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Knechtle B, Valero D, Villiger E, Thuany M, Cuk I, Forte P, Andrade MS, Nikolaidis PT, Rosemann T, Weiss K. Cycling and Running are More Predictive of Overall Race Finish Time than Swimming in IRONMAN ® Age Group Triathletes. SPORTS MEDICINE - OPEN 2025; 11:30. [PMID: 40153133 PMCID: PMC11953511 DOI: 10.1186/s40798-025-00835-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 03/14/2025] [Indexed: 03/30/2025]
Abstract
BACKGROUND Several studies have evaluated the most predictive discipline (swimming, cycling, and running) of performance in elite IRONMAN® triathletes. However, no study has ever determined the most decisive discipline for IRONMAN® age group triathletes. The present study analyzed the importance of the three disciplines on the overall race times in IRONMAN® age group triathletes, in order to try and determine the most predictive discipline in IRONMAN® for age group triathletes, and whether the importance of the split disciplines changes with increasing age. METHODS This cross-sectional study used 687,696 IRONMAN® age group triathletes race records (553,608 from males and 134,088 from females). Age group athletes were divided in 5-year age groups (i.e., 18-24, 25-29, 30-34,…,70-74, and last 75 + years). The relationships between split disciplines (i.e., swimming, cycling, and running) and overall race times were evaluated using Spearman and Pearson correlations. A multi-linear regression model was used to calculate their prediction strength. RESULTS The overall finish time correlated more with cycling and running times than with swimming times for both male and female IRONMAN® age group triathletes (r = 0.88 and r = 0.89 for females; r = 0.89 and r = 0.90 for males, respectively). All correlation coefficients decreased with increasing age, which was more noticeable for the swimming discipline. CONCLUSIONS Both cycling and running are more predictive than swimming in IRONMAN® age group triathletes, where the correlation between the overall race times and the split times decreased with increasing age more in swimming than in cycling and running. These insights are useful for IRONMAN® age group triathletes and their coaches in planning their IRONMAN® race preparation and concentrating training on the more predictive disciplines.
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Affiliation(s)
- Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, Vadianstrasse 26, St. Gallen, 9001, Switzerland.
- Institute of Primary Care, University of Zurich, Zurich, Switzerland.
| | - David Valero
- Ultra Sports Science Foundation, Pierre-Benite, France
| | - Elias Villiger
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Mabliny Thuany
- Department of Physical Education, State University of Para, Pará, Brazil
| | - Ivan Cuk
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade, Serbia
| | - Pedro Forte
- CI-ISCE, Higher Institute of Educational Sciences of the Douro, Penafiel, Portugal
- Instituto Politécnico de Bragança, Bragança, Portugal
- Research Center in Sports, Health and Human Development, Covilhã, Portugal
| | | | | | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
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Knechtle B, Valero D, Villiger E, Thuany M, Andrade MS, Cuk I, Nikolaidis PT, Rosemann T, Weiss K. Sex difference in IRONMAN age group triathletes. PLoS One 2024; 19:e0311202. [PMID: 39374257 PMCID: PMC11458036 DOI: 10.1371/journal.pone.0311202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 09/15/2024] [Indexed: 10/09/2024] Open
Abstract
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.
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Affiliation(s)
- Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - David Valero
- Ultra Sports Science Foundation, Pierre-Benite, France
| | - Elias Villiger
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Mabliny Thuany
- Department of Physical Education, State University of Para, Pará, Brazil
| | | | - Ivan Cuk
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade, Serbia
| | | | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
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Tiemeier L, Nikolaidis PT, Chlíbková D, Wilhelm M, Thuany M, Weiss K, Knechtle B. Ultra-Cycling- Past, Present, Future: A Narrative Review. SPORTS MEDICINE - OPEN 2024; 10:48. [PMID: 38679655 PMCID: PMC11056358 DOI: 10.1186/s40798-024-00715-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/06/2024] [Indexed: 05/01/2024]
Abstract
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.
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Affiliation(s)
- Lucas Tiemeier
- Centre for Rehabilitation & Sports Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | | | - Daniela Chlíbková
- Centre of Sports Activities, Brno University of Technology, 61669, Brno, Czech Republic
| | - Matthias Wilhelm
- Centre for Rehabilitation & Sports Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | | | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland.
- Medbase St. Gallen Am Vadianplatz, Vadianstrasse 26, 9001, St. Gallen, Switzerland.
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Gauckler P, Kesenheimer JS, Leierer J, Kruus M, Schreinlechner M, Theurl F, Bauer A, Denicolò S, Egger A, Seeber B, Mayer G, Kolbinger FR, Kronbichler A. Exercise-Induced Fluid Retention, Cardiac Volume Overload, and Peripheral Edema in Ultra-Distance Cyclists. Kidney Int Rep 2024; 9:152-161. [PMID: 38312776 PMCID: PMC10831365 DOI: 10.1016/j.ekir.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/03/2023] [Accepted: 10/23/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Ultracyclists expose themselves to extreme physical challenges. This study aimed to elucidate the effects of ultracycling on electrolyte and fluid balance and investigate the potential occurrence of peripheral edema. Methods A total of 4 clinical visits were performed before, during, and after a 6-day bicycle ride in 13 ultracyclists (5 female, 8 male) including serial laboratory analyses of blood and urine, bioelectrical impedance, and echocardiography. Throughout the ride, participants continuously tracked fluid intake, measured extremity circumferences daily, and self-tested urinary electrolytes using a point-of-care testing device. Portrait photos were judged by 20 physicians for occurrence of facial and eyelid edema. Results Participants covered a mean distance of 1205 km and 19,417 vertical meters. From baseline to day 6, body weight remained stable (P = 0.479); however, body composition changed with increasing total body water (TBW) (+1.98 l ± 1.37, P = 0.003) and plasma volume (+18.86 % ± 10.7, P < 0.001). A significant increase in N-terminal pro brain natriuretic peptide (NT-proBNP) (+297.99 ng/l ± 190.42, P < 0.001) until day 6 indicates concomitant cardiac volume overload. Swelling of face and eyelids peaked on day 5 (both P ≤ 0.033). On recovery, changes partly resolved. Although urinary sodium concentration showed a nadir on day 4 (-32.18 mmol/l ± 23.88, P = 0.022), plasma osmolality (+5.69 mmosmol/kg ± 5.88, P = 0.004) and copeptin (+38.28 pg/ml ± 18.90, P < 0.001) increased steadily until day 6. Conclusion Ultracycling over multiple days induces extracellular volume expansion, peripheral edema, and cardiac volume overload. Renal sodium and water retention is likely contributing to this condition.
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Affiliation(s)
- Philipp Gauckler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
| | | | - Johannes Leierer
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
| | - Maren Kruus
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
| | - Michael Schreinlechner
- Department of Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria
| | - Fabian Theurl
- Department of Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria
| | - Axel Bauer
- Department of Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria
| | - Sara Denicolò
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
| | - Alexander Egger
- Central Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital of Innsbruck, Innsbruck, Austria
| | - Beata Seeber
- Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Gert Mayer
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
| | - Fiona R. Kolbinger
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
| | - Andreas Kronbichler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
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Ryan T, Daly E, Ryan L. Exploring the Nutrition Strategies Employed by Ultra-Endurance Athletes to Alleviate Exercise-Induced Gastrointestinal Symptoms-A Systematic Review. Nutrients 2023; 15:4330. [PMID: 37892406 PMCID: PMC10610183 DOI: 10.3390/nu15204330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
(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.
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Affiliation(s)
| | | | - Lisa Ryan
- Department of Sport, Exercise and Nutrition, School of Science and Computing, Atlantic Technological University, H91 T8NW Galway, Ireland; (T.R.); (E.D.)
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Knechtle B, Valero D, Villiger E, Thuany M, Andrade MS, Nikolaidis PT, Cuk I, Weiss K. Comparing the Performance Gap Between Males and Females in the Older Age Groups in IRONMAN® 70.3: An Internet-Based Cross-Sectional Study of More Than 800,000 Race Records. SPORTS MEDICINE - OPEN 2023; 9:88. [PMID: 37733151 PMCID: PMC10514017 DOI: 10.1186/s40798-023-00636-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 09/13/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The sex difference in the three split disciplines (swimming, cycling, and running) and overall race times in triathlon races has mainly been investigated for the Olympic distance and IRONMAN® triathlon formats, but not for the half IRONMAN® distance, i.e., the IRONMAN® 70.3. The aim of the present study was to investigate the sex differences in IRONMAN® 70.3 by age group in 5-year intervals for the split disciplines of this race. Data from 823,459 records (625,393 males and 198,066 females) of all age group finishers (in 5-year intervals) competing in all official IRONMAN® 70.3 races held worldwide between 2004 and 2020 were analyzed, and sex differences by age group and split disciplines were evaluated. RESULTS Males were faster than females in all split disciplines and all age groups. The sex difference was lower in swimming than in cycling and running and less pronounced for triathletes between 20 and 50 years of age. After the age of 60 years, females were able to reduce the sex difference to males in swimming and cycling, but not in running, where the reduction in the sex difference started after the age of 70 years. The lowest sex difference was in the age group 75 + years for swimming and cycling and in the age group 30-34 years for running. Across age groups, the sex difference was U-shaped in swimming and running, with an increase after 18-24 years in swimming and after 40-44 years in running. In contrast, the sex difference decreased continuously with the increasing age for cycling. CONCLUSIONS In conclusion, the study found that the sex difference in performance decreases with age in the IRONMAN® 70.3 race distance. However, females did not outperform males at older ages. Notably, sex differences were observed across different disciplines, with swimming displaying lower differences compared to cycling and running. These findings underscore the complex interplay between age, sex, and performance in endurance sports, emphasizing the need for additional research to understand the factors influencing these differences.
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Affiliation(s)
- Beat Knechtle
- Medbase St. Gallen am Vadianplatz, Vadianstrasse 26, 9001, St. Gallen, Switzerland.
- Institute of Primary Care, University of Zurich, Zurich, Switzerland.
| | - David Valero
- Ultra Sports Science Foundation, Pierre-Benite, France
| | - Elias Villiger
- Klinik für Allgemeine Innere Medizin, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | | | | | | | - Ivan Cuk
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade, Serbia
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
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Knechtle B, Forte P, Weiss K, Cuk I, Nikolaidis PT, Sousa CV, Andrade MS, Thuany M. Biophysical characterization of the first ultra-cyclist in the world to break the 1,000 km barrier in 24-h non-stop road cycling: A case report. Front Cardiovasc Med 2022; 9:990382. [PMID: 36304551 PMCID: PMC9592711 DOI: 10.3389/fcvm.2022.990382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/09/2022] [Indexed: 11/19/2022] Open
Abstract
A plethora of factors determine elite cycling performance. Those include training characteristics, pacing strategy, aerodynamics, nutritional habits, psychological traits, physical fitness level, body mass composition, and contextual features; even the slightest changes in any of these factors can be associated with performance improvement or deterioration. The aim of the present case report is to compare the performances of the same ultra-cyclist in achieving two world records (WR) in 24 h cycling. We have analyzed and compared the distance covered and speed for each WR. The 24 h period was split into four-time intervals (0–6 h; > 6–12 h; > 12–18 h; > 18–24 h), and we compared the differences in the distance covered and speed between the two WRs. For both WRs, a strong negative correlation between distance and speed was confirmed (r = –0.85; r = –0.89, for old and new WR, respectively). Differences in speed (km/h) were shown between the two WRs, with the most significant differences in 12–18 h (Δ = 6.50 km/h). For the covered distance in each block, the most significant differences were observed in the last part of the cycling (Δ = 38.54 km). The cyclist effective surface area (ACd) was 0.25 m2 less and 20% more drag in the new WR. Additionally, the mechanical power was 8%, the power to overcome drag was 31%, and the power-weight ratio was 8% higher in the new WR. The mechanical efficiency of the cyclist was 1% higher in the new WR. Finally, the heart rate (HR) presented significant differences for the first 6 h (Old WR: 145.80 ± 5.88 bpm; New WR: 139.45 ± 5.82 bpm) and between the 12 and 18 h time interval (Old WR: 133.19 ± 3.53 bpm; New WR: 137.63 ± 2.80 bpm). The marginal gains concept can explain the performance improvement in the new WR, given that the athlete made some improvements in technical specifications after the old WR.
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Affiliation(s)
- Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland,Institute of Primary Care, University of Zurich, Zurich, Switzerland,*Correspondence: Beat Knechtle,
| | - Pedro Forte
- Higher Institute of Educational Sciences of the Douro, Penafiel, Portugal,Instituto Politécnico de Bragança, Bragança, Portugal,Research Center in Sports, Health and Human Development, Covilhã, Portugal
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Ivan Cuk
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade, Serbia
| | | | - Caio Victor Sousa
- Health and Human Sciences, Loyola Marymount University, Los Angeles, CA, United States
| | - Marilia Santos Andrade
- Departamento de Fisiologia, Disciplina de Neurofisiologia e Fisiologia do Exercício, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mabliny Thuany
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
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