FIGURE 3.

Elite athletic performance is determined by the complex interaction of intrinsic and extrinsic factors. Undisputedly, genetic predisposition, even though poorly defined and understood, contributes to athletic prowess and trainability. In fact, the “right” genes might even be a prerequisite for elite, world-class performance. The epigenetic landscape is at least in part inherited but, in contrast to the genome, can also be influenced by behavior, including prior athletic experience, nutrition, and other lifestyle factors. A higher-than-average motivation and drive, the willpower to overcome obstacles, adversities, and setbacks, perseverance, and the willingness to forgo activities common for non-athletic peers are essential. These factors as well as daily training are shaped by body perception and prior athletic experience, including a multidisciplinary/multisport practice in youths. Most likely, nutrition, ergogenic aids, and gut microbiomes mutually interact in an intimate manner, collectively affecting trainability and performance. Optimal training strategies not only comprise personalized planning but should also integrate adequate consideration of recovery and injury prevention and, if the situation arises, rehabilitation. State-of-the-art equipment and facilities are part of a permissive environment, which is also strongly shaped by socio-economic status and social interactions with coaches, medical and other staff, team members, parents, siblings, friends, and rivals. This network of supporting people helps to optimize knowledge and education for proper planning and implementation. Finally, peak performance also relies on proper and personalized sleep patterns, matched to the individual chronotype. The use of doping might confer performance enhancements in the short term but is linked to long-term health detriments and is counter to the ethos of a fair and clean sport. Figure created with BioRender.com, with permission.