Performance, physiology, and determinants of success in IRONMAN® 70.3: A systematic review
Abstract
Background: IRONMAN® 70.3 events represent a rapidly expanding endurance discipline characterized by distinct physiological demands, performance determinants, and race-specific risk profiles. Despite their global popularity, no systematic review has synthesized evidence exclusively focused on this distance.
Objective: To consolidate current knowledge on performance predictors, physiological responses, training characteristics, nutritional strategies, environmental influences, and medical considerations in IRONMAN® 70.3 triathletes, and to identify gaps requiring further investigation.
Methods: A systematic search of PubMed, Scopus, SciELO, EBSCO and Google Scholar was conducted up to 25th November 2025. Search terms were developed according to PRISMA guidelines and included variations of 'Ironman 70.3', 'half triathlon' and 'middle-distance triathlon'. Eligible studies reporting physiological, anthropometric, nutritional, environmental, medical, or performance-related outcomes specific to IRONMAN® 70.3. Risk of bias was assessed using the Newcastle-Ottawa Scale, the Cochrane RoB tool, and the NIH Quality Assessment Tool, according to study design.
Results: A total of 86 studies were included, predominantly observational in design, with sample sizes ranging from 1 to 852,721 participants, mostly trained male triathletes aged 25-39 years. Participation has increased across age groups, with pronounced growth among female and masters triathletes. Peak performance in professional…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 852,721 participants or records.
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