Endurance exercise can disturb intestinal epithelial integrity, leading to increased systemic indicators of cell injury, hyperpermeability, and pathogenic translocation. However, the interaction between exercise, diet, and gastrointestinal disturbance still warrants exploration. This study examined whether a 6-day dietary intervention influenced perturbations to intestinal epithelial disruption in response to a 25-km race walk. Twenty-eight male race walkers adhered to a high carbohydrate (CHO)/energy diet (65% CHO, energy availability = 40 kcal·kg FFM⁻¹·day⁻¹) for 6 days prior to a Baseline 25-km race walk. Athletes were then split into three subgroups: high CHO/energy diet (n = 10); low-CHO, high-fat diet (LCHF: n = 8; <50 g/day CHO, energy availability = 40 kcal·kg FFM⁻¹·day⁻¹); and low energy availability (n = 10; 65% CHO, energy availability = 15 kcal·kg FFM⁻¹·day⁻¹) for a further 6-day dietary intervention period prior to a second 25-km race walk (Adaptation). During both trials, venous blood was collected pre-, post-, and 1 hr postexercise and analyzed for markers of intestinal epithelial disruption. Intestinal fatty acid-binding protein concentration was significantly higher (twofold increase) in response to exercise during Adaptation compared to Baseline in the LCHF group (p = .001). Similar findings were observed for soluble CD14 (p < .001) and lipopolysaccharide-binding protein (p = .003), where postexercise concentrations were higher (53% and 36%, respectively) during Adaptation than Baseline in LCHF. No differences in high CHO/energy diet or low energy availability were apparent for any blood markers assessed (p > .05). A short-term LCHF diet increased intestinal epithelial cell injury in response to a 25-km race walk. No effect of low energy availability on gastrointestinal injury or symptoms was observed.

耐力运动会扰乱肠上皮的完整性，导致细胞损伤、通透性过高和致病性易位等全身指标增加。然而，运动、饮食和胃肠道紊乱之间的相互作用仍然值得探索。这项研究检验了 6 天的饮食干预是否会影响 25 公里竞走时肠上皮破坏的扰动。28 名男性竞走运动员在基线 25 公里竞走之前坚持 6 天高碳水化合物 (CHO)/能量饮食（65% CHO，能量可用性 = 40 kcal·kg FFM ^-1 ·天^{-1 ）。}然后，运动员被分为三个亚组：高 CHO/能量饮食 ( n  = 10)；低 CHO、高脂肪饮食（LCHF：n  = 8；<50 g/天 CHO，能量可用性 = 40 kcal·kg FFM ^-1 ·天^-1）；以及低能量可用性（n  = 10；65% CHO，能量可用性 = 15 kcal·kg FFM ^-1 ·天^-1），在第二次 25 公里竞走之前进行另外 6 天的饮食干预期（适应）。在这两项试验中，均在运动前、运动后和运动后 1 小时收集静脉血，并分析肠上皮破坏的标记物。与 LCHF 组的基线相比，适应期间运动对肠道脂肪酸结合蛋白浓度的响应显着更高（增加两倍）（p  = .001）。对于可溶性 CD14 ( p  < .001) 和脂多糖结合蛋白 ( p = .003)也观察到类似的结果 ，其中在适应期间运动后浓度高于 LCHF 中的基线（分别为 53% 和 36%）。对于所评估的任何血液标志物而言，高 CHO/能量饮食或低能量可用性没有明显差异 ( p  > .05)。短期 LCHF 饮食会增加 25 公里竞走时肠上皮细胞的损伤。没有观察到低可用能量对胃肠道损伤或症状的影响。