Nutrition and Altitude: Strategies to Enhance Adaptation, Improve Performance and Maintain Health: A Narrative Review
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REVIEW ARTICLE
Nutrition and Altitude: Strategies to Enhance Adaptation, Improve Performance and Maintain Health: A Narrative Review Trent Stellingwerff1,2 · Peter Peeling3,4 · Laura A. Garvican‑Lewis5,6 · Rebecca Hall7 · Anu E. Koivisto8 · Ida A. Heikura5,6 · Louise M. Burke5,6
© The Author(s) 2019
Abstract Training at low to moderate altitudes (~ 1600–2400 m) is a common approach used by endurance athletes to provide a distinctive environmental stressor to augment training stimulus in the anticipation of increasing subsequent altitude- and sealevel-based performance. Despite some scientific progress being made on the impact of various nutrition-related changes in physiology and associated interventions at mountaineering altitudes (> 3000 m), the impact of nutrition and/or supplements on further optimization of these hypoxic adaptations at low–moderate altitudes is only an emerging topic. Within this narrative review we have highlighted six major themes involving nutrition: altered energy availability, iron, carbohydrate, hydration, antioxidant requirements and various performance supplements. Of these issues, emerging data suggest that particular attention be given to the potential risk for poor energy availability and increased iron requirements at the altitudes typical of elite athlete training (~ 1600–2400 m) to interfere with optimal adaptations. Furthermore, the safest way to address the possible increase in oxidative stress associated with altitude exposure is via the consumption of antioxidant-rich foods rather than high-dose antioxidant supplements. Meanwhile, many other important questions regarding nutrition and altitude training remain to be answered. At the elite level of sport where the differences between winning and losing are incredibly small, the strategic use of nutritional interventions to enhance the adaptations to altitude training provides an important consideration in the search for optimal performance.
1 Introduction * Trent Stellingwerff [email protected] 1
Canadian Sport Institute-Pacific, Institute for Sport Excellence, 4371 Interurban Road, Victoria, BC V9E 2C5, Canada
2
Department of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
3
School of Human Sciences (Exercise and Sport Science), University of Western Australia, Crawley, Australia
4
Western Australian Institute of Sport, Mt Claremont, Australia
5
Australian Institute of Sport, Bruce, ACT, Australia
6
Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
7
School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
8
Norwegian Olympic Sports Centre, Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
Altitude training is a common feature of elite endurance preparation and is a strategically periodized intervention in various elite athlete programs [1–4]. As extensively researched, the primary adaptive responses athletes
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