Regular physical activity has numerous health-benefits and the promotion thereof is an important part of public health strategies to reduce chronic lifestyle-related conditions and premature death.   Recreational running is an accessible physical activity and the participation in mass community-based endurance running events is steadily growing. However, it is recognized that injury, illness and other medical events do occur at these races, requiring medical teams to not only plan the medical support on race day, but also to consider prevention strategies to reduce the number of medical encounters occurring at the races. Gastrointestinal illness-related (GITill) medical encounters rank among the top four organ systems affected during distance running, and can range in severity from mild to debilitating. If the risk factors related to the incidence of these GITill-related medical encounters were known, it could assist race medical teams to improve the planning of medical care at these events. To this end, researchers at UP and SEMLI set out to identify factors that may predict GITill among 153 208 race starters at the Two Oceans 56km and 21.1km races.  They found that race distance was strongest predictor of GITill, with significantly more GITill encounters in the 56km race starters than the 21km race starters. Among the 56km race starters, slower running speed was also a predictor of GITill. Age, running experience and environmental factors (wet-bulb temperature, wind speed, humidity) were not associated with a higher risk of GITill.  The researchers therefore advise medical teams responsible for care at longer races, that 1) they can expect a higher incidence of GITill that requires medical attention compared with shorter race distances, and 2) slower runners competing in ultramarathons are a subgroup at higher risk of GITill. These research results can assist medical teams at events to improve and plan medical care, target runner education and establish prevention strategies to reduce GITill in runners.

Reference for this article:

Longer race distance predicts gastrointestinal illness-related medical encounters in 153 208 endurance runners – SAFER XVI. The Journal of Sports Medicine and Physical Fitness, 2021 Feb 08, DOI:

Pillay S, Schwellnus MP, Grant C, Jansen van Rensburg A, Swanevelder S, Jordaan E

https://pubmed.ncbi.nlm.nih.gov/33555669/