ISSUE 55 / DECEMBER 2019 NUTRITION FOR IRON-DISTANCE ATHLETES

Nutrition for iron-distance

triathletes: an overview and
some practical advice
By Sally Waterworth, School of Sport, Rehabilitation and Exercise Sciences, University of Essex

OVERVIEW
Ironman® triathlons are ultra-endurance events which take competitors between
7 hours 35 minutes and 17 hours to complete. These events continue to grow
in popularity, but although the importance of nutrition to support training and
facilitate performance is acknowledged, information is often contradictory and can
result in triathletes inadvertently compromising training, health and performance.
The aim of this article is to give an evidence-informed overview of nutrition and to
provide practical advice for iron-distance triathletes and their coaches.

Introduction concentrations, glycogen utilisation and

time to fatigue can display a twofold
Ironman® or iron-distance triathlons are difference at the same absolute workload
ultra-endurance events, consisting of a in individuals with a similar V̇O2max,
3.8 km (2.4 mile) open-water swim, 180 km suggesting that factors which control
(112 mile) cycle ride and 42.2 km (26.2 mile) muscle glycogenolysis and blood lactate
run.73 Participants vary widely in ability, concentrations can affect endurance
with finishing times ranging from 7 hours performance.19 The goal of training for an
35 minutes to 17 hours.51 Competing in these iron-distance event is inevitably to improve
events requires considerable preparation these variables and in recent years, research
and a high training load, with reported has demonstrated that endurance training
weekly training volumes of 12 hours for adaptations can be augmented through
recreational athletes to over 30 hours for strategic manipulation of nutritional status.13
elite athletes.57 Performance decrements
related to inadequate energy consumption During prolonged exercise, carbohydrate
and/or dehydration are prevalent in iron- (CHO) and fat are the primary substrates
distance events,51 and as such, nutrition is oxidised for energy metabolism.79
often referred to as the fourth discipline in The oxidation rates of these substrates are
a triathlon. determined by numerous factors including
intensity and duration of the exercise,
glycogen concentrations and environmental
Physiological demands conditions.71,84 Glycogen is stored primarily
in the muscle (~80–85%) and liver
Endurance performance is physiologically (~15–20%) with small amounts circulating
determined by an athlete’s rate of in blood.3 Training status improves absolute GRAEME CLOSE
maximal oxygen consumption (V̇O2max), glycogen storage capability, but Column editor
the proportion of V̇O2max they can even in highly trained athletes, total
sustain (related to lactate turnpoint) and glycogen storage amounts to <3000 kcal
their exercise economy.11 Blood lactate (<740 g); in contrast, even in very lean

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‘The aim of
this article
is to provide
iron-distance
triathletes with
nutritional
recommen-
dations for
both training
and racing’

individuals, fat storage can amount to more CHO is oxidised, further reducing the
~68,250 kcal (7000 g).26 amount of energy provided by fat oxidation.72
Endurance training improves capacity for
The most important substrate at moderate fat oxidation63 and fat oxidation pro-
to high exercise intensity (>70% V̇O2max) portionally increases as exercise intensity
is CHO, due to its greater energy yield per decreases, yet even slower finishers (~13 h)
litre of oxygen consumption (5.01 vs. 4.85 require 875 to 1999 g of CHO to complete
kcal L-1 O2 for CHO and fat respectively)
• an iron-distance triathlon.57 In addition to its
and higher rate of ATP resynthesis.46 role as an energy substrate, glycogen acts
Using doubly labelled water, it has been as a regulatory molecule that modulates
estimated that energy expenditure for an selected skeletal muscle markers of training
iron-distance triathlon may range from adaptation.30 Performing some training
8,500-11,500 kcal,20,47 and that elite triathletes sessions with low glycogen concentrations
have an energy expenditure rate of ~20.1 (‘train-low’) can increase training
kcal min-1.57 Relative contribution of fat to
• adaptations; it is therefore important to
total energy needs is intensity dependent distinguish between CHO needs for racing
with maximal fat oxidation usually occurring and for training.37
around 59-64% V̇O2max in endurance
trained athletes.1 This corresponds to fat Fatigue during iron-distance events is
oxidation rates of 0.6 to 1 g min-1, although
• associated with muscle glycogen depletion,
values of 1.5 g min-1 have been reported
• reduced blood glucose concentrations and
(in habitual very low CHO/ketogenic dehydration.41 Glycogen becomes depleted
athletes).25 Professional iron-distance after 2-3 hours of moderate to high-intensity
triathletes compete at intensities of ~66- exercise (>70% V̇O2max); it is therefore
71% V̇O2max,61 and therefore it is clear that important that iron-distance triathletes
fat oxidation alone cannot provide energy should seek to maintain glycogen stores
at a sufficient rate. Additionally, as core through training strategies that augment
body temperature increases, proportionally fat oxidation as well as consumption of

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exogenous CHO during races,57 while train for over 4 hours a day they are 8-12
maintaining appropriate hydration status. g kg-1BM.14 There are no available data on
•

In addition to fatigue, performance is often nutritional intakes of elite iron-distance

compromised by high reported incidences triathletes, but data on good age-group
of gastrointestinal (GI) issues.43 triathletes (including Ironman® 70.3 World
Championship qualifiers) have shown daily
CHO intakes of 7 g kg-1BM with a training
•

Aims volume of ~17 h per week.55

Few studies have explored nutritional Despite the importance of nutrition for
practices in iron-distance triathlon and endurance performance and the complexity
recommendations for race fuelling have of nutritional recommendations, the use
not always differentiated between the of nutrition professionals is uncommon
needs of elite and recreational triathletes. among triathletes and nutrition information
Little attention has been paid to nutritional is predominantly sourced from the Internet,
support during training and manipulating other athletes and coaches.49 Chronic low-
glycogen status to enhance training CHO, high-fat (LCHF) diets are currently
adaptations. The aim of this article is to popular and are promoted in social media
provide iron-distance triathletes with as a method of improving endurance
nutritional recommendations for both performance through improved fat oxidation
training and racing. and concurrent weight loss, but there is
limited support for this dietary approach in
the scientific literature. Studies reporting
Nutritional requirements benefits have shown improvements in only
submaximal exercise capacity,85 which does
Physiological demands of iron-distance not necessarily relate to race performance.
training and competition are extremely
high.48 Nutritional recommendations should
be aimed at maximising training adaptation
and performance, by ensuring CHO, protein,
fat, hydration and micronutrient needs are
met. Factors that affect gut health should
also be considered because of the high
incidence of GI issues in iron-distance races.

Carbohydrates

Since the beginning of the 20th century, ‘Fatigue during

exercise physiology research has clearly
demonstrated ergogenic benefits of high iron-distance
CHO diets;50 and in the 1960s, muscle
biopsies linked the improved performance
to elevated muscle glycogen content.12
events is
The evidence that exercise performance
is improved by high CHO availability
associated
led to nutritional recommendations that
endurance athletes consume high CHO with muscle
diets before, during, and after training
sessions.14 In recent years however, glycogen
evidence has accumulated for deliberately
undertaking some training sessions with depletion,
low glycogen concentrations (termed
‘train-low’) to augment endurance training
adaptation;37 it is therefore important
reduced
to distinguish between CHO needs for
competition and those for training.
blood glucose
CARBOHYDRATES FOR TRAINING
concentrations
Daily CHO recommendations for endurance
athletes who train at a moderate to high and
intensity for 1 to 3 hours a day are 6-10
g kg-1 body mass (BM), and for those who
• dehydration’

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 Table 1. Example of CHO periodisation for an elite iron-distance triathlete

PRE-AM DURING AM POST-AM LUNCH PRE-PM WORKOUT DURING PM POST-PM WORKOUT/
WORKOUT WORKOUT WORKOUT AFTERNOON/SNACKS WORKOUT EVENING MEAL

Day 1 (easy day, fuel LOW LOW MEDIUM LOW MEDIUM LOW MEDIUM
according to needs)
AM: 1h easy swim
PM: 1h gym mobility
Day 2 (train-high, HIGH HIGH HIGH HIGH HIGH MEDIUM LOW
sleep-low). AM: 2h
threshold ride. PM:
2h run at race pace
Day 3 (train-low) LOW LOW HIGH HIGH HIGH N/A MEDIUM
AM: 4hr easy bike
Day 4 (train-high, HIGH HIGH HIGH HIGH HIGH LOW LOW
sleep-low). AM:
1h 30 swim with
threshold intervals
PM: 2h VO2max ride
This model is presented for a high-level triathlete, who mostly trains twice a day on four consecutive days. The CHO content of each feeding point
is represented as low, medium or high. Specific amounts of CHO will be dictated by athlete history, specific training goals, training status, phase
of training etc and the use of a colour scheme – rather than absolute quantities – highlights the necessity for an individualised, flexible approach.
Models should be adjusted daily according to the number of feeding points and training sessions.38

Prospective examination of nutritional fasted training where exercise is performed

intentions of long-distance triathletes before breakfast so liver glycogen and blood
demonstrated that more than half of glucose concentrations are reduced.9,28
them planned to reduce their CHO intake Prolonging the duration of low glycogen
despite increasing volume or intensity of concentrations can extend and enhance
training during the forthcoming season.49 the activation of molecular pathways
It is likely that athletes and coaches are that regulate skeletal muscle adaptation.
misunderstanding the ‘train-low’ concept A common method is a ‘sleep-low, train-low’
and believe that benefits are achieved protocol involving a glycogen depleting
through prolonged periods of CHO evening training session, CHO restriction
restriction, while in reality certain sessions overnight and a fasted training session the
are strategically targeted as ‘train-low’ and following morning.37 ‘Sleep-low, train-low’
the overall training programme is supported protocols have been shown to enhance
by a high CHO diet.66 training adaptations10,60,86 and improve
performance by 3 to 7%.53,54
Elite iron-distance triathletes have weekly
training volumes of 20 to >30 hours and need Training high
to maximise their ability to use exogenous Maintaining a high quality of training
CHO and glycogen stores as fuels in order is imperative for long-term adaptation.13
to support energy requirements for training Commencing sessions with high
and racing.41,57 The use of a periodised CHO availability (through repletion of
CHO strategy to augment fat oxidation endogenous stores and supplementation of
and preserve endogenous glycogen stores, exogenous CHO during exercise) improves
while maximising the absolute capacity exercise capacity and performance.41
for exogenous CHO oxidation, should be Regardless of the capacity to oxidise fat,
employed.29 as exercise intensity increases above
75-80% V̇O2max there is a rise in adrenaline
Training low and a shift to CHO metabolism.66
Commencing endurance training sessions Any key sessions that are >75 min and
with low muscle glycogen concentrations contain moderate to high-intensity efforts
(<300 mmol kg-1dw)38 has been shown
• (>70% V̇O2max) should be commenced
to enhance training adaptation through with high CHO availability.13 Additionally,
increased mitochondrial enzyme activity and training with high levels of exogenous
mitochondrial content,80 as well as increasing CHO helps ‘train the gut’ and can
rates of fat oxidation.4,36 ‘Training-low’ can be reduce the incidence and severity of GI
achieved by acute strategies including post- symptoms. Athletes should follow the
exercise CHO restriction, training twice per CHO guidelines for performance, outlined
day with the second session commenced below, to ensure high CHO availability in
with low glycogen concentrations, and these sessions.

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Application of periodised nutrition residue, reducing the need to defecate and

Periodised nutrition requires clear planning. the likelihood of GI distress during the
To optimise glycogen re-synthesis, athletes event, as well as helping to offset the 1-3%
should consume 1.2 g kg-1BM of CHO
• BM gain associated with the storage of
immediately after training and every hour additional glycogen/water.13
for the next four hours.15 High glycaemic
index (>70) CHO is preferable as this Race morning
maximises re-synthesis rates. The inclusion Guidelines for the pre-race meal are
of fructose along with glucose may help consumption of 1-4 g kg-1BM of easily
•

facilitate liver glycogen synthesis due digestible CHO, low in fibre, fat and protein,
to differing mechanisms of absorption 3-4 hours before the start,16,81 aimed at
and because fructose is preferentially topping up liver glycogen.26 This large
metabolised by the liver.26 Ingesting CHO range (between 75 and 300g for a 75kg
in liquid as opposed to solid form does athletes) has implications for practice: for
not affect glycogen re-synthesis rates and example, a larger meal might need to be
a sports drink can be useful if appetite is eaten 30 minutes earlier (can take longer
suppressed, as well as having the added to eat), especially first thing in the morning,
advantage of helping to restore fluid when many athletes are not in the mood
balance.42 For the rest of the day, athletes to eat such quantities. Triathletes should
should include high CHO choices in their experiment well in advance of goal races to
meals and snacks to ensure adequate energy find out what they can tolerate as a pre-race
and substrate availability for glycogen re- meal and fine-tune their own strategies,44 as
synthesis. On these days, athletes should well as trialling small amounts of CHO in
aim for 8-12 g kg-1BM of CHO. When there
• the form of sports drink, gel or similar 15-60
is a period of more than 24 hours between minutes before the start of the event.70
training sessions, maximising glycogen re-
synthesis in the post-exercise period is not CARBOHYDRATE NEEDS DURING IRON-
a priority, and athletes consuming a high DISTANCE RACES
CHO diet will replenish glycogen by the Endogenous glycogen is insufficient to meet
next session.66 the metabolic demands of iron-distance
races, and therefore CHO feeding is
If exercise intensity has been low/moderate necessary to attenuate fatigue and optimise
(<65% V̇O2max) or the session included only performance.57 For events lasting longer than
short bouts of high-intensity (eg, strength 2.5 hours, 90 g h-1 of multiple-transportable
•

training), fat oxidisation will have provided sources of CHO are recommended to
the majority of energy and moderate CHO
intake will suffice.42 CHO consumption
maximise utilisation and reduce the
likelihood of GI distress due to their higher ‘the use of
can be kept low following a moderate/ oxidation rates (glucose:fructose 1.5-1.8
hard training session if there is a deliberate g min-1 versus glucose ~0.8-1 g min-1).81
• • nutrition
decision to commence the subsequent
session with low glycogen stores or to extend Although significant correlations have been professionals
the period in which adaptive responses are reported between CHO intake and faster
elevated.66,67 Table 1 shows an example of
CHO periodisation.
finishing times in iron-distance races,64
practically, few athletes can tolerate or
is uncommon
CARBOHYDRATES FOR PERFORMANCE
are willing to consume 90g h-1 of CHO.
Additionally, although maximising CHO
•
among
Carbohydrate loading
Carbohydrates play an important role
intake might be advantageous for faster
athletes who have higher rates of energy triathletes
in preparing for competition, with expenditure, slower athletes can meet a
intake in the days before competition large proportion of their energy needs and nutrition
aimed at maximising muscle glycogen through fat oxidation.57 Exogenous CHO
concentrations,13 and intake in the hours oxidation rates can be reduced by 10% in the information is
before competition aimed at topping up liver heat,40 despite glycogen utilisation being
glycogen.29 Consumption of 8-12 g kg1BM
for 36-48 hours prior to an iron-distance
• increased, so intake should be adapted
according to the conditions. It is possible
predominantly
event is recommended81 and, combined with
the exercise taper, is sufficient to ensure
to mix various CHO sources (liquids, gels
and solids) as long as fibre, fat and protein
sourced from
high muscle glycogen concentrations.
Individuals vary in their response to
content is low to prevent delays in gastric
emptying. Athletes should take care not to the Internet,
glycogen-loading, and therefore planned
strategies should always be practised
increase CHO concentrations by combining
CHO sources, eg, consuming CHO gels or other athletes
extensively in training. Food choices in this bars along with CHO drinks and thereby
period should be low in fibre to minimise impacting CHO absorption.43 and coaches’

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‘Dietary Although professional cyclists and elite/top

age-group triathletes on the cycle leg of an
acids and triglycerides.25,83 Leaner athletes
usually finish faster in iron-distance events
fats should iron-distance triathlon usually meet CHO
recommendations, intake is lower during
and many triathletes attempt to manipulate
their diet in attempts to both reduce body
contain high the run leg (and in marathon events) and
non-existent on the swim.64 The proportion
fat and enhance fat oxidation.48,55 Chronic
LCHF diets impair CHO metabolism66 and
of energy provided from fat oxidation there is no association between maximal
levels of EFAs, increases with exercise duration,71 partially rate of fat oxidation and race time in an
mitigating the need for CHO. Although iron-distance race, even among age-group
particularly intakes of >60 g h-1 CHO are recommended
• triathletes who would be more likely
for elite/top age-group triathletes during the to benefit from increased fat oxidation
omega-3’ run,64 difficulties ingesting larger volumes rates.25 High fat diets are therefore not
of CHO and fluid during running, along recommended for elite iron-distance
with the rising temperatures due to iron- triathletes and instead athletes should as a
distance marathons usually commencing in minimum aim to meet health guidelines of
the middle of the day should be considered. daily intakes of 1 g kg-1, with intake increasing
•

CHO intake on the run can be a risk factor when necessary to meet energy needs when
for GI symptoms, but given the relationship training loads are high. Dietary fats should
between faster finishing times and higher contain high levels of EFAs, particularly
CHO intake, athletes should attempt to omega-3.81 A high-quality fish oil supplement
maximise their ability to uptake CHO during (2 g per day) is recommended for most
this portion of the race by practising race- athletes as this might reduce inflammation
fuelling strategy during specific training as well as supporting the immune system
sessions. and cardiovascular function.21

Protein requirements Hydration

Protein requirements are higher for Dehydration is a consequence of body water

endurance athletes than the general loss due to sweating and through increased
population (1.2-2.0 versus 0.8 g kg-1BM),81
• respiration over many hours. Dehydration
due to increased protein synthesis (to impairs the process of heat dissipation and
repair damage to myofibrillar proteins results in elevated core body temperature
and for mitochondrial biogenesis) as well and reduced physical and cognitive
as oxidation during exercise.65 Nitrogen performance.56 Through lowered plasma and
balance is better maintained when ~0.3- stroke volume, heart rate increases for the
0.4 g kg-1BM of high-quality protein (high
• same workload, a condition which is known
leucine content) is ingested every 3 to 4 as cardiovascular drift.58 Dehydration of more
hours throughout the day,2 amounting to than 2% is widely believed to negatively affect
~1.4-2 g kg-1BM per day. After training, 0.3-
• endurance performance, and accompanying
0.4 g kg1BM of protein should be included
• perturbations in electrolyte homeostasis
to restore nitrogen balance and to maximise have been associated with cramping and
glycogen synthesis if CHO intake is hyponatremia.52 The recommendations that
inadequate.23 Consuming 30-40 g of protein endurance athletes drink enough fluid to
before sleep can increase muscle protein avoid more than 2% body weight loss are
synthesis and facilitate recovery.39 Adequate based on controlled laboratory studies, so
CHO and energy consumption prior to sleep translation of findings into the field requires
(and immediately after exercise) ensure that caution. Proper hydration during ultra-
amino acid intake can be used for repair and endurance exercise requires a body mass
synthesis rather than being oxidised as an loss of 2% (water is generated with fuel
energy source.70 oxidation, water bound to glycogen is
released during glycogenolysis, and mass
is lost from oxidation of endogenous
Fat requirements fuel stores), therefore following re-
commendations to maintain body mass can
Fat is an important fuel for endurance result in hyperhydration.33 Heat exhaustion
exercise and some dietary intake in is most likely to occur during high-intensity
the form of essential fatty acids (EFAs) exercise.5 Even the fastest iron-distance
is necessary for.81 Most fat is stored as triathletes race at only moderate intensities
subcutaneous adipose tissue, with 1-2% (~66-71% V̇O2max),61 and serious elevations
of total body fat stored in the muscle as in core temperature are not typical during
intramuscular triacylglycerol (IMTG) and ultra-endurance events, even under hot
small amounts in blood as plasma fatty conditions.82 Furthermore, excessive

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Table 2. Micronutrients in which elite Ironman triathletes might be deficient

ROLES SYMPTOMS OF ATHLETES AT RISK FOOD SOURCES RNI AND TIMING
DEFICIENCIES

Iron Oxygen transport as Anaemia; fatigue; Intense training; training Liver, kidneys, eggs, red 8 mg males
haemoglobin and increased infections at altitude; menstruating meat, seafood, oysters, 18 mg females
myoglobin; forms females; restricted bread, legumes, nuts,
cytochromes and energy intake; specific leafy green vegetables, Ingest with Vit C to
metalloenzymes; avoidance of red meat; broccoli, figs, raisins facilitate absorption.
promotes immune vegetarians; vegans Avoid calcium, tea,
function coffee, red wine,
chocolate
Vitamin D Increases calcium Weak bones/stress Train primarily indoors; Liver, fish, eggs, 2000-4000 IU until serum
absorption in gut; fracture; sub-optimal latitudes > 35th parallel; fortified dairy products, 25(OH)D > 50nmol/L
promotes bone muscle function; train early morning/ oils, margarine
Consume with fat soluble
formation; important increased susceptibility late evening; aggressive
foods
for muscle and to infections; increased blocking of UVB exposure
immune function injury risk (eg, clothing, sun screen) *major source is by
action of sunlight on skin
Calcium Growth, maintenance Osteoporosis; Restricted energy intake; Dairy products; egg yolk; 1000 mg
and repair of bone; osteopenia; disordered eating; beans; peas; dark green
muscle contraction; osteomalacia; stress specific avoidance of vegetables; cauliflower
membrane potentials fractures; impaired dairy products; vegans
and nerve impulse muscle contraction;
transmission; blood muscle cramps
clotting; regulates
enzyme activity
Sodium Maintain fluid balance; Cramping if mild; High training volumes; Meat, fish, bread, canned 1500 mg
active transport hyponatremia is training in hot conditions; food, table salt, sauces, Can vary widely with
mechanism in cell excessively low sodium high sweat rate; high pickles athletes losing up
membranes; important levels during exercise. levels of sodium in sweat 1500mg per litre of
for nerve and muscle Symptoms include sweat, at sweat rates of
function bloating, puffiness, *Sports nutrition > 2L per hour. Athletes
weight gain, headache, products should assess their
vomiting, confusion, sodium needs along with
seizures, loss of their fluid needs.
consciousness and
possibly death. Thought
to occur as a result of
overhydration rather
than sodium losses

fluid intakes do not offer protection Athletes should aim to start iron-distance
from serious heat stroke, and should be
avoided to prevent potential health
races euhydrated by consuming CHO
drinks as part of their CHO loading strategy
‘Cramping
consequences of exercise-associated
hyponatremia.62 Cramping during iron-
in the 48 hours before the race and ingesting
400-600 mL of their preferred CHO drink in during iron-
distance races is common and usually the 2 hours before the start.41
associated with a fluid and sodium distance races
imbalance, although experimental evidence Sweat rates are significantly affected by
suggests that altered neuromuscular body weight, exercise intensity and ambient is common
control, due to greater demands on muscles conditions, with sweat rates of over 2 L h-1 •

relative to the current state of training,

is a more likely cause.33 Athletes generally
reported in hot and humid climates.6,58
Athletes can assess their sweat rate by
and usually
lose between 4 and 8% body mass during an
iron-distance race, with the fastest finishers
weighing themselves undressed before
and after training sessions, and accounting
associated
often exhibiting the greatest losses.78
There is no evidence that magnitude
for any fluid or fuel consumed during the
session and any urine passed;77 sodium with a fluid
of weight loss is associated with
risk of illness in iron-distance
concentration of sweat can be measured
at commercial facilities or otherwise and sodium
triathlons and reductions in body mass may estimated.6 However, the practicality of such
confer a performance advantage.76 actions is questionable. Fluid balance affects imbalance’

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the composition of excreted sweat, with adequate for avoidance of salt-depletion

sweat sodium concentration significantly hypohydration,31,32 and that supplemental
increased in mild dehydration (2.4%) sodium is not necessary.34,77 Rate of fluid
compared with euhydration.59 Rate of sweat absorption is closely related to the CHO
production is influenced by several factors content of the drink, with high CHO
during exercise, including exercise intensity, concentrations compromising fluid delivery.
ambient conditions, and airflow over the The optimum CHO concentration seems to
skin.35,74 Heat acclimation and sodium intake be in the range of 5-8%, when both fluid and
in the days prior to an exercise bout may CHO delivery are high.8
also influence sweat sodium concentration.7
Hydration strategies during training should
Taking all these factors into account, vary according to the desired outcome
evidence suggests that iron-distance of the session. During some sessions,
triathletes should drink water or other athletes should practise their race hydration
hypotonic fluids to quench thirst, that along with their CHO fuelling strategy
the sodium consumed with typical sports to maximise their absorption capability.41
nutrition products during races appears At other times, athletes should train with

Table 3. Overview of nutritional recommendations for elite Ironman triathletes

RECOMMENDATIONS

General daily requirements Daily CHO intake of 3-12 g•kg-1BM, according to CHO periodisation plan
to support training • 3-5 g•kg-1BM for rest or light days, or if deliberately withholding CHO
• 6-10 g•kg-1BM for 1-3 h of moderate to high intensity training
• 8-12 g•kg-1BM for over 4 h of moderate to high intensity training

Protein: 0.3-0.4 g•kg-1BM every 3-4h. 30-40 g protein (eg, casein) prior to sleep if daily protein needs
have not been met

Fat: 1 g•kg-1BM. Include 2 g of Omega-3 fatty acids

Hydration: Needs vary widely between individuals and according to the environment. Athletes should pay
attention to the colour of their urine and presence of thirst on awakening, before consuming any fluid

Micronutrients: Aim to eat a varied diet that includes all food groups and meets daily energy requirements.
Consult a health professional if inadequate consumption of key micronutrients is suspected
Recovery from races or when CHO: 1.2 g•kg-1BM high-GI sources immediately after training and every hour for the next 4 h
maximising glycogen
re-synthesis is a priority Protein: 0.3-0.4 g•kg-1BM immediately after exercise if CHO recommendations are not met. As per general
guidelines thereafter

Hydration: 125-150% of fluid deficit in the hours immediately after exercise. Ideally drinks should contain some
CHO and electrolytes to facilitate absorption
Prior to race or targeted 8–12 g•kg-1BM CHO for 36-48 h prior. Food choices should be low in fibre and fat
sessions to practise race
fuelling/train-high sessions Hydration should include CHO/electrolyte drinks

Probiotic supplementation should be considered if travelling to a race. Glutamine should be considered if hot
conditions
Race morning 1-4 g•kg-1BM CHO 3-4 h before the start from easily digestible foods that are low in fibre, fat and protein

30 g CHO from sports drink or semi-solid (eg, gel) 15-60 min before the start

400-600 mL fluid sipped in the 2 h before the start

During race Recommendations vary between individuals and race fuelling should not change from what was practised in
key sessions. Athletes should aim for the following amounts of CHO from a mixture of sports drink, gels and
solids according to their personal preferences:

Bike: 90 g•h-1 CHO, 2:1 glucose:fructose sources

Run: >60 g•h-1 CHO, 2:1 glucose:fructose sources
Fluid and electrolytes according to individual sweat rate and sweat sodium content.

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inadequate hydration to get used to the in the heat.27 There is emerging evidence
increases in heart rate and perceived effort that probiotics and glutamine may help TAKE-HOME
that will likely occur towards the end of an to preserve GI integrity, which may
iron-distance triathlon.34 Following training improve performance, particularly in hot MESSAGES
sessions, athletes should aim to restore conditions.27 Probiotics can also improve
euhydration during the recovery period.75 the gut microbiota, potentially being • Iron-distance triathletes
Strategies should involve consumption beneficial to health and immunity and have should clearly
of fluid equivalent to 125-150% of the been reported to reduce the incidence and differentiate between
fluid deficit (1.25-1.5 L kg-1BM lost), with
• severity of travellers’ diarrhoea and upper- CHO needs for training
CHO according to individual needs and respiratory tract infections (URTIs).69
and those for racing
0.45 g L-1 sodium to maximise absorption
• Probiotic supplementation should therefore
and minimise diuresis/urinary losses.81 be considered in the days leading up to • A periodised CHO
To maintain euhydration, athletes should travel and competition. The benefits of
meet their daily fluid needs outside probiotics are, however, strain-specific, approach is optimal,
of training (~1.5-3 L depending on and in some cases may exacerbate whereby ‘train-high’ and
environmental condition) by consuming symptoms.18 ‘train-low’ sessions are
sufficient fluid to avoid an overnight loss strategically combined,
in body mass of over 1% and the presence Athletes are advised to test glutamine and in line with specific
of dark coloured urine and thirst when probiotic supplements outside of races
goals of the session
assessed in the morning.8,17 because of wide inter-individual differences
in effectiveness, and ensure that all
• Athletes should start
supplements are certified by a recognised
Micronutrients third-party batch-testing programme, such iron-distance races
as Informed Sport. Aspirin and other non- with high muscle
Exercise stresses many of the metabolic steroidal anti-inflammatory drugs (NSAIDs) and liver glycogen
pathways in which micronutrients are have been shown to increase intestinal concentrations, through
required.81 These are organic (vitamins) and permeability and may increase the incidence a high-CHO diet in the
inorganic (minerals) elements required in of GI complaints. The use of NSAIDs
preceding days and
minute amounts for optimal health, growth should therefore be avoided, particularly in
and physiological function. Generally, the pre-race period or during training.22 a high-CHO pre-race
endurance athletes eating a varied breakfast
diet, with adequate energy availability, Gastrointestinal symptoms are common
meet their micronutrient needs and no in many sports, but particularly prevalent • Athletes should ‘train
supplementation is usually necessary.16 in endurance sports, with up to 96% their gut’ by practising
Single micronutrient supplements are only of participants experiencing some GI their individual race-
appropriate for correction of a clinically symptoms and 4-12% of participants fuelling strategy in
defined medical reason. Iron-distance reporting moderate or severe symptoms.68
triathletes might be at risk of deficiencies In one study, 43% of triathletes reported training, in order to
in vitamin D (in winter months, at higher serious GI problems with 7% having to maximise their ability
latitudes and if skin exposure to sun is less abandon the race.45 The intestinal tract to absorb CHO and
than 30 minutes a day); calcium (athletes is highly adaptable and practising race minimise risk of GI
who avoid dairy, low energy availability); nutrition during training can improve distress
sodium (particularly in hot conditions or absorption and alleviate some or all GI
athletes with a high sweat rate/sodium symptoms.72 • An awareness of
concentration); and iron (menstruating
individual fluid and
females, during altitude training).16,24 There is strong evidence that absorption of
Causes and symptoms of deficiencies, CHO is limited by the transport capacity sodium needs is
recommended intakes and food sources are of SGLT1 (sodium-dependent glucose useful, particularly to
shown in Table 2. transporter) and extrapolations from animal restore euhydration
studies, combined with data from humans, after training. During
suggest that a few days to two weeks of iron-distance races,
Gut health a high CHO diet is sufficient to cause
drinking to quench
significant increases in the SGLT1 content
The GI system breaks down ingested food in the intestinal lumen, thereby enhancing thirst, along with
into smaller units that can be absorbed. It CHO absorption.43 Gastric emptying is not consuming CHO drinks/
is an important athletic organ because it thought to limit absorption but might be gels/bars, appears most
is responsible for the delivery of water and compromised by the combination of high appropriate for meeting
nutrients during exercise as well as being CHO intake, heat and intense exercise.43
hydration and sodium
instrumental in health, immune function All these factors highlight the importance
and well-being.18 During exercise, blood flow of ‘training the gut’ by practising race requirements.
to the GI system is reduced and GI motility nutritional strategy in targeted sessions
and absorption are altered. Permeability is to ensure high rates of CHO and fluid
also increased, particularly when exercising absorption.

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NUTRITION FOR IRON-DISTANCE ATHLETES ISSUE 55 / DECEMBER 2019

Conclusions
practising race-fuelling strategies in
Success in iron-distance races requires a training is vital to maximise uptake and
high volume of training. Supporting this absorption and reduce GI issues. Many of
with appropriate nutritional interventions the suggestions in this article are drawn
will enhance performance by maximising from endurance/ultra-endurance literature
adaptation and facilitating recovery. because of the lack of research in elite iron-
Targeted training sessions should be used distance triathletes, and although providing
to optimise individual race nutrition and a good starting point, there is a need for
hydration strategies, as there are wide further research in this demographic.
variations in requirements and tolerances A summary of key recommendations is
among athletes. Training the gut through presented in Table 3.

AUTHOR’S BIOGRAPHY
DR SALLY WATERWORTH
Sally is a lecturer in sports therapy at the University of Essex and a tutor on the IOPN graduate diploma in
performance nutrition. She has been involved in the triathlon for many years, and completed seven Ironman 70.3
races and six Ironman races, podiuming in her age group and qualifying for World Championships on numerous
occasions. As a practitioner, she has worked with a diverse range of individuals including high-level youth and
junior triathletes, AG triathletes, para-triathletes, long and ultra-distance runners, and cyclists. Her research is
focused on optimising health and performance in endurance athletes and the general population.

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