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Girard O, Peeling P, Racinais S, Périard JD. Combining Heat and Altitude Training to Enhance Temperate, Sea-Level Performance. Int J Sports Physiol Perform 2024; 19:322-327. [PMID: 38237571 DOI: 10.1123/ijspp.2023-0250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/29/2023] [Accepted: 12/18/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND Repeated exposure to heat (ie, plasma volume expansion) or altitude (ie, increase in total hemoglobin mass), in conjunction with exercise, induces hematological adaptations that enhance endurance performance in each respective environment. Recently, combining heat and altitude training has become increasingly common for athletes preparing to compete in temperate, sea-level conditions. PURPOSE To review the physiological adaptations to training interventions combining thermal and hypoxic stimuli and summarize the implications for temperate, sea-level performance. Current Evidence: To date, research on combining heat and hypoxia has employed 2 main approaches: simultaneously combining the stressors during training or concurrently training in the heat and sleeping at altitude, sometimes with additional training in hypoxia. When environmental stimuli are combined in a training session, improvements in aerobic fitness and time-trial performance in temperate, sea-level conditions are generally similar in magnitude to those observed with heat, or altitude, training alone. Similarly, training in the heat and sleeping at altitude does not appear to provide any additional hematological or nonhematological benefits for temperate; sea-level performance relative to training in hot, hypoxic, or control conditions. CONCLUSIONS Current research regarding combined heat and altitude interventions does not seem to indicate that it enhances temperate, sea-level performance to a greater extent than "traditional" (heat or hypoxia alone) training approaches. A major challenge in implementing combined-stressor approaches lies in the uncertainty surrounding the prescription of dosing regimens (ie, exercise and environmental stress). The potential benefits of conducting heat and altitude exposure sequentially (ie, one after the other) warrants further investigation.
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Affiliation(s)
- Olivier Girard
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia
| | - Peter Peeling
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia
- Western Australian Institute of Sport, Mt Claremont, WA, Australia
| | - Sébastien Racinais
- Environmental Stress Unit, CREPS Montpellier-Font Romeu, Montpellier, France
| | - Julien D Périard
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
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Nybo L, Rønnestad B, Lundby C. High or hot-Perspectives on altitude camps and heat-acclimation training as preparation for prolonged stage races. Scand J Med Sci Sports 2024; 34:e14268. [PMID: 36350277 DOI: 10.1111/sms.14268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/11/2022]
Abstract
Adaptation to heat stress and hypoxia are relevant for athletes participating in Tour de France or similar cycling races taking place during the summertime in landscapes with varying altitude. Both to minimize detrimental performance effects associated with arterial desaturation occurring at moderate altitudes in elite athletes, respectively, reduce the risk of hyperthermia on hot days, but also as a pre-competition acclimatization strategy to boost blood volume in already highly adapted athletes. The hematological adaptations require weeks of exposure to manifest, but are attractive as an augmented hemoglobin mass may improve arterial oxygen delivery and hence benefit prolonged performances. Altitude training camps have in this context a long history in exercise physiology and are still common practice in elite cycling. However, heat-acclimation training provides an attractive alternative for some athletes either as a stand-alone approach or in combination with altitude. The present paper provides an update and practical perspectives on the potential to utilize hypoxia and heat exposure to optimize hematological adaptations. Furthermore, we will consider temporal aspects both in terms of onset and decay of the adaptations relevant for improved thermoregulatory capacity and respiratory adaptations to abate arterial desaturation during altitude exposure. From focus on involved physiological mechanisms, time course, and responsiveness in elite athletes, we will provide guidance based on our experience from practical implementation in cyclists preparing for prolonged stage races such as the Tour de France.
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Affiliation(s)
- Lars Nybo
- Department of Nutrition, Exercise and Sport, University of Copenhagen, Copenhagen, Denmark
| | - Bent Rønnestad
- Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Carsten Lundby
- Inland Norway University of Applied Sciences, Lillehammer, Norway
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Périard JD, Girard O, Townsend N, Bourdon P, Cocking S, Ihsan M, Lacome M, Nichols D, Travers G, Wilson MG, Piscione J, Racinais S. Hematological Adaptations Following a Training Camp in Hot and/or Hypoxic Conditions in Elite Rugby Union Players. Int J Sports Physiol Perform 2023; 18:1053-1061. [PMID: 37553108 DOI: 10.1123/ijspp.2023-0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE To investigate the effects of a training camp with heat and/or hypoxia sessions on hematological and thermoregulatory adaptations. METHODS Fifty-six elite male rugby players completed a 2-week training camp with 5 endurance and 5 repeated-sprint sessions, rugby practice, and resistance training. Players were separated into 4 groups: CAMP trained in temperate conditions at sea level, HEAT performed the endurance sessions in the heat, ALTI slept and performed the repeated sprints at altitude, and H + A was a combination of the heat and altitude groups. RESULTS Blood volume across all groups increased by 140 mL (95%CI, 42-237; P = .006) and plasma volume by 97 mL (95%CI 28-167; P = .007) following the training camp. Plasma volume was 6.3% (0.3% to 12.4%) higher in HEAT than ALTI (P = .034) and slightly higher in HEAT than H + A (5.6% [-0.3% to 11.7%]; P = .076). Changes in hemoglobin mass were not significant (P = .176), despite a ∼1.2% increase in ALTI and H + A and a ∼0.7% decrease in CAMP and HEAT. Peak rectal temperature was lower during a postcamp heat-response test in HEAT (0.3 °C [0.1-0.5]; P = .010) and H + A (0.3 °C [0.1-0.6]; P = .005). Oxygen saturation upon waking was lower in ALTI (3% [2% to 5%]; P < .001) and H + A (4% [3% to 6%]; P < .001) than CAMP and HEAT. CONCLUSION Although blood and plasma volume increased following the camp, sleeping at altitude impeded the increase when training in the heat and only marginally increased hemoglobin mass. Heat training induced adaptations commensurate with partial heat acclimation; however, combining heat training and altitude training and confinement during a training camp did not confer concomitant hematological adaptations.
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Affiliation(s)
- Julien D Périard
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT,Australia
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
| | - Olivier Girard
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Crawley, WA,Australia
| | - Nathan Townsend
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha,Qatar
| | - Pitre Bourdon
- Department of Sport Science, ASPIRE, Academy for Sports Excellence, Doha,Qatar
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA,Australia
| | - Scott Cocking
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- Department of Sport Science, ASPIRE, Academy for Sports Excellence, Doha,Qatar
| | - Mohammed Ihsan
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
| | - Mathieu Lacome
- Department of Research, Sport Laboratory, Expertise and Performance, French Institute of Sports (INSEP), Paris,France
- Department of Performance and Analytics, Parma Calcio, Parma,Italy
| | - David Nichols
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
| | - Gavin Travers
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- Space Medicine Team, European Astronaut Center, Köln,Germany
| | - Mathew G Wilson
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- Institute of Sport, Exercise and Health, University College London, London,United Kingdom
| | - Julien Piscione
- Department of Research, Sport Laboratory, Expertise and Performance, French Institute of Sports (INSEP), Paris,France
| | - Sebastien Racinais
- Department of Research and Scientific Support, Aspetar Orthopedic and Sports Medicine Hospital, Doha,Qatar
- Department of Research, Sport Laboratory, Expertise and Performance, French Institute of Sports (INSEP), Paris,France
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Heat Acclimation with or without Normobaric Hypoxia Exposure Leads to Similar Improvements in Endurance Performance in the Heat. Sports (Basel) 2022; 10:sports10050069. [PMID: 35622478 PMCID: PMC9147627 DOI: 10.3390/sports10050069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/19/2022] [Accepted: 04/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Combining the key adaptation of plasma volume (PV) expansion with synergistic physiological effects of other acclimation interventions to maximise endurance performance in the heat has potential. The current study investigated the effects of heat acclimation alone (H), combined with normobaric hypoxia exposure (H+NH), on endurance athletic performance. Methods: Well-trained participants completed a heat-stress trial (30 °C, 80% relative humidity (RH), 20.8% fraction of inspired oxygen (FiO2)) of a 75 min steady-state cycling (fixed workload) and a subsequent 15 min cycling time trial for distance before and after intervention. Participants completed 12 consecutive indoor training days with either heat acclimation (H; 60 min·day−1, 30 °C, 80% RH; 20.8% FiO2) or heat acclimation and overnight hypoxic environment (H+NH; ~12 h, 60% RH; 16% FiO2 simulating altitude of ~2500 m). Control (CON) group trained outdoors with average maximum daily temperature of 16.5 °C and 60% RH. Results: Both H and H+NH significantly improved time trial cycling distance by ~5.5% compared to CON, with no difference between environmental exposures. PV increased (+3.8%) and decreased (−4.1%) following H and H+NH, respectively, whereas haemoglobin concentration decreased (−2%) and increased (+3%) in H and H+NH, respectively. Conclusion: Our results show that despite contrasting physiological adaptations to different environmental acclimation protocols, heat acclimation with or without hypoxic exposure demonstrated similar improvements in short-duration exercise performance in a hot environment.
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Intensified Training Supersedes the Impact of Heat and/or Altitude for Increasing Performance in Elite Rugby Union Players. Int J Sports Physiol Perform 2021; 16:1416-1423. [PMID: 33668015 DOI: 10.1123/ijspp.2020-0630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To investigate whether including heat and altitude exposures during an elite team-sport training camp induces similar or greater performance benefits. METHODS The study assessed 56 elite male rugby players for maximal oxygen uptake, repeated-sprint cycling, and Yo-Yo intermittent recovery level 2 (Yo-Yo) before and after a 2-week training camp, which included 5 endurance and 5 repeated-sprint cycling sessions in addition to daily rugby training. Players were separated into 4 groups: (1) control (all sessions in temperate conditions at sea level), (2) heat training (endurance sessions in the heat), (3) altitude (repeated-sprint sessions and sleeping in hypoxia), and (4) combined heat and altitude (endurance in the heat, repeated sprints, and sleeping in hypoxia). RESULTS Training increased maximal oxygen uptake (4% [10%], P = .017), maximal aerobic power (9% [8%], P < .001), and repeated-sprint peak (5% [10%], P = .004) and average power (12% [14%], P < .001) independent of training conditions. Yo-Yo distance increased (16% [17%], P < .001) but not in the altitude group (P = .562). Training in heat lowered core temperature and increased sweat rate during a heat-response test (P < .05). CONCLUSION A 2-week intensified training camp improved maximal oxygen uptake, repeated-sprint ability, and aerobic performance in elite rugby players. Adding heat and/or altitude did not further enhance physical performance, and altitude appears to have been detrimental to improving Yo-Yo.
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Mujika I, Sharma AP, Stellingwerff T. Contemporary Periodization of Altitude Training for Elite Endurance Athletes: A Narrative Review. Sports Med 2020; 49:1651-1669. [PMID: 31452130 DOI: 10.1007/s40279-019-01165-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Since the 1960s there has been an escalation in the purposeful utilization of altitude to enhance endurance athletic performance. This has been mirrored by a parallel intensification in research pursuits to elucidate hypoxia-induced adaptive mechanisms and substantiate optimal altitude protocols (e.g., hypoxic dose, duration, timing, and confounding factors such as training load periodization, health status, individual response, and nutritional considerations). The majority of the research and the field-based rationale for altitude has focused on hematological outcomes, where hypoxia causes an increased erythropoietic response resulting in augmented hemoglobin mass. Hypoxia-induced non-hematological adaptations, such as mitochondrial gene expression and enhanced muscle buffering capacity may also impact athletic performance, but research in elite endurance athletes is limited. However, despite significant scientific progress in our understanding of hypobaric hypoxia (natural altitude) and normobaric hypoxia (simulated altitude), elite endurance athletes and coaches still tend to be trailblazers at the coal face of cutting-edge altitude application to optimize individual performance, and they already implement novel altitude training interventions and progressive periodization and monitoring approaches. Published and field-based data strongly suggest that altitude training in elite endurance athletes should follow a long- and short-term periodized approach, integrating exercise training and recovery manipulation, performance peaking, adaptation monitoring, nutritional approaches, and the use of normobaric hypoxia in conjunction with terrestrial altitude. Future research should focus on the long-term effects of accumulated altitude training through repeated exposures, the interactions between altitude and other components of a periodized approach to elite athletic preparation, and the time course of non-hematological hypoxic adaptation and de-adaptation, and the potential differences in exercise-induced altitude adaptations between different modes of exercise.
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Affiliation(s)
- Iñigo Mujika
- Department of Physiology, Faculty of Medicine and Odontology, University of the Basque Country, Leioa, Basque Country, Spain. .,Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile.
| | - Avish P Sharma
- Griffith Sports Physiology and Performance, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Triathlon Australia, Burleigh Heads, QLD, Australia
| | - Trent Stellingwerff
- Canadian Sport Institute-Pacific, Victoria, BC, Canada.,Department of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
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No ergogenic effects of a 10-day combined heat and hypoxic acclimation on aerobic performance in normoxic thermoneutral or hot conditions. Eur J Appl Physiol 2019; 119:2513-2527. [PMID: 31555926 DOI: 10.1007/s00421-019-04215-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 08/21/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Hypoxic acclimation enhances convective oxygen delivery to the muscles. Heat acclimation-elicited thermoregulatory benefits have been suggested not to be negated by adding daily exposure to hypoxia. Whether concomitant acclimation to both heat and hypoxia offers a synergistic enhancement of aerobic performance in thermoneutral or hot conditions remains unresolved. METHODS Eight young males ([Formula: see text]: 51.6 ± 4.6 mL min-1 kg-1) underwent a 10-day normobaric hypoxic confinement (FiO2 = 0.14) interspersed with daily 90-min normoxic controlled hyperthermia (target rectal temperature: 38.5 °C) exercise sessions. Prior to, and following the confinement, the participants conducted a 30-min steady-state exercise followed by incremental exercise to exhaustion on a cycle ergometer in thermoneutral normoxic (NOR), thermoneutral hypoxic (FiO2 = 0.14; HYP) and hot (35 °C, 50% relative humidity; HE) conditions in a randomized and counterbalanced order. The steady-state exercise was performed at 40% NOR peak power output (Wpeak) to evaluate thermoregulatory function. Blood samples were obtained from an antecubital vein before, on days 1 and 10, and the first day post-acclimation. RESULTS [Formula: see text] and ventilatory thresholds were not modified in any environment following acclimation. Wpeak increased by 6.3 ± 3.4% in NOR and 4.0 ± 4.9% in HE, respectively. The magnitude and gain of the forehead sweating response were augmented in HE post-acclimation. EPO increased from baseline (17.8 ± 7.0 mIU mL-1) by 10.7 ± 8.8 mIU mL-1 on day 1 but returned to baseline levels by day 10 (15.7 ± 5.9 mIU mL-1). DISCUSSION A 10-day combined heat and hypoxic acclimation conferred only minor benefits in aerobic performance and thermoregulation in thermoneutral or hot conditions. Thus, adoption of such a protocol does not seem warranted.
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