 kg ± 3.6 kg or 8.6% ± 5.4% of their weight. Coaches and fellow wrestlers were the primary influence on weight loss methods; however, 40.2% indicated that the new NCAA rules deterred extreme weight loss behaviors. The primary methods of weight loss reported were gradual dieting (79.4%) and increased exercise (75.2%). However, 54.8% fasted, 27.6% used saunas, and 26.7% used rubber/ plastic suits at least once a month. Cathartics and vomiting were seldom used to lose weight, and only 5 met three or more of the criteria for bulimia nervosa. WM behaviors were more extreme among freshmen, lighter weight classes, and Division II wrestlers. Compared to previous surveys of high school wrestlers, this cohort of wrestlers reported more extreme WM behaviors. However, compared to college wrestlers in the 1980s, weight loss behaviors were less extreme. Conclusions: The WM practices of college wrestlers appeared to have improved compared to wrestlers sampled previously. Forty percent of the wrestlers were influenced by the new NCAA rules and curbed their weight loss practices. Education is still needed, as some wrestlers are still engaging in dangerous WM methods.

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Richelle M. Williams, R. Curtis Bay and Tamara C. Valovich McLeod

.9 (53) 4.8 (6) 8.7 (4) 14.4 Sadness 18.8 (50) 3.2 (4) 8.7 (4) 13.3 Numbness/tingling 12.4 (33) 1.6 (2) 0.0 (0) 8.0 Vomiting 6.8 (18) 0.8 (1) 0.0 (0) 4.4 Table 3 Symptom Severity Score Means and Standard Deviations Symptom 0–7 Days Mean (SD) (n = 266) 8–14 Days Mean (SD) (n = 125) 15–21 Days Mean (SD) (n

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Luana Farias de Oliveira, Bryan Saunders and Guilherme Giannini Artioli

, with symptoms including bloating and abdominal pain; nausea and vomiting are other commonly reported side effects ( Carr et al., 2011b ). Typically, a dose of 0.3 g/kg·BM (or 21 g for a 70-kg individual) increases blood HCO 3 − by ∼6 mmol/L ( McNaughton, 1992 ); this represents only ∼15% of the