Participation and performance trends in ultra-triathlons from 1985 to 2009

Sex difference in IRONMAN age group triathletes

BACKGROUND

The sex difference in athletic performance has been thoroughly investigated in single sport disciplines such as swimming, cycling, and running. In contrast, only small samples of long-distance triathlons, such as the IRONMAN® triathlon, have been investigated so far.

AIM

The aim of the study was to examine potential sex differences in the three split disciplines by age groups in 5-year intervals in a very large data set of IRONMAN® age group triathletes.

METHODS

Data from 687,696 (553,608 men and 134,088 women) IRONMAN® age group triathletes (in 5-year intervals from 18-24 to 75+ years) finishing successfully between 2002 and 2022 an official IRONMAN® race worldwide were analyzed. The differences in performance between women and men were determined for each split discipline and for the overall race distance.

RESULTS

Most finishers were in the age group 40-44 years. The fastest women were in the age group 25-29 years, and the fastest men were in the age group 30-34 years. For all split disciplines and overall race time, men were always faster than women in all groups. The performance difference between the sexes was more pronounced in cycling compared to swimming and running. From the age group 35-39 years until 60-64 years, the sex differences were nearly identical in swimming and running. For both women and men, the smallest sex difference was least significant in age group 18-24 years for all split disciplines and increased in a U-shaped manner until age group 70-74 years. For age groups 75 years and older, the sex difference decreased in swimming and cycling but increased in running. Considering the different characteristics of the race courses, the smallest performance gaps between men and women were found in river swimming, flat surface cycling and rolling running courses.

CONCLUSIONS

The sex difference in the IRONMAN® triathlon was least significant in age group 18-24 years for all split disciplines and increased in a U-shaped manner until age group 70-74 years. For 75 years and older, the sex difference decreased in swimming and cycling but increased in running.

Effects of Environmental Conditions on Athlete's Cardiovascular System

Environmental factors such as extreme temperatures, humidity, wind, pollution, altitude, and diving can significantly impact athletes' cardiovascular systems, potentially hindering their performance, particularly in outdoor sports. The urgency of this issue is heightened by the increasing prevalence of climate change and its associated conditions, including fluctuating pollution levels, temperature variations, and the spread of infectious diseases. Despite its critical importance, this topic is often overlooked in sports medicine. This narrative review seeks to address this gap by providing a comprehensive, evidence-based evaluation of how athletes respond to environmental stresses. A thorough assessment of current knowledge is essential to better prepare athletes for competition under environmental stress and to minimize the harmful effects of these factors. Specifically, adaptative strategies and preventative measures are vital to mitigating these environmental influences and ensuring athletes' safety.

Ultra-Cycling- Past, Present, Future: A Narrative Review

BACKGROUND

Ultra-endurance events are gaining popularity in multiple exercise disciplines, including cycling. With increasing numbers of ultra-cycling events, aspects influencing participation and performance are of interest to the cycling community.

MAIN BODY

The aim of this narrative review was, therefore, to assess the types of races offered, the characteristics of the cyclists, the fluid and energy balance during the race, the body mass changes after the race, and the parameters that may enhance performance based on existing literature. A literature search was conducted in PubMed, Scopus, and Google Scholar using the search terms 'ultracycling', 'ultra cycling', 'ultra-cycling', 'ultra-endurance biking', 'ultra-bikers' and 'prolonged cycling'. The search yielded 948 results, of which 111 were relevant for this review. The studies were classified according to their research focus and the results were summarized. The results demonstrated changes in physiological parameters, immunological and oxidative processes, as well as in fluid and energy balance. While the individual race with the most published studies was the Race Across America, most races were conducted in Europe, and a trend for an increase in European participants in international races was observed. Performance seems to be affected by characteristics such as age and sex but not by anthropometric parameters such as skin fold thickness. The optimum age for the top performance was around 40 years. Most participants in ultra-cycling events were male, but the number of female athletes has been increasing over the past years. Female athletes are understudied due to their later entry and less prominent participation in ultra-cycling races. A post-race energy deficit after ultra-cycling events was observed.

CONCLUSION

Future studies need to investigate the causes for the observed optimum race age around 40 years of age as well as the optimum nutritional supply to close the observed energy gap under consideration of the individual race lengths and conditions. Another research gap to be filled by future studies is the development of strategies to tackle inflammatory processes during the race that may persist in the post-race period.

Exploring the Nutrition Strategies Employed by Ultra-Endurance Athletes to Alleviate Exercise-Induced Gastrointestinal Symptoms-A Systematic Review

(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.

Patterns of energy allocation during energetic scarcity; evolutionary insights from ultra-endurance events

Exercise physiologists and evolutionary biologists share a research interest in determining patterns of energy allocation during times of acute or chronic energetic scarcity.. Within sport and exercise science, this information has important implications for athlete health and performance. For evolutionary biologists, this would shed new light on our adaptive capabilities as a phenotypically plastic species. In recent years, evolutionary biologists have begun recruiting athletes as study participants and using contemporary sports as a model for studying evolution. This approach, known as human athletic palaeobiology, has identified ultra-endurance events as a valuable experimental model to investigate patterns of energy allocation during conditions of elevated energy demand, which are generally accompanied by an energy deficit. This energetic stress provokes detectable functional trade-offs in energy allocation between physiological processes. Early results from this modelsuggest thatlimited resources are preferentially allocated to processes which could be considered to confer the greatest immediate survival advantage (including immune and cognitive function). This aligns with evolutionary perspectives regarding energetic trade-offs during periods of acute and chronic energetic scarcity. Here, we discuss energy allocation patterns during periods of energetic stress as an area of shared interest between exercise physiology and evolutionary biology. We propose that, by addressing the ultimate "why" questions, namely why certain traits were selected for during the human evolutionary journey, an evolutionary perspective can complement the exercise physiology literature and provide a deeper insight of the reasons underpinning the body's physiological response to conditions of energetic stress.

Gender and Age Differences in Performance of Over 70,000 Chinese Finishers in the Half- and Full-Marathon Events

(1) Background: The aim of the present study was to examine the characteristics of over 70,000 long-distance finishers over the last four years in Chinese half- and full-marathon events; (2) Methods: The available data of all finishers (n = 73,485; women, n = 17,134; men, n = 56,351) who performed half- and full-marathon events in Hangzhou from 2016 to 2019 were further analyzed for the characteristics of gender, age and average running speed; (3) Results: The total men-to-women ratio was the lowest in the half-marathon event (1.86) and the highest in the full-marathon event (17.42). Faster running performance in males than in females and faster average running speed in short-distance runners were shown. Gender and race distance were observed to have the most significant effects on average running speed (p < 0.01). For both male and female finishers, the slowest running speed was shown in older age groups (p < 0.01) during the full marathon. Our results indicated that the gender difference in performance was attenuated in the longer race distances and older age groups; (4) Conclusions: Understanding the participation and performances across different running distances would provide insights into physiological and biomechanical characteristics for training protocols and sports gear development in different groups.

Kinetics of Cardiac Remodeling and Fibrosis Biomarkers During an Extreme Mountain Ultramarathon

Objectives

The effects of ultra-distance on cardiac remodeling and fibrosis are unclear. Moreover, there are no data reporting the kinetics of cardiac alterations throughout the event and during recovery. Our aim was to investigate the kinetics of biological markers including new cardiac fibrosis biomarkers suppression of tumorigenicity 2 (ST2) and galectin-3 (Gal-3) during and after an extreme mountain ultramarathon.

Methods

Fifty experienced runners participating in one of the most challenging mountain ultramarathons (330 km, D+ 25,000 m) were enrolled in our study. Blood samples were collected at four time points: before (Pre-), at 148 km (Mid-), at the finish line (Post-), and 3 days after the recovery period (Recov-).

Results

The cardiac fibrosis biomarkers (ST2 and Gal-3) increased from Pre- to Mid-. During the second half, ST2 remained higher than pre-values as opposed to Gal-3. Necrosis, ischemia, and myocyte injury biomarkers increased until Mid- then decreased but remained higher at Recov- than Pre-values. Oxidative stress appeared at Mid-. Lipid peroxides remained higher at Recov- compared to Pre-. The maximal value in most of these biomarkers was observed at Mid- and not at Post-.

Conclusions

The present study supports biphasic kinetics of cardiac fibrosis biomarkers, with a relative recovery during the second half of the event that seems specific to this extreme event. Overall, performing at such an extreme ultramarathon seems less deleterious for the heart than shorter events.

Age-Related Differences in Motivation of Recreational Runners, Marathoners, and Ultra-Marathoners

Aim: This study was aimed to investigate the influence of age on the motivations of various types of runners, namely, marathoners, ultra-marathoners, and non-starters.

Methods: A total of 1,537 runners including 380 women (24.7%) and 1,157 men (75.3%) took part in the diagnostic survey and completed the motivations of marathoners’ scales questionnaire (MOMS). The effect sizes were estimated.

Results: The article presents several statistically significant differences in the impact of age on the motivations of runners in different categories and compares the motivations of marathon runners, ultramarathon runners, and non-starters. The results show that young non-starters decide to run for personal goal achievement, and for both marathon and ultramarathon runners, recognition and competition are important. However, for older people in all groups (non-starters, marathoners, and ultramarathoners), personal goal achievement is of the least importance. Among the oldest runners, the most important motives were self-esteem for non-starters and health orientation for marathoners and ultramarathoners.

Sleep Duration Correlates With Performance in Ultra-Endurance Triathlon

The relationship between sleep duration, sleep quality, and race completion time during each stage of a 3-day ultra-endurance triathlon (stage 1: 10-km swim, 146-km cycle; stage 2: 276-km cycle; and stage 3: 84.4-km run) was investigated. Seventeen triathletes partook in sleep analysis throughout the ultra-endurance multiday triathlon using an actigraphy wristband. The participants wore the band to record objective sleep outcomes for approximately 4 days (1-2 d prerace, 3 race days, and 1 d postrace), except while racing. The total sleep time (TST; prerace: 414.1 [95.3] min, prestage 1: 392.2 [138.3] min, prestage 2: 355.6 [62.5] min, and prestage 3: 299.7 [107.0] min) significantly decreased over time (P < .05). Significant Pearson moment-product correlations were found between TST and subsequent race-day performance for race stage 1 (r = -.577; P = .019) and stage 3 (r = -.546; P = .035), with further analysis revealing that TST explained 33% and 30% of the variation in performance for stages 1 and 3, respectively. During a 3-day ultra-endurance triathlon, the TST was reduced and had a significant negative correlation to exercise performance, indicating that sleep loss was associated with slower performances. Sleep onset latency, wake episodes, and sleep efficiency did not significantly change over the course of this investigation, which may stem from the close proximity of exercise to sleep.

Practicing Sport in Cold Environments: Practical Recommendations to Improve Sport Performance and Reduce Negative Health Outcomes

Although not a barrier to perform sport, cold weather environments (low ambient temperature, high wind speeds, and increased precipitation, i.e., rain/water/snow) may influence sport performance. Despite the obvious requirement for practical recommendations and guidelines to better facilitate training and competition in such cold environments, the current scientific evidence-base is lacking. Nonetheless, this review summarizes the current available knowledge specifically related to the physiological impact of cold exposure, in an attempt to provide practitioners and coaches alike with practical recommendations to minimize any potential negative performance effects, mitigate health issues, and best optimize athlete preparation across various sporting disciplines. Herein, the review is split into sections which explore some of the key physiological effects of cold exposure on performance (i.e., endurance exercise capacity and explosive athletic power), potential health issues (short-term and long-term), and what is currently known with regard to best preparation or mitigation strategies considered to negate the potential negative effects of cold on performance. Specific focus is given to "winter" sports that are usually completed in cold environments and practical recommendations for physical preparation.

Gastrointestinal pathophysiology during endurance exercise: endocrine, microbiome, and nutritional influences

Gastrointestinal symptoms are abundant among athletes engaging in endurance exercise, particularly when exercising in increased environmental temperatures, at higher intensities, or over extremely long distances. It is currently thought that prolonged ischemia, mechanical damage to the epithelial lining, and loss of epithelial barrier integrity are likely contributors of gastrointestinal (GI) distress during bouts of endurance exercise, but due to the many potential causes and sporadic nature of symptoms this phenomenon has proven difficult to study. In this review, we cover known factors that contribute to GI distress symptoms in athletes during exercise, while further attempting to identify novel avenues of future research to help elucidate mechanisms leading to symptomology. We explore the link between the intestinal microbiome, the integrity of the gut epithelia, and add detail on gut hormone and peptide secretion that could potentially contribute to GI distress symptoms in athletes. The influence of nutrition and dietary supplementation strategies are also detailed, where much research has opened up new ideas and potential mechanisms for understanding gut pathophysiology during exercise. The etiology of gastrointestinal symptoms during endurance exercise is multi-factorial with neuroendocrine, microbial, and nutritional factors likely contributing to specific, individualized symptoms. Recent work in previously unexplored areas of both microbiome and gut peptide secretion are pertinent areas for future work, and the numerous supplementation strategies explored to date have provided insight into physiological mechanisms that may be targetable to reduce the incidence and severity of gastrointestinal symptoms in athletes.

Relationship of Carbohydrate Intake during a Single-Stage One-Day Ultra-Trail Race with Fatigue Outcomes and Gastrointestinal Problems: A Systematic Review

Due to the high metabolic and physical demands in single-stage one-day ultra-trail (SOUT) races, athletes should be properly prepared in both physical and nutritional aspects in order to delay fatigue and avoid associated difficulties. However, high carbohydrate (CHO) intake would seem to increase gastrointestinal (GI) problems. The main purpose of this systematic review was to evaluate CHO intake during SOUT events as well as its relationship with fatigue (in terms of internal exercise load, exercise-induced muscle damage (EIMD) and post-exercise recovery) and GI problems. A structured search was carried out in accordance with PRISMA guidelines in the following: Web of Science, Cochrane Library and Scopus databases up to 16 March 2021. After conducting the search and applying the inclusion/exclusion criteria, eight articles in total were included in this systematic review, in all of which CHO intake involved gels, energy bars and sports drinks. Two studies associated higher CHO consumption (120 g/h) with an improvement in internal exercise load. Likewise, these studies observed that SOUT runners whose intake was 120 g/h could benefit by limiting the EIMD observed by CK (creatine kinase), LDH (lactate dehydrogenase) and GOT (aspartate aminotransferase), and also improve recovery of high intensity running capacity 24 h after a trail marathon. In six studies, athletes had GI symptoms between 65–82%. In summary, most of the runners did not meet CHO intake standard recommendations for SOUT events (90 g/h), while athletes who consumed more CHO experienced a reduction in internal exercise load, limited EIMD and improvement in post-exercise recovery. Conversely, the GI symptoms were recurrent in SOUT athletes depending on altitude, environmental conditions and running speed. Therefore, a high CHO intake during SOUT events is important to delay fatigue and avoid GI complications, and to ensure high intake, it is necessary to implement intestinal training protocols.

Participation and Performance Trends in the ITU Duathlon World Championship From 2003 to 2017

ABSTRACT

Nikolaidis, PT, Villiger, E, and Knechtle, B. Participation and performance trends in the ITU Duathlon World Championship from 2003 to 2017. J Strength Cond Res 35(4): 1127-1133, 2021-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, 150-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% (171 ± 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 ± 10.5 years, p < 0.001, η2 = 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 = 19 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.

Energetics as a driver of human morphological thermal adaptation; evidence from female ultra-endurance athletes

Functional benefits of the morphologies described by Bergmann's and Allen's rules in human males have recently been reported. However, the functional implications of ecogeographical patterning in females remain poorly understood. Here, we report the findings of preliminary work analysing the association between body shape and performance in female ultramarathon runners (n = 36) competing in hot and cold environments. The body shapes differed between finishers of hot and cold races, and also between hot race finishers and non-finishers. Variability in race performance across different settings supports the notion that human phenotype is adapted to different thermal environments as ecogeographical patterns have reported previously. This report provides support for the recent hypothesis that the heightened thermal strain associated with prolonged physical activity in hot/cold environments may have driven the emergence of thermally adaptive phenotypes in our evolutionary past. These results also tentatively suggest that the relationship between morphology and performance may be stronger in female vs. male athletes. This potential sex difference is discussed with reference to the evolved unique energetic context of human female reproduction. Further work, with a larger sample size, is required to investigate the observed potential sex differences in the strength of the relationship between phenotype and performance.

Does Cold-Water Endurance Swimming Affect Pulmonary Function in Healthy Adults?

The acute effects of cold-water endurance swimming on the respiratory system have received little attention. We investigated pulmonary responses to cold-water endurance swimming in healthy recreational triathletes. Pulmonary function, alveolar diffusing capacity (DL_CO), fractional exhaled nitric oxide (FE_NO) and arterial oxygen saturation by pulse oximetry (SpO₂) were assessed in 19 healthy adults one hour before and 2.5 h after a cold-water (mean ± SD, 10 ± 0.9 °C) swim trial (62 ± 27 min). In addition, 12 out of the 19 participants measured pulmonary function, forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁) 3, 10, 20 and 45 min post-swim by maximal expiratory flow volume loops and DL_CO by the single breath technique. FVC and FEV₁ were significantly reduced 3 min post-swim (p = 0.02) (p = 0.04), respectively, and five of 12 participants (42%) experienced exercise-induced bronchoconstriction (EIB), defined as a ≥ 10% drop in FEV₁. No significant changes were observed in pulmonary function 2.5 h post-swim. However, mean FE_NO and DL_CO were significantly reduced by 7.1% and 8.1% (p = 0.01) and (p < 0.001), respectively, 2.5 h post-swim, accompanied by a 2.5% drop (p < 0.001) in SpO₂. The absolute change in DL_CO correlated significantly with the absolute decline in core temperature (r = 0.52; p = 0.02). Conclusion: Cold-water endurance swimming may affect the lungs in healthy recreational triathletes lasting up to 2.5 h post-swim. Some individuals appear to be more susceptible to pulmonary impairments than others, although these mechanisms need to be studied further.

Biochemical markers after the Norseman Extreme Triathlon

Prolonged exercise is known to cause changes in common biomarkers. Occasionally, competition athletes need medical assistance and hospitalisation during prolonged exercise events. To aid clinicians treating patients and medical teams in such events we have studied common biomarkers after at The Norseman Xtreme Triathlon (Norseman), an Ironman distance triathlon with an accumulated climb of 5200 m, and an Olympic triathlon for comparison. Blood samples were collected before, immediately after, and the day following the Norseman Xtreme Triatlon (n = 98) and Oslo Olympic Triathlon (n = 15). Increased levels of clinical significance were seen at the finish line of the Norseman in white blood cells count (WBC) (14.2 [13.5–14.9] 109/L, p < 0.001), creatinine kinase (CK) (2450 [1620–3950] U/L, p < 0.001) and NT-proBNP (576 [331–856] ng/L, p < 0.001). The following day there were clinically significant changes in CRP (39 [27–56] mg/L, p < 0.001) and Aspartate Aminotransferase (AST) (142 [99–191] U/L, p < 0.001). In comparison, after the Olympic triathlon distance, there were statistically significant, but less clinically important, changes in WBC (7.8 [6.7–9.6] 109/L, p < 0.001), CK (303 [182–393] U/L, p < 0.001) and NT-proBNP (77 [49–88] ng/L, p < 0.01) immediately after the race, and in CRP (2 [1–3] mg/L, p < 0.001) and AST (31 [26–41] U/L, p < 0.01) the following day. Subclinical changes were also observed in Hemoglobin, Thrombocytes, K+, Ca2+, Mg2+, Creatinine, Alanine Aminotransferase and Thyroxine after the Norseman. In conclusion, there were significant changes in biomarkers used in a clinical setting after the Norseman. Of largest clinical importance were clinically significant increased WBC, CRP, AST, CK and NT-proBNP after the Norseman. This is important to be aware of when athletes engaging in prolonged exercise events receive medical assistance or are hospitalised.

SEX AND AGE-RELATED CHANGES IN PERFORMANCE IN THE DUATHLON WORLD CHAMPIONSHIPS

ABSTRACT Objective Our study analyses differences in performance between sexes, and changes in performance between age groups at Olympic distance during the ITU Duathlon World Championships, held between 2005 and 2016. During this period, a total of 9,772 duathletes were analysed (6,739 men and 3,033 women). Methods Two-way analyses of variance (ANOVA) were used to examine sex- and age-related differences in performance (time, percentage of time and performance ratio) in the first running and cycling legs, the second running leg, and total race for the top 10 male and female athletes in each age group at the Duathlon World Championships. Results The age group with the highest participation, in both male and female categories, was 40-44 years, and it was found that the mean age of female finisher participants across all age groups was 23.5±12. With regards to performance, the best results for total race time and the cycling segment were achieved in the 30-34-year age group, for both male and female athletes. With regards to performance in the first and third segments (running legs), the best times were achieved in the 25-29 and 30-34 age groups, for men and women respectively. Conclusion According to the results of our study, the best results in the professional career of a duathlete are achieved at between 30 and 35 years, therefore the athlete should incorporate this factor into their training plan. Level of evidence III; Retrospective comparative study.

Human athletic paleobiology; using sport as a model to investigate human evolutionary adaptation

The use of sport as a conceptual framework offers unprecedented opportunities to improve our understanding of what the body does, shedding new light on our evolutionary trajectory, our capacity for adaptation, and the underlying biological mechanisms. This approach has gained traction over recent years. To date, sport has facilitated exploration not only of the evolutionary history of our species as a whole, but also of human variation and adaptation at the interindividual and intraindividual levels. At the species level, analysis of lower and upper limb biomechanics and energetics with respect to walking, running and throwing have led to significant advances in the understanding of human adaptations relative to other hominins. From an interindividual perspective, investigation of physical activity patterns and endurance running performance is affording greater understanding of evolved constraints of energy expenditure, thermoregulatory energetics, signaling theory, and morphological variation. Furthermore, ultra-endurance challenges provoke functional trade-offs, allowing new ground to be broken in the study of life history trade-offs and human adaptability. Human athletic paleobiology-the recruitment of athletes as study participants and the use of contemporary sports as a model for studying evolutionary theory-has great potential. Here, we draw from examples in the literature to provide a review of how the use of athletes as a model system is enhancing understanding of human evolutionary adaptation.

Exertional rhabdomyolysis and acute kidney injury in endurance sports: A systematic review

The increase of wide-spread participation in endurance events in sports such as open water swimming, cycling, running and triathlons, has given rise to a concern about potential implications for renal function and kidney health. This study aimed to delve into the findings on exertional rhabdomyolysis (ER) and acute kidney injury (AKI) in endurance sports, emphasizing the diagnostic criteria used, physical and environmental contextual conditions in which ER and AKI are reported. Following PRISMA guidelines for systematic reviews and meta-analysis, topic related studies were searched digital sources (from 2009 to 2020). Studies with biomarkers of ER and AKI reported in endurance or ultra-endurance events were included. A total of 43 publications (sample = 813) were extracted, and 345 (43.5%) individuals were diagnosed with ER (creatinine kinase > 5000 UI/L) and 130 (16.39%) with ER + AKI (creatinine ≥ 1.88 mg/dL). Out of the total cases of ER + AKI, 96.92% were in ultra-endurance runners. There were inconsistences between studies in diagnosis criteria for ER and AKI, which represented a difficulty in the interpretation of the data. Increased levels of muscle and kidney injury immediately after endurance events were reported, but after 5.86 days these levels usually returned to baseline. There is a lack of knowledge around the potential of repeated ER and AKI predisposing to long-term chronic kidney disease. More accurate markers for subclinical and functional AKI diagnosis are needed in the analysis of kidney health after endurance events. ER and AKI are serious clinical problems with significant morbidity. Further research may be in order to help define future prevention strategies.

Self-Selected Pacing During a World Record Attempt in 40 Ironman-Distance Triathlons in 40 Days

The present case study analyzed performance, pacing, and potential predictors in a self-paced world record attempt of a professional triathlete to finish 40 Ironman-distance triathlons within 40 days. Split times (i.e., swimming, cycling, running) and overall times, body weight, daily highest temperature, wind speed, energy expenditure, mean heart rate, and sleeping time were recorded. Non-linear regressions were applied to investigate changes in split and overall times across days. Multivariate regression analyses were performed to test which variables showed the greatest influence on the dependent variables cycling, running and overall time. The athlete completed the 40×Ironman distances in a total time of 444:22 h:min. He spent 50:26 h:min in swimming, 245:37 h:min in cycling, 137:17 h:min in running and 11:02 h:min in transition times. Swimming and cycling times became slower across days, whereas running times got faster until the 20th day and, thereafter, became slower until the 40th day. Overall times got slower until the 15th day, became faster to 31st, and started then to get slower until the end. Wind speed, previous day’s race time and average heart race during cycling were significant independent variables influencing cycling time. Body weight and average heart rate during running were significant independent variables influencing running performance. Cycling performance, running performance, and body weight were significant independent variables influencing overall time. In summary, running time was influenced by body weight, cycling by wind speed, and overall time by both running and cycling performances.

Participation and Performance Trends in the Oldest 100-km Ultramarathon in the World

Participation and performance trends in ultramarathon running have been investigated for large datasets and long period of times with an increase in participants and an improvement in performance. However, the analysis of ultramarathons across many decades is missing. We analyzed these trends for 96,036 athletes (88,286 men and 7750 women) from 67 countries competing between 1956 and 2019 in ‘100 km Lauf Biel’ in Switzerland, the oldest 100-km ultramarathon in the world. More men than women participated in all years. The number of male participants reached a peak at around 1985 and a decline in participation occurred thereafter. Women started competing in 1962. Men were always faster than women and both women and men reduced their race times over years. After about 1985, both overall women and men and both female and male winners were not able to improve race times. For men, athletes from all age groups below the age of 49 years old reached a peak of participation in the 1980s, and showed a decrease since then. Regarding age groups, the decrease first started in age group 20–29 years, followed by 30–39, 40–49, 50–59, and 60–69 years. For athletes in age groups 70–79 and 80–89 years, no decrease occurred. For women, age group athletes in age groups 40–49, 50–59, and 60–69 years increased their participation, whereas age groups 20–29 and 30–39 peaked in the late 1980s and started to decrease or stabilize, respectively. Switzerland, Germany, and France were the countries with the highest numbers of participants throughout the history of the race. In men, race times increased after about 1990 for most nationalities; only runners from Germany seemed to stabilize their performance. In women, runners from Italy, France, and Austria improved their performance over the years. In summary, the analysis of the oldest 100-km ultramarathon in the world showed a decrease in participation and an impairment in performance in the last 60 years. These changes were due to a decrease in the number of male ultramarathoners in around the 1980s, where mainly the number of age group runners younger than 70 years decreased.

Number of finishers and performance of age group women and men in long-distance running: comparison among 10km, half-marathon and marathon races in Oslo

The aim of the present study was to examine the number of finishers and performance trends in 10 km, half-marathon and marathon races in Oslo. Data (total 115,725 finishers; women, n = 50,595; men, n = 65,130) from 10 km, half-marathon and marathon races in Oslo from 2008 to 2018 were analysed considering number, sex, age and running speed of finishers. The total men-to-women ratio was the smallest in the 10 km race (0.60) and the largest in the marathon (3.86) (p < 0.01, φ = 0.28). In both women and men, the slowest running speed was shown in the older age groups (p < 0.01). Based on the findings of the present study, it was concluded that relatively more women finished a 10 km and less a half-marathon and a marathon. Our results indicated that the sex difference in performance was attenuated in the longer race distances and older age groups.

Do Years of Running Experience Influence the Motivations of Amateur Marathon Athletes?

The aim of the study was to investigate if years of running experience influence the motivations of marathon athletes. An empirical study was conducted during the last (20th) PKO Poznan Marathon, one of the largest and most popular mass running events in Poland, which was held in Poznan (Poland) in October 2019. A total of 493 marathon runners (29% of whom were female, and 71% of whom were male) took part in the cross-sectional study, which used the diagnostic survey method. The questionnaire employed the division of motives from the motivation of marathoners scale (MOMS) by Masters et al., adapted to the Polish language by Dybala. Running motivations have already been analysed for variables such as age, gender and place of residence, but there is a research gap regarding existing research, as the relationship between motivations and running experience has not yet been studied. One-way analysis of variance for independent samples was used to verify statistical hypotheses. Prior to making the relevant calculations, the assumption of homogeneity of variance was checked via Levene's test. Variances were assessed with an F-test, and if they were unequal, Welch's correction was applied. Eta squared (η²) was used as a measure of effect size. The calculations carried out showed that running experience was not a statistically significant factor in the motivations of runners taking part in a marathon.

[Analysis of nutritional intake in trail runners during competition]

Introduction

Introduction: there has been an increase in the number of endurance sports events during the last 20 years, as well as in the number of their participants. An adequate nutritional plan is essential for a satisfactory performance in this type of events, both in professional and amateur athletes. Objectives: the objective was to determine, evaluate, and compare with the current scientific recommendations the consumption of carbohydrates, water, and sodium by participants in a trail-running event. Methods: the competition completed by the athletes was the "Medio Trail de Alcoy 2019" (Alcoy, Spain), with a distance of 30 km. After completing the race, participants filled out a questionnaire about their food and drink consumption during the event, in addition to other questions about their nutritional habits in general. Eleven participants who met the inclusion criteria were included in the study. Results: the result obtained for average carbohydrate intake was 14.93 g/h, for sodium intake was 146.42 mg/h, and for water intake was 399.73 mL/h. In all, 27 % of participants visited a dietitian-nutritionist on a regular basis, and none reported gastrointestinal tract issues during the race. Conclusions: the carbohydrate and sodium consumption of participants was low as compared to current scientific recommendations; however, water consumption was adequate according to them. Our advice for endurance athletes is visit a specialized dietitian-nutritionist to achieve optimal performance in competitions.

Ultra-endurance athletic performance suggests that energetics drive human morphological thermal adaptation

Both extinct and extant hominin populations display morphological features consistent with Bergmann's and Allen's Rules. However, the functional implications of the morphologies described by these ecological laws are poorly understood. We examined this through the lens of endurance running. Previous research concerning endurance running has focused on locomotor energetic economy. We considered a less-studied dimension of functionality, thermoregulation. The performance of male ultra-marathon runners (n = 88) competing in hot and cold environments was analysed with reference to expected thermoregulatory energy costs and the optimal morphologies predicted by Bergmann's and Allen's Rules. Ecogeographical patterning supporting both principles was observed in thermally challenging environments. Finishers of hot-condition events had significantly longer legs than finishers of cold-condition events. Furthermore, hot-condition finishers had significantly longer legs than those failing to complete hot-condition events. A degree of niche-picking was evident; athletes may have tailored their event entry choices in accordance with their previous race experiences. We propose that the interaction between prolonged physical exertion and hot or cold climates may induce powerful selective pressures driving morphological adaptation. The resulting phenotypes reduce thermoregulatory energetic expenditure, allowing diversion of energy to other functional outcomes such as faster running.

Ultra-endurance triathlon performance and markers of whole-body and gut-specific inflammation

PURPOSE

To examine the influence of the Ultraman Florida triathlon (3 days of non-continuous racing; stage 1: 10 km swim and 144.8 km cycle; stage 2: 275.4 km cycle; stage 3: 84.4 km run) on circulating plasma concentrations of whole-body (C-reactive protein (CRP), interleukin (IL)-6 (IL-6), and IL-10 and surrogate gut-specific inflammatory markers (IL-17 and IL-23), and determine whether these variables are associated with performance.

METHODS

Eighteen triathletes (N = 18; 15 men, 3 women; age: 37 ± 8 yrs) were evaluated at baseline and post-race for circulating concentrations of CRP, IL-6, IL-10, IL-17, and IL-23. Blood samples were drawn two days prior to stage 1 (1600 h) and one day after stage 3 (1200 h).

RESULTS

Plasma CRP significantly increased from baseline (1985.8 ± 5962.3 ng/mL) to post-race (27,013.9 ± 12,888.8 ng/mL, p < 0.001, 13-fold increase). Both plasma IL-6 and IL-10 did not significantly change from baseline to post-race. Baseline and post-race concentrations of IL-17 and IL-23 were below detectable limits. Pearson's correlation between mean finish time and post-race IL-10 revealed a significant positive correlation (r = 0.54, p < 0.05).

CONCLUSIONS

Our results suggest that cytokines such as IL-6 and IL-10 involved in the inflammatory response return to near-baseline concentrations rapidly even after ultra-endurance events of extreme duration. The absence of IL-17 and IL-23 may suggest positive gut adaptations from ultra-endurance training. A significant positive correlation between post-race IL-10 concentrations and mean finish time may indicate that a relationship between anti-inflammatory responses and performance exists.

Ultra-triathlon-Pacing, performance trends, the role of nationality, and sex differences in finishers and non-finishers

Ultra-triathlons are defined as triathlons longer than the traditional Ironman distance and became more popular in the last two decades; however, scarce scientific evidence of these events are available. Therefore, we aimed to investigate the trends of performance, pacing, nationality, sex differences, and rate of non-finishers in ultra-triathlons. Data from 1985 to 2018 were collected including Double Iron, Triple Iron, Quintuple Iron, and Deca Iron ultra-triathlons. Different pacing patterns by event and sex were observed (P < .05); athletes spent less %time in swimming and cycling, and more %time in running as the distance of event was longer; women spent more %time in cycling and less% time in running in Double and Triple. Performance analysis showed a negative trend over time for men and women since 1985. Switzerland, France, and Germany were the fastest nations in ultra-triathlons. The frequency of North Americans competing in Europe was very low (<5%), whereas Europeans often competed in North America (~25%). The rate of non-finishers between sexes was similar in all races with the exception of Deca Iron ultra-triathlon, which was much greater (~20%) for women. Non-finishers had slower race times in swimming and cycling splits than finishers. In conclusion, ultra-triathletes should redistribute their energy among swimming, cycling, and running depending on their sex and distance of race. Performance in ultra-triathlons has been decreasing in men and women over the years, but sex difference in performance remained. Europeans were the fastest ultra-triathletes and compete in Europe and North America. Additionally, non-finishers were slower swimmers and cyclists than finishers.

Effects of The Performance Level and Race Distance on Pacing in Ultra-Triathlons

The aim of this study was to examine the effects of the performance level and race distance on pacing in ultra-triathlons (Double, Triple, Quintuple and Deca), wherein pacing is defined as the relative time (%) spent in each discipline (swimming, cycling and running). All finishers (n = 3,622) of Double, Triple, Quintuple and Deca Iron ultra-triathlons between 1985 and 2016 were analysed and classified into quartile groups (Q1, Q2, Q3 and Q4) with Q1 being the fastest and Q4 the slowest. Performance of all non-finishers (n = 1,000) during the same period was also examined. Triple and Quintuple triathlons (24.4%) produced the highest rate of non-finishers, and Deca Iron ultra-triathlons produced the lowest rate (18.0%) (χ² = 12.1, p = 0.007, φC = 0.05). For the relative swimming and cycling times (%), Deca triathletes (6.7 ± 1.5% and 48.8 ± 4.9%, respectively) proved the fastest and Double (9.2 ± 1.6% and 49.6 ± 3.6%) Iron ultra-triathletes were the slowest (p < 0.008) with Q4 being the fastest group (8.3 ± 1.6% and 48.8 ± 4.3%) and Q1 the slowest one (9.5 ± 1.5% and 50.9 ± 3.0%) (p < 0.001). In running, Double triathletes were relatively the fastest (41.2 ± 4.0%) and Deca (44.5 ± 5.4%) Iron ultra-triathletes the slowest (p < 0.001) with Q1 being the fastest (39.6 ± 3.3%) and Q4 the slowest group (42.9 ± 4.7%) (p < 0.001). Based on these findings, it was concluded that the fastest ultra-triathletes spent relatively more time swimming and cycling and less time running, highlighting the importance of the role of the latter discipline for the overall ultra-triathlon performance. Furthermore, coaches and ultra-triathletes should be aware of differences in pacing between Double, Triple, Quintuple and Deca Iron triathlons.

Motivation Regulation among Black Women Triathletes

There is a paucity of information on motivation among U.S. minority triathletes. This study aimed to understand the extrinsic motivation and regulators of Black women triathletes using a modified version of the valid Motivations of Marathoners Scale and semi-structured interviews, for triathletes. The Self Determination Theory guided the dual method assessment of the extrinsic motivators and the regulators external, introjection, and integrated. Using MANOVA, data from (N = 121) triathletes were compared across participant categories of age, body mass index, and distance. Results showed a significant age difference with younger women displaying more motivation. Descriptive means indicated integration as the greatest regulator of motivation. The statements ‘to compete with myself’ and ‘to be more fit,’ had the highest means among the women. A sub-sample of 12 interviews were conducted revealing 16 extrinsic themes. Six were related to the regulator integration and two unexpectantly related to the regulator, identified. Integrated themes, including coping mechanisms, finishing course, improvement, accomplishment, and physical awareness were most represented. This research fills gaps of understanding extrinsic motivation and the regulators of a group not previously explored. Future research on motivation among triathletes may benefit knowing how motivations are regulated, as to promote personalized training and participation.

Sex Difference in Triathlon Performance

This brief review investigates how sex influences triathlon performance. Performance time for both Olympic distance and Ironman distance triathlons, and physiological considerations are discussed for both elite and non-elite male and female triathletes. The relative participation of female athletes in triathlon has increased over the last three decades, and currently represents 25-40% of the total field. Overall, the sex difference in both Olympic and Ironman distance triathlon performance has narrowed across the years. Sex difference differed with exercise mode and exercise duration. For non-elite Ironman triathletes, the sex difference in swimming time (≈12%) is lower than that which was evidenced for cycling (≈15%) and running (≈18%). For elite triathletes, sex difference in running performance is greater for Olympic triathlon (≈14%) than it is for Ironman distance triathlon (≈7%). Elite Ironman female triathletes have reduced the gap to their male counterparts to less than 10% for the marathon. The sex difference in triathlon performance is likely to be due to physiological (e.g., VO2max) and morphological (e.g., % body fat) factors but hormonal, psychological and societal (e.g., lower participation rate) differences should also be considered. Future studies should address the limited evidence relating sex difference in physiological characteristics such as lactate threshold, exercise economy or peak fat oxidation.

Pre-race determinants influencing performance and finishing of a transcontinental 4486-km ultramarathon

BACKGROUND

Pre-race determinants influencing performance and finishing of one of the largest transcontinental multistage ultramarathons were investigated.

METHODS

Forty-four participants of the TransEurope FootRace 2009 (TEFR), running 4486 km in 64 stages (average 70.1 km daily) were analyzed regarding training and running history. This included years of regular endurance running (PRY), number of finished marathons, ultramarathons (UM) and multistage ultramarathons (MSUM), pre-race records (PRR) for marathon and specific UM races and the extent of pre-race training (PRT) in the last year before TEFR: volume (km/week), duration (h/week) and intensity (km/h).

RESULTS

Mean total running speed during TEFR was 8.25 km/h.Seventy-one percent of subjects finished the race. The mean PRT-volume extends 5500 km. Finishers and non-finishers of the TEFR did not show significant difference in any tested pre-race determinants. There was no association between PRY, number of finished marathons, UM, and MSUM and TEFR performance. There was very strong positive correlation between PRT-intensity and TEFR performance. PRT volume correlated with a medium effect size to TEFR performance. PRR in specific ultra-races (6-hour, 50-km, 100-km races) showed a high correlation to TEFR performance. Performance in ultramarathon correlates inversely with age.

CONCLUSIONS

Like in other endurance disciplines with shorter distances, in ultra-long multistage endurance running the athletes also need a stage-specific pre-race experience, training and adaptation if he wants to end up with a good performance. But dropping out of a MSUM seems not to be consistent with regard to specific pre-race experience. Further research results of TEFR project may reveal potential risk factors for non-finishing a transcontinental footrace.

[Exercise-Associated Hyponatremia in Endurance Performance]

Exercise-Associated Hyponatremia in Endurance Performance Abstract. Exercise-associated hyponatremia is defined as a plasma sodium concentration of <135 mmol/l and was first described by Timothy Noakes at the Comrades Marathon in South Africa in the mid-1980s. A decrease in plasma sodium <135 mmol/l occurs with excessive fluid intake. Risk factors include long to very long endurance performance, extreme climatic conditions, female gender and competitions in the USA. Regarding its prevalence by sport, exercise-associated hyponatraemia tends to occur while swimming and running, but rarely when cycling. While mild exercise-associated hyponatremia does not lead to clinical symptoms, severe hyponatremia due to cerebral edema can lead to neurological deficits and even death. The best prevention of exercise-associated hyponatremia is the reduction of fluid intake during exercise.

Core Temperature in Triathletes during Swimming with Wetsuit in 10 °C Cold Water

Low water temperature (<15 °C) has been faced by many organizers of triathlons and swim-runs in the northern part of Europe during recent years. More knowledge about how cold water affects athletes swimming in wetsuits in cold water is warranted. The aim of the present study was therefore to investigate the physiological response when swimming a full Ironman distance (3800 m) in a wetsuit in 10 °C water. Twenty triathletes, 37.6 ± 9 years (12 males and 8 females) were recruited to perform open water swimming in 10 °C seawater; while rectal temperature (Tre) and skin temperature (Tskin) were recorded. The results showed that for all participants, Tre was maintained for the first 10–15 min of the swim; and no participants dropped more than 2 °C in Tre during the first 30 min of swimming in 10 °C water. However; according to extrapolations of the results, during a swim time above 135 min; 47% (8/17) of the participants in the present study would fall more than 2 °C in Tre during the swim. The results show that the temperature response to swimming in a wetsuit in 10 °C water is highly individual. However, no participant in the present study dropped more than 2 °C in Tre during the first 30 min of the swim in 10 °C water.

Celebrating 40 Years of Ironman: How the Champions Perform

We aimed to determine which discipline had the greater performance improvements in the history of Ironman triathlon in Hawaii and also which discipline had the greater influence in overall race time. Data from 1983 to 2018 of the top three women and men of each year who competed in the Ironman World Championship were included. In addition to exploratory data analyses, linear regressions between split times and years of achievement were performed. Further, a stepwise multiple linear regression was applied using total race time as the dependent variable and split times as the independent variables. Both women and men significantly improved their performances from 1983 to 2018 in the Ironman World Championship. Swimming had the largest difference in improvements between men and women (3.0% versus 12.1%, respectively). A negative and significant decrease in each discipline was identified for both women and men, with cycling being the discipline with the greatest reduction. The results from the stepwise multiple regression indicated that cycling was the discipline with the highest influence on overall race time for both sexes. Based on the findings of this study, cycling seems to be the Ironman triathlon discipline that most improved overall race times and is also the discipline with the greatest influence on the overall race time of elite men and women in the Ironman World Championship.

Development and Implementation of a Nutrition Knowledge Questionnaire for Ultraendurance Athletes

The nutritional intake of ultraendurance athletes is often poorly matched with the requirements of the sport. Nutrition knowledge is a mediating factor to food choice that could correct such imbalances. Therefore, the purpose of this study was to develop and validate a questionnaire to assess the nutrition knowledge of ultraendurance athletes. Nutritional knowledge was assessed using a modified sports nutrition knowledge questionnaire (ULTRA-Q). Four independent assessors with specialization in sports nutrition confirmed the content validity of the ULTRA-Q. Registered sports nutritionists, registered dietitians, and those without nutrition training completed the ULTRA-Q on two separate occasions. After the first completion, a significant difference in nutrition scores between groups (p ≤ .001) provided evidence of construct validity. After the second completion, intraclass correlation coefficients comparing nutrition scores between time points (.75-.95) provided evidence of test-retest reliability. Subsequently, experienced ultraendurance athletes (male: n = 74 and female: n = 27) completed the ULTRA-Q. Athletes also documented their sources of nutrition knowledge for ultraendurance events. The total nutrition knowledge score for ultraendurance athletes was 68.3% ± 9.5%, and there were no significant differences in knowledge scores between males and females (67.4% ± 9.6% and 70.7% ± 9.3%, respectively) or between runners and triathletes (69.1% ± 9.7% and 65.1% ± 9.4%, respectively). In general, it appeared that ultraendurance athletes favored other athletes (73%) over nutrition experts (8%) as a source of nutritional information. The findings of this study indicate that ultraendurance athletes had a reasonable level of nutrition knowledge, but interathlete variability suggests a need for targeted nutrition education.

Metabolic Mechanisms of Exercise-Induced Cardiac Remodeling

Exercise has a myriad of physiological benefits that derive in part from its ability to improve cardiometabolic health. The periodic metabolic stress imposed by regular exercise appears fundamental in driving cardiovascular tissue adaptation. However, different types, intensities, or durations of exercise elicit different levels of metabolic stress and may promote distinct types of tissue remodeling. In this review, we discuss how exercise affects cardiac structure and function and how exercise-induced changes in metabolism regulate cardiac adaptation. Current evidence suggests that exercise typically elicits an adaptive, beneficial form of cardiac remodeling that involves cardiomyocyte growth and proliferation; however, chronic levels of extreme exercise may increase the risk for pathological cardiac remodeling or sudden cardiac death. An emerging theme underpinning acute as well as chronic cardiac adaptations to exercise is metabolic periodicity, which appears important for regulating mitochondrial quality and function, for stimulating metabolism-mediated exercise gene programs and hypertrophic kinase activity, and for coordinating biosynthetic pathway activity. In addition, circulating metabolites liberated during exercise trigger physiological cardiac growth. Further understanding of how exercise-mediated changes in metabolism orchestrate cell signaling and gene expression could facilitate therapeutic strategies to maximize the benefits of exercise and improve cardiac health.

The Age-Related Performance Decline in Ironman Triathlon Starts Earlier in Swimming Than in Cycling and Running

Käch, I, Rüst, CA, Nikolaidis, PT, Rosemann, T, and Knechtle, B. The age-related performance decline in Ironman triathlon starts earlier in swimming than in cycling and running. J Strength Cond Res 32(2): 379-395, 2018-In Ironman triathlon, the number of overall male and female finishers increased in the past 30 years, while an improvement in performance has been reported. Studies concluding these numbers only analyzed the top 10 athletes per age group instead of all finishers; therefore, a selection bias might have occurred. The aim of this study was to investigate participation, performance, and the age-related performance decline of all pro- and age-group triathletes ranked in all Ironman triathlons held worldwide between 2002 and 2015. Split and overall race times of 329,066 (80%) male and 81,815 (20%) female athletes competing in 253 different Ironman triathlon races were analyzed. The number of finishers increased in all age groups with the exception of women in age group 75-79 years. In pro athletes, performance improved in all disciplines. In age-group athletes, performance improved in younger age groups for running (from 18-24 to 40-44 years) and older age groups for swimming (from 50-54 to 65-69 years) and cycling (from 35-39 to 55-59 years), whereas it impaired in younger age groups for swimming (from 18-24 to 45-49 years) and cycling (from 18-24 to 30-34 years), and older age groups in running (from 45-49 to 70-74 years). The age-related performance decline started in women in age group 25-29 years in swimming and in age group 30-34 years in cycling, running, and overall race time, whereas it started in men in age group 25-29 years in swimming and in age group 35-39 years in cycling, running, and overall race time. For athletes and coaches, performance improved in younger age groups for running and older age groups for swimming and cycling, and the age-related decline in performance started earlier in swimming than in cycling and running. In summary, women should start competing in Ironman triathlon before the age of 30 years and men before the age of 35 years to achieve their personal best Ironman race time.

Coronary artery disease in athletes: An adverse effect of intense exercise?

Regular physical exercise is responsible for various health benefits, and is recommended for primary and secondary cardiovascular (CV) prevention. Despite these recognized benefits, various clinical events can occur in athletes, including acute myocardial infarction and sudden cardiac death (SCD); the main cause of SCD in veteran athletes is coronary artery disease (CAD). The relationship between intense exercise training and CAD is controversial, and a U-shaped association has been hypothesized. If this is the case, screening for subclinical CAD in older athletes may be justified, and various different methodologies have been proposed. However, the methodology for screening veteran athletes is not consensual, and several markers of CAD, in addition to clinical CV risk factors, could improve risk stratification in this population. In the present paper we review the published data on CAD in athletes, focusing on the relationship between the dose of exercise and CAD, as well as the implications for pre-participation screening of veteran athletes.

Chronic probiotic supplementation with or without glutamine does not influence the eHsp72 response to a multi-day ultra-endurance exercise event

Probiotic and glutamine supplementation increases tissue Hsp72, but their influence on extracellular Hsp72 (eHsp72) has not been investigated. The aim of this study was to investigate the effect of chronic probiotic supplementation, with or without glutamine, on eHsp72 concentration before and after an ultramarathon. Thirty-two participants were split into 3 independent groups, where they ingested probiotic capsules (PRO; n = 11), probiotic + glutamine powder (PGLn; n = 10), or no supplementation (CON; n = 11), over a 12-week period prior to commencement of the Marathon des Sables (MDS). eHsp72 concentration in the plasma was measured at baseline, 7 days pre-race, 6-8 h post-race, and 7 days post-race. The MDS increased eHsp72 concentrations by 124% (F_[1,3] = 22.716, p < 0.001), but there was no difference in the response between groups. Additionally, PRO or PGLn supplementation did not modify pre- or post-MDS eHsp72 concentrations compared with CON (p > 0.05). In conclusion, the MDS caused a substantial increase in eHsp72 concentration, indicating high levels of systemic stress. However, chronic PRO or PGLn supplementation did not affect eHsp72 compared with control pre- or post-MDS. Given the role of eHsp72 in immune activation, the commercially available supplements used in this study are unlikely to influence this cascade.

Substance use and misuse in a mountain ultramarathon: new insight into ultrarunners population?

Endurance and ultra-endurance events have become increasingly popular. The aim of our study was to explore the use of medication among endurance runners participating in the 2014 Infernal Trail des Vosges. Among the 389 runners engaged, 297 (76.3%) completed a specific questionnaire dealing with substance use/misuse. Our results show a 27% (before the race) and 18% (during the race) prevalence of substance use. The two major classes of substances used were non-steroidal anti-inflammatory drugs (NSAIDs; 9.8%) and painkillers (6.7%), principally because of osteo-articular pain (29.6%) or to prevent pain (28.2%). A positive correlation was found between substance consumption before (past month) and during the race (overall medication: p < 0.0001; NSAIDs: p = 0.008). Our results could be explained by the specific characteristics of ultrarunners predominantly motivated by personal achievement and general health (recreational approach). However, education interventions should further be delivered regarding the risks of substance use in ultra-endurance events.

Quantifying the "Slosh Stomach": A Novel Tool for Assessment of Exercise-Associated Gastroparesis Symptoms in Endurance Athletes

Introduction. We describe a novel scale and its field use for evaluation of exercise-associated gastroparesis in the endurance athlete. Methods. A scale was created based on gastroparesis tools previously described in the medical literature. Surveys of the tool were administered to runners participating in a 210 km multiday foot race in Sri Lanka. Results. Use of this novel scale was demonstrated to be useful in assessing gastroparesis severity scores of athletes and how these symptoms affected their race performance. Of the 27 race participants who completed the survey, 27 felt that the tool adequately captured their symptoms. Conclusions. This novel survey tool was able to assess the presence and severity of exercise-associated gastroparesis symptoms in endurance racers in a remote location. This tool may be helpful with further research of the identification and management of gastroparesis and other gastrointestinal upset in the endurance race environment.

Are There Deleterious Cardiac Effects of Acute and Chronic Endurance Exercise?

Multiple epidemiological studies document that habitual physical activity reduces the risk of atherosclerotic cardiovascular disease (ASCVD), and most demonstrate progressively lower rates of ASCVD with progressively more physical activity. Few studies have included individuals performing high-intensity, lifelong endurance exercise, however, and recent reports suggest that prodigious amounts of exercise may increase markers for, and even the incidence of, cardiovascular disease. This review examines the evidence that extremes of endurance exercise may increase cardiovascular disease risk by reviewing the causes and incidence of exercise-related cardiac events, and the acute effects of exercise on cardiovascular function, the effect of exercise on cardiac biomarkers, including "myocardial" creatine kinase, cardiac troponins, and cardiac natriuretic peptides. This review also examines the effect of exercise on coronary atherosclerosis and calcification, the frequency of atrial fibrillation in aging athletes, and the possibility that exercise may be deleterious in individuals genetically predisposed to such cardiac abnormalities as long QT syndrome, right ventricular cardiomyopathy, and hypertrophic cardiomyopathy. This review is to our knowledge unique because it addresses all known potentially adverse cardiovascular effects of endurance exercise. The best evidence remains that physical activity and exercise training benefit the population, but it is possible that prolonged exercise and exercise training can adversely affect cardiac function in some individuals. This hypothesis warrants further examination.