Hypoxia and the Circulation

Volume 618 of the series Advances in Experimental Medicine and Biology pp 255-276

The Limits of Human Endurance: What is the Greatest Endurance Performance of All Time? Which Factors Regulate Performance at Extreme Altitude?

  • Timothy David NoakesAffiliated withProfessor in the Discovery Health Chair of Exercise and Sports Science and Director of the MRC/UCT Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Sports Science Institute of South Africa

* Final gross prices may vary according to local VAT.

Get Access


Humans evolved as an athletic species able to run in the midday heat, to throw with exquisite accuracy and to strike powerfully despite relatively weak upper arms compared to those of the great apes. The true extent to which humans could run long distances was first tested in a unique series of 6-day foot races contested between 1874 and 1888 by professional athletes from England and the United States. These athletes typically would have expended approximately 60 000 kcal (24.12 MJ) of energy during these races. The discovery of the bicycle soon caused the replacement of these races by 6-day cycling races which, in turn, led to the modern day Tour de France, the cycling race across America (RaAM) and two running races across the width of the United States in 1928 and 1929. The total energy expenditures during these different events can be estimated at approximately 168 000, 180 000 and 340 000 kcal respectively.

But, in terms of the total energy expenditure, all these performances pale somewhat when compared to that of Robert Falcon Scott’s Polar party during the 1911/12 British Antarctic Expedition. For most of 159 consecutive days, Scott’s team man-hauled for 10 hours a day to the South Pole and back covering a distance of 2 500 km. Their predicted total energy expenditure per individual would have been about 1 million kcal, making theirs, by some margin, the greatest sustained endurance athletic performance of all time. Interestingly, the dogs that provided the pulling power for Norwegian Roald Amundsen’s team that was the first to reach the South Pole, 35 days before Scott’s party, would have expended about 500 000 kcal in their 97 day trip, making theirs the greatest animal “sporting” performance on record. By contrast, mountain climbers expend only approximately4 000 kcal/day when climbing at extreme altitudes (above 4 000 m). This relatively low rate of energy expenditure results from the low exercise intensities that can be sustained at extreme altitude. Here I argue that this slow rate of energy expenditure is caused, not by either myocardial or skeletal muscle hypoxia as is usually argued, but is more likely the result of a process integrated HYPoXia and tHE CiRCulation Chapter 0 centrally in the brain, the function of which is to protect the body from harm. At extreme altitude the organ at greatest risk is the brain which must be protected from the catastrophic consequences of profound hypoxia. A key feature of this control is that it acts “in anticipation” specifically to insure that a catastrophic biological failure does not occur. The evidence for this interpretation is presented.

Key Words

energy expenditure heart central governor evolution hunting