Women are slower than men, but the sex difference in performance decreased in recent years to ~10–20% depending upon the length of the ultra-marathon. Previous experience (e.g., number of finishes in ultra-marathon races and personal best marathon time) is the most important predictor variable for a successful ultra-marathon performance followed by specific anthropometric (e.g., low body mass index, BMI, and low body fat) and training (e.g., high volume and running speed during training) characteristics. Ultra-marathoners are older and have a larger weekly training volume, but run more slowly during training compared to marathoners. Female ultra-marathoners account for ~20% of the total number of finishers. A typical ultra-marathoner is male, married, well-educated, and ~45 years old. The number of ultra-marathon races and the number of official finishers considerably increased in the last decades especially due to the increased number of female and age-group runners. In this overview, we summarize the findings of the literature with regards to physiology and pathophysiology of ultra-marathon running.
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