Does training at altitude enhance endurance performance at sea level?

About the Issue

In endurance sports such as cycling and distance running many coaches and athletes strongly believe that altitude training benefits performance at sea level. This belief is influenced by research showing that physiological adaptations, including increased hemoglobin and hematocrit levels, occur with exposure to altitude. Nevertheless, controversy exists in the research literature regarding whether these changes can offset potential negative effects of altitude, such as declines in VO2max and in the ability to train at high intensities. For this TIP's project, the core articles by Buskirk et al. (1967) and Burtscher et al. (1996) reflect the debate.

Buskirk et al. (1967) examined maximal oxygen uptake (VO2max), maximal ventilation, maximal heart rate, and exercise times of runners elevations of 4000 meters and 300 meters. The researchers concluded that, upon returning to sea level, the runners did not improve their maximum aerobic capacity and therefore did not enhance their sea level performance. Burtscher et al. (1996) examined VO2max as well, but they found that runners benefited from training at moderate altitudes.

The lack of conclusiveness about the effects of altitude training on sea level performance is in part due to the great variability in study conditions and unsatisfactory control groups. For example, variety exists in the amount of time and in the level of altitude that researchers have had subjects train.

Core Articles

Buskirk, E.R., Kollias, J., Akers, R.F., Prokop, E.K., & Reategui, E.P. (1967). Maximal performance at altitude and on return from altitude in conditioned runners. Journal of Applied Physiology, 23, 259-266.

Burtscher, M., Nachbauer, W., Baumgartl, P., & Philadelphy, M. (1996). Benefits of training at moderate altitude versus sea level training in amateur runners. European Journal of Applied Physiology, 74, 558-563.

Hahn, A.G. (1991). The effect of altitude training on athletic performance at sea level-a review. EXCEL, 7, 9-22.

Wolski, L.A., McKenzie, D.C., & Wenger, H.A. (1996). Altitude training for improvements in sea level performance. Sports Medicine, 22, 251-263.

Project Ideas

Position Paper

For this paper, the objective is to convince the audience that altitude training either is or is not a catalyst for improved sea level performance. To begin, read both of the core articles to get an understanding of the two sides of the argument. These two articles are fairly comparable in that they both study runners at moderate altitudes. Because they take opposing stances on the topic at hand, your challenge is to evaluate the research methods to argue for which study and conclusion is stronger.

Here are some variations of the primary debate that can be argued in position papers:

1. If you agree that altitude training does not enhance sea level performance, argue that certain physiological changes that occur at altitude actually outweigh the beneficial changes and have a negative impact on sea level performance. See Rusko (1996) and Grover et al. (1986) in the references section for more information on this idea.

2. If you agree that altitude training is beneficial to sea level performance, argue that a certain type of training at altitude leads to more benefits than others. For example, is interval training better? Does endurance training at altitude have more positive effects than interval training? Or, does altitude training for a certain sport or event have beneficial effects on performance whereas there are no effects on a different sport? Another twist that could be examined is the effects of altitude training on elite athletes vs. average athletes vs. non-athletes or men vs. women. To examine this further, read Bailey et al. (1997) and Muza et al. (2001) in the references.

Guidelines Paper

If you support the idea that altitude training does enhance sea level performance, then create a paper in which you offer guidelines to follow if an athlete plans to train at altitude. Here are some aspects to consider:

1) For what type of athlete are you creating this training plan: endurance, middle distance, female, male, a cyclist, a runner, and so on?

2) Examine the types of training in which you think the subject should partake (i.e. endurance, interval).

3) At what elevation should the subject plan to train?

To gain more information about these topics, read Martin et al. (1995). For specific information on certain types of athletes, refer to the titles in the references. For example, if you would like to focus on cyclists, look at the article by Hahn et al. (2001). Also, you might look at some sports magazines for tips, but you must make sure that the information has scientific merit.

Research Proposal

For this type of paper, your goal is to convince your audience to accept a new study investigating altitude training and sea level performance. The following are some questions and guidelines to consider when writing your paper:

1. Subject Design: Which population will you use and why? Are they all participants in the same sport? Are they all elite athletes or average recreational athletes? What age groups are you targeting and are they male and female or just one gender? What delimitations would you choose? In other words, what factors would you choose to keep people out of the study? Some considerations include the following: fitness level, recent altitude exposure, recent injuries, or any diseases/disorders that might limit a subject's ability to adapt physiologically. Remember that when you choose your subject pool you must define characteristics of the subjects. For example, if you chose elite runners, then you must define what elite means.

2. Experimental Design: What kind of protocol and methods will you choose? For example, will the design be longitudinal or maybe cross-sectional? How many treatment groups will you include and will you have a control group? What measures will you take to assure that all subjects are instructed correctly and that they carry out the instructions? How long will the study take and where will it be conducted?

There are many factors to consider when designing a research project. Keep in mind that your audience will focus on the limitations of the project. A good idea is to look at some of the review articles and see what authors have criticized about past research. Also, examine the core articles and find sources of error in their protocol. For example, in the article by Buskirk et al. (1967), is a sample size of 6 sufficient for making conclusions? Is it appropriate to test maximal work capacity of runners using bicycle ergometers? Also, since the study lacked a control group, how reliable are the conclusions? These are just some ideas of how research articles may lack proper methods and pertinent information in order for the research to be considered valid and reliable.


Bailey, D.M. & Davies, B. (1997). Physiological implications of altitude training for endurance performance at sea level. British Journal of Sports Medicine, 31, 183-190.

Daniels, J. & Oldridge, N. (1970). The effects of alternate exposure to altitude and sea level on world-class middle-distance runners. Medicine and Science in Sports, 2, 107-112.

Grover, R.F., Weil, J.V., & Reeves, J.T. (1986). Cardiovascular adaptations to exercise at high altitude. Exercise and Sport Sciences Reviews, 14, 269-302.

Hahn, A.G. & Gore, C.J. (2001). The effect of altitude on cycling performance. Sports Medicine, 31, 533-557.

Jackson, C.G.R. & Sharkey, B.J. (1988). Altitude, training and human performance. Sports Medicine, 6, 279-284.

Martin, D. (1995). Altitude training for sea-level racing. On the roads, 6-7.

Muza, S.R., Rock, P.B., Fulco, C.S., Zamudio, S., Braun, B., Cymerman, A., Butterfield, G.E., & Moore, L.G. (2001). Women at altitude: ventilatory acclimatization at 4,300 m. Journal of Applied Physiology, 91, 1791-1799.

Rusko, H.R. (1996). New aspects of altitude training. The American Journal of Sports Medicine, 24, 48-53.