ArticleFrontiers in sports and active living2026
Case Report: Stage-by-stage fueling, glucose dynamics, and next-day metabolism and biomarker responses after baseline testing in an 18.5-hour Swedish classic tetrathlon.
Article in Frontiers in sports and active living, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Amateur ultra-endurance (UE) athletes often exhibit suboptimal fueling, particularly inadequate carbohydrate (CHO) intake, during competition. Integrated real-world datasets that combine weighed-back, stage-specific fueling with blinded continuous glucose monitoring (CGM) and next-day oral glucose tolerance test (OGTT) including indirect calorimetry in a condensed multi-discipline UE setting are scarce. Case presentation: A 37-year-old amateur athlete completed a tightly timed "Swedish Classic" on official race courses within 18:30 h:min (18.5 h)-316 km road cycling, 3 km open-water swimming, 84 km roller-skiing, and 30 km trail running-with helicopter transfers between stages [433 km total; 15:01 h:min (15.0 h) active exercise]. Fasting laboratory tests were performed at 07:30 on the mornings before and after the attempt, including venous blood sampling, dual-energy x-ray absorptiometry (DXA), and a 75-g oral glucose tolerance test (OGTT; 120 min) with indirect calorimetry. Weighed-back nutrition and hydration, CGM, heart rate (HR), body mass (BM), and stage logistics were recorded throughout. Results: Total energy intake was 5,825 kcal with 1,051 g CHO (13.8 g·kg Conclusion: In this condensed UE tetrathlon case, discipline-specific feeding opportunities, rather than generic hourly targets, largely determined achievable CHO delivery, and glycaemic excursions occurred only during the terminal running stage. This integrated case provides a reference observation to inform logistics-aware fueling plans and to motivate prospective studies evaluating whether real-time CGM with predefined decision rules improves late-stage fueling and glycaemic stability in UE events.
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