Selected scientific aspects of marathon racing. An update on fluid replacement, immune function, psychological factors and the gender difference.

Four topics are addressed: fluid/fuel replacement during the marathon, marathoning and susceptibility to infection, psychological aspects of elite marathoners and the gender gap in marathon performance. Although these topics are diverse, they all relate to practical questions raised by coaches and athletes. Evidence from laboratory and field studies indicates that it is advisable for marathoners to consume 800 to 1000 L/h of sports drink providing 45 to 60 g/h of carbohydrate. It is strongly suggested to practice fluid consumption during training sessions as it is probable that tolerance to drinking during running is a trainable adaptation. Epidemiological and clinical research support the concept that marathon training and racing increase the runner's risk of upper respiratory tract infections because of negative changes in immune function. Susceptibility to infection may be reduced by proper nutrition, adequate sleep, appropriate recovery between vigorous workouts and minimal exposure to sick people during periods of heavy training and major races. Although psychological research in this area is still limited, evidence suggests that elite marathoners rely primarily on associative strategies during competition while judiciously dissociating in order to cope with pain. It is recommended that coaches and athletes interested in employing psychological interventions seek assistance from professionals well trained in the fields of both psychology and exercise science. Will women soon outrun men? Over the past 2 decades societal views and training practices of women distance runners have changed greatly, yet certain performance-related biological differences between men and women are unlikely to change.