Physiological Effects of Altitude Training to Improve VO2 Max

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Conclusion of Hypoxia and Altitude Investigation

by Brendan Gabriel

Introduction | Discussion | Conclusion

My main conclusion from my research is that acclimatisation to altitude does improve the body’s ability to utilise O2 in a substantial number of athletes. Nearly all studies show an improvement in Vo2 max in all participants.  

The graph below shows that training at high intensity at hypoxia increases VO2max more than the same training at normoxia, showing a 20% increase. Power increases were similar in both conditions, but show slightly better results at Hypoxia.  

The effect also seems to depend on individual athletes also. Studies show that athletes with a big difference between supine and standing hr, have more chance of decreasing their VO2 max, while athletes with a small difference have less chance of increasing VO2 max. [Ref 2]

Wmax and VO2 max measured in normoxia and hypoxia before and after the 6-wk training period

Altitude training

Values are means ± SE. Wmax, maximal power output; pre, before; post, after. Significant difference, pre- vs. post training values, * P < 0.05.
KEY: nor=normoxia Hyp=hypoxia High=high intensity Low=low intensity  


I conclude that training intensity at altitude is lower than at sea-level. This could lead to a decrease in power at maximal intensity in some athletes. A number of studies show very good improvements of VO2 max and performance for athletes living at 2000-3000m and moving down to a lower altitude to train. Studies on swimmers [Ref 7], runners [Ref 6], and skiers [Ref 2] show improvements in VO2max and performance for this method of training.

I believe this is due to the effects on the body of acclimatisation to altitude such as increased haemoglobin mass, increased plasma volume and therefore increased cardiac output. This results in lower sub-maximal HR which would give the athlete a higher reserve. Also the improvements in capillary and mitochondria density, and slight increases in Ventilation rate could slightly improve VO2 max. But it negates the effects of a lower training intensity indicated by lower maximal hr, lower maximal lactate levels and decreased VO2 max during training [Ref 6]

Therefore in conclusion a compromise of living at an altitude of 2000-3000m, and training at an intermediate altitude of around 1000-1500m for about 10 days, seems to show the best results in increased VO2max and performance in most athletes.  

 [Ref 1]-J Appl Physiol 91: 173-182, 2001;
8750-7587/01 $5.00
Vol. 91, Issue 1, 173-182, July 2001
Molecular adaptations in human skeletal muscle to endurance training under simulated hypoxic conditions
 [Ref 2]Cross Country Skiing: Olympic Handbook of Sports Medicine
By Heikki Rusko
Contributor Heikki Rusko
Published by Blackwell Publishing, 2003
ISBN 0632055715, 9780632055715
 [Ref 3] J Appl Physiol 81: 1946-1951, 1996;
8750-7587/96 $5.00
Journal of Applied Physiology
Vol. 81, No. 5, pp. 1946-1951, November 1996
Muscle tissue adaptations of high-altitude natives to training in chronic hypoxia or acute normoxia
 [Ref 4] J Appl Physiol 88: 1221-1227, 2000;
8750-7587/00 $5.00
Vol. 88, Issue 4, 1221-1227, April 2000
Cardiovascular response to hypoxia after endurance training at altitude and sea level and after detraining
 [Ref 5] The Use of Blood Doping as an Ergogenic Aid.
ACSM Position Stand
Medicine & Science in Sports & Exercise. 28(10):127-134, October 1996.
Sawka, Michael N. Ph.D., FACSM, (Chair); Joyner, Michael J. M.D.; Miles, D. S. Ph.D., FACSM; Robertson, Robert J. Ph.D., FACSM; Spriet, Lawrence L. Ph.D., FACSM; Young, Andrew J. Ph.D., FACSM
 [Ref 6] J Appl Physiol 83: 102-112, 1997;
8750-7587/97 $5.00
Journal of Applied Physiology
Vol. 83, No. 1, pp. 102-112, July 1997
"Living high-training low": effect of moderate-altitude acclimatization with low-altitude training on performance
Benjamin D. Levine1 and James Stray-Gundersen2
 [Ref 7] British Journal of Sports Medicine. 40(2):e4, February 2006.
Roels, B 1; Hellard, P 2; Schmitt, L 3; Robach, P 4; Richalet, J-P 5; Millet, G P 1