Introduction: Although research suggests that exercise benefits mental health, psychiatric disorders have been acknowledged in the ultra-endurance-athlete population. At present, the mental-health consequences of high-volume training associated with ultra-endurance sports are not well understood. Methods: We conducted a narrative review summarizing primary observations about mental disorders per ICD-11 criteria in ultra-endurance athletes using a keyword search in Scopus and PubMed. Results: We identified 25 papers discussing ICD-11-classified psychiatric disorders such as depression, anxiety, eating disorders, attention-deficit/hyperactivity disorder, and schizophrenia in ultra-endurance athletes. Discussion: Although evidence is limited, available papers indicate that there is a sizable incidence of mental-health issues and composite psychopathological vulnerabilities in this community. We contend that ultra-endurance athletes may represent a different, though similar, demographic than elite and/or professional athletes, as they often engage in high-volume training with similarly high motivation. This can have regulatory implications, which we also highlight. Conclusion: Mental illness in ultra-endurance athletes is an underrepresented topic in sports medicine, though psychiatric disorders may be especially prevalent in this population. Further inquiry is necessary to inform athletes and healthcare practitioners about the possible mental-health implications associated with participation in ultra-endurance sports.

Abstract. Introduction: The popularity of ultra-endurance cycling is increasing. Amongst race participants, sleep deprivation and periods of intermittent or acutely short sleep are common. Scientific research has typically focussed on the physiological or competitive performance based impact of these sleep-related paradigms. However, there is limited evidence about the mental health effects of sleep patterns in ultra-endurance cycling, despite established links between sleep deprivation and psychiatric and psychological issues. Methods: We conducted a narrative review synthesising extant empirical literature about sleep deprivation in ultra-endurance cycling. Results: Based on our search criteria, seven papers were identified discussing sleep patterns in ultra-endurance races. Each of these indicate that sleep deprivation is a prominent aspect of ultra-endurance competitions, with varying implications for riders. Discussion: Using these findings, we highlight the possible mental health consequences of sleep deprivation in these races, with reference to general scientific literature and other ultra-endurance sports. We also advocate for increased knowledge exchanges, regulatory emphasis, and additional research. Conclusion: Sleep deprivation and extreme sleep patterns are a substantial issue in elite-level cycling competitions, raising potential mental health concerns. More attention to this topic is necessary amongst organisers, participants, researchers, and community-level platforms, like the Global Cycling Network.

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IntroductionInterest in ultra endurance sport (UES) is increasing, with relevant events growing in popularity. However, these activities may encompass more complex characteristics and demands that do not correspond to scientifically validated correlations between physical activity and improved health. It is unknown whether high volume training for UES can have adverse implications, although certain sociocultural aspects of western society, such as an emphasis on autonomy and self-directed success, may encourage participation as a representation of personal achievement. As media depictions of UES can be highly influential, we aimed to explore prominent messages to better comprehend the values and aspirations of established and aspiring ultra endurance athletes (UEA).MethodsUsing qualitative, conventional content analysis techniques, we evaluated n = 15 popular YouTube videos on various UES to synthesize the most common themes. A YouTube search was conducted, and videos were selected based on sport and relevance. Subsequently, videos were analyzed and coded to discern the most frequently repeated themes.ResultsFive recurring themes were identified: discussion of the mental aspects of UES participation; the adoption of folk-tale storytelling; dietary habits of UEA; a focus on pain and suffering; the use of words associated with mental illness as a colloquial descriptor of UES/UEA.DiscussionYouTube depictions of UES participation appear to accentuate suffering and co-occurring phenomena as attractive qualities. These resonate with sociocultural ideologies in western contexts, which emphasize fitness and personal success, but appear inconsistent with evidence around potentially adverse health-related implications of UES.ConclusionDiscrepancies between popular portrayals of UES and scientific evidence suggest a need for greater community education and information sharing about sport-specific risk factors for physical and mental health conditions and appropriate training protocols. Further research is also required to better define the relationship between motivations for UES participation and overall health using interdisciplinary approaches.

Background: Weight-related issues and adverse weight-management behaviours are prominent concerns in elite-level sports, notably in competitions like men’s road cycling. Whilst other sporting bodies have introduced measures based on Body Mass Index (BMI), no such provision exists in elite-level cycling, which is overseen by the Union Cycliste Internationale (UCI). However, these may be necessary to protect the short- and long-term health of riders and improve perceptions of the sport. Methods: To ascertain the potential need for targeted policies, we gathered height and weight data from the ProCyclingStats website to investigate BMI trends for the top five male finishers between 1992-2022 in the General Classification (GC) category of the UCI’s Grand Tours: the Giro d’Italia, the Tour de France, and the Vuelta a España. Results: We calculated the BMI of 156 unique top five finishers in the GC of the Grand Tours with a total of n=445 BMI values (this includes riders who had multiple top five finishes in different races and years). Whilst singular data points varied, we observed overall declining mean BMI trends for these cyclists between 1992-2022. Conclusion: Our results supplement existing anecdotal and scholarly evidence and suggest that lower BMIs are increasingly associated with top finishing positions in the GC of the men’s Grand Tours. This could have substantial implications for athletes and regulators, since performance pressures could lead to detrimental weight-management practices that can harm short and long-term health and affect the sport’s reputation. Accordingly, we propose that the UCI could consider multifactorial interventions, including prevention and awareness campaigns, screening programs, and BMI-based guidelines.