The aim of this study was to characterize Kenyan runners in regard to their oxygen uptake and blood and ammonia responses when running. Untrained Kenyan boys (14.2 +/- 0.2 years) and Scandinavian runners were included for comparison. The studies were performed at altitude (approximately 2.000 m.a.s.l.) and, for several Kenyan and Scandinavian runners, at sea level as well. At altitude sedentary adolescent Kenyan boys had a mean maximal oxygen uptake (VO2max) of 47 (44-51) ml.kg-1.min-1, whereas similarly aged boys regularly walking or running but not training for competition reached above 62 (58-71) ml.kg-1.min-1 in VO2max. Kenyan runners in active training had 68 +/- 1.4 ml.kg-1.min-1 at altitude and 79.9 +/- 1.4 ml.kg-1.min-1 at sea level, with individuals reaching 85 ml.kg-1.min-1. The best Scandinavian runners were not significantly different from the Kenyan runners in VO2max both at altitude and at sea level, but none of the Scandinavians reached as high individual values as observed for some Kenyan runners. The running efficiency, determined as the oxygen cost at a given running speed, was less in the Kenyan runners, and the difference became more pronounced when body weight was expressed in ml.kg-0.75 min-1. Blood lactate concentration was in general lower in the Kenyan than in the Scandinavian runners, and the Kenyans also had extremely low ammonia accumulation in the blood even at very high exercise intensities. It is concluded that it is the physical activity during childhood, combined with intense training as teenagers that brings about the high VO2max observed in some Kenyan runners. Their high aerobic capacity, as well as their good running economy, makes them such superior runners. In addition, their low blood lactate and ammonia accumulation in blood when running may also be contributing factors.