Background Marathon training and running have many benefcial efects on human health and physical ftness; however, they also pose risks. To date, no comprehensive review regarding both the benefts and risks of marathon running on diferent organ systems has been published. Main Body The aim of this review was to provide a comprehensive review of the benefts and risks of marathon training and racing on diferent organ systems. A predefned search strategy including keywords (e.g., marathon, car diovascular system, etc.) and free text search was used. Articles covering running regardless of sex, age, performance level, and event type (e.g., road races, mountain marathons) were considered, whereas articles examining only cycling, triathlon, stress-tests or other sports were excluded. In total, we found 1021 articles in PubMed, Scopus, and Google Scholar, of which 329 studies were included in this review. Overall, marathon training ofers several benefts for dif ferent organ systems and reduces all-cause mortality. As such, it improves cardiovascular risk factors, leads to favora ble cardiac adaptations, enhances lung function, and improves quality of life in chronic kidney disease patients. It also enhances gastrointestinal mobility and reduces the risk of specifc tumors such as colorectal cancer and hepa tocellular carcinoma. Marathon training enhances bone health and skeletal muscle metabolism. It further positively afects hematopoiesis and cytotoxic abilities of natural killer cells, and may act neuroprotective on a long-term basis. After a marathon, changes in biomarkers suggesting pathological events in certain organ systems such as cardiovas cular, renal, gastrointestinal, liver, hematological, immune, musculoskeletal, central nervous, and endocrine systems can often be observed. Mostly, these changes are limited to 1-3 days post-race and usually normalize within a week. Moreover, marathon running poses the risk of serious adverse events such as sudden cardiac death or acute liver failure. Concerning lung function, a decrease after a marathon race was observed. Acute kidney injury, as well as elec trolyte imbalances, are relatively common amongst marathon fnishers. Many runners complain of gastrointestinal symptoms during or after long-distance running. Many runners sufer from running-related musculoskeletal injuries often impairing performance. A marathon is often accompanied by an acute infammatory response with transient immunosuppression, making runners susceptible to infections. Also, hormonal alterations such as increased cortisol levels or decreased testosterone levels immediately after a race are observed. Disturbances in sleep patterns are com monly found in marathon runners leading up to or directly after the race. Conclusion All in all, marathon training is generally safe for human health and individual organ systems. Consider ing the high popularity of marathon running, these fndings supply athletes, coaches, sports scientists, and sports medicine practitioners with practical applications. Further large-scale studies examining long-term efects on the car diovascular, renal, and other system are needed.
© Copyright 2025 Sports Medicine - Open. Springer Open. Alle Rechte vorbehalten.