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Practical Application of Altitude/Hypoxic Training for Olympic Medal Performance: The Team USA Experience

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Abstract

Although scientific conclusions remain equivocal, there is evidence-based research, as well as anecdotal support, suggesting that altitude training can enhance performance among Olympic level athletes, particularly in endurance sport. This appears to be due primarily to hypoxia-induced increases in total hemoglobin mass and subsequent improvements in maximal oxygen uptake and other factors contributing to aerobic performance. Although less clear, it is possible that non-hematological adaptations may contribute secondarily to improvements in post-altitude performance. These physiological effects are most likely realized when the altitude exposure is of sufficient “hypoxic dose” to provide the necessary stimuli for performance-affecting changes to occur via hypoxia-inducible factor 1α (HIF-1α) and hypoxia-inducible factor 2α (HIF-2α) pathways and their downstream molecular signaling. Team USA has made a strong commitment over the past 20 years to utilizing altitude training for the enhancement of performance in elite athletes in preparation for the Olympic Games and World Championships. Team USA’s strongest medal-producing Olympic sports—USA Swimming and USA Track and Field—embraced altitude training several years ago, and they continue to be leaders within Team USA in the practical and successful application of altitude training. Whereas USA Swimming utilizes traditional “live high and train high” (LH + TH) altitude training, USA Track and Field tends more toward the use of the altitude training strategy whereby athletes live high (and potentially sleep higher, either naturally or via simulated altitude), while training high during moderate-intensity (< lactate threshold 2) training sessions, and train low during high-intensity (> lactate threshold 2) training sessions (LH + TH[<LT] + TL[>LT]). Although USA Swimming and USA Track and Field have taken different approaches to altitude training, they have been equally successful at the Olympic Games and World Championships, both teams being ranked first in the world based on medals earned in these major international competitions. In addition to USA Swimming and USA Track and Field, several other Team USA sports have had consistently competitive performance results in conjunction with regular and systematic altitude training blocks. The purpose of this paper was to describe select altitude training strategies used by Team USA athletes, and the impact of those strategies on podium performance at major international competitions, specifically the Olympic Games and World Championships.

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Data Availability

All data generated or analyzed during this study are included in this published article [and its supplementary information files].

References

  1. Aughey RJ, Clark SA, Gore CJ, Townsend NE, Hahn AG, Kinsman TA, Goodman C, Chow CM, Martin DT, Hawley JA, McKenna MJ. Interspersed normoxia during live high, train low interventions reverses an early reduction in muscle Na+, K+ ATPase activity in well-trained athletes. Eur J Appl Physiol. 2006;98(3):299–309. https://doi.org/10.1007/s00421-006-0280-z.

    Article  CAS  PubMed  Google Scholar 

  2. Aughey RJ, Gore CJ, Hahn AG, Garnham AP, Clark SA, Petersen AC, Roberts AD, McKenna MJ. Chronic intermittent hypoxia and incremental cycling exercise independently depress muscle in vitro maximal Na+-K+-ATPase activity in well-trained athletes. J Appl Physiol. 2005;98(1):186–92. https://doi.org/10.1152/japplphysiol.01335.2003.

    Article  CAS  PubMed  Google Scholar 

  3. Bonetti DL, Hopkins WG. Sea-level exercise performance following adaptation to hypoxia. Sports Med. 2009;39(2):107–27. https://doi.org/10.2165/00007256-200939020-00002.

    Article  PubMed  Google Scholar 

  4. Brugniaux JV, Schmitt L, Robach P, Jeanvoine H, Zimmermann H, Nicolet G, Duvallet A, Fouillot JP, Richalet JP. Living high-training low: tolerance and acclimatization in elite endurance athletes. Eur J Appl Physiol. 2006;96(1):66–77. https://doi.org/10.1007/s00421-005-0065-9.

    Article  PubMed  Google Scholar 

  5. Brugniaux JV, Schmitt L, Robach P, Nicolet G, Fouillot JP, Moutereau S, Lasne F, Pialoux V, Saas P, Chorvot MC, Cornolo J. Eighteen days of “living high, training low” stimulate erythropoiesis and enhance aerobic performance in elite middle-distance runners. J Appl Physiol. 2006;100(1):203–11. https://doi.org/10.1152/japplphysiol.00808.2005.

    Article  PubMed  Google Scholar 

  6. Chapman RF, Karlsen T, Resaland GK, Ge RL, Harber MP, Witkowski S, Stray-Gundersen J, Levine BD. Defining the “dose” of altitude training: how high to live for optimal sea level performance enhancement. J Appl Physiol. 2014;116(6):595–603. https://doi.org/10.1152/japplphysiol.00634.2013.

    Article  PubMed  Google Scholar 

  7. Chapman RF, Laymon Stickford AS, Lundby C, Levine BD. Timing of return from altitude training for optimal sea level performance. J Appl Physiol. 2014;116(7):837–43. https://doi.org/10.1152/japplphysiol.00663.2013.

    Article  PubMed  Google Scholar 

  8. Chapman RF, Stray-Gundersen J, Levine BD. Individual variation in response to altitude training. J Appl Physiol. 1998;85(4):1448–56. https://doi.org/10.1152/jappl.1998.85.4.1448.

    Article  CAS  PubMed  Google Scholar 

  9. Garvican-Lewis LA, Halliday I, Abbiss CR, Saunders PU, Gore CJ. Altitude exposure at 1800 m increases haemoglobin mass in distance runners. J Sports Sci Med. 2015;14(2):413.

    PubMed  PubMed Central  Google Scholar 

  10. Garvican-Lewis LA, Sharpe K, Gore CJ. Time for a new metric for hypoxic dose? J Appl Physiol. 2016;121(1):352–5. https://doi.org/10.1152/japplphysiol.00579.2015.

    Article  PubMed  Google Scholar 

  11. Girard O, Brocherie F, Goods PS, Millet GP. An updated panorama of “living low-training high” altitude/hypoxic methods. Front Sports Act Living. 2020. https://doi.org/10.3389/fspor.2020.00026.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Girard O, Brocherie F, Millet GP. Effects of altitude/hypoxia on single-and multiple-sprint performance: a comprehensive review. Sports Med. 2017;47(10):1931–49. https://doi.org/10.1007/s40279-017-0733-z.

    Article  PubMed  Google Scholar 

  13. Gore CJ, Hahn AG, Aughey RJ, Martin DT, Ashenden MJ, Clark SA, Garnham AP, Roberts AD, Slater GJ, McKenna MJ. Live high: train low increases muscle buffer capacity and submaximal cycling efficiency. Acta Physiol Scand. 2001;173(3):275–86. https://doi.org/10.1046/j.1365-201X.2001.00906.x.

    Article  CAS  PubMed  Google Scholar 

  14. Gore CJ, Hopkins WG. Counterpoint: positive effects of intermittent hypoxia (live high: train low) on exercise performance are not mediated primarily by augmented red cell volume. J Appl Physiol. 2005;99(5):2055–7. https://doi.org/10.1152/japplphysiol.00820.2005.

    Article  PubMed  Google Scholar 

  15. Haase VH. Hypoxic regulation of erythropoiesis and iron metabolism. Am J Physiol Renal Physiol. 2010;299(1):F1–13. https://doi.org/10.1152/ajprenal.00174.2010.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Hall R, Peeling P, Nemeth E, Bergland D, McCluskey WT, Stellingwerff T. Single versus split dose of iron optimizes hemoglobin mass gains at 2106 m altitude. Med Sci Sports Exerc. 2019;51(4):751–9. https://doi.org/10.1249/MSS.0000000000001847.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Hopkins WG, Hewson DJ. Variability of competitive performance of distance runners. Med Sci Sports Exerc. 2001;33(9):1588–92. https://doi.org/10.1097/00005768-200109000-00023.

    Article  CAS  PubMed  Google Scholar 

  18. International Association of Athletics Federations (IAAF). World Outdoor Athletics Championship results. 2021. https://worldathletics.org/. Accessed 01 Dec 2021

  19. Koivisto-Mørk AE, Svendsen IS, Skattebo Ø, Hallén J, Paulsen G. Impact of baseline serum ferritin and supplemental iron on altitude-induced hemoglobin mass response in elite athletes. Scand J Med Sci Sports. 2021;31(9):1764–73. https://doi.org/10.1111/sms.13982.

    Article  PubMed  Google Scholar 

  20. Levine BD, Stray-Gundersen J. “Living high-training low”: effect of moderate-altitude acclimatization with low-altitude training on performance. J Appl Physiol. 1997;83(1):102–12. https://doi.org/10.1152/jappl.1997.83.1.102.

    Article  CAS  PubMed  Google Scholar 

  21. Levine BD, Stray-Gundersen J. Point: positive effects of intermittent hypoxia (live high: train low) on exercise performance are mediated primarily by augmented red cell volume. J Appl Physiol. 2005;99(5):2053–5. https://doi.org/10.1152/japplphysiol.00877.2005.

    Article  PubMed  Google Scholar 

  22. Millet GP, Brocherie F. Hypoxic training is beneficial in elite athletes. Med Sci Sports Exerc. 2020;52(2):515–8. https://doi.org/10.1249/MSS.0000000000002142.

    Article  PubMed  Google Scholar 

  23. Millet GP, Faiss R, Pialoux V. Point: Hypobaric hypoxia induces different responses from normobaric hypoxia. J Appl Physiol. 2012;112(10):1783–4. https://doi.org/10.1152/japplphysiol.00067.2012.

    Article  PubMed  Google Scholar 

  24. Millet GP, Roels B, Schmitt L, Woorons X, Richalet JP. Combining hypoxic methods for peak performance. Sports Med. 2010;40(1):1–25. https://doi.org/10.2165/11317920-000000000-00000.

    Article  PubMed  Google Scholar 

  25. Mounier R, Brugniaux JV. Counterpoint: Hypobaric hypoxia does not induce different responses from normobaric hypoxia. J Appl Physiol. 2012;112(10):1784–6. https://doi.org/10.1152/japplphysiol.00067.2012a.

    Article  PubMed  Google Scholar 

  26. Okazaki K, Stray-Gundersen J, Chapman RF, Levine BD. Iron insufficiency diminishes the erythropoietic response to moderate altitude exposure. J Appl Physiol. 2019;127(6):1569–78. https://doi.org/10.1152/japplphysiol.00115.2018.

    Article  CAS  PubMed  Google Scholar 

  27. Pedlar C, Whyte GR, Emegbo S, Stanley N, Hindmarch I, Godfrey R. Acute sleep responses in a normobaric hypoxic tent. Med Sci Sports Exerc. 2005;37(6):1075–9. https://doi.org/10.1249/01.mss.0000171623.52757.0f.

    Article  PubMed  Google Scholar 

  28. Robach P, Schmitt L, Brugniaux JV, Roels B, Millet G, Hellard P, Nicolet G, Duvallet A, Fouillot JP, Moutereau S, Lasne F. Living high–training low: effect on erythropoiesis and aerobic performance in highly-trained swimmers. Eur J Appl Physiol. 2006;96(4):423–33. https://doi.org/10.1007/s00421-005-0089-1.

    Article  PubMed  Google Scholar 

  29. Saugy JJ, Schmitt L, Cejuela R, Faiss R, Hauser A, Wehrlin JP, Rudaz B, Delessert A, Robinson N, Millet GP. Comparison of “Live High-Train Low” in normobaric versus hypobaric hypoxia. PLoS ONE. 2014;9(12): e114418. https://doi.org/10.1371/journal.pone.0114418.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Saunders PU, Telford RD, Pyne DB, Cunningham RB, Gore CJ, Hahn AG, Hawley JA. Improved running economy in elite runners after 20 days of simulated moderate-altitude exposure. J Appl Physiol. 2004;96(3):931–7. https://doi.org/10.1152/japplphysiol.00725.2003.

    Article  CAS  PubMed  Google Scholar 

  31. Siebenmann C, Dempsey JA. Hypoxic training is not beneficial in elite athletes. Med Sci Sports Exerc. 2020;52(2):519–22. https://doi.org/10.1249/MSS.0000000000002141.

    Article  PubMed  Google Scholar 

  32. Stray-Gundersen J, Chapman RF, Levine BD. “Living high-training low” altitude training improves sea level performance in male and female elite runners. J Appl Physiol. 2001;91(3):1113–20. https://doi.org/10.1152/jappl.2001.91.3.1113.

    Article  CAS  PubMed  Google Scholar 

  33. Townsend NE, Gore CJ, Hahn AG, McKenna MJ, Aughey RJ, Clark SA, Kinsman T, Hawley JA, Chow CM. Living high-training low increases hypoxic ventilatory response of well-trained endurance athletes. J Appl Physiol. 2002;93(4):1498–505. https://doi.org/10.1152/japplphysiol.00381.2002.

    Article  PubMed  Google Scholar 

  34. Wehrlin JP, Zuest P, Hallén J, Marti B. Live high-train low for 24 days increases hemoglobin mass and red cell volume in elite endurance athletes. J Appl Physiol. 2006;100(6):1938–45. https://doi.org/10.1152/japplphysiol.01284.2005.

    Article  CAS  PubMed  Google Scholar 

  35. Wilber RL. Application of altitude/hypoxic training by elite athletes. Med Sci Sports Exerc. 2007;39(9):1610–24. https://doi.org/10.1249/mss.0b013e3180de49e6.

    Article  PubMed  Google Scholar 

  36. Wilber RL. Altitude training and athletic performance. Champaign-Urbana:Human Kinetics; 2004.

  37. Wilber RL. Live high+ train low: thinking in terms of an optimal hypoxic dose. Int J Sports Physiol Perform. 2007;2(3):223–38. https://doi.org/10.1123/ijspp.2.3.223.

    Article  Google Scholar 

  38. Wilber RL, Holm PL, Morris DM, Dallam GM, Callan SD. Effect of FIO2 on physiological responses and cycling performance at moderate altitude. Med Sci Sports Exerc. 2003;35(7):1153–9. https://doi.org/10.1249/01.mss.0000074495.34243.b5.

    Article  PubMed  Google Scholar 

  39. Wilber RL, Holm PL, Morris DM, Dallam GM, Subudhi AW, Murray DM, Callan SD. Effect of FIO2 on oxidative stress during interval training at moderate altitude. Med Sci Sports Exerc. 2004;36(11):1888–94. https://doi.org/10.1249/01.mss.0000145442.25016.dd.

    Article  CAS  PubMed  Google Scholar 

  40. Wilber RL, Stray-Gundersen J, Levine BD. Effect of hypoxic" dose" on physiological responses and sea-level performance. Med Sci Sports Exerc. 2007;39(9):1590–9. https://doi.org/10.1249/mss.0b013e3180de49bd.

    Article  PubMed  Google Scholar 

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Acknowledgements

The author acknowledges and greatly appreciates the mentorship and collaboration of the following vis a vis the advancement of altitude/hypoxic training with Team USA: Jay T. Kearney, PhD, Steve Fleck, PhD, Michael Shannon MS, Lindsay Golich MS, Sam Callan MS, Paige Holm MS, David Morris, PhD, Robert Chapman, PhD, Ben Levine, MD, Jim Stray-Gundersen, MD, Michael Brothers, PhD, Andy Subudhi, PhD, George Dallam, PhD, Bill Byrnes, PhD, Bob Bowman, Keenan Robinson, Jerry Schumacher and Pete Julian.

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The author declares that no funds, grants, or other support were received during the preparation of this manuscript.

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  1. United States Olympic & Paralympic Committee, 1 Olympic Plaza, Colorado Springs, CO, 80909, USA

    Randall L. Wilber

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Wilber, R.L. Practical Application of Altitude/Hypoxic Training for Olympic Medal Performance: The Team USA Experience. J. of SCI. IN SPORT AND EXERCISE 4, 358–370 (2022). https://doi.org/10.1007/s42978-022-00168-y

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