Tri Talk Triathlon Podcast

Why altitude training works, but not for you

By David Warden

The immortal author Hans Christian Andersen wrote a delightful tale about two tailors who convinced a community that their textiles were finer than any other in the land. There was only one catch: those who were great fools could not see the fabric. Not wanting to appear dim-witted, the citizens praised the quality and beauty of the non-existent cloth upon their king. That is, until one child, too young to be influenced by peer-pressure, pointed out the king was in fact, naked.

When I think of altitude training, I can’t help but apply this fable. I’m perfectly willing to accept the possibility that 30 years from now, when more research has been done on this subject, I’ll be the one proved to be a great fool. But in the meantime, based on all existing independent scientific data, I can’t help but feel that altitude training hasn’t got any clothes on.

In the following paragraphs, I’ll present what I hope will be an introduction to an open and honest dialogue on altitude training. I’ll discuss:

- The theoretical and anecdotal evidence supporting altitude training
- The scientific evidence against altitude training
- The scientific evidence supporting altitude training
- The anecdotal evidence against altitude training
- The reasons behind continued belief in contemporary altitude training techniques

For the purposes of this article, unless otherwise indicated, the term “altitude” means 1600 meters (5250 feet) or higher, which is the point where significant physiological changes take place.

Theoretical and Anecdotal Evidence for Altitude Training
In closely reviewing articles and promotional material for altitude training, you’ll find that what they primarily consist of is the physiological responses to altitude, not necessarily how it can make you faster. Including technical descriptions of physiological changes that occur at altitude such as partial pressure of oxygen, pressure gradients, and respiratory alkalosis are impressive, but it does not follow that these changes will improve performance.

Publications that do specify the performance advantages of altitude training primarily cite three theoretical benefits. The first is the development of new red blood cells and therefore more blood plasma at elevation, thus resulting in an increased stroke volume. And second, altitude training may lead to a decrease in the production of, or an increase in the ability to clear, lactate. The third is an increase in VO2max.

These are all outstanding benefits, and multiple studies have confirmed that these changes do occur at altitude. Increased cardiac stroke volume and VO2max and decreased lactate would certainly improve performance at almost any level. However, as discussed in the following section, at a training intensity cost to the athlete.

Another scenario that theoretically endorses the advantages of altitude training is the fact that when sea-level athletes perform at altitude, there is a notable change in performance. There is no doubt that individuals feel the effect of moving to a higher altitude. The question is not is there a physiological change that takes place as you change altitude, the question is, can applying those physiological changes make you faster when you return to seal-level.

Athletes “feel” the change as they move from low to high. The natural assumption is “if going from low to high makes me temporarily slower, then going from high to low must make me temporarily faster.” Although it is has been established that going from sea-level to an elevation over 5,250 feet will result in temporary physiological changes that diminish performance, it does not necessarily follow that the opposite effect is true. This will also be established in the following section.

But finally, the evidence possibly cited more often than any other, is the fact that many professional and Olympic athletes use altitude training in their training regimen. What is often overlooked when using this argument is the number of athletes who do not incorporate altitude training in their plan, who are just as successful. This line of logic can be extended to say, “That athlete is fast. That athlete wears red singlets. Therefore, red singlets make you fast.” We could just as easily site the number of champion endurance athletes who train at low altitude as “evidence” of sea-level superiority. If there is a better example of anecdotal evidence vs. scientific evidence in endurance training, I don’t know of one.

Scientific Evidence Against Altitude Training
What these pro-altitude articles and proponents fail to mention is the cost of altitude training. As published in the Journal of Applied Physiology, elite cyclists who were asked to perform maximum sprint and endurance intervals performed the tests 13-18 watts lower at altitude than at sea level. This is no surprise, we would all expect that kind of change at altitude. But what is often overlooked from this study, is that this confirms that at altitude, an athlete can no longer perform at the same intensity that they can at sea level.

Performance is not only about cardiac stroke volume, VO2max and lactate. It is a chain of factors including biomechanical adaptations, tendons, developing slow twitch and fast twitch muscles, training your body to use fat primarily for fuel, etc. All these other performance components have restricted capacity and improvement at altitude simply because they cannot achieve the same intensity that they can at lower altitudes. The same environment that brings the advantages of increased cardiac stroke volume and decreased lactate is the same environment that does not allow full development of the other factors of performance improvement, simply because they can no longer achieve the same intensity.

This does not imply that altitude training is detrimental to performance. The consensus among scientists (not coaches) is that good altitude training is no better or worse than good sea-level training. The advantages of increased cardiac stroke volume and decreased lactate “cancel out” the disadvantages of decreased intensity capacity at altitude. Conversely, the advantages of seal-level training cancel out the disadvantages of reduced cardiac stroke volume and lactate.

This was established by the two “silver bullets” of altitude research performed by the Institute for Environmental Medicine in Dallas, Texas. In the first study, 39 competitive runners were divided into 3 groups. A low-low, where the athlete lived and trained just above sea-level. A high-high group, where the athletes lived and trained at 8,200 feet. And a high-low group, where the athletes lived at 8,200 feet but trained at 4,100 feet. The performance level between the low-low and high-high group was the same. In fact, the high-high group had even improved their VO2max by a whopping 5%, while the low-low group had not. Despite this significant increase in VO2max in the high-high group, why didn’t the high-high group improve their performance? Because even though they gained VO2max abilities, they lost other fitness due to the inability to train at appropriate intensities at altitude.

In short, there is overwhelming independent data to support that training at altitude is no better than training at sea-level on well-trained athletes. It is important to note again that there is also no evidence that altitude training is detrimental to performance at lower altitudes. There is, however, a narrow protocol in which incorporating altitude into your training does show significant performance improvements. But the irony is, to make it work you don’t actually train at altitude.

The Scientific Evidence Supporting Altitude Training
In the study just referenced above, there was a third group, the high-low group, who lived high but trained low. The theory behind this group is that it allowed the beneficial physiological changes that altitude provides (cardiac stroke volume, VO2max, and lactate clearing), while still allow the athlete to reach required intensities for improved performance. Once the study was performed, the theory went from theory to results. That high-low group also improved their VO2max by 5%, just like the high-high group, but unlike the high-high group, they did significantly improve performance.

To further the study, the researchers then took 22 elite athletes and essentially duplicated the results of the high-low group. A significant increase in performance and VO2max when the athletes lived high, but trained at over 4,000 lower than where they lived.

There are very few places where this kind of scenario will work for an athlete. The practicalities of dropping 4,000 feet each time to train is impossible in most geographies, and difficult in the rest. There are athletes who are able to meet this unusual demand, but it is rare. This is the motive behind this article’s subtitle. Altitude training works, but not for you.

It is also important to note that altitude training becomes more important if a majority of your training will be training at sea level, but you will be racing at altitudes greater than 5,250 feet. However, there is a marked difference in using altitude training to get faster vs. incorporating altitude training in order to not get slower on race day. This type of altitude training does not make you faster overall, it simply makes you more prepared for a particular event (which I concede, does make you faster for that event). Training to compete at altitude allows you to adapt and train for the environmental conditions of the event. Just like training for heat, or humidity. Training in altitude, heat, or humidity does not make you faster, it simply makes you more prepared to race at events with significant altitude, heat or humidity.

There is also evidence that if you compete within 24 hours of arriving at altitude or several weeks after arriving at altitude, you will minimize the effects of that change.

Anecdotal Evidence Against Altitude Training
Suppose that the scientific research studies still do not impress you. Perhaps you doubt that results from a controlled environment will reflect in actual racing. I can accept that. There is a type of athlete who takes more stock in competition results over controlled research studies. This section is for you. Let’s look at the actual athletic results of individuals who live or train at altitude.

There is a very small band of topography in the United States that holds a population living over 5,250 feet. The Rocky, Sierra-Nevada, and Cascade mountain ranges are really the only locations where individuals live or train regularly over 5,250 feet. Heck, I’ll even concede to 4,000 feet. If altitude training gives an edge, would it not imply that athletes or athletic teams from the few areas that live and train at altitude would have a significant performance improvement when competing at lower altitudes? Surely, all other training components being equal, athletes at high altitude should have an edge against their low altitude competitors.

Unfortunately, this does not hold true. When looking at professional or collegiate athletic teams, there is not an improved “away” record for high altitude home teams who compete at low altitude. Nor is there a worse away record for teams who live and train at low altitude when visit their high altitude competitors. No link between altitude and professional or collegiate teams’ long-term success has ever been established.

Perhaps basketball, football, soccer, and hockey aren’t the best sports to compare to triathlon or other endurance sports (I know some soccer players who would beg to differ, that’s 90 minutes of pretty hard running). How about distance running? In looking at 20 years of collegiate NCAA Division I cross-country results from 1985-2005, only twice has a college team from an altitude greater than 800 feet won the championship, Colorado in 2001 and 2004. The other 18 years’ worth of championships went to low-altitude teams. And unlike professional sports, a collegiate athlete must actually live at the same altitude where their college is based for most of the year.

Finally, let’s take a look at some actual triathlon results. If living and training at altitude is such a big deal, would we not see an inflated representation of triathletes that live at altitude as the fastest triathletes, since they would have such an edge? All other training factors being equal?

Consider the age-group qualifiers of the 2006 Ironman world championships. These are the fastest age-group triathletes in the world at this distance. Reviewing the 42 athletes that qualified from Colorado (5.77% of the total US age-group qualifiers competing at Hawaii in 2006), and what city they live in, you’ll find that the median living altitude for those 42 athletes is 5,300 feet. The ultimate live high/train high environment. According to USAT, 4.25% of all USAT members lived in Colorado in 2006. Although not all US triathletes are members of USAT, we can assume that USAT’s numbers represent a proportion of all US triathletes’ home states.

Also qualifying for the 2006 Ironman championships were 42 age-group triathletes from the state of New York. Looking at all 42 NY athletes, the median altitude of their home cities was 36 feet. New York’s USAT membership represents 5.07% of all members. In summary, there is no statistical significance in qualifying for Hawaii between these two states. Your odds for qualifying for Hawaii appear to be the same whether you live at 36 feet or 5,300 feet.

In fact, if you look even closer at the numbers, the opposite is true. California represents 10.5% of all USAT members, but qualified a whopping 20.33% of the US age-group Hawaii triathletes, with a median altitude of 105 feet. You are essentially twice as likely to qualify for Hawaii living in California’s 105 feet of altitude than living at Colorado’s 5,300 feet. If this example does not support the irrelevance of altitude training among triathletes, I don’t know what will. (The author recognizes the significant advantage of training in California’s year-long training season, but asks that you focus on the Colorado/New York comparison, which have equal training seasons.)

Reasons Behind Contemporary Altitude Training Support
So why does the hype around altitude training continue? Although the anecdotal and theoretical evidence cited in the first section of this article started the altitude movement, what keeps the momentum going?

- The pro migration to Boulder. Pro triathletes train in Boulder and Colorado Springs not just because they believe in altitude training, but because it is the home of the US Olympic Training Center. Not only is it the home of the USOTC, it is the home of USAT, USA Swimming and USA Cycling. Some of the best coaches and training facilities in the world are in Colorado Springs, just 1.5 hours from Boulder. It is not just the fact that the triathlete has access to the best triathlon coach and facilities, they have access to the best swimming coaches and cycling coaches. In the last nearly 30 years, the momentum of coaches, facilities, and pros training in Colorado has swelled. Colorado is the Disneyland of pro triathletes. Any athlete who chooses to train in that area will be able to draw from the best of the best.

Why is Colorado Springs the home of the USOTC? Was it picked because of altitude? No, it was picked because of the Ted Stevens Olympic and Amateur Sports Act of 1978, which established the Olympic Committee. The committee needed a headquarters, and one that would accommodate training facilitates for hundreds of athletes. It was decided that the recently abandoned ENT Air Force Base and the former headquarters of the North American Defense Command would do nicely for the Olympic Complex. The fact that Colorado Springs was at altitude is purely coincidental. For example, there is no physiological benefit for a tennis player to train in southern California. But that just happens to be the place where the best tennis players in the United States train, because there is where the finest coaches and facilities are.

As a pro triathlete, the decision to move to Colorado is a no-lose situation. Since altitude training will not harm the athlete, even though it won’t help, they still have access to the best of the best in coaching and facilities.

- Altitude training is sexy. There are very few things that sound cooler than altitude training. The concept of denying ourselves oxygen for the sake of performance appeals to all of us.

But more than that, the appeal behind altitude training is reinforced by the endurance athlete media. Endurance sports magazines focus on what does work. No one wants to ever print an article about something that does not work. By saying a product or training protocol does not work, it limits potential advertisers. As a result, any article in major advertising-driven endurance publications will only note the positive aspects of altitude training (which is why this kind of article could have only been brought to you through the internet). Note that the standard book for triathlete training, Joe Friel’s Triathlete Training Bible, which is not sponsor-driven, has nothing on altitude training. Essentially saying “no comment” to altitude training, which is a pretty strong comment.

- The placebo effect. As many athletes who approach me and confirm that their altitude training did not improve their performance, I have just as many who swear that their altitude training improved their sea-level race-day performance. Never under-estimate the placebo effect in athletes. There are very real, established performance improvements that occur when the athlete believes that they have an edge over their competitors (Dumbo’s “magic feather”). Confidence is a real, critical component of peak performance.

- Follow the money. At the risk of sounding cynical, this is a fundamental force behind altitude training. There is no money in low altitude training. There are no low altitude tents, nor low altitude training chambers. However, there is money in high altitude training retreats, camps, high altitude training chambers and sleep tents. A “litmus test” for determining the credibility of a claim is to determine the motives of the source. Scientific studies, which have nothing to gain, conclude that altitude training is no better than sea-level training. Mass media, which has nothing to gain and much to lose from publishing anti-altitude articles, makes the safe bet and sticks to only positive altitude articles. Products and altitude-based coaching have much to lose from the established neutral effects of altitude training, and much to gain from the wide-spread belief that it works.

In summary, there is overwhelming evidence, both scientific and anecdotal, that altitude training is no better than sea-level training. It is important to note (one more time), that altitude training does not inhibit performance, and that athletes will experience reduced performance when going from low to very high altitude. Also, it is likely that athletes who race at altitude will gain some benefit from training at altitude.
When it comes to focusing on how altitude makes you faster, if you think that you have a bad altitude, the last thing you need is an altitude adjustment.