Case study: Nutrition and hydration status during 4,254 km of running over 78 consecutive days

The aims of this study were to assess the dietary intake and monitor self-reported recovery quality and clinical symptomology of a male ultra-endurance runner who completed a multiday ultra-endurance running challenge covering 4,254 km from North Scotland to the Moroccan Sahara desert over 78 consecutive days. Food and fluid intakes were recorded and analyzed through dietary analysis software. Body mass (BM) was determined before and after running each day, and before sleep. Clinical symptomology and perceived recovery quality were recorded each day. Whole blood hemoglobin and serum ferritin were determined before and after the challenge. Total daily energy (mean ± SD: 23.2 ± 3.2 MJ · day(-1)) and macronutrient intake (182 ± 31 g · day(-1) protein, 842 ± 115 g · day(-1) carbohydrate, 159 ± 55 g · day(-1) fat) met consensus nutritional guidelines for endurance performance. Total daily water intake through foods and fluids was 4.8 ± 2.0 L · day(-1). Water and carbohydrate intake rates during running were 239 ± 143 ml · h(-1) and 56 ± 19 g · h(-1), respectively. Immediately after running, carbohydrate and protein intakes were 1.3 ± 1.0 g · kg BM(-1) and 0.4 ± 0.2 g · kg BM(-1), respectively. Daily micronutrient intakes ranged from 109 to 662% of UK RNIs. Prerunning BM was generally maintained throughout. Overall exercise-induced BM loss averaged 0.8 ± 1.0%; although BM losses of ≥ 2% occurred in the latter stages, a reflection of the warmer climate. Varying degrees of self-reported perceived recovery quality and clinical symptomology occurred throughout the challenge. This case study highlights oscillations in dietary habits along 78 consecutive days of ultra-endurance running, dependent on changes in ambient conditions and course topography. Nevertheless, nutrition and hydration status were maintained throughout the challenge. Despite dietary iron intake above RNI and iron supplementation, this alone did not prevent deficiency symptoms.