Elizabeth Wadsworth 9272
Tunbridge Wells Girls’ Grammar School
Is altitude training the best way to legally
improve sporting performance?
Many athletes are struggling to find different ways of improving their sporting performance,
and out-perform their rivals, without the use of illegal substances. Biologists are looking into
different ways in which athletes can improve their performance level legally and without the
use of drug doping techniques.
The use of banned performance-enhancing drugs in sports is commonly referred to as
doping, particularly by the organisations that regulate sporting competitions. The use of
drugs to enhance performance is considered unethical by most international sports
organisations. The reasons for the ban are mainly the health risks of performance-enhancing
drugs and the equality of opportunity for athletes. If found to be using performance
enhancing drugs, athletes face potential bans from the sport and therefore risk throwing
their careers away.
Due to the above reasons, it is of upmost importance that biologists and athletes alike find
suitable methods to enable them to be continually improving their performance without
breaking rules set by anti-doping authorities.
Solution: Altitude Training
Altitude training invokes physiological changes. Training at altitude - where the oxygen level
is considerably lower - allows athletes to increase their red blood cell count. This enables
them to compete more effectively at sea level because more
oxygen is delivered to the muscles. (1) As a result of this claim,
it has been incorporated in the training regimes of elite athletes
in an effort to improve sea level performance. Several training
strategies, such as constant altitude exposure, intermittent
altitude exposure or ‘live high train low’, have been used in an
effort to incur an advantage in sea level performance over just
sea level training alone. At intermediate altitudes, the air still
contains approximately 20.9% oxygen, but the partial pressure
of oxygen is reduced. Partial pressure is a way of describing
how much of a gas is present at any one time. (2) However,
altitude training may not be suitable for some athletes
depending on their age, fitness level, health and the energy and
technical requirements of their sport.
Figure 1 - Britain's 5,000m
runner Mo Farah at altitude
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The physiological adaptation that is mainly responsible for the performance gains achieved
from altitude training is a subject of discussion among researchers. Some, including
American researchers Ben Levine and Jim Stray-Gunderson, claim it is primarily the
increased red blood cell volume that improves performance. (3) Others, including Australian
researcher Chris Gore, and New Zealand researcher Will Hopkins, dispute this and instead
claim that the gains are primarily a result of other adaptions such as a switch to a more
economic mode of oxygen utilization (the proportion of oxygen in the blood which diffuses
into tissues as it passes through the capillaries). (4)
Solution 1: Altitude Training
Method
The study led by James Stray-Gunderson, (5) aimed to investigate the effects of the “Living
high-training low” aspect of altitude training and how it improves sea level performance in
male and female elite runners. This training idea involves living at higher altitudes in order
to experience the physiological adaptations that occur, such as increased erythropoietin
(EPO) levels (EPO is a hormone that controls red blood cell production), increased red blood
cell levels and higher VO2 max, while maintaining the same exercise intensity during training
at sea level. VO2 max is the maximum or optimum rate at which the heart, lungs, and
muscles can effectively use oxygen during exercise, used as a way of measuring a person's
individual aerobic capacity. (6)
A group of scientists realised that acclimatisation to moderate high altitude accompanied by
training at low altitude (living high-training low) has been shown to improve sea level
endurance performance in accomplished, but not elite, runners. Elite athletes are athletes
amongst the best in their country, competing in international and national competitions,
using sport as their profession and earning money from it. Accomplished athletes are ones
that still train regularly yet compete in a lower level band of competitions (possibly regional
level). Whether elite athletes, who may be closer to the maximal structural and functional
adaptive capacity of the respiratory (i.e., oxygen transport from environment to
mitochondria) system, may achieve similar performance gains is unclear. Thus, the
experiment was carried out in order to answer this question.
Athletes who use Live High and Train Low live and/or sleep at moderate altitude (2000-3000
m) and simultaneously train at low elevation (< 1500 m).
To answer this question, they studied 14 elite men and 8 elite women before and after 27
days of living at 2,500 m while performing high-intensity training at 1,250 m. The
experiment took place in Salt Lake City, which is the capital and the most populous city in
the US state of Utah (Figure 3). The altitude break began 1 week after the USA Track and
Field National Championships, when the athletes were close to their season’s fitness peak.
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The detailed timetable of the experiment is shown in Figure 2. From this figure you can also
learn that the competition took place throughout June and July.
The athletes used in the study were required to be competitive at a national level in a longdistance running event from the 1,500 m to the marathon. Twenty-four of the 26 athletes
were ranked in the US top 50 for their event in 1997. The athletes included two 1996
Olympians, and 50% of the athletes had competed in the 1996 US Olympic Trials. All but
four athletes competed in the 1997 NCAA Championships or the 1997 USA Track and Field
Championships or both. Exclusion criteria included altitude residence (+1,000m) or recent
illness or injuries preventing normal training and racing. All of the subjects involved had
given their written consents to partake in the study. The study had gained approval from the
Institutional Review Board of the University of Texas South-western Medical Centre.
This study protocol was a modification of one previously developed by the same authors for
college runners, not elite performers (7). College runners are ones that represent their
college or university at a sport.
1) First of all the athletes were assessed at sea level in the week before 27 days of living
at 2,500 m (see Figure 2).
2) The NCAA Championships were held at sea level 3 weeks before the altitude break,
and the USA Track and Field Championships had ended 1 week before the altitude
break.
3) Individualised training plans were developed specifically for the athlete by his/her
coach. These plans were discussed with the investigators and conformed to a
training template presented by the investigators.
4) The athletes were required to perform high-intensity and high-velocity training at
1,250 m for 27 days. All other training took place between 1,250 and 3,000 m high
with most of the training occurring between 2,000 m and 2,800 m.
5) All athletes received an oral liquid iron supplementation (Feo-Sol, 9mg elemental
iron/ml) with dose adjusted on the basis of plasma ferritin concentration.
6) The athletes were then tested once more and results of the study were gained.
This slight modification of the “Living high-training low” (HiLo) model, the modification
termed “HiHiLo,” (living at moderate altitude, low-intensity base training at moderate
altitude, high-intensity interval training at low altitude), has been demonstrated in pilot
work to provide identical improvement in VO2 max and 5,000-m time as the original HiLo
model (8).
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Figure 2 - Timetable for the
experiment. NCAA (National Collegiate
Athletic Association); USATF (USA Track
and Field); Hi (high altitude); Lo (low
altitude).
Figure 3 – Salt Lake City, where the 27 day training
camp was run
The Athlete Testing Phase Process
The scientists required a sea-level performance control from each athlete, so that the
effects of the altitude training could be compared to an original fitness level.
Racing Performance - They were assessed by a 3,00m time trial race performed on a 400m
all-weather track (Indiana University, Bloomington, IN) the day before and again 3 days after
the altitude break. The time trials were run in men’s and women’s heats in the early evening
(7pm to 8pm). The athletes were instructed to achieve the best time possible on each time
trial, and they ensured that this would occur by making it a competitive environment
between the athletes. Experienced pace setters (athletes not otherwise involved in the
project) were utilized to set a fast, competitive pace for the first 1,600 m of the 3,000 m
race to ensure physiological rather than tactical performance. The pace setter or “rabbit”
ran the same preselected race pace in both the pre-altitude and post-altitude time trials.
Temperatures ranged from 25 to 27°C, relative humidity ranged between 50 and 75%, and
there was no wind. Time was recorded for each subject to the nearest 0.1 s.
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Results
Fourteen men and eight women successfully completed the protocol. Four subjects (three
male and one female) suffered injury or illness during the break that prevented normal
training or racing and were not included in the analysis. There were no gender differences
with respect to the response to the altitude camp; therefore, data for men and women are
considered together. The results are reliable because the journal in which the article is
found has been published and accepted by other scientists in the scientific community.
The group 3,000-m performance at sea level was significantly improved after the HiLo
treatment. Both men and women’s time trial times were reduced significantly. (6) 3 athletes
improved their sea level 3,000-m time by as much as 23 s; however one athlete ran 18 s
slower. This is an anomaly, and one can only assume that this person was not performing to
his/her maximal ability during the trial, was feeling unwell or his body did not react to the
altitude training in the same way as the other 23 participants. As only one person ran
significantly slower, the proportion that ran faster is much larger so as a majority we can
conclude that the altitude training did improve running performance. Figure 4 (Table) and
Figure 5 (Graph) backs up this conclusion, showing the change in average running time for
the group. There is a clear and definite improvement in running time seen by both genders.
The women ran 5.5 seconds quicker, and the males 5.8 seconds. Both results are similar,
proving that the effects of altitude are seen in both genders of the athletes.
Figure 4 – Changes in running team shown by participants,
pre and post altitude training
The results of this experiment are valid because the same athletes were used throughout
the 27day camp. The weather could have had an effect on the results validity however
because the athletes are less likely to perform to their full capabilities in the time-trial if it
was raining or snowing than they would do if it was a clear and crisp sunny day. The
temperature outside would have also affected the results as hot and humid conditions are
harder to perform in than cool, crisp ones. This is because humans are sensitive to changes
in humidity, because our skin uses the air around us to get rid of moisture in the form of
sweat. If the relative humidity is very high, the air is already saturated with water vapor and
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our sweat won’t evaporate. When this happens, we feel hotter than the actual temperature,
affecting athletic performance.
Figure 5 – Graph showing the
change in 3,000-m performance
in elite male (A) and female (B)
runners after a 27day living
high-training low-altitude break.
The major finding from this study is that, in this group of elite runners, sea level 3,000 m
running performance improved significantly in response to a 27 day camp utilising the HiLo
model. In fact, nine athletes recorded personal records at the distance after the HiLo camp,
despite having prepared for and completed in national championships events just before
the camp.
Why is this method appropriate?
This method is appropriate to the question being asked because the subjects are being
tested after taking part in a 27day camp and training sessions at altitude, and we are
questioning whether altitude has an effect on the athletes sporting capabilities. This
produces valid results because they directly answer the question being asked. Also many
more than one athlete took part in the study, meaning that averages can be worked out if
anomalies were to occur. Anomalies may occur because every human body is different and
it is common that they will react to the altitude in different ways.
To improve the experiment, more elite athletes could have been involved. This would give a
larger number of results for the experiment and also represent a wider variety of people.
This can make the averages more accurate as there are more results gained from the
experiment, creating a wider range and improving reliability. Another improvement could
have been to perform the training camp for a longer period of time, in order to see if an
increased training time at altitude would improve the athlete’s performance even more.
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Scientist Profile – Dr. James Stray-Gundersen (9)
(Leader of the above ‘Living high-training low’ study)
Dr. Stray-Gundersen, as shown in Figure 6, received his
Board Certification in General Surgery in 1985. Dr.
Stray-Gundersen’s his primary research was altitude
training, performance training, and anti-doping work.
Career Highlights - Anti Doping: In an effort to stop
cheating in sport, Dr. Stray-Gundersen began his AntiDoping work in 1985, where he and his colleague
(Benjamin Levine) were the first to administer invasive
blood doping testing at a World Championship event. He
is considered a pioneer in the anti-doping community.
Figure 6 - Dr. James StrayGundersen during a lecture
In 1989, Dr. Stray-Gundersen and his colleague Dr. Ben Levine began a 15-year-study on
Altitude Training for Maximal Performance. Over the years, the study and both researchers
have received numerous accolades and awards and were nominated for the United States
Olympic Award — the highest honor given by the committee. “Live High/Train Low”
changed the way International sport used altitude to train its athletes.
The background of this scientist improves the reliability of my study as Dr. Stray-Gundersen
has achieved a Board Certification in General Surgery meaning that he has undergone a
voluntary process that demonstrates a surgeon's commitment to lifelong learning and
quality patient care. Surgeons certified by the American Board of Surgery (ABS) have
completed at least five years of residency training following medical school, met all ABS
training requirements, and successfully completed the ABS examination process. This means
that Dr. Stray-Gundersen has gained extra qualifications meaning his work could be more
accurate and reliable as he has gained more experience and practice. Also, the experiment
itself was nominated for the United States Olympic Award, meaning that other people have
respected the work done by Stray-Gundersen.
In my opinion, the fact that Dr. Stray-Gundersen has undergone extra training and
education to receive his ABS proves that he is committed to his particular area of study and
because of that is likely to produce reliable studies that are well accepted by the scientific
community.
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Do any Studies back up Stray-Gundersen’s results? (10)
Another example of Live High and Train Low (LH + TL) via natural altitude training in elite
sport is the U.S. national team in long track speed skating, a group that initially used LH + TL
in preparation for the 2002 Salt Lake City Winter Olympics. Speed skating, as shown in
Figure 7 is a competitive form of ice skating in which the competitors race each other in
traveling a certain distance on skates. Three years before the Salt Lake City Olympics, the
U.S. long track speed skaters began living in the Deer Valley/Park City area at approximately
2500 m for the purpose of acclimatisation at an elevation markedly higher than the altitude
of their competition venue (1425 m) in the Salt Lake City area. The speed skaters utilized a
modified LH + TL regimen in which they performed
high intensity workouts in Salt Lake City (1250m),
whilst still living in Deer Valley (2500m). During the
year prior to the Salt Lake City Olympics, the speed
skaters had access to the Olympic speed skating
venue (Utah Olympic Oval; 1425 m), thereby
gaining valuable experience and knowledge of the
venue’s ice conditions and aerodynamic
characteristics. The U.S. long track speed skaters
enjoyed unprecedented success in the 2002 Salt
Figure 7 - Shani Davis competing for
Lake City Winter Olympics, with six athletes winning
the USA Speed Skating in Sochi
eight medals, including three gold medals and two
2014
world records (11).
Implications of the Solution
Economical
In order to be able to begin altitude training, you must first travel to the parts of the world
that are situated at a high altitude. Some of the most popular examples of these places
include (12):
o Sierra Nevada, Spain - Altitude: 2320m
o Mammoth Lakes, USA - Altitude: 2400m
o Iten, Kenya - Altitude: 2400m
The cost of these plane flights can be enormously high for a British based athlete. As an
example, a typical budget return flight to Iten, Kenya would cost £528 (13) to Nairobi
Central. You would then have to gain a transfer to Iten from the airport, adding more to the
total cost of the trip. If you were an elite athlete, you would also have to sort out funding for
your coach to accompany you on the trip, in order for the training schedule to take place.
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Once you had arrived in the location, you would also have to make monetary provisions for
food, drink and residency whilst on the break. There are also added costs when travelling
such a visas, car hire and spending money. All of these added expenses would have to be
taken into account before deciding to undertake an intensive altitude training session.
Economic Risks – as altitude training costs are high, athletes must be aware that due to
funding difficulties that may be sustained, going on such training schemes may not be
possible. This must be taken into account when deciding that altitude training will be
included in your training plan. If an athlete plans to train, and the funding is not available,
the trip would have to be cancelled and this could affect the athlete’s performance in the
long term. Paying for such trips, in which an increase in performance capability is not 100%
guaranteed, is a risk. The fact that the training course would be so expensive then makes
the training opportunity selective, meaning that some athletes would be excluded from
such opportunities to improve their sporting performance, due to their lack of funding. This
means that people with a higher economic security are in a more advantageous position.
Economic Benefits – however, as an elite athlete it is highly likely that sponsorship deals
would be available if funding for training was an issue. These sponsors wish for the athlete
to perform well, so that their brand gains more coverage, and if altitude training was going
to be improving your performance hugely, it is likely that they would be willing to sponsor
your trip. Prize money is also available in competitions, so if you were to win a race as a
result of your training, you could always use this money to fund trips later on in your career.
The altitude training is proven to improve athletic sporting performance, so spending such
money should not be a risk.
Environmental
When travelling across the globe to take part in such training, you must also take into
consideration how the flights will be effecting the environment. Air transport's contribution
to climate change represents 2% of human-induced CO2 emissions and Flights produce
628,000,000 tons of CO2 yearly (14). Both of those figures represent the negative effect that
air travel has on the environment. Also, travelling to such high and obscure places does not
always guarantee great weather in which to train. Snow is common in high altitude areas,
and this would be far from suitable for athletic training as the terrain would be slippery and
unsafe to run on.
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Environmental Risks – Despite the amount of flights being taken for the primary reason of
altitude training being a miniscule proportion of the total flights each year, it must still be
considered. Before travelling such distances athletes should ensure that the training is
worth it and that they are travelling at a time that will best benefit career, for example
before a large event. Although thousands of flights are being taken all around the world
every day of the year, the damage to the environment is evident. It is possible, that in the
future flights taken will be reduced, and this would result in the closure of the more obscure
and faraway airports. The areas being travelled air rather obscure, and access may not be
guaranteed in the future. Terrain would be trampled whilst the training was taking place,
and habitats could be disturbed.
Environmental Benefits – although there are no direct benefits to the environment as a
result of air travel, it is not always a negative thing. Being able to travel to these places
means that they are visited, and this can benefit the local environments as funding will be
offered to make the areas more accessible. This funding can be used to maintain the areas
and also ensure biodiversity is attained. As an athlete, the training would be beneficial and it
would be hoped that the local area would be looked after throughout the duration of the
stay.
Alternative Solution 1: Lucozade Sport
Drink
Sports drinks are beverages with the sole purpose to help athletes
replace water, electrolytes, and energy, whilst performing and after
training/competition. Athletes actively training and competing, lose
water and electrolytes by sweating, and expending energy.
Lucozade Sport is a range of still, fruit-based, isotonic energy drinks,
designed mainly for use during sports and physically demanding
activities. Figure 8 shows how the Lucozade isotonic sports bottle is
designed.
Figure 8 – Lucozade Sport Bottle
Lucozade Sport is formulated to maintain hydration to improve endurance performance. It
provides a source of fluid but importantly contains both carbohydrate and sodium. The
carbohydrate, along with the sodium, helps your body absorb fluid more effectively. (*15) The
carbohydrate is also a source of energy during this exercise. The Lucozade Sport website
claims that the drink ‘can help maintain fluid and electrolyte balance, as well as endurance
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(*15) this source has a high chance of being biased, and therefore
unreliable, as it came directly from the Lucozade website. This
could make it biased because they will not be negative about
their product, as they wish to sell it to consumers.
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exercise performance’ (15). However, as this came from the product website itself, it must be
expected to be biased, as they are trying to sell the product and its perks to the consumers.
The NCAA banned the consumption of caffeine during elite sports because it was found to
be a performance enhancer. (16) It is for this reason that elite performers must not
consume energy drinks that contain caffeine, such as red bull, or else they risk
disqualification or being banned from the sport. Figure 9 is listing the ingredients present in
Lucozade Sport and we can see that is contains no caffeine, and is therefore a suitable
replacement.
Figure 9 – Table showing ingredients in a 500ml
bottle of Lucozade Sport.
Studies have been found that support the claims that Lucozade make. For Example:
A study led by Mr. Phillips in February 2008 (17) aimed to examine the effects of ingesting a
carbohydrate‐electrolyte solution on endurance capacity during a prolonged intermittent,
high‐intensity shuttle running test. Nine trained male games players performed two exercise
trials, 7 days apart. On each occasion, they completed 75 min exercise, comprising of five
15‐min periods of intermittent running, consisting of sprinting, interspersed with periods of
jogging and walking (Part A), followed by intermittent running to fatigue (Part B). The
subjects were randomly allocated either a 6.9% carbohydrate‐electrolyte solution or a non‐
carbohydrate placebo immediately prior to exercise and every 15 min thereafter. During
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Part B, the subjects were able to continue running longer when fed the carbohydrateelectrolyte solution 8.9 ± 1.5 min versus the control which scored 6.7 ± 1.0 min.
These results show that drinking a carbohydrate‐electrolyte solution improves endurance
running capacity during prolonged intermittent exercise. However, this information was
gained from an abstract of a study, so not all the details have necessarily been mentioned.
This means that the reliability is lacking, however as it has been submitted in a scientific
journal one would assume that the investigators performed the experiment consistently and
fairly, and that the results are therefore valid sources of information.
These results have however, been challenged. In an analysis by Matthew Thompson and
colleagues from the Oxford Centre for Evidence Based Medicine, of 431 marketing claims of
performance enhancement, most cited no evidence. 174 sources were quoted for Lucozade;
of them, Thompson found only three studies of high quality with a low risk of bias. The
rigorous studies that did show improved endurance were "of limited relevance to most
people because the tests were on elite athletes". (*18)
(*18) Source 15 comes from the Telegraph. This could be unreliable as it is based on one
single person’s opinion. However, in this case the article was formed after analysing many
studies surrounding the successfulness of Lucozade, and as these studies contain
scientific evidence and facts, it is hard to argue with the journalist as the evidence would
have been clear, making his write up hard to bias.
Alternative Solution 2: Ice Baths
After intense exercise, it is becoming more and more common for athletes to plunge in an
iced water bath (a tub of 12-15 degree Celsius iced water) as a way to recover more quickly
and reduce muscle pain and soreness after intense training sessions or
competitions. Hopefully, as a result of taking a bath, the after exercise
pain would be considerably relieved, and therefore the athlete would be
able to perform more efficiently and effectively after a particularly
intense session or major competition. The style of the bath is
demonstrated in Figure 10, however a household bath filled with ice can
also be sufficient.
The theory behind ice baths is related the fact that intense exercise
actually causes micro-trauma, or tiny tears in muscle fibers. This muscle
damage not only stimulates muscle cell activity and helps repair the
damage and strengthen the muscles ( muscle hypertrophy), but it is also
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Figure 10 – Team GB’s
Mo Farah taking an
ice bath
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linked with delayed onset muscle pain and soreness (DOMS) , which occurs between 24 and
72 hours after exercise.
The ice bath is thought to:



Constrict blood vessels and flush waste products, like lactic acid, out of the affected
tissues
Decrease metabolic activity and slow down physiological processes
Reduce swelling and tissue breakdown
Then, with rewarming, the increased blood flow speeds circulation, and in turn, improves
the healing process. Although there is no current protocol regarding the ideal time and
temperature for cold immersion routines, most athletes or trainers who use them
recommend immersion times of 5 to 10 and sometimes up to 20 minutes.
One study from the July 2008 issue of the International Journal of Sports Medicine (19)
found ‘cold water immersion and contrast water therapy may help recovery from short
maximal efforts or during events like stage races where athletes repeat high-intensity efforts
on successive days’. In this study, researchers had cyclists complete a week of intense daily
training routines. After each workout, they used one of four different recovery methods and
took nine days off between each week of workouts.
The four recovery methods included:
1.
2.
3.
4.
Immersion in a 15 degree C (59 degree F) pool for 14 minutes;
Immersion in 38 degree C (100.4 degree F) water for 14 minutes;
Alternating between cool and hot water every minute for 14 minutes;
14 minutes of complete rest.
They reported that the cyclists performed better in the sprint and time trial after cool water
immersion and contrast water therapy, but their performance declined with both hot water
baths and complete rest.
Although more research and studies must be carried out, the evidence so far is looking
promising. Before final conclusions can be made about the effectiveness of such therapies,
more experiments must be carried out the results must be published. This makes the
evidence more valid and reliable as the experiment would have been carried out more times
by many different scientists (repetitions), as well as having more data to be able to compare
to, and create averages and general trends from.
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Conclusion
In conclusion, altitude training is the best way to improve sporting performance. This is
because it has the capability, if used correctly, to alter the bodies physiological systems, as
well as aiding the performance level as a whole. The effects of altitude training are clear to
see, and the majority of studies taken prove it to be a positive training technique. Despite
having to travel across the globe in order to reach such places to train, and the cost that is
involved within such travel, the benefit the athlete receives to his/her performance rate is
undisputable. Lucozade sport offers a short term increase in performance level, by pumping
your body with unnatural sugars and other energy forms. This is short lived however, once
the Lucozade has left the body the effects will not be seen anymore. It is however a much
cheaper option for an athlete, and helps to keep them hydrated. Ice Baths are a form of
sports therapy that are still majorly in investigation, however the results gained so far
suggest that taking a bath after intense exercise or competitions is worthwhile. It does not
however improve your sporting performance instantaneously; it helps the athlete to recover
more quickly, therefore enabling him/her to return to training more quickly, which then
benefits your performance levels. Again it is a cheaper option, and is much less time
consuming. Perhaps, as an athlete, a combination of all three techniques would work out
most beneficially for improving sporting performance.
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