Mlinaric Janez, Mohorko Nina
University of Primorska, Faculty of Health Sciences, Izola, Slovenia.
Ruhr University Bochum, Faculty of Sport Science, Germany.
J Int Soc Sports Nutr. 2025 Dec;22(1):2529910. doi: 10.1080/15502783.2025.2529910. Epub 2025 Jul 11.
The gastrointestinal (GI) tract plays a critical role in achieving peak athletic performance either during training or in competitions. Despite its significance, the GI tract's role in the training process of athletes is often neglected, resulting in frequent GI symptoms. These disturbances are particularly prevalent in endurance sports, where GI function is commonly compromised, leading to adverse effects on performance. In this review, we examine potential nutritional causes of the GI symptoms and provide possible solutions to mitigate them, aiming to enhance athletes' overall performance and well-being.
PRISMA methodology was used to search through PubMed Database from January 2023 to March 2023. The selected studies were comprised of randomized controlled trials, crossover trials and case studies.
Twenty-nine studies met the inclusion criteria for this systematic review. The studies were categorized into five distinct areas of research on GI symptoms in endurance exercise: gut training protocols, effects of different carbohydrate solutions and mixtures, low FODMAP diet, hydrogel CHO technology, and probiotic supplementation.Gut training protocols seem promising in improving GI symptoms over time. Optimizing carbohydrate intake during exercise according to current recommendations has been associated with lower incidence and severity of GI symptoms as well. The low FODMAP diet also shows potential to reduce GI symptoms, although its restrictive nature could negatively affect athletes in other ways. Hydrogel carbohydrate products, at present, do not demonstrate any benefits over standard carbohydrate products. Probiotic supplementation shows mixed evidence regarding its effectiveness in alleviating and reducing GI symptoms during endurance exercise.
We have acknowledged that the onset of GI symptoms is very complex, and that onset is influenced by a huge variety of factors. It should be emphasized that the elimination of GI symptoms in each athlete must be approached individually and thoughtfully.
胃肠道在训练或比赛期间实现最佳运动表现方面起着关键作用。尽管其重要性，但胃肠道在运动员训练过程中的作用常常被忽视，导致胃肠道症状频发。这些紊乱在耐力运动中尤为普遍，在耐力运动中胃肠道功能通常会受到损害，从而对运动表现产生不利影响。在本综述中，我们研究了胃肠道症状的潜在营养原因，并提供了减轻这些症状的可能解决方案，旨在提高运动员的整体表现和健康水平。
采用PRISMA方法在2023年1月至2023年3月期间检索PubMed数据库。所选研究包括随机对照试验、交叉试验和案例研究。
29项研究符合本系统综述的纳入标准。这些研究被分为耐力运动中胃肠道症状的五个不同研究领域：肠道训练方案、不同碳水化合物溶液和混合物的影响、低FODMAP饮食、水凝胶碳水化合物技术和益生菌补充剂。随着时间的推移，肠道训练方案似乎有望改善胃肠道症状。根据当前建议在运动期间优化碳水化合物摄入量也与胃肠道症状的较低发生率和严重程度相关。低FODMAP饮食也显示出减轻胃肠道症状的潜力，尽管其限制性可能会在其他方面对运动员产生负面影响。目前，水凝胶碳水化合物产品与标准碳水化合物产品相比没有显示出任何益处。关于益生菌补充剂在减轻和减少耐力运动期间胃肠道症状方面的有效性，证据不一。
我们已经认识到胃肠道症状的发作非常复杂，并且发作受到多种因素的影响。应该强调的是，必须针对每位运动员个体并深思熟虑地消除胃肠道症状。
