Thursday, March 2, 2017

Is Altitude Training Beneficial?

Athletes and recreational gym heroes are always looking for the next edge to dominate competition or personal records. Recently, a new trend of training like a villain has emerged. Specifically, suiting up like Bane from The Dark Knight Rises with an altitude training mask. However, there has been no clear evidence to support their use, despite investigations in cardiovascular training and resistance training.4,5,9,10 There seems to be no statistical significance or magnitude of improvements in aerobic capacity (VO2 Max), pulmonary function, or hematological variables. Little evidence suggests improved ventilatory thresholds and respiratory compensation thresholds, which is something at least.4 In resistance training activities, there are indications masks will reduce the total volume of training and increase perceived exertion acutely.10 Chronically, this reduction in mechanical stimuli could diminish an overload response or hypertrophic response over time.10 All of which equates to negative or no gains, which no one wants.
If they function, they function as respiratory muscle training devices.4 Furthermore, the specific mechanism of low bodily concentrations of oxygen exhibited in using the masks has been hypothesized to occur due to rebreathing carbon dioxide that accumulates in the mask.5 The benefits of using this specific mechanism in training are not clear, but from previous studies, there is limited significance in the usefulness of elevations masks oppose to a properly periodized training regimens.
When real altitude training is performed, individuals are exposed to hypobaric and hypoxic environments. Different training methods exist such as live low, train high (LLTH), live high, train high (LHTH), and live high, train low (LHTL) models. Therefore, to stimulate physiological adaptations: increased oxygen-carrying capacity via greater erythropoietic response (increased hemoglobin mass) and muscle buffering capacity via intramuscular carnosine levels.1,6 So far, research has suggested LHTL training has enhanced physiological adaptations on performance.7 However, before committing to this training regimen, further considerations should be implemented.
Variability responses among participants in studies have suggested individuals are either “responders” or “non-responders” to adaptations of altitude training.2 When investigating year-to-year changes in hemoglobin mass, Mclean and colleagues (2013) yielded similar increases in the altitude (2,100 m) groups response in increased hemoglobin mass. Except, individual athletes within the group did not exhibit changes from year-to-year. This suggests, there is no “responders” or “non-responders” grouping, but monitoring individual’s incidences of illness and body mass may be more advantageous.2  
Incidences of illness, such as infections may promote the proinflammatory cytokine interleukin 1. The importance of this cytokine is that as this increases, there is a decrease in erythropoietic response.1 Furthermore, a decrease in body mass may also blunt erythropoietic responses due to the mismatch between energy intake and energy expenditure, creating an overall catabolic environment.2
Moreover, for altitude training to be effective, the key factor may be proper nutritional strategies.3 As exposures to higher altitudes promote increased respiratory rates, urinary losses, the rate of perceived exertion, and decreased muscle protein synthesis enzymatic activity and appetite.1,2,3 Proper hydration is vital as men may lose up to 1900 mL and women 850 mL of water per day at moderate altitudes, as well as urinary losses up to 500 mL per day.3 Therefore, careful monitoring of hydration status should take place. Carbohydrates in the diet should be approximately 60% and may need to increase from 7-10 g/kg/day to 12 g/kg/day to compensate for training.
Praz and colleagues (2015) monitored nutritional behaviors of amateur ski-mountaineering athletes prior to competition. Their investigation revealed the athletes did not comply with pre-race carbohydrate, energy, and fluid intakes. Further suggesting, athletes need to be better informed about nutrition and how energy intake and energy expenditure can affect performance.8 However, precise guidelines are difficult due to varying altitudes (2000-3500 m) effect on physiology during training and recovery.3
Therefore, careful planning of training and nutritional periodization may be ideal if altitude training is of interest to an athlete or coach. If altitude training is a potential interest, consulting someone such as a Certified Strength and Conditioning Specialist (CSCS) may be beneficial to assess individual needs for an exercise program. Also, consulting a Registered Dietitian Nutritionist (RDN) would be equally beneficial to address dietary needs during training.
  1. McLean B, Buttifant D, Gore C, White K, Liess C, & Kemp J. (2013). Physiological and Performance Responses to a Preseason Altitude-Training Camp in Elite Team-Sports. International Journal of Sports Physiology and Performance, 8(4) 391-399.
  2. McLean B, Buttifant D, Gore C, White K, & Kemp J. (2013). Year-to-year variability in hemoglobin mass response to two altitude training camps. British Journal of Sports Medicine, 47, i51-i58.
  3. Michalczyk M, Czuba M, Zydek G, Zajac A, & Langfort J. (2016). Dietary Recommendations for Cyclists During Altitude Training. Nutrients, 8(6), 377; doi:10.3390/nu8060377
  4. Porcari J, Probst L, Forrester K, Doberstein S, Foster C, Cress M, & Schmidt K. (2016). Effect of Wearing the Elevation Training Mask on Aerobic Capacity, Lung Function, and Hematological Variables. Journal of Sports Science and Medicine, 15, 379-386.
  5. Granados J, Jansen L, Harton H, Gillum T, Christmas K, & Kuennen M. (2014). “Elevation Training Mask” Induces Hypoxemia but Utilizes A Novel Feedback Signaling Mechanism. International Journal of Exercise: Conference Proceedings, 2(6), 26.
  6. Mizuno M, Juel C, Bro-Rasmussen T, et al. (1990). Limb skeletal muscle adaptation in athletes after training at altitude. Applied Physiology, 68(2), 496-502.
  7. Ness J. (2015). Is live high/train low the ultimate endurance training model. NSCA Coach, 2(1), 20-24.
  8. Praz C, Granges M, Burtin C, & Kayser B. (2015). Nutritional behavior and beliefs of ski-mountaineers: a semi-quantitative and qualitative study. Journal of the International Society of Sports Nutrition, 12(46); DOI: 10.1186/s12970-015-0108-5
  9. Maspero M & Smith J. (2016). Effect of an acute bout of exercise using an altitude training mask simulating 12,000 ft on physiological and perceptual variables. International Journal of Exercise Science: Conference Proceedings, 2(8), Article 90.
Andre T, Gann J, Hwang P, et al. (2017). Restrictive breathing mask reduces total repetitions in resistance-trained males: an ongoing study. International Journal of Exercise Science: Conference Proceedings, 2(9), Article 76.

Dan Prenatt studied Exercise Science at Slippery Rock University. During this time, he discovered his passion for exercise and nutrition and their effects on human performance by training individuals at the campus recreation center. Solidifying his knowledge by obtaining credentials such as the Certified Strength and Conditioning Specialist (CSCS) from the National Strength and Conditioning Association and Certified Exercise Physiologist (EP-C) from the American College of Sports Medicine. Currently, he is a graduate student at Ohio University studying Nutrition where he serves as a teaching assistant with plans to obtain the RDN credential. Ultimately, Dan aspires to obtain the Certified Specialist in Sports Dietetics (CSSD) credential to further enhance his passion, knowledge, and experiences into helping clients achieve their goals and maintain an active, healthy lifestyle.