"Living High-Training Low" for Olympic Medal Performance: What Have We Learned 25 Years After Implementation?

Best-Practice Training Characteristics Within Olympic Endurance Sports as Described by Norwegian World-Class Coaches

BACKGROUND

World-class coaches collect training data from their athletes systematically and exhibit an experimental mindset when making individual training adjustments in response to this data and other forms of feedback. However, the methods, expertise, and insights of highly accomplished endurance coaches is so far almost untouched in the scientific literature. The aim of this study was to provide a synthesis of common features and sport-specific variations in best-practice training characteristics within Olympic endurance sports as described by world-class Norwegian coaches.

METHODS

A multiple case-study design was used, and twelve successful male Norwegian coaches served as key informants. Together, they were responsible for athletes winning more than 380 international medals, representing long-distance running, biathlon, rowing, cross-country skiing, speed skating, road cycling, swimming, and triathlon. The study design included: (1) an extensive, email-administered and Word™-based questionnaire related to training characteristics at the macro-, meso-, micro-, and session-level; (2) cross-referencing data with historically reported training logs from successful athletes; (3) in-depth and semi-structured in-person interviews with each coach; (4) a review process among authors and coaches. The data collection was undertaken in 2022.

RESULTS

All coaches adhere to a traditional periodization model, including a gradual shift towards lower overall training volume and more competition-specific training as the competitive period approaches. The coaches also employ a pragmatic approach to align training organization with the various constraints faced in the training process. Another common emerging feature was an emphasis on high volume of low-intensity training combined with 2-3 weekly "key workout" days consisting of 3-5 intensive training sessions. Finally, coaches across all sports focused on achieving high training quality by optimizing training sessions, systematically controlling the load-recovery balance, and ensuring optimal preparations for major competitions. Substantial sport-specific differences were evident in terms of volume, frequency, intensity distribution, and application of strength and cross training, mainly due to variations in exercise mode constraints (i.e., mechanical, and muscular loading), competition distance, and organizational aspects.

CONCLUSIONS

This study offers novel insights into best-practice training characteristics in Olympic endurance, shedding light on both commonalities and sport-specific variations. These insights can be used to generate new hypotheses to be further elucidated and contribute to the development of evidence-based training practices.

Isolated and Combined Effects of Moderate Normobaric Hypoxia and Sleep Restriction on Energy Intake and Food Reward

Hypoxia (HY) and sleep deprivation have opposite effects on appetite. As HY may alter sleep, it may be informative to assess the accumulative effects of these two stressors on hunger, energy intake (EI), and food reward. Seventeen young, active, healthy males completed four 5-hr sessions in normoxia (NO) or normobaric HY (FIO2 = 13.6%, ∼3,500 m) after a night of habitual sleep (HS; total sleep time >6 hr) or sleep restriction (SR; total sleep time <3 hr). Subjective appetite was assessed regularly using visual analogic scales and EI during an ad libitum lunch after 3.5 hr of exposure. Food reward was assessed using the Leeds Food Preference Questionnaire just before the lunch. As expected, EI was lower for the HY-HS (4.32 ± 0.71 MJ; p = .048) and HY-SR (4.16 ± 0.68 MJ, p = .013) sessions than the NO-HS (4.90 ± 0.84 MJ) session without acute mountain sickness-related gastrointestinal symptoms. No significant effect of SR alone was observed (NO-SR: 4.40 ± 0.68 MJ). Subjective appetite was not affected. Explicit liking for high-fat foods was higher with SR than HS (main effect: p = .002) and implicit wanting for high-fat foods was higher for the NO-SR, HY-HS, and HY-SR sessions than the NO-HS session (p < .006). Thus, acute SR did not modify subjective appetite or EI despite the increasing food reward for high-fat foods and did not alter the HY-induced changes of appetite or food reward.

Individual sex-based variability to altitude training in elite badminton players

To assess how altitude training impacts force-velocity-power (F-V-P) profiling and muscular power and anaerobic capacity in elite badminton players in reference to intra- and inter-individual sex-based variability. Following a quasi-experimental design, 14 players (6 females, 8 males) from the French national badminton singles and doubles teams performed a 3-week 'living high-training high' camp at natural altitude (2320 m). F-V-P profile and Wingate anaerobic test were assessed Pre- and Post-intervention, using ANOVA repeated measures conventional statistics, with further estimation statistics to show the magnitude of the testing condition and visualize intra- and inter-individual responses. No significant interaction nor time effect (Pre- vs. Post-) was observed for any variables (all p > 0.05), but a significant sex effect was observed for maximal theoretical velocity (p < 0.01), relative maximal theoretical power (Pmaxrel) (p = 0.02) and relative F-V-P profile and for peak and mean power outputs (both p < 0.001) during Wingate test. Pre-to-Post changes (from -11.0% to + 14.4%) did not significantly differ between sexes, except for Pmaxrel (p < 0.05) in favor of female athletes (+10.2% vs. -4.3% for male athletes). Hedge's g effect sizes (male minus female) revealed moderate and large effects for F-V-P profiling-derived variables. Mean conventional statistics did not reveal significant effect of altitude training, mainly due to high intra- and inter-variability across F-V-P profiling-derived variables and Wingate test. Substantial sex-based difference contributes to this variability, emphasizing the importance of individualized approach to enhance participant responsiveness to altitude training.

SARS-CoV-2 infection decreases cardiorespiratory fitness and time-trial performance even two months after returning to regular training - Insights from a longitudinal case series of well-trained kayak athletes

Objective

The aims of this study were to examine the effect of SARS-CoV-2 infection on cardiorespiratory fitness (CRF) and time-trial performance in vaccinated well-trained young kayak athletes.

Methods

This is a longitudinal observational study. Sixteen (7 male, 9 female) vaccinated kayakers underwent body composition assessment, maximal graded exercise test, and 1000-m time-trial tests 21.9 ± 1.7 days before and 66.0 ± 2.2 days after the SARS-CoV-2 infection. The perception of training load was quantified with Borg's CR-10 scale before and after the infection return to sport period.

Results

There were significant decreases in peak oxygen uptake (-9.7 %; effect size [ES] = 1.38), peak oxygen pulse (-5.7 %; ES = 0.96), and peak heart rate (-1.9 %; ES = 0.61). Peak minute ventilation, and minute ventilation/carbon dioxide production slope were unchanged after infection compared to the pre-infection values. In the entire 1000-m, the impaired tendencies were found in completion time, mean power, and mean speed (-2.4 to 1.2 %; small ESs = -0.40 to 0.47) as well as significant changes in stroke rate and stroke length (-4.5 to 3.7 %; ESs = -0.60 to 0.73).

Conclusion

SARS-CoV-2 infection decreased CRF and time-trial performance even two months after return to regular training in vaccinated athletes.

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 returning to sea level, 22 athletes included IHE (2 h rest) + CHT (1 h training) in their training every third day for 1 mo (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%, means ± SE) and HYPSL (4.1 ± 0.6%) (both P < 0.001). Compared with PRE, Hbmass at POST2 remained 4.2 ± 0.8% higher in HYPIHE + CHT (P < 0.001) and 1.9 ± 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.NEW & NOTEWORTHY Sets of 2-h intermittent hypoxic exposure + 1-h continuous hypoxic training, every third day, possess the potential to mitigate the typical decline in Hbmass that is commonly observed during the initial weeks after return to sea level from an altitude camp. Inclusion of IHE + CHT in the training regimen was also accompanied by improvements in V̇o2max and exercise performance in most but not all Tier 3-Tier 5 level endurance athletes during the training season.

Four-week experimental plus 1-week taper period using live high train low does not alter muscle glycogen content

This study aimed to investigate the effects of a 4-week live high train low (LHTL; FiO2 ~ 13.5%), intervention, followed by a tapering phase, on muscle glycogen concentration. Fourteen physically active males (28 ± 6 years, 81.6 ± 15.4 kg, 179 ± 5.2 cm) were divided into a control group (CON; n = 5), and the group that performed the LHTL, which was exposed to hypoxia (LHTL; n = 9). The subjects trained using a one-legged knee extension exercise, which enabled four experimental conditions: leg training in hypoxia (TLHYP); leg control in hypoxia (CLHYP, n = 9); leg trained in normoxia (TLNOR, n = 5), and leg control in normoxia (CLNOR, n = 5). All participants performed 18 training sessions lasting between 20 and 45 min [80-200% of intensity corresponding to the time to exhaustion (TTE) reached in the graded exercise test]. Additionally, participants spent approximately 10 h day-1 in either a normobaric hypoxic environment (14.5% FiO2; ~ 3000 m) or a control condition (i.e., staying in similar tents on ~ 530 m). Thereafter, participants underwent a taper protocol consisting of six additional training sessions with a reduced training load. SpO2 was lower, and the hypoxic dose was higher in LHTL compared to CON (p < 0.001). After 4 weeks, glycogen had increased significantly only in the TLNOR and TLHYP groups and remained elevated after the taper (p < 0.016). Time to exhaustion in the LHTL increased after both the 4-week training period and the taper compared to the baseline (p < 0.001). Although the 4-week training promoted substantial increases in muscle glycogen content, TTE increased in LHTL condition.

Making History in 1 h: How Sex, Aging, Technology, and Elevation Affect the Cycling Hour Record

PURPOSE

The purpose of this article was to analyze more than a century of cycling hour records (CHR) to examine the effects of sex, age, and altitude on cycling performance. Our hypotheses were that men's performance (distance) would exceed those of women by more than 10% but would decline at similar rates with aging and that altitude would have a small benefit, which might reach a maximum.

METHODS

Data were cultivated from the Facebook World Hour Record Discussion Group's crowd-sourced database of more than 600-known-hour records and verified through extensive online research and/or personal communication. Regression and statistical modeling were produced using STATA v15.0. R2 values were used to ascertain model quality, with four distinct models being produced for comparisons. Alpha was set at 0.05 significance for all tests.

RESULTS

R2 values ranged from 65% to 74.9%. Women's distances were 10.8% shorter ( P < 0.001) than those of men, but the difference was narrower than either the historical elite women's difference of 14.2% or the 2022 record difference of 13.3%. Age-related decline modeling indicates performance declines significantly past age 40 yr at a rate of 1.08% per year. Altitude had a significant ( P < 0.001) marginal improvement up to 1000 m before declining. The marginal benefits of altitude were small, but this is consistent with the finding benefits reach a maximum at a moderate altitude with "benefits" becoming ambiguous starting at ~1000 m. Technological advancement was estimated to be a small but significant ( P < 0.001) improvement of ~0.18% per year.

CONCLUSIONS

Across decades of CHR data in well-trained endurance cyclists, men are only ~11% faster, and this difference remains stable until at least age 80 yr. CHR attempts greater than 500 m likely offer at best a small advantage. Despite small year-on-year improvements, the CHR has likely improved more than 10 km because of technological advancements.

Potential for using simulated altitude as a means of prehabilitation: a physiology study

The current pandemic of surgical complications necessitates urgent and pragmatic innovation to reduce postoperative morbidity and mortality, which are associated with poor pre-operative fitness and anaemia. Exercise prehabilitation is a compelling strategy, but it has proven difficult to establish that it improves outcomes either in isolation or as part of a multimodal approach. Simulated altitude exposure improves performance in athletes and offers a novel potential means of improving cardiorespiratory and metabolic fitness and alleviating anaemia within the prehabilitation window. We aimed to provide an initial physiological foundation for 'altitude prehabilitation' by determining the physiological effects of one week of simulated altitude (FI O2 15%, equivalent to approximately 2438 m (8000 ft)) in older sedentary volunteers. The study used a randomised, double-blind, sham-controlled crossover design. Eight participants spent counterbalanced normoxic and hypoxic weeks in a residential hypoxia facility and underwent repeated cardiopulmonary exercise tests. Mean (SD) age of participants was 64 (7) y and they were unfit, with mean (SD) baseline anaerobic threshold 12 (2) ml.kg-1 .min-1 and mean (SD) peak V̇O2 15 (3) ml.kg-1 .min-1 . Hypoxia was mild (mean (SD) Sp O2 93 (2) %, p < 0.001) and well-tolerated. Despite some indication of greater peak exercise capacity following hypoxia, overall there was no effect of simulated altitude on anaerobic threshold or peak V̇O2 . However, hypoxia induced a substantial increase in mean (SD) haemoglobin of 1.5 (2.7) g.dl-1 (13% increase, p = 0.028). This study has established the concept and feasibility of 'altitude prehabilitation' and demonstrated specific potential for improving haematological fitness. Physiologically, there is value in exploring a possible role for simulated altitude in pre-operative optimisation.

Optimal type and dose of hypoxic training for improving maximal aerobic capacity in athletes: a systematic review and Bayesian model-based network meta-analysis

Objective: This study aimed to compare and rank the effect of hypoxic practices on maximum oxygen consumption (VO2max) in athletes and determine the hypoxic dose-response correlation using network meta-analysis. Methods: The Web of Science, PubMed, EMBASE, and EBSCO databases were systematically search for randomized controlled trials on the effect of hypoxc interventions on the VO2max of athletes published from inception until 21 February 2023. Studies that used live-high train-high (LHTH), live-high train-low (LHTL), live-high, train-high/low (HHL), intermittent hypoxic training (IHT), and intermittent hypoxic exposure (IHE) interventions were primarily included. LHTL was further defined according to the type of hypoxic environment (natural and simulated) and the altitude of the training site (low altitude and sea level). A meta-analysis was conducted to determine the standardized mean difference between the effects of various hypoxic interventions on VO2max and dose-response correlation. Furthermore, the hypoxic dosage of the different interventions were coordinated using the "kilometer hour" model. Results: From 2,072 originally identified titles, 59 studies were finally included in this study. After data pooling, LHTL, LHTH, and IHT outperformed normoxic training in improving the VO2max of athletes. According to the P-scores, LHTL combined with low altitude training was the most effective intervention for improving VO2max (natural: 0.92 and simulated: 0.86) and was better than LHTL combined with sea level training (0.56). A reasonable hypoxic dose range for LHTH (470-1,130 kmh) and HL (500-1,415 kmh) was reported with an inverted U-shaped curve relationship. Conclusion: Different types of hypoxic training compared with normoxic training serve as significant approaches for improving aerobic capacity in athletes. Regardless of the type of hypoxic training and the residential condition, LHTL with low altitude training was the most effective intervention. The characteristics of the dose-effect correlation of LHTH and LHTL may be associated with the negative effects of chronic hypoxia.