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Table 6 Chronic health issues/lifestyle factors

From: Is There Evidence for the Development of Sex-Specific Guidelines for Ultramarathon Coaches and Athletes? A Systematic Review

Study

Participants

Measures

Design

Evidence quality

Major findings

Boldt et al.[48]

281 athletes (159 females aged 37.7 ± 10.5 years, and 122 males aged 42.8 ± 11.1 years) including a 10 km control group, 103 half marathoners and 70 marathon/ultramarathon runners

Health survey

Cross-sectional

Low

Higher rates of hypothyroidism in females (X2 = 8.515, p = 0.014, φc = 0.174). Females more likely to take supplements prescribed by a doctor (X2 = 8.554, p = 0.014, φc = 0.174). Males more likely to report weight loss resulting from running (X2 = 9.444, p = 0.024, φc = 0.183),

Tokudome

et al.[50]

180 athletes (36 females aged 48.9 ± 6.9 years, and 144 males aged 50.5 ± 9.4 years) entered in a 2 day ultramarathon

Health survey,

blood indices,

BMI

Cross-sectional

Low

Training volume was negatively correlated with ferritin in both sexes. Female runners were more likely to report daily bowel motion than the general population (96.5%, 95% CI 92–100%; vs 70.5%, 95% CI 68.4–72.5%)

Martin et al.[49]

636 athletes (95 females and 541 males). From Italy, France and United States

Sleep survey

Cross-sectional

Low

Prevalence of reported sleep disorders was 38.9% in females compared with 22% in males (p < 0.005)

Hoeg et al.[51]

123 athletes (40 females and 83 males). Mean age 41.8 and 46.2 years, respectively) who competed in a 100 mile ultramarathon in 2018 or 2019

Triad cumulative risk assessment score, DEXA, serum ferritin, vitamin D, sex hormones

Cross-sectional

Low

Proportion of athletes with: elevated risk of eating disorders: Males 44.5%, females 62.5%; history of bone stress injury: Males 20.5%, females 37.5%; BMI < 18.5 kg/m2: Males 0%, females 15%; BMD Z score < 1.0: Males: 30.1%, females 16.7%; Triad cumulative risk assessment: males—29.2% moderate risk, 5.6% high risk; females—61.1% moderate risk, 5.6% high risk

  1. BMI, body mass index; DEXA, dual-energy X-ray absorptiometry; BMD, bone mineral density; and CI, confidence interval