Table 1.

Causes of Nausea and Associated Prevention Strategies.

Sources of Nausea	Prevention/Mitigation Strategies
SNS activation and catecholamine secretion	Reduce exercise intensity Avoid high-dose caffeine and other stimulants Avoid prolonged fasting
Hypohydration and heat stress	If possible, drink enough fluid during exercise to prevent large body mass losses (i.e., >2–3% of mass) Acclimatize to thermally challenging environments Use pre- and per-cooling strategies to reduce the impact of heat stress
Altitude exposure	Pre-acclimatize to competition elevation Speak to a healthcare provider about drugs such as acetazolamide and metoclopramide
Excessive fluid intake	Avoid consuming large fluid volumes during exercise (≥750–1,000 mL/h)
Concentrated carbohydrate drinks	Consume only small amounts of hypertonic beverages during exercise Choose carbohydrate sources that contain a mix of glucose and fructose when consuming large amounts of carbohydrate (>50 g/h) during exercise
Inappropriate pre-exercise food choices	Limit fat and solid protein intake within 1–2 h of exercise Avoid large doses of fiber (>5–10 g) within 1 to 2 h of exercise
Supplements	If using caffeine, avoid large doses, particularly before stressful competition If using sodium bicarbonate, take 2–3 h before competition, co-ingest it with food, or use a multi-day regimen instead of an acute protocol If taking exogenous ketones, use an ester form Avoid very large dosages of sodium during exercise (>1–2 g/h) For other supplements that cause nausea (glycerol, medium chain triglycerides, etc.) reduce the amount, spread out doses, or take with food
Traveler’s diarrhea	Take precautions to reduce the chance of infection (avoid tap water, only eat food served piping hot, avoid raw foods, etc.) Speak to a healthcare provider about prophylactic antibiotic treatment
Competition stress and anxiety	Try relaxation techniques such as deep breathing and mindfulness meditation Consult with a sports psychologist