The Genetic Basis of Endurance and Long-Distance Running Performance in Athletes from the African Region: A Narrative Review

This narrative review examines why African athletes, particularly those from Kenya and Ethiopia, who have consistently dominated international long-distance running, prompting research into the interplay between genetic and environmental determinants of endurance. Although high-altitude living, habitual physical activity, and cultural practices contribute significantly, genetic predispositions are increasingly recognized as central to this phenomenon. Candidate genes such as ACTN3, ACE, PPARGC1A, VEGFA, and ADRB2 have been implicated in muscle fiber composition, mitochondrial biogenesis, oxygen delivery, and energy metabolism, although associations vary across populations. Studies have also highlighted the role of mitochondrial DNA variants, nuclear mitochondrial interactions and epigenetic modifications in regulating endurance adaptations. Inconsistent findings in African cohorts underscore the complexity of genetic diversity and polygenic inheritance. Beyond genetics, physiological traits such as higher VO₂ max fractions, superior fatigue resistance, and more efficient running economy distinguish East African runners from their non-African counterparts. Environmental influences, including hypoxic exposure, habitual childhood running, and strong sociocultural incentives, interact dynamically with genetic factors, supporting the concept of gene culture coevolution. Emerging areas such as the gut microbiome and injury- susceptibility genetics further broaden the scope of endurance research. Practical applications of these findings include the potential use of genetic profiling to personalize training, nutrition, and injury prevention strategies, however ethical concerns and limited predictive accuracy remain barriers. Future directions emphasize the integration of multi-omics combining genomics with transcriptomics, proteomics, and metabolomics to reveal functional pathways underlying endurance beyond simple genetic associations. Overall elite endurance performance in African athletes reflects a multifactorial synergistic effect of genetics, environment, and culture, offering insights for advancing sports genomics and performance optimization.