Ultrarunning and Long-Term Health
Ultrarunning and Long-Term Health: How Nutrition Helps you go the Distance
Ultrarunning has exploded in popularity over the last decade, with more athletes pushing their bodies through 50km, 100-mile and multi-day events than ever before. While the physical and mental benefits of endurance exercise are well established, research suggests that extremely high training volumes may also carry some long-term health risks if recovery is poorly managed.
The good news? Nutrition is one of the most powerful tools ultrarunners have to protect their health, improve recovery and continue running well for decades.
A scientific review examining the long-term effects of ultra-endurance exercise ‘Potential Long-Term Health Problems Associated with Ultra-Endurance Running’ identified several areas of concern for ultrarunners, including cardiovascular strain, immune suppression, hormonal disruption, kidney stress, gastrointestinal problems and chronic musculoskeletal injury. However, many of these risks were strongly linked to inadequate recovery, chronic energy deficits and poor fuelling strategies - not simply running itself.
Here are the nutrition takeaways from the research.
The Biggest Risk: Chronic Under-Fuelling
One of the clearest themes from the review is that many endurance athletes consistently fail to eat enough to support their training load. This is known as low energy availability, where the body does not have sufficient calories left over for normal physiological function after exercise.
Over time, this can lead to impaired recovery, increased injury risk, suppressed immunity, hormonal disruption, low bone density, chronic fatigue and RED-S (Relative Energy Deficiency in Sport).
Many ultrarunners unintentionally under-fuel because high mileage suppresses appetite, busy schedules limit recovery eating, or body weight concerns influence intake.
But ultrarunning is not a sport where “less is more” nutritionally. The athletes who stay healthiest long-term are often those who recover best, not simply those who train hardest.
Carbohydrates are Essential for Fuelling and Recovery
Despite the popularity of low-carb approaches in endurance sport, the review reinforces the importance of carbohydrate intake for recovery and long-term health.
Long runs heavily deplete glycogen stores. If these are not restored properly, athletes may experience elevated stress hormones, impaired immune function and slower recovery between sessions.
Plus, an issue for ultrarunners is that many don’t feel like eating on the run due to low appetite or nausea, or they struggle to keep food down, and so they are depleted of carbs during the run itself. This only gets worse when too few carbs are taken afterwards.
Finding simple, easy to digest carbs that can be taken during long runs is key here, and this is what our maple syrup gels were built for - gentle fuelling over long distances.
After hard or prolonged runs, athletes should prioritise:
1. Carbohydrate-rich meals within 30–60 minutes
2. Regular carbohydrate intake throughout the day
3. Adequate overall calorie intake during heavy training blocks
4. High carb recovery foods include oats, rice, potatoes, fruit, cereal, smoothies and bagels.
Carbohydrates are key for both fuelling and recovery and mustn’t be neglected.
Protein and Collagen Support Long-Term Recovery
The review also highlights the significant musculoskeletal stress caused by repeated ultra-endurance training. Muscle breakdown, tendon strain and bone stress accumulate over time, making recovery nutrition critical.
Many endurance athletes still consume protein levels better suited to recreational fitness than high-volume training.
For optimal recovery, runners should aim to:
1. Include protein after every key session, at least 20g protein 30mins-1 hour after a run/workout. A quality protein shake like our Accelerate can help here, especially when runners are away from home or can’t face food.
2, Spread protein intake evenly across the day.
3. Consume high-quality protein sources.
Collagen is also gaining increasing attention in endurance sport for its role in supporting connective tissues including tendons, ligaments and cartilage. Research shows that collagen supplementation, such as with Run Easy, can help support ongoing tissue repair and resilience in athletes exposed to repetitive impact loading, such as ultrarunners.
Hydration is About Electrolytes too
The review discusses the kidney stress and electrolyte disturbances that can occur during prolonged events, particularly in hot conditions.
Many runners focus heavily on water intake but can neglect electrolyte replacement. In some cases, over-drinking plain water can actually become dangerous, leading to hyponatremia.
Healthy hydration means replacing both fluids and electrolytes, with research pointing towards the need for runners to take approximately 500mg sodium per hour of a long run, with heavy sweaters needing more than this. Potassium, magnesium, calcium and chloride should also be replaced, not just sodium alone.
After long sessions, electrolyte-containing drinks and salty foods can also help restore balance.
Micronutrients Could be Lacking
Ultrarunners frequently under consume key micronutrients, particularly: Iron, calcium, vitamin D, magnesium and zinc.
Deficiencies can contribute to fatigue, stress fractures, impaired immunity and poor performance.
A focus on eating natural, minimally processed foods both in the everyday diet and during ultramarathons can help to avoid micronutrient deficiencies. The maple syrup in our gels, for example, naturally contain a number of micronutrients including potassium, calcium, manganese and iron.
Gut Health Shouldn’t be Ignored
Gastrointestinal distress is extremely common in ultramarathon events due to reduced blood flow to the digestive system during prolonged exercise.
The review notes that repeated gut stress may contribute to inflammation and poor nutrient absorption over time.
To support gut recovery:
1. Focus on simple, easy-to-digest foods during and after long sessions and races
2. Avoid excessively fatty foods before, during and immediately after a run
3. Practice race fuelling during training
4. Avoid experimenting with new nutrition strategies on race day
This is one area where more natural fuelling options may offer an advantage. Foods with simpler ingredient lists and fewer artificial additives – like our Maple Ignite and Maple Coffee gels - are easier on the gut during prolonged exercise, particularly for runners who struggle with gastrointestinal issues from highly processed sports nutrition products.
Sleep is One of the Most Powerful Recovery Tools
Nutrition also plays an important role in sleep quality, which is essential for muscle repair, hormonal balance and immune recovery.
Magnesium is particularly important for ultra-endurance runners due to losses through sweat and increased physical stress. Adequate magnesium intake may help support relaxation, nervous system function and sleep quality - all key components of effective recovery. If you don’t get enough magnesium, supplementing should be considered such as with our seawater-sourced magnesium, Power Up.
Prioritising sleep is one of the simplest ways runners can improve long-term resilience and consistency.
Recovery is More Than Calories
Nutrition supports recovery best when combined with adequate sleep, recovery days, strength training and stress management.
The review suggests that many long-term problems emerge not from individual races, but from repeated cycles of hard training without sufficient recovery.
Ultrarunning can absolutely be part of a healthy lifestyle. In fact, endurance exercise is associated with improved cardiovascular health, metabolic health and psychological wellbeing for most people.
But extreme training requires equally serious recovery habits.
The takeaway from the research is clear: ultrarunners should think less about simply surviving their next race and more about building the nutritional foundations that allow them to keep running strongly for years to come.
