Erythropoiesis and Performance after Two Weeks of Living High and Training Low in Well Trained Triathletes

Abstract

The purpose of our study was to evaluate hematologic acclimatization during 2 weeks of intensive normoxic training with regeneration at moderate altitude (living high-training low, LHTL) and its effects on sea-level performance in well trained athletes compared to another group of equally trained athletes under control conditions (living low - training low, CONTROL). Twenty-one triathletes were ascribed either to LHTL (n = 11; age: 23.0 ± 4.3 yrs; V˙O₂max: 62.5 ± 9.7 [ml × min^-1 × kg^-1]) living at 1956 m of altitude or to CONTROL (n = 10; age: 18.7 ± 5.6 yrs; V˙O₂max: 60.5 ± 6.7 ml × min^-1 × kg^-1) living at 800 m. Both groups perfomed an equal training schedule at 800 m. V˙O₂max, endurance performance, erythropoietin in serum, hemoglobin mass (Hb_tot, CO-rebreathing method) and hematological quantities were measured. A tendency to improved performance in LHTL after the camp was not significant (p < 0.07). Erythropoietin concentration increased temporarily in LHTL (Δ 14.3 ± 8.7 mU × ml^-1; p < 0.012). Hb_tot remained unchanged in LHTL whereas was slightly decreased from 12.5 ± 1.3 to 11.9 ± 1.3g × kg^-1 in CONTROL (p < 0.01). As the reticulocyte number tended to higher values in LHTL than in CONTROL, it seems that a moderate stimulation of erythropoiesis during regeneration at altitude served as a compensation for an exercise-induced destruction of red cells.

Key words

Blood volume - endurance performance - erythropoietin - intermittent hypoxia - reticulocytes

References

• 1 Alexander J K, Hartley L H, Modelski M, Grover R F. Reduction of stroke volume during exercise in man following ascent to 3100 m altitude.  J Appl Physiol. 1967;  23 849-858
• 2 Ashenden M J, Gore C J, Dobson G P, Boston T T, Parisotto R, Emslie K R, Trout G J, Hahn A G. Simulated moderate altitude elevates serum erythropoietin but does not increase reticulocyte production in well-trained runners.  Eur J Appl Physiol. 2000;  81 428-435
• 3 Ashenden M J, Gore C J, Dobson G P, Hahn A G. “Live high, train low” does not change the total haemoglobin mass of male endurance athletes sleeping at a simulated altitude of 3000 m for 23 nights.  Eur J Appl Physiol. 1999;  80 479-484
• 4 Ashenden M J, Gore C J, Martin D T, Dobson G P, Hahn A G. Effects of a 12-day “live high, train low” camp on reticulocyte production and haemoglobin mass in elite female road cyclists.  Eur J Appl Physiol. 1999;  80 472-478
• 5 Bailey D M, Davies B. Physiological implications of altitude training for endurance performance at sea level: a review.  Br J Sports Med. 1997;  31 183-190
• 6 Beaver W L, Wasserman K, Whipp B J. A new method for detecting anaerobic threshold by gas exchange.  J Appl Physiol. 1986;  60 2020-2027
• 7 Berglund B. High-altitude training. Aspects of haematological adaption.  Sports Med. 1992;  14 289-303
• 8 Bigard A X, Brunet A, Guezennec C Y, Monod H. Skeletal muscle changes after endurance training at high altitude.  J Appl Physiol. 1991;  71 2114-2121
• 9 Böning D. Altitude and hypoxia training - a short review.  Int J Sports Med. 1997;  18 565-570
• 10 Burge C M, Skinner S L. Determination of hemoglobin mass and blood volume with CO: evaluation and application of a method.  J Appl Physiol. 1995;  79 623-631
• 11 Chapman R F, Stray-Gundersen J, Levine B D. Individual variation in response to altitude training.  J Appl Physiol. 1998;  85 1448-1456
• 12 Daniels J, Oldridge N. The effects of alternate exposure to altitude and sea level on world-class middle-distance runners.  Med Sci Sports Exerc. 1970;  2 107-112
• 13 Dick F W. Training at altitude in practice.  Int J Sports Med. 1992;  13 203-206
• 14 Digicaylioglu M, Lipton S A. Erythropoietin-mediated neuroprotection involves cross-talk between Jak2 and NF-κB signalling cascades.  Nature. 2001;  412 641-647
• 15 Dressendorfer R H, Keen C L, Wade C E, Claybaugh J R, Timmis G C. Development of runner's anemia during a 20-day road race: effect of iron supplements.  Int J Sports Med. 1991;  12 332-336
• 16 Friedmann B D, Jost J, Rating T, Weller E, Werle E, Eckardt K U, Bärtsch P, Mairbäurl H. Effect of iron supplementation on total body hemoglobin during endurance training at moderate altitude.  Int J Sports Med. 1999;  20 78-85
• 17 Green H J, Sutton J R, Cymerman A, Young P M, Houston C S. Operation Everest II: adaptations in human skeletal muscle.  J Appl Physiol. 1989;  66 2454-2461
• 18 Grover R F, Weil J V, Reeves J T. Cardiovascular adaptation to exercise at high altitude.  Exerc Sport Sci Rev. 1986;  14 269-302
• 19 Gunga H, Kirsch K, Rocker L, Schobersberger W. Time course of erythropoietin, triiodothyronine, thyroxine, and thyroid-stimulating hormone at 2315 m.  J Appl Physiol. 1994;  76 1068-1072
• 20 Jackson C G, Sharkey B J. Altitude, training and human performance.  Sports Med. 1988;  6 279-284
• 21 Jung R C, Dill D B, Horton R, Horvath S M. Effects of age on plasma aldosterone levels and hemoconcentration at altitude.  J Appl Physiol. 1971;  31 593-597
• 22 Kanstrup I L, Ekblom B. Blood volume and hemoglobin concetration as determinants of maximal aerobic power.  Med Sci Sports Exerc. 1984;  16 256-262
• 23 Klausen T, Mohr T, Ghisler U, Nielsen O J. Maximal oxygen uptake and erythropoietic responses after training at moderate altitude.  Eur J Appl Physiol. 1991;  62 376-379
• 24 Laitinen H, Alopaeus K, Heikkinen R, Hietanen H, Mikkelsson L, Tikkanen H, Rusko H K. Acclimatization to living in normobaric hypoxia and training in normoxia at sea level in runners. Med.  Sci Sports Exerc. 1995;  27 109
• 25 Levine B D, Stray-Gundersen J. “Living high - training low”: effect of moderate altitude acclimatization with low altitude training on performance.  J Appl Pysiol. 1997;  83 102-112
• 26 Levine B D, Stray-Gundersen J. A practical approach to altitude training: where to live and train for optimal performance enhancement.  Int J Sports Med. 1992;  13 209-212
• 27 Levine B D, Engfred K, Friedman D B, Kjaer M, Saltin B, Clifford P S, Secher N H. High altitude endurance training; effect on aerobic capacity and work performance.  Med Sci Sports Exerc. 1990;  22 35
• 28 Levine B D, Stray-Gundersen J, Duhaime G, Snell P G, Friedman D B. “Living high - training low”: The effect of altitude acclimatization normoxic training in trained runners.  Med Sci Sports Exerc. 1991;  23 25
• 29 Liu Y, Steinacker J M, Dehnert C, Menold E, Baur S, Lormes W, Lehmann M. Effect of “Living high - Training low” on the cardiac functions at sea level.  Int J Sports Med. 1998;  19 380-384
• 30 Mairbäurl H, Schobersberger W, Humpeler E, Hasibeder W, Fischer W, Raas E. Beneficial effects of exercising at moderate altitude on red cell oxygen transport and on exercise performance.  Pflügers Arch. 1986;  406 594-599
• 31 Mattila V, Rusko H. Effect of living high and training low on sea level performance in cyclists.  Med Sci Sports Exerc. 1996;  28 156
• 32 Miayazaki S, Sakai A. The effect of “living high - training low” on physical performance in rats.  Int J Biometerol. 2000;  44 24-30
• 33 Nummela A, Jouste P, Rusko H. Effect of living high and training low on sea level anaerobic performance in runners.  Med Sci Sports Exerc. 1996;  28 124
• 34 Ou L C, Tenney S M. Properties of mitochondria from hearts of cattle acclimatized to high altitude.  Respir Physiol. 1970;  38 806-810
• 35 Piehl Aulin K, Svedenhag J, Wide L, Berglund B, Saltin B. Short-term intermittent normobaric hypoxia - haematological, physiological and mental effects.  Scand J Med Sci Sports. 1998;  8 132-137
• 36 Puranen A S, Rusko H K. On- and off-response of EPO, reticulocytes, 2,3-DPG and plasma volume to living high, training low.  Med Sci Sports Exerc. 1996;  28 159
• 37 Radomski M W, Sabiston B H, Isoard P. Development of “sports anemia” in physically fit men after daily sustained submaximal exercise.  Aviat Space Environ Med. 1980;  51 41-45
• 38 Roskamm H, Landry F, Samek L, Schlager M, Weidemann H, Reindell H. Effects of a standardized ergometer training program at three different altitudes.  J Appl Physiol. 1969;  27 840-847
• 39 Rusko H K, Penttinen J TT, Koistinen P O, Vahasoyrinki P I, Leppaluoto J O. A new solution to simulate altitude and stimulate erythropoiesis at sea level in athletes. Helsinki, Finland; International Congress on Applied Research in Sports 1994: pp287-289
• 40 Schmidt W, Eckhardt K U, Hilgendorf A, Strauch S, Bauer C. Effects of maximal and submaximal exercise under normoxic and hypoxic conditions on serum erythropoietin level.  Int J Sports Med. 1991;  12 457-461
• 41 Schmidt W, Maassen N, Trost F, Böning D. Training induced effects on blood volume, erythrocyte turnover and haemoglobin oxygen binding properties.  Eur J Appl Physiol. 1988;  57 490-498
• 42 Souillard A, Audran M, Bressolle F, Gareau R, Duvallet A, Chanal J L. Pharmacokinetics and pharmacodynamics of recombinant human erythropoietin in athletes. Blood sampling and doping control.  Br J Clin Pharmacol. 1996;  42 355-364
• 43 Steinacker J M, Halder A, Liu Y, Thomas A, Stauch M. Hypoxic ventilatory response during rest and exercise after a Himalaya expedition.  Eur J Appl Physiol. 1996;  73 202-209
• 44 Steinacker J M, Liu Y, Böning D, Halder A, Maassen N, Thomas A, Stauch M. Lung diffusion capacity, oxygen uptake, cardiac output and oxygen transport during exercise before and after an Himalaya expedition.  Eur J Appl Physiol. 1996;  74 187-193
• 45 Stray-Gundersen J, Chapman R F, Levine B D. “Living high - training low” altitude training improves sea level performance in male and female elite runners.  J Appl Physiol. 2001;  91 1113-1120
• 46 Stray-Gundersen J, Levine B D. “Living high-training high and low” is equivalent to “living high-training low” for sea-level performance.  Med Sci Sports Exerc. 1997;  29 S.136
• 47 Surks M I, Chinn K S, Mathoush L R. Alterations in body composition in man after acute exposure to high altitude.  J Appl Physiol. 1966;  21 1741-1746
• 48 Sutton J R, Reeves J T, Groves B M, Wagner P D, Alexander J K, Hultgren H N, Cymerman A, Houston C S. Oxygen transport and cardiovascular function at extreme altitude: lessons from Operation Everest II.  Int J Sports Med. 1992;  13 13-18
• 49 Sutton J R, Reeves J T, Wagner P D, Groves B M, Cymerman A, Malconian M K, Rock P B, Young P M, Walter S D, Houston C S. Operation Everest II: oxygen transport during exercise at extreme simulated altitude.  J Appl Physiol. 1988;  64 1309-1321
• 50 Terrados N. Altitude training and muscular metabolism.  Int J Sports Med. 1992;  13 206-209
• 51 Terrados N, Melichna J, Jansson E, Kaijser L. Effects on training at simulated altitude on performance and muscle metabolic capacity in competitive road cyclists.  Eur J Appl Physiol. 1988;  57 203-209
• 52 Wang R Y, Tsai S C, Lu C C, Shih H C, Chen Y H, Tung Y F, Wang W F, Wang S W, Wang P S. Effect of aging on erythropoietin secretion in male rats.  J Gerontol A Biol Sci Med Sci. 1996;  51 B434-438
• 53 Weight L M, Byrne M J, Jacobs P. Haemolytic effects of exercise.  Clin Sci (Colch). 1991;  81 147-152