For most of recreational or amateur athletes, training at altitude isn’t really possible while maintaining a steady job and normal family life. Month-long trips to Boulder or the Alps just aren’t realistic for most of us. That’s where Intermittent Hypoxic Training (IHT) comes in. IHT is an alternative to traditional altitude training that can improve aerobic and anaerobic performance by enhancing muscle function and how well we use and transport oxygen. It can be put to use in three different forms: a prolonged passive exposure ranging from eight to 12 hours, a short passive exposure ranging from 1 to 2 hours, or short training exposures to improve aerobic or anaerobic metabolism.
To employ IHT in your training it’s important to first understand how it differs from simply training at altitude. Moving to Boulder, or engaging in IHT, can bring on hypoxia, basically a reduced total body oxygen saturation. This occurs, however, in two different ways. At altitude, the “thinner air” (created by changes in atmospheric pressure) leads to a degree of hypoxia that is more intense than the kind IHT exposure leads to.

On the flip side, IHT creates a hypoxic environment by reducing the oxygen content of the air you’re already breathing. As a result, a simulated altitude setting on IHT equipment is not the same as experiencing real altitude.

In order to put the two types of hypoxia on a level playing field, an objective measure of hypoxic stress must be measured through the use of a pulse oximeter. This provides a measure of arterial oxygen saturation (SpO2 percent), which indicates the level of hypoxia the body’s tissues are experiencing. At sea level the body is 100 percent saturated with oxygen and, in order to receive benefit, the saturation level must drop below 92 percent. Much like any type of training, the hypoxic training stimulus is determined by the intensity (SpO2percent) and duration of the exposure. This is commonly referred to as the hypoxic training index. This index can be used to tailor the training regime for different individuals and, over time, determine the necessary hypoxic stimulus to produce desired training effects such as increased lactate tolerance or increases in red blood cell volume.

The 2011 USOC International Altitude Training Symposium will bring together  coaches, athletes  and sport scientists who have  interest in the practical application of hypoxic altitude training for athletic performance enhancement. It will nurture collaborative research efforts amongst coaches, athletes and sport-scientists for the purpose of better understanding of altitude training applicable to athletic performance.

The cause of muscle fatigue has been the subject of much debate. Some researchers emphasise the importance of physical changes such as lactic acid build-up, while others back a “central governor” theory whereby fatigue is a sensation generated by the brain.

Emma Ross of the University of Brighton, UK, and colleagues asked 11 men to carry out knee extensor muscle exercises while breathing normal air – which has 21 per cent oxygen – as well as mixes with 16 per cent, 13 per cent and 10 per cent oxygen to represent mild, moderate and severe hypoxia. As the oxygen levels fell, so did the forces the participants could generate voluntarily.

FULL STORY:

http://www.newscientist.com/article/dn20693-sluggish-movement-at-altitude-is-partly-a-brain-effect.html

In a nutshell, it works like this: Our kidneys have internal sensors that can tell when there’s a drop in oxygen, and they respond by making EPO, the hormone that prompts the body to make red blood cells.  Since a cyclist who lives at high altitude has more of those cells than one lives at sea level, why shouldn’t the low altitude cyclist be able to naturally balance things out? The World Anti-Doping Agency (WADA) found itself curiously flummoxed when it considered that question in 2006.  Its Ethical Issues Review Panel said the chambers violated the “spirit of sport,” and a high-ranking official called them “tacky.” But seven dozen doctors from around the world wrote a passionate defense, insisting that “altering the ambient oxygen concentration requires no more passive use of technology than getting into a car, turning on the ignition, and driving to the top of a mountain.” WADA ultimately agreed.

Substantial improvements in their max  O2 deficit (29 %) and treadmill exercise  time to exhaustion ETE (17%) were found after the athletes returned to sea level. Additionally, a “+” correlation (r = 0.91, p < 0.05) was shown between the increase in buffering capacity of the gastro-cnemius muscle and treadmill run ETE.

Gore et al  {2001} also reports that skeletal muscle buffer capacity improved  18% (p < 0.05) in male cyclists, triathletes, and cross-country skiers after 23 days of residing at altitude of 3000 m (9840 ft) and physical training at 600 m (1970 ft).  Additionally, they found that athlete’s  mechanical efficiency considerably improved during for- three – four 4-min submaximal cycling test after the 23-day ‘live high train low’ training period.

The exact mechanisms are unclear yet – what is responsible for improved skeletal muscle buffering capacity after high altitude training  but may  relate to changes in creatine phosphate and/or muscle protein content  (Mizuno et al. 1990).  Enhancements  in blood buffering capacity may be becasue of the increases in bicarbonate (Nummela and Rusko 2000) or hemoglobin content.

Swim:  for Triathletes
Bike:  Training for Triathletes
Run:  Technique for Triathletes
Plans and Strategies for Triathletes

http://www.researchgate.net/publication/7474551_VO2_responses_to_intermittent_swimming_sets_at_velocity_associated_with_VO2max

The mild forms of mountain sickness can usually be treated with rest, hydration, analgesics (eg. ibuprofen), and alcohol avoidance. If you are already experiencing these symptoms do not go to higher altitudes.
Symptoms of headache, malaise, and decreased appetite are fairly common amongst individuals traveling to altitudes greater than 8,000 ft, but these can occur event at lower altitudes.

Slow progressive step-acclimatisation minimises the risk of AMS.
Individuals who have already experienced an episode of mountain sickness are at risk for future trips and should seek medical advice.

Severe forms are characterized by severe shortness of breath, cough, severe headache, confusion, or hallucinations. This may progress to coma and death. This is a medical emergency. Immediate descent to lower altitude, administration of oxygen, and medical attention are required.

A very effective way of minimising the adverse effects of mountain sickness is preacclimation using
hypoxicators for simulated altitude training.

Hypoxia challenge stimulates cell to transcript over 30 genes in the due course of altitude training adaptation.  Body produces more EPO –> of red blood cells , builds new capillaries (small blood vessels),  enzymes anti-oxidants and many other beneficial reactions take place in human cells.  This  increase ability to transfer and utilize oxygen in mitochondria more efficiently thus resulting in better performance and body functions..

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Patients were either given pure oxygen or air to inhale in the 24 hours following the onset of heart attack symptoms. The researchers included data from three trials in their studies.  Of the 387 patients involved in the studies only 14 died, but of these, almost three times as many had inhaled oxygen as opposed to air.

Globally, more than 30 million people have heart attacks every year, according to the World Health Organisation. Heart attacks occur when the flow of oxygenated blood to the heart is interrupted. Heart attack patients are often given oxygen to try to improve oxygenation of the heart tissue. However, there is little evidence that this intervention improves outcomes for heart patients and some evidence even suggests it may cause further damage.

Reference

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ScienceDaily (June 16, 2010)
Although the results appear to suggest giving oxygen could do more harm than good, the researchers say there is not yet enough data to be certain. “This result does not necessarily mean that giving oxygen increases the risk of dying from a heart attack,” said hDr Amanda Burls of the Department of Primary Health Care at the University of Oxford in Oxford, UK. “The numbers are so small that this may just have been due to chance.”

ScienceDaily (March 2011) One of the most comprehensive studies of its kind.  Researchers at the University of Colorado School of Medicine in partnership with the Harvard School of Global Health have found that people living at higher altitudes have a lower chance of dying from ischemic heart disease and tend to live longer than others.

“Lower oxygen levels turn on certain genes and we think those genes may change the way heart muscles function. They may also produce new blood vessels that create new highways for blood flow into the heart.”

Honigman, senior author of the study, along with researchers that included Robert Roach, PhD, director of the School of Medicine’s Altitude Research Center, Deborah Thomas, PhD, a geographer at the University of Colorado Denver and Majid Ezzati of the Harvard School of Global Health, spent four years analyzing death certificates from every county in the U.S. They examined cause-of-death, socio-economic factors and other issues in their research.
“If living in a lower oxygen environment such as in our Colorado mountains helps reduce the risk of dying from heart disease it could help us develop new clinical treatments for those conditions,” said Benjamin Honigman, MD, professor of Emergency Medicine at the CU School of Medicine and director of the Altitude Medicine Clinic.

Another explanation, he said, could be that increased solar radiation at altitude helps the body better synthesize vitamin D which has also been shown to have beneficial effects on the heart and some kinds of cancer.

At the same time, the research showed that altitudes above 4,900 feet were detrimental to those suffering from chronic obstructive pulmonary disease.

The study said: “Even modestly lower oxygen levels in people with already impaired breathing and gas exchange may exacerbate hypoxia and pulmonary hypertension {leading to death}”.

Compared to those living near sea-level, the men lived 1.2 to 3.6 years longer and women 0.5 to 2.5 years more.

The men lived between 75.8 and 78.2 years, while women ranged from 80.5 to 82.5 years.

They found that of the top 20 counties with the highest life expectancy, eleven for men and five for women were located in Colorado and Utah. And each county was at a mean elevation of 5,967 feet above sea level.

Despite these numbers, the study showed that when socio-economic factors, solar radiation, smoking and pulmonary disease were taken into account, the net effect of altitude on overall life expectancy was negligible.

This is a public health issue in Colorado and the mountain West. We have more than 700,000 people living at over 7,000 feet above sea level. Does living at altitude change the way a disease progresses? Does it have health effects that we should be investigating? Ultimately, we hope this research will help people lead healthier lives.” “We want to now look at these diseases in a more focused way so we can see the mechanisms behind hypoxia and why they affect the body the way they do,” Honigman said. ”
Still, Honigman said, altitude seems to offer protection against heart disease deaths and may also play a role in cancer development.

Colorado, has the fewest deaths from heart disease and a lower incidence of colon and lung cancer compared to others the highest state in the nation, is also the leanest state, the fittest state.

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