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      International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing

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          In this Position Statement, the International Society of Sports Nutrition (ISSN) provides an objective and critical review of the literature pertinent to nutritional considerations for training and racing in single-stage ultra-marathon. Recommendations for Training . i) Ultra-marathon runners should aim to meet the caloric demands of training by following an individualized and periodized strategy, comprising a varied, food-first approach; ii) Athletes should plan and implement their nutrition strategy with sufficient time to permit adaptations that enhance fat oxidative capacity; iii) The evidence overwhelmingly supports the inclusion of a moderate-to-high carbohydrate diet (i.e., ~ 60% of energy intake, 5–8 g·kg − 1·d − 1) to mitigate the negative effects of chronic, training-induced glycogen depletion; iv) Limiting carbohydrate intake before selected low-intensity sessions, and/or moderating daily carbohydrate intake, may enhance mitochondrial function and fat oxidative capacity. Nevertheless, this approach may compromise performance during high-intensity efforts; v) Protein intakes of ~ 1.6 g·kg − 1·d − 1 are necessary to maintain lean mass and support recovery from training, but amounts up to 2.5 − 1·d − 1 may be warranted during demanding training when calorie requirements are greater; Recommendations for Racing . vi) To attenuate caloric deficits, runners should aim to consume 150–400 Kcal·h − 1 (carbohydrate, 30–50 g·h − 1; protein, 5–10 g·h − 1) from a variety of calorie-dense foods. Consideration must be given to food palatability, individual tolerance, and the increased preference for savory foods in longer races; vii) Fluid volumes of 450–750 mL·h − 1 (~ 150–250 mL every 20 min) are recommended during racing. To minimize the likelihood of hyponatraemia, electrolytes (mainly sodium) may be needed in concentrations greater than that provided by most commercial products (i.e., > 575 mg·L − 1 sodium). Fluid and electrolyte requirements will be elevated when running in hot and/or humid conditions; viii) Evidence supports progressive gut-training and/or low-FODMAP diets (fermentable oligosaccharide, disaccharide, monosaccharide and polyol) to alleviate symptoms of gastrointestinal distress during racing; ix) The evidence in support of ketogenic diets and/or ketone esters to improve ultra-marathon performance is lacking, with further research warranted; x) Evidence supports the strategic use of caffeine to sustain performance in the latter stages of racing, particularly when sleep deprivation may compromise athlete safety.

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          American College of Sports Medicine position stand. Exercise and fluid replacement.

          This Position Stand provides guidance on fluid replacement to sustain appropriate hydration of individuals performing physical activity. The goal of prehydrating is to start the activity euhydrated and with normal plasma electrolyte levels. Prehydrating with beverages, in addition to normal meals and fluid intake, should be initiated when needed at least several hours before the activity to enable fluid absorption and allow urine output to return to normal levels. The goal of drinking during exercise is to prevent excessive (>2% body weight loss from water deficit) dehydration and excessive changes in electrolyte balance to avert compromised performance. Because there is considerable variability in sweating rates and sweat electrolyte content between individuals, customized fluid replacement programs are recommended. Individual sweat rates can be estimated by measuring body weight before and after exercise. During exercise, consuming beverages containing electrolytes and carbohydrates can provide benefits over water alone under certain circumstances. After exercise, the goal is to replace any fluid electrolyte deficit. The speed with which rehydration is needed and the magnitude of fluid electrolyte deficits will determine if an aggressive replacement program is merited.
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            Immune function in sport and exercise.

            Regular moderate exercise is associated with a reduced incidence of infection compared with a completely sedentary state. However, prolonged bouts of strenuous exercise cause a temporary depression of various aspects of immune function (e.g., neutrophil respiratory burst, lymphocyte proliferation, monocyte antigen presentation) that usually lasts approximately 3-24 h after exercise, depending on the intensity and duration of the exercise bout. Postexercise immune function dysfunction is most pronounced when the exercise is continuous, prolonged (>1.5 h), of moderate to high intensity (55-75% maximum O(2) uptake), and performed without food intake. Periods of intensified training (overreaching) lasting 1 wk or more may result in longer lasting immune dysfunction. Although elite athletes are not clinically immune deficient, it is possible that the combined effects of small changes in several immune parameters may compromise resistance to common minor illnesses, such as upper respiratory tract infection. However, this may be a small price to pay as the anti-inflammatory effects of exercise mediated through cytokines and/or downregulation of toll-like receptor expression are likely mediators of many of the long-term health benefits of regular exercise.
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              Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis.

              Quantity and timing of protein ingestion are major factors regulating myofibrillar protein synthesis (MPS). However, the effect of specific ingestion patterns on MPS throughout a 12 h period is unknown. We determined how different distributions of protein feeding during 12 h recovery after resistance exercise affects anabolic responses in skeletal muscle. Twenty-four healthy trained males were assigned to three groups (n = 8/group) and undertook a bout of resistance exercise followed by ingestion of 80 g of whey protein throughout 12 h recovery in one of the following protocols: 8 × 10 g every 1.5 h (PULSE); 4 × 20 g every 3 h (intermediate: INT); or 2 × 40 g every 6 h (BOLUS). Muscle biopsies were obtained at rest and after 1, 4, 6, 7 and 12 h post exercise. Resting and post-exercise MPS (l-[ring-(13)C6] phenylalanine), and muscle mRNA abundance and cell signalling were assessed. All ingestion protocols increased MPS above rest throughout 1-12 h recovery (88-148%, P INT>PULSE hierarchy in magnitude of phosphorylation. MuRF-1 and SLC38A2 mRNA were differentially expressed with BOLUS. In conclusion, 20 g of whey protein consumed every 3 h was superior to either PULSE or BOLUS feeding patterns for stimulating MPS throughout the day. This study provides novel information on the effect of modulating the distribution of protein intake on anabolic responses in skeletal muscle and has the potential to maximize outcomes of resistance training for attaining peak muscle mass.

                Author and article information

                +44-0-1223-675-154 ,
                J Int Soc Sports Nutr
                J Int Soc Sports Nutr
                Journal of the International Society of Sports Nutrition
                BioMed Central (London )
                7 November 2019
                7 November 2019
                : 16
                [1 ]ISNI 0000 0001 0157 6501, GRID grid.239844.0, Division of Pulmonary and Critical Care Physiology and Medicine, , The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, ; Torrance, CA USA
                [2 ]ISNI 0000 0001 0303 540X, GRID grid.5884.1, Academy of Sport and Physical Activity, Faculty of Health and Wellbeing, , Sheffield Hallam University, ; Sheffield, UK
                [3 ]ISNI 0000 0001 2299 5510, GRID grid.5115.0, Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sports Science, , Anglia Ruskin University, ; Cambridge, UK
                [4 ]GRID grid.417900.b, School of Social and Health Sciences, , Leeds Trinity University, ; Leeds, UK
                [5 ]ISNI 0000 0000 8794 7109, GRID grid.255434.1, Sport Nutrition and Performance Research Group, Department of Sport and Physical Activity, , Edge Hill University, ; Ormskirk, Lancashire UK
                [6 ]ISNI 0000 0001 0745 8880, GRID grid.10346.30, Carnegie School of Sport, , Leeds Beckett University, ; Leeds, UK
                [7 ]ISNI 0000 0001 2168 8324, GRID grid.261241.2, College of Health Care Sciences, , Nova Southeastern University, ; Fort Lauderdale, FL USA
                [8 ]ISNI 0000 0001 2111 2894, GRID grid.252890.4, Department of Health, Human Performance, and Recreation, , Baylor University, ; Waco, TX USA
                [9 ]ISNI 0000 0001 2191 0423, GRID grid.255364.3, Department of Physiology, Brody School of Medicine, , East Carolina University, ; Greenville, NC USA
                [10 ]ISNI 0000 0001 1034 1720, GRID grid.410711.2, Department of Exercise and Sport Science, , University of North Carolina, ; Chapel Hill, NC USA
                [11 ]ISNI 0000 0004 0472 0419, GRID grid.255986.5, Institute of Sports Sciences & Medicine, Department of Nutrition, Food and Exercise Sciences, , Florida State University, ; Tallahassee, FL USA
                [12 ]ISNI 0000 0001 0723 4123, GRID grid.16463.36, Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, , University of KwaZulu-Natal, ; Durban, South Africa
                [13 ]ISNI 0000 0000 9894 7796, GRID grid.253566.1, Department of Kinesiology, , California State University San Marcos, ; San Marcos, CA USA
                [14 ]ISNI 0000 0004 4687 2082, GRID grid.264756.4, Department of Health & Kinesiology, , Texas A&M University, ; College Station, TX USA
                [15 ]ISNI 0000 0001 0806 6926, GRID grid.272362.0, Kinesiology and Nutrition Sciences, , University of Nevada, ; Las Vegas, NV USA
                [16 ]ISNI 0000 0001 2159 2859, GRID grid.170430.1, College of Health Professions and Sciences, , University of Central Florida, ; Orlando, FL USA
                [17 ]ISNI 0000 0001 0816 8287, GRID grid.260120.7, Department of Kinesiology, , Mississippi State University, ; Mississippi, MS USA
                [18 ]ISNI 0000 0000 9075 106X, GRID grid.254567.7, Department of Exercise Science, , University of South Carolina, ; Columbia, SC USA
                [19 ]ISNI 0000 0001 2353 285X, GRID grid.170693.a, Exercise Science Program, Performance & Physique Enhancement Laboratory, , University of South Florida, ; Tampa, FL USA
                [20 ]Institute of Performance Nutrition, London, UK
                © The Author(s). 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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                © The Author(s) 2019

                Sports medicine

                ultra-marathon, supplementation, racing, performance, nutrition, endurance, training


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