[ALTITUDE TRAINING AND PERFORMANCE]

Author: [JOHANNA BRISCOE]

Every minute and second matters in competitive sports. In 2019, the Boston Marathon came down to a mere two seconds with Lawerance Cherono breaking the tape. During the 2016 Summer Olympics in Rio, the top three finishers in the 100 meters butterfly swim were separated by less than one second. With such close competitive times, it is no wonder that athletes are looking for a way to gain an edge and those top spots. The most common natural way to achieve this advantage is through altitude training.

At high altitudes, one breathes less oxygen per breath compared to a sea level. This means working muscles are also receiving less oxygen. During the acclimation process, the body produces more red blood cells naturally as a response, which delivers more oxygen to the muscles. When an athlete then returns to sea level for competition, their body has more red blood cells then what is normal at sea level normal to carry the increase of oxygen found at the lower elevations. Thus they can perform more efficiently and better than before.

In Korea, elite athletes (n = 156) from a variety of sports were selected to participate in a research study. They tested the result of oxygen delivery capacity of the blood during aerobic activities during altitude training (experimental group) as compared to sea level training (control group). Maximal oxygen consumption (VO2max), red blood cell count (RBC), erythropoietin (EPO), hemoglobin (Hb), and hematocrit (Hct) were all used to quantify the oxygen delivery capacity. The study proved there was a greater oxygen delivery capacity as well as a greater outcome in performance when high altitude training was included into an athletes program (Park et al., 2016). The performance boost was proved to be about a 1-2% increase, and lasted for about 2-3 weeks at sea level (Levine, 2016).

The effects of altitude training can be accomplished in two traditional approaches: “live high-train high” (LHTH) and “live high-train low” (LHTL). Living high-training high (LHTH) was the original approach, utilized successfully first by the Kenyans, Eritreans, and Terra Humera tribe of Mexico, as their natural living environments are far above sea level. While this is effective, as more research has come to light, there proved to be a drawback. Athletes living in high altitudes are unable to train consistently at the same intensity as athletes living at sea level.

So instead of LHTH, the newest and most effective version is LHTL, which incorporates the best part of both situations. Established by Dr. Benjamin Levine in the early 1990s, this approach uses the effects of living at high altitudes and then going down to lower elevation to be able to train at the proper needed intensities. This is also accomplished via “training camps”, where the athletes live at high altitude camps for a period of time, but come down in elevation to train. Common locations of these camps in the US are Boulder, Albuquerque, and Flagstaff. A study published in the Journal of sports medicine and physical fitness looked to determine if “living high-training high” (LHTH) or “living high-training low” (LHTL) had a greater effect on exercise performance and erythropoietin response. A group of cross-countries skiers underwent two trials. During the first trial the LHTH- modality was tested, in which the participants lived for approximately a month at 5000-6700 ft, and trained there as well. For the second trial, LHTL was tested, in which the participants lived at 5000-6700 ft, but trained at near sea level. Blood samples and VO2 max (via a maximal cycle ergometer test at sea level) were measured on the first and last days of both trials. The findings indicated that the most significant increase in VO2 max and RBC came from the LHTL trial, and that integrating this concept into training could improve endurance performance (Christoulas et al., 2015).

Since living at altitude is not an option for all athletes, living in hypoxic environments or training in an hypoxic state can be used at sea level with similar outcomes to altitude training. Intermittent hypoxic training (IHT) is training under low oxygen levels, and can be accomplished by living in “altitude tents'' or training in hypoxic masks. Czuba, Waskiewicz and Zajac conducted a study in Poland that tested the efficacy of IHT. Elite male cyclists (n = 20) were split into two randomized groups: hypoxia (n=10) vs. control (n=10). The hypoxia group performed three training sessions a week (at 95% effort for 30 to 45 mins) for three week in a normobaric hypoxic environment. The control did the same training schedule, but in an environment with normal levels of oxygen (normoxia). RBC and VO2 were measured, and the results showed significant increase in aerobic capacity (VO2 max) with a p < 0.05 for the hypoxic group. “This data suggests that intermittent hypoxic training at lactate threshold intensity and medium duration (30-40min) is an effective training means for improving aerobic capacity and endurance performance at sea level,” (Czuba et al., 2016).

For recreational athletes, proper coaching, nutrition, and training can make all the difference. However, for elite athletes pushing boundaries of only seconds, fine-tuning performance with altitude training would be beneficial. Alberto Salazar, one of the legendary coaches of distance running, was famous for making sure all the little details lined up to create historic athletes. One of these details was altitude training. At one point in his career, Alberto Salazar had one of his athletes, Galen Rupp, “living in an ‘altitude house’ in Portland, with an air-filtering system that simulated high altitude oxygen tents and naturally boosted his hemoglobin levels” (Ingle, 2015). It has been long agreed upon that training at altitude helps increase performance. Many olympics training centers are located at high altitude and many professional athletes travel up to mountain towns to train. Most coaches host performance - boosting camps high above sea level. The science proves it, and the performances back it.

[REFERENCES]

Source 1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899894/

Park, H. Y., Hwang, H., Park, J., Lee, S., & Lim, K. (2016). THE EFFECTS OF ALTITUDE/HYPOXIC TRAINING ON OXYGEN DELIVERY CAPACITY OF THE BLOOD AND AEROBIC EXERCISE CAPACITY IN ELITE ATHLETES - a meta-analysis. Journal of exercise nutrition & biochemistry, 20(1), 15–22.

Source 2: https://pubmed.ncbi.nlm.nih.gov/21297566

Christoulas, K., Karamouzis, M., & Mandroukas, K.. "LIVING HIGH - TRAINING LOW" VS. "LIVING HIGH - TRAINING HIGH": erythropoietic responses and performance of adolescent cross-country skiers. The Journal of sports medicine and physical fitness, 51(1), 74–81.

Source 3: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737917/

Czuba, M., Waskiewicz, Z., Zajac, A., Poprzecki, S., Cholewa, J., & Roczniok, R. THE EFFECTS OF INTERMITTENT HYPOXIC TRAINING ON AEROBIC CAPACITY AND ENDURANCE PERFORMANCE IN CYCLISTS. Journal of sports science & medicine, 10(1), 175–183.

Source 4: https://www.theguardian.com/sport/2015/jun/04/albert-salazar-obsessive-coaching-mo-fara 

Ingle, S. (2015, June 4). ALBERTO SALAZAR'S OBSESSIVE APPROACH TAKES COACHING TO EXTREMES.

Source 5: https://utswmed.org/medblog/high-altitude-training/ 

Levine, B. (2016, November 21). HOW HIGH-ALTITUDE TRAINING CAN BENEFIT ELITE ENDURANCE ATHLETES LIKE RUNNERS AND SWIMMERS: Heart: UT Southwestern Medical Center. Retrieved June 15, 2020