Nausea is associated with endotoxemia during a 161-km ultramarathon
Abstract
This study explored possible contributing factors to gastrointestinal distress, including endotoxemia, hyperthermia, dehydration and nutrition, during a 161-km ultramarathon. Thirty runners participated in the study and 20 finished the race. At three checkpoints and the finish, runners were interviewed to assess the incidence and severity of 12 gastrointestinal symptoms and to determine dietary intake. Core temperature was measured at the same locations. Runners were weighed pre-race, at the three checkpoints and the finish to monitor hydration status. Blood markers for endotoxemia (sCD14) and inflammation (interleukin-6 and C-reactive protein) were measured pre- and post-race. Gastrointestinal symptoms were experienced by most runners (80%), with nausea being the most common complaint (60%). Runners with nausea experienced significantly greater (P = 0.02) endotoxemia than those without nausea (sCD14 mean increase 0.7 versus 0.5 µg · mL(-1)). There was a significant positive correlation (r = 0.652, P = 0.005) between nausea severity and endotoxemia level. Inflammatory response, core temperature, hydration level and race diet were similar between runners with and without nausea. This study links endotoxemia to nausea in ultramarathon runners. Other possible contributing factors to nausea such as hyperthermia, dehydration and nutrition did not appear to play a role in the symptomatic runners in this study.
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When GI defences are disrupted or LPS sensing is overloaded, a heightened inflammatory response may result which could relate to GI symptoms associated with exercise.
“However, when GI defences are either disrupted (i.e., luminal damage from exercise) or LPS “sensing” is “overloaded” a heightened inflammatory response may result which could, in part, relate to GI symptoms associated with exercise [42].”
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- Authors
- Stuempfle, K. J., Valentino, T., Hew-Butler, T., Hecht, F. M., & Hoffman, M. D.
- Affiliations
- Gettysburg College (US)
- San Francisco State University (US)
- University of California, San Francisco (US)
- VA Northern California Health Care System (US)
- Corresponding author
- Stuempfle, Kristin J.
- Venue
- Journal of Sports Sciences
- Publisher
- Informa UK Limited
- Published
- 2015-12-28
- Volume
- 34
- Issue
- 17
- Pages
- 1662-1668
- ISSN
- 0264-0414 (ISSN-L)
- 1466-447X
- OpenAlex
- W2212054412
- Cited by
- 41
- References
- 37
- Citations by year
- 2025: 4 · 2023: 5 · 2022: 6 · 2021: 4 · 2020: 3 · 2019: 6 · 2018: 6 · 2017: 4 · 2016: 3
- FWCI
- 4.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Sports Sciences (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Topics
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- nausea, endotoxemia, ultramarathon, gastrointestinal distress, soluble CD14, interleukin-6, C-reactive protein, inflammation, hyperthermia, dehydration, long-distance running
- MeSH terms
- Adult, Body Temperature, C-Reactive Protein, Dehydration, Diet, Female, Fever, Gastrointestinal Diseases, Humans, Male, Nausea, Physical Endurance, Running, Interleukin-6, Body Mass Index, Lipopolysaccharide Receptors, Endotoxemia, Young Adult
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