Altitude training and hypoxic conditioning with Dr Grégoire Millet
Jan 15, 2023
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Dr Grégoire Millet, a world leader in altitude training and hypoxic conditioning, discusses the history of altitude training, different training techniques, immediate and long-term responses to hypoxia, health effects of altitude, improved blood vessel function with LLTH, and the impact of low and high oxygen. They also talk about VO2 max training at altitude, increased carbohydrate usage, sympathetic activation, and oxidative stress.
Altitude training methods have evolved from Live High-Train High (LHTH) to Live High-Train Low (LHTL) and combination approaches like LLTH and LHTL (and High), with the choice depending on the specific training goals.
Altitude and breathing low oxygen are not the same, with altitude affecting oxygen delivery and causing lower VO2 max, making high-intensity exercise more challenging.
Tailoring training methods to individual responses and combining hypoxic conditioning, such as repeated sprints in hypoxic conditions, can be effective for improving performance and adaptation at altitude.
Deep dives
Altitude Training and Hypoxic Conditioning
Altitude training and hypoxic conditioning have been of interest in the sports and scientific communities for several decades. The traditional approach of living at high altitudes and training at high altitudes (live high, train high) is well-known for improving oxygen transport capacity. However, recent research has explored new methodologies. One of these is the concept of live high, train low and high, where athletes either live at high altitudes or breathe low oxygen air, and train with normal oxygen levels while supplementing with repeated sprints in hypoxic conditions. This approach is particularly promising for intermittent sports and team-based activities. Hypoxic conditioning has also shown potential benefits for health, such as treatments for hypertension and peripheral arterial disease. More research is being done to understand the mechanisms and optimize these training methods.
Acute Responses to Altitude and Hypoxia
Exposure to altitude and hypoxia induces several physiological responses in the body. When at high altitudes or breathing low oxygen air, individuals experience increased ventilation and heart rate to compensate for the reduced oxygen pressure. This leads to respiratory alkalosis and dehydration initially. Maximal oxygen uptake (VO2 max) decreases at altitude due to reduced oxygen delivery, making high-intensity exercise more challenging. Altitude training can cause an increase in red blood cell mass, thus improving oxygen transport capacity, but these adaptations take time and prolonged exposure. Additionally, altitude training can affect mitochondrial density and oxidative capacity in muscle, but exercise is necessary to enhance these peripheral adaptations.
Training Recommendations and Considerations at Altitude
The type of training recommended at altitude depends on the desired outcome. Interval training for improving VO2 max may not be as effective at altitude, as it relies on higher intensities that can be difficult to maintain due to the reduced oxygen availability. Interval training is more beneficial at lower altitudes or sea level. On the other hand, repeated sprints in hypoxic conditions have proven to be effective at altitude, as they induce peripheral adaptations without relying heavily on oxygen transport capacity. It is important to consider the increased sympathetic activation, shift in substrate oxidation, and risk of hypoglycemia at altitude, which may require adjustments in sports nutrition strategies, such as increased carbohydrate intake. Understanding individual responses and tailoring training methods accordingly is crucial to optimizing performance and adaptation at altitude.
The Benefits of Live High Train Low
A study published in the Journal of Applied Physiology showed that after a few weeks of live high train low, participants experienced a large performance enhancement compared to other training methods. The translation from physiological adaptation to performance was better in the live high train low group. This approach has changed the way elite athletes train worldwide, with many sports institutes incorporating sleeping rooms for altitude training.
The Potential Health Benefits of Hypoxic Conditioning
Hypoxic conditioning, which involves alternating between hypoxic and hyperoxic conditions, has shown promise for various health benefits. It has been found to improve cerebral function, slow down neurodegenerative symptoms, enhance vascular function, and potentially lead to improved body composition. Hypoxic conditioning may have applications for elderly individuals, athletes with peripheral artery disease, those with neurodegenerative diseases, and people struggling with weight management.
Dr Glenn McConell chats with Professor Grégoire Millet from the University of Lausanne in Switzerland. He is an absolute world leader in research into altitude training and hypoxic conditioning. This area has progressed greatly from Live High-Train High (LHTH) to Live High-Train Low (LHTL),
LLTH and LHTL (and High). The type of attitude training/hypoxic conditioning one would undertake depends on if training for endurance or team sports. We also discussed using low oxygen (hypoxia) and high oxygen (hyperoxia) for health benefits.
0:00. Introduction and Grégoire’s background
4:58. History of altitude training
6:52. Many combinations of altitude training
LHTH, Live High-Train Low (LHTL), LLTH, LHTL (and High)
9:45. Altitude and oxygen availability
12:45. Altitude vs breathing low oxygen: not the same
14:32. Immediate responses to hypoxia
20:12. Lower VO2 max at altitude
24:39. Absolute vs relative exercise intensity
25:46. Placebo effect?
28:45. Long-term responses to altitude
32:24. Need to exercise for optimal adaptations in muscle
33:34. LHTL
36:19. LLTH
41:34. Health effects of LLTH
43:04. Repeated sprints in hypoxia (RSH)
45:29. LLTH and improved blood vessel function
47:54. Health effects of low and high oxygen
54:50. Hypoventilation at low lung volume (VHL) to cause hypoxia
59:00. VO2 max training at altitude
1:00:55. Use more carbohydrate during exercise at altitude
1:02:30. Greater sympathetic activation (adrenaline etc) at altitude
1:04:52. Oxidative stress/ Reactive oxygen species
1:08:42. What doesn’t kill you makes you stronger
1:10:12. Manipulating repeated sprints duration to alter aerobic/anaerobic contributions
1:13:20. Specificity of training to achieve required outcomes
1:13:51. LHTL (and High) in Rugby players
1:17:40. LHTL and LHTL (and High) for endurance
1:19:09. Ultramarathon star Killian Jornet and altitude training
1:21:15. Controversies in the area
1:24:47. Health benefits the most exciting for him
1:25:37. Outro (9 secs)
Inside Exercise brings to you the who's who of exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all.
The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University.