Nutritional status and practices among Chinese marathon runners: data from the China marathon nutrition survey (CMNS)

The increasing popularity of marathon running in China highlights the need to better understand the dietary habits and nutritional needs of marathon runners to optimize performance and health outcomes. The study aimed to assess the dietary behaviors, nutritional knowledge, and running-specific nutritional practices of Chinese marathon runners as part of the China Marathon Nutrition Survey (CMNS).

This nationwide cross-sectional survey was conducted between January and December 2024. Participants were recruited via official websites, social media, and onsite events. A structured and pre-tested questionnaire, referred to as the China Marathon Nutrition Survey questionnaire, was developed by the research team for the CMNS project. The CMNS questionnaire was used to collect data on demographic characteristics, running experience, and nutrition-related behaviors among Chinese marathon runners across different genders, ages, and performance levels. Descriptive statistics, chi-square tests, and logistic regression were employed to identify factors associated with nutritional practices.

A total of 5668 valid questionnaires were included in the analysis, comprising 77.6% male (39.8 ± 10.9 yrs) and 22.4% female (41.0 ± 9.7 yrs) runners, representing a wide distribution across age groups and performance levels. Nearly half of the runners (49.1%) of runners reported no specific dietary habits, while among those with dietary practices, 26.4% adhered to a high-carbohydrate diet. In terms of running-related nutrition, 23.3% of Chinese runners regularly or frequently used dietary supplements, and 31.7% used them occasionally before important races. Carbohydrate-loading strategies were adopted by 57.2% of runners prior to races. However, only 36.7% of participants met the recommended fluid intake (1500-1700 mL/day) set by the Chinese Nutrition Society. Higher nutrition knowledge significantly predicted adherence to recommended hydration practices (p < 0.001), according to logistic regression analysis. Significant variability in the nutritional knowledge of Chinese marathon runners was observed, with 36.6% scoring 6 or higher on a 9-point scale. Male runners (OR = 1.39, 95% CI: 1.22-1.57, p < 0.001) and younger participants (≤34 years) (OR = 1.42, 95% CI: 1.22-1.66, p < 0.001) tended to score higher.

This study provides insights into the nutritional knowledge, dietary behaviors, and race-specific nutrition practices of Chinese marathon runners, offering important baseline data for improving endurance nutrition. Common issues were identified in daily macronutrient intake, hydration, and race-day fueling. These findings underscore the gaps between knowledge and practice, emphasizing the need for tailored nutrition education, particularly for recreational runners through race organizers or public platforms.