Low FODMAP: A Preliminary Strategy to Reduce Gastrointestinal Distress in Athletes

LIS, DANA M.; STELLINGWERFF, TRENT; KITIC, CECILIA M.; FELL, JAMES W.; AHUJA, KIRAN D. K.

doi:10.1249/mss.0000000000001419

Cited by 112Gastrointestinal motility and disordersSports Performance and TrainingMuscle metabolism and nutrition

Low FODMAP: A Preliminary Strategy to Reduce Gastrointestinal Distress in Athletes

LIS, DANA M., STELLINGWERFF, TRENT, KITIC, CECILIA M., FELL, JAMES W., AHUJA, KIRAN D. K.·2018·Medicine & Science in Sports & Exercise

DOI 10.1249/mss.0000000000001419

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Abstract

INTRODUCTION: Gastrointestinal (GI) distress in endurance athletes is prevalent and detrimental to performance. Adverse GI symptomatology can be analogous with irritable bowel syndrome, where fermentable oligosaccharide, disaccharide, monosaccharide, and polyols (FODMAP) reduction has demonstrated efficacy. This study investigated the effects of low FODMAP (LFOD) diet on GI distress parameters in runners with a history of nonclinical exercise-associated GI symptoms. METHODS: Eleven recreationally competitive runners (five men, six women; 5-km personal best 23:00 ± 4:02 min:s) participated in the study. Runners were allocated to a randomized 6-d LFOD or high FODMAP (HFOD) diet separated by a 1-d wash-out in a controlled, single-blinded cross-over study. In each period participants completed two strenuous running sessions consisting of 5 × 1000 m and a 7-km threshold run. GI symptoms (during-exercise and daily) and the Daily Analysis of Life Demand for Athletes questionnaires were completed. Area under the curve was calculated for daily GI symptoms across each dietary period and analysis was conducted using multilevel mixed-effects linear regression for comparison between the two diets. RESULTS: A significantly smaller area under the curve for daily GI symptoms 6 d during the LFOD compared with HFOD (mean difference, -13.4; 95% confidence interval, -22 to -4.60; P = 0.003) was observed. The daily GI symptoms that were significantly lower during LFOD were flatulence (P < 0.001), urge to defecate (P = 0.04), loose stool (P = 0.03), and diarrhea (P = 0.004). No significant differences in during exercise symptoms or Daily Analysis of Life Demand for Athletes responses were observed between diets (P > 0.05). CONCLUSIONS: Preliminary findings suggest that short-term FODMAP reduction may be a beneficial intervention to minimize daily GI symptoms in runners with exercise-related GI distress.

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Practicing a low FODMAP diet has been shown to reduce GI distress acutely where symptoms of IBS are present.
“Where symptoms of irritable bowel syndrome (IBS) are present, practicing a low FODMAP (fermentable oligosaccharide, disaccharide, monosaccharide and polyol) diet has been shown to reduce GI distress acutely [142, 143].”
From International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing (2019) · cites this paper as [143]

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Low FODMAP: A Preliminary Strategy to Reduce Gastrointestinal Distress in Athletes
Lis, D. M., Stellingwerff, T., Kitic, C. M., Fell, J. W., & (12465006), K. D. A. (2018) · Figshare · Cited by 3 · see citing works
Self-citation
Case Study: Utilizing a Low FODMAP Diet to Combat Exercise-Induced Gastrointestinal Symptoms
Lis, D. M., Ahuja, K., Stellingwerff, T., Kitic, C. M., & Fell, J. W. (2016) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2015-0293 · Cited by 43 · see citing works
Self-citation
Case Study
Lis, D. M., Ahuja, K., Stellingwerff, T., Kitic, C. M., & Fell, J. W. (2016) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000487895.11134.b7 · Cited by 1 · see citing works
Self-citation
Effect of a short-term low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet on exercise-related gastrointestinal symptoms
Wiffin, M., Smith, L., Antonio, J., Johnstone, J., Beasley, L., & Roberts, J. (2019) · Journal of the International Society of Sports Nutrition · doi:10.1186/s12970-019-0268-9 · Cited by 27 · see citing works
Low FODMAP Diet in Athletes
Hill, T. (2021) · Digital Commons - Winthrop University (Winthrop University)

Authors: LIS, D. M., STELLINGWERFF, T., KITIC, C. M., FELL, J. W., & AHUJA, K. D. K.
Affiliations: University of Tasmania (AU)
ORCID: LIS, DANA M.
STELLINGWERFF, TRENT
KITIC, CECILIA M.
FELL, JAMES W.
Venue: Medicine & Science in Sports & Exercise
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2018-01
Volume: 50
Issue: 1
Pages: 116-123
ISSN: 0195-9131 (ISSN-L)
DOI: 10.1249/mss.0000000000001419
OpenAlex: W2750930888
Cited by: 112
References: 37
Citations by year: 2026: 5 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 7 · 2021: 9 · 2020: 56 · 2019: 16 · 2018: 10
FWCI: 23.63
Type: journal article
Language: en
Open access: closed
Locations: Medicine & Science in Sports & Exercise (publishedVersion)
PubMed (publishedVersion)
eCite Digital Repository (University of Tasmania) (submittedVersion)
UTAS Research Repository (submittedVersion)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
Keywords: low FODMAP diet, FODMAPs, endurance runners, irritable bowel syndrome, flatulence, diarrhea, dietary intervention, recreational runners
MeSH terms: Adult, Diet, Dietary Carbohydrates, Female, Gastrointestinal Diseases, Humans, Male, Middle Aged, Polymers, Running, Single-Blind Method, Cross-Over Studies, Athletes

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Low FODMAP: A Preliminary Strategy to Reduce Gastrointestinal Distress in Athletes

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