Mountains of research: Where and whom high-altitude physiology has overlooked.

High altitude is a natural setting in which to study human acclimatization and adaptation. Here, I identify where and in whom high-altitude physiology research has occurred. There has been a mismatch between countries with large high-altitude populations vs. where high-altitude research has been conducted. From 1970 to 2020, 83% of high-altitude physiology research took place in just seven countries: Nepal, China, USA, Peru, India, Bolivia and Italy. Collectively, these countries account for only 35% of the global population living above 2500 m. Furthermore, high-altitude physiology research has predominantly studied low-altitude residents visiting high altitude and female participants are under-represented. Accordingly, the included populations are not necessarily a proportional representation of high-altitude residents. Here, I discuss how this influences our understanding of high-altitude adaptation. Finally, I highlight past initiatives to increase diversity in high-altitude research. By identifying the broad gaps in high-altitude physiology research, I propose exciting, inclusive opportunities to study human high-altitude physiology.