Fluid retention, muscle damage, and altered body composition at the Ultraman triathlon

Glycaemic Effects of a 156-km Ultra-trail Race in Athletes: An Observational Field Study

BACKGROUND

Ultra-trail running races pose appreciable physiological challenges, particularly for glucose metabolism. Previous studies that yielded divergent results only measured glycaemia at isolated times.

OBJECTIVES

We aimed to explore the impact of an ultra-endurance race on continuously measured glycaemia and to understand potential physiological mechanisms, as well as the consequences for performance and behavioural alertness.

METHODS

Fifty-five athletes (78% men, 43.7 ± 9.6 years) ran a 156-km ultra-trail race (six 26-km laps, total elevation 6000 m). Participants wore a masked continuous glucose monitoring sensor from the day before the race until 10 days post-race. Blood was taken at rest, during refuelling stops after each lap, and after 24-h recovery. Running intensity (% heart rate reserve), performance (lap times), psychological stress, and behavioural alertness were explored. Linear mixed models and logistic regressions were carried out.

RESULTS

No higher risk of hypo- or hyperglycaemia was observed during the exercise phases of the race (i.e. excluding stops for scientific measurements and refuelling) compared with resting values. Laps comprising a greater proportion of time spent at maximal aerobic intensity were nevertheless associated with more time > 180 mg/dL (P = 0.021). A major risk of hyperglycaemia appeared during the 48-h post-race period compared with pre-race (P < 0.05), with 31.9% of the participants spending time with values > 180 mg/dL during recovery versus 5.5% during resting. Changes in circulating insulin, cortisol, and free fatty acids followed profiles comparable with those usually observed during traditional aerobic exercise. However, creatine phosphokinase, and to a lesser extent lactate dehydrogenase, increased exponentially during the race (P < 0.001) and remained high at 24-h post-race (P < 0.001; respectively 43.6 and 1.8 times higher vs. resting). Glycaemic metrics did not influence physical performance or behavioural alertness.

CONCLUSION

Ultra-endurance athletes were exposed to hyperglycaemia during the 48-h post-race period, possibly linked to muscle damage and inflammation. Strategies to mitigate muscle damage or subsequent inflammation before or after ultra-trail races could limit recovery hyperglycaemia and hence its related adverse health consequences.

TRIAL REGISTRATION NUMBER

NCT05538442 2022-09-21 retrospectively registered.

100 Long-Distance Triathlons in 100 Days: A Case Study on Ultraendurance, Biomarkers, and Physiological Outcomes

The physical demands of a single long-distance triathlon (LDT) are sufficient to cause robust physiological perturbations. In this unique case study, an ultraendurance athlete completed 100 LDTs in 100 days (100LDT).

PURPOSE

This study aims to describe and analyze this single athlete's performance, physiological biomarkers, and sleep parameters throughout the 100LDT.

METHODS

An ultraendurance athlete completed an LDT (2.4-mile swim, 112-mile bike ride, and 26.2-mile marathon) each day for 100 consecutive days. Physical work, physiological biomarkers, and sleep parameters were recorded each night using a wrist-worn photoplethysmographic sensor. Clinical exercise tests were performed before and after the 100LDT. Time-series analysis assessed changes in biomarkers and sleep parameters across the 100LDT, and cross-correlations considered the associations between exercise performance and physiological metrics at varying time lags.

RESULTS

The swim and cycling performances varied across the 100LDT, while the run was relatively stable. Resting heart rate, heart-rate variability, oxygen saturation, sleep score, light sleep, sleep efficiency, and sleep duration were all best characterized by cubic models. Additional post hoc subanalyses suggest that the first half of the 100LDT most influenced these dynamics.

CONCLUSIONS

The 100LDT resulted in nonlinear alterations to physiological metrics. This world record was a unique event but allows valuable insights into the limits of human endurance performance.

Long-Term Combined Effects of Citrulline and Nitrate-Rich Beetroot Extract Supplementation on Recovery Status in Trained Male Triathletes: A Randomized, Double-Blind, Placebo-Controlled Trial

Citrulline (CIT) and nitrate-rich beetroot extract (BR) are widely studied ergogenic aids. Nevertheless, both supplements have been studied in short-term trials and separately. To the best of the authors' knowledge, the effects of combining CIT and BR supplementation on recovery status observed by distance covered in the Cooper test, exercise-induced muscle damage (EIMD) and anabolic/catabolic hormone status have not been investigated to date. Therefore, the main purpose of this research was to assess the effect of the long-term (9 weeks) mixture of 3 g/day of CIT plus 2.1 g/day of BR (300 mg/day of nitrates (NO3-)) supplementation on recovery by distance covered in the Cooper test, EIMD markers (urea, creatinine, AST, ALT, GGT, LDH and CK) and anabolic/catabolic hormones (testosterone, cortisol and testosterone/cortisol ratio (T/C)) in male trained triathletes. Thirty-two triathletes were randomized into four different groups of eight triathletes in this double-blind, placebo-controlled trial: placebo group (PLG), CIT group (CITG; 3 g/day of CIT), BR group (BRG; 2.1 g/day of BR (300 mg/day of NO3-)) and CIT-BR group (CIT-BRG; 3 g/day of CIT plus 2.1 g/day of BR (300 mg/day of NO3-)). Distance covered in the Cooper test and blood samples were collected from all participants at baseline (T1) and after 9 weeks of supplementation (T2). There were no significant differences in the interaction between group and time in EIMD markers (urea, creatinine, AST, ALT, GGT, LDH and CK) (p > 0.05). However, significant differences were observed in the group-by-time interaction in distance covered in the Cooper test (p = 0.002; η2p = 0.418), cortisol (p = 0.044; η2p = 0.247) and T/C (p = 0.005; η2p = 0.359). Concretely, significant differences were observed in distance covered in the Cooper test percentage of change (p = 0.002; η2p = 0.418) between CIT-BRG and PLG and CITG, in cortisol percentage change (p = 0.049; η2p = 0.257) and in T/C percentage change (p = 0.018; η2p = 0.297) between CIT-BRG and PLG. In conclusion, the combination of 3 g/day of CIT plus 2.1 g/day of BR (300 mg/day of NO3-) supplementation for 9 weeks did not present any benefit for EIMD. However, CIT + BR improved recovery status by preventing an increase in cortisol and showing an increase in distance covered in the Cooper test and T/C.

Consistency Is Key When Setting a New World Record for Running 10 Marathons in 10 Days

Background: We describe the requirements and physiological changes when running 10 consecutive marathons in 10 days at the same consistent pace by a female ultra-endurance athlete. Methods: Sharon Gayter (SG) 54 yrs, 162.5 cm, 49.3 kg maximal oxygen uptake (VO₂ max) 53 mL/kg⁻¹/min⁻¹. SG completed 42.195 km on a treadmill every day for 10 days. We measured heart rate (HR), Rating of Perceived Exertion (RPE), oxygen uptake (VO₂), weight, body composition, blood parameters, nutrition, and hydration. Results: SG broke the previous record by ~2.5 h, with a cumulative completion time of 43 h 51 min 39 s. Over the 10 days, weight decreased from 51 kg to 48.4 kg, bodyfat mass from 9.1 kg to 7.2 kg (17.9% to 14.8%), and muscle mass from 23.2 kg to 22.8 kg. For all marathons combined, exercise intensity was ~60% VO₂ max; VO₂ 1.6 ± 0.1 L.min⁻¹/32.3 ± 1.1 mL.kg⁻¹.min⁻¹, RER 0.8 ± 0, HR 143 ± 4 b.min⁻¹. Energy expenditure (EE) was 2030 ± 82 kcal/marathon, total EE for 10 days (including BMR) was 33,056 kcal, daily energy intake (EI) 2036 ± 418 kcal (20,356 kcal total), resulting an energy deficit (ED) of 12,700 kcal. Discussion: Performance and pacing were highly consistent across all 10 marathons without any substantial physiological decrements. Although overall EI did not match EE, leading to a significant ED, resulting in a 2.6 kg weight loss and decreases in bodyfat and skeletal muscle mass, this did not affect performance.

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.

Cortical and Subcortical Brain Volume Alterations Following Endurance Running at 38.6 km and 119.2 km in Male Athletes

BACKGROUND Although several studies have shown that ultramarathon running causes severe physical and mental stress and harms organ systems, its effect on brain tissue remains unclear. The purpose of this study was to investigate the volumetric change of cortical and subcortical brain structures following 38.6-km and 119.8-km mountain races. MATERIAL AND METHODS A total of 23 healthy male runners (age, 49.05±5.99 years) were classified as short-trail (ST; n=9) and ultra-trail (UT; n=14) endurance running. Pre- and post-test scanning of brain tissue was performed by using a 3-Tesla magnetic resonance imaging (MRI). Pre- and post-race differences in cortical and subcortical volumes in the ST and UT groups were separately determined by Wilcoxon signed-rank test. RESULTS Cortical gray matter (GM) and cerebral GM volume significantly increased after the race in both ST and UT groups, whereas the volume of the thalamus, caudate, pallidus, and hippocampus significantly increased only in the UT group. Cerebrospinal fluid (CSF) and white-matter (WM) volumes did not change after endurance running and remained unaltered in both groups. CONCLUSIONS Endurance running has a site-specific acute effect on cortical and subcortical structures and may attenuate GM volume decrease in older adult male athletes. The increased volume of subcortical structures might be a response of physical exercise and additional physical stress experienced by ultramarathon runners.

Physiological Changes, Activity, and Stress During a 100-km-24-h Walking-March

Background

Long-endurance exercises like ultramarathons are known to elicit various metabolic and physiological changes in the human body. However, little is known about very long-duration exercise at low intensities regarding healthy human subjects.

Aim

The purpose of this study was to evaluate changes in body composition and metabolism in long-endurance but low-intensity events.

Methods

Twenty-five male and 18 female healthy recreational athletes (age 34.6 ± 8.8 years; BMI: 22.4 ± 2.0 kg/m²) of the "100 km Mammutmarsch" were recruited for participation during the events in 2014-2016. Other than classical ultramarathons, the "Mammutmarsch" is a hiking event, in which participants were required to walk but not run or jog. It was expected to complete the 100-km distance within 24 h, resulting in a calculated mean speed of 4.17 km/h, which fits to the mean speed observed (4.12 ± 0.76 km/h). As not all participants reached the finish line, comparison of finishers (FIN, n = 11) and non-finishers (NON, n = 21) allowed differential assessment of performance. Body composition measured through bioelectrical impedance analysis (BIA) was determined pre- and post-event, and serum samples were taken pre-event, at 30, 70, and 100 km to determine NT-pro-BNP, troponin T, C-reactive protein (CRP), cortisol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, total creatine kinase (CK), CK-MB, aminotransferase (AST), ALT, and sodium levels. Nineteen participants wore actimeter armbands (SenseWear^®) to gain information about body activity and exercise intensity [metabolic equivalent of task (MET)]. Sixteen participants wore mobile heart rate monitors to assess mean heart rate during the race. Serum parameter alterations over the course of the race were analyzed with mixed-effects ANOVA and additional t-tests. All serum parameters were analyzed for correlation concerning different MET levels, speed, age, BMI, baseline NT-pro-BNP, mean heart rate during the race, and sex with linear regression analysis.

Results

We found significant elevations for muscle and cardiac stress markers (CRP, CK, CK-MB, AST, ALT, cortisol, and NT-pro-BNP) as well as decreasing markers of lipid metabolism (cholesterol, triglycerides, LDL). Although the intensity level demanded from our participants was low compared with other studies on (ultra-) marathons, the alteration of tested parameters was similar to those of high-intensity exercise, e.g., NT-pro-BNP showed a fourfold increase (p < 0.01) and LDL decreased by 20% (p = 0.05). Besides the duration of exercise, age, BMI, training status, and sex are relevant parameters that influence the elevation of stress factors. Notably, our data indicate that NT-pro-BNP might be a marker for cardiovascular fitness also in healthy adults.

Conclusion

This low-intensity long-endurance walk evoked a strong systemic reaction and large cell stress and shifted to a favorable lipid profile, comparable to higher intensity events. Despite increasing cardiac stress parameters, there were no indications of cardiac cell damage. Remarkably, the duration seems to have a greater influence on stress markers and metabolism than intensity.

The Effect of Acute Hypohydration on Indicators of Glycemic Regulation, Appetite, Metabolism and Stress: A Systematic Review and Meta-Analysis

Evidence synthesizing the effects of acute body water losses on various markers of glycemic regulation, appetite, metabolism, and stress is lacking. Thus, the purpose of this review was to summarize the response of various hormonal changes involved in these physiologic functions to dehydration. A comprehensive literature search for peer-reviewed research in the databases PubMed, Scopus, CINAHL, and SportDiscus was conducted. Studies were included if they contained samples of adults (>18 years) and experimentally induced dehydration as measured by acute body mass loss. Twenty-one articles were eligible for inclusion. Findings suggested cortisol is significantly elevated with hypohydration (standard mean difference [SMD] = 1.12, 95% CI [0.583, 1.67], p < 0.0001). Testosterone was significantly lower in studies where hypohydration was accompanied by caloric restriction (SMD= -1.04, 95% CI [-1.93, -0.14], p = 0.02), however, there were no changes in testosterone in studies examining hypohydration alone (SMD = -0.17, 95% CI [-0.51 0.16], p = 0.30). Insulin and ghrelin were unaffected by acute total body water losses. Acute hypohydration increases markers of catabolism but has a negligible effect on markers of glycemic regulation, appetite, anabolism and stress. Given the brevity of existing research, further research is needed to determine the impact of hydration on glucagon, leptin, peptide YY and the subsequent outcomes relevant to both health and performance.

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.

Body Composition Changes During a 24-h Winter Mountain Running Race Under Extremely Cold Conditions

Background: To date, no study has focused on body composition characteristics and on parameters associated with skeletal muscle damage and renal function in runners participating in a 24-h winter race held under extremely cold environmental conditions (average temperature of -14.3°C). Methods: Anthropometric characteristics, plasma urea (PU), plasma creatinine (Pcr), creatine kinase (CK), plasma volume (PV) and total body water (TBW) were assessed pre- and post-race in 20 finishers (14 men and 6 women). Results: In male runners, body mass (BM) (p = 0.003) and body fat (BF) (p = 0.001) decreased [-1.1 kg (-1.4%) and -1.1 kg (-13.4%), respectively]; skeletal muscle mass (SM) and TBW remained stable (p > 0.05). In female runners, BF decreased (p = 0.036) [-1.3 kg (-7.8%)] while BM, SM and TBW remained stable (p > 0.05). The change (Δ) in BM was not related to Δ BF; however, Δ BM was related to Δ SM [r = 0.58, p = 0.007] and Δ TBW (r = 0.59, p = 0.007). Δ SM correlated with Δ TBW (r = 0.51, p = 0.021). Moreover, Δ BF was negatively associated with Δ SM (r = -0.65, p = 0.002). PV (p < 0.001), CK (p < 0.001), Pcr (p = 0.004) and PU (p < 0.001) increased and creatinine clearance (CrCl) decreased (p = 0.002). The decrease in BM was negatively related to the increase in CK (r = -0.71, p < 0.001). Δ Pcr was positively related to Δ PU (r = 0.64, p = 0.002). The decrease in CrCl was negatively associated with the increase in both PU (r = -0.72, p < 0.001) and CK (r = -0.48, p = 0.032). Conclusion: The 24-h running race under extremely cold conditions led to a significant BF decrease, whereas SM and TBW remained stable in both males and females. Nevertheless, the increase in CK, Pcr and PU was related to the damage of SM with transient impaired renal function.

Changes in hormone levels of participants in a 622-km ultramarathon race based on distance and recovery period

BACKGROUND

Runners who participate in endurance sports such as marathons or ultramarathons have superior physical capabilities and health benefits compared to others. However, they may suffer long-term effects of the negative physiological changes during long-distance running. This study aimed to examine the effects of an ultramarathon on hormone levels, and the associated risks.

METHODS

Ten participants who completed a 622-km ultramarathon were included. Blood was collected prerace, at the 300-km mark, the 622-km mark, and on the 3rd day of recovery (RD3) and the 6th day of recovery (RD6) and analyzed for human growth hormone (HGH), cortisol, beta-endorphin, serotonin, testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) levels.

RESULTS

HGH and beta-endorphin showed the highest increase at the 300-km mark compared to prerace levels, with recovery on RD3 and RD6, respectively. LH, cortisol, and serotonin showed the highest levels of increase at the 622-km mark, with recovery on RD6 for LH, and RD3 for cortisol and serotonin. FSH showed the highest level of decrease at both 300-km and 622-km marks compared to prerace levels, with recovery on RD3. Testosterone decreased the most at the 300-km mark compared to the prerace level and this decrease was below the normal levels; however, it recovered to normal levels on RD3.

CONCLUSIONS

Hormone levels after the 622-km ultramarathon were within their normal ranges, except for testosterone. However, all the hormones recovered to prerace levels on RD3 or RD6. This study showed that running ultramarathons does not cause abnormal hormone levels.

Characteristics and Challenges of Open-Water Swimming Performance: A Review

CONTEXT

Although the popularity of open-water swimming (OWS) events has significantly increased in the last decades, specific studies regarding performance of elite or age-group athletes in these events are scarce.

PURPOSE

To analyze the existing literature on OWS.

METHODS

Relevant literature was located via computer-generated citations. During August 2016, online computer searches on PubMed and Scopus databases were conducted to locate published research.

RESULTS

The number of participants in ultraendurance swimming events has substantially increased in the last 10 y. In elite athletes there is a higher overall competitive level of women than of men. The body composition of female athletes (different percentage and distribution of fat tissue) shows several advantages (more buoyancy and less drag) in aquatic conditions that determine the small difference between males and females. The main physiological characteristics of open-water swimmers (OW swimmers) are the ability to swim at high percentage of [Formula: see text] (80-90%) for many hours. Furthermore, to sustain high velocity for many hours, endurance swimmers need a high propelling efficiency and a low energy cost.

CONCLUSION

Open-water races may be characterized by extreme environmental conditions (water temperature, tides, currents, and waves) that have an overall impact on performance, influencing tactics and pacing. Future studies are needed to study OWS in both training and competition.

Aerobic but not Resistance Exercise Can Induce Inflammatory Pathways via Toll-Like 2 and 4: a Systematic Review

BACKGROUND

Only a few studies have addressed the relationship between toll-like receptors 2 and 4 (TLR2 and TLR4) and the production of local and systemic cytokines in response to physical exercise, and they have produced conflicting results. We aimed to determine whether acute and chronic exercise outcomes are associated with changes in TLR2 and TLR4 expression and signaling and if so, the mechanisms that connect them.

METHODS

PubMed database were consulted. This systematic review selected 39 articles, 26 involving humans and 13 based on rodents.

RESULTS

In acute resistance exercise studies, 75% reported a decrease in TLR4 or TLR2 expression and 25% did not find differences. For chronic resistance exercise studies, 67% reported a reduction of expression and 33% did not find differences. Studies of both types reported reductions in pro-inflammatory cytokines. In acute aerobic exercise studies, 40% revealed a decline in the expression of the receptors, 7% reported no significant difference, 40% showed an increase, and 13% did not evaluate their expression. Fifty-eight percent of studies of chronic aerobic exercise revealed a reduction in expression, 17% did not find a difference, and 25% reported increases; they also suggested that the expression of the receptors might be correlated with that of inflammatory cytokines. In studies on combined exercise, 50% reported a decline in receptors expression and 50% did not find a difference.

CONCLUSIONS

The majority of the articles (54%) link different types of exercise to a decline in TLR4 and TLR2 expression. However, aerobic exercise may induce inflammations through its influence on these receptor pathways. Higher levels of inflammation were seen in acute sessions (40%) than regular sessions (25%).

Greater muscle damage in athletes with ACTN3 R577X (RS1815739) gene polymorphism after an ultra-endurance race: a pilot study

In this study, we aimed to investigate the influence of ACTN3 R577X gene polymorphism on muscle damage responses in athletes competing in an ultra-endurance race. Twenty moderate to well-trained ultra-runners who had entered in an official 37.1 km adventure race (22.1 km mountain biking, 10.9 km trekking, 4.1 km water trekking, 30 m rope course, and orienteering) volunteered for the study. Blood samples were collected for genotyping and analysis of muscle protein levels before and after the race. Percentage changes (pre- to post-race) of serum myoglobin [XX = 5,377% vs. RX/RR = 1,666%; P = 0.005, effect size (ES) = 1.73], creatine kinase (XX = 836.5% vs. RX/RR = 455%; P = 0.04, ES = 1.29), lactate dehydrogenase (XX = 82% vs. RX/RR = 65%; P = 0.002, ES = 1.61), and aspartate aminotransferase (XX = 148% vs. RX/RR = 75%; P = 0.02, ES = 1.77) were significantly greater for XX than RX/RR genotypes. ES analysis confirmed a large magnitude of muscle damage in XX genotype ultra-runners. Therefore, athletes with the ACTN3 577XX genotype experienced more muscle damage after an adventure race. This suggests that ultra-runners with alpha-actinin-3 deficiency may be more susceptible to rhabdomyolysis and associated health complications during ultra-endurance competitions.

Sex differences in pacing during 'Ultraman Hawaii'

Background

To date, little is known for pacing in ultra-endurance athletes competing in a non-stop event and in a multi-stage event, and especially, about pacing in a multi-stage event with different disciplines during the stages. Therefore, the aim of the present study was to examine the effect of age, sex and calendar year on triathlon performance and variation of performance by events (i.e., swimming, cycling 1, cycling 2 and running) in ‘Ultraman Hawaii’ held between 1983 and 2015.

Methods

Within each sex, participants were grouped in quartiles (i.e., Q1, Q2, Q3 and Q4) with Q1 being the fastest (i.e., lowest overall time) and Q4 the slowest (i.e., highest overall time). To compare performance among events (i.e., swimming, cycling 1, cycling 2 and running), race time in each event was converted in z score and this value was used for further analysis.

Results

A between-within subjects ANOVA showed a large sex × event (p = 0.015, η² = 0.014) and a medium performance group × event interaction (p = 0.001, η² = 0.012). No main effect of event on performance was observed (p = 0.174, η² = 0.007). With regard to the sex × event interaction, three female performance groups (i.e., Q2, Q3 and Q4) increased race time from swimming to cycling 1, whereas only one male performance group (Q4) revealed a similar trend. From cycling 1 to cycling 2, the two slower female groups (Q3 and Q4) and the slowest male group (Q4) increased raced time. In women, the fastest group decreased (i.e., improved) race time from swimming to cycling 1 and thereafter, maintained performance, whereas in men, the fastest group decreased race time till cycling 2 and increased it in the running.

Conclusion

In summary, women pace differently than men during ‘Ultraman Hawaii’ where the fastest women decreased performance on day 1 and could then maintain on day 2 and 3, whereas the fastest men worsened performance on day 1 and 2 but improved on day 3.