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

Trial Summary

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 data supports the effectiveness of the treatment Individualized, periodized endurance training for ultra-endurance triathlon?

Research suggests that successful endurance training involves a mix of low-intensity and high-intensity workouts, with most sessions being low-intensity. This approach helps optimize performance and manage stress, which is important for ultra-endurance events like triathlons. ^{1 2 3 4 5}

Is endurance training for ultra-endurance triathlons safe for healthy individuals?

The sport of triathlon, including ultra-endurance training, is generally safe for well-prepared and well-supplied athletes. Most injuries are not serious, but there is a small risk of sudden death during competition, mostly related to swimming. Heavy training may temporarily weaken the immune system, and more research is needed to understand long-term health effects. ^{3 6 7 8 9}

How does individualized, periodized endurance training for ultra-endurance triathlon differ from other treatments?

This treatment is unique because it tailors endurance training specifically to the individual's needs and adjusts the training intensity and volume over time (periodization) to optimize performance in ultra-endurance triathlons. Unlike standard endurance training methods, it focuses on personalized and strategic planning to enhance key endurance variables, which can lead to better performance outcomes. ^{3 9 10 11 12}

What is the purpose of this trial?

The purpose of this study is to investigate the effect of 12-months of individualized endurance-training (swimming, cycling and running) on physiological and psychological adaptations in exercise naïve individuals. Due to the potential seasonal changes that naturally occur in individuals across a year (even without training) the investigators will also compare the exercise-trained group to a time-aligned control group.

Research Team

Robert Shave, PhD

Principal Investigator

University of British Columbia

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

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]

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 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 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]

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]

References

1. United States 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. [2012]

2. Switzerland pubmed.ncbi.nlm.nih.gov

The aspect of experience in ultra-triathlon races. [2020]

3. United States pubmed.ncbi.nlm.nih.gov

100 Long-Distance Triathlons in 100 Days: A Case Study on Ultraendurance, Biomarkers, and Physiological Outcomes. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

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

5. United States 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. [2022]

6. New Zealand pubmed.ncbi.nlm.nih.gov

The impact of triathlon training and racing on athletes' general health. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Variability in power output during cycling in international Olympic-distance triathlon. [2014]

8. England pubmed.ncbi.nlm.nih.gov

Changes in transition times in 'Ironman Hawaii' between 1998 and 2013. [2020]

9. Italy pubmed.ncbi.nlm.nih.gov

Physiological profile and predictors of cycling performance in ultra-endurance triathletes. [2017]

10. Switzerland pubmed.ncbi.nlm.nih.gov

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

11. United States pubmed.ncbi.nlm.nih.gov

Using Physiological Laboratory Tests and Neuromuscular Functions to Predict Extreme Ultratriathlon Performance. [2023]

12. New Zealand pubmed.ncbi.nlm.nih.gov

Analysis of ultra-triathlon performances. [2021]