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Purpose: Antarctic expeditions are exceptional physiological challenges. Sleep plays a critical role in athletic performance, recovery, and wellness, with sleep disturbances having a negative impact on health and performance. Methods: The authors investigated sleep, fatigue, and recovery profiles of the longest solo unsupported one-way polar ski journey across Antarctica. A 33-year-old woman covered 1484.53 km from Hercules Inlet to the South Pole, finishing at the Ross Ice Shelf, in 70 days and 16 hours. Questionnaires on sleep (Pittsburgh Insomnia Rating Scale and Karolinska Sleepiness Scale), fatigue (Subjective Assessment of Fatigue), recovery (Total Quality Recovery), and wellness were completed at different time points (before, during, and after the expedition). Results: Average daily sleep time was between 4 and 5 hours, increasing to 7 hours for the final part of the expedition. Satisfaction of sleep and lack of energy deteriorated as the expedition progressed, alongside signs of clinical insomnia. Fatigue and muscle soreness increased with increasing milage, with extreme levels and very poor recovery toward the end of the expedition. Despite this, the adventurer continued to perform on extremely high levels. Postexpedition scores returned to baseline, demonstrating the incredible adaptation and ability to recovery. The postexpedition interview showed that prior experience of an Antarctic expedition may have prepared the athlete and made her more resilient for this challenge. Conclusions: The data provide unique insights into Antarctic expeditions and may help us understand the limits of human performance when planning future expeditions of this nature. Female athletes are capable of extreme challenges, breaking established performance boundaries. [ABSTRACT FROM AUTHOR]

Ultramarathon running is of increasing popularity, where the time-limited 24-hour run is one of the most popular events. Although we have a high scientific knowledge about different topics for this specific race format, we do not know where the best 24-hour runners originate from and where the fastest races are held. The purpose of the present study was to investigate the origin of these runners and the fastest race locations. A machine learning model based on the XG Boost algorithm was built to predict running speed based on the athlete´s age, gender, country of origin and the country where the race takes place. Model explainability tools were used to investigate how each independent variable would influence the predicted running speed. A sample of 171,358 race records from 63,514 unique runners from 73 countries participating in 24-hour races held in 57 countries between 1807 and 2022 was analyzed. Most of the athletes originated from the USA, France, Germany, Great Britain, Italy, Japan, Russia, Australia, Austria, and Canada. Tunisian athletes achieved the fastest average running speed, followed by runners from Russia, Latvia, Lithuania, Island, Croatia, Slovenia, and Israel. Regarding the country of the event, the ranking looks quite similar to the participation by the athlete, suggesting a high correlation between the country of origin and the country of the event. The fastest 24-hour races are recorded in Israel, Romania, Korea, the Netherlands, Russia, and Taiwan. On average, men were 0.4 km/h faster than women, and the fastest runners belonged to age groups 35–39, 40–44, and 45–49 years. In summary, the 24-hour race format is spread over the world, and the fastest athletes mainly originate from Eastern Europe, while the fastest races were organized in European and Asian countries. [ABSTRACT FROM AUTHOR]

Abstract Ultramarathon running is of increasing popularity, where the time-limited 24-hour run is one of the most popular events. Although we have a high scientific knowledge about different topics for this specific race format, we do not know where the best 24-hour runners originate from and where the fastest races are held. The purpose of the present study was to investigate the origin of these runners and the fastest race locations. A machine learning model based on the XG Boost algorithm was built to predict running speed based on the athlete´s age, gender, country of origin and the country where the race takes place. Model explainability tools were used to investigate how each independent variable would influence the predicted running speed. A sample of 171,358 race records from 63,514 unique runners from 73 countries participating in 24-hour races held in 57 countries between 1807 and 2022 was analyzed. Most of the athletes originated from the USA, France, Germany, Great Britain, Italy, Japan, Russia, Australia, Austria, and Canada. Tunisian athletes achieved the fastest average running speed, followed by runners from Russia, Latvia, Lithuania, Island, Croatia, Slovenia, and Israel. Regarding the country of the event, the ranking looks quite similar to the participation by the athlete, suggesting a high correlation between the country of origin and the country of the event. The fastest 24-hour races are recorded in Israel, Romania, Korea, the Netherlands, Russia, and Taiwan. On average, men were 0.4 km/h faster than women, and the fastest runners belonged to age groups 35–39, 40–44, and 45–49 years. In summary, the 24-hour race format is spread over the world, and the fastest athletes mainly originate from Eastern Europe, while the fastest races were organized in European and Asian countries.

This study investigates the comprehensive physiological, biomechanical, and thermographic responses of male athletes during an ultra-endurance race, the Santander Four Days (S4D). Involving a 160 km race over four consecutive days with a 10 kg backpack, the study focuses on key aspects such as body mass, cortical arousal, handgrip strength, heart-rate variability, hydration status, blood glucose and lactate concentrations, and thermographic responses. The results indicate changes in heart-rate variability, indicating increased cardiovascular strain, consistent neuromuscular performance, significant body-weight reduction possibly due to dehydration and energy use, stable pH and glucose, but increased protein in urine suggesting renal stress, and varied body temperatures reflecting physical exertion and environmental factors. These findings highlight the body's adaptive mechanisms and the importance of specialized training and recovery strategies in such physically demanding events. [ABSTRACT FROM AUTHOR]

Sport psychology research of ultra-endurance (UE) athletes focused predominantly on their psychological characteristics, traits, and behaviors. However, their happiness and passion, as well as a unified framework for UE hobby phenomenon, were not sufficiently investigated. This study aims to: (1) identify the main contributors to happiness and passion of non-professional UE athletes; and (2) explore the possible relationships between types of sport passion, motivation, and athletic identity. During data collection, 116 non-professional UE athletes (mean age 43.66 years, SD = 8.97, 16.4% female) responded to an online questionnaire. Statistical analyses revealed that obsessive UE passion (p < 0.05) and amotivation (p < 0.05) predicted lower levels of happiness. A higher level of obsessive passion was predicted by extrinsic motivation (p < 0.005), amotivation (p < 0.05), and exclusivity identity (p < 0.001); a lower level was predicted by social identity (p < 0.05) and years in sports (p < 0.05). Weekly training hours and age correlated positively with passion strength, while amotivation was strongly negatively related to training volume. These results indicate that happiness of UE athletes depends on the type of sport passion formed and the quality of the underlying motivation: obsessive passion and amotivation seem to be the main enemies of happiness for UE athletes. This novel finding connecting passion, happiness, and motivation contributes to both a better understanding of the psychology of UE athletes and has practical implications for UE athletes, coaches, athletes' social circles, and sport psychologists. Due to known maladaptive outcomes of obsessive passion, including its negative impact on overall well-being, health, and now also on happiness, its formation in UE athletes needs to be observed and prevented. While the study shows predictors of obsessive passion and high vs. low obsessive passion, future research should investigate how harmonious passion impacts athletes' happiness, motivation, and identity. Likewise, research among the UE entourage would help to better understand the social impact of UE as a serious hobby and the formation of UE lifestyles. We also suggest our Temporal Framework for Progressive UE Engagement and Passion, which was further developed based on the results of this study, to be used and validated by sport psychologists. [ABSTRACT FROM AUTHOR]

The 24‐h ultramarathon (UM) race is one of the most demanding competitive sports in terms of muscular and physiological exertion. In this context, predictors of UM athletes' physical performance are in high demand; however, data on the predictive capabilities of hematological variables are still sparse. In the present paper, we retrospectively took into consideration the pre‐race blood biomarker levels (including basic blood count, leukocyte subpopulations, markers of inflammation and organ function, metabolic profile, and electrolytes) of 50 UM athletes (M = 33, F = 17) who completed a 24‐h competition in order to identify a combination of analytes capable of predicting the athletic performance in terms of distance covered during the 24‐h run. The multiple regression analysis produced a model that explained a significant portion of the variance in the dependent variable, with an adjusted R‐squared value of 0.783 (F(13, 36) = 14.58, p < 0.001). A greater race distance was correlated with higher pre‐race values of hematocrit, lactate dehydrogenase (LDH), total cholesterol, HDL/LDL ratio, and triglycerides and lower levels of monocytes, eosinophils, alanine aminotransferase (ALT), gamma‐glutamyl transferase (GGT), total proteins, and sodium. This study represents the first of its kind conducted on 24‐h UM athletes that investigated the association between blood markers and endurance performance. Our model, given its promising predictive power, would serve as a starting point that will require refinement and integration with other traditional performance prediction measures, in order to support athletes and coaches in better managing the training loads during the race‐approaching phases. Highlights: A combination of pre‐race hematological parameters was found to predict the 24‐h ultramarathon race distance in ultra‐endurance athletes.A greater race distance was correlated with higher pre‐race values of hematocrit, lactate dehydrogenase, total cholesterol, HDL/LDL ratio, and triglycerides, and lower levels of monocytes, eosinophils, alanine aminotransferase, gamma‐glutamyl transferase, total proteins, and sodium.The predictive model generated by the multiple regression analysis explained a significant portion of the variance in the dependent variable (race distance), with an adjusted R‐squared value of 0.783. [ABSTRACT FROM AUTHOR]

Thru-hiking requires high energy intake to support performance and reduce injury risks. Currently, there is limited information on the dietary demands, the practical considerations for optimal nutrient intake, and the negative consequences associated with reduced caloric intakes during a thru-hike, particularly in women. This case study's purpose was to quantify energy intake vs energy expenditure during a thru-hiker's trek and assess its relationship to performance and health. A highly trained, female thru-hiker (Age (yrs): 62, Ht (cm): 157, Wt (kg): 53.5, BMI (kg/m2): 21.7, %BF: 26.0) embarked on a 4-month journey through the Pacific Crest Trail, USA. The athlete's body composition and 3-day diet record were assessed before (PRE) and after the hike (POST). During the hike, she tracked her diet and performance daily and completed a wellness survey each time she reached a town-check point. Data were analyzed for descriptive (weekly averages, means ± SD) and frequency statistics. She spent 10 wk (∼70 days) on the trail and hiked 1,506.35 km (26.1 ± 3.2 km/day) with an estimated energy expenditure of ∼2334 ± 351 kcal/day. During the hike, she under consumed calories (1285.3 ± 103 kcal) and dietary carbohydrate (169.5 ± 19.5g), fat (49.7 ± 5.8g), protein (41.9 ± 4.8g; 0.8 g/kg), fiber (11.8 ± 2.1g) and sodium (1642.4 ± 298.6 mg) when compared to ultra-endurance nutrition recommendations. She was unable to complete the trail due to fatigue and anthropometric changes. By POST, she had decreased total mass (PRE: 53.5 kg vs POST: 48.4 kg), BMI (PRE 21.6 vs POST: 19.5), fat-free mass (PRE: 39.6 vs POST: 38.8), and body fat (PRE: 26% vs POST: 19.6%) when compared to PRE. Trail-related challenges combined with high energy expenditures led to low nutrient intake which contributed to trail-ending injuries and performance decrements. Research aimed at addressing the barriers associated with thru-hike fueling is needed to identify nutritional opportunities to support hikers' performance and reduce injury risks. [ABSTRACT FROM AUTHOR]

Abstract The Tour Divide (TD) is a 4385 km ultra‐endurance bicycle race that follows the continental divide from Canada to Mexico. In this case study, we performed a comprehensive molecular and physiological profile before and after the completion of the TD. Assessments were performed 35 days before the start (Pre‐TD) and ∼36 h after the finish (Post‐TD). Total energy expenditure was assessed during the first 9 days by doubly labelled water (2H218O), abdominal and leg tissue volumes via MRI, and graded exercise tests to quantify fitness and substrate preference. Vastus lateralis muscle biopsies were taken to measure mitochondrial function via respirometry, and vascular function was assessed using Doppler ultrasound. The 47‐year‐old male subject took 16 days 7 h 45 min to complete the route. He rode an average of 16.8 h/day. Neither maximal O2 uptake nor maximal power output changed pre‐ to post‐TD. Measurement of total energy expenditure and dietary recall records suggested maintenance of energy balance, which was supported by the lack of change in body weight. The subject lost both appendicular and trunk fat mass and gained leg lean mass pre‐ to post‐TD. Skeletal muscle mitochondrial and vascular endothelial function decreased pre‐ to post‐TD. Overall, exercise performance was maintained despite reductions in muscle mitochondrial and vascular endothelial function post‐TD, suggesting a metabolic reserve in our highly trained athlete.

The Tour Divide (TD) is a 4385 km ultra‐endurance bicycle race that follows the continental divide from Canada to Mexico. In this case study, we performed a comprehensive molecular and physiological profile before and after the completion of the TD. Assessments were performed 35 days before the start (Pre‐TD) and ∼36 h after the finish (Post‐TD). Total energy expenditure was assessed during the first 9 days by doubly labelled water (2H218O), abdominal and leg tissue volumes via MRI, and graded exercise tests to quantify fitness and substrate preference. Vastus lateralis muscle biopsies were taken to measure mitochondrial function via respirometry, and vascular function was assessed using Doppler ultrasound. The 47‐year‐old male subject took 16 days 7 h 45 min to complete the route. He rode an average of 16.8 h/day. Neither maximal O2 uptake nor maximal power output changed pre‐ to post‐TD. Measurement of total energy expenditure and dietary recall records suggested maintenance of energy balance, which was supported by the lack of change in body weight. The subject lost both appendicular and trunk fat mass and gained leg lean mass pre‐ to post‐TD. Skeletal muscle mitochondrial and vascular endothelial function decreased pre‐ to post‐TD. Overall, exercise performance was maintained despite reductions in muscle mitochondrial and vascular endothelial function post‐TD, suggesting a metabolic reserve in our highly trained athlete. What is the main observation in this case?This paper provides a unique multi‐parameter physiological analysis of a male subject who completed a 4385 km ultra‐endurance bicycle race. Although no specific hypotheses were tested, several intriguing observations were made. First, measurements of energy intake and expenditure indicated that energy balance was maintained, as was body mass. Second, after completion of the race, exercise performance was maintained despite reductions in skeletal muscle mitochondrial and vascular endothelial function.What insights does it reveal?Overall, the data provide a unique insight into the plasticity and tolerability of multiple physiological systems for the extreme physical stress imposed by multi‐day ultra‐endurance events in a trained athlete. [ABSTRACT FROM AUTHOR]

This paper examines the connection between endurance athletes, their bodies, the world, and the present through the lens of trail running, a competitive race in which athletes cover distances longer than a marathon. The study draws on Platonic texts, Rosa's theory of resonance, and Hadot's concept of oceanic feeling to understand how running helps athletes connect with the landscape, their bodies, and the present. According to Platonic writings, running immerses athletes in a state of active presence, while Hadot argues that running provokes feelings of wonder and apprehension that he calls "oceanic feelings," which connect athletes to their bodies and the world. Rosa's theory of resonance posits that consonance between the athlete and the surrounding landscape helps establish a connection between the athlete, their body, and the world. [ABSTRACT FROM AUTHOR]

PurposeThis study aimed to investigate the carbohydrate beliefs and practices of ultra-endurance runners in Ireland to gain an understanding of their gastrointestinal symptom (GIS) management strategies.MethodologyAn adapted version of a previously developed and validated questionnaire was distributed online to ultra-endurance runners, recognized as those who completed a single bout of exercise lasting 4 or more hours. The questionnaire asked about carbohydrate awareness and sourcing, and dietary practices, particularly in relation to GIS management.ResultsA total of n = 68 individuals completed the adapted questionnaire. Of these, n = 1 was excluded due to their reporting of an ulcerative colitis diagnosis. The remaining participants included 46 men and 21 women. Personal previous experience was the main source directing participants’ nutrition practices (n = 30), while only 3 participants quoted sourcing information from qualified professionals. Forty-two participants experienced GIS, usually equally around training and competition times. Many participants had not previously implemented any specific dietary or non-dietary strategies to alleviate exercise-induced GIS. Supplementing with nitrates (n = 9) and probiotics (n = 4) were the most common dietary practices to alleviate GIS, while other practices (n = 14) and portion control (n = 13) were the most reported non-dietary practices.DiscussionSimilar to previous studies, these findings suggest that GISs are prevalent in the ultra-endurance running community, occurring regardless of whether during training or an event. Similarly, this research highlights the vast range of GISs experienced by this population. However, the absence of both dietary and non-dietary-related practices used for GIS management alludes to a current deficit in the availability of nutrition information specific to this problem. Further research is required to understand the mechanisms behind ultra-endurance-associated GISs and its various management strategies as well as best practices for communicating these to the target audience to reduce individuals’ risks of developing long-term, chronic health complications.

Abstract Background The sex difference in the three split disciplines (swimming, cycling, and running) and overall race times in triathlon races has mainly been investigated for the Olympic distance and IRONMAN® triathlon formats, but not for the half IRONMAN® distance, i.e., the IRONMAN® 70.3. The aim of the present study was to investigate the sex differences in IRONMAN® 70.3 by age group in 5-year intervals for the split disciplines of this race. Data from 823,459 records (625,393 males and 198,066 females) of all age group finishers (in 5-year intervals) competing in all official IRONMAN® 70.3 races held worldwide between 2004 and 2020 were analyzed, and sex differences by age group and split disciplines were evaluated. Results Males were faster than females in all split disciplines and all age groups. The sex difference was lower in swimming than in cycling and running and less pronounced for triathletes between 20 and 50 years of age. After the age of 60 years, females were able to reduce the sex difference to males in swimming and cycling, but not in running, where the reduction in the sex difference started after the age of 70 years. The lowest sex difference was in the age group 75 + years for swimming and cycling and in the age group 30–34 years for running. Across age groups, the sex difference was U-shaped in swimming and running, with an increase after 18–24 years in swimming and after 40–44 years in running. In contrast, the sex difference decreased continuously with the increasing age for cycling. Conclusions In conclusion, the study found that the sex difference in performance decreases with age in the IRONMAN® 70.3 race distance. However, females did not outperform males at older ages. Notably, sex differences were observed across different disciplines, with swimming displaying lower differences compared to cycling and running. These findings underscore the complex interplay between age, sex, and performance in endurance sports, emphasizing the need for additional research to understand the factors influencing these differences.

This study investigates the comprehensive physiological, biomechanical, and thermographic responses of male athletes during an ultra-endurance race, the Santander Four Days (S4D). Involving a 160 km race over four consecutive days with a 10 kg backpack, the study focuses on key aspects such as body mass, cortical arousal, handgrip strength, heart-rate variability, hydration status, blood glucose and lactate concentrations, and thermographic responses. The results indicate changes in heart-rate variability, indicating increased cardiovascular strain, consistent neuromuscular performance, significant body-weight reduction possibly due to dehydration and energy use, stable pH and glucose, but increased protein in urine suggesting renal stress, and varied body temperatures reflecting physical exertion and environmental factors. These findings highlight the body’s adaptive mechanisms and the importance of specialized training and recovery strategies in such physically demanding events.

(1) Background: Participation in ultra-endurance sports, particularly ultra-running, has increased over the previous three decades. These are accompanied by high energetic demands, which may be further exacerbated by extreme environmental conditions. Preparation is long-term, comprising of sufficient exercise management, supportive dietary habits, and nutritional intakes for optimal adaptations. Gastrointestinal symptoms are often cited as causing underperformance and incompletion of events. Though the majority do not pose serious long-term health risks, they may still arise. It has been suggested that the nutritional interventions employed by such athletes prior to, during, and after exercise have the potential to alter symptom incidence, severity, and duration. A summary of such interventions does not yet exist, making it difficult for relevant personnel to develop recommendations that simultaneously improve athletic performance by attenuating gastrointestinal symptoms. The aim of this research is to systematically review the literature investigating the effects of a nutrition intervention on ultra-endurance athletes exercise-induced gastrointestinal symptom incidence, severity, or duration. (2) Methods: A systematic review of the literature was conducted (PubMed, CINAHL, Web of Science, and Sports Discus) in January 2023 to investigate the effects of various nutrition interventions on ultra-endurance athletes' (regardless of irritable bowel syndrome diagnosis) exercise-induced gastrointestinal symptoms. Variations of key words such as "ultra-endurance", "gastrointestinal", and "nutrition" were searched. The risk of bias in each paper was assessed using the ADA quality criteria checklist. (3) Results: Of the seven eligible studies, one was a single field-based case study, while the majority employed a crossover intervention design. A total of n = 105 participants (n = 50 male; n = 55 female) were included in this review. Practicing a diet low in short-chain, poorly absorbed carbohydrates, known as fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), as well as employing repetitive gut challenges of carbohydrates, remain the most promising of strategies for exercise-induced gastrointestinal symptom management. (4) Conclusion: Avoiding high-FODMAP foods and practicing repetitive gut challenges are promising methods to manage gastrointestinal symptoms. However, sample sizes are often small and lack supportive power calculations. [ABSTRACT FROM AUTHOR]

Purpose: Exercise‐associated hyponatremia (EAH) is common in ultra‐endurance events and severe cases are more common in females. The purpose of this paper is to compare the clinical presentation of EAH between male and female triathletes in ultra‐endurance competitions. Methods: Medical records with sodium concentrations (n = 3138) from the IRONMAN® World Championships over the timeframe of 1989–2019 were reviewed for both male (n = 2253) and female (n = 885) competitors. Logistic regression was used to explore the relationships between sex, sodium concentration, and various clinical presentations. Results: When comparing male and female triathletes, clinical variables found to have a different relationship with sodium concentration include altered mental status (inversely related in males and not related in females), abdominal pain, muscle cramps, hypotension, and tachycardia (directly related in males and not related in females), and vomiting and hypokalemia (not related in males and inversely related in females). Overall, males lost significantly more weight than females, and notably, approximately half of all athletes were dehydrated and lost weight. Conclusions: Altered mental status, vomiting, abdominal pain, muscle cramps, hypotension, tachycardia, and hyperkalemia appear to present differently between sexes when comparing hyponatremic to eunatremic athletes. Although overhydration is the most common etiology of hypervolemic hyponatremia, hypovolemic hyponatremia comprises a significant amount of hyponatremic triathletes. Further understanding of how EAH presents helps athletes and medical professionals identify it early and prevent life‐threatening complications. [ABSTRACT FROM AUTHOR]

Sport psychology research of ultra-endurance (UE) athletes focused predominantly on their psychological characteristics, traits, and behaviors. However, their happiness and passion, as well as a unified framework for UE hobby phenomenon, were not sufficiently investigated. This study aims to: (1) identify the main contributors to happiness and passion of non-professional UE athletes; and (2) explore the possible relationships between types of sport passion, motivation, and athletic identity. During data collection, 116 non-professional UE athletes (mean age 43.66 years, SD = 8.97, 16.4% female) responded to an online questionnaire. Statistical analyses revealed that obsessive UE passion (p < 0.05) and amotivation (p < 0.05) predicted lower levels of happiness. A higher level of obsessive passion was predicted by extrinsic motivation (p < 0.005), amotivation (p < 0.05), and exclusivity identity (p < 0.001); a lower level was predicted by social identity (p < 0.05) and years in sports (p < 0.05). Weekly training hours and age correlated positively with passion strength, while amotivation was strongly negatively related to training volume. These results indicate that happiness of UE athletes depends on the type of sport passion formed and the quality of the underlying motivation: obsessive passion and amotivation seem to be the main enemies of happiness for UE athletes. This novel finding connecting passion, happiness, and motivation contributes to both a better understanding of the psychology of UE athletes and has practical implications for UE athletes, coaches, athletes’ social circles, and sport psychologists. Due to known maladaptive outcomes of obsessive passion, including its negative impact on overall well-being, health, and now also on happiness, its formation in UE athletes needs to be observed and prevented. While the study shows predictors of obsessive passion and high vs. low obsessive passion, future research should investigate how harmonious passion impacts athletes’ happiness, motivation, and identity. Likewise, research among the UE entourage would help to better understand the social impact of UE as a serious hobby and the formation of UE lifestyles. We also suggest our Temporal Framework for Progressive UE Engagement and Passion, which was further developed based on the results of this study, to be used and validated by sport psychologists.

Purpose: The purpose was to determine the effect of a single-dose prophylactic ibuprofen use before a 164-km road cycling event in high ambient temperature on the circulating cytokine and leukocyte responses. Methods: Twenty-three men (53 ± 8 y, 172.0 ± 22.0 cm, 85.1 ± 12.8 kg, 19.6 ± 4.4% body fat) completed a 164-km self-paced recreational road cycling event in a hot, humid, sunny environment (WBGT = 29.0 ± 2.9°C) after consuming 600 mg of ibuprofen (n = 13) or a placebo (n = 10). Blood samples were obtained one to two hours before (PRE) and immediately after (POST) the event, and analyzed for concentrations of circulating cytokines interleukins (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, GM-CSF, IFN-γ, and TNF-α and leukocytes (total leukocytes, granulocytes, monocytes, and lymphocytes). Results: Event completion time was 400.2 ± 74.8 min. Concentrations of all cytokines (except IL-1β, IL-2, IL-5, IL-12, GM-CSF, and IFN-γ) and of all leukocyte subsets increased from PRE to POST. Ibuprofen ingestion attenuated the increase in IL-10 (86% increase with Ibuprofen; 270% increase with placebo). Conclusions: Consuming 600 mg of Ibuprofen prior to a 164-km road cycling event in a hot-humid environment attenuates exercise-induced increases in the concentration of the anti-inflammatory cytokine IL-10, but does not alter the effect of the exercise event on concentrations of other circulating cytokines or leukocyte subset concentrations. [ABSTRACT FROM AUTHOR]

Sleep deprivation (SD) usually impairs psychomotor performance, but most experiments are usually focused on sedentary conditions. The purpose of this study was to evaluate the influence of 30 h of complete SD combined with prolonged, moderate exercise (SDE) on human psychomotor performance. Eleven endurance-trained men accustomed to overnight exertion were tested twice: in well-slept and non-fatigued conditions (Control) and immediately after 30 h of SDE. They performed a multiple-choice reaction time test (MCRT) at rest and during each workload of the graded exercise test to volitional exhaustion. At rest, the MCRT was shorter after SDE than in the Control (300 ± 13 ms vs. 339 ± 11 ms, respectively, p < 0.05). During graded exercise, there were no significant differences in MCRT between groups, but the fastest reaction was observed at lower workloads after SDE (158 ± 7 W vs. 187 ± 11 W in Control, p < 0.05). The total number of missed reactions tended to be higher after SDE (8.4 ± 0.7 vs. 6.3 ± 0.8 in Control, p = 0.06). In conclusion, SDE is different from SD alone; however, well-trained men, accustomed to overnight exertion can maintain psychomotor abilities independently of the extent of central fatigue. Exercise can be used to enhance psychomotor performance in sleep-deprived subjects in whom special caution is required in order to avoid overload. [ABSTRACT FROM AUTHOR]

The aim of this case study was to report on the performance outcomes and subjective assessments of long-term low-carbohydrate, high-fat (LCHF) diet in a world-class long-distance triathlete who had been suffering from gastrointestinal distress in Ironman competition. The lacto-ovo vegetarian athlete (age = 39 years; height = 179 cm; usual racing body mass = 75 kg; sum of seven skinfolds = 36 mm) changed his usual high carbohydrate (CHO) availability diet to an LCHF diet for 32 weeks (∼95% compliance). He participated in three professional races while on the LCHF diet, but acutely restored CHO availability by consuming CHO in the preevent meals and during the race as advised. The athlete had his worst-ever half-Ironman performance after 21 weeks on the LCHF diet (18th). After 24 weeks on LCHF, he had his second worst-ever Ironman performance (14th) and suffered his usual gastrointestinal symptoms. He did not finish his third race after 32 weeks on LCHF. He regained his usual performance level within 5 weeks back on a high CHO diet, finishing second and fourth in two Ironman events separated by just 3 weeks. Subjective psychological well-being was very negative while on the LCHF diet, with feelings of depression, irritability, and bad mood. In conclusion, this long-term (32 weeks) LCHF intervention did not solve the gastrointestinal problems that the athlete had been experiencing, it was associated with negative performance outcomes in both the half-Ironman and Ironman competitions, and it had a negative impact on the athlete's subjective well-being. [ABSTRACT FROM AUTHOR]

Physical training for ultra-endurance running provides physiological adaptations for exercise-induced substrate oxidation. We examined the effects of New Zealand blackcurrant (NZBC) extract on running-induced metabolic and physiological responses in a male amateur ultra-endurance runner (age: 40 years, body mass: 65.9 kg, BMI: 23.1 kg·m−2, body fat: 14.7%, V ˙ O2max: 55.3 mL·kg−1·min−1, resting heart rate: 45 beats·min−1, running history: 6 years, marathons: 20, ultra-marathons: 28, weekly training distance: ~80 km, weekly running time: ~9 h). Indirect calorimetry was used and heart rate recorded at 15 min intervals during 120 min of treadmill running (speed: 10.5 km·h−1, 58% V ˙ O2max) in an environmental chamber (temperature: ~26 °C, relative humidity: ~70%) at baseline and following 7 days intake of NZBC extract (210 mg of anthocyanins·day−1) with constant monitoring of core temperature. The male runner had unlimited access to water and consumed a 100-kcal energy gel at 40- and 80 min during the 120 min run. There were no differences (mean of 8, 15 min measurements) for minute ventilation, oxygen uptake, carbon dioxide production and core temperature. With NZBC extract, the respiratory exchange ratio was 0.02 units lower, carbohydrate oxidation was 11% lower and fat oxidation was 23% higher (control: 0.39 ± 0.08, NZBC extract: 0.48 ± 0.12 g·min−1, p < 0.01). Intake of the energy gel did not abolish the enhanced fat oxidation by NZBC extract. Seven days' intake of New Zealand blackcurrant extract altered exercise-induced substrate oxidation in a male amateur ultra-endurance runner covering a half-marathon distance in 2 h. More studies are required to address whether intake of New Zealand blackcurrant extract provides a nutritional ergogenic effect for ultra-endurance athletes to enhance exercise performance. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The knowledge of the most predictive split discipline and the pacing during a triathlon race is of utmost importance for planning an ultra-triathlon race. This study aimed at investigating the pacing during cycling and running splits in three different multi-stage ultra-triathlon race formats (i.e., Quintuple, Deca, and Double Deca Iron ultra-triathlon with 5x, 10x and 20x the daily distance of a full Ironman-distance triathlon). SUBJECTS AND METHODS: A total of 48 male ultra-triathletes competing in Quintuple (n=14), Deca (n=25), and Double Deca (n=9) Iron ultra-triathlon "swissultra" between 2016 and 2019 in Switzerland were analyzed. For each race day, we calculated the total performance (sum of all laps time), average individual performance (average of all laps time within a race day) and pacing variation (coefficient of variation of race laps time) for cycling and running. Discipline (cycling and running) and race distance (Quintuple, Deca, and Double Deca Iron ultra-triathlon) were used as independent parameters. The primary outcome variables were the time performance (daily and total) and the pacing variation. We applied two general linear models (GLM): the first model was a one-way ANOVA comparing total and daily performance by race distance, and the second model was a two-way ANOVA (race distance' discipline) using pacing variation (average pace oscillation) as a dependent variable. RESULTS: The first GLM identified a significant race distance effect for total performance in both cycling (F = 375.6; p < 0.001; ηp ² = 0.943) and running (F = 267.8; p < 0.001; ηp ² = 0.922) with Double Deca Iron ultra-triathlon being the fastest and Quintuple Iron ultra-triathlon the slowest. The GLM for daily average performance showed no significant effect of race distance on cycling performance (F = 0.171; p = 0.843; ηp ² = 0.008), but on running performance (F = 6.408; p = 0.004; ηp ² = 0.222). The two-way GLM comparing pacing variation showed a significant effect for race distance (F = 11.81; p<0.001; ηp ² = 0.344) with Deca presenting larger pace variation than Quintuple and Double Deca Iron ultra-triathlon in both cycling and running, but not for discipline (F = 0.067; p=0.797; ηp 2 = 0.001), nor for interaction (F = 1.469; p=0.241; ηp 2 = 0.061). CONCLUSIONS: Athletes achieved a stable cycling performance independent of the length of the race, and the cycling split had an influence on the subsequent running split depending upon the length of the race. [ABSTRACT FROM AUTHOR]

We analyzed the courses of experience of 10 runners who volunteered to describe their experiences of withdrawal during an ultra-trail race. Data collected contained traces of past activities elicited in self-confrontation interviews. Data were coded and compared with identify structures in common sequences. Seven representative sequences were identified: feeling pain; putting meaning to those feelings; adjusting one's running style; attempting to overcome the problem; other runners' influences; assessing the situation; and deciding to withdraw. Results showed that disruptive events could cause progressive, cumulative, and varied transformations in runners' courses of experience that led inevitably to withdrawal. Practical implications for mental preparation and race management are proposed. [ABSTRACT FROM AUTHOR]

This case study describes the nutrition plans, intakes and experiences of five ultra-marathon runners who completed the Marathon des Sables in 2011 and 2013; age 37 (28-43) y, height 184 (180-190) cm, body mass 77.5 (71-85.5) kg, marathon personal best 3:08 (2:40-3:32). MdS is a 7-day, six-stage ultra-running stage race held in the Sahara Desert (total distance of timed stages 1-5 was 233.2 km in 2011, 223.4 km in 2013). Competitors are required to carry all equipment and food (except water) for the race duration, a minimum of 8,360 kJ/day and total pack weight of 6.5-15 kg. Total food mass carried was 4.2 (3.8-4.7) kg or 0.7 (0.5-1.1) kg/day. Planned energy (13,550 (10,323-18,142) kJ/day), protein (1.3 (0.8-1.8) g/kg/day), and carbohydrate (6.2 (4.3-9.2) g/kg/day) intakes on the fully self-sufficient days were slightly below guideline recommendations, due to the need to balance nutritional needs with food mass to be carried. Energy density was 1,636 (1,475-1,814) kJ/100g. 98.5% of the planned food was consumed. Fluid consumption was ad libitum with no symptoms or medical treatment required for dehydration or hyponatremia. During-stage carbohydrate intake was 42 (20-64) g/hour. Key issues encountered by runners included difficulty consuming foods due to dry mouth, and unpalatability of sweet foods (energy gels, sports drinks) when heated in the sun. Final classification of the runners ranged from 11th to 175th of 970 finishers in 2013, and 132nd of 805 in 2011. The described pattern of intake and macronutrient quantities were positively appraised by the five runners. [ABSTRACT FROM AUTHOR]

Background: To finish an endurance race, athletes perform a vigorous effort that induces the release of cardiac damage markers. There are several factors that can affect the total number of these markers, so the aim of this review was to analyze the effect of endurance running races on cardiac damage markers and to identify the factors that modify the levels of segregation of these cardiac damage markers. Methods: A systematic search of PubMed, Web of Science, and the Cochrane Library databases was performed. This analysis included studies where the acute effects of running races on cardiac damage markers (troponin I and troponin T) were analyzed, assessing the levels of these markers before and after the races. Results: The effects of running races on troponin I (mean difference = 0.0381 ng/mL) and troponin T (mean difference = 0.0256 ng/mL) levels were significant. The ages (R2 = 14.4%, p = 0.033) and body mass indexes (R2 = 14.5%, p = 0.045) of the athletes had a significant interaction with troponin I. In addition, gender, mean speed, time to finish the race, and type of race can affect the level of cardiac damage markers. Conclusion: Endurance running races induce the release of cardiac-damage markers that remain elevated for at least 24 h after the races. In addition, young male athletes with high body mass indexes who perform races combining long duration and moderate intensity (i.e., marathons) release the highest levels of cardiac damage markers. Physicians should take into consideration these results in the diagnosis and treatment of patients admitted to the hospital days after finishing endurance running races.

Sleep deprivation (SD) usually impairs psychomotor performance, but most experiments are usually focused on sedentary conditions. The purpose of this study was to evaluate the influence of 30 h of complete SD combined with prolonged, moderate exercise (SDE) on human psychomotor performance. Eleven endurance-trained men accustomed to overnight exertion were tested twice: in well-slept and non-fatigued conditions (Control) and immediately after 30 h of SDE. They performed a multiple-choice reaction time test (MCRT) at rest and during each workload of the graded exercise test to volitional exhaustion. At rest, the MCRT was shorter after SDE than in the Control (300 ± 13 ms vs. 339 ± 11 ms, respectively, p < 0.05). During graded exercise, there were no significant differences in MCRT between groups, but the fastest reaction was observed at lower workloads after SDE (158 ± 7 W vs. 187 ± 11 W in Control, p < 0.05). The total number of missed reactions tended to be higher after SDE (8.4 ± 0.7 vs. 6.3 ± 0.8 in Control, p = 0.06). In conclusion, SDE is different from SD alone; however, well-trained men, accustomed to overnight exertion can maintain psychomotor abilities independently of the extent of central fatigue. Exercise can be used to enhance psychomotor performance in sleep-deprived subjects in whom special caution is required in order to avoid overload.

A series of case studies aimed to assess bone and stress fractures in a 768-km ultra-trail race for 11 days. Four nonprofessional male athletes completed the event without diagnosing any stress fracture. Bone turnover markers (osteocalcin (OC), serum C-terminal cross-linking telopeptide of type I collagen (CTX), bone-specific alkaline phosphatase (BALP), and serum turnover calcium (Ca2+)) were assessed before (pre) and after the race (post) and on days two and nine during the recovery period (rec2 and rec9), respectively. Results showed: post-pre-OC = −45.78%, BALP = −61.74%, CTX = +37.28% and Ca2+ = −3.60%. At rec2 and rec9, the four parameters did not return to their pre-run levels: OC, −48.31%; BALP, −61.66%; CTX, +11.93% and Ca2+, −3.38%; and OC = −25.12%, BALP = −54.65%, CTX = +93.41% and Ca2+ = +3.15%), respectively. Our results indicated that the ultra-trail race induced several changes in bone turnover markers, uncoupling of bone metabolism, increased bone resorption: OC and BALP and suppressed bone formation: CTX and Ca2+. Bone turnover markers can help determine the response of bone to extreme effort and might also help predict the risk of stress fractures. [ABSTRACT FROM AUTHOR]

Background and objectives: Ultra-trail races can cause episodes of acute kidney injury (AKI) and exercise-associated hyponatremia (EAH) in healthy subjects without previous renal pathology. This systematic review aims to review the incidence of these two syndromes together and separately taking into account the length and elevation of the ultra-trail race examined. Materials and Methods: A systematic review was conducted through electronic search in four electronic databases (PubMed, EBSCO, Web of Science and Alcorze). Results: A total of 1127 articles published between January 2006 and December 31, 2021 were included, 28 of which met the inclusion criteria. The studies were categorized according to the length and stages of the race in four categories: medium (42 to 69 km), long (70 to 99 km), extra (>100 km) and multi-stage if they included various stages. A total of 2950 runners (666 females and 2284 males) were extracted from 28 publications. The AKI incidence found was 42.04% (468 cases of 1113), and 195 of 2065 were diagnosed with EAH, accounting for 9.11%. The concurrence of both pathologies together reached 11.84% (27 individuals) from a total of 228 runners with AKI and EAH simultaneously analyzed. Sorted by race category, the AKI+EAH cases were distributed as follows: 18 of 27 in the extra (13.63% and n = 132), 4 in the large (5.79% and n = 69) and 5 in the medium category (18.15% and n = 27). Conclusions: According to these results, extra and medium races showed a similar incidence of AKI+EAH. These findings underline the importance of the duration and intensity of the race and may make them responsible for the etiology of these medical conditions. Due to their variable incidence, EAH and AKI are often underdiagnosed, leading to poorer prognosis, increased condition seriousness and hindered treatment. The results of this review urge participants, coaches and race organizers to take measures to improve the early diagnosis and urgent treatment of possible EAH and AKI cases. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to investigate the relationships between Perceived Control (PC) and Heart rate variability (HRV) during a 27-day expedition, during which an unsupported crossing was made from the west coast to the east coast of Greenland (across the Ice Sheet); and that therefore a high PC represents a favourable factor for recovery and stress management. Methods: Four subjects participated in the study. PC was measured on alternated days in the evening at the end of the day, using the Pearlin Mastery Scale; and the next day, upon waking, heart rate using a wrist heart rate monitor and a chest strap. Together with the PC, the perceived effort was measured through the CR-100 Borg scale and each subject was asked to indicate the most emotionally significant event of the day. Time and frequency domain indices for heart rate variability were calculated. Results: Several correlations were observed between PC and HRV indices. In particular two indices in the time domain, standard deviation of all NN intervals (SDNN) (rrm = 0.51) and root mean square of successive (RMSSD) (rrm = 0.46), showed a significant and strong positive correlation. Conclusion: The existence of a positive correlation between PC and cardiac vagal regulation is of great interest to individuals immerged into extreme situations, because it can affect performance or prevents maladaptive states or injuries. To improve stress management, it could be convenient for members of extreme expeditions to adopt forms of cognitive training that modify their cognitive appraisal in order to raise their perception of control. [ABSTRACT FROM AUTHOR]

Objective Ultra‐marathon running is an extremely demanding sport. Psychological factors that affect responses to stressors and may contribute to ultra‐runners' ability to engage in their sport include resilience, personality characteristics, and affective processing. This exploratory study investigated ultra‐runners' resilience, personality traits, emotion regulation abilities, and self‐report and physiological responses to emotionally negative stimuli. Method Twenty ultra‐runners and 20 non‐running controls completed the Connor–Davidson Resilience Scale (CD‐RISC), Emotion Regulation Questionnaire, Cognitive Emotion Regulation Questionnaire (CERQ), and Multidimensional Personality Questionnaire–Brief Form (MPQ–BF). Participants also completed a computerised emotion regulation task in which they were instructed to down‐regulate their responses to emotionally negative images. They provided self‐report ratings of their responses to the images and their heart rate and skin conductance responses were also recorded. Results The ultra‐runners scored higher than controls on the CD‐RISC (p = .014; d = 0.81) and Positive Reappraisal subscale of the CERQ (p = .034; d = 0.70). They also scored lower on the Social Closeness scale of the MPQ‐BF (p = .037; d = −0.68). In the emotion regulation task, they did not differ in their self‐report responses to negative images but displayed smaller cardiac and skin conductance responses to these images (both p = .04; ≥ .11). Conclusions Compared with non‐runners, ultra‐runners appear to be more resilient, more likely to engage in positive reappraisal, lower in affiliative extraversion, and less physiologically responsive to emotionally negative stimuli. They otherwise appear to be broadly similar to non‐runners with respect to their personality traits and emotion regulation processes.

Ultra‐endurance sports are growing in popularity but can be associated with adverse health effects, such as exercise‐induced muscle damage (EIMD), which can lead to exertional rhabdomyolysis. Circulating microRNAs (miRNAs) may be useful to approach the degree of EIMD. We aimed to (1) investigate the relevance of circulating miRNAs as biomarkers of muscle damage and (2) examine the acute response of skeletal/cardiac muscle and kidney biomarkers to a 24‐h run in elite athletes. Eleven elite athletes participated in the 24‐h run World Championships. Counter‐movement jump (CMJ), creatine kinase (CK), myoglobin (Mb), creatinine (Cr), high‐sensitive cardiac troponin T (hs‐cTnT), and muscle‐specific miRNA (myomiR) levels were measured before, immediately after, and 24 and 48h after the race. CMJ height was reduced immediately after the race (−84.0 ± 25.2%, p < 0.001) and remained low at 24 h (−43.6 ± 20.4%, p = 0.002). We observed high CK activity (53 239 ± 63 608 U/L, p < 0.001) immediately after the race, and it remained elevated 24h after (p < 0.01). Circulating myomiR levels (miR‐1‐3p, miR‐133a‐3p, miR‐133b, miR‐208a‐3p, miR‐208b‐3p, and miR‐499a‐5p) were elevated immediately after the 24‐h run (fold changes: 18–124,723, p<0.001) and significantly (p < 0.05) correlated or tended to significantly (p < 0.07) correlate with the reduction in CMJ height at 24 h. We found no significant correlation between CMJ height loss at 24 h and CK (p = 0.23) or Mb (p = 0.41) values. All elite ultramarathon runners included in our study were diagnosed with exertional rhabdomyolysis after the 24‐h ultramarathon race. MyomiR levels may be useful to approach the degree of muscle damage. [ABSTRACT FROM AUTHOR]

Background and objective: Existing research shows that the sex differences in distance limited ultra-cycling races decreased with both increasing race distance and increasing age. It is unknown, however, whether the sex differences in time-limited ultra-cycling races will equally decrease with increasing race distance and age. This study aimed to examine the sex differences regarding performance for time-limited ultra-cycling races (6, 12, and 24 h). Methods: Data were obtained from the online database of the Ultra-Cycling Marathon Association (UMCA) of time limited ultra-cycling races (6, 12, and 24 h) from the years 1983–2019. A total of 18,241 race results were analyzed to compare cycling speed between men and women by calendar year, age group (<29; 30–39; 40–49; 50–59; 60–69; >70 years), and race duration. Results: The participation of both men (85.1%) and women (14.9%) increased between 1983 and 2019. The age of peak performance was between 40 and 59 years for men and between 30 and 59 years for women. Between 2000 and 2019, more men (63.1% of male participants and 52.2% of female participants) competed in 24 h races. In the 24 h races, the sex difference decreased significantly in all age groups. Men cycled 9.6% faster than women in the 12 h races and 4% faster in the 24 h races. Both women and men improved their performance significantly across the decades. Between 2000 and 2019, the improvement in the 24 h races were 15.6% for men and 21.9% for women. Conclusion: The sex differences in cycling speed decreased between men and women with increasing duration of ultra-cycling races and with increasing age. Women showed a greater performance improvement than men in the last 20 years. The average cycling speed of men and women started to converge in the 24 h races. [ABSTRACT FROM AUTHOR]

Physical training for ultra-endurance running provides physiological adaptations for exercise-induced substrate oxidation. We examined the effects of New Zealand blackcurrant (NZBC) extract on running-induced metabolic and physiological responses in a male amateur ultra-endurance runner (age: 40 years, body mass: 65.9 kg, BMI: 23.1 kg·m−2, body fat: 14.7%, V˙O2max: 55.3 mL·kg−1·min−1, resting heart rate: 45 beats·min−1, running history: 6 years, marathons: 20, ultra-marathons: 28, weekly training distance: ~80 km, weekly running time: ~9 h). Indirect calorimetry was used and heart rate recorded at 15 min intervals during 120 min of treadmill running (speed: 10.5 km·h−1, 58% V˙O2max) in an environmental chamber (temperature: ~26 °C, relative humidity: ~70%) at baseline and following 7 days intake of NZBC extract (210 mg of anthocyanins·day−1) with constant monitoring of core temperature. The male runner had unlimited access to water and consumed a 100-kcal energy gel at 40- and 80 min during the 120 min run. There were no differences (mean of 8, 15 min measurements) for minute ventilation, oxygen uptake, carbon dioxide production and core temperature. With NZBC extract, the respiratory exchange ratio was 0.02 units lower, carbohydrate oxidation was 11% lower and fat oxidation was 23% higher (control: 0.39 ± 0.08, NZBC extract: 0.48 ± 0.12 g·min−1, p < 0.01). Intake of the energy gel did not abolish the enhanced fat oxidation by NZBC extract. Seven days’ intake of New Zealand blackcurrant extract altered exercise-induced substrate oxidation in a male amateur ultra-endurance runner covering a half-marathon distance in 2 h. More studies are required to address whether intake of New Zealand blackcurrant extract provides a nutritional ergogenic effect for ultra-endurance athletes to enhance exercise performance.

Participation and performance trends have been analyzed for different ultramarathons for limited time periods. This study examined trends in participation and performance in the oldest ultramarathon in the world, the 'Comrades Marathon' (South Africa), during a century (1921−2019). Data from www.ultra-marathon.org on 100 000 unique finishers were analysed using different general linear models. Women represented 4.2% of the total sample (n=4152), and the first women ran this race in 1978. Before the year 1965, the number of participants in the race ranged between 5 and 35 athletes, then started to grow exponentially until mid 90's. An increase in finishers in the 70 s mainly due to an increase in male athletes in age groups 30−39, 40−49 and 50−59 years was observed (p<0.001). A stable running speed for overall women and men but an improvement in performance for the annual top five women and men were shown (p<0.001). Male runners were faster than female runners for all age groups (p<0.001). While overall performance was not improved across years, the annual top five women and men were able to improve their performance over years. [ABSTRACT FROM AUTHOR]

Physical performance in a tropical environment, combining high heat and humidity, is a difficult physiological challenge that requires specific preparation. The elevated humidity of a tropical climate impairs the thermoregulatory mechanisms by limiting the rate of sweat evaporation. Hence, a proper management of whole-body temperature is required to complete an ultra-endurance event in such an environment. In these long-duration events, which can last from 8 to 20 h, held in hot and humid settings, performance is tightly linked to the ability in maintaining an optimal hydration status. Indeed, the rate of withdrawal in these longer races was associated with lower water intake, and the majority of finishers exhibited alterations in electrolyte balance (e.g., sodium). Hence, this work reviews the effects on performance of high heat and humidity in two representative ultra-endurance sports, ultramarathons and long-distance triathlons, and several countermeasures to counteract the impact of these harsh environmental stresses and maintain a high level of performance, such as hydration, cooling strategies and heat acclimation.

Participation and performance across years have been studied extensively in various endurance and ultra-endurance sports; however, less information exists with regards to duathlon (i.e., Run 1, Bike, and Run 2). The aim of this study was to examine performance and participation trends of duathletes competing either to short (10-km Run 1, 50-km Bike, and 5-km Run 2) or to long distance (10-km Run 1, 1 50-km Bike, and 30-km Run 2) in the Powerman World Championship "Powerman Zofingen." We analyzed 7,951 finishers (women, n = 1,236, age 36.7 ± 9.1 years; men, n = 6,715, 40.1 ± 10.1 years) competing in "Powerman Zofingen" from 2003 to 2017. Men were faster than women by 8.2% (1 71 ± 21 minutes vs. 186 ± 21 minutes, p < 0.001, η² = 0.068) and 7.5% (502 ± 57 minutes vs. 543 ± 64 minutes, p < 0.001, η² = 0.068) in the short and long distances, respectively. Women were younger than men by 4.6 years (35.0 ± 9.0 years vs. 39.6 ± 1 0.5 years, p < 0.001, rη² = 0.026) and 1.8 years (38.8 ± 8.7 years vs. 40.6 ± 9.5 years, p < 0.001, η² = 0.005) in the short and long distances, respectively. An increase of women finishers across years in the long distance was observed (e.g., n = 1 9 in 2003 and n = 58 in 2017; p < 0.001), whereas no change was shown in short distance and men finishers. The men-to-women ratio (MWR) decreased across years in the long, but not in the short distance. No change of race time across years was observed. The sex difference in race time increased in long distance (p = 0.014), whereas it did not change in the short. Age increased across years in both sexes and distances (p < 0.001). The sex difference in age decreased in the long (p = 0.007), but not in the short distance. In summary, the number of women finishers increased and the MWR decreased in the long distance. The age of the finishers increased across years, and their performance remained unchanged. The increase of the sex difference in race time in the long distance might be attributed to the increased number of women finishers. [ABSTRACT FROM AUTHOR]

Background: Long-endurance exercises like ultramarathons are known to elicit various metabolic and physiological changes in the human body. However, little is known about very long-duration exercise at low intensities regarding healthy human subjects. Aim: The purpose of this study was to evaluate changes in body composition and metabolism in long-endurance but low-intensity events. Methods: Twenty-five male and 18 female healthy recreational athletes (age 34.6 ± 8.8 years; BMI: 22.4 ± 2.0 kg/m2) of the "100 km Mammutmarsch" were recruited for participation during the events in 2014–2016. Other than classical ultramarathons, the "Mammutmarsch" is a hiking event, in which participants were required to walk but not run or jog. It was expected to complete the 100-km distance within 24 h, resulting in a calculated mean speed of 4.17 km/h, which fits to the mean speed observed (4.12 ± 0.76 km/h). As not all participants reached the finish line, comparison of finishers (FIN, n = 11) and non-finishers (NON, n = 21) allowed differential assessment of performance. Body composition measured through bioelectrical impedance analysis (BIA) was determined pre- and post-event, and serum samples were taken pre-event, at 30, 70, and 100 km to determine NT-pro-BNP, troponin T, C-reactive protein (CRP), cortisol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, total creatine kinase (CK), CK-MB, aminotransferase (AST), ALT, and sodium levels. Nineteen participants wore actimeter armbands (SenseWear®) to gain information about body activity and exercise intensity [metabolic equivalent of task (MET)]. Sixteen participants wore mobile heart rate monitors to assess mean heart rate during the race. Serum parameter alterations over the course of the race were analyzed with mixed-effects ANOVA and additional t -tests. All serum parameters were analyzed for correlation concerning different MET levels, speed, age, BMI, baseline NT-pro-BNP, mean heart rate during the race, and sex with linear regression analysis. Results: We found significant elevations for muscle and cardiac stress markers (CRP, CK, CK-MB, AST, ALT, cortisol, and NT-pro-BNP) as well as decreasing markers of lipid metabolism (cholesterol, triglycerides, LDL). Although the intensity level demanded from our participants was low compared with other studies on (ultra-) marathons, the alteration of tested parameters was similar to those of high-intensity exercise, e.g., NT-pro-BNP showed a fourfold increase (p < 0.01) and LDL decreased by 20% (p = 0.05). Besides the duration of exercise, age, BMI, training status, and sex are relevant parameters that influence the elevation of stress factors. Notably, our data indicate that NT-pro-BNP might be a marker for cardiovascular fitness also in healthy adults. Conclusion: This low-intensity long-endurance walk evoked a strong systemic reaction and large cell stress and shifted to a favorable lipid profile, comparable to higher intensity events. Despite increasing cardiac stress parameters, there were no indications of cardiac cell damage. Remarkably, the duration seems to have a greater influence on stress markers and metabolism than intensity. [ABSTRACT FROM AUTHOR]

Recent studies suggest that long-term endurance training may be damaging to the heart, thus increasing cardiovascular disease (CVD) risk. However, studies utilizing cardiac imaging are conflicting and lack measures of central and peripheral vascular structure and function, which are also independently predictive of CVD events. We performed a comprehensive assessment of cardiovascular structure and function in long-term (≥ 10 years) ultra-endurance athletes (ATH, 14 M/11 F, 50 ± 1 y) and physically active controls (CON, 9 M/9 F, 49 ± 2 y). As expected, left ventricular mass and end-diastolic volume (echocardiography) were greater in ATH vs CON, whereas there was no difference in cardiac function at rest. Coronary artery calcium scores (computed tomography) were not statistically different between groups. There was no evidence of myocardial fibrosis (contrast magnetic resonance imaging) in any subject. Aortic stiffness (carotid-femoral pulse wave velocity) was lower in ATH vs CON (6.2 ± 0.2 vs 6.9 ± 0.2 m/s, p < 0.05), whereas carotid intima-media thickness (ultrasound) was not different between groups. Peripheral vascular endothelial function (flow-mediated vasodilation of the brachial artery) and microvascular function (peak blood velocity) in response to 5 min of forearm ischemia were not different between groups. Furthermore, there was no difference in 10-year coronary heart disease risk (ATH; 2.3 ± 0.5 vs CON; 1.6 ± 0.2%, p > 0.05). Our data indicate that middle-aged ultra-endurance ATH do not have marked signs of widespread cardiovascular dysfunction or elevated CHD risk compared to CON meeting physical activity guidelines. Image 1 • Coronary artery calcium was present in 8 ultra-endurance athletes and 2 controls. • No myocardial fibrosis was detected in any participant. • Aortic stiffness was reduced in athletes compared to controls. • Carotid wall thickness was not different between athletes and controls. • Athletes did not have an elevated risk of heart disease. [ABSTRACT FROM AUTHOR]

• Endurance foot races increase the levels of markers for heart damage, which persist at high levels for a 24-h minimum period. • Gender, body mass index, and intensity of the race exert a moderating effect on the acute increase of troponin T and troponin I. • It is recommended that individuals should be adequately prepared for foot-race competition, particularly races that combine long duration and moderate intensity (i.e., marathons). Men and less experienced or young participants with high fat percentages or high body mass indexes should be especially adequately prepared. To finish an endurance race, athletes perform a vigorous effort that induces the release of cardiac damage markers. There are several factors that can affect the total number of these markers, so the aim of this review was to analyze the effect of endurance running races on cardiac damage markers and to identify the factors that modify the levels of segregation of these cardiac damage markers. A systematic search of PubMed, Web of Science, and the Cochrane Library databases was performed. This analysis included studies where the acute effects of running races on cardiac damage markers (troponin I and troponin T) were analyzed, assessing the levels of these markers before and after the races. The effects of running races on troponin I (mean difference = 0.0381 ng/mL) and troponin T (mean difference = 0.0256 ng/mL) levels were significant. The ages (R 2 = 14.4%, p = 0.033) and body mass indexes (R 2 = 14.5%, p = 0.045) of the athletes had a significant interaction with troponin I. In addition, gender, mean speed, time to finish the race, and type of race can affect the level of cardiac damage markers. Endurance running races induce the release of cardiac-damage markers that remain elevated for at least 24 h after the races. In addition, young male athletes with high body mass indexes who perform races combining long duration and moderate intensity (i.e., marathons) release the highest levels of cardiac damage markers. Physicians should take into consideration these results in the diagnosis and treatment of patients admitted to the hospital days after finishing endurance running races. [Display omitted] [ABSTRACT FROM AUTHOR]

Background and objectives: Ultra-trail races can cause episodes of acute kidney injury (AKI) and exercise-associated hyponatremia (EAH) in healthy subjects without previous renal pathology. This systematic review aims to review the incidence of these two syndromes together and separately taking into account the length and elevation of the ultra-trail race examined. Materials and Methods: A systematic review was conducted through electronic search in four electronic databases (PubMed, EBSCO, Web of Science and Alcorze). Results: A total of 1127 articles published between January 2006 and December 31, 2021 were included, 28 of which met the inclusion criteria. The studies were categorized according to the length and stages of the race in four categories: medium (42 to 69 km), long (70 to 99 km), extra (>100 km) and multi-stage if they included various stages. A total of 2950 runners (666 females and 2284 males) were extracted from 28 publications. The AKI incidence found was 42.04% (468 cases of 1113), and 195 of 2065 were diagnosed with EAH, accounting for 9.11%. The concurrence of both pathologies together reached 11.84% (27 individuals) from a total of 228 runners with AKI and EAH simultaneously analyzed. Sorted by race category, the AKI+EAH cases were distributed as follows: 18 of 27 in the extra (13.63% and n = 132), 4 in the large (5.79% and n = 69) and 5 in the medium category (18.15% and n = 27). Conclusions: According to these results, extra and medium races showed a similar incidence of AKI+EAH. These findings underline the importance of the duration and intensity of the race and may make them responsible for the etiology of these medical conditions. Due to their variable incidence, EAH and AKI are often underdiagnosed, leading to poorer prognosis, increased condition seriousness and hindered treatment. The results of this review urge participants, coaches and race organizers to take measures to improve the early diagnosis and urgent treatment of possible EAH and AKI cases.

Purpose: This study aimed to investigate the carbohydrate beliefs and practices of ultra-endurance runners in Ireland to gain an understanding of their gastrointestinal symptom (GIS) management strategies., Methodology: An adapted version of a previously developed and validated questionnaire was distributed online to ultra-endurance runners, recognized as those who completed a single bout of exercise lasting 4 or more hours. The questionnaire asked about carbohydrate awareness and sourcing, and dietary practices, particularly in relation to GIS management., Results: A total of n  = 68 individuals completed the adapted questionnaire. Of these, n  = 1 was excluded due to their reporting of an ulcerative colitis diagnosis. The remaining participants included 46 men and 21 women. Personal previous experience was the main source directing participants' nutrition practices ( n  = 30), while only 3 participants quoted sourcing information from qualified professionals. Forty-two participants experienced GIS, usually equally around training and competition times. Many participants had not previously implemented any specific dietary or non-dietary strategies to alleviate exercise-induced GIS. Supplementing with nitrates ( n  = 9) and probiotics ( n  = 4) were the most common dietary practices to alleviate GIS, while other practices ( n  = 14) and portion control ( n  = 13) were the most reported non-dietary practices., Discussion: Similar to previous studies, these findings suggest that GISs are prevalent in the ultra-endurance running community, occurring regardless of whether during training or an event. Similarly, this research highlights the vast range of GISs experienced by this population. However, the absence of both dietary and non-dietary-related practices used for GIS management alludes to a current deficit in the availability of nutrition information specific to this problem. Further research is required to understand the mechanisms behind ultra-endurance-associated GISs and its various management strategies as well as best practices for communicating these to the target audience to reduce individuals' risks of developing long-term, chronic health complications., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ryan, Daly and Ryan.)

The aims of this study were to assess the dietary intake and monitor self-reported recovery quality and clinical symptomology of a male ultra-endurance runner who completed a multiday ultra-endurance running challenge covering 4,254 km from North Scotland to the Moroccan Sahara desert over 78 consecutive days. Food and fluid intakes were recorded and analyzed through dietary analysis software. Body mass (BM) was determined before and after running each day, and before sleep. Clinical symptomology and perceived recovery quality were recorded each day. Whole blood hemoglobin and serum ferritin were determined before and after the challenge. Total daily energy (mean ± SD: 23.2 ± 3.2MJ·day–1) and macronutrient intake (182 ± 31g·day–1 protein, 842 ± 115g·day–1 carbohydrate, 159 ± 55 g·day–1 fat) met consensus nutritional guidelines for endurance performance. Total daily water intake through foods and fluids was 4.8 ± 2.0L·day–1. Water and carbohydrate intake rates during running were 239 ± 143ml·h–1 and 56 ± 19g·h–1, respectively. Immediately after running, carbohydrate and protein intakes were 1.3 ± 1.0g·kg BM–1 and 0.4 ± 0.2g·kg BM–1, respectively. Daily micronutrient intakes ranged from 109 to 662% of UK RNIs. Prerunning BM was generally maintained throughout. Overall exercise-induced BM loss averaged 0.8 ± 1.0%; although BM losses of ≥ 2% occurred in the latter stages, a reflection of the warmer climate. Varying degrees of self-reported perceived recovery quality and clinical symptomology occurred throughout the challenge. This case study highlights oscillations in dietary habits along 78 consecutive days of ultra-endurance running, dependent on changes in ambient conditions and course topography. Nevertheless, nutrition and hydration status were maintained throughout the challenge. Despite dietary iron intake above RNI and iron supplementation, this alone did not prevent deficiency symptoms. [ABSTRACT FROM AUTHOR]

Pantelis T Nikolaidis,1,2 Elias Villiger,3 Luca P Ardigò,4 Zbigniew Waśkiewicz,5 Thomas Rosemann,3 Beat Knechtle3,6 1Exercise Physiology Laboratory, Nikaia, Greece; 2Exercise Testing Laboratory, Hellenic Air Force Academy, Acharnes, Greece; 3Institute of Primary Care, University of Zurich, Zurich, Switzerland; 4Department of Neurosciences, Biomedicine and Movement Sciences, School of Exercise and Sport Science, University of Verona, Verona, Italy; 5Department of Team Sports, Academy of Physical Education, Katowice, Poland; 6Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland Purpose: The age of peak performance (APP) has been studied extensively in various endurance and ultra-endurance sports; however, less information exists in regard to duathlon (ie, Run1, Bike, and Run2). The aim of the present study was to assess the APP of duathletes competing either in a short (ie, 10 km Run1, 50 km Bike, and 5 km Run2) or a long distance (ie, 10 km Run1, 150 km Bike, and 30 km Run2) race. Participants and methods: We analyzed 6,671 participants (women, n=1,037, age 36.6±9.1 years; men, n=5,634, 40.0±10.0 years) in “Powerman Zofingen” from 2003 to 2017. Results: Considering the finishers in 5-year age groups, in the short distance, a small main effect of sex on race time was observed (p

Pantelis Theodoros Nikolaidis,1,2 Beat Knechtle3,4 1Exercise Physiology Laboratory, Nikaia, Greece; 2Laboratory of Exercise Testing, Hellenic Air Force Academy, Dekelia, Greece; 3Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland; 4Institute of Primary Care, University of Zurich, Zurich, Switzerland Purpose: Despite the increasing popularity of 50-km ultramarathons during the last few years, only limited information is available regarding the trends in its performance and participation. The aim of the present study was to examine the age of peak running performance in female and male 50-km ultramarathoners using second-order nonlinear regression analyses.Methods: Data from 494,414 runners (124,045 women and 370,369 men) who finished a 50-km ultramarathon between 1975 to 2016 were analyzed. Results: When the top ten finishers in 1-year age-groups were analyzed, the age of peak running speed was 41 years in both women and men. When the fastest finishers in 1-year age-group intervals were analyzed, the age of peak running speed was 40 years in women and 39 years in men.Conclusion: In summary, the age of peak running speed in 50-km ultramarathoners is older than what has been reported by previous studies for marathons. Women seem to achieve the best race time in a 50-km ultramarathon later in life compared with men. These findings are of great practical value for coaches and fitness trainers when setting performance goals for 50-km ultramarathon runners. Keywords: master athlete, running, sex difference, ultra-endurance, aerobic capacity, aging, cardiorespiratory fitness

The aim of the present study was to investigate the effects of altitude and distance on uphill vertical speed (VS) and the main spatio-temporal gait parameters during an extreme mountain ultra-marathon. The VS, stride height (SH) and stride frequency (SF) of 27 runners were measured with an inertial sensor at the shank for two different altitude ranges (low 1300–2000 m vs high 2400–3200 m) of 10 mountains passes distributed over a 220 km course. There was a significant interaction (F(4,52) = 4.04, p < 0.01) for the effect of altitude and distance on VS. During the first passes, the mean VS was faster at lower altitudes, but this difference disappeared at a quarter of the race length, suggesting that neuromuscular fatigue influenced the uphill velocity to a larger extent than the oxygen delivery. The average VS, SH and SF were 547 ± 135 m/h, 0.23 ± 0.05 m and 0.66 ± 0.09 Hz. The individual VS change for each uphill portions was more strongly correlated with the changes in SH (r = 0.80, P < 0.001, n = 321) than SF (r = 0.43, P < 0.001, n = 321). This suggests a large effect of the knee extensors strength loss on the diminution of VS. [ABSTRACT FROM AUTHOR]

Participation and performance trends as well as the performance differences among sexes in ultra-endurance running have been well described in the adult population; however, less information on such trends existed in youth ultramarathoners. The aim of the present study was to investigate the age-related participation and performance trends of children and adolescent ultramarathoner runners. Data on runners, younger than 19 years of age, competing from 1960 to 2018 in distance-limited ultramarathons of 50 km, 100 km, 50 miles and 100 miles, were analysed. During this period, the number of ultramarathon participation increased, most notably among boys, most runners originated from Europe, and the 50- and 100-km race distances were the most popular. Overall, male runners were faster than female runners, except in the case of European and Oceanian origin, where girls were faster over the 50-km race. The fastest male runners originated from Africa and the fastest girls from Oceania, and the average running speed has largely decreased for both sexes over calendar years. In summary, this study was the first to report details on participation and performance trends in youth ultramarathoners competing in distance-limited ultramarathons. [ABSTRACT FROM AUTHOR]

Objective: Ultra‐marathon running is an extremely demanding sport. Psychological factors that affect responses to stressors and may contribute to ultra‐runners' ability to engage in their sport include resilience, personality characteristics, and affective processing. This exploratory study investigated ultra‐runners' resilience, personality traits, emotion regulation abilities, and self‐report and physiological responses to emotionally negative stimuli. Method: Twenty ultra‐runners and 20 non‐running controls completed the Connor–Davidson Resilience Scale (CD‐RISC), Emotion Regulation Questionnaire, Cognitive Emotion Regulation Questionnaire (CERQ), and Multidimensional Personality Questionnaire–Brief Form (MPQ–BF). Participants also completed a computerised emotion regulation task in which they were instructed to down‐regulate their responses to emotionally negative images. They provided self‐report ratings of their responses to the images and their heart rate and skin conductance responses were also recorded. Results: The ultra‐runners scored higher than controls on the CD‐RISC (p =.014; d = 0.81) and Positive Reappraisal subscale of the CERQ (p =.034; d = 0.70). They also scored lower on the Social Closeness scale of the MPQ‐BF (p =.037; d = −0.68). In the emotion regulation task, they did not differ in their self‐report responses to negative images but displayed smaller cardiac and skin conductance responses to these images (both p =.04; ηp2 ≥.11). Conclusions: Compared with non‐runners, ultra‐runners appear to be more resilient, more likely to engage in positive reappraisal, lower in affiliative extraversion, and less physiologically responsive to emotionally negative stimuli. They otherwise appear to be broadly similar to non‐runners with respect to their personality traits and emotion regulation processes. [ABSTRACT FROM AUTHOR]