This paper brings together evidence from five linked studies to explore how lifelong marathon participation connects with health, wellbeing, and event safety. Drawing on data from over a thousand multi-marathoners worldwide, it highlights key areas where policy guidance can enhance athlete welfare and support sustainable participation. 

The study outlines practical recommendations for screening, event safety, and health promotion, aiming to inform organisers, governing bodies, and public-health stakeholders as the multi-marathon community continues to expand internationally.