Living high–training low: effect on erythropoiesis and maximal aerobic performance in elite Nordic skiers

The “living high–training low” model (Hi–Lo) may improve aerobic performance in athletes, and the main mechanism of this improvement is thought to be augmented erythropoiesis. A positive effect of Hi–Lo has been demonstrated previously by using altitudes of 2,000–3,000 m. Since the rate of erythropoiesis is altitude-dependent, we tested whether a higher altitude (3,500 m) during Hi–Lo increases erythropoiesis and maximal aerobic performance. Nordic skiers trained for 18 days at 1,200 m, while sleeping at 1,200 m in ambient air (control group, n = 5) or in hypoxic rooms (Hi–Lo, n = 6; 3 × 6 days at simulated altitudes of 2,500, 3,000 and finally 3,500 m, 11 h day⁻¹). Measurements were done before, during (blood samples only) and 2 weeks after the intervention (POST). Maximal aerobic performance was examined from \(\dot{V}\hbox{O}_{2}\hbox{max}\) and time to exhaustion (T _exh) at \(v\dot{V}\hbox{O}_{2}\hbox{max}\) (minimum speed associated with \(\dot{V}\hbox{O}_{2}\hbox{max}\)), respectively. Erythropoietin and soluble transferrin receptor responses were higher during Hi–Lo, whereas reticulocytes did not change. In POST (vs. before): hematological parameters were similar to basal levels, as well as red blood cell volume, being 2.68 ± 0.83 l (vs. 2.64±0.54 l) in Hi–Lo and 2.62±0.57 l (vs. 2.87 ± 0.59 l) in controls. At that time, neither \(\dot{V}\hbox{O}_{2}\hbox{max}\) nor T _exh were improved by Hi–Lo, \(\dot{V}\hbox{O}_{2}\hbox{max}\) being non-significantly decreased by 2.0% (controls) and 3.7% (Hi–Lo). The present results suggest that increasing the altitude up to 3,500 m during Hi–Lo stimulates erythropoiesis but does not confer any advantage for maximal O₂ transport.