Six years ago, Ben True became the first American runner to win the the TD Beach to Beacon 10K. Derek Davis/Staff Photographer

CAPE ELIZABETH — Excitement for the TD Beach to Beacon 10K reached a fever pitch in 2016 when local favorite Ben True became the first American runner to win the race long dominated by East Africans.

True, who grew up in North Yarmouth and ran and skied at Greely High in Cumberland before heading to New Hampshire for college, withdrew from this year’s race on Thursday evening because of an unspecified illness.

“I think he was trying to make it work, but he’s just not feeling well,” said race founder Joan Benoit Samuelson. “Disappointed, but you want what’s best for the athletes, because Maine roots run deep, especially in the road racing community.”

Now living in West Lebanon, New Hampshire, True has run Beach to Beacon six times and finished among the top three in 2014, 2017 and 2018 in addition to his breakthrough victory in 2016.

Earlier this week, True said he was uncertain if he’d be able to compete on Saturday as he was “trying to overcome a bit of sickness.” He elaborated by text message Friday, saying that he wasn’t able to rebound fast enough “to feel like racing would be a smart choice, either day of performance or longer term.”

True, 36, plans to run his second New York City Marathon in the fall, and said he needs to “make sure I’m fully healthy with no setbacks for that. Just bad timing this year.”

With True out of the men’s field, the favorite seems to be Mathew Kimeli, 24, of Kenya. Other top contenders are Zouhair Talbi of Morocco and Americans Emmanuel Bor, Biya Simbassa, Ryan Hill and Matt McDonald.

The women’s elite field includes two native Mainers, Emily Durgin of Standish and Rachel (Schneider) Smith of Sanford. Both achieved all-America status in college (UConn and Georgetown, respectively) and now live and train in Arizona.

Smith, who competed in the 2020 Olympics at 5,000 meters, attended Friday morning’s press conference under a tent near the finish line at Fort Williams. Durgin, meanwhile, was forced to drive here from Philadelphia after her connecting flight was canceled.

Other top women include Fentaye Belayneh and Bruktayit Degefa Eshetu of Ethiopia, Zenah Jamatai Yego of Kenya, Marielle Hall of New Jersey and Jordan Hasay of California.

MEDICAL DIRECTOR Chris Troyanos took note of the warm weather and warned runners to take heed. Temperatures are expected to be in the mid-to-upper 70s Saturday morning.

“It’s not so much the temperature, it’s the humidity and the dew point,” he said. “Runners need to understand that because it’s so humid, the sweat doesn’t evaporate off your body. That’s a cooling mechanism. So if you’re not able to cool, what’s going to happen? Your body core temperature is going to go up.”

So what would Troyanos advise?

“Slow down,” he said. “If you’re not feeling well, you’re getting a little woozy or a dizzy, that’s the time to slow down or stop and seek medical care. If you think (Saturday) is a good day to go after a PR, you’re sadly mistaken. You really need to pay attention to the weather.”

Troyanos directed the Boston Athletic Association 10K in June under similar conditions. Out of 6,000 runners, he said 60 were treated in the medical tent and 14 had exertional heat stroke. The core temperature of one runner reached 110 degrees and two others reached 109 before ice baths cooled them to appropriate levels, he said.

“If we don’t do what we did there and what we do here,” Troyanos said, gesturing toward the tubs and cots set up inside the Beach to Beacon medical tent, “that ends up being a fatality. I know that sounds dramatic, but it’s true. … Our hope is that the surge of people we’re going to get (Saturday) isn’t beyond what we’ve set up to handle.”

THE PAST FEW years have been challenging for Dave McGillivray, the longtime Beach to Beacon race director who also directs the Boston Marathon and Falmouth (Massachusetts) Road Race. After 40 years in the business, he saw his industry evaporate in 2020 because of the pandemic.

He had 35 events planned and ready to go, “and then in a nanosecond, it all went over a cliff,” he said.

“Our job is to gather as many people as possible, jam them in a really tight space, breathing and sweating all over each other. Well, what’s exactly what we were told we can’t do anymore. So it went away.”

Instead of throwing up his hands, McGillivray turned to outdoor drive-in movies and renting equipment to restaurants. When COVID vaccinations came along, the Massachusetts state government called on the guy who knows best how to deal with large crowds. McGillivray’s DMSE road-racing operation became the DMSE vaccination clinic. Using Gillette Stadium, Fenway Park, the Reggie Lewis Track Center and the Hynes Convention Center in Boston, McGillivray’s crew helped vaccinate 1.3 million people.

“We got booted out of our industry by the pandemic,” he said, “but we ended up in a different industry that fought the pandemic, which allowed us to get back into our (road-racing) industry.”

BETWEEN FRIDAY’S High School Mile and Kids’ Fun Run, there was the first Beacon Walk, Run and Roll. About two dozen between the ages of 12 and 72 covered four tenths of a mile in a nod toward this year’s beneficiary, the Cromwell Center for Disabilities Awareness.

Susan Greenwood, executive director of the organization, spoke Friday morning about Cromwell’s programming, which takes place from Grade 1 in classrooms across much of Maine.

“The point of what we do is to change attitudes and change mindsets early,” she said, “so that inclusion is not an activity; inclusion becomes a way of thinking for children. We’re helping them to understand that disability is just one way that we differ from each other. It is not the most important way. It’s not the only way. As humans, we have far more commonalities than we do differences.”