Characterizing the plasma metabolome during 14 days of live-high, train-low simulated altitude: A metabolomic approach.

NEW FINDINGS: What is the central question of this study? Does 14 days of live-high, train-low simulated altitude alter an individual's metabolomic/metabolic profile? What is the main finding and its importance? This study demonstrated that ∼200 h of moderate simulated altitude exposure resulted in greater variance in measured metabolites between subject than within subject, which indicates individual variability during the adaptive phase to altitude exposure. In addition, metabolomics results indicate that altitude alters multiple metabolic pathways, and the time course of these pathways is different over 14 days of altitude exposure. These findings support previous literature and provide new information on the acute adaptation response to altitude. ABSTRACT: The purpose of this study was to determine the influence of 14 days of normobaric hypoxic simulated altitude exposure at 3000 m on the human plasma metabolomic profile. For 14 days, 10 well-trained endurance runners (six men and four women; 29 ± 7 years of age) lived at 3000 m simulated altitude, accumulating 196.4 ± 25.6 h of hypoxic exposure, and trained at ∼600 m. Resting plasma samples were collected at baseline and on days 3 and 14 of altitude exposure and stored at -80°C. Plasma samples were analysed using liquid chromatography-high-resolution mass spectrometry to construct a metabolite profile of altitude exposure. Mass spectrometry of plasma identified 36 metabolites, of which eight were statistically significant (false discovery rate probability 0.1) from baseline to either day 3 or day 14. Specifically, changes in plasma metabolites relating to amino acid metabolism (tyrosine and proline), glycolysis (adenosine) and purine metabolism (adenosine) were observed during altitude exposure. Principal component canonical variate analysis showed significant discrimination between group means (P < 0.05), with canonical variate 1 describing a non-linear recovery trajectory from baseline to day 3 and then back to baseline by day 14. Conversely, canonical variate 2 described a weaker non-recovery trajectory and increase from baseline to day 3, with a further increase from day 3 to 14. The present study demonstrates that metabolomics can be a useful tool to monitor metabolic changes associated with altitude exposure. Furthermore, it is apparent that altitude exposure alters multiple metabolic pathways, and the time course of these changes is different over 14 days of altitude exposure.

Iron considerations for the athlete: a narrative review.

Iron plays a significant role in the body, and is specifically important to athletes, since it is a dominant feature in processes such as oxygen transport and energy metabolism. Despite its importance, athlete populations, especially females and endurance athletes, are commonly diagnosed with iron deficiency, suggesting an association between sport performance and iron regulation. Although iron deficiency is most common in female athletes (~ 15-35% athlete cohorts deficient), approximately 5-11% of male athlete cohorts also present with this issue. Furthermore, interest has grown in the mechanisms that influence iron absorption in athletes over the last decade, with the link between iron regulation and exercise becoming a research focus. Specifically, exercise-induced increases in the master iron regulatory hormone, hepcidin, has been highlighted as a contributing factor towards altered iron metabolism in athletes. To date, a plethora of research has been conducted, including investigation into the impact that sex hormones, diet (e.g. macronutrient manipulation), training and environmental stress (e.g. hypoxia due to altitude training) have on an athlete's iron status, with numerous recommendations proposed for consideration. This review summarises the current state of research with respect to the aforementioned factors, drawing conclusions and recommendations for future work.

Special Environments: Altitude and Heat.

High-level athletes are always looking at ways to maximize training adaptations for competition performance, and using altered environmental conditions to achieve this outcome has become increasingly popular by elite athletes. Furthermore, a series of potential nutrition and hydration interventions may also optimize the adaptation to altered environments. Altitude training was first used to prepare for competition at altitude, and it still is today; however, more often now, elite athletes embark on a series of altitude training camps to try to improve sea-level performance. Similarly, the use of heat acclimation/acclimatization to optimize performance in hot/humid environmental conditions is a common practice by high-level athletes and is well supported in the scientific literature. More recently, the use of heat training to improve exercise capacity in temperate environments has been investigated and appears to have positive outcomes. This consensus statement will detail the use of both heat and altitude training interventions to optimize performance capacities in elite athletes in both normal environmental conditions and extreme conditions (hot and/or high), with a focus on the importance of nutritional strategies required in these extreme environmental conditions to maximize adaptations conducive to competitive performance enhancement.

Transcriptional Dynamics Driving MAMP-Triggered Immunity and Pathogen Effector-Mediated Immunosuppression in Arabidopsis Leaves Following Infection with Pseudomonas syringae pv tomato DC3000.

Transcriptional reprogramming is integral to effective plant defense. Pathogen effectors act transcriptionally and posttranscriptionally to suppress defense responses. A major challenge to understanding disease and defense responses is discriminating between transcriptional reprogramming associated with microbial-associated molecular pattern (MAMP)-triggered immunity (MTI) and that orchestrated by effectors. A high-resolution time course of genome-wide expression changes following challenge with Pseudomonas syringae pv tomato DC3000 and the nonpathogenic mutant strain DC3000hrpA- allowed us to establish causal links between the activities of pathogen effectors and suppression of MTI and infer with high confidence a range of processes specifically targeted by effectors. Analysis of this information-rich data set with a range of computational tools provided insights into the earliest transcriptional events triggered by effector delivery, regulatory mechanisms recruited, and biological processes targeted. We show that the majority of genes contributing to disease or defense are induced within 6 h postinfection, significantly before pathogen multiplication. Suppression of chloroplast-associated genes is a rapid MAMP-triggered defense response, and suppression of genes involved in chromatin assembly and induction of ubiquitin-related genes coincide with pathogen-induced abscisic acid accumulation. Specific combinations of promoter motifs are engaged in fine-tuning the MTI response and active transcriptional suppression at specific promoter configurations by P. syringae.

The athlete's hematological response to hypoxia: A meta-analysis on the influence of altitude exposure on key biomarkers of erythropoiesis.

Altitude training is associated with changes in blood markers, which can confound results of the Athlete?s Biological Passport (ABP). This meta-analysis aims to describe the fluctuations during- and post-altitude in key ABP variables; hemoglobin concentration ([Hb]), square-root transformed reticulocyte percentage (sqrt(retic%)) and the OFF-score. Individual de-identified raw data were provided from 17 studies. Separate linear mixed effects analyses were performed for delta values from baseline for [Hb], sqrt(retic%) and OFF-score, by altitude phase (during and post). Mixed models were fitted with the hierarchical structure: study and subject within study as random effects. Delta values as response variables and altitude dose (in kilometer hours; km.hr = altitude (m) / 1000 x hours), sex, age, protocol and baseline values as fixed effects. Allowances were made for potential autocorrelation. Within two days at natural altitude [Hb] rapidly increased. Subsequent delta [Hb] values increased with altitude dose, reaching a plateau of 0.94 g/dL [95%CI (0.69, 1.20)] at ~1000 km.hr. Delta sqrt(retic%) and OFF-score were the first to identify an erythrocyte response, with respective increases and decreases observed within 100 to 200 km.hr. Post-altitude, [Hb] remained elevated for two weeks. Delta sqrt(retic%) declined below baseline, the magnitude of change was dependent on altitude dose. Baseline values were a significant covariate (p<0.05). The response to altitude is complex resulting in a wide range of individual responses, influenced primarily by altitude dose and baseline values. Improved knowledge of the plausible hematological variations during- and post-altitude provides fundamental information for both the ABP expert and sports physician.

Training Quantification and Periodization during Live High Train High at 2100 M in Elite Runners: An Observational Cohort Case Study.

The questionable efficacy of Live High Train High altitude training (LHTH) is compounded by minimal training quantification in many studies. We sought to quantify the training load (TL) periodization in a cohort of elite runners completing LHTH immediately prior to competition. Eight elite runners (6 males, 2 females) with a V̇O2peak of 70 ± 4 mL·kg-1·min-1 were monitored during 4 weeks of sea-level training, then 3-4 weeks LHTH in preparation for sea-level races following descent to sea-level. TL was calculated using the session rating of perceived exertion (sRPE) method, whereby duration of each training session was multiplied by its sRPE, then summated to give weekly TL. Performance was assessed in competition at sea-level before, and within 8 days of completing LHTH, with runners competing in 800 m (n = 1, 1500 m/mile (n = 6) and half-marathon (n = 1). Haemoglobin mass (Hbmass) via CO rebreathing and running economy (RE) were assessed pre and post LHTH. Weekly TL during the first 2 weeks at altitude increased by 75% from preceding sea-level training (p = 0.0004, d = 1.65). During the final week at altitude, TL was reduced by 43% compared to the previous weeks (p = 0.002; d = 1.85). The ratio of weekly TL to weekly training volume increased by 17% at altitude (p = 0.009; d = 0.91) compared to prior sea-level training. Hbmass increased by 5% from pre- to post-LHTH (p = 0.006, d = 0.20). Seven athletes achieved lifetime personal best performances within 8 days post-altitude (overall improvement 1.1 ± 0.7%, p = 0.2, d = 0.05). Specific periodization of training, including large increases in training load upon arrival to altitude (due to increased training volume and greater stress of training in hypoxia) and tapering, were observed during LHTH in elite runners prior to personal best performances. Periodization should be individualized and align with timing of competition post-altitude.

Low carbohydrate, high fat diet impairs exercise economy and negates the performance benefit from intensified training in elite race walkers.

KEY POINTS: Three weeks of intensified training and mild energy deficit in elite race walkers increases peak aerobic capacity independent of dietary support. Adaptation to a ketogenic low carbohydrate, high fat (LCHF) diet markedly increases rates of whole-body fat oxidation during exercise in race walkers over a range of exercise intensities. The increased rates of fat oxidation result in reduced economy (increased oxygen demand for a given speed) at velocities that translate to real-life race performance in elite race walkers. In contrast to training with diets providing chronic or periodised high carbohydrate availability, adaptation to an LCHF diet impairs performance in elite endurance athletes despite a significant improvement in peak aerobic capacity. ABSTRACT: We investigated the effects of adaptation to a ketogenic low carbohydrate (CHO), high fat diet (LCHF) during 3 weeks of intensified training on metabolism and performance of world-class endurance athletes. We controlled three isoenergetic diets in elite race walkers: high CHO availability (g kg-1  day-1 : 8.6 CHO, 2.1 protein, 1.2 fat) consumed before, during and after training (HCHO, n = 9); identical macronutrient intake, periodised within or between days to alternate between low and high CHO availability (PCHO, n = 10); LCHF (< 50 g day-1 CHO; 78% energy as fat; 2.1 g kg-1  day-1 protein; LCHF, n = 10). Post-intervention, V̇O2 peak during race walking increased in all groups (P < 0.001, 90% CI: 2.55, 5.20%). LCHF was associated with markedly increased rates of whole-body fat oxidation, attaining peak rates of 1.57 ± 0.32 g min-1 during 2 h of walking at ∼80% V̇O2 peak . However, LCHF also increased the oxygen (O2 ) cost of race walking at velocities relevant to real-life race performance: O2 uptake (expressed as a percentage of new V̇O2 peak ) at a speed approximating 20 km race pace was reduced in HCHO and PCHO (90% CI: -7.047, -2.55 and -5.18, -0.86, respectively), but was maintained at pre-intervention levels in LCHF. HCHO and PCHO groups improved times for 10 km race walk: 6.6% (90% CI: 4.1, 9.1%) and 5.3% (3.4, 7.2%), with no improvement (-1.6% (-8.5, 5.3%)) for the LCHF group. In contrast to training with diets providing chronic or periodised high-CHO availability, and despite a significant improvement in V̇O2 peak , adaptation to the topical LCHF diet negated performance benefits in elite endurance athletes, in part due to reduced exercise economy.

Factors influencing the post-exercise hepcidin-25 response in elite athletes.

PURPOSE: The extent to which hepcidin regulation after acute bouts of exercise is influenced by baseline (resting) concentrations of key iron parameters remains uncertain. This investigation explored the influence of selected iron parameters and 25-km race walk time on 3-h post-exercise hepcidin-25 levels in international-level race walkers. METHODS: Twenty-four male race walkers completed a graded exercise test and a 25-km race-walk trial. Throughout the 25-km race-walk, venous blood samples were collected pre-exercise, immediately post-exercise, and at 3-h post-exercise. Blood was analysed for serum ferritin, serum iron, Interleukin-6 (IL-6), and hepcidin-25 concentration. RESULTS: IL-6 and hepcidin-25 increased (7.6- and 7.5-fold, respectively) in response to the 25-km race-walk trial (both p < 0.01). Significant individual relationships were evident between 3-h post-exercise hepcidin-25, baseline serum ferritin and serum iron (r > 0.62; p < 0.05). Multiple regression analysis showed that these two iron parameters, in addition to post-exercise IL-6 concentration and 25-km race-walk time, accounted for ~77% of the variance in 3-h post-exercise hepcidin-25 (p < 0.01). A median split by the cohort's baseline serum ferritin concentration (LOW: 58.0 vs. HIGH: 101.8 µg/L; p < 0.01) showed a significant between group difference in the 3-h post-exercise hepcidin-25 (LOW: 6.0 ± 3.6 vs. 11.3 ± 5.4 nM; p = 0.01), despite no differences in baseline serum iron, post-exercise IL-6, or 25-km race-walk time (all p > 0.05). CONCLUSION: Despite exercise activating numerous hepcidin regulators, baseline iron status appears to play a dominant role in the regulation of hepcidin-25 in elite-level athletes subsequent to endurance exercise.

Four Weeks of Classical Altitude Training Increases Resting Metabolic Rate in Highly Trained Middle-Distance Runners.

High altitude exposure can increase resting metabolic rate (RMR) and induce weight loss in obese populations, but there is a lack of research regarding RMR in athletes at moderate elevations common to endurance training camps. The present study aimed to determine whether 4 weeks of classical altitude training affects RMR in middle-distance runners. Ten highly trained athletes were recruited for 4 weeks of endurance training undertaking identical programs at either 2200m in Flagstaff, Arizona (ALT, n = 5) or 600m in Canberra, Australia (CON, n = 5). RMR, anthropometry, energy intake, and hemoglobin mass (Hbmass) were assessed pre- and posttraining. Weekly run distance during the training block was: ALT 96.8 ± 18.3km; CON 103.1 ± 5.6km. A significant interaction for Time*Group was observed for absolute (kJ.day-1) (F-statistic, p-value: F(1,8)=13.890, p = .01) and relative RMR (F(1,8)=653.453, p = .003) POST-training. No significant changes in anthropometry were observed in either group. Energy intake was unchanged (mean ± SD of difference, ALT: 195 ± 3921kJ, p = .25; CON: 836 ± 7535kJ, p = .75). A significant main effect for time was demonstrated for total Hbmass (g) (F(1,8)=13.380, p = .01), but no significant interactions were observed for either variable [Total Hbmass (g): F(1,8)=1.706, p = .23; Relative Hbmass (g.kg-1): F(1,8)=0.609, p = .46]. These novel findings have important practical application to endurance athletes routinely training at moderate altitude, and those seeking to optimize energy management without compromising training adaptation. Altitude exposure may increase RMR and enhance training adaptation,. During training camps at moderate altitude, an increased energy intake is likely required to support an increased RMR and provide sufficient energy for training and performance.

The Ventilation-Corrected ParvoMedics TrueOne 2400 Provides a Valid and Reliable Assessment of Resting Metabolic Rate (RMR) in Athletes Compared With the Douglas Bag Method.

The aim of the current study was to determine if a single ParvoMedics TrueOne 2400 metabolic cart provides valid and reliable measurement of RMR in comparison with the criterion Douglas Bag method (DB). Ten endurance-trained participants completed duplicate RMR measurements on 2 consecutive days using the ParvoMedics system in exercise mode, with the same expirate analyzed using DB. Typical error (TE) in mean RMR between the systems was 578.9 kJ or 7.5% (p = .01). In comparison with DB, the ParvoMedics system over-estimated RMR by 946.7 ± 818.6 kJ. The bias between systems resulted from ParvoMedics VE(STPD) values. A regression equation was developed to correct the bias, which reduced the difference to -83.3 ± 631.9 kJ. TE for the corrected ParvoMedics data were 446.8 kJ or 7.2% (p = .70). On Day 1, intraday reliability in mean RMR for DB was 286.8 kJ or 4.3%, (p = .54) and for ParvoMedicsuncorrected, 359.3 kJ or 4.4%, (p = .35), with closer agreement observed on Day 2. Interday reliability for DB was 455.3 kJ or 6.6% (p = .61) and for ParvoMedicsuncorrected, 390.2 kJ or 6.3% (p = .54). Similar intraday and interday TE was observed between ParvoMedicsuncorrected and ParvoMedicscorrected data. The ParvoMedics TrueOne 2400 provided valid and reliable RMR values compared with DB when the VE(STPD) error was corrected. This will enable widespread monitoring of RMR using the ParvoMedics system in a range of field-based settings when DB is not available.

Increased Hypoxic Dose After Training at Low Altitude with 9h Per Night at 3000m Normobaric Hypoxia.

This study examined effects of low altitude training and a live-high: train-low protocol (combining both natural and simulated modalities) on haemoglobin mass (Hbmass), maximum oxygen consumption (VO2max), time to exhaustion, and submaximal exercise measures. Eighteen elite-level race-walkers were assigned to one of two experimental groups; lowHH (low Hypobaric Hypoxia: continuous exposure to 1380 m for 21 consecutive days; n = 10) or a combined low altitude training and nightly Normobaric Hypoxia (lowHH+NHnight: living and training at 1380 m, plus 9 h.night(-1) at a simulated altitude of 3000 m using hypoxic tents; n = 8). A control group (CON; n = 10) lived and trained at 600 m. Measurement of Hbmass, time to exhaustion and VO2max was performed before and after the training intervention. Paired samples t-tests were used to assess absolute and percentage change pre and post-test differences within groups, and differences between groups were assessed using a one-way ANOVA with least significant difference post-hoc testing. Statistical significance was tested at p < 0.05. There was a 3.7% increase in Hbmass in lowHH+NHnight compared with CON (p = 0.02). In comparison to baseline, Hbmass increased by 1.2% (±1.4%) in the lowHH group, 2.6% (±1.8%) in lowHH+NHnight, and there was a decrease of 0.9% (±4.9%) in CON. VO2max increased by ~4% within both experimental conditions but was not significantly greater than the 1% increase in CON. There was a ~9% difference in pre and post-intervention values in time to exhaustion after lowHH+NH-night (p = 0.03) and a ~8% pre to post-intervention difference (p = 0.006) after lowHH only. We recommend low altitude (1380 m) combined with sleeping in altitude tents (3000 m) as one effective alternative to traditional altitude training methods, which can improve Hbmass. Key pointsIn some countries, it may not be possible to perform classical altitude training effectively, due to the low elevation at altitude training venues. An additional hypoxic stimulus can be provided by simulating higher altitudes overnight, using altitude tents.Three weeks of combined (living and training at 1380 m) and simulated altitude exposure (at 3000 m) can improve haemoglobin mass by over 3% in comparison to control values, and can also improve time to exhaustion by ~9% in comparison to baseline.We recommend that, in the context of an altitude training camp at low altitudes (~1400 m) the addition of a relatively short exposure to simulated altitudes of 3000 m can elicit physiological and performance benefits, without compromise to training intensity or competition preparation. However, the benefits will not be greater than conducting a traditional altitude training camp at low altitudes.

Altitude Exposure at 1800 m Increases Haemoglobin Mass in Distance Runners.

The influence of low natural altitudes (< 2000 m) on erythropoietic adaptation is currently unclear, with current recommendations indicating that such low altitudes may be insufficient to stimulate significant increases in haemoglobin mass (Hbmass). As such, the purpose of this study was to determine the influence of 3 weeks of live high, train high exposure (LHTH) at low natural altitude (i.e. 1800 m) on Hbmass, red blood cell count and iron profile. A total of 16 elite or well-trained runners were assigned into either a LHTH (n = 8) or CONTROL (n = 8) group. Venous blood samples were drawn prior to, at 2 weeks and at 3 weeks following exposure. Hbmass was measured in duplicate prior to exposure and at 2 weeks and at 3 weeks following exposure via carbon monoxide rebreathing. The percentage change in Hbmass from baseline was significantly greater in LHTH, when compared with the CONTROL group at 2 (3.1% vs 0.4%; p = 0.01;) and 3 weeks (3.0% vs -1.1%; p < 0.02, respectively) following exposure. Haematocrit was greater in LHTH than CONTROL at 2 (p = 0.01) and 3 weeks (p = 0.04) following exposure. No significant interaction effect was observed for haemoglobin concentration (p = 0.06), serum ferritin (p = 0.43), transferrin (p = 0.52) or reticulocyte percentage (p = 0.16). The results of this study indicate that three week of natural classic (i.e. LHTH) low altitude exposure (1800 m) results in a significant increase in Hbmass of elite distance runners, which is likely due to the continuous exposure to hypoxia. Key pointsTwo and three weeks of LHTH altitude exposure (1800 m) results in a significant increase in HbmassLHTH altitude exposure increased Hbmass by 3.1% after 2 weeks, and 3.0% after 3 weeks of exposureLHTH altitude exposure may be a practical method to increase Hbmass in well-trained athletes.

Relative Match Intensities at High Altitude in Highly-Trained Young Soccer Players (ISA3600).

To compare relative match intensities of sea-level versus high-altitude native soccer players during a 2-week camp at 3600 m, data from 7 sea-level (Australian U17 National team, AUS) and 6 high-altitude (a Bolivian U18 team, BOL) native soccer players were analysed. Two matches were played at sea-level and three at 3600 m on Days 1, 6 and 13. The Yo-Yo Intermittent recovery test (vYo-YoIR1) was performed at sea-level, and on Days 3 and 10. Match activity profiles were measured via 10-Hz GPS. Distance covered >14.4 km.h(-1) (D>14.4 km·h(-1)) and >80% of vYo-YoIR1 (D>80%vYo-YoIR1) were examined. Upon arrival at altitude, there was a greater decrement in vYo-YoIR1 (Cohen's d +1.0, 90%CL ± 0.8) and D>14.4 km·h(-1) (+0.5 ± 0.8) in AUS. D>14.4 km.h(-1) was similarly reduced relative to vYo-YoIR1 in both groups, so that D>80%vYo-YoIR1 remained similarly unchanged (-0.1 ± 0.8). Throughout the altitude sojourn, vYo-YoIR1 and D>14.4 km·h(-1) increased in parallel in AUS, so that D>80%vYo-YoIR1 remained stable in AUS (+6.0%/match, 90%CL ± 6.7); conversely D>80%vYo-YoIR1 decreased largely in BOL (-12.2%/match ± 6.2). In sea-level natives competing at high-altitude, changes in match running performance likely follow those in high-intensity running performance. Bolivian data confirm that increases in 'fitness' do not necessarily translate into greater match running performance, but rather in reduced relative exercise intensity. Key pointsWhen playing at high-altitude, players may alter their activities during matches in relation to their transient maximal physical capacities, possibly to maintain a 'tolerable' relative exercise intensity.While there is no doubt that running performance per se in not the main determinant of match outcomes (Carling, 2013), fitness levels influence relative match intensity (Buchheit et al., 2012, Mendez-Villanueva et al., 2013), which in-turn may impact on decision making and skill performance (Rampinini et al., 2008).In the context of high-altitude competitions, it is therefore recommended to arrive early enough (i.e., ~2 weeks) to allow (at least partial) acclimatisation, and in turn, allow sea-level native players to regulate their running activities in relation to both actual game demands and relative match intensity.

Acute hypoxic exercise does not alter post-exercise iron metabolism in moderately trained endurance athletes.

PURPOSE: This study measured the influence of acute hypoxic exercise on Interleukin-6 (IL-6), hepcidin, and iron biomarkers in athletes. METHODS: In a repeated measures design, 13 moderately trained endurance athletes performed 5 × 4 min intervals at 90 % of their peak oxygen consumption velocity (vVO2peak) in both normoxic [NORM, fraction of inspired oxygen (F IO2) = 0.2093, 15.3 ± 1.7 km h(-1)] and simulated hypoxic (HYP, F IO2 = 0.1450, 13.2 ± 1.5 km h(-1)) conditions. Venous blood samples were obtained pre-, post-, and 3 h post-exercise, and analysed for serum hepcidin, IL-6, ferritin, iron, soluble transferrin receptor (sTfR), and transferrin saturation. RESULTS: Peak heart rate was significantly lower in HYP compared with NORM (p = 0.01); however, the rating of perceived exertion was similar between trials (p = 0.24). Ferritin (p = 0.02), transferrin (p = 0.03), and IL-6 (p = 0.01) significantly increased immediately post-exercise in both conditions, but returned to baseline 3 h later. Hepcidin levels significantly increased in both conditions 3 h post-exercise (p = 0.05), with no significant differences between trials. A significant treatment effect was observed between trials for sTfR (p = 0.01), but not iron and transferrin saturation. CONCLUSION: Acute exercise in hypoxia did not influence post-exercise IL-6 production, hepcidin activity or iron metabolism compared with exercise at the same relative intensity in normoxia. Hence, acute exercise performed at the same relative intensity in hypoxia poses no further risk to an athlete's iron status, as compared with exercise in normoxia.

Relationship between changes in haemoglobin mass and maximal oxygen uptake after hypoxic exposure.

BACKGROUND: Endurance athletes have been using altitude training for decades to improve near sea-level performance. The predominant mechanism is thought to be accelerated erythropoiesis increasing haemoglobin mass (Hb(mass)) resulting in a greater maximal oxygen uptake (VO2(max)). Not all studies have shown a proportionate increase in VO2(max) as a result of increased Hb(mass). The aim of this study was to determine the relationship between the two parameters in a large group of endurance athletes after altitude training. METHODS: 145 elite endurance athletes (94 male and 51 female) who participated in various altitude studies as altitude or control participants were used for the analysis. Participants performed Hb(mass) and VO2(max) testing before and after intervention. RESULTS: For the pooled data, the correlation between per cent change in Hb(mass) and per cent change in VO2(max) was significant (p<0.0001, r(2)=0.15), with a slope (95% CI) of 0.48 (0.30 to 0.67) intercept free to vary and 0.62 (0.46 to 0.77) when constrained through the origin. When separated, the correlations were significant for the altitude and control groups, with the correlation being stronger for the altitude group (slope of 0.57 to 0.72). CONCLUSIONS: With high statistical power, we conclude that altitude training of endurance athletes will result in an increase in VO2(max) of more than half the magnitude of the increase in Hb(mass), which supports the use of altitude training by athletes. But race performance is not perfectly related to relative VO2(max), and other non-haematological factors altered from altitude training, such as running economy and lactate threshold, may also be beneficial to performance.

Ten days of simulated live high:train low altitude training increases Hbmass in elite water polo players.

OBJECTIVES: Water polo requires high aerobic power to meet the demands of match play. Live high:train low (LHTL) may enhance aerobic capacity at sea level. Before the Olympics, the Australian women's water polo team utilised LHTL in an attempt to enhance aerobic fitness. METHODS: Over 6 months, 11 players completed three normobaric LHTL exposures (block 1:11 days at 3000 m; block 2+3:9 days at 2500 m, 11 days normoxia, 10 days at 2800 m). Haemoglobin mass (Hbmass) was measured through carbon monoxide-rebreathing. Before each block, the relationship between Hbmass and water polo-specific aerobic fitness was investigated using the Multistage Shuttle Swim Test (MSST). Effect size statistics were adopted with likely, highly likely and almost certainly results being >75%, >95%, >99%, respectively. A Pearson product moment correlation was used to characterise the association between pooled data of Hbmass and MSST. RESULTS: Hbmass (mean ± SD, pre 721 ± 66 g) likely increased after block 1 and almost certainly after block 2+3 (% change; 90% confidence limits: block 1: 3.7%; 1.3-6.2%, block 2+3: 4.5%; 3.8-5.1%) and the net effect was almost certainly higher after block 2+3 than before block 1 (pre) by 8.5%; 7.3-9.7%. There was a very large correlation between Hbmass (g/kg) and MSST score (r=0.73). CONCLUSIONS: LHTL exposures of <2 weeks induced approximately 4% increase in Hbmass of water polo players. Extra Hbmass may increase aerobic power, but since match performance is nuanced by many factors it is impossible to ascertain whether the increased Hbmass contributed to Australia's Bronze medal.

Yin and yang, or peas in a pod? Individual-sport versus team-sport athletes and altitude training.

The question of whether altitude training can enhance subsequent sea-level performance has been well investigated over many decades. However, research on this topic has focused on athletes from individual or endurance sports, with scant number of studies on team-sport athletes. Questions that need to be answered include whether this type of training may enhance team-sport athlete performance, when success in team-sport is often more based on technical and tactical ability rather than physical capacity per se. This review will contrast and compare athletes from two sports representative of endurance (cycling) and team-sports (soccer). Specifically, we draw on the respective competition schedules, physiological capacities, activity profiles and energetics of each sport to compare the similarities between athletes from these sports and discuss the relative merits of altitude training for these athletes. The application of conventional live-high, train-high; live-high, train-low; and intermittent hypoxic training for team-sport athletes in the context of the above will be presented. When the above points are considered, we will conclude that dependent on resources and training objectives, altitude training can be seen as an attractive proposition to enhance the physical performance of team-sport athletes without the need for an obvious increase in training load.

Predicting sickness during a 2-week soccer camp at 3600 m (ISA3600).

OBJECTIVES: To examine the time course of changes in wellness and health status markers before and after episodes of sickness in young soccer players during a high-altitude training camp (La Paz, 3600 m). METHODS: Wellness and fatigue were assessed daily on awakening using specifically-designed questionnaires and resting measures of heart rate and heart rate variability. The rating of perceived exertion and heart rate responses to a submaximal run (9 km/h) were also collected during each training session. Players who missed the morning screening for at least two consecutive days were considered as sick. RESULTS: Four players met the inclusion criteria. With the exception of submaximal exercise heart rate, which showed an almost certain and large increase before the day of sickness (4%; 90% confidence interval 3 to 6), there was no clear change in any of the other psychometric or physiological variables. There was a very likely moderate increase (79%, 22 to 64) in self-reported training load the day before the heart rate increase in sick players (4 of the 4 players, 100%). In contrast, training load was likely and slightly decreased (-24%, -78 to -11) in players who also showed an increased heart rate but remained healthy. CONCLUSIONS: A >4% increased heart rate during submaximal exercise in response to a moderate increase in perceived training load the previous day may be an indicator of sickness the next day. All other variables, that is, resting heart rate, heart rate variability and psychometric questionnaires may be less powerful at predicting sickness.

Changes in blood gas transport of altitude native soccer players near sea-level and sea-level native soccer players at altitude (ISA3600).

OBJECTIVES: The optimal strategy for soccer teams playing at altitude is not known, that is, 'fly-in, fly-out' versus short-term acclimatisation. Here, we document changes in blood gas and vascular volumes of sea-level (Australian, n=20) and altitude (Bolivian, n=19) native soccer players at 3600 m. METHODS: Haemoglobin-oxygen saturation (Hb-sO2), arterial oxygen content (CaO2), haemoglobin mass (Hbmass), blood volume (BV) and blood gas concentrations were measured before descent (Bolivians only), together with aerobic fitness (via Yo-YoIR1), near sea-level, after ascent and during 13 days at 3600 m. RESULTS: At baseline, haemoglobin concentration [Hb] and Hbmass were higher in Bolivians (mean ± SD; 18.2 ± 1.0 g/dL, 12.8 ± 0.8 g/kg) than Australians (15.0 ± 0.9 g/dL, 11.6 ± 0.7 g/kg; both p ≤ 0.001). Near sea-level, [Hb] of Bolivians decreased to 16.6 ± 0.9 g/dL, but normalised upon return to 3600 m; Hbmass was constant regardless of altitude. In Australians, [Hb] increased after 12 days at 3600 m to 17.3 ± 1.0 g/dL; Hbmass increased by 3.0 ± 2.7% (p ≤ 0.01). BV decreased in both teams at altitude by ∼400 mL. Arterial partial pressure for oxygen (PaO2), Hb-sO2 and CaO2 of both teams decreased within 2 h of arrival at 3600 m (p ≤ 0.001) but increased over the following days, with CaO2 overcompensated in Australians (+1.7 ± 1.2 mL/100 mL; p ≤ 0.001). Yo-YoIR1 was lower on the 3rd versus 10th day at altitude and was significantly related to CaO2. CONCLUSIONS: The marked drop in PaO2 and CaO2 observed after ascent does not support the 'fly-in, fly-out' approach for soccer teams to play immediately after arrival at altitude. Although short-term acclimatisation was sufficient for Australians to stabilise their CaO2 (mostly due to loss of plasma volume), 12 days appears insufficient to reach chronic levels of adaption.

Wellness, fatigue and physical performance acclimatisation to a 2-week soccer camp at 3600 m (ISA3600).

OBJECTIVES: To examine the time course of wellness, fatigue and performance during an altitude training camp (La Paz, 3600 m) in two groups of either sea-level (Australian) or altitude (Bolivian) native young soccer players. METHODS: Wellness and fatigue were assessed using questionnaires and resting heart rate (HR) and HR variability. Physical performance was assessed using HR responses to a submaximal run, a Yo-Yo Intermittent recovery test level 1 (Yo-YoIR1) and a 20 m sprint. Most measures were performed daily, with the exception of Yo-YoIR1 and 20 m sprints, which were performed near sea level and on days 3 and 10 at altitude. RESULTS: Compared with near sea level, Australians had moderate-to-large impairments in wellness and Yo-YoIR1 relative to the Bolivians on arrival at altitude. The acclimatisation of most measures to altitude was substantially slower in Australians than Bolivians, with only Bolivians reaching near sea-level baseline high-intensity running by the end of the camp. Both teams had moderately impaired 20 m sprinting at the end of the camp. Exercise HR had large associations (r>0.5-0.7) with changes in Yo-YoIR1 in both groups. CONCLUSIONS: Despite partial physiological and perceptual acclimatisation, 2 weeks is insufficient for restoration of physical performance in young sea-level native soccer players. Because of the possible decrement in 20 m sprint time, a greater emphasis on speed training may be required during and after altitude training. The specific time course of restoration for each variable suggests that they measure different aspects of acclimatisation to 3600 m; they should therefore be used in combination to assess adaptation to altitude.