Altitude Training –Research and Practical Applications into Elite Athlete Training and Competition Preparation Dr Philo Saunders Senior Physiologist Australian Institute of Sport National Team Coach Athletics Australia Background • Altitude training used by endurance athletes for past 50+ yr – Balke et al. JAMA 194 (6):176-179, 1965. – Saltin. Symposium proceedings. RF Goddard (Ed), Chicago: The Athletic Institute, 1967, p. 97-102 – Dill & Adams. J.Appl.Physiol. 30 (6):854-59, 1971. • Widespread acceptance that altitude training improves performance at altitude and at sea-level – Dick FW. Int.J.Sports Med. 13 (Suppl 1):S203-S206, 1992. • Scientific evidence more equivocal Altitude and O2 levels Less Oxygen per Volume Decrease of athmospheric pressure with increasing altitude Molecular mechanisms of hypoxia • Hypoxia Inducible Factor (HIF) a ubiquitous transcription factor •Stabilised in hypoxia (also stimulated by insulin and IGFs) • HIF target genes (>100) include those for: • Oxygen transport: erythropoiesis and iron metabolism – EPO -erythropoiesis; Transferrin -iron transport; Tranferrin receptor -iron uptake; Ceruloplasmin -iron oxidation • Oxygen transport: vascular regulation • VEGF, EG-VEGF, PAI 1-angiogenisis; Flt 1-VEGF-receptor 1; Endothelin 1; Atrial Natriuretic Peptide, Adrenomedullin; alpha-1B adrenergic receptor -vascular tone; iNOS -NO production; Heme oxygenase 1-CO production • Anaerobic energy: glucose uptake and glycolysis • Glucose transporters 1&3- glucose uptake; Hexokinase, Phosphofrutco kinase L, aldolase, enolase 1, Lactate dehydrogenase, phosphoglycerate kinase 1 -glycolysis • Other • Carbonic anhydrase-pH regulation, IGFBP-1-growth factor • Transglutaminase 2, Asparagine synthase-amino acid metabolism • EPO increase of “responders” to hypoxia may be co-incident with, but not solely causative of, possible performance benefits Types of Hypoxia • Classical altitude training • Live and train at moderate natural altitude (2000-3000m) for 2-6wk (multiple times per year?) • Live high:train low (LHTL) • Natural or simulated moderate altitude for 2-4 wk • Intermittent Hypoxic Exposure (IHE) • Passive (normobaric or hypobaric) • 5 min hypox:5 min normox for ~60min/d for 2-4 wk • ~4000-6000 m (individual SaO2) • Intermittent Hypoxic Training (IHT) • exercising for ~1 hour/day (normobaric) for 2-4 wk • individualised intensity - SaO2 ~83-88% (low to moderate altitude equivalent - check) 2001-2005 Liquid Mechanism of AIS Altitude Nitrogen Air Outflow House Cylinder Pump Valves CO2 Altitude House Flow Scrubber Filter Regulators Air Return LHTL Research • Initial studies at AIS 8-10 h/d, 2-4wk, continuous or 1-2 days at normoxia per wk • 1.0-1.5% improvement in performance in events 45s to 17min (Hahn et al. 2001) • No real change in red cell mass or VO2max • Improvements in exercise economy and/or muscle buffering (Gore et al. 2001; Saunders et al. 2004) 3.60 p=0.005 Pre Post 3.55 3.50 ) -1 LSD=0.08 3.45 (L.min 2 VO 3.40 3.35 3.30 LHTL LMTM LLTL Group AUSTRALIAN ALL-TIME LIST As at 1st March 2017 Compiled by Paul Jenes - AA Statistician, Fletcher McEwen & David Tarbotton 10,000 METRES 1. 27.24.95 Ben St.Lawrence N 071181 3 Palo Alto, USA 1 May 11 2. 27.29.73 Collis Birmingham V 271284 2 Berkeley, USA 25 Apr 09 3. 27.31.92 Shaun Creighton A 150567 2 Melbourne 25 Nov 96 4. 27.34.48 Craig Mottram V 180680 1 Stanford, USA 4 May 08 5. 27.37.00 Darren Wilson V 090868 3 Melbourne 25 Nov 96 6. 27.39.89 Ron Clarke V 210237 1 Oslo,Norway 14 Jul 65 7. 27.45.01 Dave McNeill V 061086 4 Palo Alto, USA 2 May 15 8. 27.46.71 Bill Scott V 080252 2 Melbourne 6 Feb 80 9. 27.47.69 Steve Moneghetti V 260962 7 Oslo,Norway 4 Jul 92 10. 27.49.09 Sisay Bezabeh A 090977 1 Taraniki, New Zealand 21 Jan 02 11. 27.50.7h Gerard Barrett Q 311256 3 Moscow, Russia 21 Jul 79 12. 27.50.73 Dean Cavuoto A 040675 2 Taraniki, New Zealand 21 Jan 02 13. 27.51.27 Lee Troop V 220373 1 Inglewood, New Zealand 15 Feb 03 14. 27.52.10 Shawn Forrest V 100783 3 Stanford, USA 2 May 09 15. 27.53.30 Steve Austin V 140251 3 Stockholm, Sweden 9 Jul 81 16. 27.54.93 Brett Cartwright S 250173 3 Taraniki, New Zealand 21 Jan 02 17. 27.57.34 Andrew Lloyd N 140259 1 Melbourne 12 Dec 87 18. 27.59.64 Paul Patrick V 150971 1 Melbourne 16 Dec 93 19. 27.59.74 Patrick Tiernan Q 110994 1 Melbourne 8 Dec 16 20. 27.59.77 Michael Shelley Q 101083 9 Berkeley, USA 25 Apr 09 Natural altitude 2006-2010 Race Walking Race Walking Race Walking PLA LHTL NOC 860 840 820 800 780 2400 760 2350 Hbmass (g) Hbmass 740 2300 720 2250 700 2200 680 2150 660 2100 0 1 2 3 4 Week 2050 Distance (m) 2000 74 72 1950 70 1900 68 1850 66 1800 64 Altitude Placebo Nocebo 62 Group 60 max (ml/min/kg) max 58 2 VO 56 54 52 50 48 Altitude Placebo Nocebo Group Race Walking • Protocol from this study formed basis of altitude exposure prior to 2008 Olympics • 21 days LHTL at 3000m for 14 h/d • 7 days no altitude – recovery • 14 days LHTL at 3000m for 14 h/d • Finished LHTL 3 days prior to departure ~3 wk prior to first competition LHTL for 400m Runners May June 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 Travel Altitude First night Fri 20th, Last night Thurs 9th (21 nights) Treadmill Blood Hbmass Track Race • Hbmass measured via CO rebreathing • Treadmill test 4x4min submax stages followed by an all out effort to exhaustion at 21km/h for females and 24 km/h for males. – Blood measures to assess buffering capacity • Track session 2 x(2x200m) with 1min between each 200, and 15min between sets. – Blood measures taken 3 min after the first set and at 3, 6 and 9 min after the second set Pre Day 14 Day 20 % change Athlete 1 865 885 892 3.1 Athlete 2 519 544 547 5.4 Athlete 3 992 1007 1012 2.1 Athlete 4 859 887 910 5.9 Athlete 5 843 916 918 8.8 Mean 815 848 856 5.1 • HR and lactate during submax stages were clearly lower across all workloads. • Running economy tended to be better (~1-2%) • VO2max showed a variable response across individuals – mean response does no change – increase in Hbmass within the group it would be expected that the aerobic capacity is increased • MAOD increased by 4% across the group – slightly greater ANAEROBIC contribution. – lower lactates after the effort (despite similar or more work) – greater pH disturbance. Increased anaerobic capacity and improved muscle and/or blood buffering capacity • The mean performance time in the maximal test improved by 4.6s (3%) • Athletes performed better in the first set following altitude, and better able to back up for the second set • 200m times in the 1st set were 3.5% (0.9s) and 1.6% (0.4s) faster • 200m times in the 2nd set were 1.9% faster on rep 1 but 2.8% slower on rep 2 • 1% (1s) improvement in the total “800m” time, with a better first “400” and equal second “400” • Similar pH disturbance and bicarb decrease after the efforts • Higher lactate values indicating other improved buffering capabilities aside from blood bicarbonate. These may be intra-muscular or associated with extra blood volume Running Running Running Altitude training Considerations • Fitness level • Fatigue level • Iron supplementation • Injury/Illness • Travel • Focus of camp (racing, training, competition) When to use altitude • - Early-mid season preparation – 3-4 weeks LHTL or LHTH (International) – Accelerate fitness gains – Training focus post altitude – Keep momentum through season • Pre competition / competition (domestic) – Maybe lower altitude (LHTH domestic) with train low options – Multiple shorter stints an option • Competition International – 3-4 wk LHTL or LHTH (international) individual timing of when to compete Altitude training Considerations • Type of altitude – LHTL, LHTH, train low options, heat acclimation • Timing – pre competition, early season camp, season, around competitions • Travel • Height of LHTH venues • Facilities available – pool, track, lake, gym, trails, accommodation • Weather Iten, Kenya Flagstaff 2013 Flagstaff 2013 140 120 100 # 80 # 60 # # 40 # 20 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Hbmass 930 16.0 920 910 15.5 900 890 15.0 880 870 14.5 860 850 14.0 840 830 13.5 Pre Post Pre Post 6.8% 9.5% VO2max 81.0 80.0 79.0 78.0 77.0 76.0 75.0 74.0 73.0 Pre Post 5.8% vVO2max 20.8 20.7 20.6 20.5 20.4 20.3 3.0% 20.2 20.1 20 19.9 19.8 Pre Post Lactate Threshold 18.2 18.1 1.1% 18 17.9 17.8 Pre Post Performance 3:58.46 3:58.03 3:57.60 3:57.17 3:56.74 3:56.30 3:55.87 3:55.44 3:55.01 3:54.58 3:54.14 Pre Post1 Post8 Lyon 2013 Day 50 and 55 Post Altitude Flagstaff 2015 3-4 weeks live high train high Post altitude Altitude altitude camp, Flagstaff USA 4 week lead competition in period (2100m) Control 4 weeks training Continued training Hb mass RE @ 16 kmph Racing Training monitoring via sRPE 12/14/18 43 Flagstaff 2015 Training load Flagstaff 2015 Hbmass Haemoglobin mass # Pre Altitude (g) Post Altitude (g) % change 1 552 566 2.5 2 604 638 5.6 3 599 633 5.7 4 1161 1195 2.9 5 886 897 1.2 6 543 562 3.5 7 808 886 9.7 8 891 969 8.8 Mean (SD) 5.0 12/14/18 45 2015 Race performances Days post # Personal best Season’s best Post Altitude Change (s) % change altitude 1 2:01.26 2:02.17 2:02.41 0.2 0.9 1 2 4:05.76 4:09.41 4:05.56 -1.5 -0.1 6 3 4:13.26 4:13.26 4:13.22 0.0 0.0 1 4 4:04.69 4:06.20 4:01.81 -1.8 -1.2 1 5 3:50.61 3:50.61 3:48.55 -0.9 -0.9 8 6 71:51:00 71:51:00 71:07:00 -1.0 -1.0 2 7 1:45.80 1:47.52 1:45.79 -1.6 0.0 57 8 4:06.60 4:06.60 4:05.39 -0.5 -0.5 3 9a 3:50.50 3:50.50 3:46.33 -1.8 -1.8 7 9b 1:50.73 1:50.73 1:49.46 -1.1 -1.1 1 Mean - 1.0 3.7 2015-2016 Natural Altitude Group n VO2 max MOD3 10 72 ± 4 HI3 6 70 ± 4 HI4 10 69 ± 4 HI5 6 71 ±