SUMMIT Project
(Health during Ultra marathons and it’s limits.)
A brief introduction

Close to 20.000 runners took part in Barcelona Marathon, and there are almost 2500 people willing to run for more than 24 hours and climb a 9600 m positive elevation during this years edition of the Mont Blanc Ultra marathon. There are an increasing number of athletes signing up to participate in marathons and ultra marathons without having a sufficient physical training, a correct nutrition and without going through a medical check up.

A high-intensity physical activity for an extended period of time could result to be unhealthy; on the other hand it may be riskier to run 10km without an adequate physical training, than running 85 km after having had a complete physical and check up, and training regularly, we don’t know.

The SUMMIT study’s main goal is to determine if the population that practices high intensity physical activities for an extended period of time has a higher health risk than those of the moderate physical activity and the low physical activity groups.

Operational goals

1. Find out, in baseline conditions, the differences between ultra endurance athletes and non active general population at different levels:

  • Physiological: VO2Max, maximal oxygen consumption, lactate accumulation ...).
  • Biochemical
  • Psychological (perceived exertion)
  • Nutritional
  • Training
  • Genetic
  • Cardiac (Do they have a substrate such as cardiac fibrosis that may make them more  susceptible to serious arrhythmias?).
  • Immune (Does excessive effort produce immune-depression?).
  • Hormonal
  • Global and segmental bioimpedance in lower muscle groups

2. Find out which of the abovementioned characteristics change significantly during an endurance race and what health implications it may have on the different study groups.

3. Set general training and medical control standards, which any individual may need according to their sporting goals and lifestyle.


People that are not physically fit have a higher health risk during the practice of physical activities than people that are physically fit even though these may practice ultra endurance sports.

We expect to see in the low physical activity group  more alterations on all the levels that could indicate a threat for the subjects health, if he does not train more regularly, have a better nutrition and go through regular medical controls.

Conversely we predict that we will find that in the other two groups (the high and medium physical activity groups), these alterations will be transitory and will go into remission in a few days without putting their health at risk, and therefore this will corroborate that practicing sports, albeit it being ultra endurance sports, in high and medium physically active athletes is beneficial and not harmful fro their health.

The research team will be composed by

Resposable and PhD Project: Emma Roca degree in Biochemistry from the UAB.

Thesis Director:

Dra. Lexa Nescolarde, Department of Electronic Engineering, Center for Biomedical Engineering Research, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain.

Researchers associated in different areas:

Dr. Daniel Brotons, Senior consultant in sports medicine of the Consell Català de L’Esport and of the ergometrics and sports medicine unit of the Metrad Clinic.

Dr Antoni Bayés-Genís, ICREC Research Program, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain. Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. Department of Medicine, Universitat Autònoma de Barcelona, Barcelona.

Prof. José Antonio Hernández Hermoso, MD, PhD; Cap del Servei de Traumatologia i Cirurgia Ortopédica, Hospital Universitari Germans Trias i Pujol.

The Clinical Lab Metropolitana Nord, Hospital Germans Trias i Pujol with all its managers and workers coordinated by Jaume Barallat: since 2006 they have been processing all the runners' samples.

Dr Enrique Roche, Applied Biology Department – Nutrition/Institute of Bioengineering, Universidad Miguel Hernandez, Elche.

Dr José Manuel Soria, cap de la Unitat de Genòmica de Malalties Complexes de l'Hospital de la Santa Creu i Sant Pau.

Dr Oriol Sibila, cap de la unitat de Neumología, Hospital de la Santa Creu i Sant Pau, Barcelona.

Dr. Joan Cadefau, cap d'investigació del Departament de Fisiologia i ciència, Institut Nacional d'Educació Física de Catalunya (INEFC).


Population Study: >500 persons from 15 different races.

  • Low activity group: from 0 to 3 hours of physical activity per week. (Under the minimum recommended to achieve health goals): 20 male + 20 female.
  • Medium activity group: from 3 to 10 hours of physical activity per week: 20 male + 20 female.
  • High activity group and elite athletes more than 10 hours of physical activity per week: 20 male + 20 female.

The population is defined by the duration (hours) and intensity of their training, randomly selecting the subjects from all of the people that volunteer for this study, that must fill out a preliminary survey and sign a consent form. The elite group is selected taking into account their results in competition and by the lists of the athletes selected by the different sports federations.

Each individual will be subject to:

1) Basal Analysis:

  • Questionnaire aimed to learn demographic and health data, as well as time, volume and intensity of physical training amongst other things.
  •  Nutritional survey.
  • Sports medicine check up aimed to determine la physical capacities: Stress test (aerobic capability, VO2 Max, Max lactate to measure the glycolytic capacity, O2 saturation, heart rate variability (RR), …) and Borg test to analyze the psychological profile.

In hospital:

  • Specific analysis.
  • Urine.
  • Saliva.
  • Freeze blood for a later RNA analysis.
  • Echocardiography and carotid ecodoppler.
  • Electrocardiogram.

2) Field work:

During the race we carry out the study on the selected population and we will use a group of randomly selected athletes that take part in the race as a control group.

For logistic, interest and location reasons we have selected some races from the field: Volta Cerdanya de Ultrafons (Ultra Cerdanya), Cavalls del Vent (Ultra Pirineus), Cami de Cavalls, Ultra Barcelona, Transalpine, Maratón Barcelona, Zegama, Transvulcania, Pyrenees Stage Run.

Awareness generated

We consider that a global vision of the SUMMIT project will have a very high impact in the biomedical field; SUMMIT will significantly contribute in the knowledge of the physiological and genetic bases of the physical activity, both at a moderate and a high level of intensity, as well as in the knowledge of the mechanisms involved in effort and physical endurance.

Specifically the SUMMIT project will have a high impact in the following fields:

  • Recreational and elite athletes
  • Scientific community through the diffusion of new concepts and tools.
  • Biopharmaceutical and nutrition industries through the use of our findings.
  • Health and Public health policies.
Relevance for athletes:

Finding out the mechanisms of response and adaptation to the effort, as well as the genetic base of endurance athletes can mean a giant leap forward towards a safe and healthy practice of these kinds of sports.  There is a need to improve the training methods and to find better nutritional strategies in order to better adapt oneself to the demands of the practice of high endurance sports, as well as to avoid injuries or, even worse, cardiovascular pathologies.
By Characterizing new biological mechanisms involved in these processes, SUMMIT will provide information to improve nutritional strategies, and allow to develop highly specific training guidelines, adapted to the characteristics of each athlete.
The dissemination of the findings through health care and sports providers as well as sports organizations is a key element in the translational approach of project SUMMIT.

?Relevance for the scientific community:

The design, strategy and data base established in project SUMMIT are very new, even at an international level. It is highly improbable that the results obtained by this study will be generated in other places. We can foresee that the fruits of collaborating with important investigation groups will generate scientific papers that will be published in high impact publications.

Relevance for the Biopharmaceutical and Nutritional Industries:

Project SUMMIT’s goals and the strengths we can achieve through academic collaboration render it a very attractive partner for companies in the biopharmaceutical, nutritional and sports industries. SUMMIT could enable long lasting synergies between the academic world and the industry, and it is probable it could help achieve major public health improvements.

Amongst the possible valuation of results, we can emphasize the potential of the project to help develop and market of nutritional aides aimed to improve the adaptation and response to high intensity efforts based on the findings of this study.

Relevance for health and public health policies:

SUMMIT will develop unpublished information about the mechanisms involved in the response and adaptation to high intensity efforts and associated pathologies that are still, in many cases, unknown. The knowledge generated by project SUMMIT and the possible products and services marketed will allow improvements in the practice of sports medicine, influencing in public health policies and the wellbeing of the population.

If you want to take part in this study or learn more about it please write us at:


Next studies:


Sherpa-Everest with Ferran Latorre:


Pyrenees Stage Run:



Collaborating Institutions
ALTRA shoes
World Of People to Inspire
SUMMIT Sport Data Lab
Arch Max
Miquel Salinas
Enric Violan Podologia
Wong Performance
programador php freelance Barcelona
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