The Impact of Altitude Training on Athletes’ Aerobic Capacity

The Impact of Altitude Training on Athletes’ Aerobic Capacity

Altitude training, also known as hypoxic training, has become increasingly popular among athletes and coaches aiming to enhance aerobic capacity and overall performance. The physiological benefits of training at high altitudes have been widely studied, but a comprehensive understanding of the best practices for altitude training remains elusive. A recent systematic review and meta-analysis by Baoxia Chen and colleagues provides valuable insights into the effectiveness of altitude training on athletes' aerobic capacity, specifically focusing on maximum oxygen uptake (VO2max) and hemoglobin (Hb) levels.

The Rationale Behind Altitude Training

The concept of altitude training gained prominence during the 1968 Olympic Games held in Mexico City, situated at an altitude of 2300 meters. The reduced oxygen levels presented a unique challenge, emphasizing the need for optimized training regimens to prepare athletes for high-altitude competitions. Altitude training involves exposing athletes to lower oxygen levels either through natural high-altitude environments or simulated hypoxic conditions. This exposure is believed to stimulate physiological adaptations that enhance aerobic capacity, crucial for endurance sports.

Key Findings from the Meta-Analysis

The meta-analysis conducted by Chen et al. included 17 studies published between 1979 and September 2020, encompassing data from various databases such as Web of Science, SpringerLink, Science Direct, EBSCO, and PubMed. The analysis revealed significant improvements in both VO2max and Hb levels among athletes undergoing altitude training compared to those training at sea level or lower altitudes.

  1. Improvement in VO2max: The meta-analysis showed a standardized mean difference (SMD) of 0.67 (95% CI 0.35–1.00, P < 0.001) in VO2max, indicating a moderate to large effect size. This suggests that altitude training can substantially enhance the maximum oxygen uptake, a critical indicator of aerobic capacity.

  2. Increase in Hemoglobin Levels: Athletes training at high altitudes also experienced a significant increase in hemoglobin levels, with an SMD of 0.50 (95% CI 0.11–0.90, P = 0.013). Higher hemoglobin levels improve the blood's oxygen-carrying capacity, directly benefiting aerobic performance.

Optimal Altitude Training Regimen

One of the standout findings from the meta-analysis is the identification of the most effective altitude training regimen. The high-altitude living and low-altitude training (Hi-Lo) strategy emerged as particularly beneficial. Athletes following the Hi-Lo regime, which involves living at high altitudes (around 2500 meters) and training at lower altitudes, showed greater improvements in aerobic capacity compared to other training modes.

  1. Training Duration and Altitude: The analysis indicated that training cycles of about three weeks at altitudes around 2500 meters are most effective. Training at altitudes below 2000 meters may not provide sufficient hypoxic stimulus, while altitudes above 3000 meters could impose excessive physiological stress.

  2. Comparison with Other Training Modes: The Hi-Lo training mode was found to be superior to the traditional high-altitude living and training (Hi-Hi) mode, suggesting that alternating between high and low altitudes may optimize the balance between hypoxic adaptation and effective training intensity.

Mechanisms Behind the Benefits

The benefits of altitude training are attributed to both hematological and non-hematological mechanisms:

  • Hematological Mechanisms: Hypoxic conditions stimulate erythropoietin production, increasing red blood cell count and enhancing oxygen delivery to muscles. This mechanism directly impacts VO2max and Hb levels.
  • Non-Hematological Mechanisms: At the gene level, hypoxia-inducible factor 1 (HIF-1) plays a critical role in regulating responses to hypoxia, including angiogenesis and metabolic efficiency improvements in muscle cells.

Limitations and Future Directions

Despite the promising findings, the meta-analysis acknowledges several limitations. The sample sizes of included studies were relatively small, and external factors such as training environment, athlete health, and specific sport disciplines were not extensively analyzed. Moreover, the variability in training protocols and individual responses to altitude training underscores the need for more high-quality research to refine these findings.


The systematic review and meta-analysis by Chen et al. provide robust evidence supporting the benefits of altitude training in enhancing athletes' aerobic capacity. The Hi-Lo training mode, particularly at altitudes around 2500 meters for three weeks, appears to be the most effective strategy. These findings offer valuable guidance for athletes and coaches seeking to optimize training regimens for improved performance. However, further research is necessary to address the remaining questions and refine altitude training practices across different sports and individual athlete needs.

Read the full research article by clicking here.


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