| Summary: | Background: This study investigated the nationalities of finishers, the annual number of finishers participating in a specific region and the performance of athletes regarding their nationality of all 161km ultra-marathons held worldwide from 1998 to 2011. Methods: The associations between nationality and performance and changes in performance across years in 36,425 finishers were analysed using correlation and linear regression analyses. Results: Participation increased significantly for athletes originating from North America, Europe and Australia (P<0.01). Most runners originated from the USA (84%). The share of US-American athletes decreased significantly from 89.6% (1998) to 75.9% (2011) (P<0.01), while the share of European finishers increased significantly from 1.6% (1998) to 14.5% (2011) (P<0.01). The share of finishers competing in races held in the USA decreased significantly from 92.1% (1998) to 80.7% (2011) (P<0.01), while the share of finishers competing in European races increased significantly from 0% (1998) to 12.8% (2011) (P<0.01). The share of US-American athletes in the annual top ten decreased significantly from 76% (1998) to 52% (2011) (P<0.01), while the share of European athletes in the annual top ten increased significantly from 1% (1998) to 18% (2011) (P<0.01). Top ten US-American athletes achieved the fastest race times ever in women and men. Top ten European runners improved their performance to a higher extent than US-American athletes. Conclusion: These findings indicate that (i) ultra-marathoners originating from the USA dominated 161km ultra-marathons in participation and performance, (ii) 161km ultra-marathons were becoming more popular in Europe, and (iii) European athletes increasingly tended to compete in European races rather than to compete in the USA and improved their performance across years.
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