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Bonato G, Goodman S, Tjh L. Physiological and performance effects of live high train low altitude training for elite endurance athletes: A narrative review. Curr Res Physiol 2023; 6:100113. [PMID: 38107789 PMCID: PMC10724230 DOI: 10.1016/j.crphys.2023.100113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 11/10/2023] [Accepted: 11/21/2023] [Indexed: 12/19/2023] Open
Abstract
Altitude training has become an important training application for athletes due its potential for altering physiology and enhancing performance. This practice is commonly used by athletes, with a popular choice being the live high - train low approach. This model recommends that athletes live at high altitude (1250-3000 m), but train at low altitude or sea-level (0-1200 m). Exposure to altitude often leads to hypoxic stress and in turn stimulates changes in total haemoglobin mass, erythropoietin, and soluble transferrin receptors, which alter further underlying physiology. Through enhanced physiology, improved exercise performance may arise through enhancement of the oxygen transport system which is important for endurance events. Previous investigations into the effects of altitude training on exercise performance have been completed in a range of contexts, including running, cycling, swimming, and triathlon. Often following a LHTL altitude intervention, athletes realise improvements in maximal oxygen consumption capacity, time trial performance and peak power outputs. Although heterogeneity exists among LHTL methodologies, i.e., exposure durations and altitude ranges, we synthesised this data into kilometre hours, and found that the most common hypoxic doses used in LHTL interventions ranged from ∼578-687 km h. As this narrative review demonstrates, there are potential advantages to using altitude training to enhance physiology and improve performance for endurance athletes.
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Affiliation(s)
- G. Bonato
- Exercise and Sports Science, School of Science and Technology, The University of New England, Armidale, 2350, Australia
- College of Arts, Society and Education, James Cook University, Townsville, 4811, Australia
| | - S.P.J Goodman
- Exercise and Sports Science, School of Science and Technology, The University of New England, Armidale, 2350, Australia
| | - Lathlean Tjh
- Exercise and Sports Science, School of Science and Technology, The University of New England, Armidale, 2350, Australia
- The Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, 5000, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, 5000, Australia
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Ghaleb AM, Ramadan MZ, Badwelan A, Mansour L, Al-Tamimi J, Aljaloud KS. Determining the time needed for workers to acclimatize to hypoxia. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:1995-2005. [PMID: 32794023 DOI: 10.1007/s00484-020-01989-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 07/27/2020] [Accepted: 08/05/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to determine the influence of intermittent hypoxia and the days required for a worker to be acclimatized in high-altitude countries. We conducted an experimental study. Ten nonsmoking male students were randomly recruited from King Saud University. Fourteen days of exposure to intermittent normobaric hypoxia (15%) was the independent variable. Heart rate (HR), respiratory frequency (RF), minute ventilation (VE), respiratory exchange ratio (RER), tidal volume (VT), oxygen uptake (VO2),VO2/kg, VO2/HR, VE/VO2, and VE/VCO2 were the dependent variables. Our results showed that 12 days of exposure to intermittent hypoxia were sufficient for workers to acclimatize to hypoxia based on their respiratory responses (i.e., HR, RF, VE). This type of acclimatization session is very important for workers who are suddenly required to work in such an environment, because prolonged exposure to high altitude without acclimatization leads to cell death due to a lack of oxygen, and this, in turn, puts workers' lives at risk.
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Affiliation(s)
- Atef M Ghaleb
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh, Saudi Arabia.
| | - Mohamed Z Ramadan
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Badwelan
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh, Saudi Arabia
| | - Lamjed Mansour
- Department of Zoology , College of Science, King Saud University, P.O. Box 2455, Riyadh, 11451, Saudi Arabia
| | - Jameel Al-Tamimi
- Department of Zoology , College of Science, King Saud University, P.O. Box 2455, Riyadh, 11451, Saudi Arabia
| | - Khalid Saad Aljaloud
- Department of Exercise Physiology, College of Sport Sciences & Physical Activity, King Saud University, Riyadh, Saudi Arabia
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Gangwar A, Paul S, Ahmad Y, Bhargava K. Intermittent hypoxia modulates redox homeostasis, lipid metabolism associated inflammatory processes and redox post-translational modifications: Benefits at high altitude. Sci Rep 2020; 10:7899. [PMID: 32404929 PMCID: PMC7220935 DOI: 10.1038/s41598-020-64848-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 04/09/2020] [Indexed: 01/27/2023] Open
Abstract
Intermittent hypoxia, initially associated with adverse effects of sleep apnea, has now metamorphosed into a module for improved sports performance. The regimen followed for improved sports performance is milder intermittent hypoxic training (IHT) as compared to chronic and severe intermittent hypoxia observed in sleep apnea. Although several studies have indicated the mechanism and enough data on physiological parameters altered by IH is available, proteome perturbations remain largely unknown. Altitude induced hypobaric hypoxia is known to require acclimatization as it causes systemic redox stress and inflammation in humans. In the present study, a short IHT regimen consisting of previously reported physiologically beneficial FIO2 levels of 13.5% and 12% was administered to human subjects. These subjects were then airlifted to altitude of 3500 m and their plasma proteome along with associated redox parameters were analyzed on days 4 and 7 of high altitude stay. We observed that redox stress and associated post-translational modifications, perturbed lipid metabolism and inflammatory signaling were induced by IHT exposure at Baseline. However, this caused activation of antioxidants, energy homeostasis mechanisms and anti-inflammatory responses during subsequent high-altitude exposure. Thus, we propose IHT as a beneficial non-pharmacological intervention that benefits individuals venturing to high altitude areas.
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Affiliation(s)
- Anamika Gangwar
- Peptide and Proteomics Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Subhojit Paul
- Peptide and Proteomics Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Yasmin Ahmad
- Peptide and Proteomics Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India.
| | - Kalpana Bhargava
- Peptide and Proteomics Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India.
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Michalczyk M, Czuba M, Zydek G, Zając A, Langfort J. Dietary Recommendations for Cyclists during Altitude Training. Nutrients 2016; 8:E377. [PMID: 27322318 PMCID: PMC4924218 DOI: 10.3390/nu8060377] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 05/30/2016] [Accepted: 06/12/2016] [Indexed: 01/08/2023] Open
Abstract
The concept of altitude or hypoxic training is a common practice in cycling. However, several strategies for training regimens have been proposed, like "live high, train high" (LH-TH), "live high, train low" (LH-TL) or "intermittent hypoxic training" (IHT). Each of them combines the effect of acclimatization and different training protocols that require specific nutrition. An appropriate nutrition strategy and adequate hydration can help athletes achieve their fitness and performance goals in this unfriendly environment. In this review, the physiological stress of altitude exposure and training will be discussed, with specific nutrition recommendations for athletes training under such conditions. However, there is little research about the nutrition demands of athletes who train at moderate altitude. Our review considers energetic demands and body mass or body composition changes due to altitude training, including respiratory and urinary water loss under these conditions. Carbohydrate intake recommendations and hydration status are discussed in detail, while iron storage and metabolism is also considered. Last, but not least the risk of increased oxidative stress under hypoxic conditions and antioxidant supplementation suggestions are presented.
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Affiliation(s)
- Małgorzata Michalczyk
- Department of Nutrition & Supplementation, the Jerzy Kukuczka Academy of Physical Education in Katowice, Faculty of Physical Education, Mikołowska 72A, Katowice 40-065, Poland.
| | - Miłosz Czuba
- Department of Sports Training, the Jerzy Kukuczka Academy of Physical Education in Katowice, Faculty of Physical Education, Mikołowska 72A, Katowice 40-065, Poland.
| | - Grzegorz Zydek
- Department of Nutrition & Supplementation, the Jerzy Kukuczka Academy of Physical Education in Katowice, Faculty of Physical Education, Mikołowska 72A, Katowice 40-065, Poland.
| | - Adam Zając
- Department of Sports Training, the Jerzy Kukuczka Academy of Physical Education in Katowice, Faculty of Physical Education, Mikołowska 72A, Katowice 40-065, Poland.
| | - Józef Langfort
- Department of Nutrition & Supplementation, the Jerzy Kukuczka Academy of Physical Education in Katowice, Faculty of Physical Education, Mikołowska 72A, Katowice 40-065, Poland.
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Park HY, Hwang H, Park J, Lee S, Lim K. The effects of altitude/hypoxic training on oxygen delivery capacity of the blood and aerobic exercise capacity in elite athletes - a meta-analysis. J Exerc Nutrition Biochem 2016; 20:15-22. [PMID: 27298808 PMCID: PMC4899894 DOI: 10.20463/jenb.2016.03.20.1.3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/02/2016] [Accepted: 03/03/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This study was designed as a meta-analysis of randomized controlled trials comparing effectiveness of altitude/hypoxic training (experimental) versus sea-level training (control) on oxygen delivery capacity of the blood and aerobic exercise capacity of elite athletes in Korea. METHODS Databases (Research Information Service System, Korean studies Information Service System, National Assembly Library) were for randomized controlled trials comparing altitude/hypoxic training versus sea-level training in elite athletes. Studies published in Korea up to December 2015 were eligible for inclusion. Oxygen delivery capacity of the blood was quantified by red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), erythropoietin (EPO); and aerobic exercise capacity was quantified by maximal oxygen consumption (VO2max). RBC, Hb, Hct, VO2max represented heterogeneity and compared post-intervention between altitude/hypoxic training and sea-level training in elite athletes by a random effect model meta-analysis. EPO represented homogeneity and meta-analysis performed by a fixed effect model. Eight independent studies with 156 elite athletes (experimental: n = 82, control: n = 74) were included in the metaanalysis. RESULTS RBC (4.499×10(5) cell/ul, 95 % CI: 2.469 to 6.529), Hb (5.447 g/dl, 95 % CI: 3.028 to 7.866), Hct (3.639 %, 95 % CI: 1.687 to 5.591), EPO (0.711 mU/mL, 95% CI: 0.282 to 1.140), VO2max (1.637 ml/kg/min, 95% CI: 0.599 to 1.400) showed significantly greater increase following altitude/hypoxic training, as compared with sea-level training. CONCLUSION For elite athletes in Korea, altitude/ hypoxic training appears more effective than sea-level training for improvement of oxygen delivery capacity of the blood and aerobic exercise capacity.
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Affiliation(s)
- Hun-Young Park
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul Republic of Korea
| | - Hyejung Hwang
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul Republic of Korea
| | - Jonghoon Park
- Department of Physical Education, Korea University, Seoul Republic of Korea
| | - Seongno Lee
- Department of Physical Education, Hanyang University, Seoul Republic of Korea
| | - Kiwon Lim
- Physical Activity and Performance Institute (PAPI), Konkuk University, SeoulRepublic of Korea; Department of Physical Education, Konkuk University, SeoulRepublic of Korea
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Wilber RL, Stray-Gundersen J, Levine BD. Effect of hypoxic "dose" on physiological responses and sea-level performance. Med Sci Sports Exerc 2007; 39:1590-9. [PMID: 17805093 DOI: 10.1249/mss.0b013e3180de49bd] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Live high-train low (LH+TL) altitude training was developed in the early 1990s in response to potential training limitations imposed on endurance athletes by traditional live high-train high (LH+TH) altitude training. The essence of LH+TL is that it allows athletes to "live high" for the purpose of facilitating altitude acclimatization, as manifest by a profound and sustained increase in endogenous erythropoietin (EPO) and ultimately an augmented erythrocyte volume, while simultaneously allowing athletes to "train low" for the purpose of replicating sea-level training intensity and oxygen flux, thereby inducing beneficial metabolic and neuromuscular adaptations. In addition to "natural/terrestrial" LH+TL, several simulated LH+TL devices have been developed to conveniently bring the mountain to the athlete, including nitrogen apartments, hypoxic tents, and hypoxicator devices. One of the key questions regarding the practical application of LH+TL is, what is the optimal hypoxic dose needed to facilitate altitude acclimatization and produce the expected beneficial physiological responses and sea-level performance effects? The purpose of this paper is to objectively answer that question, on the basis of an extensive body of research by our group in LH+TL altitude training. We will address three key questions: 1) What is the optimal altitude at which to live? 2) How many days are required at altitude? and 3) How many hours per day are required? On the basis of consistent findings from our research group, we recommend that for athletes to derive the physiological benefits of LH+TL, they need to live at a natural elevation of 2000-2500 m for >or=4 wk for >or=22 h.d(-1).
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Affiliation(s)
- Randall L Wilber
- Athlete Performance Laboratory, United States Olympic Committee, Colorado Springs, CO 80909, USA.
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Abstract
“Live high-train low” (LH+TL) altitude training allows athletes to “live high” for the purpose of facilitating altitude acclimatization, as characterized by a significant and sustained increase in endogenous erythropoietin and subsequent increase in erythrocyte volume, while simultaneously enabling them to “train low” for the purpose of replicating sea-level training intensity and oxygen flux, thereby inducing beneficial metabolic and neuromuscular adaptations. In addition to natural/terrestrial LH+TL, several simulated LH+TL devices have been developed including nitrogen apartments, hypoxic tents, and hypoxicator devices. One of the key issues regarding the practical application of LH+TL is what the optimal hypoxic dose is that is needed to facilitate altitude acclimatization and produce the expected beneficial physiological responses and sea-level performance effects. The purpose of this review is to examine this issue from a research-based and applied perspective by addressing the following questions: What is the optimal altitude at which to live, how many days are required at altitude, and how many hours per day are required? It appears that for athletes to derive the hematological benefits of LH+TL while using natural/terrestrial altitude, they need to live at an elevation of 2000 to 2500 m for >4 wk for >22 h/d. For athletes using LH+TL in a simulated altitude environment, fewer hours (12-16 h) of hypoxic exposure might be necessary, but a higher elevation (2500 to 3000 m) is required to achieve similar physiological responses.
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Abstract
At the Olympic level, differences in performance are typically less than 0.5%. This helps explain why many contemporary elite endurance athletes in summer and winter sport incorporate some form of altitude/hypoxic training within their year-round training plan, believing that it will provide the "competitive edge" to succeed at the Olympic level. The purpose of this paper is to describe the practical application of altitude/hypoxic training as used by elite athletes. Within the general framework of the paper, both anecdotal and scientific evidence will be presented relative to the efficacy of several contemporary altitude/hypoxic training models and devices currently used by Olympic-level athletes for the purpose of legally enhancing performance. These include the three primary altitude/hypoxic training models: 1) live high+train high (LH+TH), 2) live high+train low (LH+TL), and 3) live low+train high (LL+TH). The LH+TL model will be examined in detail and will include its various modifications: natural/terrestrial altitude, simulated altitude via nitrogen dilution or oxygen filtration, and hypobaric normoxia via supplemental oxygen. A somewhat opposite approach to LH+TL is the altitude/hypoxic training strategy of LL+TH, and data regarding its efficacy will be presented. Recently, several of these altitude/hypoxic training strategies and devices underwent critical review by the World Anti-Doping Agency (WADA) for the purpose of potentially banning them as illegal performance-enhancing substances/methods. This paper will conclude with an update on the most recent statement from WADA regarding the use of simulated altitude devices.
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Affiliation(s)
- Randall L Wilber
- Athlete Performance Laboratory, United States Olympic Committee, Colorado Springs, CO 80909, USA.
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