Combined intermittent hypoxic exposure at rest and continuous hypoxic training can maintain elevated hemoglobin mass after a hypoxic camp.

Athletes use hypoxic living and training to increase hemoglobin mass (Hbmass), but Hbmass declines rapidly upon return to sea level. We investigated whether Intermittent Hypoxic Exposure (IHE) + Continuous Hypoxic Training (CHT) after return to sea level maintained elevated Hbmass, and if changes in Hbmass were transferred to changes in maximal oxygen uptake (V̇O2max) and exercise performance. Hbmass was measured in 58 endurance athletes before (PRE), after (POST1), and 30 days after (POST2) a 27 ± 4-day training camp in hypoxia (n=44, HYP) or at sea level (n=14, SL). After return to sea level, 22 athletes included IHE (2 h rest) + CHT (1 h training) into their training every third day for one month (HYPIHE+CHT), whereas the other 22 HYP athletes were not exposed to IHE or CHT (HYPSL). Hbmass increased from PRE to POST1 in both HYPIHE+CHT (4.4 ± 0.7%, mean ± SEM) and HYPSL (4.1 ± 0.6%) (both p<0.001). Compared to PRE, Hbmass at POST2 remained 4.2 ± 0.8% higher in HYPIHE+CHT (p<0.001) and1.9 ± 0.5% higher in HYPSL (p=0.023), indicating a significant difference between the groups (p=0.002). In SL, no significant changes were observed in Hbmass with mean alterations between -0.5% and 0.4%. V̇O2max and time to exhaustion during an incremental treadmill test (n=35) were elevated from PRE to POST2 only in HYPIHE+CHT (5.8 ± 1.2% and 5.4 ± 1.4%, respectively, both p<0.001). IHE+CHT possesses the potential to mitigate the typical decline in Hbmass commonly observed during the initial weeks after return to sea level.

Carbohydrate intake in young female cross-country skiers is lower than recommended and affects competition performance.

Purpose: (1) To evaluate if energy availability (EA), macronutrient intake and body composition change over four training periods in young, highly trained, female cross-country skiers, and (2) to clarify if EA, macronutrient intake, body composition, and competition performance are associated with each other in this cohort. Methods: During a one-year observational study, 25 female skiers completed 3-day food and training logs during four training periods: preparation, specific preparation, competition, and transition periods. A body composition measurement (bioimpedance analyzer) was performed at the end of the preparation, specific preparation, and competition periods. Competition performance was determined by International Ski Federation (FIS) points gathered from youth national championships. Results: EA (36-40 kcal·kg FFM-1·d-1) and carbohydrate (CHO) intake (4.4-5.1 g·kg-1·d-1) remained similar, and at a suboptimal level, between training periods despite a decrease in exercise energy expenditure (p = 0.002) in the transition period. Higher EA (r = -0.47, p = 0.035) and CHO intake (r = -0.65, p = 0.002) as well as lower FM (r = 0.60, p = 0.006) and F% (r = 0.57, p = 0.011) were associated with lower (better) FIS-points. CHO intake was the best predictor of distance competition performance (R2 = 0.46, p = 0.004). Conclusions: Young female cross-country skiers had similar EA and CHO intake over four training periods. Both EA and CHO intake were at suboptimal levels for performance and recovery. CHO intake and body composition are important factors influencing competition performance in young female cross-country skiers.

Nutritional intake and anthropometric characteristics are associated with endurance performance and markers of low energy availability in young female cross-country skiers.

BACKGROUND: Low energy availability (LEA) can have negative performance consequences, but the relationships between LEA and performance are poorly understood especially in field conditions. In addition, little is known about the contribution of macronutrients to long-term performance. Therefore, the aim of this study was to evaluate if energy availability (EA) and macronutrient intake in a field-based situation were associated with laboratory-measured performance, anthropometric characteristics, blood markers, training volume, and/or questionnaire-assessed risk of LEA in young female cross-country (XC) skiers. In addition, the study aimed to clarify which factors explained performance. METHODS: During a one-year observational study, 23 highly trained female XC skiers and biathletes (age 17.1 ± 1.0 years) completed 3-day food and training logs on four occasions (September-October, February-March, April-May, July-August). Mean (±SD) EA and macronutrient intake from these 12 days were calculated to describe yearly overall practices. Laboratory measurements (body composition with bioimpedance, blood hormone concentrations, maximal oxygen uptake (VO2max), oxygen uptake (VO2) at 4 mmol·L-1 lactate threshold (OBLA), double poling (DP) performance (time to exhaustion), counter movement jump (height) and the Low Energy Availability in Females Questionnaire (LEAF-Q)) were completed at the beginning (August 2020, M1) and end of the study (August 2021, M2). Annual training volume between measurements was recorded using an online training diary. RESULTS: The 12-day mean EA (37.4 ± 9.1 kcal·kg FFM-1·d-1) and carbohydrate (CHO) intake (4.8 ± 0.8 g·kg-1·d-1) were suboptimal while intake of protein (1.8 ± 0.3 g·kg-1·d-1) and fat (31 ± 4 E%) were within recommended ranges. Lower EA and CHO intake were associated with a higher LEAF-Q score (r = 0.44, p = 0.042; r = 0.47, p = 0.026). Higher CHO and protein intake were associated with higher VO2max (r = 0.61, p = 0.005; r = 0.54, p = 0.014), VO2 at OBLA (r = 0.63, p = 0.003; r = 0.62, p = 0.003), and DP performance at M2 (r = 0.42, p = 0.051; r = 0.44, p = 0.039). Body fat percentage (F%) was negatively associated with CHO and protein intake (r = -0.50, p = 0.017; r = -0.66, p = 0.001). Better DP performance at M2 was explained by higher training volume (R2 = 0.24, p = 0.033) and higher relative VO2max and VO2 at OBLA at M2 by lower F% (R2 = 0.44, p = 0.004; R2 = 0.47, p = 0.003). Increase from M1 to M2 in DP performance was explained by a decrease in F% (R2 = 0.25, p = 0.029). CONCLUSIONS: F%, and training volume were the most important factors explaining performance in young female XC skiers. Notably, lower F% was associated with higher macronutrient intake, suggesting that restricting nutritional intake may not be a good strategy to modify body composition in young female athletes. In addition, lower overall CHO intake and EA increased risk of LEA determined by LEAF-Q. These findings highlight the importance of adequate nutritional intake to support performance and overall health.

Hemoglobin mass and performance responses during 4 weeks of normobaric "live high-train low and high".

PURPOSE: To investigate whether 4 weeks of normobaric "live high-train low and high" (LHTLH) causes different hematological, cardiorespiratory, and sea-level performance changes compared to living and training in normoxia during a preparation season. METHODS: Nineteen (13 women, 6 men) cross-country skiers competing at the national or international level completed a 28-day period (∼18 h day-1 ) of LHTLH in normobaric hypoxia of ∼2400 m (LHTLH group) including two 1 h low-intensity training sessions per week in normobaric hypoxia of 2500 m while continuing their normal training program in normoxia. Hemoglobin mass (Hbmass ) was assessed using a carbon monoxide rebreathing method. Time to exhaustion (TTE) and maximal oxygen uptake (VO2max ) were measured using an incremental treadmill test. Measurements were completed at baseline and within 3 days after LHTLH. The control group skiers (CON) (seven women, eight men) performed the same tests while living and training in normoxia with ∼4 weeks between the tests. RESULTS: Hbmass in LHTLH increased 4.2 ± 1.7% from 772 ± 213 g (11.7 ± 1.4 g kg-1 ) to 805 ± 226 g (12.5 ± 1.6 g kg-1 ) (p < 0.001) while it was unchanged in CON (p = 0.21). TTE improved during the study regardless of the group (3.3 ± 3.4% in LHTLH; 4.3 ± 4.8% in CON, p < 0.001). VO2max did not increase in LHTLH (61.2 ± 8.7 mL kg-1 min-1 vs. 62.1 ± 7.6 mL kg-1 min-1 , p = 0.36) while a significant increase was detected in CON (61.3 ± 8.0-64.0 ± 8.1 mL kg-1 min-1 , p < 0.001). CONCLUSIONS: Four-week normobaric LHTLH was beneficial for increasing Hbmass but did not support the short-term development of maximal endurance performance and VO2max when compared to the athletes who lived and trained in normoxia.

Nutrition Knowledge Is Associated with Energy Availability and Carbohydrate Intake in Young Female Cross-Country Skiers.

The aim of this study was to provide information on energy availability (EA), macronutrient intake, nutritional periodization practices, and nutrition knowledge in young female cross-country skiers. A total of 19 skiers filled in weighted food and training logs before and during a training camp. Nutrition knowledge was assessed via a validated questionnaire. EA was optimal in 11% of athletes at home (mean 33.7 ± 9.6 kcal·kgFFM-1·d-1) and in 42% at camp (mean 40.3 ± 17.3 kcal·kgFFM-1·d-1). Most athletes (74%) failed to meet recommendations for carbohydrate intake at home (mean 5.0 ± 1.2 g·kg-1·d-1) and 63% failed to do so at camp (mean 7.1 ± 1.6 g·kg-1·d-1). The lower threshold of the pre-exercise carbohydrate recommendations was met by 58% and 89% of athletes while percentages were 26% and 89% within 1 h after exercise, at home and at camp, respectively. None of the athletes met the recommendations within 4 h after exercise. Nutrition knowledge was associated with EA at home (r = 0.52, p = 0.023), and with daily carbohydrate intake at home (r = 0.62, p = 0.005) and at camp (r = 0.52, p = 0.023). Carbohydrate intake within 1 and 4 h post-exercise at home was associated with better nutrition knowledge (r = 0.65, p = 0.003; r = 0.53, p = 0.019, respectively). In conclusion, young female cross-county skiers had difficulties meeting recommendations for optimal EA and carbohydrate intake. Better nutrition knowledge may help young athletes to meet these recommendations.

Body Composition, Energy Availability, Training, and Menstrual Status in Female Runners.

PURPOSE: To determine body composition, energy availability, training load, and menstrual status in young elite endurance running athletes (ATH) over 1 year, and in a secondary analysis, to investigate how these factors differ between nonrunning controls (CON), and amenorrheic (AME) and eumenorrheic (EUM) ATH. Correlations to injury, illness, and performance were also examined. METHODS: Altogether 13 ATH and 8 CON completed the Low Energy Availability in Females Questionnaire. Anthropometric, energy intake, and peak oxygen uptake assessments were made at 4 time points throughout the year: at baseline post competition season, post general preparation, post specific preparation, and post competition season the following year. Logs of physical activity, menstrual cycle, illness, and injury were kept by all participants. Performance was defined using the highest International Association of Athletics Federations points prior to and after the study. RESULTS: ATH had significantly lower body mass (P < .008), fat percentage (P < .001), and body mass index (P < .027) compared with CON, while energy availability did not differ between ATH and CON. The Low Energy Availability in Females Questionnaire score was higher in ATH than in CON (P < .028), and 8 ATH (vs zero CON) were AME. The AME had significantly more injury days (P < .041) and ran less (P < .046) than EUM, while total annual running distance was positively related to changes in performance in ATH (r < .62, P < .043, n < 11). CONCLUSIONS: More than half of this group of runners was AME, and they were injured more and ran less than their EUM counterparts. Furthermore, only the EUM runners increased their performance over the course of the year.