The Science

Simulated altitude training is exercising in, sleeping in, or simply inhaling the oxygen-reduced air that you find at high altitudes in order to improve athletic performance, body composition, health and wellness and for pre-acclimation prior to altitude travel.

How Does It Work?

Reducing the oxygen in the environment increases the training stimulus on the aerobic and anaerobic systems. Hypoxia also triggers production of Hypoxia Inducible Factor (HIF-1A). HIF-1A has different effects on different systems, some of which include improving blood flow to allow greater oxygen delivery and increasing the body’s ability to deliver and process oxygen. The combination of a greater training stimulus and production of transcription factors like HIF-1A drive performance adaptions. These adaptations improve cardiovascular, metabolic and respiratory health and allow individuals to work at higher intensities for longer without accumulating excess fatigue.

ALTITUDE CASE STUDIES

Simulated altitude training has demonstrated measurable benefits for a range of individuals – from elite athletes, to regular people seeking general health and fitness goals, to clinical populations. Click below to view case studies for endurance training, strength and power, general health and wellness, and clinical applications.

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rehab and reconditioning

LLTH vs. LHTL

 

There are two main strategies for altitude training: Live High, Train Low and Live Low, Train High. Both methods have been shown to improve performance in recreational and professional athletes, and those travelling to high altitudes.

 

 

 

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altitude training

Live Low Train High (LLTH)

The LLTH strategy is for individuals who live at (or near) sea level, and train at high altitudes or in low-oxygen environments that simulate high altitudes. This method is also known as Intermittent Hypoxic Training (IHT).

The physiological adaptations and corresponding performance benefits that occur as a result of LLTH and IHT depend on the exposure times and training protocols used. For example:

1. Shorter duration sessions (30-40 Minutes) at higher intensities

Adaptations in untrained to moderately trained individuals (sub-elite) include an increase in:

  • Mitochondrial density (greater capacity to produce energy aerobically)
  • Capillary-to-muscle-fibre ratio (greater oxygen delivery)
  • Increased buffering capacity and blood PH regulation (delays onset of fatigue)

2. Longer exposures (90+ Minutes)

Can lead to hematological effects including:

  • Increased Erythropoietin (EPO) and number of red blood cells (RBC’s)
  • Lower average age of RBC’s
  • Lower affinity for oxygen – easier offloading at the tissue

Health, Fitness and Performance Benefits of LLTH and IHT

  1. Improved Cardiovascular Function: IHT enhances cardiovascular health by promoting the development of new blood vessels (angiogenesis), increasing cardiac output, and improving the efficiency of the cardiovascular system. This can lead to better overall heart health and aerobic performance.

  2. Enhanced Endurance and Stamina: Training in a hypoxic environment increases your body’s ability to transport and utilize oxygen, which can lead to improved endurance, stamina, and exercise performance. This is particularly beneficial for athletes and individuals involved in endurance sports and hiking, climbing and mountaineering.

  3. Aid in Fat Loss and Weight Management: Studies show that IHT helps with weight management by increasing metabolism and promoting fat oxidation. IHT can also stimulate the release of growth hormone (GH), which plays a role in muscle growth and fat loss.

  4. Improved Lung Function: Intermittent hypoxic training can help enhance lung function, including increasing lung capacity and oxygen utilization, which is beneficial for respiratory health and overall well-being.

  5. Enhanced Recovery and Resistance to Fatigue: IHT can help reduce muscle soreness and accelerate the recovery process after strenuous exercise by promoting the release of growth factors and anti-inflammatory responses. Prolonged exposure can elicit positive changes in muscle buffering capacity (that burning feeling in your muscles during exercise) for better lactate clearance to delay the onset of fatigue

  6. Time Efficiency: IHT elicits a greater training stimulus on the body compared to normoxic (sea-level) training and can help individuals with busy schedules maximize the effectiveness of their training in a shorter time frame.

  7. Improved Power Output and Repeat Sprint Ability: IHT can help sprinters maintain high power output over multiple sprint efforts. By improving recovery times and increasing oxygen utilization, IHT allows athletes to perform more high-intensity intervals during training, ultimately improving power output and sprinting performance.

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altitude training

Live HIGH Train LOW (LHTL)

Doing sedentary tasks at altitude for longer durations, i.e “Living High”, while training at a lower level, can stimulate erythropoiesis (the process that produces red blood cells).

Almost any athlete that uses LHTL can reap the performance benefits of an expanded oxygen carrying capacity. These are changes that your body would otherwise not achieve through typical training at sea level.

Exposure can also help someone prepare for a trip to altitude and can mitigate acute mountain sickness (AMS).

  • Improves endurance, stamina and aerobic Performance
  • Increases red blood cell volume and haemoglobin mass
  • Increases oxygen transport in the body
  • Pre-acclimatization benefits for mountaineers
  • Reduces the risk of AMS by up to 40%
  • Can improve sleep at higher altitudes
  • Improves general physiology for better performance at higher altitude

Altitude and Red Blood Cells

References

  1. Bonetti, D. L., & Hopkins, W. G. (2009). Sea-Level Exercise Performance Following Adaptation to Hypoxia. Sports Medicine, 39(2), 107-127. doi:10.2165/00007256-200939020-00002 
  2. Chapman, R. F., Stray-Gundersen, J., & Levine, B. D. (1998). Individual variation in response to altitude training. Journal of Applied Physiology, 85(4), 1448-1456. doi:10.1152/jappl.1998.85.4.1448 
  3. Clark, S. A., Quod, M. J., Clark, M. A., Martin, D. T., Saunders, P. U., & Gore, C. J. (2009). Time course of haemoglobin mass during 21 days live high:train low simulated altitude. European Journal of Applied Physiology, 106(3), 399-406. doi:10.1007/s00421-009-1027-4 
  4. Friedmann, B., Frese, F., Menold, E., Kauper, F., Jost, J., & Bärtsch, P. (2005). Individual variation in the erythropoietic response to altitude training in elite junior swimmers. British Journal of Sports Medicine, 39(3), 148. doi:10.1136/bjsm.2003.011387 
  5. Garvican, L., Martin, D., Quod, M., Stephens, B., Sassi, A., & Gore, C. (2012). Time course of the hemoglobin mass response to natural altitude training in elite endurance cyclists. Scandinavian Journal of Medicine & Science in Sports, 22, 95-103. 
  6. Garvican, L. A., Martin, D. T., Clark, S. A., Schmidt, W. F., & Gore, C. J. (2007). Variability of erythropoietin response to sleeping at simulated altitude: a cycling case study. International Journal of Sports Physiology and Performance, 2(3), 327-331. 
  7. Garvican, L. A., Pottgiesser, T., Martin, D. T., Schumacher, Y. O., Barras, M., & Gore, C. J. (2011). The contribution of haemoglobin mass to increases in cycling performance induced by simulated LHTL. European Journal of Applied Physiology, 111(6), 1089-1101. doi:10.1007/s00421-010-1732-z 
  8. Hauser, A., Schmitt, L., Troesch, S., Saugy, J., Cejuela-Anta, R., Fiass, R., . . . Millet, G. (2016). Similar Hemoglobin Mass Response in Hypobaric and Normobaric Hypoxia in Athletes. Medicine & Science in Sports & Exercise, 48(4), 734-741. 
  9. Levine, B., & Stray-Gundersen, J. (2006). Dose-Response of Altitude Training: How Much Altitude is Enough? New York: Springer. 
  10. Millet, G. P., Chapman, R. F., Girard, O., & Brocherie, F. (2019). Is live high–train low altitude training relevant for elite athletes? Flawed analysis from inaccurate data. British Journal of Sports Medicine, 53(15), 923. doi:10.1136/bjsports-2017-098083 
  11. Reynafarje, C., Lozano, R., & Valdivieso, J. (1959). The Polycythemia of High Altitudes: Iron Metabolism and Related Aspects. Blood, 14(4), 433-455   
  12. Rodriguez, F. A., Iglesias, X., Feriche, B., Calderon-Soto, C., Chaverri, D., Wachsmuth, N., . . . Levine, B. (2015). Altitude Training in Elite Swimmers for Sea Level Performance. Medicine & Science in Sport & Exercise, 47(9), 1965-1978. 
  13. Wilber, R. L., Stray-Gundersen, J., & Levine, B. D. (2007). Effect of hypoxic “dose” on physiological responses and sea-level performance. Medicine & Science in Sport & Exercise, 39, 1590-1599. 

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