The impact of 48 h high carbohydrate diets with high and low FODMAP content on gastrointestinal status and symptoms in response to endurance exercise, and subsequent endurance performance

Rachel Scrivin; Gary Slater; Alice Mika; Christopher Rauch; Pascale Young; Isabel Martinez; Ricardo J S Costa

doi:10.1139/apnm-2023-0508

The impact of 48 h high carbohydrate diets with high and low FODMAP content on gastrointestinal status and symptoms in response to endurance exercise, and subsequent endurance performance

Appl Physiol Nutr Metab. 2024 Feb 15. doi: 10.1139/apnm-2023-0508. Online ahead of print.

Authors

Rachel Scrivin^{1

2}, Gary Slater¹, Alice Mika³, Christopher Rauch³, Pascale Young³, Isabel Martinez³, Ricardo J S Costa³

Affiliations

¹ School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia.
² Faculty of Health, Education and Environment, Toi Ohomai Institute of Technology, Tauranga, New Zealand.
³ Faculty of Medicine Nursing & Health Sciences, Department of Nutrition Dietetics and Food, Monash University, Melbourne, VIC, Australia.

PMID: 38359412
DOI: 10.1139/apnm-2023-0508

Abstract

This study investigated the effects of a high carbohydrate diet, with varied fermentable oligo-, di-, and mono-saccharide and polyol (FODMAP) content, before endurance exercise on gastrointestinal integrity, motility, and symptoms; and subsequent exercise performance. Twelve endurance athletes were provided with a 48 h high carbohydrate (mean ± SD: 12.1 ± 1.8 g kg day^-1) diet on two separate occasions, composed of high (54.8 ± 10.5 g day^-1) and low FODMAP (3.0 ± 0.2 g day^-1) content. Thereafter, participants completed a 2 h steady-state running exercise at 60% of $\dot{V} O_{2 \max}$ (22.9 ± 1.2 °C, 46.4 ± 7.9% RH), followed by a 1 h distance performance test. Pre-exercise and every 20 min during steady-state exercise, 100 mL maltodextrin (10% w/v) solution was consumed. A 150 mL lactulose (20 g) solution was consumed 30 min into the distance performance test to determine orocecal transit time (OCTT) during exercise. Blood was collected pre- and post exercise to determine gastrointestinal integrity biomarkers (i.e., I-FABP, sCD14, and CRP). Breath hydrogen (H₂) and gastrointestinal symptoms (GIS) were determined pre-exercise, every 15 min, during and throughout recovery. No differences in gastrointestinal integrity biomarkers, OCTT, or distance completed were observed between trials. Pre-exercise total-GIS (1.3 ± 2.9 vs. 4.3 ± 4.4), gut discomfort (9.9 ± 8.1 vs. 15.8 ± 9.0), and upper-GIS (2.8 ± 2.6 vs. 5.7 ± 4.8) during exercise were less severe on high carbohydrate low FODMAP (HC-LFOD) versus high carbohydrate high FODMAP (HC-HFOD) (p < 0.05). Gut discomfort (3.4 ± 4.4 vs. 0.2 ± 0.6) and total-GIS (4.9 ± 6.8 vs. 0.2 ± 0.6) were higher during recovery on HC-LFOD versus HC-HFOD (p < 0.05). The FODMAP content of a 48 h high carbohydrate diet does not impact gastrointestinal integrity or motility in response to endurance exercise. However, a high FODMAP content exacerbates GIS before and during exercise, but this does not impact performance outcomes.

Keywords: CRP; EIGS; I-FABP; OCTT; epithelial integrity; sCD14.