A good deal of information is available on the influence of hypoxia, or altitude, on physical performance, especially during prolonged exercise (2, 3, 4, 7, 8, 12, 18-22, 29, 33, 34-37, 41, 44, 45, 52). But, more than any other recent event, it was the Olympic Games in Mexico City that aroused so much interest in the problems surrounding altitude and sport performance; Four main questions were, at that time, asked.1. To what extent is performance affected at moderate altitude (about 2,000m -6,600 ft)?2. Can the negative effects be overcome by the processes of adaptation; to what extent can they be overcome; and how long does adaptation take? 3. Can extremely hard training at this altitude lead to any bodily harm?4. Can the performance at sea level be improved by training at altitude?This last question is still of considerable interest as we are constantly confronted with athletes who want to carry out some portion of their training programme at altitude to improve their performance at sea level.
The Delivery of EnergyThe two main energy delivering pathways in the resynthesis of adenosine triphosphate (ATP) should here be recalled to mind:1. The breakdown of energy-yielding substrates without the participation of oxygen; that is, the anaerobic energy delivery.2. The degradation of substrates in which oxygen is the ultimate hydrogen acceptor; that is, the aerobic process. Figure 1 shows the shift of anaerobic to aerobic energy delivery in relation to the work time at sea level for individuals with high maximal power for both. For a maximal effort of less than two minutes duration, the anaerobic processes dominate, but for muscular work of more than two minutes duration the energy cost must be defrayed primarily through oxidative processes (29 reduced when the oxygen content in the inspired air, and therefore the oxygen content in the blood, is also red uced.In the following discussion the influence of adaptive mechanisms on the aerobic and anaerobic processes during altitude training must be separated.The values for arterial oxygen saturation, obtained under resting conditions at various altitudes, or using hypoxia-simulating gas mixtures, are reduced relative to those obtained at sea level (Fig. 2) (13,29). The effect of this decreasing arterial oxygen saturation is to reduce the ability to perform prolonged work.There is an actual diminution of the maximal oxygen uptake -or physical working capacity -for some days after arrival in Mexico City (Fig. 4). During residence at Mexico City (2,250m -7,382 ft) there is, however, an improvement as a resuft of various adaptive mechanisms; the maximal capacity as measured at sea level, nevertheless, was not reached even after prolonged residence. The measurements of different research groups show considerable variation in the degree both of diminution and of readjustment that can occur in maximal capacity (2,18,29,44,50,52 As a result of the lower arterial oxygen supply due to breathing a 15.9% hypoxic mixture under the same conditions of exercise, the coronary arterio-v...