b'STRESS AND PERFORMANCE ANXIETYAthletes, like all of us, experience many day-to-day external (e.g., relationship, financial, bereavement) and internal (e.g., self-criticism, social anxiety) psychological stressors, but also have the added pressure to deliver peak performance. Research has shown that professional athletes are likely to experience over 640 stressors that may increase susceptibility to development of common mental disorders 21 . Acute anxiety in preparation for a competitive event (commonly referred to as pre-race jitters) is experienced by athletes across all levels of competition and is generally considered normal and healthy. However, chronic and/or poorly managed psychological stress or anxiety can manifestBoth GI and immune perturbations that occur as a result of as physical symptoms, including immunodepression, GIstress, may be mediated via the gut-brain axis. As a result, symptoms and sleep disruptions, that may be detrimental toresearchers have investigated the gut as a target organ performance. for managing stress and anxiety by dietary interventions. Diets high in plant-based foods, such as the Mediterranean Acutely, stressors activate the HPA and sympatho- diet, have been linked to beneficial microbial profiles and adrenomedullary (SAM) axes to release catecholaminesreduced symptoms of anxiety and depression 25-27 . Clinical (adrenaline and noradrenaline) and cortisol to physicallystudies have also linked pre- and probiotics (Lactobacillus and prepare the body to deal with the demands of incomingBifidobacterium) to improved anxiety symptoms 28 , specifically stress. Stress stimuli can be physical (i.e., exercise aboveamongst athletes 29 . On the other hand, cognitive focused 60% VO 2max ) or psychological (i.e., anticipation of competition).stress management strategies, such as cognitive-behavioural The stress responses for physical and psychological stresscoping therapy CBT, breathwork and meditation, might help to share similar pathways and effector limbs and appearrelieve GI symptoms via the gut-brain axis.to present similar physical consequences of chronic dysregulation. Indeed, chronic stress can lead to dysregulation of the HPA axis and prolonged activation of the stress response. Chronic stress may increase the risk of cognitive and metabolic comorbidities and has also been associated immunosuppression. Chronic stress resulting from excessive training load and/or inadequate recovery is estimated to afflict between 20-60% of athletes 22 . To date, the effect of chronic psychological stress on immune parameters as an underlying mechanism for risk of illness and infection has not been systematically investigated in athletic populations. One study, however, has shown that in an Olympic athletic population, symptoms of depression and higher perceived stress were significantly associated with illness resulting in limited training or competition 23 . GI symptoms may also occur as a result of dysregulation of the HPA and gut-brain axes. For example, sustained activation of the HPA axis and an altered microbial profile has been demonstrated in those with IBS, compared with healthy control 24 . Likewise, severe psychological stress or anxiety brought on by anticipation of competition may present with GI symptoms, including poor appetite, poor tolerance to food and drinks, or altered bowel movements, such as urgent bowel movements, loose stools or diarrhoea. Acute dietary strategies such as small, frequent meals, low fermentable dietary fibre intake, and focus on sweet and palatable foods can be implemented to ease symptoms.11'