Height training is a much-discussed topic in the sports world. Scientists and trainers have been falling over each other for decades when it comes to training at height. Through altitude training the performance of an athlete is often literally and figuratively raised to greater heights. With regard to the effects of altitude training there are dozens of theories. Today, scientists agree that the so-called 'Live High Train Low method' gives the best return.
Based on the literature, the three methods of altitude training were compared and it was determined which one was the best in terms of erythropoietin (the notorious EPO = the hormone that stimulates the production of erythrocytes/red blood cells) and haemoglobin (a protein that is responsible for the transport of oxygen).
Altitude training erupted when in 1963 the 1968 Olympic Games were assigned to Mexico City (2240m). A great deal of research was also conducted into the possibilities of simulated altitude training in a laboratory (1). It turned out that altitude training (both simulated and real) had a clear positive effect on the performance of an athlete. The result was that more and more athletes were incorporating altitude training in their program, but it was also found that training at height had an adverse effect: the absolute training intensity decreased, the athletes could not maintain the same training hours as at sea level . In order to prevent a decrease in performance, while still obtaining the positive effects of training at heights, other methods of altitude training have been applied.
In addition to the traditional way of training at high altitude and living, experiments were conducted with: high life - low training (so during training, people did not suffer from a reduced oxygen percentage and they could still be trained with the same intensity as at sea level) and also high training - low life (this way one would not experience the disadvantages of a long stay at height, but would benefit from training at a lower oxygen percentage). The automatic acclimatization of the human body to the changing conditions at height results in a number of physiological and hematological changes. These are clear and easy to test, for example a blood analysis can determine the hematological changes.
Effect with the classical method (Living High, Training High)
The classical, and currently the most widely used, form of altitude training is therefore the method in which people stay at a constant height. People are subject to a reduced oxygen concentration during training and recovery (eating and sleeping). From a hematological point of view, altitude training can best take place at an altitude between 2000 and 2500m (2). Indeed, it has been shown that an increase in the amount of erythrocytes [red blood cells] starts when the oxygen pressure falls below 65 mmHg, which corresponds to a height of approximately 2200m. With exercise this starts at an even lower level. If one goes higher than 3000m, the increase in erythrocytes is stronger, but this result is not achieved because the VO2max drops to such an extent that it becomes difficult to undergo such a training load (3).
Erythropoietin Definition: A hormone produced in the kidneys that stimulates the production of erythrocytes (red blood cells). After 2-3 days at a height (2500m), the erythropoietin has risen by 50-100% and is therefore at its peak.
Subsequently, the concentration starts to decrease as a result of the feedback control system in the body: an increased amount of erythrocytes inhibits the release of erythropoietin, but it remains higher at sea level during the entire stay (2). The amount of erythrocytes reaches its maximum value after about 7 days and then stays up to date during the stay. Due to an increase in erythrocytes, the ratio of red blood cell volume to total blood volume changes, the 'blood thickness' increases (4).
- Hemoglobin Definition: protein in red blood cells that binds and transports oxygen. Within 2-3 days at altitude, the hemoglobin [Hb] concentration in the blood increases by 10 to 15% compared to the sea level (5). This increase is caused by an increase in 'the product' erythrocytes, so that there is more demand for the 'transporter' (6).
- Result at sea level Upon return at sea level, after a training period at altitude, an immediate decrease of erythropoietin occurs. Due to this decrease in the hormone EPO, there is of course also an acute decrease in the production of erythrocytes. The hemoglobin level remains elevated for about 2/3 weeks after returning to sea level.
Subsequently, the concentration starts to decrease as a result of the feedback control system in the body: an increased amount of erythrocytes inhibits the release of erythropoietin, but it remains higher at sea level during the entire stay (2). The amount of erythrocytes reaches its maximum value after about 7 days and then stays up to date during the stay. Due to an increase in erythrocytes, the ratio of red blood cell volume to total blood volume changes, the 'blood thickness' increases (4).
- Hemoglobin Definition: protein in red blood cells that binds and transports oxygen. Within 2-3 days at altitude, the hemoglobin [Hb] concentration in the blood increases by 10 to 15% compared to the sea level (5). This increase is caused by an increase in 'the product' erythrocytes, so that there is more demand for the 'transporter' (6).
- Result at sea level
Upon return to sea level, after an altitude training period, an immediate decrease in erythropoietin occurs. Due to this decrease in the hormone EPO, there is of course also an acute decrease in the production of erythrocytes. The hemoglobin level remains elevated for about 2/3 weeks after returning to sea level.
An additional disadvantage may be that the persons who have been on altitude training experience symptoms of anemia (anemia) after 1 to 2 months. This is of course caused by a decrease in the EPO activity and then by a decrease in the Hb level in the blood. The performance at sea level could therefore theoretically decline after 1 to 2 months after return.
Effect with the LHTL (Living High, Training Low)
In addition to the classical method discussed above (Living High, Training High), two other forms of altitude training have been investigated. The next method that I have investigated is called the LHTL method. Experiments have begun with other forms of altitude training because some studies have shown that it is possible that performance at sea level decreases as a result of classical altitude training (7). This is because the decreased oxygen at height ensures that the intensity with which training can be done decreases, so that the eventual training load decreases with respect to sea level (8). To prevent a reduced training load due to height, the principle of 'living high - low training' was introduced (LHTL: Living High Training Low).
The athletes stayed at an altitude of 2500m, and only for training were the athletes transported to a training facility that was at an altitude of 1300m. In this way the athletes were subject to reduced oxygen pressure for 16 to 18 hours per day, but the training sessions took place under a normal oxygen percentage. This reduced the O2 saturation to 94% at rest and to 80% with exercise (9).
Because training takes place at a lower altitude, you have a higher absolute VO2max and you can work with the same training load as at sea level. The time after the training is again spent at height, this ensures favorable physiological adjustments with regard to the O2 transport by hemoglobin (10). The combination of maintaining the training load and the acclimatization at height must ultimately be the perfect combination that leads to an improvement of the performance capacity at sea level.
- Erythropoietin & Hemoglobin
As with classical altitude training, an increase in blood [EPO] was measured with the LHTL method (11). This increase in EPO was equal to slightly higher than with traditional altitude training. As with classical altitude training, the strongest increase is the strongest in days 2-4. In the following days, the amount of EPO & reticulocytes in the blood is still increased, but is increasing relatively less compared to the first four days. Studies show that LHTL causes the same hematological changes as classical altitude training, but produces a longer lasting effect, the results last almost twice as long, 4 to 6 weeks to peak.
Effect with the LLTH method (Living Low, Training High)
A third form of altitude training is the method whereby one lives at sea level and trains at altitude (Living Low, Training High). Most of the time the body is subject to normal oxygen pressure and only a few hours a day, the time of training, is it subject to hypoxia (reduced oxygen). The main difference between the previously described classical way & LHTL and this way is that in this way the body is exposed to hypoxia for a much shorter time compared to the previous two ways of altitude training. The advantage of this is that the time after training at altitude can also be used to carry out other training, which means that there is no reduction in the training load, as is the case with classic altitude training. Also, the chance of negative effects (altitude sickness for example) of prolonged exposure to altitude is smaller (12).
- Erythropoietin & Hemoglobin
There are several studies that describe the effect of LLTH on the [EPO] concentration in the body differently. In general it appears that no hematological changes take place at LLTH. The probable cause for this is that the (training) time spent at height is simply too short to see results. A significant increase in [EPO] was only found with a training time longer than 124 minutes (at an altitude of 3000m). Back at sea level, the EPO concentration continued to rise for 1.5 hours, after which it quickly declined and returned to normal.
Main objective:
- Which way of altitude training does, according to the analyzed RTCs, cause the most physiological (positive) changes within the human body? The above extracts from all investigated and analyzed RCTs, articles, internet sources and books show that the Living High, Training Low method is the most successful.
The traditional method of altitude training has so far been used most in practice, but here the hemoglobin remains raised at sea level for only 2 weeks. The results of the Living Low, Training High method are even worse. With the Living High, Training Low method, the hemoglobin concentration remains elevated in the body for longer, so that performance at sea level can be much improved from a physical point of view.
After all, an increased EPO concentration means more red blood cells, and this in turn means more oxygen transport within the body of the athlete, also during performance because the transporter of the red blood cells is also increased: the hemoglobin concentration is indeed increased!
These results lead to the answer of the main objective:
The Living High, - Training Low - method brings about the most positive physiological changes in the human body and thus provides the greatest possibility of increasing performance at sea level!
LITERATURE 1. Hollman W. and Liesen H., 1973. The influence of hypoxia and hyperoxia training in a laboratory on the cardiopulmonary capacity. In: Keul J. (ed.), Limiting factors on physical performance. Thieme, Stutgart, 212-218.
2. Wolski LA, McKenzie DC and Wenger HA, 1996. Altitude training for improvements in sea level performance: is there scientific evidence of benefit? Sports Med., 22 (4), 251-263.
3. Katayama K., Sato Y., Ishida K., Mori S. and Miyamura M., 1998. The effects of intermittent exposure to hypoxia during endurance exercise training on the ventilatory responses to hypoxia and hypercapnia in humans. EUR. J. Appl. Physiol., 78 189-194.
4. Berglund B., 1992. High-altitude training: aspects of heamatological adaptation. Sports Medicine, 14 (5), 289-303.
5. Böning B., 1996. Höhent training - was ist sichert? Deutsche Zeitschrift for Sportmedizin, 47 196-200.
6. Saltin B., 1996. Exercise and the environment: focus on altidude. Research Quarterly for Exercise and Sport. Full. 67 Suppl. 3 1-10.
7. Faulkner JA, Daniels JT and Balke B., 1967. Effects of training at moderate altitude on physical performance capacity. J. Appl. Physiol., 23 (1), 85-89.
8. Roskamm H., Landry F., Samek L., Schlager H., Weidemann H. and Reindell H., 1969. Effects of a standardized ergometer training program at three different altitude.
9. Rusko HK, Kirvesniemi H., Paavolainen L., Vähäsöyrinki P. and Kyrö K.-P., 1996. Effect of altitude training on sea level aerobic and anaerobic power or elite athletes. Med. Sc. Sports Exerc., 28 S5.
10. Wolski LA, McKenzie DC and Wenger HA, 1996. Altitude training for improvements in sea level performance: is there scientific evidence of benefit? Sports Med., 22 (4), 251-263.
11. Laitinen H., Alopaeus K., Heikkinen R., Hietanen H., Mikkelsson L., Tikkanen H. and Rusko H., 1995. Acclimatization to living in normobaric hypoxia and training in normoxia at sea level in runners. Med.Sci. Sports Exerc. 28 S156.
12. Favier R., Spielvogel H., Desplanches D., Ferretti G., Kayser B., Grünenfelder A., Leuenberger M., Tüscher L., Caceres E. and Hoppeler H., 1995. Training in hypoxia vs.. training in normoxia in high altitude natives. J. Appl. Physiol., 78 (6), 2286-2293.
