Current trends in altitude training.

Recently, endurance athletes have used several novel approaches and modalities for altitude training including: (i) normobaric hypoxia via nitrogen dilution (hypoxic apartment); (ii) supplemental oxygen; (iii) hypoxic sleeping devices; and (iv) intermittent hypoxic exposure (IHE). A normobaric hypoxic apartment simulates an altitude environment equivalent to approximately 2000 to 3000m (6560 to 9840ft). Athletes who use a hypoxic apartment typically 'live and sleep high' in the hypoxic apartment for 8 to 18 hours a day, but complete their training at sea level, or approximate sea level conditions. Several studies suggest that using a hypoxic apartment in this manner produces beneficial changes in serum erythropoietin (EPO) levels, reticulocyte count and red blood cell (RBC) mass, which in turn may lead to improvements in postaltitude endurance performance. However, other studies failed to demonstrate significant changes in haematological indices as a result of using a hypoxic apartment. These discrepancies may be caused by differences in methodology, the hypoxic stimulus that athletes were exposed to and/or the training status of the athletes. Supplemental oxygen is used to simulate either normoxic (sea level) or hyperoxic conditions during high-intensity workouts at altitude. This method is a modification of the 'high-low' strategy, since athletes live in a natural terrestrial altitude environment but train at 'sea level' with the aid of supplemental oxygen. Limited data regarding the efficacy of hyperoxic training suggests that high-intensity workouts at moderate altitude (1860m/6100ft) and endurance perfor- mance at sea level may be enhanced when supplemental oxygen training is utilised at altitude over a duration of several weeks. Hypoxic sleeping devices include the Colorado Altitude Training (CAT) Hatch (hypobaric chamber) and Hypoxico Tent System (normobaric hypoxic system), both of which are designed to allow athletes to sleep high and train low. These devices simulate altitudes up to approximately 4575 m/15006 ft and 4270 m/14005 ft, respectively. Currently, no studies have been published on the efficacy of these devices on RBC production, maximal oxygen uptake and/or performance in elite athletes. IHE is based on the assumption that brief exposures to hypoxia (1.5 to 2.0 hours) are sufficient to stimulate the release of EPO, and ultimately bring about an increase in RBC concentration. Athletes typically use IHE while at rest, or in conjunction with a training session. Data regarding the effect of IHE on haematological indices and athletic performance are minimal and inconclusive.

Self-reported symptoms and exercise-induced asthma in the elite athlete.

PURPOSE: The purpose of this study was to compare self-reported symptoms for exercise-induced asthma (EIA) to postexercise challenge pulmonary function test results in elite athletes. METHODS: Elite athletes (N = 158; 83 men and 75 women; age: 22 +/- 4.4 yr) performed pre- and post-exercise spirometry and were grouped according to postexercise pulmonary function decrements (PFT-positive, PFT-borderline, and PFT-normal for EIA). Before the sport/environment specific exercise challenge, subjects completed an EIA symptoms-specific questionnaire. RESULTS: Resting FEV1 values were above predicted values (114--121%) and not different between groups. Twenty-six percent of the study population demonstrated >10% postexercise drop in FEV1 and 29% reported two or more symptoms. However, the proportion of PFT-positive and PFT-normal athletes reporting two or more symptoms was not different (39% vs. 41%). Postrace cough was the most reported symptom, reported significantly more frequently for PFT-positive athletes (P < 0.05). Sensitivity/specificity analysis demonstrated a lack of effectiveness of self-reported symptoms to identify PFT-positive or exclude PFT-normal athletes. Postexercise lower limit reference ranges (MN-2SDs) were determined from normal athletes for FEV1, FEF25--75% and PEF to be -7%, -12.5%, and -18%, respectively. CONCLUSION: Although questionnaires provide reasonable estimates of EIA prevalence among elite cold-weather athletes, the use of self-reported symptoms for EIA diagnosis in this population will likely yield high frequencies of both false positive and false negative results. Diagnosis should include spirometry using an exercise/environment specific challenge in combination with the athlete's history of asthma symptoms.

Incidence of exercise-induced bronchospasm in Olympic winter sport athletes.

PURPOSE: The purpose of this project was to determine the incidence of exercise-induced bronchospasm (EIB) among U.S. Olympic winter sport athletes. METHODS: Subjects included female and male members of the 1998 U.S. Winter Olympic Team from the following sports: biathlon, cross-country ski, figure skating, ice hockey, Nordic combined, long-track speedskating, and short-track speedskating. Assessment of EIB was conducted in conjunction with an "actual competition" (Olympic Trials, World Team Trials, World Cup Event, U.S. National Championships) or a "simulated competition" (time trial, game), which served as the exercise challenge. Standard spirometry tests were performed preexercise and at 5, 10, and 15 min postexercise. An athlete was considered EIB-positive based on a postexercise decrement in FEV1 > or = 10%. RESULTS: For the seven sports evaluated on the 1998 U.S. Winter Olympic Team, the overall incidence of EIB across all sports and genders was 23%. The highest incidence of EIB was found in cross-country skiers, where 50% of the athletes (female = 57%; male = 43%) were diagnosed with EIB. Across the seven sports evaluated, the prevalence of EIB among the female and male athletes was 26% and 18%, respectively. Among those individuals found to be EIB-positive were athletes who won a team gold medal, one individual silver medal, and one individual bronze medal at the Nagano Winter Olympics. CONCLUSIONS: These data suggest that: 1) EIB is prevalent in several Olympic winter sports and affects nearly one of every four elite winter sport athletes; 2) the winter sport with the highest incidence of EIB is cross-country skiing; 3) in general, EIB is more prevalent in female versus male elite winter sport athletes; and 4) athletes may compete successfully at the international level despite having EIB.

Exercise-induced asthma screening of elite athletes: field versus laboratory exercise challenge.

PURPOSE: The purpose of this study was to compare a laboratory based exercise challenge (LBC) to a field based exercise challenge (FBC) for pulmonary function test (PFT) exercise-induced asthma (EIA) screening of elite athletes. METHODS: Twenty-three elite cold weather athletes (14 men, 9 women) PFT positive for EIA (FBC screened) served as subjects. Twenty-three gender and sport matched controls (nonasthmatics) were randomly selected to establish PFT reference values for normal elite athletes. Before FBC, athletes completed a medical history questionnaire for EIA symptoms. FBC evaluations consisted of baseline spirometry, actual or simulated competition, and 5, 10, and 15 min postexercise spirometry. PFT positive athletes were evaluated in the laboratory using an exercise challenge simulating race intensity (ambient conditions: 21 degrees C, 60% relative humidity). PFT procedures were identical to FBC. RESULTS: 91% of PFT positive and 48% of PFT normal athletes reported at least one symptom of EIA, with postrace cough most frequent. Baseline spirometry was the same for PFT positives and normal controls. Lower limit reference range (MN - 2 SD) of FEV1 for controls suggests that postexercise decrements of greater than approximately -7% indicate abnormal airway response in this population. Exercise time duration did not effect bronchial reactivity; 78% of FBC PFT positives were PFT normal post-LBC. CONCLUSION: Self-reported symptoms by elite athletes are not reliable in identifying EIA. Reference range criterion for FEV1 decrement in the elite athlete postexercise contrasts current recommended guidelines. Moreover, a large number of false negatives may occur in this population if EIA screening is performed with inadequate exercise and environmental stress.

Effect of altitude training on serum creatine kinase activity and serum cortisol concentration in triathletes.

In this investigation we evaluated the effect of a 5-week training program at 1860 m on serum creatine kinase (CK) activity and serum cortisol concentration in national-caliber triathletes for the purpose of monitoring the response to training in a hypobaric hypoxic environment. Subjects included 16 junior-level female (n = 8) and male (n = 8) triathletes who were training for the International Triathlon Union (ITU) World Championships. After an initial acclimatization period, training intensity and/or volume were increased progressively during the 5-week altitude training camp. Resting venous blood samples were drawn at 0700 hours following a 12-h overnight fast and were analyzed for serum CK activity and serum cortisol concentration. Subjects were evaluated before [7-10 days pre-altitude (SL 1)] and after [7-10 days post-altitude (SL 2)] the 5-week training camp at 1860 m. At altitude, subjects were evaluated within 24-36 h after arrival (ALT 1), 7 days after arrival (ALT 2), 18 days after arrival (ALT 3), and 24-36 h prior to leaving the altitude training camp (ALT 4). A repeated-measures analysis of variance was used to evaluate differences over time from SL 1 to SL 2. Compared to SL 1, serum CK activity increased approximately threefold (P < 0.05) within the initial 24-36 h at altitude (ALT 1), and increased by an additional 70% (P < 0.05) after the 1st week of altitude training (ALT 2). Serum CK activity remained significantly elevated over the duration of the experimental period compared to pre-altitude baseline levels. Serum cortisol concentration was increased (P < 0.05) at the end of the 5-week altitude training period (ALT 4) relative to SL 1, ALT 1 and ALT 3. These data suggest that: (1) the initial increase in serum CK activity observed in the first 24-36 h at altitude was due primarily to acute altitude exposure and was independent of increased training intensity and/or training volume, (2) the subsequent increases in serum CK activity observed over the duration of the 5-week altitude camp were probably due to the combined effects of altitude exposure and increased training load, and (3) the increase in serum cortisol concentration observed at the end of the altitude training camp reflects the additive effect of 5 weeks of altitude exposure in combination with a progressively increased training intensity and/or volume.

Physiological profiles of elite off-road and road cyclists.

There are minimal scientific data describing international caliber off-road cyclists (mountain bikers), particularly as they compare physiologically with international caliber road cyclists. Elite female (N = 10) and male (N = 10) athletes representing the United States National Off-Road Bicycle Association (NORBA) Cross-Country Team were compared with elite female (N = 10) and male (N = 10) athletes representing the United States Cycling Federation (USCF) National Road Team. Submaximal and maximal exercise responses were evaluated during the "championship" phase of the training year when athletes were in peak condition. All physiological tests were conducted at 1860 m. Among the female athletes, physiological responses at lactate threshold (LT) and during maximal exercise (MAX) were similar between NORBA and USCF cyclists with two exceptions: 1) USCF cyclists demonstrated a significantly greater (P < 0.05) absolute (16%) and relative (10%) maximal aerobic power, and 2) MAX heart rate was significantly higher (P < 0.05) for the USCF athletes (6%). Among the male athletes, physiological responses at LT and MAX were similar between NORBA and USCF cyclists with two exceptions: 1) USCF cyclists produced significantly greater (P < 0.05) absolute (18%) and relative (16%) power at LT, and 2) USCF cyclists produced significantly greater (P < 0.05) absolute (12%) and relative (10%) power at MAX. These data suggest that, in general, elite off-road cyclists possess physiological profiles that are similar to elite road cyclists.

Influence of water run training on the maintenance of aerobic performance.

The purpose of this study was to examine the effect of a 6-wk deep water running program on the maintenance of cardiorespiratory performance (VO2max, ventilatory threshold, running economy); metabolic measurements of blood glucose, blood lactate, and plasma norepinephrine; and body composition. Sixteen trained male runners (VO2max = 58.6 +/- 3.6 ml.kg-1.min-1) were assigned to one of two groups matched by VO2max, treadmill run (R) or water run (WR). Subjects participated in their respective training programs, which consisted of workouts of a) 30 min at 90-100% VO2max and b) 60 min at 70-75% VO2max alternated daily for 5 d.wk-1. Following 6 wk of workouts, no significant intra- or intergroup differences were observed for treadmill VO2max for R (pre = 58.4 +/- 2.3, post = 60.1 +/- 3.6 ml.kg-1.min) and WR (pre = 58.7 +/- 4.7, post = 59.6 +/- 5.4 ml.kg-1.min-1). Similarly, ventilatory threshold was unaltered in R (pre = 47.5 +/- 1.8, post = 48.2 +/- 3.3 ml.kg-1.min-1) and WR (pre = 46.5 +/- 6.4, post = 47.4 +/- 6.7 ml.kg-1.min-1), nor were there any changes in running economy in R (pre = 48.4 +/- 2.3, post = 48.9 +/- 2.0 ml.kg-1.min-1 at 255 m.min-1) and WR (pre = 51.8 +/- 2.0, post = 48.9 +/- 2.2 ml.kg-1.min-1 at 255 m.min-1). No significant differences were observed within or between groups for maximal blood glucose, blood lactate, and plasma norepinephrine concentration as well as for body composition indices. It was concluded that deep water running may serve as an effective training alternative to landbased running for the maintenance of aerobic performance for up to 6 wk in trained endurance athletes.

Influence of carbohydrate ingestion on blood glucose and performance in runners.

Ten trained male runners performed a treadmill exercise test at 80% VO2max under two experimental conditions, carbohydrate (CHO, 7% carbohydrate) and placebo (P), to determine the effect of carbohydrate ingestion on endurance performance (treadmill run time), blood glucose concentration, respiratory exchange ratio (RER), and subjective ratings of perceived exertion (RPE). Treatment order was randomized and counterbalanced and test solutions were administered double-blind. Ingestion took place 5 min preexercise (250 ml) and at 15-min intervals during exercise (125 ml). Performance was enhanced by 29.4% (p < 0.05) during CHO (115 +/- 25 min) compared to P (92 +/- 27 min). Blood glucose concentration was significantly greater during CHO (5.6 +/- 0.9 mM) relative to P (5.0 +/- 0.7 mM). There was a significant increase in mean RER following CHO ingestion (.94 +/- .01) compared to P (.90 +/- .01). Average RPE was significantly less during CHO (14.5 +/- 2.3) relative to P (15.4 +/- 2.4). These data suggest that time to exhaustion of high-intensity treadmill exercise is delayed as a result of carbohydrate ingestion and that this effect is mediated by favorable alterations in blood glucose concentration and substrate utilization.