Nutritional strategies for the preservation of fat free mass at high altitude.

Exposure to extreme altitude presents many physiological challenges. In addition to impaired physical and cognitive function, energy imbalance invariably occurs resulting in weight loss and body composition changes. Weight loss, and in particular, loss of fat free mass, combined with the inherent risks associated with extreme environments presents potential performance, safety, and health risks for those working, recreating, or conducting military operations at extreme altitude. In this review, contributors to muscle wasting at altitude are highlighted with special emphasis on protein turnover. The article will conclude with nutritional strategies that may potentially attenuate loss of fat free mass during high altitude exposure.

Effect of leucine supplementation on fat free mass with prolonged hypoxic exposure during a 13-day trek to Everest Base Camp: a double-blind randomized study.

Loss of body weight and fat-free mass (FFM) are commonly noted with prolonged exposure to hypobaric hypoxia. Recent evidence suggests protein supplementation, specifically leucine, may potentially attenuate loss of FFM in subcaloric conditions during normoxia. The purpose of this study was to determine if leucine supplementation would prevent the loss of FFM in subcaloric conditions during prolonged hypoxia. Eighteen physically active male (n = 10) and female (n = 8) trekkers completed a 13-day trek in Nepal to Everest Base Camp with a mean altitude of 4140 m (range 2810-5364 m). In this double-blind study, participants were randomized to ingest either leucine (LEU) (7 g leucine, 93 kcal, 14.5 g whey-based protein) or an isocaloric isonitrogenous control (CON) (0.3 g LEU, 93 kcal, 11.3 g collagen protein) twice daily prior to meals. Body weight, body composition, and circumferences of bicep, thigh, and calf were measured pre- and post-trek. There was a significant time effect for body weight (-2.2% ± 1.7%), FFM (-1.7% ± 1.5%), fat mass (-4.0% ± 6.9%), and circumferences (p < 0.05). However, there was no treatment effect on body weight (CON -2.3 ± 2.0%; LEU -2.2 ± 1.5%), FFM (CON -2.1 ± 1.5%; LEU -1.2 ± 1.6%), fat mass (CON -2.9% ± 5.9%; LEU -5.4% ± 8.1%), or circumferences. Although a significant loss of body weight, FFM, and fat mass was noted in 13 days of high altitude exposure, FFM loss was not attenuated by leucine. Future studies are needed to determine if leucine attenuates loss of FFM with longer duration high altitude exposure.

Effects of purified oxygenated water on exercise performance during acute hypoxic exposure.

The purpose of this study was to assess the effects of purified oxygenated water on exercise performance under hypoxic conditions. Nine recreational male cyclists (age = 26.6 +/- 5.2 y, weight = 87.6 +/- 19.5 kg, VO2peak = 46.5 +/- 5.9 mL x kg(-1) x min(-1)) completed two 600 kJ cycling time trials under hypoxic conditions (FIO2 = 13.6% O2, Pbar = 641 mmHg) separated by 2 wk. Trials were completed following 3 d ingestion of 35 mL x kg(-1) x d(-1) of control (CON) or experimental (EXP) water. Time to completion, heart rate (HR), rate of perceived exertion (RPE), pulse oximetry (SaO2), blood gases (PcO2 and PcCO2), and lactate were measured during the trials. Hydration was assessed with pre- and post-exercise body weight and 24-h urine specific gravity. Performance, hydration, and blood oxygenation were unaffected by EXP water. Results of this study suggest that purified oxygenated water does not improve exercise performance in moderately active males.