McConnell, A. (2004). Altitude training -- Reaching for new heights: Is it all a waste of time and money? Peak Performance, 202, 1-4.

This article reviews literature involved with training at altitude, living-high and training-low, and using nitrogen tents, the last two topics being variations that persist to perpetuate the myth of beneficial altitude training. This abstract reports the major thrusts of the article.

1. The 1968 Olympic Games required individuals to train at altitude to perform at altitude. Since then, altitude training has been embraced but rather than increase sporting performances because of the assumed/asserted belief in its benefits, sporting performances have been depressed.
2. The theoretical basis of altitude training benefit is that blood adaptations to hypoxia (low oxygen) provide a greater oxygen-delivery capability (VO2max).
3. VO2max declines progressively with altitude, which compromises training intensity and initiates detraining [or low-intensity training].
4. Live-high/train-low (LHTL) programming was originally predicated on the benefit of red blood cell (RBC) increases and that sleeping at altitude was enough to stimulate RBC over-production.
5. “The LHTL and LHTH [live-high/train-high] groups both showed increases in VO2max (5%) that were ‘related’ to the increase in their RBC volume (9%). However, only 14% of the variation in VO2maxx could be explained by the change in RBC volume. Performance in a 5,000m running time trial improved only in the LHTL group, but again less than half (42%) of the variation in performance could be explained by the change in VO2max” (p. 2).
6. Studies in Australia using an “altitude house” as part of a LHTL regimen, showed initial increases in erythropoietin (EPO) of 80%. However, as the studies progressed this declined to baseline or control levels. RBC formation and mass did not increase, and VO2max declined.
7. “ . . . any benefits to performance of LHTL was unlikely to be due to an increase in RBC mass or VO2max” (p. 2). Methodological differences, biological variability, and random error of measurement are strongly suspected in causing differences between and within studies.
8. If any form of altitude training is beneficial, it is not likely to be caused by oxygen transport effects.
9. It is possible that total altitude training could improve the mechanical efficiency of sporting performances. [Example: cyclists training against lowered air-resistance might adapt to faster sprinting.]
10. It is possible that some benefit for anaerobic function could be derived from altitude training, but the research is not yet conclusive on this matter.
11. Intermittent hypoxic training involves training high and living low (THLL). The Russians allegedly have released information that shows this to have ergogenic effects on sea-level performances. It is based on the assumption that exercising in exaggerated hypoxia enhances muscle adaptations to training. The meager research on this topic suggests there might be some benefit from this training but that still remains at the hypothetical stage with theory being stronger than the evidence. [Some studies have shown sub-cellular changes that theoretically could improve performance but there is no evidence of functional (performance) benefit.]
12. There is insufficient evidence to conclude one way or the other about the role of exaggerated hypoxia as an ergogenic aid.
13. If one is to compete at altitude, acclimatization is essential.
14. “What does this mean for athletes and coaches? In practical terms, those considering altitude training should be cautious about investing a large amount of time and money in a practice that will, at best, yield only minor benefits and at worst may even be detrimental to sea-level performance” (p. 4).

Implication. This article confirms the conclusions of previous reviews. If anything, recent publications have dampened any assertion of possible value of any form of augmented hypoxic training.

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