Case report on the marathon preparation of two middle-aged women aiming for a 4-hour finish

This study demonstrates that a combination of prescribed training load, nutritional education, body mass reduction primarily through fat mass loss, as well as optimized pacing strategy can substantially improve marathon performance in middle-age women targeting a ∼4-h finish. Despite experiencing health issues in the final weeks of preparation, both participants achieved meaningful progress, underscoring the practical value of an integrated approach. Although not generalizable, these insights may assist coaches and athletes in designing effective preparation strategies for similar goals.