Con: Live High–Train Low Does Not Improve Sea-Level Performance Beyond that Achieved with the Equivalent Living and Training at Sea Level

Abstract

T he live-high train-low (LHTL) model is postulated to improve sea-level performance beyond that which can be achieved by reciprocal training near sea level alone (live low-train low, LLTL) by residing at moderate/high altitude and training at low altitude (Levine and Stray-Gundersen, 1997). The assumptions inherent to the LHTL postulate are: 1) Physiological adaptations to moderate/high altitude are beneficial to sea-level performance; 2) Hypoxic traininginduced adaptations to sea-level performance are subordinate to those obtained with normoxic training; and 3) The desired physiological adaptations specific to acclimatization can and do reliably occur in elite athletes. These inherent assumptions of the LHTL model are either unsubstantiated or prove invalid.

Altitude training and haemoglobin mass from the optimised carbon monoxide rebreathing method determined by a meta-analysis

“…Athletes have been using altitude training of various forms for many years54 and, given that a worthwhile increase in performance for an elite athlete is of the order of 0.3–0.4%,55 56 it is possible that they are attuned to small but important changes in their physiology that might improve race performance. As indicated by Jacobs,57 the possibility of type II errors (falsely accepting null findings due to modest statistical power) may cloud our interpretation of studies of altitude training, particularly when it comes to performance. Atkinson et al 58 support this idea and state specifically that “statistical significance and non-significance can no longer be taken as sole evidence for the presence or absence of a practically meaningful effect.”

What are the new findings

The optimised carbon monoxide rebreathing method to determine haemoglobin mass (Hbmass) has an analytical error of ∼2%, which provides a sound basis to interpret changes in Hbmass of athletes exposed to moderate altitude.

During-altitude Hbmass increases by ∼1.1%/100 h of adequate altitude exposure, so when living and training on a mountain (classic altitude) for just 2 weeks, a mean increase of ∼3.4% is anticipated.

Living high and training low (LHTL) at 3000 m simulated altitude is just as effective as classic altitude training at ∼2320 m at increasing Hbmass, when the total hours of hypoxia are matched.

∼97.5% of adequately prepared athletes are likely to increase Hbmass by at least 1% after approximately 300 h of altitude exposure, either classic or LHTL.

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“…Athletes have been using altitude training of various forms for many years 54 and, given that a worthwhile increase in performance for an elite athlete is of the order of 0.3–0.4%, 55 56 it is possible that they are attuned to small but important changes in their physiology that might improve race performance. As indicated by Jacobs, 57 the possibility of type II errors (falsely accepting null findings due to modest statistical power) may cloud our interpretation of studies of altitude training, particularly when it comes to performance. Atkinson et al 58 support this idea and state specifically that “statistical significance and non-significance can no longer be taken as sole evidence for the presence or absence of a practically meaningful effect.”

What are the new findings The optimised carbon monoxide rebreathing method to determine haemoglobin mass (Hbmass) has an analytical error of ∼2%, which provides a sound basis to interpret changes in Hbmass of athletes exposed to moderate altitude.

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Improving biologic predictors of cycling endurance performance with near‐infrared spectroscopy derived measures of skeletal muscle respiration: E pluribus unum

“…Together these findings highlight the inconsistencies and potential methodological pitfalls when relying on VO 2max to describe endurance performance potential, as is too common across exercise science research. An example of such research includes inappropriately controlled studies testing the live‐high train‐low model to improve sea level performance with VO 2max as the only measure of performance (Jacobs, ).…”

Rebuttal to the Pro Statement

“…Hitherto there is principally one such (nonblinded) study that supports LHTL over LLTL (Levine and Stray-Gundersen, 1997). Alternatively, there are numerous studies that repeatedly fail to demonstrate an improvement in sea-level performance following LHTL when compared to equivalent LLTL, as stated in my original position ( Jacobs, 2013). Many of these studies have been inappropriately referenced in support of the LHTL model (Wilber, 2013): 1) Maximal aerobic power (Vo 2max ) and volume of oxygen consumed (Vo 2 ) in a 2 minute all-out effort actually diminished significantly in the LHTL group, while the corresponding LLTL values were unchanged.…”