INTRODUCTION: Gastrointestinal (GI) symptoms during exercise are common in female athletes (Parnell et al, 2020). The prevalence and severity of symptoms varies between athletes, yet common symptoms can negatively impact performance and exercise completion. Pre- during- and post-exercise nutritional intake may be altered in an attempt to reduce GI symptoms and prevent performance detriments (Parnell et al, 2020). However, most research has been conducted in female endurance athletes, with limited data in team sport athletes. Therefore, the aim of this study was to identify the prevalence and severity of GI symptoms, and nutrition habits, in elite female soccer players. METHODS: In this cross-sectional study, elite female soccer players (n= 106) from English, Spanish, and Italian leagues (n= 23, 73, 10 respectively) completed a GI symptom prevalence and nutrition habit questionnaire. Players rated the number and severity (1 (very mild) to 10 (extremely severe)) of GI symptoms experienced during soccer training and matches. Any symptom rated >4 was classified as severe. Questions on pre-exercise nutrition habits and food/drink avoidance were also included. Chi-square tests were used to determine relationships between nutrition habits and number of GI symptoms. RESULTS: During training and matches, 20% and 13% of players experienced one GI symptom, and 8% and 12% of players reported experiencing two GI symptoms, respectively. Five players (5%) reported experiencing three or more symptoms during both training and matches. During training, flatulence (n=12), bloating (n=12), heartburn (n=11) and belching (n=11) were the most common symptoms. Eight players ranked the severity of the symptom as severe. During matches, bloating (n=15), flatulence (n=8), defecation (loose stool) (n=7), and stomach pain (n=6) were the most common symptoms. Ten players ranked the severity of the symptom as severe. A total of 28% and 35% of players reported regularly avoiding certain foods/drinks to prevent GI symptoms; this was most commonly high fat foods. Caffeine was frequently ingested prior to both training and matches but was not associated with the number or severity of GI symptoms experienced (X2(8,n=110)=8.9, P=0.350). CONCLUSION: Most (70%) elite female soccer players do not experience GI symptoms during training and/or matches. The severity of GI symptoms experienced during training and matches was generally low but highly individual. The impact of mild GI symptoms on soccer specific performance warrants further investigation.
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