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Mental and Physical Health Related Determinants and Consequences of Marathon and Ultra-Marathon Running

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Exercise and Health".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 65071

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Guest Editor
Institute of Sport Science, Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
Interests: running; ultra-marathons; sports training; team sports
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Physiological and Medical Sciences, Institute of Sport Science, Academy of Physical Education, 40-065 Katowice, Poland
Interests: physiology of sport; sport training and nutrition; athletes’ hearts; sports nutrition; high-intensity interval training
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Traditional recreational running is very popular around the world, but parallel to this interest in moderate-intensity running, there is growing participation in very intense running, such as marathons and ultra-marathon events, which demand very good physical conditions and great mental preparation. Indeed, the number of runners participating in ultra-marathon events has reached more than one hundred thousand participants in more than a thousand races around the world, while the number of marathon runners exceeds millions. The originality and specificity of these races have attracted the attention of scientists from many areas, from social sciences to sports medicine. Extreme conditions and exhausting efforts allow the human body to attain very high levels of ability for physical performance and mental toughness. This Special Issue will focus on scientific research related to psychological and physical determinants of running performance on long and ultra-long distances as well as on consequences of participation in competitions starting with 42,195 km and finishing with hundreds of kilometers. We invite papers describing:

  1. Biochemical and physiological processes resulting from training, racing, and recovery in extreme distances;
  2. Medical consequences of long-term endurance running training and competition;
  3. Biomechanical description of runners’ technique in training and competition conditions;
  4. Psychological backgrounds of human performance in the exhaustive condition of long-term running;
  5. Psychological processes occurring during the ultra-marathon race and its consequences to the post-race recovery;
  6. Health benefits of training and participation in marathon and ultra-marathon running.

Prof. Dr. Zbigniew Waśkiewicz
Dr. Aleksandra Żebrowska
Guest Editors

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Keywords

  • Marathon and ultra-marathon
  • Running
  • Psychological and physiological determinants
  • Health benefits and consequences

Published Papers (18 papers)

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Research

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12 pages, 669 KiB  
Article
Physiological and Somatic Principal Components Determining VO2max in the Annual Training Cycle of Endurance Athletes
by Natalia Grzebisz-Zatońska, Stanisław Poprzęcki, Arkadiusz Stanula, Ewa Sadowska-Krępa and Dagmara Gerasimuk
Int. J. Environ. Res. Public Health 2022, 19(7), 3951; https://doi.org/10.3390/ijerph19073951 - 26 Mar 2022
Cited by 2 | Viewed by 2276
Abstract
The purpose of the study was to assess the impact of training on the physiological variables achieved during the test effort in the macrocycle of road cyclists and their use in the maximal oxygen uptake (VO2max) prediction at individual training stages [...] Read more.
The purpose of the study was to assess the impact of training on the physiological variables achieved during the test effort in the macrocycle of road cyclists and their use in the maximal oxygen uptake (VO2max) prediction at individual training stages in the VO2max test. Nine well-trained male cyclists (age 25.6 ± 5.2 years and body weight 72.4 ± 7.35 kg) participated in the study and each phase of the macrocycle was followed by a time to exhaustion test (TTE) on the bicycle ergometer. The research showed that training loads significantly influence the maximum power (PPO), ventilation (VE) in the preparatory period (T1), time of the test (TTmax) at the start of the competition period (T2), percentage of body fat in total body weight (%FAT) and skeletal muscle mass (MMS) during the competition period (T3). Of the 16 variables taken for the analysis of the principal components (PC), the regression model determined one principal variable responsible for VO2max in the training macrocycle of cyclists, the relative value of maximum power (PPORV) and the accompanying variables in individual periods: breathing frequency (BF), delta blood lactate concentration (ΔLA), body fat (FAT) and MMS. Determining PC influencing the exercise capacity can be crucial in achieving the intended goals by athletes. Monitoring these indicators can help protect the health of professional athletes and provide guidelines in the training process, stimulate the body properly while protecting against overtraining. Full article
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13 pages, 1373 KiB  
Article
The Prevalence of Use of Various Post-Exercise Recovery Methods after Training among Elite Endurance Athletes
by Eduard Bezuglov, Artemii Lazarev, Vladimir Khaitin, Sergey Chegin, Aleksandra Tikhonova, Oleg Talibov, Dagmara Gerasimuk and Zbigniew Waśkiewicz
Int. J. Environ. Res. Public Health 2021, 18(21), 11698; https://doi.org/10.3390/ijerph182111698 - 07 Nov 2021
Cited by 9 | Viewed by 5562
Abstract
There is now compelling evidence of the effectiveness of a range of post-exercise recovery techniques, including extended nights of sleep, cold water immersion, massage, and compression garments. Currently, limited information is available on post-exercise recovery methods used by elite endurance athletes. Therefore, this [...] Read more.
There is now compelling evidence of the effectiveness of a range of post-exercise recovery techniques, including extended nights of sleep, cold water immersion, massage, and compression garments. Currently, limited information is available on post-exercise recovery methods used by elite endurance athletes. Therefore, this study investigated the actual methods of recovery used in this group of athletes. Google Forms were used to collect information on the recovery methods used by elite endurance track and field athletes (n = 153, 61.4% men, 38.6% women; average age: 22.7 ± 4.6 years). The most used methods of recovery were sauna bathing (96.7%), massage (86.9%), daytime nap (81.0%), and long night sleep (at least 9h) (61.4%). Recovery methods with proven effectiveness such as cold water immersion and compression garments were rarely used (15.0% and 7.8%, respectively). Overall, recovery methods were used more often when the tiers of the track and field athletes were higher. Massage and sauna bathing were the most used methods of post-exercise recovery among Russian endurance track and field athletes. In most cases, they were used in conjunction with short daytime nap and long night sleep. Higher tier athletes were more likely to use sauna bathing, massage, long night sleep, and daytime nap but not cold water immersion and compression garments as recovery methods; however, all these methods except for cold water immersion were widely used among elite-tier athletes. Full article
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10 pages, 757 KiB  
Article
The Influence of Endurance Training on the Lipid Profile, Body Mass Composition and Cardiovascular Efficiency in Middle-Aged Cross-Country Skiers
by Natalia Grzebisz-Zatońska, Tomasz Grzywacz and Zbigniew Waśkiewicz
Int. J. Environ. Res. Public Health 2021, 18(20), 10928; https://doi.org/10.3390/ijerph182010928 - 18 Oct 2021
Cited by 3 | Viewed by 1887
Abstract
Monitoring the training of amateur long-distance cross-country skiers (XCS) can help athletes’ achieve a higher exercise capacity and protect their health. The aim of this study was to assess body composition changes and lipid profiles in middle-aged amateur long-distance XCS after four months [...] Read more.
Monitoring the training of amateur long-distance cross-country skiers (XCS) can help athletes’ achieve a higher exercise capacity and protect their health. The aim of this study was to assess body composition changes and lipid profiles in middle-aged amateur long-distance XCS after four months of training, including specialized roller ski training. The results of the time-to-exhaustion (TTE) test and blood tests and changes in body composition were analyzed with basic descriptive statistics: the paired Wilcoxon test was used to compare the results (initial and final). Spearman’s rank correlation coefficient (R) was used to assess the influence of various variables on maximum oxygen uptake (VO2max). The findings show that training of amateur long-distance XCS improved maximal oxygen uptake (p = 0.008) and had a positive effect on fat reduction, measured in percentages (p = 0.038) and in kilograms (p = 0.023), but did not change blood lipids or other parameters. Further research could focus on other aspects of the annual training cycle: the competition period, and women in a larger group of athletes. Training with roller skis and a cross-country skiing training machine (a specialized machine for strengthening the arms and upper body) can support health and prevent obesity, overweight, and cardiovascular disease. Full article
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9 pages, 1429 KiB  
Article
From Athens to Sparta—37 Years of Spartathlon
by Beat Knechtle, Margarida Gomes, Volker Scheer, Robert Gajda, Pantelis Theodoros Nikolaidis, Lee Hill, Thomas Rosemann and Caio Victor Sousa
Int. J. Environ. Res. Public Health 2021, 18(9), 4914; https://doi.org/10.3390/ijerph18094914 - 05 May 2021
Cited by 5 | Viewed by 2449
Abstract
(1) Background: Recent studies analyzed the participation and performance trends of historic races such as the oldest ultra-marathon (Comrades) or the oldest 100-km ultra-marathon (Biel). One of the toughest and historic ultra-marathons in the world is the ‘Spartathlon’ (246-km ultra-marathon from Athens to [...] Read more.
(1) Background: Recent studies analyzed the participation and performance trends of historic races such as the oldest ultra-marathon (Comrades) or the oldest 100-km ultra-marathon (Biel). One of the toughest and historic ultra-marathons in the world is the ‘Spartathlon’ (246-km ultra-marathon from Athens to Sparta). The present study aimed to analyze the trends in participation and performance of this race. (2) Methods: Different general linear models were applied as follows: the first model was a two-way ANOVA (Decade × Sex), with separate models for all participants and for only the top five finishers in each race; the second model was a two-way ANOVA (Age Group × Sex); the third model was a two-way ANOVA (Nationality × Sex). (3) Results: Between 1982 and 2019, 3504 ultra-marathoners (3097 men and 407 women) officially finished the Spartathlon at least once. Athletes from Japan were the majority with 737 participants, followed by far by runners from Germany (n = 393), Greece (n = 326), and France (n = 274). The nations with the highest numbers of athletes amongst the top five performers were Japan (n = 71), followed by Germany (n = 59), and Great Britain (n = 31). Runners from the USA were the fastest in men, and runners from Great Britain were the fastest in women. Female and male runners improved performance across the decades. The annual five fastest women and men improved their performance over time. Runners achieved their best performance earlier in life (20–29 and 30–39 years) than female runners (30–39 and 40–49 years). Runners in age group 30–39 years were the fastest for all nationalities, except for Greece. (4) Conclusions: Successful finishers in the Spartathlon improved performance in the last four decades and male runners achieved their best performance ~10 years earlier in life than female runners. Full article
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13 pages, 389 KiB  
Article
Influence of Psychological Factors on the Success of the Ultra-Trail Runner
by David Méndez-Alonso, Jose Antonio Prieto-Saborit, Jose Ramón Bahamonde and Estíbaliz Jiménez-Arberás
Int. J. Environ. Res. Public Health 2021, 18(5), 2704; https://doi.org/10.3390/ijerph18052704 - 08 Mar 2021
Cited by 14 | Viewed by 4908
Abstract
The aim of this study was to analyze the psychological variables of runners of ultra-trail mountain races and their association with athletic performance and success. The sample was made up of 356 mountain runners, 86.7% men and 13.2% women, with a mean age [...] Read more.
The aim of this study was to analyze the psychological variables of runners of ultra-trail mountain races and their association with athletic performance and success. The sample was made up of 356 mountain runners, 86.7% men and 13.2% women, with a mean age of 42.7 years and 5.7 years of experience. Using pre- and post-race questionnaires, data were collected regarding mental toughness, resilience, and passion. The performance of each runner in the race was also recorded. The results showed very high values in the psychological variables analyzed compared with other sports disciplines. Completion of the race (not withdrawing) and the elite quality of the runners were presented as the most relevant indicators in the processes of resilience, mental toughness, and obsessive passion. Differences were noted between the pre- and post-race results, suggesting that the competition itself is a means of training those psychological factors that are essential to this sports discipline. It can be concluded that psychological factors are decisive to athletic performance and race completion in mountain ultra-marathon races. Full article
12 pages, 1798 KiB  
Article
An Analysis of Participation and Performance of 2067 100-km Ultra-Marathons Worldwide
by Angelika Stöhr, Pantelis Theodoros Nikolaidis, Elias Villiger, Caio Victor Sousa, Volker Scheer, Lee Hill and Beat Knechtle
Int. J. Environ. Res. Public Health 2021, 18(2), 362; https://doi.org/10.3390/ijerph18020362 - 06 Jan 2021
Cited by 20 | Viewed by 3023
Abstract
This study aimed to analyze the number of successful finishers and the performance of the athletes in 100-km ultra-marathons worldwide. A total of 2067 100-km ultra-marathon races with 369,969 men and 69,668 women competing between 1960 and 2019 were analyzed, including the number [...] Read more.
This study aimed to analyze the number of successful finishers and the performance of the athletes in 100-km ultra-marathons worldwide. A total of 2067 100-km ultra-marathon races with 369,969 men and 69,668 women competing between 1960 and 2019 were analyzed, including the number of successful finishers, age, sex, and running speed. The results showed a strong increase in the number of running events as well as a strong increase in the number of participants in the 100-km ultra-marathons worldwide. The performance gap disappeared in athletes older than 60 years. Nevertheless, the running speed of athletes over 70 years has improved every decade. In contrast, the performance gap among the top three athletes remains persistent over all decades (F = 83.4, p < 0.001; pη2 = 0.039). The performance gap between the sexes is not significant in the youngest age groups (20–29 years) and the oldest age groups (>90 years) among recreational athletes and among top-three athletes over 70 years. In summary, especially for older athletes, a 100-km ultra-marathon competition shows an increasing number of opponents and a stronger performance challenge. This will certainly be of interest for coaches and athletes in the future, both from a scientific and sporting point of view. Full article
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11 pages, 1737 KiB  
Article
Even Pacing Is Associated with Faster Finishing Times in Ultramarathon Distance Trail Running—The “Ultra-Trail du Mont Blanc” 2008–2019
by Daniel Suter, Caio Victor Sousa, Lee Hill, Volker Scheer, Pantelis Theo Nikolaidis and Beat Knechtle
Int. J. Environ. Res. Public Health 2020, 17(19), 7074; https://doi.org/10.3390/ijerph17197074 - 27 Sep 2020
Cited by 13 | Viewed by 3083
Abstract
In recent years, there has been an increasing number of investigations analyzing the effects of sex, performance level, and age on pacing in various running disciplines. However, little is known about the impact of those factors on pacing strategies in ultramarathon trail running. [...] Read more.
In recent years, there has been an increasing number of investigations analyzing the effects of sex, performance level, and age on pacing in various running disciplines. However, little is known about the impact of those factors on pacing strategies in ultramarathon trail running. This study investigated the effects of age, sex, and performance level on pacing in the UTMB® (Ultra-trail du Mont Blanc) and aimed to verify previous findings obtained in the research on other running disciplines and other ultramarathon races. Data from the UTMB® from 2008 to 2019 for 13,829 race results (12,681 men and 1148 women) were analyzed. A general linear model (two-way analysis of variance (ANOVA)) was applied to identify a sex, age group, and interaction effect in pace average and pace variation. A univariate model (one-way ANOVA) was used to identify a sex effect for age, pace average, and pace variation for the fastest men and women. In our study, pace average and a steadier pace were positively correlated. Even pacing throughout the UTMB® correlated with faster finishing times. The average pace depended significantly on sex and age group. When considering the top five athletes in each age group, sex and age group also had significant effects on pace variation. The fastest women were older than the fastest men, and the fastest men were faster than the fastest women. Women had a higher pace variation than men. In male competitors, younger age may be advantageous for a successful finish of the UTMB®. Faster male runners seemed to be younger in ultramarathon trail running with large changes in altitude when compared to other distances and terrains. Full article
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11 pages, 312 KiB  
Article
Myocardial Injury and Overload among Amateur Marathoners as Indicated by Changes in Concentrations of Cardiovascular Biomarkers
by Anna Maria Kaleta-Duss, Zuzanna Lewicka-Potocka, Alicja Dąbrowska-Kugacka, Grzegorz Raczak and Ewa Lewicka
Int. J. Environ. Res. Public Health 2020, 17(17), 6191; https://doi.org/10.3390/ijerph17176191 - 26 Aug 2020
Cited by 13 | Viewed by 2187
Abstract
Marathons continue to grow in popularity among amateurs. However, the impact of intensive exercise on the amateur’s cardiovascular system has not yet been studied. Analysis of the influence of the marathon on kinetics of biomarkers reflecting cardiac injury and overload may bring new [...] Read more.
Marathons continue to grow in popularity among amateurs. However, the impact of intensive exercise on the amateur’s cardiovascular system has not yet been studied. Analysis of the influence of the marathon on kinetics of biomarkers reflecting cardiac injury and overload may bring new insights into this issue. We investigated the effect of running a marathon on the concentrations of high sensitivity cardiac troponin I (hs-cTnI), heart-type fatty acid binding protein (H-FABP), N-terminal proatrial natriuretic peptide (NT-proANP), B-type natriuretic peptide (BNP), growth differentiation factor 15 (GDF-15) and galectin 3 (Gal-3) in the population of male amateur runners. The study included 35 amateur marathoners and followed 3 stages: S1—two weeks prior to the marathon, S2—at the finish line and S3—two weeks after. Blood samples were collected at each stage and analyzed for biomarkers and laboratory parameters. Concentrations of all studied biomarkers were significantly higher at S2, whereas at S3 did not differ significantly compared to S1. Running a marathon by an amateur causes an acute rise in biomarkers of cardiac injury and stress. Whether repetitive bouts of intensive exercise elicit long-term adverse cardiovascular effects in amateur marathoners needs further research. Full article
14 pages, 982 KiB  
Article
Right Ventricular Diastolic Dysfunction after Marathon Run
by Zuzanna Lewicka-Potocka, Alicja Dąbrowska-Kugacka, Ewa Lewicka, Rafał Gałąska, Ludmiła Daniłowicz-Szymanowicz, Anna Faran, Izabela Nabiałek-Trojanowska, Marcin Kubik, Anna Maria Kaleta-Duss and Grzegorz Raczak
Int. J. Environ. Res. Public Health 2020, 17(15), 5336; https://doi.org/10.3390/ijerph17155336 - 24 Jul 2020
Cited by 6 | Viewed by 1926
Abstract
It has been raised that marathon running may significantly impair cardiac performance. However, the post-race diastolic function has not been extensively analyzed. We aimed to assess whether the marathon run causes impairment of the cardiac diastole, which ventricle is mostly affected and whether [...] Read more.
It has been raised that marathon running may significantly impair cardiac performance. However, the post-race diastolic function has not been extensively analyzed. We aimed to assess whether the marathon run causes impairment of the cardiac diastole, which ventricle is mostly affected and whether the septal (IVS) function is altered. The study included 34 male amateur runners, in whom echocardiography was performed two weeks before, at the finish line and two weeks after the marathon. Biventricular diastolic function was assessed not only with conventional Doppler indices but also using the heart rate-adjusted isovolumetric relaxation time (IVRTc). After the run, IVRTc elongated dramatically at the right ventricular (RV) free wall, to a lesser extent at the IVS and remained unchanged at the left ventricular lateral wall. The post-run IVRTc_IVS correlated with IVRTc_RV (r = 0.38, p < 0.05), and IVRTc_RV was longer in subjects with IVS hypertrophy (88 vs. 51 ms; p < 0.05). Participants with measurable IVRT_RV at baseline (38% of runners) had longer post-race IVRTc_IVS (102 vs. 83 ms; p < 0.05). Marathon running influenced predominantly the RV diastolic function, and subjects with measurable IVRT_RV at baseline or those with IVS hypertrophy can experience greater post-race diastolic fatigue. Full article
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11 pages, 1335 KiB  
Article
The Effect of the Ultra-Marathon Run at a Distance of 100 Kilometers on the Concentration of Selected Adipokines in Adult Men
by Anna Czajkowska, Jadwiga Ambroszkiewicz, Anna Mróz, Katarzyna Witek, Dariusz Nowicki and Łukasz Małek
Int. J. Environ. Res. Public Health 2020, 17(12), 4289; https://doi.org/10.3390/ijerph17124289 - 16 Jun 2020
Cited by 6 | Viewed by 2248
Abstract
Pro-inflammatory adipokines have a multifunctional role in adipogenesis, angiogenesis, glucose homeostasis, and inflammation. The aim of the present study is to evaluate the effect of running a 100 km ultra-marathon on serum levels of two adipokines: resistin and chemerin. Fifteen male participants complete [...] Read more.
Pro-inflammatory adipokines have a multifunctional role in adipogenesis, angiogenesis, glucose homeostasis, and inflammation. The aim of the present study is to evaluate the effect of running a 100 km ultra-marathon on serum levels of two adipokines: resistin and chemerin. Fifteen male participants complete a medical questionnaire and their body composition is assessed. Serum resistin, chemerin, high sensitivity C-reactive protein (hs-CRP), glucose, and lactate levels are measured at baseline and post-race. During-race data on fluid and food consumption and energy expenditure are calculated. There is a higher (p < 0.001) post-race concentration of resistin and hs-CRP compared with resting values, with no change in chemerin levels. There is an inverse correlation of the change in resistin levels with post-run glucose values (r = 0.742, p < 0.001) and a positive correlation between changes in hs-CRP and energy expenditure (r = 0.782, p < 0.001). The present results show the impact of running an ultra-marathon on serum levels of pro-inflammatory markers released by adipose tissue. It is difficult to establish whether these results may be due to the stress of exercise, high energy expenditure or caloric deficit. However, we suggest that an addition of resistin to traditional pro-inflammatory markers (including CRP) may improve the assessment of inflammation in conditions of high-energy expenditure. Full article
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7 pages, 294 KiB  
Article
Skinfold Thickness Distribution in Recreational Marathon Runners
by Pantelis Theodoros Nikolaidis, Thomas Rosemann and Beat Knechtle
Int. J. Environ. Res. Public Health 2020, 17(9), 2978; https://doi.org/10.3390/ijerph17092978 - 25 Apr 2020
Cited by 8 | Viewed by 3036
Abstract
The relationship of body fat (BF) percentage with performance of elite marathon runners has been well studied; however, less information is available about the variation of skinfold thickness by sex and performance in non-elite marathon runners. The aim of the present study was [...] Read more.
The relationship of body fat (BF) percentage with performance of elite marathon runners has been well studied; however, less information is available about the variation of skinfold thickness by sex and performance in non-elite marathon runners. The aim of the present study was to examine the variation of skinfold thickness by sex and performance in recreational marathon runners. Participants included 32 female (age 40.1 ± 9.0 years, BF 19.6 ± 4.7%, and training volume 47.7 ± 22.6 km) and 134 male marathon runners (44.3 ± 8.8 years, 17.6 ± 4.0%, and 53.0 ± 21.2 km, respectively). The largest skinfold thickness was the abdomen in both sexes, whereas the smallest was biceps in men, and chins in women (p < 0.001). The largest sex difference in skinfold thickness was observed in triceps being the fattest in women (p < 0.001). The largest difference in skinfold thickness among men’s performance groups was observed in the iliac crest, and the smallest in the patella and proximal calf (p < 0.001). In summary, skinfold measurements indicated that women had more fat in both their upper and lower limbs, while men had more fat in their trunk. With regards to the role of performance level, the slowest runners presented relatively more fat in the upper limbs and trunk anatomical sites, i.e., away from the active muscles of legs. Full article
13 pages, 582 KiB  
Article
The Effect of Vitamin D3 Supplementation on Hepcidin, Iron, and IL-6 Responses after a 100 km Ultra-Marathon
by Katarzyna Kasprowicz, Wojciech Ratkowski, Wojciech Wołyniec, Mariusz Kaczmarczyk, Konrad Witek, Piotr Żmijewski, Marcin Renke, Zbigniew Jastrzębski, Thomas Rosemann, Pantelis T. Nikolaidis and Beat Knechtle
Int. J. Environ. Res. Public Health 2020, 17(8), 2962; https://doi.org/10.3390/ijerph17082962 - 24 Apr 2020
Cited by 13 | Viewed by 3902
Abstract
Deficiencies in iron and vitamin D are frequently observed in athletes. Therefore, we examined whether different baseline vitamin D3 levels have any impact on post-exercise serum hepcidin, IL-6 and iron responses in ultra-marathon runners. In this randomized control trial, the subjects (20 [...] Read more.
Deficiencies in iron and vitamin D are frequently observed in athletes. Therefore, we examined whether different baseline vitamin D3 levels have any impact on post-exercise serum hepcidin, IL-6 and iron responses in ultra-marathon runners. In this randomized control trial, the subjects (20 male, amateur runners, mean age 40.75 ± 7.15 years) were divided into two groups: experimental (VD) and control (CON). The VD group received vitamin D3 (10,000 UI/day) and the CON group received a placebo for two weeks before the run. Venous blood samples were collected on three occasions—before the run, after the 100 km ultra-marathon and 12 h after the run—to measure iron metabolism indicators, hepcidin, and IL-6 concentration. After two weeks of supplementation, the intervention group demonstrated a higher level of serum 25(OH)D than the CON group (27.82 ± 5.8 ng/mL vs. 20.41 ± 4.67 ng/mL; p < 0.05). There were no differences between the groups before and after the run in the circulating hepcidin and IL-6 levels. The decrease in iron concentration immediately after the 100-km ultra-marathon was smaller in the VD group than CON (p < 0.05). These data show that various vitamin D3 status can affect the post-exercise metabolism of serum iron. Full article
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9 pages, 688 KiB  
Article
Marathon Run-induced Changes in the Erythropoietin-Erythroferrone-Hepcidin Axis are Iron Dependent
by Maja Tomczyk, Jakub Kortas, Damian Flis, Barbara Kaczorowska-Hac, Agata Grzybkowska, Andzelika Borkowska, Ewa Lewicka, Alicja Dabrowska-Kugacka and Jędrzej Antosiewicz
Int. J. Environ. Res. Public Health 2020, 17(8), 2781; https://doi.org/10.3390/ijerph17082781 - 17 Apr 2020
Cited by 10 | Viewed by 2539
Abstract
Alterations in iron metabolism after physical activity are manifested through the rise of blood hepcidin (Hpc) levels. However, in many athletes, no changes in Hpc levels are observed after exercise despite the presence of inflammation. The missing links could be erythropoietin (EPO) and [...] Read more.
Alterations in iron metabolism after physical activity are manifested through the rise of blood hepcidin (Hpc) levels. However, in many athletes, no changes in Hpc levels are observed after exercise despite the presence of inflammation. The missing links could be erythropoietin (EPO) and erythroferrone (ERFE), which down-regulate Hpc biosynthesis. EPO, ERFE and Hpc biosynthesis is modified by serum iron through transferrin receptor 2. Consequently, we investigated whether marathon-induced changes in EPO, ERFE and Hpc levels are blood iron-dependent. Twenty-nine healthy male marathon runners were analyzed. Serum iron, ferritin, transferrin, EPO, ERFE and Hpc levels were assessed before, immediately after, and 9 ± 2 days after the marathon. The runners whose serum Hpc decreased after the marathon (n = 15), showed a significant increase in ERFE levels. In athletes whose serum iron levels were below 105 µg/day (n = 15), serum EPO (p = 0.00) and ERFE levels (p = 0.00) increased with no changes in Hpc concentration. However, in athletes with low serum iron, no changes in EPO levels were observed when serum ferritin exceeded 70 ng/mL (n = 7). Conversely, an increase in ERFE levels was observed in marathoners with low serum iron, independently of serum ferritin (n = 7). This indicates modulation of blood iron may affect exercise-induced changes in the EPO/ERFE/Hpc axis. Further study is needed to fully understand the physiological meaning of the interdependence between iron and the EPO/ERFE/Hpc axis. Full article
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Review

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23 pages, 897 KiB  
Review
Predictive Performance Models in Long-Distance Runners: A Narrative Review
by José Ramón Alvero-Cruz, Elvis A. Carnero, Manuel Avelino Giráldez García, Fernando Alacid, Lorena Correas-Gómez, Thomas Rosemann, Pantelis T. Nikolaidis and Beat Knechtle
Int. J. Environ. Res. Public Health 2020, 17(21), 8289; https://doi.org/10.3390/ijerph17218289 - 09 Nov 2020
Cited by 30 | Viewed by 5991
Abstract
Physiological variables such as maximal oxygen uptake (VO2max), velocity at maximal oxygen uptake (vVO2max), running economy (RE) and changes in lactate levels are considered the main factors determining performance in long-distance races. The aim of this review [...] Read more.
Physiological variables such as maximal oxygen uptake (VO2max), velocity at maximal oxygen uptake (vVO2max), running economy (RE) and changes in lactate levels are considered the main factors determining performance in long-distance races. The aim of this review was to present the mathematical models available in the literature to estimate performance in the 5000 m, 10,000 m, half-marathon and marathon events. Eighty-eight articles were identified, selections were made based on the inclusion criteria and the full text of the articles were obtained. The articles were reviewed and categorized according to demographic, anthropometric, exercise physiology and field test variables were also included by athletic specialty. A total of 58 studies were included, from 1983 to the present, distributed in the following categories: 12 in the 5000 m, 13 in the 10,000 m, 12 in the half-marathon and 21 in the marathon. A total of 136 independent variables associated with performance in long-distance races were considered, 43.4% of which pertained to variables derived from the evaluation of aerobic metabolism, 26.5% to variables associated with training load and 20.6% to anthropometric variables, body composition and somatotype components. The most closely associated variables in the prediction models for the half and full marathon specialties were the variables obtained from the laboratory tests (VO2max, vVO2max), training variables (training pace, training load) and anthropometric variables (fat mass, skinfolds). A large gap exists in predicting time in long-distance races, based on field tests. Physiological effort assessments are almost exclusive to shorter specialties (5000 m and 10,000 m). The predictor variables of the half-marathon are mainly anthropometric, but with moderate coefficients of determination. The variables of note in the marathon category are fundamentally those associated with training and those derived from physiological evaluation and anthropometric parameters. Full article
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9 pages, 298 KiB  
Review
The Role of Nationality in Ultra-Endurance Sports: The Paradigm of Cross-Country Skiing and Long-Distance Running
by Beat Knechtle, Thomas Rosemann and Pantelis Theo Nikolaidis
Int. J. Environ. Res. Public Health 2020, 17(7), 2543; https://doi.org/10.3390/ijerph17072543 - 08 Apr 2020
Cited by 5 | Viewed by 2753
Abstract
Although the variation of performance by nationality in endurance sports such as marathon has been well studied, little information exists so far on the role of nationality on performance in ultra-endurance sports. The aim of the present study was to review the role [...] Read more.
Although the variation of performance by nationality in endurance sports such as marathon has been well studied, little information exists so far on the role of nationality on performance in ultra-endurance sports. The aim of the present study was to review the role of nationality on cross-country skiing and ultra-endurance running. Scopus and PubMed were searched using the syntax “nationality AND (ultra-endurance OR ultra-marathon OR cross-country skiing) in 1/4/2020. This search identified 17 articles, whose references were further examined for relevant literature. It was observed that Russian athletes dominated ultra-endurance running and cross-country skiing races. It was shown that these races were in other countries, where it was assumed that only the best Russians competed. Potential explanations could be misuse of performance enhancing substances, historical, climate-geographical and psychophysiological (e.g., combination of genetic and social factors). In summary, recent studies found a dominance of Russian athletes in specific races (i.e., ‘Comrades Marathon’, ‘Vasaloppet’, and ‘Engadin Ski Marathon’) and disciplines (i.e., ultra-marathon running, cross-country skiing) over a period of several decades. Future studies are need to investigate other events and other sport disciplines to confirm this Russian dominance. Full article

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24 pages, 566 KiB  
Case Report
To Be a Champion of the 24-h Ultramarathon Race. If Not the Heart ... Mosaic Theory?
by Robert Gajda, Aleksandra Samełko, Miłosz Czuba, Agnieszka Piotrowska-Nowak, Katarzyna Tońska, Cezary Żekanowski, Anna Klisiewicz, Wojciech Drygas, Anita Gębska-Kuczerowska, Jacek Gajda, Beat Knechtle and Jakub Grzegorz Adamczyk
Int. J. Environ. Res. Public Health 2021, 18(5), 2371; https://doi.org/10.3390/ijerph18052371 - 01 Mar 2021
Cited by 7 | Viewed by 3293
Abstract
This comprehensive case analysis aimed to identify the features enabling a runner to achieve championship in 24-h ultramarathon (UM) races. A 36-year-old, multiple medalist of the World Championships in 24-h running, was assessed before, one and 10 days after a 24-h run. Results [...] Read more.
This comprehensive case analysis aimed to identify the features enabling a runner to achieve championship in 24-h ultramarathon (UM) races. A 36-year-old, multiple medalist of the World Championships in 24-h running, was assessed before, one and 10 days after a 24-h run. Results of his extensive laboratory and cardiological diagnostics with transthoracic echocardiography (TTE) and a one-time cardiopulmonary exercise test (CPET) were analyzed. After 12 h of running (approximately 130 km), the athlete experienced an increasing pain in the right knee. His baseline clinical data were within the normal range. High physical efficiency in CPET (VO2max 63 mL/kg/min) was similar to the average achieved by other ultramarathoners who had significantly worse results. Thus, we also performed genetic tests and assessed his psychological profile, body composition, and markers of physical and mental stress (serotonin, cortisol, epinephrine, prolactin, testosterone, and luteinizing hormone). The athlete had a mtDNA haplogroup H (HV0a1 subgroup, belonging to the HV cluster), characteristic of athletes with the highest endurance. Psychological studies have shown high and very high intensity of the properties of individual scales of the tools used mental resilience (62–100% depending on the scale), openness to experience (10th sten), coherence (10th sten), positive perfectionism (100%) and overall hope for success score (10th sten). The athlete himself considers the commitment and mental support of his team to be a significant factor of his success. Body composition assessment (%fat 13.9) and the level of stress markers were unremarkable. The tested athlete showed a number of features of the champions of ultramarathon runs, such as: inborn predispositions, mental traits, level of training, and resistance to pain. However, none of these features are reserved exclusively for “champions”. Team support’s participation cannot be underestimated. The factors that guarantee the success of this elite 24-h UM runner go far beyond physiological and psychological explanations. Further studies are needed to identify individual elements of the putative “mosaic theory of being a champion”. Full article
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17 pages, 1185 KiB  
Case Report
Physiological Responses and Nutritional Intake during a 7-Day Treadmill Running World Record
by Nicolas Berger, Daniel Cooley, Michael Graham, Claire Harrison and Russ Best
Int. J. Environ. Res. Public Health 2020, 17(16), 5962; https://doi.org/10.3390/ijerph17165962 - 17 Aug 2020
Cited by 7 | Viewed by 3673
Abstract
Ultra-running comprises running events longer than a marathon (>42.2 km). The prolonged duration of ultra-running leads to decrements in most or all physiological parameters and considerable energy expenditure (EE) and energy deficits. SG, 47 years, 162.5 cm, 49 kg, VO2max 4 mL/kg/min [...] Read more.
Ultra-running comprises running events longer than a marathon (>42.2 km). The prolonged duration of ultra-running leads to decrements in most or all physiological parameters and considerable energy expenditure (EE) and energy deficits. SG, 47 years, 162.5 cm, 49 kg, VO2max 4 mL/kg/min−1/2.37 L/min−1, ran continuously for 7 days on a treadmill in 3 h blocks followed by 30 min breaks and slept from 1–5 a.m. Heart rate (HR) oxygen uptake (VO2), rating of perceived exertion, weight, blood lactate (mmol·L−1), haemoglobin (g·dL), haematocrit (%) and glucose (mmol·L−1), and nutrition and hydration were recorded. SG ran for 17.5 h/day, covering ~120 km/day at ~7 km/h. Energy expenditure for each 24 h period was 6878 kcal/day and energy intake (EI) was 2701 kcal/day. EE was 382 kcal/h, with 66.6% from fat and 33.4% from carbohydrate oxidation. 7 day EI was 26,989 kcal and EE was 48,147 kcal, with a total energy deficit (ED) of 21,158 kcal. Average VO2 was 1.2 L·min−1/24.7 mL·kg·min−1, Respriatory echange ratio (RER) 0.80 ± 0.03, HR 120–125 b·min−1. Weight increased from 48.6 to 49.5 kg. Haemoglobin decreased from 13.7 to 11 g·dL and haematocrit decreased from 40% to 33%. SG ran 833.05 km. SG exhibits an enhanced fat metabolism through which she had a large daily ED. Her success can be attributed to a combination of physiological and psychological factors. Full article
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11 pages, 6681 KiB  
Case Report
Right Knee—The Weakest Point of the Best Ultramarathon Runners of the World? A Case Study
by Robert Gajda, Paweł Walasek and Maciej Jarmuszewski
Int. J. Environ. Res. Public Health 2020, 17(16), 5955; https://doi.org/10.3390/ijerph17165955 - 17 Aug 2020
Cited by 11 | Viewed by 2386
Abstract
The impact of ultramarathons (UM) on the organs, especially in professional athletes, is poorly understood. We tested a 36-year-old UM male runner before and after winning a 24-h marathon. The primary goal of the study was cardiovascular assessment. The athlete experienced right knee [...] Read more.
The impact of ultramarathons (UM) on the organs, especially in professional athletes, is poorly understood. We tested a 36-year-old UM male runner before and after winning a 24-h marathon. The primary goal of the study was cardiovascular assessment. The athlete experienced right knee pain for the first time after 12 h of running (approximately 130 km), which intensified, affecting his performance. The competitors ran on a 1984 m rectangle-loop (950 × 42 m) in an atypical clockwise fashion. The winner completed 516 rectangular corners. Right knee Magnetic Resonance Imaging (MRI) one day after the run showed general overload in addition to degenerative as well as specific features associated with “turning to the right”. Re-examination after three years revealed none of these findings. Different kinds of overloading of the right lower limb, including right knee pain, were indicated in 6 of 10 competitors from the top 20, including a woman who set the world record. The affected competitors suggested as cause for discomfort the shape of the loop and running direction. They believed that changing the direction of the run during the competition and an athletics stadium loop shape on a 2000–2500 m length is better for 24-h UM runners. In the absence of technical alternatives, the “necessary evil” is a counterclockwise run (also Association of Athletics Federations IAAF recommendation). Results suggest that a one-way, clockwise, 24-h UM run had an adverse effect on the athlete’s right knee, as a result of unsymmetrical load. Organizers of 24-h UM runs should consider the shape of the competition loop and apply the principle of uniform load on the musculoskeletal system (alternate directions run). In case of technical impossibility, it would be better to run counterclockwise, which is more common, preferred by runners, and recommended by the IAAF. Full article
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