Endurance Training for Healthy Individuals

(ULTRA Trial)

Overseen By Neil Eves, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of British Columbia

Must not be taking: Antibiotics, Antivirals, NSAIDs, Antihistamines

Disqualifiers: Heart disease, Lung disease, Metabolic disease, Cancer, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 12 months

60 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how a year-long endurance training program affects physical and mental health in individuals new to structured exercise. Participants will either follow a personalized training routine involving swimming, cycling, and running, known as individualized, periodized endurance training for ultra-endurance triathlon, or maintain their usual lifestyle as part of a control group. The researchers aim to compare the training's impact on the body and mind against natural changes over a year. Ideal candidates for the exercise group are premenopausal individuals aged 19-39 who can swim 100 meters and currently engage in no more than two hours of structured endurance exercise weekly. As an unphased trial, this study provides a unique opportunity to contribute to understanding the holistic benefits of endurance training.

Will I have to stop taking my current medications?

The trial excludes participants who use chronic medications like antibiotics, antivirals, antimicrobials, non-steroidal anti-inflammatory drugs (NSAIDs), and antihistamines. If you are taking these regularly, you may need to stop to participate.

What prior data suggests that this endurance training is safe for healthy individuals?

Research has shown that triathlon training, even for long distances, is usually safe with proper preparation and supplies. Most injuries from this training are not serious. To stay safe, pay attention to surroundings and use cold-water baths to prevent overheating.

Some possible long-term risks exist, such as a higher chance of stroke for individuals with certain genetic traits, but these are rare. Overall, physical activity can reduce the risk of death from various causes and promote longevity.

In summary, with adequate preparation and monitoring, training for ultra-endurance triathlons is generally safe and well-tolerated. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this endurance training protocol because it offers a personalized approach to ultra-endurance triathlon preparation, which is not typically available in current standard training plans. Unlike traditional methods that often apply a one-size-fits-all strategy, this protocol uses individualized, periodized training programs delivered via an app, allowing for tailored adjustments based on each participant's progress and needs. Additionally, the integration of both endurance and supplemental strengthening exercises over a 12-month period offers a comprehensive training regimen that could optimize performance and minimize injury risk. This innovative approach provides insights into how personalized training can enhance athletic performance and adaptability in ultra-endurance sports.

What evidence suggests that individualized endurance training is effective for physiological and psychological adaptations in exercise naïve individuals?

Research shows that personalized endurance training, which participants in this trial may receive, can significantly enhance performance in activities like swimming, cycling, and running. One study found that customized training plans improve these activities compared to baseline performance. The training adapts to the type, amount, and frequency of exercise, promoting fitness over time. Previous research suggests that following a personalized endurance routine can lead to positive bodily changes, such as increased stamina and strength. Meanwhile, participants in the control arm will maintain their usual activities to evaluate natural biological changes over 12 months. ^{4 6 7 8 9}

Who Is on the Research Team?

Robert Shave, PhD

Principal Investigator

University of British Columbia

Are You a Good Fit for This Trial?

This trial is for healthy individuals who haven't done much endurance training before. They'll be part of a study that looks at how their bodies and minds adapt to a year-long triathlon training program.

Inclusion Criteria

Inclusion Criteria: Exercise Intervention Group

Aged 19-39 years

Non-smoker (quit >6 months)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Initial assessment of physiological and psychological measures before starting the intervention

1 week

1 visit (in-person)

Treatment

Participants engage in 12 months of individualized endurance-training including swimming, cycling, and running, with supplementary strengthening exercises

12 months

Weekly virtual check-ins via app

Follow-up

Participants are monitored for physiological and psychological changes post-intervention

3 months

1 visit (in-person) at 15 months

What Are the Treatments Tested in This Trial?

Interventions

• Individualized, periodized endurance training for ultra-endurance triathlon
• Time-Aligned Control

Trial Overview The study tests the effects of a personalized, year-long swimming, cycling, and running regimen on participants' physical and mental states. It includes a control group not undergoing the training for comparison.

How Is the Trial Designed?

Group I: Exercise Intervention Experimental Treatment 1 Intervention

Participants will engage in 12 months of individualized endurance-training (swimming, cycling and running) and 9 months of supplemental strengthening exercises. Exercise prescriptions will be provided to participants weekly via an app (TrainingPeaks). Sessions will vary in length from 30 min to 8 hours throughout the program.

Group II: Time-Aligned Control Active Control 1 Intervention

Participants in the control arm will continue to live their lives exactly as they would if they were not enrolled in a study to allow evaluation of natural biological changes that occur across 12-months of free-living.

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials

1,506

Recruited

2,528,000+

Published Research Related to This Trial

In a study of ultra-triathletes, personal best times in shorter races (like Double and Triple Iron) were found to be more predictive of performance in longer races (like Quintuple and Deca Iron) than the number of races completed.

The research indicates that for athletes aiming to excel in longer ultra-triathlons, focusing on improving race times in shorter events is more beneficial than simply accumulating more race finishes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The aspect of experience in ultra-triathlon races. Knechtle, B., Zingg, MA., Rosemann, T., et al.[2020]

The training of a world-class middle-/long-distance runner over a year showed an average weekly volume of 145.8 km, with different training intensity distributions (TID) observed depending on the analysis method used.

The study challenges the idea that polarized training is the best approach for endurance performance, as it only appeared in the last 6 weeks of the season when analyzed physiologically, while a pyramidal distribution was seen over longer periods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training Characteristics of a World Championship 5000-m Finalist and Multiple Continental Record Holder Over the Year Leading to a World Championship Final. Kenneally, M., Casado, A., Gomez-Ezeiza, J., et al.[2022]

In a study involving 48 well-trained endurance athletes over 9 weeks, polarized training (POL) led to the most significant improvements in endurance performance, including a 11.7% increase in peak oxygen uptake (VO2peak) and a 17.4% increase in time to exhaustion.

High-intensity interval training (HIIT) also showed benefits, particularly in reducing body mass by 3.7%, but traditional high-volume training (HVT) and threshold training (THR) did not yield further enhancements in endurance performance metrics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Polarized training has greater impact on key endurance variables than threshold, high intensity, or high volume training. Stöggl, T., Sperlich, B.[2021]

In a study of 5 elite male triathletes during 7 international races, the average power output during the cycling section of Olympic-distance triathlons was found to be 252 W, with significant variability in power output, indicating a demanding cycling profile.

The analysis revealed that triathletes experienced frequent peaks in power output, with 34 peaks above 600 W and approximately 18% of the time spent exerting more than 100% of their maximal aerobic power, suggesting that the cycling segment involves intense and variable efforts rather than steady-state cycling.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Variability in power output during cycling in international Olympic-distance triathlon. Etxebarria, N., D'Auria, S., Anson, JM., et al.[2014]

In the 'Ironman Hawaii' competition, transition times increased for both elite men and women, indicating a trend towards slower transitions in this more challenging race compared to previous years.

In contrast, transition times decreased for both genders in the shorter 'Ironman 70.3' event, suggesting that athletes are becoming more efficient in transitions at shorter distances.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changes in transition times in 'Ironman Hawaii' between 1998 and 2013. Rüst, CA., Rosemann, T., Lepers, R., et al.[2020]

In a study of 73 ultra-triathletes, it was found that swimming contributed less to overall performance compared to cycling and running, highlighting the importance of running in shorter ultra-triathlons (2IMT and 3IMT).

The performance in 2IMT and 3IMT events was significantly correlated with the performance in the longer 10IMT event, allowing for a predictive equation to estimate 10IMT race times based on 3IMT results.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Analysis of ultra-triathlon performances. Lepers, R., Knechtle, B., Knechtle, P., et al.[2021]

Participants in a longer ultra-endurance cycling race demonstrated higher training intensity compared to those in a shorter race, indicating that different race demands require distinct training strategies.

The study highlights the need for future research to explore personality and motivation differences among ultra-endurance athletes, which could further explain their performance and training adaptations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A comparison of ultra-endurance cyclists in a qualifying ultra-cycling race for Paris-Brest-Paris and Race Across America-Swiss cycling marathon. Knechtle, B., Wirth, A., Knechtle, P., et al.[2012]

Ultra-endurance triathletes have significantly larger heart structures and better cardiovascular function compared to age-matched controls, which may enhance their cycling performance during events like Ironman races.

Cycling performance is closely linked to heart mass and stroke volume, indicating that well-conditioned athletes can maintain higher cardiac output during prolonged cycling, while factors like the preceding swim in triathlons may also influence performance outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physiological profile and predictors of cycling performance in ultra-endurance triathletes. Whyte, G., Lumley, S., George, K., et al.[2017]

In a study of 11 extreme ultra-triathletes, cycling and running split times were found to be much better predictors of overall race performance than swimming split times, highlighting the importance of cycling and running in EUT events.

Key physiological measures, specifically VO2peak during running and VT power output during cycling, were identified as the strongest predictors of performance, suggesting that training and assessment should focus on these metrics to enhance athlete performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Physiological Laboratory Tests and Neuromuscular Functions to Predict Extreme Ultratriathlon Performance. Abad, CCC., Crivói Carmo, E., Prado, DMLD., et al.[2023]

Endurance athletes typically train 10 to 13 times per week, with about 80% of their sessions at low intensity and 20% at high intensity, suggesting that a balanced approach to training intensity is key for performance.

Studies indicate that increasing high-intensity interval training in already well-trained athletes does not lead to significant long-term performance improvements, highlighting the effectiveness of a low-intensity, high-volume training strategy for optimizing fitness adaptations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What is best practice for training intensity and duration distribution in endurance athletes? Seiler, S.[2022]

An ultraendurance athlete completed 100 long-distance triathlons in 100 days, revealing significant physiological changes, particularly in heart rate, sleep quality, and oxygen saturation, which were best described by cubic models over time.

The study found that while swimming and cycling performances fluctuated, running performance remained stable, indicating that the first half of the 100LDT had a greater impact on the athlete's physiological responses and overall endurance limits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

100 Long-Distance Triathlons in 100 Days: A Case Study on Ultraendurance, Biomarkers, and Physiological Outcomes. Anderson, T., van Mourik, RA., Martin, KJ., et al.[2023]

Triathlon is generally safe for well-prepared athletes, with most injuries being non-serious, but the recurrence of these injuries is high and not well-documented, leading to unclear outcomes.

The sudden death rate during competition is 1.5 per 100,000 participants, primarily related to swimming, while the long-term stroke risk during training remains uncertain, highlighting the need for more research on the health impacts of triathlon training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of triathlon training and racing on athletes' general health. Vleck, V., Millet, GP., Alves, FB.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9473708/

Individualized Endurance Training Based on Recovery and ... The main findings of the study were that the predefined and individualized training protocols improved endurance performance from the baseline in the ...

2. withpower.com withpower.com/trial/phase-healthy-subjects-hs-5-2024-f2547

Endurance Training for Healthy Individuals (ULTRA Trial) The purpose of this study is to investigate the effect of 12-months of individualized endurance-training (swimming, cycling and running) on physiological ...

3. researchgate.net researchgate.net/publication/43501252_Expertise_in_Ultra-Endurance_Triathletes_Early_Sport_Involvement_Training_Structure_and_the_Theory_of_Deliberate_Practice

(PDF) Expertise in Ultra-Endurance Triathletes Early Sport ... The purpose of this paper was to examine the quantity and type of training performed by expert UE triathletes.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6571715/

Training and Competition Readiness in Triathlon - PMC Endurance training adaptations are dependent on the mode of exercise, the volume, intensity, and frequency of the contractile stimuli [23].

5. bmcsportsscimedrehabil.biomedcentral.com bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-019-0153-5

Futureproofing triathlon: expert suggestions to improve health ... This has led some authors to conclude that triathlon training leads to negative health outcomes ... training and competition of endurance ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7099231/

The Impact of Triathlon Training and Racing on Athletes ... The data thus far collected indicate that the sport of triathlon is relatively safe for the well-prepared, well-supplied athlete.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8450723/

Potential Long-Term Health Problems Associated with ... It is well established that physical activity reduces all-cause mortality and can prolong life. Ultra-endurance running (UER) is an extreme ...

8. acsm.org acsm.org/ultra-endurance-safety/

Safety in Ultra-Endurance Racing Important aspects of best practices guidelines for ultra-endurance racing often include active environmental monitoring, cold-water immersion tubs and ...

9. researchgate.net researchgate.net/publication/266525346_The_Impact_of_Triathlon_Training_and_Racing_on_Athletes'_General_Health

The Impact of Triathlon Training and Racing on Athletes' ... The sudden death rate is unknown for training, although stroke risk may be increased, in the long-term, in genetically susceptible athletes.