Altitude Training for Cardiac Rehab and Treatment

by | Altitude Training Information, General Fitness

WHY USE ALTITUDE TRAINING FOR CARDIOVASCULAR DISEASE?

 

Cardiovascular disease (CVD) is the leading cause of death in men and women worldwide (1). Additionally, coronary artery disease and hypertension are two of the most prevalent forms of CVD. Physical inactivity is one of the main risk factors of CVD. Therefore, it is important that we improve the methods used to combat this disease. 

Hypoxic exposures, and exercise (IHT) in a simulated altitude environment (hypoxic training) can provide greater improvements in CVD symptoms and the quality of life of CVD patients. (2)

Indeed, the benefits of hypoxic exposure and exercise have been shown to result in greater improvements than sea-level exercise and/or medication alone (3,4). Exercise in hypoxia can also be done with lower overall workloads and reduced physical effort for the same or greater aerobic training effect (1,5,6). Even for patients with advanced conditions or comorbidities that limit their ability to perform exercise, passive hypoxic exposure can improve many factors of CVD and increase exercise tolerance and capacity. For example, in older people with and without CVD, passive exposure improved resting heart rate, blood pressure, stress on the cardiac muscle (reduced rate pressure product), arterial oxygen content and peak workload compared to control groups (3). 

 

Altitude Training For Cardiovascular Disease – Evidence-Based Benefits 

 

Accumulated research over the past 50 years has demonstrated hypoxic exposure and exercise is safe, and effective for patients with varying levels of CVD (1,3,4) . Also, the research has shown the mechanisms underpinning why hypoxic exposure is more effective for CVD patients.

IHT increases mitochondrial metabolism and density (1,5), stimulates endothelial Nitric Oxide production enhancing vasodilation and increases capillary density. Indeed, these mechanisms result in numerous beneficial performance and CVD outcomes.

Clinically relevant improvements for hypertensive, CVD, and chronic heart failure patients that are greater than what would be seen with sea-level exercise or traditional interventions alone. These include:

  • Lower Resting Blood Pressure (1,3,4)
  • Lower Resting & Active HR (1,3,4)
  • Reduced Rate Pressure Product (Cardiac Stress) (3)
  • Fewer Hypertensive Episodes (4)
  • Increased Aerobic Capacity (2,3,5)
  • Increased Exercise Capacity & Tolerance (2,3)
  • Improved Quality of Life (2,4)

Protocols can be either passive or active and built for varying levels of exercise tolerance. For example, passive protocols involving intermittent hypoxic breathing (IHB)* are ideal for patients suffering from CVD or other co-morbidities who cannot tolerate exercise. Active protocols are designed to allow patients to ease into exercise without compromising performance benefit. 

*IHB involves breathing very low oxygen air from a stationary position (seated) in a series of intervals interspersed with sea-level breathing.

 

Opportunities for Physicians and Clinics

 

  1. Incorporate altitude training sessions during cardiac rehab
    • Minimize deconditioning
    • Reduce inflammation
    • Regain fitness quicker
    • Slowly increase training intensity without compromising fitness
  2. Offer solutions for individuals with advanced conditions or comorbidities that limit their ability to perform exercise
    • Prevent further decline in aerobic fitness 
    • Increase aerobic capacity, building toward increasing physical activity 
    • Increase exercise tolerance building toward future exercise programs 

 

Speak with one of our coaches about training options for cardiovascular disease to improve health outcomes and quality of life.

Altitude Athletic is Toronto’s first and one of the largest altitude training facilities in the world. We’re here to help you prepare for your next big climb, event or meet your health goals. Click here to learn more about what we do at Altitude.

Contact Us

References

 

(1) Safety and Efficacy of Intermittent Hypoxia Conditioning as a New Rehabilitation/Secondary Prevention Strategy for Patients with Cardiovascular Diseases: A Systematic Review and Meta-analysis

(2) Improved Exercise Performance and Skeletal Muscle Strength After Simulated Altitude Exposure: A Novel Approach for Patients With Chronic Heart Failure

(3) Intermittent hypoxia increases exercise tolerance in elderly men with and without coronary artery disease

(4) Intermittent hypoxia training as non-pharmacologic therapy for cardiovascular diseases: Practical analysis on methods and equipment

(5) Training High- Living Low: Changes of Aerobic Performance and Muscle Structure with Training at Simulated Altitude

(6) Endurance Training in Normobaric Hypoxia Imposes Less Physical Stress for Geriatric Rehabilitation

(7) The effect of acute exercise in hypoxia on flow-mediated vasodilation

Performance Assessment for the Cycling Athlete

by | Altitude Training Information, Endurance

You’re busy with work, life and training. With so much going on, it’s helpful to see if your hard work is paying off. Where does your fitness stand right now? Is there a way you can do things better and train smarter?

A performance assessment is a great tool for cyclists (or in fact, any athlete) to gain valuable data to understand their baseline and to help better guide their training. Learn more about some of the data a performance assessment will tell you and why this data matters:

 

VO2 Max – What is It and How Can It Help Me?

 

In a good performance assessment, a coach will measure something called VO2 Max. Your VO2 Max can help provide insight into your current performance. Also, it can guide your training plan to ensure you continue improving and be used to track progress.

VO2 Max measures the amount of oxygen your body can take in and use during maximal exercise. This is basically your ‘upper limit’ when it comes to intense exercise. The measurement looks at the liters of oxygen you consume per minute. The number we get helps us look at the health and function of different systems.

In other words, how well you breath in, extract oxygen from the atmosphere via the lungs, how well that oxygen is loaded into the circulator system and delivered to working muscles via the heart and arteries, and finally how well the muscles extract and use that oxygen. (1)

Cycling is an aerobic sport and cyclists are highly dependent on using oxygen for energy production. Therefore, VO2 Max is a large contributing factor to how well you can perform on the bike.

 

Performance assessment for the cycling athlete

Functional Threshold Power, What is It and Why Should I Know It?

 

In addition to measuring VO2 Max, a good assessment for cyclists will also find Functional Threshold Power (FTP). FTP is the highest power output that you can hold for ~60 minutes. FTP is a good indication of your specific anaerobic threshold, meaning you will know exactly how hard you can work before anaerobic energy systems begin contributing excessively (2).

This shift is typically noticed as an intense burning sensation in the muscle, as anaerobic energy system produces metabolic by-products such as hydrogen ions leading to the burn. This will allow you to optimize your training by using percentage of FTP to create specific training zones that correlate to specific training goals, for example a work rate of 56-75% of your FTP would be an ideal training zone for developing aerobic endurance.

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Our performance assessment will provide you with your HR (heart rate) at threshold, power at threshold, VO2 Max and more. You’ll gain a deeper understanding of your current level of performance, and data to optimize your training. Learn more about assessments and services at Altitude: ASSESSMENTS

 

 

 

 

Altitude Athletic is Toronto’s first and one of the largest altitude training facilities in the world. We’re here to help you prepare for your next big climb, event or meet your health goals. Click here to learn more about what we do at Altitude.

Contact Us

References

(1) “Measurement of VO2 Max-VO2 Peak is no longer acceptable”. David C. Poole and Andrew M. Jones. Journal of Applied Physiology (2017).
https://journals.physiology.org/doi/full/10.1152/japplphysiol.01063.2016

(2) “Functional Threshold Power in Cyclists: Validity of the Concept and Physiological Responses.” Borszcz, Fernando and Tramontin, Artur and Bossi, Arthur and Carminatti, Lorival and Costa, Vitor. (2018). International Journal of Sports Medicine

(3) “VO2 Primer” University of California – Davis. Health – Sports Medicine: VO2 – Rate of Oxygen Consumption

Altitude Training for Fat Loss, Muscle Mass and Body Composition

by | Altitude Training Information, General Fitness, Hypoxic Training Resources

We know elite cyclists use altitude training to get a fitness boost before racing in the Tour de France. And we’ve heard that olympic runners will head to high altitude camps in places like Flagstaff or St. Moritz to get that extra lung for events at sea-level.

But what if you’re not headed to Le Portet d’Aspin (a famous Tour de France climb) or the upcoming summer Olympics? What if you’re not a professional cyclist or runner or athlete? What if you consider yourself a ‘normal person’ whose goal is to simply get stronger, maintain a healthy body fat % and feel good in your body. And do so without having to invest a huge amount of time and energy, which is already being divided amongst so many other things in your life.

We tend to diminish a goal like this, as if it’s embarrassing that we’re not headed to the Olympics and we’re ‘just exercising to look and feel good’ instead. But this is actually an extremely important goal. Maintaining the healthiest version of your body is one of the most important things you can do for yourself physically and mentally.

Just like altitude training can help elite cyclists and runners get an edge in their competitions, it can also help you increase muscle mass, lose body fat and improve overall health. Here’s how:

 

How can altitude training help me increase my muscle mass?

Research shows that intermittent hypoxic training can result in greater gains in muscle mass compared to similar training performed at sea-level. For example, resistance training done at altitude was shown to:

  • Increase the metabolic stimulus for muscle growth
  • Have a similar effect to BFR (Blood Flow Restriction) training, but without the discomfort and common problems associated with BFR
  • Enhance metabolic efficiency in the muscle tissue, which enhances muscular endurance

The effects are increased with a specific transition time between exercises and rest between circuits combined with appropriate volume and muscular tension. Therefore, it’s important to work with a coach who understands strength training methods at altitude. 

 

How can altitude training help me lose body fat?

Studies have shown differences in fat loss when doing the same exercise program at sea-level vs. altitude. It’s been found that altitude training can decrease fat mass more effectively and create a larger caloric deficit with the same amount of exercise. In one of these studies, participants saw an almost 7% reduction in fat mass by training at altitude compared to the group training at sea-level, which didn’t see any reduction. Altitude training may also play a role in healthy weight loss through influences on leptin secretion (a hormone that tells the body it has had enough to eat).

 

How can altitude training impact health factors: metabolism, blood pressure and cholesterol? 

There are also benefits that contribute to overall health and disease prevention. For example, IHT can increase your body’s capacity to use fat as fuel. If you’re struggling with a slow metabolism, this can help improve those symptoms. Also, there’s research showing that altitude can help reduce the risk of Type 2 Diabetes. And help with insulin resistance in overweight individuals. 

For those looking to improve vascular health and slow down the progress of peripheral arterial disease (PAD), it’s been shown that training at altitude can help reduce arterial stiffness and improved blood pressure, as well as improving blood lipid profile such as having a positive effect on cholesterol.

So, if you’re looking to feel better and see greater improvements in body composition, altitude training can definitely help. For the fastest route to your goals, make sure you work with a coach and get access to a well-structured program that addresses your specific needs in exercise and nutrition. Learn more about personalized programming at Altitude through our Memberships.

 

References:

[1]A. Törpel, B. Peter, D. Hamacher and L. Schega, “Dose–response relationship of intermittent normobaric hypoxia to stimulate erythropoietin in the context of health promotion in young and old people”, European Journal of Applied Physiology, vol. 119, no. 5, pp. 1065-1074, 2019. Available: 10.1007/s00421-019-04096-8.

[2]I. Guardado, B. Ureña, A. Cardenosa, M. Cardenosa, G. Camacho and R. Andrada, “Effects of strength training under hypoxic conditions on muscle performance, body composition and haematological variables”, Biology of Sport, vol. 37, no. 2, pp. 121-129, 2020. Available: 10.5114/biolsport.2020.93037.

[3]B. Yan, X. Lai, L. Yi, Y. Wang and Y. Hu, “Effects of Five-Week Resistance Training in Hypoxia on Hormones and Muscle Strength”, Journal of Strength and Conditioning Research, vol. 30, no. 1, pp. 184-193, 2016. Available: 10.1519/jsc.0000000000001056.

[4]B. Feriche, A. García-Ramos, A. Morales-Artacho and P. Padial, “Resistance Training Using Different Hypoxic Training Strategies: a Basis for Hypertrophy and Muscle Power Development”, Sports Medicine – Open, vol. 3, no. 1, 2017. Available: 10.1186/s40798-017-0078-z.

[5]R. Timon, I. Martínez-Guardado, A. Camacho-Cardeñosa, J. Villa-Andrada, G. Olcina and M. Camacho-Cardeñosa, “Effect of intermittent hypoxic conditioning on inflammatory biomarkers in older adults”, Experimental Gerontology, vol. 152, p. 111478, 2021. Available: 10.1016/j.exger.2021.111478.

[6] Park, Hun-Young & Lim, Kiwon. (2017). The Effects of Aerobic Exercise at Hypoxic Condition during 6 Weeks on Body Composition, Blood Pressure, Arterial Stiffness, and Blood Lipid Level in Obese Women. International Journal of Sports Science. 1. 1-5.

Base Building: 5 Benefits of Off-Season High Altitude Training 

by | Altitude Training Information, Endurance, General Fitness

As the leaves begin to turn and temperatures begin to drop, for many people this time of year becomes staying indoors with Netflix. For the endurance athlete however, the time between November and April can represent a big wide window of opportunity. This is your opportunity to reflect on what went well in your season. You can also identify areas of focus for next season and develop a finely-tuned base-building plan to prep you to conquer the spring.

If your racing season took you into the fall, it’s always a good idea to take a few weeks, or even a couple of months, off of a structured training plan. Physically, this gives your body a true chance to recover. Recovery is needed because prolonged racing and training causes a substantial degree of muscle breakdown and a systemic inflammatory response. It can take up to 19 days after an Ironman-distance triathlon for inflammation and cortisol to return to baseline levels, even in a well-trained athlete. Mentally, endurance events require long term commitment, self-discipline, and a high degree of day-to-day planning and time management. It’s healthy to give yourself a break from the rigidity of this type of schedule. 

So once you’ve refreshed your mind and body and as the mornings continue to get darker, here are 5 reasons why you should get yourself back in gear with off-season high altitude training over the colder indoor months. 

off-season high altitude training

Controlled environments let you hone in on specific weaknesses. 

Did hills eat you up this year? Does your form start to fall apart at a certain speed? Now is the time to work on whatever’s holding you back from the next level. Not having a race schedule allows you to build training blocks and choose training workouts with these goals in mind. Try running or cycling workouts using the treadmills and indoor trainers at Altitude. These workouts can help you work on goals like building aerobic capacity, speed and endurance.

Altitude workouts give you more bang for your buck.

In the altitude chamber, the air contains less oxygen, forcing your body to work harder to meet its oxygen demands. This natural challenge triggers a cascade of physiological adaptations, resulting in increased red blood cell production, enhanced lung capacity, and improved overall endurance. Altitude workouts supercharge your cardiovascular system, making every breath count and maximizing your calorie burn. This is a good thing, since even the strongest mental game can go a little bananas when on a trainer for long periods of time. Which brings us to our next point…

Classes do the job, and they’re social. 

Endurance sports can be a little lonely. Maybe you’ve got some friends in the summer that you can join for long runs or rides, but the winter can be much more isolating. Rather than hole up, try a class specifically designed to challenge runners or cyclists at high altitude. Whether you’ve got a friend to go with you or not, the time always passes much more quickly in a group setting, not to mention it’s way more fun. Check out Altitude’s classes here!

Hit March with a spring in your step. 

Most athletes look to start racing again for March-April. Nothing feels worse than sitting on your couch for several months, only to blow the dust off of your shoes in spring and have to dedicate the first 6-12 weeks of training to just base build. Even doing a few key workouts per week can keep you from detraining. Or, even better, can help you beef up your base before the warm weather comes around again. You’ll see faster progress and better results with consistent off-season high altitude training.

Keeps the winter blues at bay.

SADS, or seasonal affective disorder syndrome, is a proven disorder that manifests as an increase in sleep, sedentary behavior, depression and sometimes weight gain that occurs during the fall/winter months and remits in the spring. Research has shown that light therapy and getting outside is helpful to combat symptoms, as well as aerobic exercise. Bonus points if you can grab a buddy to join you.

Don’t let the cold winter days get in the way of your progress. Off-season high altitude training can help you build strength and maximize your fitness gains for your next big race.

Altitude Training Rooms – The Evolution

by | Altitude Training Information, General Fitness

Altitude training, once the secret weapon of elite athletes, has evolved dramatically over the years. The concept of training in reduced oxygen environments to enhance performance has a rich history dating back to the mid-20th century. Today, altitude training rooms, often referred to as hypoxic chambers, have become accessible to a wider range of athletes and fitness enthusiasts. In this blog post, we will explore the evolution of altitude training rooms and how they have revolutionized the way athletes prepare for peak performance.

 

The Early Days of Altitude Training:

The history of altitude training can be traced back to the 1940s when it was first used as a method to improve athletic performance. Initially, athletes had to travel to high-altitude locations to benefit from the reduced oxygen environment. These high-altitude camps were remote and often inconvenient, making altitude training accessible only to a select few.

 

The Emergence of Hypoxic Chambers:

The next major development in altitude training was the creation of hypoxic chambers or altitude training rooms. These rooms, equipped with specialized equipment, allow individuals to simulate high-altitude conditions without leaving the comfort of their training facilities. This marked a significant shift, making altitude training more convenient and accessible.

altitude training toronto

Altitude Training Rooms Today:

Modern altitude training rooms have come a long way from their early iterations. They are now equipped with advanced technology that allows for precise control of oxygen levels, temperature, and humidity. Athletes and fitness enthusiasts can customize their altitude training experience to suit their specific goals and training regimens.

 

Benefits of Altitude Training Rooms:

  1. Enhanced Endurance: Training in reduced oxygen environments helps the body adapt by increasing red blood cell production, leading to improved oxygen-carrying capacity and enhanced endurance.
  2. Faster Recovery: Altitude training can accelerate the recovery process, allowing athletes to train harder and more frequently.
  3. Increased Stamina: Athletes can build greater stamina, vital for endurance sports, by incorporating altitude training into their routines.
  4. Mental Toughness: Altitude training not only enhances physical capabilities but also strengthens mental resilience, a key component of success in sports.
  5. Accessible to All: With the availability of altitude training rooms, this powerful training method is no longer limited to elite athletes and is accessible to individuals of all fitness levels.

 Conclusion:

The evolution of altitude training rooms, from the early days of high-altitude camps to the advanced hypoxic chambers of today, has revolutionized the way athletes prepare for peak performance. These rooms offer a controlled and convenient environment for athletes and fitness enthusiasts to harness the benefits of altitude training. As technology continues to advance, we can expect even more precise and effective altitude training methods in the future. This technology will help individuals push their physical and mental boundaries to achieve their fitness and performance goals.

How to properly implement altitude training in your race build-up

by | Altitude Training Information, Endurance

If you are reading this, you are probably thinking about experimenting with low oxygen (hypoxic) training.

Great move. Altitude training has many benefits when it comes to marathon training. Exercise physiologists around the world say that it can improve fitness by increasing mitochondrial activity, augmenting red blood cell count, even changing gene expression.

But here’s the thing: no matter your fitness level or sport of choice, it’s best to have a plan when implementing a new form of training. Here, we suggest how you can make the most of Altitude Athletic in each phase of your race build-up.

1) The Base Phase

When: up to two months before race day

You might like to start to build your base five to six months in advance of your race, particularly if it’s a longer event like a half-marathon, marathon or Ironman. If so, your question might be: when do I start implementing altitude training? New research indicates that there could be a memory component to altitude training benefits. The more accustomed you are to low-oxygen training, the greater the benefits you might reap. So, best to acquaint yourself with thin air as soon as possible.

That being said, ease into running, cycling or other workouts at altitude slowly. If this is your first experience with low-oxygen training, and your goal race is still months away, start your build with easy efforts in the first week at altitude.

So, if you’re focused on an upcoming marathon training, begin by targeting recovery and non-workout runs. And adjust how you define “easy pace.” Unlike running at a measly 250m in Toronto, running even the easiest of paces at, say, 9,000 ft will at first feel challenging. After one month of base, also try one of your weekly workouts at altitude.

Tip: Monitor your blood ferritin and haemoglobin levels monthly during this phase to see how you are responding to the change in stimulus.

2) The Added Stimulus Phase (two months to two weeks before race day)

This is when you dive into harder, higher-volume and race simulation workouts. Executing these tough sessions at altitude can boost fitness and confidence.

In this phase, alternating between altitude simulation and sea level workouts can be useful for two reasons:

First, working out in a low-oxygen environment will make it harder to hit splits. Use those workouts for building fitness and accustom yourself to the feeling of running hard, and use the sea level workouts for teaching your body what it’s like to run at your goal pace.

Second, doing big workouts at altitude may tire you out at times in this phase. By mixing in sea level workouts, you mitigate the risk of overtraining and burnout.

Tip: Hard training at altitude will likely elevate your basal metabolism, so hydrate aggressively and eat many nutrient-rich foods in this phase. Remember that this phase is more refined. It’s where you can make the most gains, but it’s where you are most likely to overexert yourself. These tenets are significantly augmented at altitude, so make sure you are giving your body enough fuel to recover.

3) The Sharpening Phase

Last two weeks before race day

If altitude simulation feels comfortable by now, try to train exclusively at low oxygen for these last two weeks. It is common practice for athletes to spend the two weeks prior to a goal race at altitude, before coming down two to three days before your race.

That is because even though it likely takes longer than two weeks to see haematological (blood) adaptations, studies show that other benefits of altitude training can be made faster. In the two weeks before your race, training at altitude could improve your muscles’ buffering capacity, making them better at working in acidic conditions (like the final parts of your race.)

Tip: Do not fret over workout splits in this phase. Remember that workouts at altitude will still feel harder than normal, even if you are sharp. If you have made it to this phase healthy and fit, your reward should be to feel good during workouts, instead of worrying about pace.

Tip II: Do your last training session at altitude at least three days before your race, to ensure that you do not have leftover fatigue on the start line.

No matter the training phase you are in, approach altitude training like regular marathon training: with diligence. Eat well, drink lots of water, and always listen to your body’s signals. Do those three things, follow our tips, and put in the work – the results will take care of themselves.

Learn more about altitude training for endurance athletes here.

Want to do some more research on hypoxic training literature? Check out our Hypoxic Training Literature folder in our Linktree!